Celebrate Solutions: Training Community Health Workers in Lesotho

By: Mariko Rasmussen, Communications Specialist at Women DeliverLesotho_Training_Wiki.jpg

In Lesotho, community health workers are saving lives, one mother at a time. Lesotho is a small Southern African country that faces numerous development challenges. There is a high prevalence of HIV and AIDS – nearly 1 in 4 adults is HIV positive – and there are high rates of maternal mortality and morbidity. The mountainous terrain makes it difficult for many people, especially pregnant women, to reach healthcare services. Partners In Health (PIH), with support from the Elton John AIDS Foundation, began a pilot project in 2009 to increase services to pregnant women in the area surrounding the Bobete health center and reverse this problem.

PIH’s Maternal Health Initiative in Lesotho began with training 100 traditional birth attendants (TBAs) to become specialized community health workers called Maternal Mortality Reduction Project Assistants (MMRPA). Traditional birth attendants are an important part of Lesotho’s traditional midwifery community. PIH Lesotho sought to maximize their potential by furthering their education so as to allow them to better serve their communities. MMRPAs are a direct link between the Bobete health center and pregnant women.

MMRPAs completed training, surveyed their villages, and began visiting pregnant women in their homes in the first year of the program. MMRPAs identify and counsel women in their villages about the importance of antenatal care (ANC), including testing and treatment for HIV and anemia, and encourage delivery at the Bobete health center. They provide women living in the 71 rural mountain villages in the area access to other services such as methods of preventing HIV transmission from mother-to-child, immunizations, and general reproductive health services. MMRPAs receive incentives for accompanying pregnant women to the health center for comprehensive ANC and for bringing women to the health center for delivery, thereby replacing the income that was once paid to them by the families of the pregnant woman for delivering in their village.

PIHL also constructed waiting homes near the clinic to house expectant mothers and help bridge the geographic gap that separates remote villages from the health center. Pregnant women can make the journey to the center before labor begins, allowing them access to antenatal services and emergency obstetric care immediately if labor complications occur. PIHL is also incentivizing mothers to give birth at the centers by providing a ‘new baby package’ to those who fulfill certain criteria (completing HIV testing, at least three prenatal visits, and delivery at the clinic.) 60 new baby packages, which include clothing and other supplies, have been distributed within the program’s first six months.

The project has been very successful, increasing significantly the amount of pregnant women utilizing the Bobete health center’s services. In the pilot year, MMRPAs accompanied pregnant women on 383 first prenatal care visits, 442 follow-up prenatal care visits, and 153 deliveries at the Bobete health center. In 2010, deliveries at the health center steadily increased – the center saw nearly 1,000 women for ANC and delivered 180 babies. To expand on the success of this project, the Positive Action for Children Fund will help bring it to six other health centers in Lesotho.

Photo via Partners in Health

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