Projects

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.

Summary of the 2023 BABPS Resource Mobilization Workshop

The Botswana Association for the Blind and Partially Sighted (BABPS), in collaboration with Research Xcellas Glocal Solutions (RX), hosted a Resource Mobilization Workshop at the Kagisong Conference Centre, Mogoditshane in 2023. The aim was to build the resource mobilization capacity of BABPS Secretariat staff and Board members.

BABPS presented its mission, vision, values, and organizational structure, reminding attendees of the organization’s purpose and guiding principles. Research Xcellas led the session on Resource Mobilization Basics, explaining disability programming, the meaning of resource mobilization, and the link between organizational capacity and funding success.

An audit session evaluated BABPS’s current resource mobilization practices, identifying strengths and areas for improvement. This was followed by an in-depth discussion on developing resource mobilization plans, advocacy strategies, connecting projects with funding needs, and practical tools and templates for immediate application.

The workshop also emphasized relationship building, highlighting the importance of strong partnerships for sustainable resource mobilization.

This initiative significantly strengthened BABPS’s ability to attract resources, empowering the organization to enhance its programs and advocate more effectively for the blind and partially sighted community in Botswana.

Project Summary

Recognizing that investment in health is a political and social responsibility, Research Xcellas Glocal Solutions, in partnership with the Budget Justice Coalition (BJC) and BONELA, facilitated a transformative four-day training workshop aimed at strengthening civil society participation in health budget accountability and advocacy in Botswana.

The initiative was driven by the growing urgency to improve transparency and efficiency in health resource allocation—especially in light of challenges exposed by the COVID-19 pandemic and long-standing issues related to HIV/AIDS, limited domestic health financing, and inadequate healthcare access. The workshop was designed to empower civil society organizations (CSOs) with the tools and knowledge needed to effectively engage in health policy reform, budget monitoring, and resource tracking to advocate for universal health coverage and sustainable health investments.

Key Objectives of the Training:

• Develop tailored training materials simplifying Botswana’s health budget cycle and identifying participation opportunities.
• Build stakeholder knowledge on national health policies, budget processes, and relevant international legal frameworks.
• Strengthen BONELA’s internal capacity to support CSOs nationwide in advocating for equitable and transparent health financing.

Context and Background: Botswana’s efforts to provide equitable healthcare are hampered by limited resources, uneven service utilization, and insufficient engagement of civil society in budget processes. While infrastructure has improved, service quality and financial sustainability remain concerns. A key gap identified is the lack of systematic civil society involvement in health budget planning and monitoring.

This workshop directly addressed that gap by helping CSOs understand the policy landscape, track public health expenditures, and hold the government accountable for the progressive realization of the right to health. It also aligned with global best practices of building informed, vocal constituencies to reframe policy debates and influence health financing decisions.

Outcomes:

• Enhanced CSO capacity in health budgeting, policy analysis, and advocacy.
• Strengthened BONELA’s technical ability to lead and coordinate CSO efforts.
• Laid the foundation for ongoing engagement in budget justice, particularly at the sub-national level.

Conclusion
This initiative marked a critical step toward achieving a people-centered, accountable, and rights-based health financing system in Botswana. Through knowledge-sharing and capacity-building, Research Xcellas and partners helped lay the groundwork for a more inclusive and transparent health budgeting process.

Project Summary

This report presents the findings of a baseline study conducted by Research Xcellas Glocal Solutions under the AGA Project, initiated by the Botswana Family Welfare Association (BOFWA), an affiliate of the International Planned Parenthood Federation (IPPF). The project aims to advance sexual and reproductive health and rights (SRHR) among adolescents and young people (AYPs), aged 10–24, with and without disabilities, in Botswana. It contributes to national and global commitments, including the 2030 Agenda for Sustainable Development and the Sustainable Development Goals (SDGs).

The AGA Project seeks to:

• Foster an inclusive environment for AYPs to access SRHR services.
• Integrate SRH education and services into community health systems.
• Strengthen community structures to support long-term SRHR outcomes.

The baseline study was conducted in Ramotswa and Mochudi, located in Botswana’s South East and Kgatleng Districts. The study utilized a mixed-methods approach, including:

• An online survey of 98 AYPs.
• Semi-structured interviews with family members, teachers, health workers, and community leaders.

Key Findings:

• AYPs are open and willing to access accurate, age-appropriate, and scientific SRHR information.
• There is a strong demand for education on contraceptives, HIV/AIDS, STIs, family planning, puberty, and disability-inclusive SRHR rights.
• Despite general SRHR awareness and positive attitudes, behaviors often do not align with knowledge due to cultural sensitivities and social stigma surrounding SRH discussions.
• Disability inclusion remains a critical area for focus, as barriers persist in access to tailored services.

Implications: These findings offer valuable insight into the SRHR knowledge, attitudes, and practices (KAPs) among young people in Botswana. They underscore the importance of community-based education, youth-friendly services, and inclusive policy frameworks. The study also highlights the need for culturally sensitive yet rights-based programming to translate knowledge into practice.

Conclusion: The AGA Project provides a vital platform for addressing SRHR challenges among Botswana’s youth, especially those with disabilities. Evidence from this baseline study supports the development of targeted, community-driven interventions to improve SRHR access and outcomes for all young people in Botswana.

Project Summary

This research, undertaken by Research Xcellas Glocal Solutions, evaluates the implementation of labour laws and workplace health policies in Botswana, highlighting critical gaps that affect worker well-being, productivity, and equity across sectors.

The study reveals inconsistent compliance with labour legislation across industries. While sectors such as security services show relatively strong adherence, industries like mining display significant shortcomings. This disparity points to the urgent need for a cohesive national regulatory framework and stronger enforcement mechanisms to ensure uniform application of labour standards.

A central finding of the study is the restricted access to healthcare for many workers. Rigid sick leave policies, limited typically to 20 days, are insufficient for managing chronic illnesses such as HIV and TB. Workers are often forced to deplete paid leave and rely on unpaid days, impacting recovery and income stability.

Stigma and fear of discrimination, particularly regarding HIV and TB, deter workers from seeking medical care or disclosing their health status. This challenge is intensified by the absence of confidential health systems in many workplaces and the lack of on-site healthcare, especially in remote mining areas. Even when healthcare is available, workers often avoid it due to fear of discrimination.

Operational barriers like inflexible work hours and inefficient public health systems further restrict access, particularly for hourly-wage earners. Long queues, bureaucratic delays, and geographical isolation exacerbate the situation.

The study also identifies a severe neglect of mental health in the workplace. With no formal mental health policies or support structures, employees face high levels of stress and burnout with little organizational response or care.

Key structural issues include:

• Lack of worker awareness regarding rights such as sick leave and maternity benefits.
• Inadequate stakeholder engagement in policy development, leading to impractical implementation.
• Absence of protections against discrimination based on sexual orientation.
• Limitations in the Workmen’s Compensation Act, where HIV and TB are not recognized as occupational diseases—even in high-risk industries.

Conclusion

The study emphasizes the need for comprehensive policy reform, improved enforcement, greater worker education, and inclusive, flexible health and labour policies. Addressing these issues is critical for creating a safer, fairer, and healthier working environment in Botswana, ultimately enhancing national productivity and social equity.

Project Summary

This study critically evaluates Botswana’s Community-Based Natural Resource Management (CBNRM) program, which has been operational for over two decades. The central goal of the CBNRM initiative is to promote biodiversity conservation while simultaneously enhancing rural livelihoods through community participation in natural resource governance.

The research aimed to:

• Assess the effectiveness of CBNRM in achieving its twin goals of conservation and socioeconomic development.
• Examine the institutional and policy frameworks guiding CBNRM implementation.
• Identify key challenges and propose strategic policy interventions to strengthen CBNRM outcomes.

Using a mix of primary and secondary data, the study found that CBNRM has produced mixed results across Botswana. Some community projects have delivered tangible benefits, including job creation, income generation, and provision of social services, particularly in wildlife-rich northern regions. Additionally, reduced poaching rates and improved local conservation practices were observed in CBNRM areas.

However, the study also highlighted a range of implementation failures. Several projects collapsed due to issues such as:

• Limited capacity and entrepreneurial skills within Community-Based Organizations (CBOs)
• Mismanagement and misappropriation of funds
• Inequitable benefit-sharing
• Inadequate reinvestment of CBNRM-generated revenue

While Botswana has a policy framework supportive of CBNRM, it is characterized as fragmented and lacking legal enforceability, making it vulnerable to exploitation. Most policies exist only as guidelines rather than binding legislation. The research recommends the development of a comprehensive CBNRM law, drawing from successful models in peer countries, to provide legal clarity, improve governance, and enhance sustainability.

Conclusion

CBNRM has shown promising potential as a tool for achieving conservation and community development goals in Botswana. However, to realize its full impact, a strong, unified legal framework is necessary, alongside efforts to build local capacity, ensure accountability, and promote equitable benefit-sharing. Strengthening these areas will empower communities to play a more meaningful role in the sustainable use and protection of natural resources.

Overview
Research Xcellas Glocal Solutions led the Botswana arm of a regional study examining the relationship between alcohol availability and gender-based violence (GBV), using a community-centered approach. This initiative forms part of a broader multi-country effort to explore how alcohol outlet density (AOD) and outlet trading times (OTT) act as structural drivers of GBV, particularly intimate partner violence (IPV) and non-partner sexual violence (NPSV).

Botswana, like much of Southern Africa, faces high levels of alcohol-related harm and gender violence. Although alcohol is not the sole cause of GBV, heavy episodic drinking—especially binge drinking—has been closely linked to both the frequency and severity of IPV. This study builds on evidence showing that regions with high alcohol availability, unregulated outlets, and extended trading hours also experience elevated levels of GBV.

Study Locations & Methodology
The project was implemented in two sites in Botswana: Lobatse and Molepolole, selected due to their visible alcohol outlet concentrations and high GBV reports. The study utilized a qualitative research methodology, including:

• Two Focus Group Discussions (FGDs) – one in each site
• Ten Key Informant Interviews (KIIs) – five per site

Participants included community members, local authorities, health professionals, and representatives from GBV response services.

Key Findings

• High alcohol outlet density and non-compliance with trading hours were widespread in both communities.
• Alcohol availability was identified as a major contributing factor to excessive consumption, and in turn, to physical and sexual violence.
• Binge drinking patterns were prevalent and often coincided with spikes in violence, particularly during weekends or after payday.
• Participants noted that alcohol-related violence disproportionately affects women and vulnerable groups, including women with disabilities, adolescent girls, and those living with HIV.
• The lack of localized regulations and enforcement on alcohol outlets, as well as community normalization of harmful drinking, were cited as enabling factors.

Policy Implications & Recommendations
The study underlines the urgent need for structural interventions, including:

• Stricter regulation and enforcement of alcohol outlet licensing and trading hours
• Community-informed alcohol policy reforms and awareness campaigns
• Integration of GBV prevention efforts with alcohol harm reduction strategies
• Community participation in alcohol governance and GBV response systems

The findings support the case for evidence-based, community-led action to reduce alcohol-related harms and GBV in Botswana and across the Southern African region.