Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2015

Details for Mechanism ID: 12008
Country/Region: Botswana
Year: 2013
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health
Organizational Type: University
Funding Agency: HHS/CDC
Total Funding: $1,599,800

John Hopkins University (JHPIEGO) supports the CDC and Government of Botswana (GOB) in promoting primary prevention of HIV by scaling up provision of Safe Male Circumcision (SMC) services in Botswana - consistent with PEPFARs goals and priorities - with the ultimate goal of building technical and management capacity of the government to continue this work after the project ends. During Project Year 4 (FY2012), JHPIEGO will increase its efforts towards Safe Male Circumcision Service provision by conducting over 13,000 circumcision procedures towards the national target of 385,000 circumcisions by the end of project. Concerted efforts will also be made towards continued mentoring of the service providers at the appointed sites in order to maintain the quality of services stipulated in the Botswana guidelines for Safe Male Circumcision. In the same year JHPIEGO will also conclude and analyze the data from the Active Clinical Monitoring of Adverse Events study. The findings of the study will be used to guide the project further in terms of quality of services being offered to the circumcised men. Once the rollout plan for Early Infant Male Circumcision (EIMC) is finalized, JHPIEGO will make plans for the training of the identified cadres and sites as this is also an area of priority for the GOB. To ensure that the project is on track, continuous monitoring and evaluation will be done in the year and appropriate reports submitted accordingly.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $1,599,800

The principal goal of this activity is to scale up Safe Male Circumcisions (SMC)in Botswana. Jhpiego hopes to achieve this by addressing six main objectives:

Objective 1: To strengthen the collaboration between MOH National SMC technical working group, CDC and other partners, JHPIEGO will participate in SMC project meetings and sharing best practices.

Objective 2: To increase SMC service delivery, Jhpiego will use FY 2012 funds to support seven dedicated SMC teams comprising of seven doctors, 35 nurses, 7 Auxiliary nurses, 7 site administrators, and seven receptionists. Using delayed FY 2011 funds, Jhpiego plans to conduct 13200 SMC procedures in FY 2012 with three teams being service delivery on a staggered basis. With FY 2012 funds, Jhpiego will expand to seven full teams with a target of 50000 SMC procedures to be completed in FY 2013. Models for volume and efficiencies (MOVE) will be used as a scale-up strategy for SMC.

Objective 3: To continue training health care workers in SMC, in FY 2012, 40 health care workers primarily working at dedicated sites will be trained by Jhpiego. This is in line with the new strategic direction agreed to by MOH and partners. MOH-approved revision of the current SMC training materials will be conducted during 2012. Overall, SMC training will be scaled down from previous years as direct service delivery increases.

Objective 3: To support the Early Infant Male Circumcision (EIMC), Jhpiego will complete the development of the EIMC curriculum and support the MOH with drafting the rollout plans. The rollout itself will be deferred until the adult program is launched as priority is placed on scale up of the adolescent and adult SMC program.

Objective 5: To integrate EIMC and adolescent/adult SMC into pre-service education curriculum for Botswana health professionals,

Jhpiego will continue to engage relevant stakeholders in this integration exercise. This builds on integrating activities and training conducted and completed in FY 2011, using revised materials. Jhpiego will look into possibilities of integrating SMC training into the Botswana Medical school as pre-service training.

Objective 6: To develop systems for quality assurance and Monitoring and Evaluation (M&E) , Jhpiego will support clinical monitoring and reporting of SMC. It will also provide training and mentoring on monitoring and evaluation to GOB healthcare workers. A study on active surveillance of Adverse Events related to SMC will be completed in the 2nd and 3rd quarters of FY 2013. The data analysis, report writing and dissemination of the results will be performed during the latter part of that period. The findings of the study are expected to influence the revision of the national SMC M&E framework.

Objective 7: To establish Private Public Partnerships (PPP) for SMC, Jhpiego will continue to support the Botswana Family Welfare Association (BOFWA) to start offering SMC services at another one of their sites. This will complement the facility in Mochudi, Kgatleng district and will be done through the recruitment and seconding of an additional SMC team (one medical officer and three nurses), refurbishment and equipment. Further support will be provided through regular mentoring and support supervision. This initiative is expected to yield another 13800 circumcisions during the year.

Objectice 8: Procurement of a limited amount of SMC supplies as a contigency to stock outs experienced at Central Medical Stores (CMS).

Cross Cutting Budget Categories and Known Amounts Total: $1,644,800
Human Resources for Health $1,599,800
Motor Vehicles: Purchased $45,000
Key Issues Identified in Mechanism
Implement activities to change harmful gender norms & promote positive gender norms