INTRODUCTION

The initial focus of Botswana Family welfare Association (BOFWA) in 1988 when it was established was to curb teenage pregnancies which were reflected by the Botswana Family Health Survey (BFHS II-1988), to be escalating. The IPPF Strategic Plan (Vision 2000, Manila1992) and the International Conference on Population and Development (ICPD, Cairo 1994)  later served as an eye-opener that there are other factors that are detrimental to the development of the population besides those that the countries (through both government and non-governmental organisations) focused and invested on. Hence the decision by BOFWA to move into a holistic approach through its existing two Youth Centres and establishment of three new ones across the country. Such Youth Centres are located in Gaborone, Lobatse, Mochudi, Kanye and Maun.

GOAL

The goal of the BOFWA programme is to promote SRH towards improved quality of life for the general population especially the youth, through the establishment of a wide range of user-friendly services. It stands to empower the youth with sexual and reproductive health information and services, population education, and life/survival skills for informed decision making and responsible living.

The project will further strengthen and maintain an effective project management capacity and establish an effective Management Information System (MIS).

ACTIVITIES

To realise the goal, the Youth Centres enjoy a chain of activities, some of which have resumed and some of which are yet to resume. These are as listed below:

SRH Clinics: Clinical services were introduced in the Gaborone Centre during 1997. The Mochudi Centre was equipped in 1997 through fund raising proceeds, and Clinical services were anticipated to be offered starting in 1998. A caravan was procured to house the Lobatse Clinic in 1997 through DANIDA/IPPF,NIP II funds for the two Centres (Mochudi and Lobatse). In Kanye and Maun, the two offices presently being used are temporary office accomodation while waiting for the renovation of structures within the plots awarded to BOFWA as community contributions to be completed. The development of plots in terms of shaping the physical structures of the Youth Centres commenced in 1998. Basic equipment is in place and more equipment will be needed in the future. This will be sought from Government and other donors.

Clinical Services - all the five Centres in Gaborone, Mochudi, Lobatse, Kanye and Maun will provide Clinical Services. As already mentioned, there is a Program Officer Service Deliver (PO (SD)) who is stationed in Gaborone and faced with the responsibility of running the Youth User-friendly Clinics in all the five Centres.

Outreach Clinical services/Community Based Service Provision - in addition to the Centre service delivery point, BOFWA is planning to introduce  mobile clinical service (health on wheels), where those who cannot reach the clinics can be attended to on scheduled days. The same nurses who will be offering the services in the Centre clinics will be scheduled to offer services in different needy communities. Negotiations will be entered into with the Government of Botswana (GoB) to at least attach Family Welfare Educator (FWE) to BOFWA outreach services, especially in the three project areas where funds are not available to hire personnel. There will be need to engage sessional doctors in all the clinics to attend to referral cases.

The Tirelo Sechaba Participants (TSPs) already allocated to the Centres by the Government will continue to be of great help as well as the trained Peer Educators and Community Based Sevice Providers (CBSPs).

The CBSPs were trained to serve as agents for the Association during an intense CBS workshop which was spear-headed by the PO(SD). In all, 25 out-of-school youth were trained with 5 youth (both males and females) from each Centre. The mentioned Youth will serve under the supervision of the nurses to provide clinical information and services where possible. Where not possible they will refer the clients to the Centres or make appointments for them with the nurse.  Funding for the training of YCBS was solicited from UNFPA.

The following Clinical services will be offered both at the Centres and during Clinical outreach:

Contraceptives: these will include orals, IUDs, condoms (male and female), foam tablets, injectables, and jells.

Diagnostic tests: these will include pregnancy tests, urine analysis, hemoglobin level, high vaginal Swab, Erythro sedimentary rate (ESR), pap smears, micro culture, and sensitivity tests. All the listed tests will be taken to the Government and Mission hospital laboratories.

Personal Examinations: since BOFWA is dealing with young people who are conscious of their looks and at the same time live in a world of pressures, the following examinations will be taken care of:

Treatments: STDs and minor ailments like menstrual pains, headaches, etc.

Clinical IEC(Information, Education and Communication):

Other IEC components of the project include: material development, reviews, seminars and workshops.

Other SRH Services: The Association starting 1999 will have a project on Safe Motherhood which will entail the following components:

This project aims at promoting safe motherhood through provision of education, information, economic concepts, counselling, and services to adolescents, especially girls and boys. The project will have the above mentioned three pillar components that are the underlying causes of morbidity and mortality especially among young girls.

Male Involvement: a male involvement component will be included in the programme. It is to be directed at men of various ages aimed at providing accurate information on safe and responsible sexual behaviour, to promote changes in high risk behaviour, by ensuring that men share responsibility and target male dominated places such as football clubs, the disciplined forces, and truck companies/work places. The activities will also include sensitising men to women's health issues.

IEC: over the years, BOFWA has developed a number of IEC materials which need to be reviewed, improved, and be translated into Setswana. There is also a need to develop additional IEC material to address issues such as male involvement, clinical services, safe motherhood which will be distributed during the project life. The IEC component will run through all the project, therefore a common plan has to be developed and be directed by the Program Officer(IEC).

1) Exchange Programmes: national and international exchange programmes will be embarked on to expose the youth to other SRH environments which are different from theirs. The exchange programme will provide the youth with a fora where they can learn from each other and exchange experiences.

2) Strengthening of STD/HIV/AIDS: to strengthen BOFWA's STD/HIV/AIDS component, there is a need to develop IEC material, specifically for HIV/AIDS behaviour change and awareness creation in both English and Setswana. A youth AIDS support group to cater for infected and affected youth is going to be in place. Already, a group of Youth in the Gaborone branch have undergone the HIV/AIDS home-based care training. A similar training will also be introduced to the Community Based Service Providers (CBSP).

Recreational Activities: Youth will be instructed through indoor and outdoor games. Table tennis, football, netball, and volleyball teams will be formed which will be used for marketing the Association as part of the outreach educational activity.

Management Information System (MIS): BOFWA is to develop an Information Technology Management and Skills Development project in 1999. This will aim at improving and enhancing the management capability and efficiency through information technology and also develop research skills and improve monitoring and evaluation capacity of staff.

Marketing: the services offered by the Centres will be marketed through various activities including jam sessions, radio talk shows, football/volleyball/netball/table tennis games, trade fair stalls, etc. where publicity items such as T-shirts, caps, badges, rulers, etc. will be distributed. In addition to this, advocacy workshops will be held with leaders and parents to gain support for the programme.

Botswana Family Welfare Association (BOFWA). Copyrights (c) Reserved 1999.       Webmaster: Hendrei Mphathiwa: hendrei@homail.com  Tel: 372710  Cell: 71306568