We believe that the end of AIDS is possible if there is more focus on key populations. Our project in Botswana addresses barriers faced by the LGBT community related to their sexual and reproductive health and rights. Driven by community champions, we work to realize competent and LGBT-friendly healthcare facilities; legislation supportive to LGBT people’s rights and needs; and a strong key population coalition supported by allies and religious leaders.
Homosexuality is ‘unafrican’
The Republic of Botswana is a landlocked country located in Southern Africa which is home to just over two million people. In spite of impressive gains in economic and social development, Botswana continues to face great challenges in terms of sustainable human development and poverty reduction. Same-sex sexual practices are criminalised and LGBT people are often harassed and threatened. Stigma and discrimination against LGBT people is widespread, with many in society believing homosexuality is ‘un-African’ and against traditional values. As a result, the LGBT community faces exclusion from society, from health services and from the job market. This increases their vulnerability and their risk of contracting HIV. Around 319,750 people are living with HIV in Botswana. HIV prevalence among men who have sex with men (MSM) is estimated at around 13%. The HIV prevalence among women who have sex with women and the transgender community is not known.
LGBT people claim a right-based HIV and SRHR response
Bridging the Gaps works with a Theory of Change approach. A Theory of Change is a description of a list of events that is expected to lead to a particular desired outcome. It is a visualization how change is believed to happen. In 2016, LGBT representatives developed a specified Theory of Change that consists of short-,medium, and long term outcomes. The Theory of Change describes how we plan to realize competent and LGBT-friendly healthcare facilities; legislation supportive to LGBT people’s rights and needs; and a strong key population coalition supported by allies and religious leaders.
Through innovation and by building on previous work, we will strengthen civil society organisations’ ability to:
1. We facilitate community development
- Involving country partners in a regional participatory community needs assessment for evidence-based interventions and advocacy.
- Building the capacity of local research coordinators
- Empowering LGBT people through community building initiatives to increase knowledge about health and human rights.
- Developing and sharing lessons learnt and best practices documents
2. We advocate for the continuously strengthening of services and upholding human rights
- Advocating religious and traditional leaders, organizing dialogues and utilizing opportunities to raise awareness in these forums
- Building the capacity of leaders to become and act as champions for LGBT health and rights issues.
- Involving and representing LGBT community in the national Technical Working Group on Key Populations of the Ministry of Health
- Advocating for the inclusion of key populations needs in national curricular of healthcare workers.
3. We deliver inclusive, rights-based and gender sensitive services
- Developing and distributing IEC materials
- Increasing knowledge on safer sex practices among LGBT people (through peer-education, outreach and workshops)
- Providing direct services like HIV testing and counseling and psychosocial support.
- Referencing and alliance strengthening by Botswana partners with local (sensitized) health care providers.
4. We foster global and in-country process and partnerships that reinforce results
- Creating a key affected population task force (a LGBT people coalition) to systemize feedback from the community to national mechanisms, such as the Country Coordinating Mechanism of Global Fund.
- Engaging empowered LGBT people in the Country Operational Plan of PEPFAR.
Our project builds on the strong advocacy work of our partners LEGABIBO, BONELA, Rainbow Identity Association, Pilot Mathambo and Men for Health and Gender Justice to put LGBT health issues on the political agenda and get them included in national plans. Their work is internationally supported by COC and MSMGF.