The MSH/BLC project is aligned to contribute towards two Partnership Framework goals: to reduce morbidity and mortality and provide essential support to Basotho people living with or affected by HIV and AIDS through expanding access to high quality treatment, care, and OVC services by 2014. The project reaches 47,000 OVC and care givers in five districts.The project goals are: 1) technical and institutional systems strengthened and capacity built in Lesotho; 2) community-based outreach program developed and strengthened that can provide needed community-based care and support services and effective tracking and referrals to clinical settings for people infected with and affected by HIV/AIDS; 3) a mechanism developed and strengthened for providing needed community-based care for OVC and; 4) national policy and guidelines strengthened for comprehensive community-based care and a supportive environment for OVC affected by HIV/AIDS.To ensure sustainability of program activities, MSH/BLC emphasizes capacity strengthening and empowerment of communities and local organizations. The project plans a phase out approach to exit from a community, resulting in minimizing the need for external inputs, strengthening the community capacity and transferring responsibilities as quickly as possible.Vehicle needs: BLC project is being implemented in the lowlands, foothills, Senqu river valley, and mountains Mohales Hoek, Qachas Nek, and Thaba Tseka characterized by limited communication and transport infrastructure. Transport and communication between communities is almost exclusively limited to Four-wheel drive vehicle, foot or pony since existing paths are often too narrow or steep for even a motorcycle to pass.

The BLC project, has partnered with LENASO, LENEPWHA and CCJP to support provision of community base care and support services for adults and adolescents predominantly women who are the caregivers. These include socio-economic security; food security and nutrition; care and support; health and; psycho-social support.The project implements activities in five districts: Mohales Hoek, Quthing, Qachas Nek, Mokhotlong, and Thaba Tseka. BLC contributes to the Partnership Framework Goal: to reduce morbidity and mortality and provide essential support to Basotho people living with or affected by HIV and AIDS through expanding access to high quality treatment, care, and OVC services by 2014. The program contributes to the following strategic options of Lesotho National HIV/AIDS strategic plan 2006-2011: Increase access of OVC households to treatment, care and support services, develop standardized basic support package for OVC, and establish community based mechanisms for provision of social and psychological care for use by community home-based care givers.BLC project ensures that community referral systems are strengthened to provide a holistic continuum of care and support. Services include: Social welfare services, Child protection, nutrition, spiritual and pastoral counseling and clinical services to PLWHA who provide care to children. The program maps types of community-based care services, and the delivery points and shares the information with community groups and other stakeholders. The program will develop referral tools. The BLC project facilitates referrals for PLWHA to clinical and community-based care services. This includes home-based care, palliative care, stigma reduction, HIV prevention, positive living, livelihood opportunities, legal rights to prepare for the future of the children and/or nutritional support programs, and adherence to treatment.BLC has developed monitoring tools to be used by sub-grantees providing care and support for PLWHA. The project trains CBO staff in M&E to collect field level data for monthly activity reports to track activities and output level data. Detailed activities for community based nutrition activities are outlined in the FY12 NACS integration plan.

Management Sciences for Health/Building Local Capacity for delivery of HIV Services in Southern Africa (BLC) project; International NGOThe project goals are: 1) technical and institutional systems strengthened and capacity built in Lesotho; 2) community-based outreach program developed and strengthened that can provide needed community-based care and support services and effective tracking and referrals to clinical settings for people infected with and affected by HIV/AIDS; 3) a mechanism developed and strengthened for providing needed community-based care for OVC and; 4) national policy and guidelines strengthened for comprehensive community-based care and a supportive environment for OVC affected by HIV/AIDS.Key Strategies:Capacity strengthening of GOL systems and local CBOs for OVC coordination and service delivery: BLC is strengthening the Social Welfare workforce through training and mentoring of senior staff in leadership and management;Invest in pre-service and in-service education through working with academic institutions to mainstream leadership and management concepts and practical problem-solving techniques into the Social Welfare curricula.Sub-granting and capacity building of local organizations to expand quality service delivery of OVC and community based care services including training of community workers in nutrition assessments and counseling for PMTCT.Pediatric care and support: The program will strengthen two-way referrals between health facilities and communities and implement community based activities for HIV exposed infants. This will include nutrition assessments, counseling and support.Dissemination of relevant legislations and legal frameworks related to childrens rights and welfare.Challenges: This is a new partner so program challenges were associated with start-up, e.g. getting the MOU with the Department of Social Welfare signed. This has since been achieved.

MSH subgrantee, IHM, will build SI capacity among key stakeholders via strategic engagements of partners at national, district, & community level, & specifically for the Directorate of Planning (MOHSW), where M&E is located. IHMs goals & objectives are based on the MOHSW NSP, HMIS Strategy, & USGs PFIP. IHM will provide technical assistance, training, & mentoring. Specifically, IHM will:

Advocate that GOL fill M&E staffing gaps & retain current staff & lobby for inclusion of M&E curricula in medical training institutions;Conduct 2 basic M&E training for data clerks, district Information officers, & other staff;Train 60 people on routine DQA for HIS staff;Adapt a training curriculum on data demand & use, to train program managers & other end users;Provide targeted TA to communities & districts & create a tracking system for M&E trainees.

IHM will also support community-based M&E initiatives, like LOMSHA, & support the restructured NAC. As needed, IHM will provide SI TA to CSOs (e.g., LENASO).

To enhance data quality & its use, IHM will provide supportive supervision at district & national levels. To ensure basic data quality criteria & monitoring of quality assurance & improvement procedures, IHM will continue to use the RDQA & the PRISM tools to identify key SI interventions for communities, districts, & centrally. Additionally, IHM will acquire 2 HMIS staff to support MOHSW data collation, verification, analysis & reporting. They will support the data quality review processes at districts & centrally. To ensure greater coverage, the project will leverage MOHSWs Global Fund activity to conduct data quality audits & provide TA for this activity.

IHM will also:Develop SOPs for reporting at community & district level to ensure the production of quality data;Conduct DQAs in a sample of facilities & support the development & implementation of DQA plans;Conduct basic training in data analysis & report writing to ensure that data clerks & M&E officers can analyze & understand their data;Support the institutionalization of the data quarterly review process by providing technical support to at least 2 rounds of district quarterly reviews annually.