Detailed Mechanism Funding and Narrative

Years of mechanism: 2011 2012 2014 2015

Details for Mechanism ID: 13480
Country/Region: Botswana
Year: 2012
Main Partner: Management Sciences for Health
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $300,000

Building Local Capacity (BLC) is a five-year project which aims to strengthen the sustainability, quality and reach of HIV/AIDS organizations to implement policies and health services for those infected and affected by HIV in Botswana, Lesotho, Namibia and Swaziland. In Botswana, the program contributes to achieving improved delivery of quality health care services through the application of leadership and management practices, utilization of service data, work climate improvement and sound management systems. The objective responds to 2 strategic objectives of Goal 2, Capacity Building and Health Systems Strengthening, of the Government of Botswana (GOB) National Strategic Framework II (2010-2016).

The program is presently being implemented in 13 health facilities. This number will increase in FY 2012 to 16 to meet received expressions of readiness for accreditation. It will continue to target health managers in the Ministry of Healths (MOH) Health Inspectorate and Clinical Services Departments and District Health Management Teams (DHMTs).

Lessons learnt from FY 2011 have informed the adoption of an integrated approach of quality improvement and leadership (QIL) and introduction of activities to improve coordination and supportive supervision. This will reduce the number of workshops and overall costs. BLC will continue to explore incremental cost-share from GOB as it continues to demonstrate political will for the accreditation of public health facilities. Emphasis will be placed on technical assistance, accompaniment and participatory skills development for MOH staff and DHMTs to become better drivers of the accreditation process. BLC will continue to pursue and report on results-oriented indicators.

Funding for Health Systems Strengthening (OHSS): $300,000

Botswana has had one of the most developed public health systems in Africa with impressive key successes in improving health indices. However, HIV/AIDS remains the most significant social and public health problem in the country and meeting the Millennium Development Goals is proving a major challenge. Responding to the HIV epidemic has severely stressed the otherwise strong health systems foundation and quality has been compromised.In response, BLC will focus on strengthening institutional systems across the three tiers of the national response, namely MOH, DHMTs and health facilities, so that they can continuously improve the quality of healthcare. From within the Management Sciences for Health global approach to system strengthening, BLC will adapt and develop targeted interventions to address the prioritized systems barriers articulated in the Botswana/USG Partnership Framework. BLC will provide technical assistance to build leadership and governance and empower teams to identify and overcome priority challenges that impede quality care. It will, in partnership with the Council for Health Service Accreditation in South Africa (COHSASA), continue to implement the QIL project to improve quality service delivery. BLC will incorporate coordination and supportive supervisory components to its assistance to enhance transparency, decision making, and accountability. BLC will also focus on human resources by using proven approaches, innovations, and tools to strengthen human resources management systems and improve workplace climate.BLC will continue to partner with COHSASA to support the expressed interest in accreditation of public facilities to meet international standards of care. The program is presently being implemented in 13 health facilities. This number will increase in FY 2012 to 16 to meet received expressions of readiness for accreditation. In addition, BLC will facilitate the development of a pilot MOH quality improvement (QI) structure with representatives of the Gaborone, Serowe and Selebi Phikwe DHMTs to demonstrate continuous improvement of health care service delivery in 18 facilities in the first instance. BLC will assist in the development of operational systems for the structure that focuses on developing appropriate skills for leadership, coordination and scaling-up of the QI and accreditation process across Botswana. BLC and COHSASA will approach this in a way that the QI structure incrementally takes on the leadership and roles in the process by training appropriate staff to identify challenges and plan appropriate actions. BLC will work with the MOH to facilitate periodic stakeholder forums with representatives from USG and the three tiers to share and promote lessons from the BLC approach.The QIL project is implemented to address the root causes of the challenges in improving service elements in facilities based on the COHSASA accreditation system with the understanding that improvements in the critical service elements of management, clinical services and clinical support services will lead to direct improvements in the broader HIV services such as HIV investigations and counseling, antiretroviral therapy dispensing and administration; and improvements of in-patient and out-patient care.

Cross Cutting Budget Categories and Known Amounts Total: $100,000
Human Resources for Health $100,000