Botswana Project Celebrates Global Fund Success for SRHR and HIV Linkages

Botswana is in the final stages of a successful pilot project to strengthen SRHR and HIV Linkages at the policy systems and service delivery levels, and is celebrating approval of a recent Global Fund application. The project supported development of the application, which includes financial support for Linkages scale-up, strengthening comprehensive sexuality education, and mainstreaming gender into SRHR and HIV.

Botswana is one of 7 countries taking part in Southern Africa. The Ministry of Health began implementation in 2011, in collaboration with UNFPA and UNAIDS, and with funding from the European Union and the Governments of Norway and Sweden. The Linkages project works toward universal access to reproductive health and HIV and AIDS services by increasing access to, and use of, a broad range of quality services. Crucially, implementation is also intended to strengthen health systems by supporting Botswana and the other participating countries to address barriers to linking HIV and SRHR policies in effective and efficient ways.

Approval of the Global Fund concept note is a major achievement and includes over $830,000 in funding for the scaling up of RMNCAH/TB/HIV integration to 16 districts in the country. Botswana continues to bear the burden of HIV and AIDS with a national prevalence of 17.6%[1] and 30.3% among pregnant women accessing antenatal services.[2] This high burden of HIV and AIDS has heavily impacted on health and the national economy, and Global Fund support will be a valuable tool moving forward.

Botswana has made significant progress in providing services in Sexual and Reproductive health. AIDS related deaths have declined by over 50% thanks to the country’s ART programme, and the provision of antiretroviral therapy for prevention of mother to child transmission of HIV ensures that 95% of HIV positive pregnant women receive ART. But despite many notable achievements, critical health outcome indicators in the country remain high.

Botswana’s pilot project focused on three key result areas, to integrate SRHR and HIV Linkages in national health and development plans, to improve uptake and delivery of integrated quality services for HIV and SRHR, and to disseminate best practice models to support strengthening linkages between HIV and SRHR.

Among the many achievements this year, the project has also brought about the completion of the costed Scale Up plan, training for staff and health care providers, steps to improve data reporting, incorporation of integration in key documents such as the National Strategic Framework, Investment Case and National Development Plan 11, programme evaluation, and effective collaboration with in-country partners.

The Global Fund application also includes funds for RHMCAH linkages with GBV and Comprehensive Sexuality education, including integrated services for young people. Youth pregnancy and STI transmission remain a challenge and are largely attributed in the country to inconsistent and incorrect condom use. Global Fund funding for education will play an important role in reduction of both.

[1] 2008 Botswana AIDS Impact Survey III (BAIS III) Statistical Report, November 2009, Central Statistical Office (CSO), Government of Botswana.

[2] Sentinel Surveillance 2011, Ministry of Health Botswana.