The Oregon State University Botswana Global Health Internship Program, under the leadership of Dr. Sunil Khama, offers students an opportunity to work as part of a team of interns and professors on projects related to understanding local cultural practices and beliefs, the impact of infrastructure on everyday life and health, education and health infrastructure and services, community food and nutrition, in-clinic and outreach services provided by the local community clinic and health outposts, and related topics. More information about the internship program and its activities is available online.

The Botswana Global Health Program promotes community-based research projects by faculty and graduate students. The projects broadly focus on health, education, tech literacy, self-efficacy, business development skills, financial independence, inclusion, leadership through sports, and youth development. Since its beginning, the Botswana Global Health Program has developed an innovative community-based participatory research and intervention strategy that promotes Sustainable Community Partnership and Empowerment (SCOPE). The program has initiated several community-based projects in Maunatlala – a rural village located in the central region of Botswana. These projects represent the research interest and activities of faculty and graduate students and provide opportunities for student interns to learn how to work in a cross-cultural community-based setting. All of the projects initiated by the Botswana Global Health Program have the support of the local communities, the Ministry of Health and Wellness and the Ministry of Youth Empowerment, Sport, and Culture Development. Both ministries provide expert advice and logistical support for our work and assist in the broader dissemination of programming and sustainability. Below is a brief overview of the progression of the current projects.

1. Using School-Based and Home-Based Education to Promote Sexual and Reproductive Health. With a total population of 2.3 million, Botswana has the fourth-highest HIV prevalence (20.3%) in the world, despite the provision of universal free ART to people living with HIV. As a result of our work in Botswana since summer 2018, we learned that youth, especially in the 10-17 age group have limited opportunities to learn about sexual and reproductive health issues. This limitation makes them vulnerable to contracting a sexually transmitted infection, unintended pregnancies, contracting HIV, and experiencing gender-based violence. In 2018 and 2019, we worked with a diverse group of stakeholders, including youth groups, schoolteachers, clinic staff, and students to develop a comprehensive sexual and reproductive education program for students in the local Junior High School and their parents. We plan to implement and evaluate the program beginning in summer 2022.

• Inclusive Social Club/Mainstreaming Disability. Several individuals in Maunatlala are affected by mental or physical disabilities. However, they are largely underrepresented in the community. This lack of representation may adversely impact the opportunities of those with disabilities to receive proper education, quality healthcare, or positive social interaction. Building on the needs assessment that was carried out by the Botswana program interns in 2018, we evaluated the level of services offered to individuals with disabilities in the Masupe Primary School’s Special Education program and the Maunatlala Clinic. We also conducted in-depth interviews and focus group discussions to learn about the perceptions and attitudes of community members towards disability. Finally, we engaged diverse stakeholders to develop a comprehensive plan to effectively address the needs of persons with disabilities. This program provides afterschool activities for children led by community youth leaders and promotes healthy relationship building, self-efficacy, self-image, and inclusion of children with disabilities. Older youth leaders serve as mentors. The program helps children cultivate essential life skills and develop positive social and emotional skills. We plan to also provide family learning opportunities. The program instills in youth the values, ideas, and practices of leadership, community service, self-efficacy, and inclusion.

• Brighter Kids Program. This afterschool program creates a safe, friendly learning environment for children (5-12 years old). Program activities include structured and unstructured reading and learning, arts and crafts, computer skills, structured physical activities, excursions, and game nights. The program uses games and toys to help children sharpen their learning skills, promote critical thinking, and develop intellectually, physically, and emotionally.

• Alcohol-Free Village. Several community members, youth leaders, and community leaders identified alcohol/substance abuse as a serious social problem in Maunatlala. As the pastime usage of alcohol has risen, along with the popularity of the local bars, many social problems have arisen concurrently including theft, violence, and negative health behaviors generally attributable to drinking. Youth have been identified specifically as heavy users of alcohol, largely due to both high rates of unemployment and limited social outlets within the community. To address this issue, we carried out a community needs assessment to better understand the current situation and develop a more comprehensive intervention plan to address this social problem. We are currently developing an innovative community-based and community-supported alcohol abuse prevention program. The program will be implemented and evaluated beginning in summer 2022.

• Preventing Gender-Based Violence/Intimate Partner Violence. Nearly 67 percent of women in Botswana have experienced some form of gender-based violence (GBV) in their lifetime. These include both partner and non-partner violence. Nearly 44 percent of men in Botswana admit to perpetrating violence against women. Based on our initial assessment, several women in Maunatlala have reported experiencing intimate partner violence primarily due to alcohol and drug use, economic reasons, and relationship factors. No formal mechanisms are available to women for reporting instances of GBV or intimate partner violence. With support from community leaders and government-appointed social workers in Maunatlala, we plan to conduct a household survey and target focus group discussions to better understand the problem of gender-based violence in the community and develop community-led GBV prevention programs.