In the small, landlocked nation of Lesotho, in southern Africa, the challenges to providing high-quality health care can be as tall as the mountains.
Many of Lesotho’s 2.2 million people live in remote villages that are hours away from the nearest health facility. They take long treks or costly taxi rides to access care, often traveling over steep slopes, across rough terrain and through harsh weather, even snow, in the only country in the world with an elevation entirely above 1,000 meters.
Nonetheless, a sweeping health reform is bringing transformative change across Lesotho. Partners In Health, known locally as Bo-mphato Litsebeletsong Tsa Bophelo, is working with the government to combat some of the world’s highest rates of HIV and tuberculosis, vastly improve maternal and child health, and reshape how care is delivered.
We've worked in Lesotho since 2006, when the government invited us to support its response to the HIV epidemic. One year later, Lesotho’s Ministry of Health and PIH launched a program to bring HIV care to more than 90,000 people served by seven mountain clinics, in the most remote areas of the country. The program has since enrolled thousands of people in long-term HIV treatment.
PIH also is helping the Ministry of Health fight TB. The country’s first national TB program began in 2007 and is based at the PIH-supported Botšabelo Hospital, in the capital city of Maseru. Botšabelo is the country’s only facility for the treatment of multidrug-resistant tuberculosis, a severe strain of TB, and is the hub of a national TB outreach program.
The multi-year success of the HIV and TB programs helped build a foundation for a comprehensive reform of Lesotho's health system. That reform began in 2014, with PIH as the government’s primary technical advisor. The reform supports more than 70 health centers across four districts, and reaches about 40 percent of Lesotho’s population. Work is underway to scale the reform nationally. A primary focus is maternal and child health, with improvements such as maternal waiting homes at every health center. The waiting homes give expectant mothers a safe place to stay before birth, so they are near care when labor begins. Newborns are then given free checkups, immunizations and care through childhood, to make sure families start healthy and stay healthy.
The foundation of PIH’s work in Lesotho is a vast network of community health workers, who visit families and neighbors in their homes to provide support and access to care. They are vital to PIH’s goal, which is nothing short of making that access universal in this beautiful country known as the Mountain Kingdom.