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Last mile towards dual elimination of Mother-to-Child Transmission of HIV and Syphilis: Can Botswana be the first?

The Ministry of Health and Wellness (MoHW) requested for technical support from WHO, UNICEF, UNAIDS and CDC to review data processes and assist the country in determining the best modalities for data quality improvement and priority actions for the country to progress toward the path to elimination.

The PMTCT/Syphilis data is collected from service delivery sites (health facilities) on a paper based system and summarized on monthly data collection forms. Data is then aggregated and entered into the DHIS2 electronic system at DHMT level and transmitted through the system to the national level for analysis and feedback. The verification exercise showed varying data at different levels of reporting (facility to District) caused among others by information that is recorded or updated after the reports have been submitted.   On the other hand, data on syphilis is recorded at facility level but is not reported at national level, despite a good strategy for syphilis prevention among pregnant women, integrated within the antenatal care programme and other SRH services. There is a need to streamline syphilis data and implement monthly aggregate reporting together with HIV among pregnant women.

In order to address the above issues, missions to Botswana were convened, which recommend that the ministry should maintain momentum and commitment to Elimination of mother-to-child transmission in Botswana and to invest more in data management including capacity building for national and district Monitoring & Evaluation officers and programme managers on data analysis and utilization.

In addition, other key issues to be addressed were the use of standard indicator definitions for tracking and reporting programme coverage especially on the area of EID, lack of system to routinely and systematically report retention in care for women when they exit or graduate from PMTCT program. A special emphasis was put on congenital syphilis elimination in Botswana.

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