1. Health Professional Training in Human Rights, Ethics, and Law in the Context of Pediatric HIV/AIDS Care in Botswana
Peter Navario, MPH
Associate Director
BroadReach Healthcare
(Formerly HIV Training Coordinator at the Baylor International Pediatric AIDS Initiative)
Kristi Kenyon, MA
PhD Candidate
University of British Columbia
(Formerly Human Rights Research Officer, Botswana Network on Ethics, Law and HIV/AIDS (BONELA))

2. Impetus/Genesis of the Module
Outline
Collaborators
Objectives
Impetus/Genesis of the Module
Training Content and Format
Results and Discussion

3. Botswana Network on Ethics, Law and HIV/AIDS (BONELA)
Collaborators
Botswana - Baylor Children’s Clinical Centre of Excellence/Baylor International Pediatric AIDS Initiative (BIPAI)
Botswana Network on Ethics, Law and HIV/AIDS (BONELA)
KITSO – Botswana National HIV/AIDS Training Program

4. Objectives of the Training:
Advance the Public Health plus Human Rights paradigm
Elucidate the role of human rights, and the absence/presence of legal instruments in place to ensure them
Galvanize a conscious expansion of health professionals’ roles to include advocacy and activism around human rights and legal protection for children
Sensitize health professionals to a driver of the epidemic that falls outside their traditional spheres of expertise and knowledge

5. Parental refusal of medically necessary treatment
Genesis of the Module
Primary Catalyst:
Pediatric health professional questions re: unique challenges associated with treating children:
Parental refusal of medically necessary treatment
Consent for orphaned children
Age of consent
Disclosure
Reporting sexual abuse
Child’s right to know his/her status

6. Contextual Catalysts:
Genesis of the Module
Contextual Catalysts:
Lack of legal protection for HIV-infected individuals
Lack of consensus on the definition of a child and the age of majority
Limited interaction between civil society groups and health care professionals
Children raised outside of the nuclear family or by one parent
Routine Testing

7. Training Content and Format
Single, three hour module within a 13 module, week long comprehensive pediatric HIV/AIDS training course for health professionals
Module facilitated by BONELA, and pediatric nurse or doctor from BIPAI
Format: Didactic, Discussion, Case Scenarios and interactive group work

8. Content: Module Outline
1. Introduction
2. Definition of Concepts
2.1. What are Human Rights?
2.2. What are Ethics?
2.3. What is Law?
2.4 How does the law relate to ethics and human rights?
2.5. What is the difference between law and policy?
2.6 Ethics and law in the medical field
3. Professional Ethics of Medical Practitioners
4. Consent
4.1 What is Informed Consent?
4.2 Consent vs. Assent for Children
4.3. Third Party Consent for Children’s Medical Treatment
4.4 Discussion Points

9. Content: Module Outline
5. Confidentiality and Disclosure
6. Gaps and Weaknesses in the Current Legal Framework
6.1 HIV/AIDS: Lack of Anti-Discrimination Legislation
6.2 The Children’s Act
6.3 General Problems with the Law
7. Conclusions
7.1 General Conclusions
7.2 Roles and Responsibilities of Health Care Professionals

10. Perspectives: Doctor, Mother, Grandmother Case Description:
Content: Scenarios
Perspectives: Doctor, Mother, Grandmother
Case Description:
4 y.o HIV-infected boy on ART
Lives with grandmother who is unaware of his status
Biological mother is afraid to tell grandmother and ask to assist with administering ARVs
Doctor is frustrated with the boy’s lack of adherence

11. Results and Discussion
More than 173 health professionals trained in the first year
Consistently rated as being rated as one of the most valuable modules
No formal audit to date to assess impact in the workplace

12. Results and Discussion
Lack of knowledge in this area and very favorable feedback indicate that this module fills a critical need
The module can be easily modified or expanded: adolescent care; training for legal and political professionals
Interdisciplinary intervention to address interdependent drivers of the epidemic
Promotion of a rights respective health care environment should be central to health promotion efforts

13. Baylor International Pediatric AIDS Initiative (BIPAI) – BBCCCOE
Thank you
Baylor International Pediatric AIDS Initiative (BIPAI) – BBCCCOE
Professor Gabriel Anabwani
Clinic Health Professionals
BONELA
Kristi Kenyon
Christine Stegling
Elizabeth Maxwell
Botswana Ministry of Health - KITSO
Dr. Patson Mazonde

14. For further information:
BIPAI: Mr. Segolame Ramotlhwa
BONELA: Mrs. Christine Stegling