Lesotho

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Equity in health has been a cornerstone of Jhpiego’s work since 2008.

  • More than 121,000 Basotho have learned their HIV status through Jhpiego-led initiatives, and over 209,000 men have received voluntary medical male circumcision services, thereby benefiting from this procedure’s protective effect against HIV infection.
  • Jhpiego pioneered the first-ever integrated, comprehensive, nurse-led male clinic, which received over 18,000 patient visits in the first two years. The clinic, which provides client-centered, male-friendly health services and improves male health-seeking behaviors, has been endorsed by the Ministry of Health and is being replicated at 13 primary health care clinics.
  • Jhpiego supported the Lesotho Nursing Council to introduce task shifting for nurse practitioners to establish and implement a sustainable, nurse-led HIV/AIDS response. This includes nurse-initiated and nurse-managed antiretroviral therapy services for people living with HIV, thereby reducing the burden on doctors so they can focus on more advanced care needs.
  • Jhpiego is supporting the Ministry of Health to provide pre-exposure prophylaxis and other combination prevention services to more than 13,000 people at high risk of contracting HIV, primarily adolescent girls and young women.

Our Work in Lesotho

With funding from the U.S. Agency for International Development (USAID), Jhpiego is working in select countries, including Lesotho, to address the COVID-19 pandemic. In Lesotho, RISE will support the Ministry of Health to support two inter-related pillars of the COVID-19 response: 1) case management to set up and maintain designated COVID-19 treatment centers, and scale-up of case management and basic respiratory care at the remaining 15 hospitals countrywide; and 2) context-specific risk communication with a focus on health care workers. RISE is a five-year global project—funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and USAID—that works with countries to achieve a shared vision of attaining and maintaining epidemic control, with stronger local partners capable of managing and achieving results through sustainable, self-reliant and resilient health systems. The project is led by Jhpiego with the following partners: ICAP at Columbia University, Management Sciences for Health, Anova, BAO Systems, Johns Hopkins University Center for Public Health and Human Rights, and Mann Global Health.

The Technical Support to Enhance HIV/AIDS Prevention and Opportunities in Nursing Education (TSEPO, or “hope” in Sesotho) Project is funded by the U.S. Agency for International Development. Jhpiego is strengthening the Government of Lesotho’s capacity to respond to national priorities in health and HIV/AIDS and to contribute to the national target of reducing the number of new HIV infections. Specifically, Jhpiego is supporting the Ministry of Health to implement voluntary medical male circumcision (VMMC) and early infant male circumcision (EIMC) services for HIV prevention, with a focus on providing services at six fixed sites, seven private-practitioner sites and 110 outreach sites. Jhpiego is also strengthening nursing education by expanding the primary health care clinical placement program at all six nursing schools and by working with the Lesotho Nursing Council to strengthen regulatory capacity, including piloting VMMC/EIMC task sharing to nurses. In addition, under the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) Initiative, Jhpiego is supporting the introduction of pre-exposure prophylaxis (PrEP) among high-risk populations through a core package of client- and community-centered health services with strong linkages to care and treatment. Peer educators—who are adolescent girls and young women, female sex workers and men having sex with men—support targeted mobilization among their peers and provide continuation support to people newly initiated on PrEP. PrEP is issued as a one-stop shop model of services for HIV prevention and sexually transmitted infections, as well as family planning services for young women. Other partners for this program include the Lesotho Planned Parenthood Association and Lesotho Network of AIDS Services Organizations, among others.

With funding from the Global Fund for AIDS, TB and Malaria, Jhpiego is supporting programs for TB and HIV treatment, support and care in Lesotho. The objectives of the project are to: 1) improve the quality of TB/HIV care by revitalizing a clinical mentorship program for HIV care and treatment and TB at 20 health care facilities in five districts, and establishing community-based antiretroviral groups to support improved adherence and retention in care; 2) build the capacity of nurse-midwives to provide voluntary medical male circumcision and community health advocates to mobilize and refer potential clients for services; 3) conduct community-based TB screening campaigns among school children, the elderly and factory workers to intensify TB case finding; 4) support improved community involvement in case detection and adherence and retention in care; 5) train and coordinate volunteer health workers to support community-based TB control activities; and 6) strengthen the community-to-facility referral system and implement digital health solutions to reduce turnaround times for communicating results.

Since 2020, the Global Fund is also supporting Jhpiego to contribute to knowledge of HIV status, such that 95% of Basotho living with HIV will know their status by 2023 through differentiated community-based HIV testing services (HTS), prompt linkage to HIV care and treatment and linkage to HIV prevention services. The project is: 1) using human-centered design methodologies to develop tailored strategies for reaching at least 126,000 individuals from target populations with HTS demand generation and direct service delivery; 2) offering HTS to at least 105,000 individuals from target populations using novel approaches including HIV self-testing, index testing and assisted partner services; and identifying 5,600 newly diagnosed HIV-positive persons; 3) conducting at least 10 targeted HTS delivery campaigns to reach undiagnosed individuals from target populations; 4) successfully linking 5,600 newly diagnosed HIV-positive persons with HIV care and treatment, and linking HIV-negative persons with HIV prevention services; and 5) improving human resource capacity for testing at all testing sites by training and mentoring providers.