Building Local Capacity for Delivery of HIV Services in Southern Africa: Our Impact

 {Photo credit: BLC staff/MSH.}Chief Motleleng of Thabang village shares a book with his four-year-old grandson, Tsoanelo.Photo credit: BLC staff/MSH.

Lesotho is the only independent state in the world that lies entirely above 1,000 meters, and Mokhotlong is the highest of the country’s ten districts. Mokhotlong’s extreme climate and terrain pose significant challenges to children’s nutrition, development, and well-being. Rugged mountains, some impassible by vehicle, and frequent snow cover during the winter months limit access to health services, education, and a balanced diet.

 {Photo credit: AAM}Manuel, an AAM activist, conducts a sensitization session in Sambizanga district, Luanda.Photo credit: AAM

Angola, like many countries, struggles to provide good sexual and reproductive health (SRH), especially for youth. SRH is a “state of physical, emotional, mental, and social well-being related to sexuality and to the reproductive system” (UNFPA). Good SRH implies that both men and women have a right to decide about their sexual identity, sex life, and if and when to have children. 

 {Photo credit: MSH}Tshoeu, skeptical at first, now encourages others to access health care.Photo credit: MSH

The role of community leaders in the response to tuberculosis (TB) in South Africa cannot be overrated. Approximately 500,000 of the country’s residents acquire active TB every year. South Africa also faces treatment adherence challenges, partially due to the stigma associated with TB in communities: nearly one in five patients with multiple‐drug resistant TB do not complete their course of medication.

{Photo credit: BLC staff/MSH.}Photo credit: BLC staff/MSH.

“You are stronger than this disease,” Ana’s sister reminds her. Ana Paz is a 35-year-old community health worker for Mwenho, a civil society organization in Angola. She works at Centro de Salúde de Alegria, a public health facility in the capital city, Luanda. Her day is busy, providing HIV counseling and testing (HCT), basic medication, and support to people living with HIV.

 {Photo credit: Moroesi Makhetha/GROW.}A health worker weighing a child, Mokhotlong district, Lesotho.Photo credit: Moroesi Makhetha/GROW.

More than 180,000 vulnerable children in Lesotho, a mountainous country, are in need of essential services such as health care, access to education, and psychosocial support. Nutritional deficiencies and conditions are a challenge because of widespread poverty, food insecurity, and inadequate access to services. In addition, community health workers, health facilities, and local civil society organizations sometimes lack basic equipment to assess child nutritional status.

 {Photo credit: Jabulani Mavudze/MSH}A community health agent conducting home-based HIV testing and counseling in Cunene Province, Angola.Photo credit: Jabulani Mavudze/MSH

Many countries in sub-Saharan Africa discovered too late that they had an HIV epidemic, and some of these countries were equally slow to respond. This has had devastating consequences in terms of deaths due to AIDS, and new HIV infections among adults and children. Angola, due in part to the country's civil war and resulting insulation, is one of the few countries in the sub-Saharan region with a relatively low HIV prevalence, giving the country a unique opportunity to maintain and reduce the prevalence by implementing relevant and context-specific HIV prevention and treatment interventions.

{Photo credit: MSH/Johanna Theunissen}Photo credit: MSH/Johanna Theunissen

Thousands of children in Lesotho will soon have a brand new pair of shoes on their feet, some for the first time in their lives, thanks to an on-going partnership between Management Sciences for Health (MSH) and TOMS Shoes. 

Momotaung holds Sabelo. {Photo credit: J. Mavudze/MSH.}Photo credit: J. Mavudze/MSH.

In rural Lesotho, Momotaung wakes up early to prepare for a trip to the hospital for her checkup, a hospital two hours away from her home. On her way, she stops to pick up an elderly neighbor’s child, a three-year-old orphan named Sabelo---one of 12 siblings and cousins being cared for by their grandmother. She collects three other children from the village also needing care at the hospital.

How do you measure the overall health of an organization? Evaluating a person’s health is relatively easy – doctors around the world agree on the basic concepts of physical health, and measurements and standards have been well established for “ideal” height, weight, blood pressure, heart rate, and other components of health.

MSH South AfricaMSH South Africa

More than ten years after gaining independence and holding its first democratic elections, South Africa has made substantial development gains and boasts a growing economy. Despite these achievements, South Africa still faces the largest HIV-positive population in the world. Apartheid is no longer law, yet the health system still retains many inequities from that era. A major challenge for the government of South Africa is improving the accessibility and quality of basic health services.