Thinking of a Career in Emergency Management?
- BY Nicole Pelette
Background and Justification
Botswana with a population of 2,324,232, is currently among the countries with highest HIV and AIDS epidemic burden in Southern Africa. Just over a quarter (27%) of the total population are women of child-bearing age, while children under five years constitute12 per cent of the population. The annual population growth rate stands at 2.4 per cent and total fertility rate at 2.9 per cent (BDS 2017). The Botswana PMTCT programme prides itself of being the first national programme in Africa to have achieved 100% geographic coverage in a space of 3 years starting in 2000. Progress in service delivery shows that PMTCT services have been decentralized to the lowest levels. With the implementation of option B+ and adoption of “Treat All” strategy, the capacity of nurses to initiate lifelong ART has been strengthened.
Since its inception, PMTCT has recorded major achievements in terms of access, testing of pregnant mothers, HIV positive mothers taking up HIV prophylaxis and treatment and the proportion of new-borns tested at 6 weeks. Among the notable successes are: increases from 92 per cent in 2012 to 97 per cent in 2019 in the proportion of pregnant women accessing ARVs; a decline of HIV prevalence in pregnant women from 37.4 per cent in 2003 to 26.5 per cent in 2015, an increase in testing uptake of 98 per cent in 2019. Early infant diagnosis (EID) coverage has improved overtime from 49 per cent in 2016 to 85 per cent in 2019. The trend in infant feeding within the context of HIV infection also showed an increase in proportion of mothers breast-feeding their babies, though the proportion was only 41 per cent in 2019.
Botswana has a good syphilis prevention strategy among pregnant women integrated within the antenatal care programme and other SRH services. This program has been in place for decades (from the 1970s) which has resulted in low prevalence of syphilis among pregnant women. However, data on this indicator was not routinely reported at national level for monitoring of program progress.
The Government of Botswana aims to eliminate mother-to-child transmission (EMTCT) of HIV after two decades of implementation of the PMTCT programme. The Mother-to-Child-Transmission of HIV (MTCT) has significantly declined from 40 per cent at the inception of the programme in 2003 to 1.94 per cent (2019 spectrum estimates) and has been consistently less than per cent for at least the past three consecutive years. It is through these achievements that Botswana is among a few high burden HIV countries in the African region considered eligible for validation for being on the Path to Elimination (PTE) of MTCT.
Due to existing challenges and data gaps that needed to be addressed including the exclusion of non-citizens in program data reporting at national level and gaps in syphilis data, Botswana in February 2020 conducted a national data collection and verification exercise for syphilis and PMTCT programmes (including non-citizens data) for reconstruction of the national data base to improve EMTCT validation prospects. The results indicate that Botswana is in good standing for classification in one of the PTE of MTCT categories.
In this regard, the country seeks to apply for validation for being on the path to elimination of MTCT based on the criteria set by WHO for high HIV burden countries (refer to table above). This activity will allow the country to collect the data needed to apply for EMTCT validation. The findings and recommendations generated will be used to determine Botswana’s qualification and to apply towards the EMTCT validation and accreditation process. In addition, the findings will influence advocacy, policy, strategic direction and partnerships required to achieve the results and targets outlined in NSF3 and to accelerate progress towards EMTCT of HIV. The exercise will also provide recommendations on how the Botswana government can best re-position the PMTCT programme to qualify for the Global EMTCT validation. It is for this reason that the Botswana government wishes to embark on EMTCT of HIV and Syphilis assessment and submit the report of the assessment to the EMTCT Regional Validation Committee for consideration.
With support from the UN (WHO, UNICEF and UNAIDS), a team of national consultants will be recruited to work closely with the National Validation Committee to support the PTE validation process. The team will comprise of a Team Leader, Data Management, Gender and Human Rights and Laboratory consultants. UNICEF will support the recruitment of the data management consultant.
It is against this background that UNICEF is seeking the services of a national data management consultant. These ToR are specifically for the data management consultant.
Scope of Work
Goal and objective:
This assignment is linked to delivery of results within output 2.2 of the 2020 Annual Workplan and will contribute to supporting Path to Elimination (PTE) processes including data collection and reporting and will take place between December 2020 and February 2021.
Specific activities and tasks for the Data Management Consultant:
Administrative issues and Conditions