SADC Experiences on SRHR and HIV Linkages
11-13 December, 2012
Johannesburg
Lesotho
Health Indicators
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Population = 1.8 Million
Annual growth rate = 1.9%.
The life expectancy at birth = 41.2
The Infant Mortality Rate (IMR) 94/1000
HIV prevalence rate = 23%
HIV prevalence among pregnant women 27%
ANC 1st visit 92%
Focused ANC 70%
Health indicators cont..
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The Maternal Mortality Ratio (MMR) 1155
PMTCT coverage 84%
Facility Delivery 62%
Home delivery 38%
PNC within 48hrs 55%
CPR 47%
Lesotho Policy Background
• Lesotho does not have a specific universal HIV and SRH
linkages and integration policy or strategy.
• Lesotho’s policy response to HIV and SRH is captured in
various independent policy documents.
• SRH and HIV are vertically programmed.
• There has been a mapping exercise of SRH and HIV
tools in 2012 that will inform the review of such
policies.
• Although there is bilateral programming of SRH/HIV,
both invite each other during the development or
review of the policies and budget.
National HIV Policies
• Lesotho National Health and Social Welfare Policy 2011 provides
the national framework for addressing health issues and identifies
HIV, STI,TB; and SRHR/FP as priority health issues.
• National HIV and AIDS Policy 2006 and National HIV and AIDS
Strategic Plan 2006-2011, provide the overall framework for the
country’s HIV response.
• Health Sector Policy on Comprehensive HIV Prevention 2010, aims
to integrate HIV prevention activities into all activities of the
Lesotho health-care system. The policy commits to linkages and
integration of HIV&AIDS with poverty reduction strategies including
a broader focus on SRH.
National SRH policy
• National Reproductive Health Policy 2008 commits to
ensuring the integration of HIV & AIDS into SRH.
• Lesotho National Adolescent Health Policy 2006 aims to
protect the health, development and rights of all
adolescents in Lesotho.
• Adolescents Health Standards –2012 draft document
addresses SRH and HIV in broader manner.
• SRH draft strategic plan- addresses both SRH and HIV
(2011-2016)
SRH Policies Cont..
• Lesotho Obstetric Record (LOR)- integrates ANC,
Delivery, PNC and HIV
• e-MTCT Plan (2011 – 2016) -has integrated MNCH and
HIV.
• ANC, FP, Ca Cx ,STI and PMTCT guidelines- are
integrated
• ANC, delivery and postnatal registers- are integrated
• CHW Training Manual- includes all essential package of
care.
• Patient Tracking Tool- used by CHW to track all lost to
follow clients (HIV infected,TB,ANC etc)
Key challenges
• The
available
policies,
strategies, guidelines and
tools are not fully integrated.
• Donor funding mainly focuses
on HIV alone and do not
accommodate
other
programs e.g. SRH
Way Forward
• MOH is in the phase of reviewing both the
SRH and HIV documents to incorporate the
recommendations of the assessment.
• Although countries feel that having a stand
alone policy for integration is a waste of time
and funds, there is need to have one
integrated policy for SRH and HIV to address
some burning issues.
Conclusion
Bringing SRH and HIV together
will reduce the costs, save
patient time, enhance scarce
human resource and addresses
infrastructural problems.
thank you
KHOTSO PULA
NALA