In FY2012 COP, the following activities will be implemented1) Infection Control Measures: Procure N95 Masks,paper masks,sputum jars, refurbishment of St James Hospital, Mantaonyane to accommodate TB Patient separately from general patients to enhance infection control.2) TB Monitoring and Evaluation: TB/HIV will be supported through procurement of lap top. Strengthening Advocacy, Communication and Social Mobilization (ACSM) nationally will be done through commemoration of World TB day. Activities will include development and dissemination of IEC material according to the current Stop TB Partnership tool kit and support branding of TB messages.3) Site assessment and supportive supervision: In order to help set a baseline for determining the true magnitude of the TB problem in the country, the 2010 external programme review recommended to conduct at least one TB disease prevalence survey in the country before 2015.According to the WHO 2010 report the prevalence of TB is 635/100,000. Information gathered through prevalence survey will assist the programme to design targeted activities with clear knowledge on where to put more efforts. There is also a concern of low notification in other districts like Thaba-Tseka and without the survey it becomes difficult to appreciate that indeed the TB prevalence is declining in such districts.4) Human resource-training: The program will support admin and technical staff to implement the TB-HIV coordination at national and district levels. As part of human resource strengthening, the National TB Program (NTP) plans to send at least two officers to attend IUATLD trainings and conference.

Global Fund / Programmatic Engagement Questions

1. Is the Prime Partner of this mechanism also a Global Fund principal or sub-recipient, and/or does this mechanism support Global Fund grant implementation? Yes2. Is this partner also a Global Fund principal or sub-recipient? Sub Recipient3. What activities does this partner undertake to support global fund implementation or governance?

Budget Code Recipient(s) of Support Approximate Budget Brief Description of ActivitiesHVTB Support for TB/HIV 2802144 Infrastructure support and scalling up access to Quality Community-based integrated MDR/XDR-TB and HIV management and care in Lesotho

In FY2012 COP, the following activities will be implemented1) Infection Control Measures: Procure N95 Masks,paper masks,sputum jars, refurbishment of St James Hospital, Mantaonyane to accommodate TB Patient separately from general patients to enhance infection control.2) TB Monitoring and Evaluation: TB/HIV will be supported through procurement of lap top. Strengthening Advocacy, Communication and Social Mobilization (ACSM) nationally will be done through commemoration of World TB day. Activities will include development and dissemination of IEC material according to the current Stop TB Partnership tool kit and support branding of TB messages.3) Site assessment and supportive supervision: In order to help set a baseline for determining the true magnitude of the TB problem in the country, the 2010 external programme review recommended to conduct at least one TB disease prevalence survey in the country before 2015.According to the WHO 2010 report the prevalence of TB is 635/100,000. Information gathered through prevalence survey will assist the programme to design targeted activities with clear knowledge on where to put more efforts. There is also a concern of low notification in other districts like Thaba-Tseka and without the survey it becomes difficult to appreciate that indeed the TB prevalence is declining in such districts.4) Human resource-training: The program will support admin and technical staff to implement the TB-HIV coordination at national and district levels. As part of human resource strengthening, the National TB Program (NTP) plans to send at least two officers to attend IUATLD trainings and conference

In FY2012, the following activities will be implemented1) Expansion and strengthening the National Quality Assurance Program. To ensure high quality services are being offered by all health facilities providing diagnostics and monitoring services quality assured and tiered laboratory services will be supported. MOHSW will implement the WHO-AFRO Stepwise laboratory accreditation approach in all facilities. The support will include refresher trainings, site assessment and supportive supervision and EQA schemes. The QA Unit will support the preparation and distribution of the HIV Rapid proficiency panels and quality control samples to all 266 facilities twice a year. TB smear microscopy panels will be prepared, distributed and on site assessments will be conducted. Annual Quality Review meetings will be conducted, where all participants will be sharing their achievements, experiences and challenges.2) Strengthen referral test services and scale up EID: Referral of samples has been maintained through courier services and sample transporters. Facilities have benefitted from the installed Toll free line for the speedy access of DNA-PCR results, timely management of exposed infants has been achieved and the activities will be continuing and referral system will be strengthened through courier services. In FY2012, 65% of infants born to HIV-positive women will receive virologic HIV testing (DNA PCR) in the first 2 months of life.3) Equipment maintenance: In order to provide uninterrupted laboratory services, MOHSW will Rapid support equipment maintenance and validation through vendor contract for major laboratory equipment. Procurement of minor equipment will also be provided.4) Procurement of minor equipment and laboratory supplies and inventory management: Laboratory Supply Chain Management will be strengthened to ensure that there is constant supply of reagents/testing kits for PMTCT clients5) Expansion and Strengthen CD4 monitoring: CD4 monitoring services will be available at hard to reach facilities with high workload, six POC analyzers, reagents and consumables will be procured, as CD4 testing is being done by non-laboratory personnel intensive supportive supervision will be conducted. 6) Minor renovation and furnishing with basic equipment will be supported for 5 hospital/health center laboratories. This will improve the workflow laboratory diagnosis and monitoring, biosafety, storage and cold chain system. The health center renovation will ensure the PMTCT lab packages are provided at primary health care level, laboratory services will be established at health centers. This included renovation of facilities and furnishing with minor equipments. .

In FY2012 the following activities will be implemented.1) Two specific surveys will be conducted i.e. the HIV Sentinel Surveillance and Drug Resistance survey. They will assist the ministry to monitor the extent and trends of the national HIV and AIDS Epidemic besides the DHS and also contribute to the overall national strategy of the HIV and AIDS and STI. These surveys have been partially supported through the Global Fund Round 8, Phase 2 year 3. The COP2012 budge will be used to fill the finical gaps required to complete the surveys.2) Support DHMT: will continue mentoring 10 districts to collect, clean, analyze, use and demand data. The formal feedback and data utilization mechanisms through Performance Reviews will be strengthened. All the districts, the central programs and the Health sector will continue to be supported to execute their performance reviews. Four performance review meetings will be held at the district, central and one annual review meeting in which all stakeholders participate. The M&E Unit will continue to sensitize staff working at all levels, including health leaders, on data demand and use concepts emphasizing the potential programmatic benefits of using data for decision making.3) Strengthening institutionalized Routine Data Quality Assurance (RDQA) at district level: Poor data quality limits health leaders at the level ability to use data for evidence-based decision making and has a negative impact on facilities strategic planning activities and their efforts to advocate for resources. To address data quality concerns the M&E Unit is institutionalizing Routine Data Quality at district level. The Unit will conduct one M&E system assessment and continue to mentor RDQA champions at district level and support the 10 districts to carry out data verifications per quarter. The system will be assessed to establish its capacity to manage data and also monitor capacity improvements and performance of the data management and reporting system at the level4. Strengthening Strategic Information (SI) HR capacityThe unit in collaboration with Institute for Health Measurement (IHM) and will facilitate access to regional and in-country M&E training events.The M&E Unit will continue to sensitize staff working at all levels, including health leaders, on data demand and use concepts emphasizing the potential programmatic benefits of using data for decision making.SI seeks to secure four positions to support and ensure functionability as well as sustainability of the integrated HMIS.Two (2) HMIS officers trained in Regional M&E curricula60 data clerks trained in M&E concepts locally; data collection tolls and reporting mechanismsTotal In service training completed is 125

Human resourceThe Ministry of Health will continue support personnel for efficient implementation of cooperative Project programmatic activities towards improved health services. The following positions will be supported with salaries and administrative and technical staff already employed. These include project Manager, Logistics Coordinator, Administrator, administration assistances (2), LIS Focal person, Laboratory Technologists and Data Clecks (10) and 60 M & E data clerks.In FY 20212, there will be a need to strengthen human resource at health centre level-employment of ten (10) lab data clerks will be required to supplement existing staff and task shift activities from the laboratory technologists.The newly developed data ware house requires technical support by these people. There is need to put in place two (2) Information officers and retain some of the key HMIS personnel (3) is very crucial. An addition of one (1) M&E Officer and Two (2) HMIS officers also stems as very essential. These key HIMS personnel ensure proper data management while also strengthening data flow and reporting mechanisms. The MOHSW will support and supervise the 60 data clerks. They will be provided refresher training in basic M&E especially honing down to MOHSW data collection and reporting tools