Gearing Up for Option B+: Health Worker Training in Lesotho

The 2013 WHO guidelines present new roles and potential challenges for healthcare workers in Lesotho. Read to learn how the Elizabeth Glaser Pediatric AIDS Foundation plans to tackle this problem.

With the third highest HIV/AIDS prevalence in the world, approximately 23 percent of people in Lesotho between the ages of 15 and 49 are HIV-positive.  And even more shocking — more than 25 percent of pregnant women in Lesotho are living with HIV. Without services to prevent these women from transmitting the virus to their unborn babies, approximately 6,000 children per year across the country could become infected with HIV.

But thanks to the support of the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), the Government of Lesotho has made great strides to improve access to health services that prevent vertical transmission of HIV from mothers to their infants. One hundred percent of eligible health facilities are able to offer prevention of mother-to-child transmission (PMTCT) services to HIV-positive pregnant woman as of 2011.

Despite this success, Lesotho continues to struggle with human resource capacity challenges and universal uptake of PMTCT services, including the initiation of HIV-positive pregnant women on antiretroviral therapy (ART). In 2012, four out of 10 pregnant women living with HIV in Lesotho did not receive the necessary medicines to prevent mother-to-child transmission, and an estimated 3,700 new pediatric HIV infections occurred.

On April 1, 2013, the Government of Lesotho began implementing new national PMTCT guidelines, based on the World Health Organization (WHO) recommendation to provide lifelong ART to all HIV-positive pregnant women (Option B+). The goal of Option B+ is to prevent new pediatric HIV infections and improve the health of mothers nationwide.

To prepare clinics for the rollout, EGPAF partnered with UNICEF to offer onsite training for health workers in the Thaba Tseka district in order to increase the proportion of HIV-positive women receiving ART. Throughout August and September 2013, EGPAF provided onsite training to 180 health care workers in 16 health facilities in Thaba Tseka. Pre- and post-test questionnaires were administered, and showed increased knowledge in the new PMTCT guidelines. Across the 16 facilities, the average test score increased by nearly 5 percent after the training was completed.

EGPAF will continue to track progress in Thaba Tseka with regards to the implementation of quality PMTCT Option B+ services and the number of HIV-positive pregnant women receiving ART over time.

You can learn about our work in Lesotho here!

Ashley Thompson is the Country Officer for EGPAF/Lesotho.