LeBoHA works with the Government to tackle the implications of HIV/AIDS epidemic in Lesotho. We are committed to building sustainable programs to strengthen management, policy, planning, and clinical capacity in the health sector. Our work has shown that providing high-quality clinical training and building support networks among professionals boosts morale, improves retention, and significantly improves healthcare delivery.
Physician Recruitment and Postgraduate Training
In response to the severe health professional shortage in Lesotho, LeBoHA partnered with the MOH in 2008 to develop the Family Medicine Specialty Training Program (FMSTP). This 4-year Family Medicine Specialty Training Program (FMSTP) is the first fully accredited, physician training program in Lesotho. Since there is no medical school in Lesotho, talented Basotho students leave Lesotho each year to attend medical school abroad. These medical students are drawn to higher salaries and better working conditions and very rarely return to work in Lesotho. In 2012, after a very comprehensive evaluation of the program that included several site visits from experts from South Africa, the Lesotho Council on Higher Education (CHE) first granted full accreditation in December 2015. The FMSTP is now not only the first, but the first fully accredited, physician training program ever in Lesotho.
The young physicians in the FMSTP are assigned to rural districts where they each hold management positions (DMO or hospital superintendent). They convene with faculty for one week each month for clinical, quality improvement, public health and management training. These sessions provide needed professional support and collegiality. They attend monthly educational meetings held for all health professionals that we organize, and an annual conference with colleagues from across the continent. They participate in intern and student teaching, conduct research and publish papers. After 4 years they are awarded the MMedFam degree designating them as specialists and compensated on the consultant pay scale. Graduates are highly sought after in clinical and government service providing desirable career tracks.
LeBoHA now confers the Masters of Medicine in Family Medicine degree, and runs the newly initiated 2-year national internship program. Our approach is to recruit talented Basotho physicians back home to complete high quality postgraduate specialty training in their home country, improve retention through support of trainees and graduates and improve management of district hospitals.
Nursing Education and Professional Support
Prior to LeBoHA programs, most nurse-midwives and nurses staffing the health centers have been practicing years or even decades since their pre-service training with no opportunity to refresh or advance their delivery skills. Nurses no longer have the skills required to treat high risk individuals, manage complications or emergencies, or provide appropriate referrals at the community level.
LeBoHA has for many years supported nursing education and training. LeBoHA is the first organization to initiate the in-service competency-based nursing and midwifery training programs in Lesotho. As a result, LeBoHA supported the MOH and Nursing Counsel in developing the nursing policies and procedures in order to standardize nursing and midwifery care in Lesotho. The LeBoHA nurse training manual is now adopted as the national MOH curriculum.
A second major initiate of LeBoHA nursing program is the Lesotho’s Maternal and Newborn Health Performance-Based Financing (PBF) Project in which the MOH sponsored one nurse-midwife from each district to receive advanced midwifery training in South Africa. These nurse-midwives are expected to transfer their knowledge and skills to other nurse-midwives throughout the district, but there was no supporting curriculum, structure, or process to facilitate this knowledge transfer. With support from the Izumi Foundation, LeBoHA started a midwifery training program in the Leribe district to partner with and support Motebang Hospital’s nurse-midwife to train nurse-midwives from 16 health centers throughout the Leribe district. Because of the program’s success, the Lesotho MOH is seeking to expand this training program to five other districts.
Bill Bicknell Academic Center
The Bill Bicknell Academic Center is a place for residents to stay during the contact sessions. It is used by visitors from around the world. Along with Global Primary Care, LeBoHA raised funds in honor of Bill Bicknell, a public health pioneer who led BU’s first delegation to Lesotho.
With funding from the USAID American Schools and Hospitals Abroad (ASHA) program, LeBoHA is now building three houses, a second dormitory to complement the “Bill Bicknell House” and a large academic center for administration, teaching and research on its 7 acre site adjacent to the Motebang Hospital, the northern referral hospital in the Leribe district of Lesotho.
Civil Society Strengthening
LeBoHA has also worked to strengthen health professional civil society. With support from the European Union we carried out a 4 year program that aimed to support and capacitate the non-governmental health associations and regulatory bodies in Lesotho that we believe have an important role in identifying, prioritizing and addressing health issues in the country. With this goal, we partnered with the Lesotho Medical Association, nurses association, the Lesotho Medical, Dental and Pharmacy Council, and the Nursing Council to connect these organizations with partners in South Africa, and to design procedures, protocols and business plans designed to assist these organizations to do their work. There were many successes of this program including the organization and institutionalization of a national program required for continuing nursing education credits and collaboration in the “Learning and Sharing Forum, student caucuses, LMA Journal among others. These programs have led to excellent relationships with these organizations. LeBoHA and the LMA now share office spaced in Maseru.