Access to High Quality Clinical Services
Due to the Lesotho Boston Health Alliance’s (LeBoHA) constant presence at district hospitals, we quickly realized we needed to also work with the ancillary services (radiology, laboratory and pharmacy) to improve patient care. LeBoHA uses a case based approach to improve the ancillary services. For example, to reduce drug stock outs, LeBoHA reviewed the procurement procedures of the Ministry of Health and Social Welfare and the National Drug Supply Organization. After a thorough assessment of each step in the procurement process, LeBoHA identified bottlenecks and worked with the pharmacy to implement simple interventions to reduce stock outs. Another example, is LeBoHA’s assistance with the radiology department at one district hospital. The radiology staff did not receive training since their initial, sometimes informal, training; meaning some had not been trained for over 20 years. LeBoHA facilitated a quarterly on-the-job training by the chief radiologists at Lesotho’s national referral hospital. This training has improved quality and types of x-rays offered at the district hospital. LeBoHA has also initiated an exchange program between hospitals to build the professions of the ancillary services, provide a support network, and exchange best practices. From this exchange program, the radiology staff has organized the first radiology association in Lesotho and the pharmacies at other hospitals has adopted the idea from other hospitals of a Hospital Therapeutics Committees.
Faculty, fellows, residents, and medical students from Boston University and Boston Medical Center have been serving as clinical volunteers in Lesotho since February 2004. Since that time, more than 80 medical students, residents, fellows, and faculty from the Departments of Family Medicine, Pediatrics, Internal Medicine, Emergency Medicine, and Obstetrics have completed rotations in Lesotho. With the growth of the LeBoHA program, these clinical volunteers are now integrated into the teaching activities of the Family Medicine Specialty Training Program at Motebang and Maluti hospitals.
In 2006, the Lesotho Boston Health Alliance (LeBoHA) started working to increase capacity in the Berea district to provide needed HIV and AIDS counseling, testing, and treatment services of good quality through the promotion and advancement of the “Know Your Status” (KYS) Campaign. We have trained Community Based Counselors (CBCs) in 15 health facilities and worked more intensely with senior CBCs from each health center to establish a sustainable mechanism for supervising and coordinating community-based counseling and testing services.
In September 2008, the MOHSW with support from LeBoHA submitted a successful application to Merck’s Gardasil Access Program for 120,000 doses of Gardasil to cover all females ages 9-18 in the Leribe and Mohale’s Hoek District. In October, the Family Health Division of the MOHSW initiated a committee to plan for the launch of Gardasil with representatives from several MOHSW departments, the UN groups, and international partners. The swiftness and enthusiasm with which the MOHSW lead and carried out plans for the launch is exemplary and greatly strengthened the national commitment to the elimination of cervical cancer. After the first three rounds, 66,772 doses of Gardasil were administered to over 20,000 girls in the Leribe district, reaching 89% of the target.