June 1, 2020
By Christine Hills
Lesotho, the tiny land-locked country surrounded by South Africa, was hard hit by the HIV epidemic in the early 2000s. As of 2016, it had the second highest rate of infection in the world, with 340,000 people, or 25% of its population, living with HIV.
Partners In Health (PIH) began working in Lesotho in 2006 during the height of the epidemic, at the invitation of the country’s Ministry of Health, supporting HIV care and treatment in seven health clinics. Since then, PIH Lesotho has worked to revitalize primary health care delivery by increasing the number and capacity of staff, improving infrastructure and working to upgrade community health workers.
In July, PWRDF will begin a three-year partnership with PIH Lesotho to provide maternal and newborn care in the catchment area of the Bobete Health Centre to prevent maternal and infant death. The total budget for the project is $320,000 Cdn, and PWRDF is contributing $180,000. PIH has shifted its focus on HIV case identification and treatment to a comprehensive primary health care approach, including maternal and child health and the Government of Lesotho has based its National Health Care Reform initiative on PIH Lesotho’s model of care. PIH is a partner and a technical advisor at the community, district and national levels to reduce child mortality, improve maternal health, and combat HIV and TB through the progressive realization of universal health coverage for comprehensive primary care services. PWRDF and PIH have built a strong relationship over the years, working together in Haiti, Rwanda and Malawi.
“PIH has an excellent reputation and is known to deliver quality programming. I am confident PWRDF will have a similar experience implementing this project in Lesotho,” says PWRDF Development Program Coordinator Jeanine Cudmore.
Mountainous terrain, limited transportation infrastructure and a largely rural population make the delivery of health services extremely challenging in Lesotho, especially maternal and newborn care. Lesotho’s maternal mortality rate is 487 per 100,000 live births, and one in 61 women face a lifetime risk of dying during childbirth. In rural Thaba-Tseka district, 68% of births occur in health facilities, compared to the national rate of 77%. Although antenatal care rates are relatively high at 74%, it is essential that this reach be increased and that all women receive at least four antenatal care visits, especially given the high HIV prevalence rate and the importance of providing prevention of mother to child transmission.
The project will provide maternal and newborn care in the catchment area of the Bobete Health Centre to prevent maternal and infant mortality and includes at least four antenatal care sessions with each pregnant woman and postnatal care for the mothers and their newborns.
Pregnant women will be encouraged to stay at the maternal waiting home in the lead-up to their due date to ensure they deliver safely at the health centre. Moms-to-be will also be tested for HIV. Transmission of the virus from mother to child will be prevented in women who test positive, and newborns who test positive will receive appropriate treatments.
Over the three years of the project, pregnant women will be accompanied to the Bobete Health Centre for antenatal care and provided with infant starter packs to encourage their attendance at antenatal care appointments.
Women who live far away from the facility will be provided with food and lodging, and accompanied to the Health Centre for safe delivery. Emergency obstetric cases will be transported to the hospital.
Nurses and midwives will join the Ministry of Health employee team at the Health Centre. Funds will also be used to provide obstetric care medical supplies and postnatal care visits. Infants will be immunized and those exposed to HIV will be provided with the appropriate care.