In an effort to fulfill the mandate of the National Strategic Framework 2003-2009 and to bring Botswana’s HIV/AIDS Response closer to the people of Botswana, ACHAP decided in late 2004 to support the HIV/AIDS responses of seven Districts.  After consultation with Ministry of Local Government, several Districts, Central Government officials and relevant Non-governmental organizations, it was decided that the following Districts  would receive support for their HIV/AIDS responses: Chobe, Francistown, Ghanzi, Mabutsane, Ngamiland, Selebi/Phikwe and Serowe-Palapye.

 ACHAP’s support to the districts was driven by a need to steadfastly increase the pace of rolling out programmes to communities thereby ensuring greater coverage and impact of the Botswana Government’s national response to the HIV/AIDS epidemic. This would also ensure that specific attention is paid to the varied and localised issues that are best understood within a smaller administrative unit such as the district. The District Multi-Sectoral AIDS Committee (DMSAC), therefore, forms an appropriate channel through which HIV/AIDS initiatives are developed, fine-tuned and implemented.  HIV/AIDS initiatives at the district level fall within the four ACHAP strategic priorities of 1.HIV prevention, 2.HIV counseling and testing and post-test services, 3. Antiretroviral treatment and 4. Advocacy and mobilization of communities and PLWAs.

Support at district level varies from district to district depending on the identified needs. The support has been guided by ACHAP’s four (4) thematic areas of programme focus namely: HIV prevention; HIV counseling and testing including post-test services; Anti-Retro Viral Treatment; and advocacy and mobilization/empowerment of communities including people living with HIV/AIDS (PLWHA).

During 2008, support in these districts was directed towards a generic set of interventions based on ACHAP’s four focus areas. This enabled the partner districts to support programmes in line with the organisation’s focus areas for strategic direction, while retaining the flexibility to implement programmes informed by district specific needs.

The partner districts accounted for about 25% of the projected national total population of 1.78 million in 2008. Some of these districts have amongst the highest population-based HIV prevalence rates in the country ranging between 29.4% and 15.6% for Chobe and Ghanzi districts, respectively (BAIS II, 2004) as compared to a national average of 17.1% in 2004. The HIV prevalence rates among pregnant women are equally high ranging between 49% in Selebi-Phikwe and 25.3% in Mabutsane (Second Generation HIV and AIDS Surveillance Report, 2007). It is against this background as well as the need to include rural and urban settings that ACHAP selected these localities to provide additional support for district and community-based interventions.