Questions/Answers

The Elderly Care in Lotsane project emanated from the imminent threat to the existence of our aged generation. The decline in the number of elderly clientele visiting facilities to seek healthcare, the deteriorating patterns for those that actually reach the health facilities, the gross negligence by the family members and also their worsening psychosocial upkeep necessitated the inception of this project. there are 1598 over 65 elders in Palapye. Established issues faced by our elders in accessing healthcare services in our facilities. b) Set up collaborative coalition with the community leadership, community based committees and caretakers. c) Provision of appropriate, targeted and tailor-made health care interventions including strengthening of Primary Healthcare Services to the elderly population of Lotsane Ward.

To Establish issues faced by our elders in accessing healthcare services in our facilities. To Set up collaborative coalition with the community leadership, community based committees and caretakers. To Provide appropriate, targeted and tailor-made health care interventions including strengthening of Primary Healthcare Services to the elderly population of Lotsane Ward.

Increases the access of the poorest and most vulnerable people to quality and affordable public services. The initiative promotes quality of care to elderly people who are 65years and above; Empowered care givers on issues related to their wellbeing and care of elderly people. • Empower community on care of elderly • Promote community engagement and accountability on health matters • Restore dignity of the geriatric population

Following the project inception, general improvement in the care of the elderly within the Lotsane community was realised. While we had previously noticed rejection at both their homesteads together with where they access health services, there was a drastic change in acceptance of elderly people hence aiding and facilitating their access to care was noted to have improved. There has been an increase in community involvement in elderly care as more are coming forth to report any health incident that affect elders and also communities/families are more aware of their health care obligations.

General health status has very much improved with almost perfect perennial care and good compliance to ARV with a Suppressed VL and increased CD4 count. New bookings to oncology clinic was done and family complying well with it. No longer defaulting treatment and appointments the BP is now controlled with an improved general health status Blood Preasure is controlled and stable. The initiative processes and success was an inspiration not just for health professionals but also to other public service officers and departments involved and engaged in the project. Departments such as the social welfare and Old Age Pension to mention a few were inspired to develop their own outreach program after they realised the initiative ground breaking results. Public service delivery was also illuminated in restoring dignity of its mandate.

The initiative major success benefit was directly seen on the smiles and the response from the elderlies that the initiative was directed to. It had brought health and self-worth to the elderly population to live the life in fullness and in dignity. Some clients were now being self-sustaining and able to play their role in the society. This initiatives came highly appreciated to all people of different walks of life as it left no stones unturned. It reinstated spirit of humanity within the society, inspired public service officers to be proud of their service while also encouraging and building an all in one government which has shown to be the ideal way of governing public service.

The project was driven by the Ministry of Health & Wellness objectives and key result areas mainly focusing on providing accessible, preventive, curative and rehabilitative care to the nation. Even though BOTHO (humane) is one of our core values as health professionals, there has been some limitations in exercising that principle, therefore the project has proudly ensured that the respect and the courteousness behaviour was at the disposal of our elders when they reach our health facilities. Despite the shortage of human resource, which cuts across the government sector, the frequent house visits by not only volunteers but also health professionals to the identified clients was one of the strongholds of the innovative approaches of this project. The project has ensured that the identified elders are escorted to their scheduled checkups in different health facilities across the country with the dedicated project team.

The creative and innovative approaches are as follows: a) Conduct Health Pitso (Health Education and Promotion gathering) , tailor-made for the geriatric population b) Wellness activities for elderly population c) Medication packaging for easy reference and administration at home d) General cleaning activities at the homesteads of the clients. The care of elderly initiatives made a sweeping change in the complexion of how service delivery is rendered across our service centres. It brought about acceptable atmosphere of not just the project target, being, ‘‘the elderly people’’ in accessing of health care at our health facilities, but it watered across the other service consumers of different age range and needs, germinating a positive public service integrity. Through the initiative, public service officers grew a noticeable degree of selflessness in their rendering of service

The team drew up a plan composing of a wide range of health promoting activities, as follows: Frequent house visits to the identified clients; Ensuring that they go and are escorted to their scheduled check-ups in different health facilities across the country; Conduct Health open days, tailor-made for the geriatric population’ Wellness activities for elderly population; Medication packaging for easy reference and administration at home; and, General cleaning activities at the homesteads of the subjects. Through engagement of the Kgosi, Village Development Committee (VDC), and Village Health Committee (VHC) the team conducted a baseline assessment to establish the issues impeding access to health services, support and care of the elderly.

Yes

This initiative has been a worthwhile project that did not only see the health of our elderlies revived but also saw social structures such as families reuniting from conflicts and despair and bringing in unity and teamwork within people as a whole, community and government structures .We therefore undoubtedly believe that the initiative can be executed in any level of social structure as it is both achievable and supportable even in the most scarce resource areas

In the face of the tremendous results gained from the initiative we were able to cover so many grounds with less resource put forth. The project was done entirely on the drive to produce the desired goal of promoting care to our elderlies as well as their families and community in collaboration with the existing different community based organisations and government sectors. It able to fully utilise the Botswana governing structures policies, procedures and initiatives as a guideline for our success. The Botswana Ministry of health and Wellness also had laid down structures and an open innovative platform that gave us the much needed drive to accomplish the project initiative by puzzling our innovative juices within our health system as a guiding principle towards the success of the initiation.

The project was done entirely on the drive to produce the desired goal of promoting care to our elderlies as well as their families and community in collaboration with the existing different community based organisations and government sectors. It able to fully utilise the Botswana governing structures policies, procedures and initiatives as a guideline for our success. The Botswana Ministry of health and Wellness also had laid down structures and an open innovative platform that gave us the much needed drive to accomplish the project initiative by puzzling our innovative juices within our health system as a guiding principle towards the success of the initiation.

Yes

It is worth noting that the initiative have overly shown to have brought about a community based change to general public service delivery as it has been a key cry within our society . This was acknowledged and evaluated by our priority evaluators which are the consumers of our service. Time and again at different platforms (public gathering, community and one on one conversation and) have immensely appreciated the impact that the initiative has done in their livelihood and how it had opened a channel of communication, acceptance and tolerance towards public service delivery and care. More so, through the Botswana Ministry of health and wellness the authenticity of the initiative was carried through an intense assessment and evaluation of the process engaged throughout the innovative initiative. This assessments and evaluations made it to be the best innovative project within the ministry for 2015/16. The Director of Public Service Management was also involved in the assessment and evaluation of the project initiative as another body of knowledge to authenticate the impact that the initiative has done to wards public service delivery and care. The results of the evaluation placed this project worthiness including sustainability and absorbability to other areas and sectors to become one of the best four (4) innovative projects in the country.

Through the initiative, it was evident that majority of the affected were woman, children and the generally socially insufficient population of the community. This therefore meant that we approach a multi-disciplinary care system that will put these vulnerable groups in a more uplifting state. The health care system together with the local and rural development government collaborated to ensure the uplifting of the life of this population. The project team made arrangement that included home visits to this population with the multidisciplinary team to assess and manage the situation as need be including referrals.

i. General health status has very much improved with almost perfect perennial care and good compliance to ARV with a Suppressed and increased CD4 count. New bookings to oncology clinic was done and family complying well with it. ii. No longer defaulting treatment and appointments the BP is now controlled with an improved general health status iii. BP is controlled and stable. The general health condition is improved and fully active. iv. Controlled and stable Blood Pressure. The general health condition is improved and fully active.

The critical stakeholders in this exercise was the community leadership ( Chiefs and the Honourable Councillors) with support from the Village Development Committee (VDC), Village Health Committee (VHC) and Community Home Based Care (CHBC) the business community, all gratefully facilitated the comprehensive baseline assessment of the respective clients all through into their homesteads. The community of Lotsane ward have been quite instrumental in ensuring that the project sees another day. The elderly clientele, both enrolled in the project and those who were just benefitting from CHBC were key in realising the success of this project. Their commitment and cooperation beyond the expectation of the project, hence its sustainability as the relationship was nurtured to another level.

Through this initiative one of the lessons we learned was that the department of health as a single entity is not sufficient to provide the needed support for an individual to sustain self, but other stakeholders and sectors of the society needs to play a part and more especially the individual to insure that they stay afloat in living. The initiative promoted health for the elderly, who seemed to have shown to be the major family bonding structure within our community. Households with an elderly who had poor health and wellness were more affected with poverty and hunger. The initiative was based at taking care of these family bonds. The results of the initiative as earlier alluded showed that good health and wellbeing culminated to one being able to sustain self and people around them.