Nurse-driven, community-supported HIV/AIDS treatment at the primary health care level in rural Lesotho: 2006-2008 programme report

Nurse-driven, community-supported HIV/AIDS treatment at the primary health care level in rural Lesotho: 2006-2008 programme report

A community-based approach to HIV and AIDS service provision

Lesotho has the third highest HIV prevalence in the world, with an estimated 270,000 people living with
HIV and AIDS in the country, and 18,000 deaths annually of AIDS-related complications.

In an effort to tackle the challenges related to a severe shortage of human resources, and geographic and financial barriers, that prohibit patients from accessing care and treatment, a decision was taken to decentralise HIV and AIDS services in Lesotho to the primary health care level.

This report by Médecins Sans Frontières (MSF) outlines the community-based approach to the decentralisation of HIV and AIDS services. The Wellspring of Hope was the first programme in Lesotho to provide HIV and AIDS treatment and care through an entire health service area as a result of this initiative.

The report discusses the following: 

  • delivery of HIV and AIDS services, specifically testing and counselling, prevention of mother to child transmission and antiretroviral therapy
  • a nurse driven approach to the provision of antiretroviral therapy at the community level
  • activities aimed at health systems strengthening
  • challenges associated with the implementation of this model.

This innovative approach, of a nurse-driven, community-supported model of care, has proven to be successful in delivering quality HIV and AIDS, and TB services integrated into existing primary health care structures for a population living in remote, rural areas.

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