Summary

BIPAI Botswana spends considerable resources to train and educate the country’s health professionals in the care and treatment of HIV/AIDS, and related conditions such as tuberculosis and malnutrition. Educational programs provided by BIPAI Botswana include:
  • KITSO training  
  • Tuberculosis training  
  • School staff training  
  • TOT and community volunteer training  
  • Visiting scholars program  

Kitso Training

The KITSO training program provides comprehensive, standardized and coordinated HIV/AIDS training, and brings all HIV/AIDS-focused trainings under the direction of the Botswana Ministry of Health. "Kitso" is the Setswana word for "knowledge." KITSO AIDS also stands for "Knowledge, Innovation, and Training Shall Overcome AIDS."
 
There are three different KITSO courses offered to healthcare workers: 
  • Basic KITSO, which provides general HIV education; 
  • Pediatric KITSO, which focuses on the needs of HIV-positive children; and 
  • Advanced KITSO, which covers resistance mutations and other topics on treatment for patients who have failed standard antiretroviral regimens. 
BIPAI Botswana doctors conduct all pediatric KITSO trainings throughout the country, covering about 45 different sites annually. Each pediatric KITSO session is a week-long course taught to approximately 40 health care workers, including nurses, medical officers, pharmacists, dieticians and social workers.
 
The KITSO training program was developed with technical assistance from several organizations working in partnership, including the contributions of BIPAI Botswana personnel. KITSO is made possible by support from PEPFAR through CDC/BOTUSA, UNICEF-Botswana, the Botswana Ministry of Health and Ministry of Local Government.

Tuberculosis In Children In Botswana

BIPAI Botswana continues to upgrade and expand its services for tuberculosis care for children in Botswana according to the national guidelines. Major components of that effort include improved diagnostic capacity, health worker education, mentorship, enhancing collaborative partnerships and patient education.
 
Since the beginning of the Baylor's TB-related training activities, 11 Sputum Induction Training Workshops have been conducted. So far we have trained a total of 188 health care workers in sputum induction countrywide, including:
  • Nurses: 85 
  • Doctors: 20 
  • Auxiliaries: 30 
  • Physios: 11 
  • IHS lecturers: 5 
  • Aux lecturer: 1 
  • Nursing students: 32 
  • Other: 4 
Diverse attendance is encouraged to ensure the information is widely disseminated. Out of these 188, about 14 of them have begun training others and a majority of those trained conduct sputum inductions in their respective hospitals as part of their routine work. 
 
BIPAI Botswana worked with the Botswana National TB Program (BNTP) to produce 15,000 pamphlets and 10,000 posters on Pediatric TB/HIV IEC (Information, education and communication), written in Setswana and English, for free distribution to all health centers countrywide.
 
We hope that as we increase the routine use of sputum induction in children as a diagnostic modality for TB in children countrywide we will be able to gather Botswana-specific data about the actual prevalence of TB in children. This data and other relevant parameters can then be used to inform the crafting of our National Pediatric TB diagnostic algorithm.

Additional TB training

In addition to the didactic trainings above, BIPAI Botswana continues to provide mentorship-type training and clinical support to medical practitioners in rural areas and ARV sites throughout Botswana, with a focus on pediatric TB. 
 
In 2009, pediatricians from the program, in collaboration with colleagues at Princess Marina Hospital and Nyangabgwe Referral Hospital, increased outreach to various district hospital ARV sites around Botswana. Nearly 25 outreach sites received regular visits, more than triple the number in 2008. Both the didactic sessions and case-based mentorship offered during these visits incorporate a strong TB/HIV component.
 
Given the rate at which the Pediatric TB Project is expanding, we look forward to sharing our successes and findings with our colleagues and, when appropriate, the international community.
 
This program is supported by the CDC/BOTUSA.

School Staff Training

BIPAI Botswana launched its school staff training in 2006. The program is designed to equip teachers and non-teaching staff with the knowledge, skills and attitudes to support HIV-infected children in schools. 
 
The project is based on the realization that care for HIV-infected children could be maximized if the major elements in a child's life (family, school, community and health care) are responsive to their needs.
 
The workshops, given in Setswana, span two afternoons, with four hours each day devoted to lectures and question-and-answer sessions. Topics include the spectrum of pediatric HIV; treatment and medications; infection control; nutritional care; rights/ethics/legal issues; psychosocial needs of HIV infected and affected children; HIV prevention messages for pupils, students and school staff; and teaching strategies for all content.
 
BIPAI staff also helps schools tailor the course for their students and Parent Teachers Associations (PTA) or to integrate pediatric HIV education into other school health activities.
 
School staff training is a collaborative project between BIPAI Botswana and the Botswana Ministry of Education and Skills Development (MOESD). BIPAI also works with the Department of Teacher Training and Development at MOESD to bring this course to students in Colleges of Education as part of pre-service HIV/AIDS training. The project is funded by MOESD, I-CATCH and PEPFAR through CDC/BOTUSA.

Project Concern International Collaborative Tot And Community Volunteer Training

In 2009, BIPAI Botswana undertook a new, exciting training partnership with Project Concern International Building Bridges Program, which provides grants and technical assistance to 12 of Botswana's NGOs with a goal of delivering integrated HIV/AIDS services to families. The major approach used by NGOs to providing services to the family is through home visits, during which clients are identified, needs assessed, services provided when necessary and referrals made. At the center of service provision in a home are community volunteers.
 
Integrated family services are: 
  • Support services for orphans and vulnerable children, 
  • Palliative care, 
  • ART access and adherence support, and 
  • Prevention for PLHA and vulnerable children/adolescents. 
In the first of two trainings, BIPAI trainers facilitated a course designed to familiarize NGO leadership with age-appropriate ART access and support for children, adolescents and their families. The COE training team then conducted a second course, this time using a train-the-trainer approach to certify trainers among the NGO workers. These workers in turn train community volunteers to provide support to children and families affected and infected by HIV/AIDS, including: 
  • ART access and adherence support to enable them to identify needs of families, 
  • Appropriate home-based care services, and 
  • Appropriate referrals as necessary. 
In the coming months BIPAI and PCI will support the ToTs to mobilize and train community volunteers. This model of training has been highly rated by attendees. BIPAI intends to standardize the training model and make it available to other organizations.

Visiting Scholars Program

The visiting scholars program familiarizes medical professionals with the general systems of pediatric HIV/AIDS treatment and care in Botswana; builds human capacity and encourages the development of best practices in pediatric HIV/AIDS medicine within Botswana and internationally; and trains and mentors international physicians and professionals to be leaders in pediatric HIV treatment and care in their home countries.
 
Every year, about 30 physicians and nurses come from the U.S., Canada, South Africa and Namibia and elsewhere for this training. In the last three years the program has attracted increasing numbers of nursing and social work interns from University of Botswana; medical interns from Princess Marina Hospital and other professionals from all over Botswana. 
 
Scholars can spend from 2-6 weeks to a year at the center of excellence and Princess Marina Hospital where they learn and experience best practices of pediatric HIV treatment and care.
 
All visiting scholars are supervised and mentored by highly experienced BIPAI Botswana staff, working side-by-side with a physician, nurse, social worker, nutritionist or psychologist -- consulting with patients, discussing lab results, helping to diagnose childhood ailments, observing adherence classes, attending in-reach and out-reach sessions. Through this process, scholars gain an understanding of the unique health care needs of HIV infected children and strategies to address those needs.
 
Most scholars perform the following rotations:
  • Pediatric HIV care in the center of excellence 
  • Princess Marina Hospital pediatric ward 
  • Outreach visits to peripheral health facilities 
  • In-reach visits to the homes of patients