Basic themes | Organising themes | Global themes |
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1. Botswana government HIV National Strategic Framework (NSF) lead by NACA 2. All ministries, development partners CBOs, NGOs and private sector are part of the NSF 3. MH, DP1,DP2 are three main partners in the SMC program 4. DHMT works at district level 5. All partners involved throughout the planning process since 2007 6. All partners target HIV negative men aged 15–49 years to circumcise through SMC 7. All partners aim to have circumcised 80 % of HIV negative men by year 2016 | Clear Partner Mission | Input |
8. Botswana government integrated circumcision within health services nationwide since 2007 9. DPs introduced MOVE project in 2011 to help government push set target in selected areas | Approaches to the mission | |
10. DP1 viewed as a major financial contributor: more monetary funds; sub-constructs companies; built 2 permanent clinics; provides surgery kit; provides mobile clinics and transport 11. DP1 contributes funds and funds medical personnel and transport 12. MH contributes funds; provides health structures nationally; provides medical equipment and transport | Financial Resource Contribution | |
13. DPs deployed medical staff to Government health centers to do SMC 14. DPs deployed staff moved to form dedicated MOVE teams 15. DP1 brings in special scientific expertise 16. MH’s avails its medical staff nationally to participate in SMC | Partner Resource Contribution | |
17. MH as owner, coordinator, chair, provider of space and financing 18. DP1 as technical advisor, expert, advertising, mobilisation, provider of clinics structures and main donor 19. DP2 as donor, implementer and community mobiliser | Clear Partner Roles | Throughput |
20. Partners developed short term and long term communication strategies; training manuals and reporting system together | Communication | |
21. Development partners use different reporting systems than MH’s 22. Development partners do not report to MH systematically 23. Reporting between partners was not transparent 24. Development partners reported directly to their international donors 25. The Government reported all donor funds usage to OECD 26. Way of accountability give blurry structure | ||
Financial resources 27. More finances spent but less numbers of circumcised men causes conflict 28. MH’s financial contribution queried to be not transparent 29. Ownership seems linked to finance contribution 30. MH’s ownership of the program is questioned 31. MH sees structures as big contribution | Input Interaction | |
In-kind resources 32. Donors keep sending more equipment for circumcision 33. Lots of equipment is wasted 34. There is inconsistency on balance sheet for number of circumcision instruments, wasted and remaining 35. MH is blamed for not taking care of such equipment | ||
Partner resources 36. MH viewed as a weak coordinator at times 37. MH ownership is queried 38. Government health centers is blamed to be participating little in circumcision 39. MH feels MOVE strategy naturally creates dependency on government health staff 40. Districts prioritised attending to ill patients than circumcision 41. DHMTs blamed for not prioritising SMC 42. Health centers viewed SMC as the DPs’ program | ||
43. Partners consulted with the national traditional leadership at planning stage 44. MH is seen as a leader and owner 45. There is not enough support from the highest national leadership to influence men for circumcision 46. MH’s placements of coordination leadership is queried 47. DHMTs are said to not take leadership role accordingly | Leadership | |
48. DPs blame MH for setting the target high 49. DPs blame MH for not putting enough effort and resources to push the set target 50. MH is frustrated about the mathematical model used by WHO to set country target 49. Unattainable target is seen as the highest risk in program implementation 51. MH and DPs express frustration that the 80 % target is not attained regardless of their massive efforts 51. DPs report pressure from donors on reconciling dollar to numbers | Mission threatened | Feedback mission |
52. DPs indicate that the donors will cut down on the funds 53. International donors reduce funding support to Botswana | ||
54. DP2 pulls away its employed doctors gradually from 2013 and leaves a gap in implementation 55. DP1 pulls away its financial and technical assistance abruptly in 2014 and leaves a gap in implementation | Antagony | Output |