Research Xcellas Glocal Solutions is conducting a pioneering Randomized Controlled Trial (RCT) to evaluate the effectiveness of gender-sensitive psychosocial and economic interventions in reducing vulnerability to Gender-Based Violence (GBV) and recidivism among female ex-prisoners. This study focuses on addressing the unique socio-economic vulnerabilities, stigma, and lack of support systems that contribute to the high risk of GBV and reoffending among female ex-prisoners.

The core intervention of this study is the provision of gender-sensitive psychosocial support, trauma therapy, and GBV safety planning tailored to the needs of female ex-prisoners. These interventions are survivor-centered, prioritizing the needs, choices, and rights of each participant. The services are designed to foster healing, resilience, and empowerment, with a focus on rebuilding self-esteem and agency while ensuring the safety and dignity of the participants.

The interventions are culturally sensitive and adapted to the specific traditions and contexts of the communities served, ensuring that the solutions are not only effective but also appropriate for the local cultural environment. The approach is strengths-based, recognizing the knowledge and resilience that each female ex-prisoner brings based on her lived experiences. By identifying and nurturing these strengths, the intervention helps women build the skills and confidence necessary to overcome challenges and reintegrate successfully into society.

A critical aspect of the intervention is the “whole of community response,” which emphasizes that GBV affects everyone, not just the victims. The project engages the broader community in prevention and response efforts, recognizing that collective action is vital for sustainable change. By fostering community involvement, the initiative seeks to create a supportive environment that can contribute to the long-term success of the female ex-prisoners in their reintegration process.

Conclusion

This RCT aims to provide valuable insights into the effectiveness of gender-sensitive interventions for reducing GBV and recidivism among female ex-prisoners. Through a combination of psychosocial support, trauma-informed care, and economic interventions, the study will explore new avenues for reintegration, ensuring that interventions are not only responsive to the unique needs of female ex-prisoners but also contribute to broader societal change. By focusing on strengths, empowerment, and community engagement, the project seeks to break the cycle of violence and recidivism, paving the way for a more inclusive and supportive environment for female ex-prisoners.

Title: A Multi-Level, Multi-Dimensional Integrated Investigation of the Primary Causes of Essential Medicine Shortages in the Botswana Public Sector: Stakeholder Analysis, Impact, and Mitigation Strategies

Project Overview: The research project aimed to investigate the primary causes of essential medicine shortages in Botswana’s public healthcare system, along with the associated impacts and potential mitigation strategies. Recognizing the critical role of essential medicines in treating diseases and improving health outcomes, the study sought to address a gap in Botswana’s healthcare system, where limited contextual data existed on the causes and solutions for these shortages.

The study applied a multidimensional, multilevel methodological framework combining both qualitative and quantitative approaches. This included stakeholder analysis, questionnaire surveys, and semi-structured key informant interviews. A combination of purposeful sampling for interviews and stratified random sampling for the survey allowed comprehensive data collection from diverse stakeholders within Botswana’s pharmaceutical system, including regulatory agencies, pharmaceutical manufacturers, distributors, and healthcare providers.

Key Findings: The research successfully identified and analyzed the primary causes of medicine shortages, such as regulatory challenges, parallel trade, economic decisions to suspend or discontinue production, and inefficiencies in the supply chain. The impact of these shortages on healthcare delivery was explored, highlighting how patients’ access to essential treatments was affected, particularly in underserved areas.

Mitigation Strategies: The research also proposed practical mitigation strategies aimed at improving the reliability and accessibility of essential medicines. This included recommendations for strengthening the pharmaceutical supply chain, enhancing coordination among stakeholders, and implementing regulatory reforms.

Outcome and Contribution: The completed research provided valuable insights into Botswana’s public healthcare sector and contributed to strengthening the country’s pharmaceutical system. The findings and proposed solutions are expected to inform future policy decisions and initiatives aimed at improving the supply and accessibility of essential medicines, ultimately benefiting patient care and health outcomes across the nation.

Project Summary

This project implemented a Client Satisfaction Survey (CSS) and facility assessments through Community-Led Monitoring (CLM) in Botswana, complemented by systems for identifying, tracking, and providing feedback on community health service delivery concerns. Commissioned by the Ministry of Health (MOH) through the National AIDS and Health Promotion Agency (NAHPA) and implemented by BONELA, the initiative was part of the Global Fund TB/HIV Grant targeting:

• Removing Human Rights Related Barriers (RHRRB)
• Resilient Sustainable Systems for Health (RSSH)
• Community TB Prevention, Treatment, and Care

Key Objectives

• Assess client satisfaction with healthcare services.
• Evaluate facility readiness and service quality.
• Strengthen community engagement in health system oversight.
• Establish feedback mechanisms for service improvement.

Community-Led Monitoring (CLM)

CLM is a participatory approach where trained community members, especially those living with or affected by HIV, collect and analyze data on health service delivery. Unlike traditional quality improvement models, CLM centers on community voices, ensuring their lived experiences inform service enhancements. This approach empowers marginalized populations and supports evidence-based advocacy, compelling service providers and policymakers to respond to identified gaps.

Background and Context

Botswana faces significant accountability challenges in health service delivery, particularly for vulnerable and stigmatized groups. Often, these communities lack direct avenues to influence decision-making or provide feedback. The CLM initiative addressed this by building systems that link community-generated data to national decision-making processes.

Outcomes

• Improved transparency and accountability within the health sector.
• Increased inclusion of community perspectives in health planning.
• Practical, data-driven recommendations to improve service delivery.
• Established sustainable feedback loops between communities and healthcare providers.

This initiative marked a critical advancement toward rights-based, client-centered healthcare in Botswana, ensuring that services better reflect the real needs and challenges of those most affected by HIV and TB.