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; and, the human resource capacity for HIV service delivery is improved and increased in 3 key areas (retention, training and quality improvement) by 2014. The project reaches 47,000 OVC and care givers in five districts (Quthing, Mohale's Hoek, Qacha's Nek, Mokhotlong, and Thaba Tseka). The project goals are: 1) technical and institutional systems strengthened and capacity built in Lesotho; 2) community-based outreach program developed 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. The MSH/BLC capacity building and sub-granting strategy is focused on ensuring that program activities are fully owned by local entities. Specifically, BLC supports local community and government structures; Strengthens government systems in leadership and coordination. Vehicle needs 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. For timely and effective implementation and monitoring of the project activities, the BLC project will require robust and reliable four wheel drive vehicle.

MCHIP continue to support HRH by strengthening training and improving upon CHAL schools through equipment and refurbishments. Following on FY11, MCHIP will assess and provide renovation and short-term improvements in infrastructure to existing dormitory space to increase the total number of nursing students able to be accommodated and with that the total number of health workers in Lesotho. Through a sub-contract, a well established building contractor will be hired following a competitively bidding process and hired to carry out the renovations.

MCHIP will expand on clinical training focused capacity building to develop the skills of those who are or are positioned to be clinical preceptors as well as tutors/lecturers to the clinical teaching Training for educators and preceptors will also integrate TB/HIV into didactic and clinical training. MCHIPs Technical Advisor will conduct supportive supervision visits quarterly. Provide models, demonstration materials, and other resources in cooperation with other PSE partners and orientate faculty and preceptors to the use of skills labs, through simulation workshops.

MCHIP will also assess infrastructure and education at health center practical sites, including standards of practice relative to the curriculum content and government priorities (includes assessing for integration of HIV/AIDS, TB, and other country health priorities). The project will engage relevant stakeholders to determine feasibility of clinical teaching in high-volume clinics, with development of infrastructure for student and faculty accommodation on-site so as to explore feasibility of student placement at primary health care facilities to ensure adequate clinical experience in country health priorities at a time of decentralization.

The project will continue technical and financial support to Lesotho Nursing Council to increase functional capacity to implement their Operational Plan, strategic plan development, curriculum review, nursing database entry completion and development of licensing system guidelines. The project will assist in stakeholder workshops in cooperation with HRAA partners, and continue to facilitate mentorship support by other Councils in the region.

MCHIP will continue to support the MOHSW and the MC Technical Working Group (TWG) to finalize the development of VMMC guidelines, strategy, and training materials for Lesotho, inclusive of EIMC, as part of the MOHSWs larger Prevention Program. As part of this MCHIP introduce and adapt a VMMC operational guide for Lesotho and support the development of framework and service delivery model to scale up adult VMMC.

MCHIPs Lesotho based VMMC Technical Advisor will provide direct support and oversight of MCHIPs activities, with support from Jhpiegos regional and headquarters VMMC technical experts. Geographic coverage will be national as policies and guidelines created are to cover the country. Facilities have not yet been agreed upon with the MOHSW so a clear geographic area for service delivery cannot yet be identified. Quality assurance standards will be developed in accordance with international standards and guidelines and facility staff oriented. A system of provider certification will also be established. Jhpiego will meet with facilities to discuss the project and develop shared expectations and working assumptions in MOUs with the District. MCHIP will procure supplies and equipment necessary for services for agreed upon sites, including devices, surgical instruments, gloves, sutures, local anesthesia, and other consumables. MCHIP will continue to work with communications organizations such as PSI, and together with them as well as the MOHSW and the TWG to develop IEC materials.

Up to three trainings for 16 service providers each are planned. MCHIP will also aim to conduct three five-day MC counseling training course for up 18 participants each. This program builds upon Jhpiegos competency based clinical training approach, and the WHO/UNAIDS/Jhpiego learning package in Male Circumcision under Local Anesthesia, and provides a unique opportunity to early infant circumcision which the MOHSW is strongly in favor of rolling out. MCHIP will provide supportive supervision and follow-up for newly trained MC service providers, health educators and counselors in their workplaces. Upon MOHSW endorsement task sharing and task shifting to scale up VMMC will be piloted.