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Botswana – Factfile


Overview

Botswana is severely affected by HIV, with a prevalence rate of 18.5% among the general population, but is also celebrated as an example of effective responses to HIV through the delivery of a national antiretroviral therapy (ART) programme.

Population and Geography

Botswana is landlocked and bordered by South Africa, Namibia and Zimbabwe. The country is home 2 million people, including a dwindling number of bushman hunter-gatherers in the Kalahari Desert. A strong diamond industry has helped Botswana become a middle-income nation, and the country has a history of sheltering refugees and anti-apartheid activists from South Africa. In recent years, the population of undocumented migrants has increased following economic crisis in neighbouring Zimbabwe.

Health and HIV in Botswana

Botswana has made great strides in improving health, and in the past decade life expectancy has risen significantly following the introduction of the ART programme. Although maternal mortality rate remains high, HIV-specific maternal mortality has shown a decline (from 43 per 100 000 in 2006 to 19 per 100 000 in 2007).

An estimated 319,750 people are living with HIV in Botswana, of whom around 67% Botswana are receiving ART. The HIV adjusted incidence is estimated at 1.35% (according to the Botswana AIDS Impact Survey IV (BAIS IV, 2013)). Women are disproportionally affected by HIV and there is evidence of a strong gender disparity, with prevalence among women at 20.8% compared to men at 15.6%.

The Government and Ministry of Health undertook a Rapid Assessment of Sexual & Reproductive Health and HIV linkages in 2008. The main purpose of the assessment was to gauge the existence of bi-directional linkages at policy, systems and service delivery levels, to identify gaps between the two areas and ultimately to develop measures to strengthen and bridge these gaps. Analysis found that linkages occur at service delivery rather than policy level. In addition, there were weak linkages of HIV services to SRH programmes and services. As a result, strengthening of bi-directional linkages between HIV and SRH was strongly recommended.

Malaria prevalence has declined and Botswana is one of the four Southern African Development Community countries selected to eliminate malaria by 2015. Tuberculosis prevalence is high among people living with HIV, following a resurgence of TB during the 1990s.  TB accounts for 13% of adult mortality in the country, and sexually transmitted diseases, acute respiratory infections, and diarrhoeal disease is also common.

Sources

World Health Organisation (WHO) (2014) Comprehensive Analytical Profile: Botswana, WHO. Available at : http://www.aho.afro.who.int/profiles_information/index.php/Botswana:Index

National AIDS Coordinating Agency (2014) Botswana 2013 Global AIDS Response Report, UNAIDS. Available online at: http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2014countries/BWA_narrative_report_2014.pdf

Useful Resources

Botswana AIDS Impact Survey IV. Available here: http://www.cso.gov.bw/index.php/summary-statistics/18-demography/94-botswana-aids-impact-survey-bais-iv-2013

SRHR and HIV Linkages Project

The European Union (EU) in partnership with UNFPA and UNAIDS is supporting Botswana to address barriers to effective SRH and HIV integration and service provision from 2011-2014. The project started in Botswana with the MOU signing ceremony in June 2011 followed largely by procurement processes for all items requested for systems strengthening as well as recruitment of project staff.

Currently the project is been implemented in three (3) selected pilot districts in Botswana; Mahalapye, Kgatleng and Kweneng West. Following this pilot project, recommendations for possible scale up countrywide will be made. In addition lessons learnt from the pilot project will be shared with other six (6) EU-funded countries as well as world-wide.

Expected results

The project will pilot SRHR and HIV linkages in the following three key result areas (KRAs):

  • KRA 1: To integrate SRHR and HIV linkages in Botswana National Health and development plans
  • KRA 2: To improve uptake and delivery of integrated quality services for SRHR and HIV linkages in Botswana
  • KRA 3: To disseminate best practice models from Botswana to support linkages between SRHR and HIV in order to facilitate South-South cooperation in this area.

Expected key outcomes

  • A Rapid Assessment to gauge the existence of bi-directional linkages at policy, systems and service delivery levels; to identify gaps between the two areas and ultimately develop measures to strengthen and bridge these gaps. A Needs Assessment report is available here (include link)
  • Formation of Technical Advisory (TAC) and Reference (RC) Committees for SRHR/HIV linkages that guide implementation at technical and policy levels respectively. TAC is chaired by the Director of Department of HIV and AIDS Prevention and Care while RC is chaired by Deputy Permanent Secretary, Preventative Services, Ministry of Health
  • Development of an SRHR and HIV linkages strategy
  • Initiated development of an integrated SRHR and HIV monthly data tool

Partners

To find out more about this project click here

 

Key Publications and Resources

Resources

Botswana Know Your Rights Poster
Promote integrated sexual reproductive health rights and HIV/AIDS services in Botswana.
(Download PDF)

Botswana Know Your Rights Cards
From the UNFPA, UNAIDS, EU and Ministry of Health.
(Download PDF)


Research

Sexual and Reproductive Health Rights (SRHR) and HIV & AIDS Linkages Integration Strategy and Implementation Plan.
Year 2014 | Authors: UNFPA, Ministry of Health, EU
This strategic document guides implementation, monitoring and evaluation and coordination of SRHR & HIV linkages in Botswana.
(Download PDF)

Good/Promising practice for Botswana: Provision of SRH services to People living with HIV.
A PowerPoint Presentation from the 3rd RPSC meeting – 23 September 2013
Year 2013 | Authors: UNAIDS, UNFPA, EU, Ministry of Health, Botswana
A presentation highlighting the real life, promising practices in the domain of integrated service delivery for people living with HIV in Botswana.
(Download PDF)

Sexual and reproductive health rights (SRHR) and HIV & AIDS linkages integration strategy and implementation plan. 
Year 2013 | Authors: IPPF, UNAIDS, WHO, UNFPA
This strategic document will guide implementation, monitoring and evaluation and coordination of SRHR/HIV linkages in Botswana.
(Download PDF) 

Rapid assessment of sexual and reproductive health and HIV linkages: Botswana
Year 2011 | Authors: IPPF, UNAIDS, WHO, UNFPA
This summary highlights the experiences, results and actions from the implementation of the Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages in Botswana.
(Download PDF)

Contact

For further information about the SRHR and HIV linkages pilot project in Botswana,
please contact:

Ms. J. Tlale
National Coordinator – SRHR and HIV Linkages
email: jtlale@unfpa.org
phone: +267 3633752 (Office) +267 75759412 (Mobile)

Lesego Mokganya
Ministry of Health Focal Person – Sexual and Reproductive Health Division
email: lmokganya@gov.bw
phone: +267 3632172 (Office) +267 74317431(Mobile)

The Okavango Delta, Botswana

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