Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2015 2016 2017 2018

Details for Mechanism ID: 7455
Country/Region: Lesotho
Year: 2012
Main Partner: U.S. Department of Defense
Main Partner Program: NA
Organizational Type: Other USG Agency
Funding Agency: USDOD
Total Funding: $0

In FY2012, DOD/PEPFAR activities supporting Lesotho Defense Force (LDF) will continue the successful collaboration which has been ongoing since 2002. The Lesotho Defense Force has seen tremendous scale up of their HIV/AIDS activities which include interventions to reduce stigma among military members living with HIV as well as military family members who are HIV positive. Military health care workers have been trained to provide home based palliative care for chronically and terminally ill clients. DOD supported the LDF to renovate and upgrade their current laboratory and procured a state of the art equipment, training of LDF nurses for ART, pharmacy training, provision of a mobile clinic for outreach to remote bases and surrounding communities, building of a wellness center which supports integrated care, conducted seropreavalence and risk factors study in the LDF and conducted a stake holders meeting for the dissemination of the results of the study, and implementation of an innovative electronic health record with portability for mobile services. PEPFAR funding has also supported education and sensitization of all ranks and family members on HIV prevention. DOD has also supported peer education, counseling and testing services. In 2012 DOD/PEPPFAR will support continued PMTCT training and provide alternative feeding supplements and training for mothers who choose not to breastfeed, LDF will hold workshops to disseminate the results of the seropreavalence and behavioral study to LDF senior officers and other ranks, support feeding for chronically and terminally ill patients and basic care activities including training to target reduction of stigma and discrimination, palliative care training, procurement of supplies for mobile clinic, training for peer educato

Funding for Care: Orphans and Vulnerable Children (HKID): $0

Care for OVC is a growing concern in the Lesotho Defense Force, funding will support activities that strenghten comminities and families to meet the needs of children and families affected by HIV/AIDS. Activities will include supplementary feeding for malnourished children,hosting technical assistance to enable development of OVC programs in LDF. Based on needs assessment, specific interventions may include training caregivers and providing increased OVC access to education, food, and other supportive services. A number of 11 districts will be targeted for OVC's services and they will receive paediatric support from the Naval medical center. Assessementt and interventions will include participatory approches and program evaluations. This initial focus will determine the numbers and needs of the OVC dependants for service delivery in the Lesotho Defense Force and intergrated service delivery program, with related activities described in the prevention and palliative care sections.

Funding for Care: TB/HIV (HVTB): $0

Lesotho Defense Force will use the funding to continue TB activities that have been ongoing. HIV infected clients will be provided with Antiretrovals {ART] , TB clinical care will continue to be part of a package of comprehensive HIV/AIDS care strategy by improving the infrastructure at the military hospital and also by procurement of equipment for the TB clinic, training military health providers to diagnose, treat and monitor, and report TB progression trends. Preventive cotrimoxazole prophylaxis will continue to be integrated into HV care package for adults and children to encourage prevention and reduce clinical disease. Efforts will be made to ensure that hundred percent of HIV positive adults and children enrolled into care in military sites receive TB screening and treatment and if TB is confirmed patients will be tested for HIV. All TB/ HI/V co-infected adults and children eligible for ART will be automatically enrolled and followed up. TB preventive cotrimoxazole prophylaxis will also be provided to HIV infected adults and children enrolled on care to ensure successful TB prevention. TB exposed children of TB/HIV co-infected adults will be identified, evaluated and provided with appropriate prophylaxis or treatment as indicated by the national guidance for TB management in children. HIV positive children identified will be enrolled on in ART services as part of a familyapproach to TB/HIV services provision and part of efforts to improve the quality of services offered military personnel and their families. These activities support the national plan for TB/HIV and PEPFAR goals to prevent, diagnose and treat patients with both TB and HIV.

Funding for Laboratory Infrastructure (HLAB): $0

Lesotho Defense Force in collaboration with DOD and ministry of health and social welfare have supported the building of a military LAB at the Military Hospital. DOD will support recruitment of a senior LAB technologist in order to ensure that there is a qualified personnel in the LDF LAB to ensure appropriate use of new equipment and provision of quality services and sustainability of services at the military services. As the ART services expand, CD4 testing becomes an important tool for determining clinical eligibility for HAART coupled with other basic laboratory tests for monitoring HIV disease. The LDF has indicated that it is essential to perform CD4 testing as well as other basic monitoring tests within the Military Laboratory in order to ensure effective and sustainable ART provision within the Military Health delivery system. Therefore DOD will procure on-site CD4 machines ( PIMER). Efforts will be made to upgrade the LDF laboratory to provide laboratory diagnosis of HIV, immune function and opportunistic infections, and hematological status, on-site training of LDF laboratory personnel will increase the number of technicians in the Military

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $0

"The Lesotho Defense Force will increase access to PMTCT services to military personnel and their families. Services also target other uniformed services. DOD will provide technical assistance to the LDF for delivery of quality, integrated PMTCT services within the platform of MNCH services provided at the hospital. The LDF will offer a standard package of PMTCT services as defined by WHO guidelines, contributing to the achievement of goals defined in the Lesotho PMTCT Acceleration plan and the National Plan for the Elimination of MTCT and Pediatric HIV. Services include CT with informed consent, ARV prophylaxis using combination regimens and HAART for eligible women, counseling, support, referral for family planning, MNCH services, follow-up of HIV-exposed infants for referral to appropriate services, and early infant diagnosis.

While the LDF currently does not have an accurate unit cost per patient, LDF will be included in a comprehensive costing exercise to be conducted with Acceleration funds.

In order to increase male involvement LDF will support couples and family-centered counseling and testing. PEPFAR Lesotho is currently developing a gender strategy which will help to strengthen interventions in this area. Although LDF has limited funding for care and support and OVC activities, LDF will ensure access to a comprehensive network of services for PMTCT clients and their families by linking with PEPFAR partners which have more substantial funds in these technical areas.Mothers to Mothers will provide health education for clients to increase patient involvement and community participation in PMTCT services. In FY2011 LDF health care workers received training in prevention for PLHIV, which will also be integrated in the standard package of services provided to clients. In FY 2011 LDF personnel participated in MEASURE Evaluation training in order to improve the capacity of the LDF to routinely collect data. M&E continues to be a challenge for the LDF. With support from the lead SI PEPFAR partner, LDF facilities will receive technical support and training to improve the quality of data and monitor quality of services."

Subpartners Total: $0
Lesotho Department of Defense: NA
Key Issues Identified in Mechanism
Addressing male norms and behaviors
Increasing gender equity in HIV/AIDS activities and services
Child Survival Activities
Military Populations
Mobile Populations
Safe Motherhood
Tuberculosis
Family Planning