Lesotho

In 2022, the NH will transition to a new phase of New Horizons 2.0, EGPAF as a key implementing partner along with other current partners including Partnership for Supply Chain Management, Imperial Logistics, CIPHER Paediatric HIV Matters, Right to Care, and the Paediatric European Network for Treatment of AIDS.

In 2021, the NH will transition to a new phase of New Horizons 2.0, EGPAF as a key implementing partner along with other current partners including Partnership for Supply Chain Management, Imperial Logistics, CIPHER Paediatric HIV Matters, Right to Care, and the Paediatric European Network for Treatment of AIDS.

The Accelerating Patient Access to Optimal Antiretrovirals and Relevant Health Products via a sub-agreement with CHAI (Project Optimal) is a follow-up to the Unitaid-funded SPAAN Project (August 2019 – July 2020). SPAAN streamlined and accelerated the introduction of new, child-friendly ARV formulations by focusing on plans for solid formulations of LPV/r and the DTG 50 mg tablet, as well as future plans to introduce DTG dispersible formulations. Building on the success of that project, Project Optimal aims to (1) streamline and accelerate the transition to WHO-recommended optimal pediatric ARV formulations, focusing on DTG 10mg dispersible tablets and LPV/r solid formulation’s, (2) strengthen information, supply chain, service delivery, and pharmacovigilance systems for pediatric ARVs, and (3) strengthen differentiated service delivery models of care for children, focusing on multi-month dispensing (MMD) and facility-based, family-centered models that include children < 5 years of age.

Funded by CHAI

Unitaid is funding the CaP TB project, which aims to improve TB screening in children, and accelerate access to TB diagnosis and new child-friendly treatments for both active and latent TB - a disease which affects one million children. This project, launched in 2017, will bring new child-friendly TB drug formulations and improved diagnostic technology to 10 countries.

With funding from Johnson & Johnson and in partnership with the Lesotho MOH, EGPAF provides technical assistance on pediatric second- and third-line ART access. This project, which ran in Uganda from 2018 to 2020, aims to improve sustainable ART service delivery for children and confront challenges faced by adolescents around disclosure, adherence, and psychosocial support. The heart of the Collaborative is a darunavir/etravirine donation program, which increases the availability of third-line pediatric and adult ART for children and adolescents failing second-line treatment.

The Virtual Case Management project put structures in place in 37 facilities across four districts (Mafeteng, Maseru, Mohale’s Hoek, and Thaba Tseka) for virtual case management for CLHIV, a critical component of programming to improve treatment outcomes despite immediate and anticipated longer-term interruptions at facilities.

EGPAF, in collaboration with Baylor College of Medicine Children’s Foundation-Lesotho and the Lesotho Network of AIDS Service Organizations, supported 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

The aim of this research study was to describe the current EID process, early MTCT infection rates, and the PMTCT services received by HIV-positive mothers and their infants who had an HIV test at six to eight weeks in selected sites in Lesotho in order to determine necessary steps to improve early initiation of HIV-positive infants into antiretroviral (ARV) treatment programs.

The program aimed to address an identified gap in health services and accelerate the elimination of mother-to-child transmission (MTCT) of HIV by developing the management capacity of African healthcare leaders.

While many factors affecting antenatal clinic attendance have been documented, the aim of this study was to explore the impact of a positive or negative HIV test result at a woman's first antenatal clinic visit on her subsequent clinic attendance, for which existing research was limited.

This project’s goal was to conduct operations research on ACF and IPT in the antenatal clinic context by assessing the progressive roll-out of ACF among HIV-positive and HIV-negative pregnant women and measuring the uptake of IPT among women in whom active TB has been excluded.

With support from UNICEF, EGPAF provided targeted technical assistance to improve systems for monitoring and evaluation (M&E) of PMTCT programs in Cameroon, Lesotho, and Zambia. In Lesotho, EGPAF supported the MOH and other stakeholders by training health care staff on standard operating procedures for antenatal care and labor and delivery registers. In addition, EGPAF worked with Lesotho’s MOH to strengthen the timely and accurate transfer of PMTCT data from the districts to the central level through the use of 3G internet technology.

EGPAF’s activities under this project aimed to improve sexual and reproductive health outcomes for women across all 10 districts of Lesotho.

The goal of this UNICEF-funded project was to provide integrated health services and make them accessible through community outreach.

With funding from UNICEF, EGPAF supported the MOH to improve the quality of services offered to pregnant women by integrating PMTCT into maternal, neonatal, and child health services and scaling up pediatric HIV care and treatment.

Breastfeeding is a direct route of HIV transmission from HIV-infected mothers to infants, yet there is no standardized indicator on the infant feeding practices of HIV-exposed infants. EGPAF received funding from the World Health Organization to conduct a pilot evaluation of infant feeding indicators within the context of maternal, neonatal, and child health postnatal services in select sites in Lesotho.

The Mother-Baby Pack (MBP) is a take-home pre-packaged medicine pack to prevent mother-to-child transmission of HIV. With support from UNICEF, EGPAF conducted an evaluation of Lesotho’s MBP program to determine the feasibility, acceptability, and lessons learned through use of the packs and to identify barriers or potential harms associated with their use. Results from the MBP evaluation will have significant implications for the PMTCT of HIV program in Lesotho as well as globally, as other countries consider implementation of this innovative approach for PMTCT drug distribution.

In April 2013, Lesotho’s MOH initiated a policy change to support the implementation of lifelong ART for all HIV-positive pregnant women nationwide (Option B+). To improve quality service delivery of PMTCT Option B+ in the district of Thaba Tseka, EGPAF provided onsite training to 183 healthcare workers from August-September 2013.

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.

This USAID/PEPFAR-funded project, led by Population Services International (PSI), sought to reduce HIV incidence among youth and adults by increasing the adoption of protective behaviors and supporting healthy social norms.

Due to the stigma attached to adolescent sexuality, there are gaps in accessing and providing quality adolescent-friendly reproductive health services (AFRHS) at health facilities.

By project end, there were significant improvements in key indicators, including more HIV-exposed infants tested within eight weeks of birth; more HIV-exposed infants that tested positive receiving their results within eight weeks of testing; and more HIV-exposed infants and young children (IYC) that tested positive being initiated on ART.

This research study, conducted with medical diagnostics company Cepheid, is one of two in Lesotho. EGPAF is assisting with the field-testing of an innovative HIV test using small blood samples.

CTA significantly contributed to national PMTCT achievements. EGPAF's work in Lesotho was based around four areas: expanding coverage of HIV/AIDS services; ensuring high-quality services; building community support for program sustainability; and providing support at the national level.

This project aimed to prevent the spread of HIV and mitigate the impact of AIDS among orphans and vulnerable children

The Strengthening Clinical Services (SCS) Project is made possible through support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Agency for International Development (USAID). Under SCS, EGPAF supports Lesotho’s MOH to provide a comprehensive HIV service package in more than 140 sites. In 2011, Lesotho achieved the first of its primary SCS goals: scaling up PMTCT services to all public and private facilities nationwide. EGPAF is working to establish universal access to adult and pediatric HIV/AIDS care services and 90% facility coverage for adult and pediatric ART services by 2015.

As the MOH’s key implementing partner for HIV/AIDS clinical services in Lesotho, EGPAF also plays a strong technical assistance role, nationally. EGPAF participates in all relevant national technical working groups and technical advisory committees, and serves as co-lead of the PMTCT national technical working group. EGPAF supports the MOH by leading and participating in the drafting and revision of national guidelines, training materials, and policies.

EGPAF has supported the MOH to successfully integrate HIV/AIDS services with maternal, neonatal, and child health services in health facilities. EGPAF also supported the creation of a national cervical cancer screening program at the Senkatana Center at Botshabello Hospital.

Through Population Council funding, EGPAF is leading the Integrated Management Team to Improve Maternal-Child Outcomes (IMPROVE) Study, which is a prospective, two-arm cluster-randomized study with facilities randomized to receive either the IMPROVE intervention or routine services offering the national standard of care.

AIDSFree is a five-year U.S. Agency for International Development-funded cooperative agreement led by JSI Research & Training Institute, Inc., with partners Abt Associates, Inc., EnCompass LLC, IMA World Health, the International HIV/AIDS Alliance, Jhpiego Corporation, and PATH

With U.S. Centers for Disease Control and Prevention funding, EGPAF’s STAR-L project supports Lesotho’s Ministry of Health (MOH) to implement a comprehensive package of HIV services in four districts of Lesotho (Leribe, Berea, Quthing, and Qacha’s Nek) at 64 health facilities.