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English - UNFPA Botswana

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The Ministry of Health, in partnership with <strong>UNFPA</strong>,<br />

UNAIDS and the European Union (EU), is<br />

implementing a pilot project to strengthen access<br />

to and routine provision of linked/integrated<br />

Sexual and Reproductive Health & Rights and HIV<br />

& AIDS (SRHR and HIV Linkages) services in 10<br />

health facilities within 3 health districts. Within<br />

each of the selected health districts (namely;<br />

Kgatleng, Mahalapye and Letlhakane) 3 different<br />

levels of facilities participate in the pilot. The<br />

rationale for linkages emanates from evidence<br />

that majority of HIV infections are sexually<br />

transmitted or associated with pregnancy,<br />

childbirth and breastfeeding, and ulcerative/or<br />

inflammatory sexually transmitted infections that<br />

can affect HIV transmission. A Rapid Assessment of<br />

SRH/HIV linkages was conducted in 2008 to<br />

determine the magnitude of bi-directional<br />

linkages at policy, systems and service delivery<br />

levels and to identify gaps and ultimately<br />

contribute to development of action plans to<br />

strengthen these linkages. The study revealed<br />

gaps and weaknesses on system delivery on<br />

linkages between SRH and HIV and lack of<br />

national SRHR and HIV linkage strategic guidelines<br />

to facilitate the linkages or integration process. It<br />

also noted inadequate human resources for<br />

offering integrated services. Since its inception in<br />

2011, the project has registered some progress in<br />

ensuring the execution of the project. Some of the<br />

key initiatives include the establishment of the<br />

National Reference Committee & Technical<br />

Advisory Committee as well as the Evaluation<br />

Visibility/Communication sub-committees. Key<br />

project documents developed include the<br />

National SRHR/HIV Strategy, M&E Framework,<br />

Visibility/Communication Plan and a detailed<br />

Implementation Plan. Office furniture, equipment,<br />

porta cabins and medical equipment have been<br />

procured to facilitate the implementation of the<br />

project. A bench-marking mission was undertaken<br />

in Kenya as part of the efforts to strengthen the<br />

human resource capacity of providers involved in<br />

the project. In addition, a group of health care<br />

providers from Letlhakane (20) and Mahalapye<br />

(25) districts underwent a 7-day refresher course<br />

on integration models adopted for<br />

implementation in <strong>Botswana</strong> based on the<br />

Kenyan experience. The refresher courses were<br />

also meant to update participants on the latest<br />

programme protocols, procedures and standards<br />

related to SRH & HIV&AIDS linkages. Participants<br />

were also given an understanding on the<br />

expectations, challenges and benefits of<br />

providing integrated care to the community.<br />

Participants and facilitators at one of the SRH/HIV&AIDS<br />

linkages training<br />

6

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