BUMMHI, a Botswana local non-government organization, the University of Maryland Baltimore (UMB), and Jhpiego are harnessing over 15 years of experience providing technical assistance to HIV service delivery programs across sub-Saharan Africa and the Caribbean, including over 5 years in Botswana to offer CDC the proposed program “Accelerating Botswana through the Last Mile to Epidemic Control (the ABLE Project)” in response to CDC-RFA-GH20-2008. Since its registration in 2015 as a local organization, BUMMHI has been leading the CDC-funded Botswana Partnership for Advanced Clinical Education (BPACE) Project (2015-2020) in close collaboration with CDC, MOHW, and other PEPFAR implementing partners to innovate, accelerate, and re-engineer HIV treatment strategies with impactful results. To continue our success towards epidemic control this proposal will harness the technical expertise of BUMMHI in comprehensive treatment and care; UMB’s experience in data use, analysis, health informatics and lab services; and Jhpiego’s experience in PrEP and HIV self-testing (HIVST). We will leverage our relationships and complementary experience to ensure rapid start up, immediate impact, and foster sustainability. The ABLE project will realize efficiencies through providing a single implementer across the entire cascade of HIV testing, treatment, and prevention.
ABLE will provide data driven technical assistance (TA) to MOHW to achieve epidemic control through implementing national strategies for high yield HIV case finding at targeted locations (e.g. TB, ANC, STI), prioritizing index testing; same-day ART initiation; retention; VL monitoring and suppression of HIV clients; PrEP; PMTCT; EID; TB and cryptococcal disease prevention, detection and treatment. These interventions will be tailored to close coverage gaps in underserved sites and populations, using quality patient-centered approaches, aimed at reducing morbidity and mortality. To close diagnostic gaps ABLE will strengthen labs and integrate POCT. HIV negative men will be referred to VMMC and eligible HIV negative AGYW referred to DREAMS. ABLE will instill principles of case management, tracking and follow up through structured use of LHW.
ABLE will contribute towards the successful implementation of PEPFAR’s Minimum Program Requirements (MPR) and the objectives of the Third National Strategic Framework for HIV/AIDS (NSFIII) using the successes of BPACE underpinned with greater precision and efficiency.
ABLE will enable greater precision through: (1) Responding to local epidemiology and determining the best approaches and levels of investment by facility size, patient volumes, and scopes; (2) providing site-specific interventions that offer customized clinical pathways to specific subpopulations; (3) integrating health services for greater patient-centered care and ensuring ubiquity of service delivery skills by using targeted trainings for laboratory and customized skills and mentorship for providers; and (4) providing targeted assistance to enable MOHW to stratify resource allocation. ABLE will pivot resources and strategies based on the BAIS V results.
ABLE will foster data-guided efficiencies through: (1) improving community, facility, and district collaborative efforts, workflows, data sharing mechanisms for sustainability; (2) driving data demand and information use by supporting the MOHW case-based surveillance and use of performance dashboard at all levels; (3) institutionalizing Site Improvement Monitoring System for continuous improvement; and (4) integrated technical assistance in supply chain management.
These approaches together with strategic deployment of qualified staff at the district level, will ensure implementation with fidelity and attainment of epidemic control.