Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2015

Details for Mechanism ID: 12008
Country/Region: Botswana
Year: 2010
Main Partner: Johns Hopkins University
Main Partner Program: NA
Organizational Type: University
Funding Agency: HHS/CDC
Total Funding: $1,300,000

Overall Goals and HIV Specific Objectives

John Hopkins University (JHU) puts evidence-based health innovations into everyday practice to overcome barriers to high-quality health care services for the world's most vulnerable populations. JHU's goal is to support the Government of Botswana in implementing the SMC Strategy and Operational Plan by rapidly expanding comprehensive newborn/infant, adolescent and adult SMC services to 40 health facilities.

This comprehensive package includes STI screening and treatments, HIV risk reduction and reproductive health counseling (including counseling for female partners), HIV testing and counseling and condom promotion.

The following are the objectives and accompanying activities for this project:

1. Strengthen the capacity of government to manage the SMC program at national and district levels;

2. Provide human resources through the recruitment and hiring of ten medical doctors;

3. Train health staff from both public and private health facilities in comprehensive SMC service, quality assurance and monitoring of SMC AEs using updated training guidelines and standard operating procedures;

4. Orient 20 facility managers, train 40 MC providers and train 80 MC counselors;

Provide onsite supervisory visits to facilities providing SMC for quality assurance and monitoring of AEs;

5. Support integration of SMC content and selected skills into 70% of Health Training Institutes (HTI) curricula;

6. Support the procurement of neonatal, adolescent and adult SMC equipment and supplies by coordinating with other implementing partners;

7. Strengthen quality assurance systems to enhance and maintain the quality of SMC services provided;

8. Assist the Government of Botswana (GOB) and other partners (i.e., I-TECH) in implementation of QA standards, QA mentoring guides and accreditation of SMC sites in private and public sectors; and

9. Assist the GOB and other partners in active surveillance of adverse events (AEs) and to reduce the incidence of moderate and severe AEs to rates.


The activities will be conducted nationally and target HIV-negative males 0 49 years of age. JHU will be responsible for reaching 10,000 of the national target of 20,000 for this period of time.

Contributions to health systems strengthening

Other health care programs will benefit through recruitment of additional medical doctors for SMC activities as these doctors will also be available for general health care of patients. Reducing the number of people newly infected with HIV through SMC will ease the burden on the health care system.

Cross-cutting issues

JHU will contribute to strengthening the human resource base through the hire and placement of medical doctors. Additionally the training and supervision provided to these doctors, private practitioners, facility managers and counselors will add to the goal of strengthening HR resources during this period.

JHU will also contribute to securing long term health human resources capacity in Botswana through the integration of SMC content and selected skills into Health Training Institutes (HTI) curricula. This will happen through revisions and content updates at national level for continued relevance and appropriateness. Instrumental to this process will be both the national working and technical working groups for SMC which currently drive specific technical, policy issues which are identified as critical through stakeholder consultations.

Increased efficiency

Given the various organizations working in SMC in Botswana, the SMC Reference Group and the SMC Technical Working Group will be crucial to maximizing funds and reducing overlap. These forums have and will continue to provide an opportunity to collaborate with other key stakeholders on all technical areas, including guidelines development, trainings and materials, procurement, and service delivery both within the public and private sector. JHU is an active member of these two groups. Explore MOVE models in line with evolving GOB policy on SMC standalone/mobile campaigns/service delivery and progress towards achieving country SMC targets.


The contribution to strengthening the health human resource base through the hire and placement of medical doctors, training and supervision of private practitioners, counselors and facility managers, will contribute to securing ongoing and future quality and level of SMC services and other health services offered in Botswana's public health system. By reducing the number of people newly infected with HIV and thus requiring HIV clinical care, SMC promotes the sustainability of Botswana's national HIV response.

Monitoring and evaluation plans for included activities. JHU will regularly monitor program activities and report on essential indicators identified in Botswana's SCM M&E framework and PEPFAR recommended indicators. JHU will calculate these indicators on the project level to inform implementation

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $1,300,000

10.P.MC05: JHU - Expansion of Safe MC - services - 1,300,000.00

In an effort to reach the Government of Botswana's (GOB) ambitious goal of 80% of Batswana males circumcised by 2015, John Hopkins University (JHU) has been awarded funds to assist the GOB in rapidly scaling up safe, comprehensive adult, adolescent and infant male circumcision (MC) services. In FY10, JHU will focus on assisting the GOB in expanding the MC service delivery package to 40 health facilities. In addition to the surgical operation, this package includes STI screening and treatments, HIV risk reduction and reproductive health counseling (including counseling for female partners), HIV testing and counseling (HTC) services and condom promotion. JHU will also provide training and quality assurance assistance to the GOB. Trainings will be geared towards facility managers, MC providers and counselors in the public and private sectors, as prioritized by the GOB. JHU will also recruit and hire ten additional doctors to support MC service delivery in the public sector. Finally, in addition to working with the GOB, JHU will work in coordination with the other major PEPFAR-funded service provider, I-TECH, as well collaborate with Population Services International in their communications campaign.

Cross Cutting Budget Categories and Known Amounts Total: $505,000
Human Resources for Health $505,000