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ASSESSMENT OF THE EXTENT OF INTEGRATION OF SRH/HIV & SGBV IN BOTSWANA

Background

UNFPA Botswana supports the Ministry of Health and Wellness (MoHW) to scale-up the integration of Sexual Reproductive Health and Rights (SRHR), HIV and Sexual Gender-based Violence (SGBV) services in thirteen (13) health districts under the 2gether 4SRHR programme. The 2gether 4 SRHR programme is funded by the Swedish Government the aim to improve the SRHR of all people in East and Southern Africa (ESA), particularly adolescent girls, young people and key populations. One of the main outputs of this support to Botswana is to ensure that high quality SRHR/HIV and SGBV data and strategic information is produced, analysed and used to inform evidence-based programming. To realise this output, UNFPA’s support includes provision of catalytic support to strengthen national Health Management Information Systems (HMIS) to generate high quality disaggregated SRHR, HIV and SGBV data at national and sub-national level. Scaling up and enhancing the provision of comprehensive integrated HIV, TB, Reproductive, Maternal Newborn, Child, Adolescent Health (RMNCAH)/Sexual Reproductive Health (SRH) and non-communicable (NCD) services is a key strategy of Botswana’s national strategic documents. Provision of integrated SRH/HIV and SGBV service delivery is among the health sector’s approaches to increasing access to and use of a broad range of quality SRH services and HIV prevention, treatment, care and support, with linkages to gender and justice sectors in Botswana. Following the successful pilot phase, the scaling up of integrated services is being implemented in two phases. In phase I, SRHR/HIV integration is being expanded to the remaining 91 health facilities in the three (3) pilot districts and further rollout to an additional ten (10) districts. In the second phase, all facilities in the remaining districts will be added, thereby covering all 28 health districts. Since 2018 UNFPA is supporting this phase I scale-up.

Consistent with the National Guidelines for Implementation of Integrated Community-based Health Services, Botswana implements four models of integration being the kiosk, supermarket, mall and community models. The kiosk model is a model of integration where there are a limited number of SRH/HIV services in one room. In this model an integrated package of services is provided to clients by the same health care provider and is commonly used in clinics and health posts. The supermarket model is whereby services are offered in adjacent rooms in one location. This is applied in larger health facilities that either have or do not have a maternity wing such as main clinics. The mall model entails the provision of all SRH/HIV & SGBV services in one relatively big health facility. The mall model is often used at the district, primary and referral hospitals where specialized services are provided. The community model is applied at the community level with a minimum package of services defined for provision by health education assistants, health care assistants, community health workers and community volunteers.

Although Botswana has adopted and made notable progress in rolling out the provision of integrated SRH/HIV and SGBV services across 13 districts, there remain gaps in monitoring and evaluation (M&E) of the integrated SRH/HIV and SGBV service delivery. Integration data that is reported to the national HMIS is often incomplete, inconsistently reported and of poor quality and therefore inadequate to provide a comprehensive national picture of scale-up progress. In 2020 UNFPA and the Ministry of Health and Wellness (MoHW) commissioned a Baseline Survey on the extent of integration of SRH/HIV and SGBV integration in the 13 implementing districts. It is against this background that an assessment of implementation progress is being commissioned.

Purpose of the consultancy

The purpose of the assignment is to assess the extent of SRH/HIV and SGBV integration in 13 districts using the minimum integrated service package.

Closing date: 13 August 2021

Application Process: Interested applicants are required to submit applications to mollentze@unfpa.org