Outreach

There have been remarkable advances in the expansion of paediatric HIV care in Botswana, with almost 8,000 children under the age of 12 years on antiretroviral therapy (ART). As the largest paediatric HIV care and treatment clinic in the country, the Botswana-Baylor COE provides comprehensive family-centered HIV care to more than 2,000 children. In February 2008, the COE embarked on an Extended Physician Outreach Project, funded by Texas Children's Hospital, to assist decentralization and scale-up of the care and treatment of HIV-infected children. The project's objectives are to help build capacity for comprehensive provision of paediatric HIV care in decentralized health institutions across Botswana; support preventive services; and facilitate the national goal of universal access to HIV care.

COE physicians (including faculty, members of the Pediatric AIDS Corps and medical officers) and an outreach nurse conduct monthly support visits to decentralized ART sites. These visits consist of didactic sessions along with side-by-side clinical mentorship. COE staff remain available to sites for guidance on a longitudinal basis, both during direct visits and via a specialist cell phone answered around-the-clock by BBCCCOE faculty.

Since its inception, the project has grown to sustain 28 sites with an average of 257 mentored patient visits monthly, and a total outreach site paediatric enrollment of more than 2,000 HIV-infected children

The Extended Physician Outreach Project plays an important role in supporting Botswana's national scale-up of decentralized paediatric HIV services. Strategically, the project endeavors to assure quality improvements, as well as ensure its continued presence in outreach sites. Near-term plans include implementing an adaptable monitoring and evaluation framework that will measure the effectiveness of defined outcome indicators for capacity building, as well as exploring operational methods that support and strengthen sites' sustainability as paediatric-capable ART centres.