Strengthening the community response to HIV in Botswana: A cost estimate of the USAID ASSIST community-based improvement intervention

Against the background of Government of Botswana’s expansion of ART under its Treat All strategy launched in June 2016, ASSIST was asked to support expansion of the availability of quality HIV services through the active involvement of communities. ASSIST introduced community-based improvement work in the local context focusing on addressing acute gaps and barriers to linkage, retention, and life-long adherence to ART, in close partnership with government facilities and other PEPFAR partners. By working through existing community structures and providers, ASSIST contributed to the sustainable achievement of the 90-90-90 targets by strengthening linkage to care for people who test positive for HIV and addressing gaps in patient tracking for improved retention, adherence and ultimately suppression of HIV.

ASSIST began working closely with government partners at the central and district levels in October 2015. At the request of traditional leaders, the ASSIST team supported formation of dedicated community-based improvement teams closely linked to existing mandated committees in villages or wards. Focusing its efforts on hands-on coaching of these CITs, ASSIST facilitated application of quality improvement (QI) to generate local solutions to gaps and barriers around service delivery processes. Experiences and practices from individual community teams were then shared with other communities, district governments, and implementing partners to inform wider discussions on district and nation-wide efforts to scale up and improve HIV service delivery.

This short report outlines the activities implemented by the project in its first 12 months (October 2015 to September 2016) and provides an estimation of their costs. Understanding the costs of this intervention is critical to assess the feasibility and sustainability of scaling-up community-based QI support to other regions of Botswana or similar settings and to guide decision-making by the Botswana Ministry of Health (MOH), PEPFAR, and other implementing partners.

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project/URC
ASSIST publication: 
ASSIST publication
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