COVID-19 SLOWS DOWN DREAMS
The scale up the National DREAMS Database (NDDB) has been affected by the advent of the COVID-19 pandemic as some implementing partners could not go ahead with in-person trainings which were to be facilitated by curriculum developers based out of Botswana.
DREAMS is an HIV combination prevention programme that targets adolescent girls and young women (AGYW) aged 9 to 24 years.
NAHPA Acting Coordinator, Robert Selato said at the official launch of DREAMS by the government of Botswana, and the US government and its agencies, PEPFAR, CDC and USAID that Curriculum had to be revised to comply with COVID mitigations. This led to some discussions to explore virtual trainings based on the type of curriculum and the associated requirements. DREAMS package of services includes bio-medical, education, social protection and combination socio-economic interventions that are provided to beneficiaries in a layered fashion to ensure maximum protection for identification of vulnerable AGYW.
In 2017, Botswana was selected as one of five countries to implement the Determined, Resilient, Empowered, AIDS-Free, Mentored and Safe otherwise popularly known by the acronym (DREAMS). This being a five-year project, was allocated a budget of over $52 million.
Currently, DREAMS is implemented in eight districts, Kweneng East, Gaborone, Kgatleng, Bobirwa, Mahalapye, Serowe, North East, and Southern. According to Selato, DREAMS programme successfully expanded from the initial two districts, Gaborone and Kweneng East, to six more SNUs as per the requirements of the COP20: Bobirwa, Kgatleng, Mahalapye, North East, Serowe and Southern. The selected DREAMS districts have the highest risk of incidence 1-1.36 percent in Botswana according to 2019 UNAIDS Spectrum model estimates, with an estimated average of 1 000 new infections per year (districts ranged from 150 to 530 new infections). The DREAMS SNU AGYW Incidence Total PLHIV Bobirwa District 1.30 20,713 Gaborone District 0.72 45,362 Kgatleng District 0.86 15,804 Kweneng East District 0.93 54,521 Mahalapye District 1.19 29,638 North East District 1.18 12,088 Serowe District 1.16 11,218 Southern District 0.61 12,825.
DREAMS districts also rank among the highest pregnancy rates among 15-24-year-old, ranging from 14-17 percent in FY 2018.“Partnerships with schools, communities, community leaders, and faith-based groups have provided additional opportunities to expand DREAMS services to rural areas with limited resources but high HIV disease burden,” Selato says.
He further adds that DREAMS ambassadors are strengthening multistakeholder partnerships to ensure active linkage of DREAMS beneficiaries to appropriate services and ensure services are delivered with quality and fidelity. Evidence-based curricula and comprehensive approaches is also utilized for the primary and contextual interventions to ensure services are client and family focused. As a result of the Covid-19 pandemic, interventions within the DREAMS package were also either stalled or reduced as implementing partners devised alternative models of implementation.