b. The need to ensure long term financial sustainability of the National Plan of
Action on Orphans and Vulnerable Children by facilitating strategic thinking
and management among all service providers, perform expenditure pattern
review of existing programmes so as to develop a resource allocation formula
while at the same time encouraging value for money audits.
c. The need to empower families through transformative approaches which will
include mindset change and very clear strategies to be undertaken through the
social welfare programmes.
d. The need to be constantly on the lookout for negative consequences arising from
programming actions with the view of developing and implementing mitigation
actions.
Challenges Facing the Implementation of Child Health Services
A significant portion of the population is on HIV and AIDS treatment and that
has implication for resources available to the rest of the health sector. The
tendency of young girls to submit to risky sexual relationships has been and
continues to be addressed by policy and legislative reforms as well as educational
campaigns.
Teenage pregnancy, with the obvious health and other consequences remains
unacceptably high – while a Western teenager who engages in unprotected sex and
becomes pregnant has the morning-after-pill, abortion and adoption as possible
responses to her problem, the Botswana teenager almost invariably has the child.
With a nationwide HIV prevalence of 18.5 % and an adult prevalence (15-49 yearolds) of 24.3% %38, a large number of Batswana are either infected or affected by
HIV and AIDS. Treatment, care and support of these people, to make sure they stay
healthy, productive and able to care for their families is crucial. For children too,
the issue of treatment and care is key, with an estimated 25,000 children HIV
positive by end 200339.
There is acute shortage of professional social workers to conduct thorough
assessment and registration of destitute persons and needy students. On average,
one social worker covers at least five villages. Furthermore, social workers
employed in the field use a large percentage of their time doing clerical duties such
38
BAIS IV, 2013.
39
2004 Report on the Global AIDS Epidemic, UNAIDS.
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