Country Spotlight: Lesotho

Country Overview

Nearly 25% of the population of Lesotho is living with HIV and HIV/ AIDS is the country’s leading cause of death. Lesotho is suffering from a double epidemic of both HIV and tuberculosis (TB) – it is the second-worst hit country by both diseases in the world. Women are disproportionally affected by the HIV/AIDS epidemic, with prevalence exceeding those of men in almost every age group under 40 years.

Our Work in Lesotho

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), which seeks to end pediatric HIV/ AIDS and enhance maternal, neonatal and child health (MNCH) through implementation of HIV prevention, care and treatment programs, advocacy, and research, began collaborating with Lesotho’s Ministry of Health in 2004 to eliminate the epidemic.

Through leadership from the Government of Lesotho and support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), Lesotho significantly scaled up HIV service access. EGPAF, the leading implementing partner supporting this rapid scale up, has used a district-focused approach to deliver high-quality HIV services. EGPAF provides the Ministry of Health, district health teams and health facilities with support through a refined and tailored technical assistance model. EGPAF currently supports more than 160 sites in 8 districts to implement a comprehensive HIV package of services. This package includes support for provision of HIV counseling and testing, prevention of mother-to-child transmission of HIV (PMTCT) services, adult and pediatric HIV care and treatment, adult and pediatric TB and TB/HIV care and treatment, integrated MNCH and HIV services, reproductive health care (including cervical cancer screening and treatment), nutrition support, community engagement, community-clinic linkages, and strategic information and evaluation. As a key partner to the Ministry of Health, EGPAF also actively participates in six national HIV-related technical working groups and advisory committees to develop informed policies supporting all persons affected by HIV. EGPAF-Lesotho is also dedicated to advancing basic and operations research to strengthen the effectiveness of the global HIV and AIDS response.

 

 

Key Projects in Lesotho

Comprehensive HIV/AIDS Service Expansion Project: The CHASE Project 

(USAID/PEPFAR: 2015 to 2016) EGPAF, in collaboration with Baylor College of Medicine Children’s Foundation-Lesotho and the Lesotho Network of AIDS Service Organizations, is supporting Lesotho’s Ministry of Health and district health teams to provide the comprehensive HIV service package in more than 125 sites in Maseru, Mafeteng, Mokhotlong, Thaba Tseka, Butha Buthe, and Mohale’s Hoek districts. Of these, EGPAF is providing direct site-level services at 83 sites and technical assistance to the rest of the sites to maintain quality services. The package of services includes HIV counseling and testing, PMTCT services, adult and pediatric TB and TB/HIV care and treatment, adult and pediatric HIV care and treatment, integrated MNCH and HIV services, reproductive health (including cervical cancer screening and prevention) services, nutrition support, health systems strengthening, community engagement, community-clinic linkages, and strategic information and evaluation. The overall goal of CHASE is to sustainably reduce HIV transmission and related morbidity and mortality by strengthening coverage of integrated and comprehensive HIV prevention, care, and treatment services in order to reverse Lesotho’s HIV epidemic by the end of 2020. CHASE is made possible by PEPFAR through the United States Agency for International Development (USAID) funding.

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Supporting HIV and TB Response in the Kingdom of Lesotho Through District-Based Comprehensive HIV Prevention, Care and, Treatment Programs and Health Systems Strengthening: The STAR-L Project

(CDC/PEPFAR: 2015-2020) EGPAF, in partnership with Baylor College of Medicine Children’s Foundation-Lesotho and the Lesotho Network of AIDS Service Organizations, supports Lesotho’s Ministry of Health to implement a comprehensive HIV service package in more than 75 sites in Leribe, Berea, Qacha’s Nek, and Quthing districts. Of these, EGPAF is providing direct site-level services in 45 sites in Berea and Leribe based on the PEPFAR/Government of Lesotho prioritization strategy. The goal of STAR-L is to scale-up effective, sustainable, comprehensive HIV and TB/HIV prevention, care and treatment interventions to reduce HIV transmission, morbidity, and mortality. The package of services offered in these health sites under STAR-L includes HIV counseling and testing, PMTCT services, adult and pediatric TB care, adult and pediatric HIV care and treatment, integrated MNCH services and nutrition support, health systems strengthening, community engagement, community-clinic linkages, and SI&E. STAR-L is made possible by PEPFAR through the U.S. Centers for Disease Control and Prevention (CDC) funding.

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Scaling up Provider-Initiated HIV Counseling and Testing (PITC) of Children by Integrating PITC Into Under-5 (U5) Services in Two Districts of Lesotho

(UNICEF: 2014-2015) EGPAF is systematically integrating PITC for infants and children in the U5 setting at 17 sites across two districts of Lesotho to increase the percentage of eligible children provided with HIV testing and counseling and the percentage of eligible children initiated on antiretroviral therapy.

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Publications

EGPAF Country Fact Sheet: Lesotho

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Lesotho Program 2013 Annual Report Download PDF download

Pregnant and Postpartum Women’s Experiences and Perspectives on the Acceptability and Feasibility of Copackaged Medicine for Antenatal Care and PMTCT in Lesotho

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