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Lesotho

Articles by Lesotho

Nurse Mabohlokoa Monyane (L) with male young client Thabile Janele (R)
12 January 2024

Step on the Red Carpet: Lesotho’s Youth Receiving Premium SRHR Services through IPPF’s Member Association

By Maryanne W. WAWERU Lesotho, a country situated in Southern Africa and landlocked by the Republic of South Africa, has an estimated total population of 2.1 million people. The small country is still heavily affected by HIV and AIDS, with high prevalence rates of 24.3% among women aged 15-49, and 14.2% among men in the same age bracket. The Lesotho government, in partnership with various non-governmental organizations, continues to address these alarming rates, including among adolescents and youth. One of the government’s key partners in the country is IPPF’s Member Association in Lesotho, Lesotho Planned Parenthood Association (LPPA). One of LPPA’s strategy aimed at increasing HIV linkage and retention in care and treatment among adolescents and young people living with HIV, is through an initiative known as the ‘Red-Carpet model’. The initiative, started in May 2023, is being piloted in LPPA’s youth clinic located in the capital city, Maseru. The ‘Red-Carpet model’ is aimed at providing adolescents and young people with a VIP experience as they access quality youth-friendly services at the facility. The model fast tracks services and reduces barriers for adolescents to access and utilize integrated HIV/SRH services. We had a chat with Ms. Mamojela Koneshe, LPPA’s Executive Director, who sheds more light on this initiative. How exactly does the ‘Red-Carpet’ model work? The model serves all adolescents and young people who visit the clinic, regardless of if they are first time or returning clients. For the new clients, they first report to the reception area upon arrival at the clinic. They are then referred to the waiting area where an LPPA Youth Ambassador gives them information about the model, how it works and its benefits. Youth Ambassadors are young people seconded to LPPA clinics by one of our partner organizations - Elizabeth Glaser Paediatric AIDS Foundation (EGPAF). Their duties include ensuring that adolescents in the clinic are linked to appropriate HIV prevention methods and treatment. They also hold scheduled peer support groups, and in collaboration with the Youth Nurse, link vulnerable youth to various organisations depending on their needs –for example linking sexual and gender-based violence survivors to shelters. The Youth Ambassadors also ensure that red carpet model is well implemented. While at the waiting area, the Youth Ambassador gives the adolescent or young client access to free wi-fi, which enables them to access the internet. After this, the client is enrolled in the model and given a VIP card. When their turn arrives, the Youth Ambassador escorts them to the relevant consultation or counselling room depending on the service they need. The expected time spent in the facility by the young person is 45minutes. This is the maximum time expected to be spent by young people while accessing services and was informed by the various services that young people access in our facility. Telephone follow-up interviews are then done with the clients on a weekly basis. On their return visit, upon arrival at the facility, adolescents report to the reception where they present the VIP card they were given at their first visit. They are then referred to the waiting area where once again, the Youth Ambassador gives them a free wi-fi voucher and links them to the appropriate service. Similarly, the expected time spent in the facility is 45minutes. Why is the provision of free internet to adolescents and youth at the clinic important? This is because it enables young people to access a vast amount of health information online. By connecting to the internet, they search for health-related information. It also gives them access to educational resources that can help them make informed decisions about their health. Going online also helps them to connect with their peers within established peer support groups. In addition, most of our clients are students at colleges, universities, and other learning institutions, so facilitating their free internet access helps them to continue studying and researching while waiting for services. They like this since they don’t have to use their own internet bundles, which can be quite expensive for them. The ‘Red-Carpet model’ is aimed at providing adolescents and young people with a VIP experience as they access quality youth-friendly services at the facility. The model fast tracks services and reduces barriers for adolescents to access and utilize integrated HIV/SRH services. Considering that LPPA endeavours to provide a holistic approach to our clients, the Youth Ambassador also assists the adolescents to explore online opportunities such as employment, school, etc. Client testimony “A thumbs up to LPPA for the services they offer to young people. When I first arrived at the clinic, I met a friendly lady at the reception who welcomed me and gave me information about the services they have for adolescents and young people aged 10-24 years. She handed me a free wi-fi voucher as we continued with our conversation. When it was my turn to get into the consultation room, she escorted me to the door where I was received by a kind nurse. I really loved my experience at the facility. Interestingly, a few days later, they called to tell me that they were just checking up on me, asking if I was still taking my medication as prescribed and if I was experiencing any challenges. That was very impressive. I have since recommended the services at the clinic to many of my friends as I know that they too will receive good services.” -Thabile Janele, male, 24 years. Were adolescents and youth involved in the design of this initiative? Yes, they were centrally involved as young engagement is at the heart of our work as LPPA. We factor in their input in all our programmes, right from the design, implementation, monitoring and evaluation of projects and programmes. 24-year-old Ntseiseng Moloko expounds more on youth engagement of the Red-Carpet model. “I was part of the young people who volunteered to participate in the design of the Red-Carpet model, which strives to address the various challenges that adolescents and youth face in their quest to access SRH services. Our input included the ideal time we should spend at the facility, and how LPPA can create a fully supportive environment for young people while at the clinic, especially for those who receive a positive HIV diagnosis. This is usually a life-changing and critical time for them, and we were able to offer our suggestions which were incorporated by the LPPA team. As a young client who accesses services at LPPA and who has benefited from the ‘Red-Carpet model’, I have talked to other adolescents and youth who appreciate it, because it ensures we receive services that are precisely tailored to our needs. We also like the colourful posters at the gate of the facility which inform us about the range of services we can get, as well as the arrows directing us to the reception. Inside the facility, there are many posters, booklets and other printed material offering SRH information and which have young people on them, which we find very relatable. The presence of the Youth Ambassadors who share more information, give us wi-fi access and accompany us to the consultation rooms is nice. I remember a few days after my visit to the clinic, they called me to check up on me, which made me feel special. The services at LPPA are splendid!” Which are the most frequently accessed services by adolescents and youth at the clinic? The most frequently accessed services include family planning services, HIV testing and counseling services, provision of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), antiretroviral (ART) services and STI management. How has the update of services by adolescents and youth since this initiative began been? Even though the model is still in its pilot phase, we have noted an increase in the number of clients served. Last year, from May- October 2022, we served 163 clients. For the same period this year, which is since the inception of the model (from May-October 2023), we have served 258 young clients. One of our nurses who has been trained on this model is Ms. Mabohlokoa Monyane, who speaks more about it. “There has been improved retention of newly initiated ART clients since the model started. There has also been a notable increase in the number of adolescents seeking SRH/HIV services. I would say the increase in clientele served in the clinic is significantly due to peer-to-peer referrals (word of mouth referrals) from clients enrolled in the model.” Is the Red-Carpet model meeting your expectations? Yes! In addition to the increased uptake of adolescents and youth who access SRH services, there has been retention of PrEP and ART clients in care. There has also been an improved rapport between the clients and service providers due to frequent communication following access to services. What are your sustainability plans with this model? LPPA plans to incorporate this model in the next financial year and outsource funding to support it. The plan is to scale up the model to other LPPA clinics following the report that will be obtained after the pilot phase. We expect to put in place more initiatives that will support the model. We will also provide ongoing refresher trainings to service providers. By Maryanne W. Waweru Banner image shows nurse Mabohlokoa Monyane (L) with male young client Thabile Janele (R)

sexual-reproductive-health-and-rights-in-Africa-IPPF-Africa-Region
01 March 2022

Zero Discrimination Day: Spotlight on Lesotho’s MSM Community

By Maryanne W. Waweru 1 March 2022, Zero Discrimination Day. Celebrated every year, Zero Discrimination Day underscores the right of everyone to live a full and productive life—and live it with dignity. The day promotes inclusion, compassion, peace and, above all, a movement for change. It helps to create a global movement of solidarity to end all forms of discrimination. On Zero Discrimination Day this year, IPPFAR highlights the work of it's Member Association in Lesotho -The Lesotho Planned Parenthood Association (LPPA) in providing services to men who have sex with men (MSM). We tell this through the experience of Tsepo Mokoena. Tsepo Mokoena, 36, is a volunteer peer educator at the Lesotho Planned Parenthood Association (LPPA) clinic in the capital city of Maseru. This is an activity that Tsepo, who identifies as a gay man, has been engaging in for the last five years. “I was inspired to be a volunteer after realizing that many men who have sex with men (MSM) face various challenges regarding their sexual health, yet they are hesitant to seek help from health facilities. These challenges include treatment for sexually transmitted infections (STIs), access to condoms and lubricants, as well as HIV counseling and testing. The fear of being ridiculed, stigmatized and condemned by clinicians because of their sexual orientation holds them back from visiting health facilities. However, having been a beneficiary of LPPA’s services, I could attest to the professionalism of the staff and the quality of services, so I had no reservations about referring MSM to LPPA,” he says. UNAIDS considers gay men and other men who have sex with men, sex workers, transgender people, people who inject drugs and prisoners and other incarcerated people as the five main key population groups that are particularly vulnerable to HIV and frequently lack adequate access to services. Gay men and other men who have sex with men are 27 times more likely to acquire HIV than the general population. Their vulnerability is heightened due to various behavioural factors including unprotected receptive anal sex, multiple sexual parters, sexual violence, and use of recreational substances such as drugs and alcohol. Despite having a small population of 2.1 million people, Lesotho has the second highest HIV prevalence in the world. Lesotho’s HIV prevalence rate in the 15-49 age group is 21.1%. While HIV prevalence is high among the general population, it particularly affects sex workers, men who have sex with men and women. Operating in an environment where homosexuality is decriminilized in Lesotho, the awareness of MSM’s heightened vulnerabilities to negative sexual health outcomes led LPPA to initiate programmes targeting this group. “LPPA provides services to MSM in all its clinics. Some of these services include distribution of condoms and lubricants for free, treatment services for STIs, HIV testing services (HTS), Pre-exposure prophylaxis (PrEP), Isoniazid Preventive Therapy (IPT) for the prevention of tuberculosis in people living with HIV, and antiretroviral therapy (ART) for those who are HIV positive. We offer services in our clinics and during targeted outreaches in the community. Our work is boosted by community health workers and peer educators, who have been trained by LPPA to offer non-discriminatory information and services to all people, regardless of their sexual preferences,” says Ms. Mamojela Koneshe, LPPA’s Executive Director. One of these trained peer educators is Tsepo, whose activities see him visit MSM hotspots where he shares information about sexual health and safe sex practices. Some of these hotspots include bars, lodgings, restaurants and popular streets where they hang out. Some of the MSM are sex workers, while others are married to women. While educating them, Tsepo also gives them condoms and lubricants for free, which he gets from LPPA. Studies have shown that lubricants help to lower the risk of HIV transmission by minimizing potential skin tears. “Reaching out to MSM with sexual health education is a passion for me. It is my desire to see all gay, bisexual and trans men in Lesotho receive quality sexual reproductive health services in a manner that meets their needs are are respectful of their rights. The LPPA service providers have expertise in sexual health and so when I refer MSM there, I know they are in good hands,” says Tsepo. At the LPPA Maseru clinic, Tsepo utilizes one of the counseling rooms for his volunteer services. MSM know the days and times of the week he is available there, so they ensure to come see him then. The room is well stocked with condoms and lubricants, with the walls plastered with posters about safe sex practices. “The main entry point for most MSM who come here is HIV testing and STI treatment. I have particularly found that their knowledge about issues surrounding HIV and AIDS is low, so I educate them on the same before referring them to LPPA clinicians for respective services. Afterwards, many pass by this room for a chat. This room is a safe space for MSM, where conversations are held openly and freely. For those who test negative for HIV, we talk about safe sex practices. For those who test positive, I encourage them and emphasize the importance of protecting their partners. We also discuss about the need for a healthy diet and adherence to their drug regimen,” explains Tsepo. Many times during their discussions, the clients offer Tsepo their feedback about LPPA’s services. “They tell me they feel protected and understood by the clinicians. They don’t feel judged and are treated just like any other client. This makes them happy, and this motivates them to come back for services again,” he says. In 2020, a total of 247 MSM accessed HIV self-test kits from LPPA’s clinics. A further 413 received HIV testing services, while 13 MSM were placed on Pre-exposure prophylaxis (or PrEP), which is medicine taken to prevent getting HIV. PrEP is highly effective for preventing HIV when taken as prescribed. PrEP reduces the risk of getting HIV from sex by about 99% (CDC). In the same year, 16 MSM were initiated on antiretroviral therapy (ART), while 22 were put on Isoniazid Preventive Therapy (IPT) for tuberculosis prevention. Lessons learned LPPA’s Executive Director says the organization strives to addresses the various barriers that hinder MSM’s enjoyment of their sexual rights and access to health services. “MSM require special care and friendly services as they are sensitive to cultural and societal discrimination. We ensure that we offer services that are tailored to their unique healthcare needs and are delivered in an ethical and person-centered manner. We are always happy to receive MSM in our clinics, where they are treated with respect and utmost professionalism,” she says. Ms. Koneshe notes that the number of MSM in the community are higher than is recorded, since many are still closeted. Some are married with children, or have female partners in their attempt to hide their sexual identity. “One strategy that has led to LPPA’s success in reaching MSM is including them as partners. We involve MSM at all stages of our interventions that target them; right from the design, planning and implementations. We do not impose anything on them but work with them as partners. We listen to them, adjust accordingly and work together to achieve positive health outcomes,” she says. Tsebo remains grateful to LPPA for the role it continues to play in helping MSM realize their sexual reproductive health rights in Lesotho, through provision of information and quality services that are tailored to their needs. “As a volunteer, I’m happy to be a part of the LPPA team that does this great work in the community and for the good of our country’s health goals, especially towards addressing the HIV scrouge.” Maryanne W. Waweru is the Communications Officer, IPPF Africa Regional Office. For more updates on our work, follow IPPF Africa Region on Facebook, Twitter, Instagram and You Tube.

LPPA
07 May 2019

“What I Find to be Most Unique about LPPA’s Volunteer Program” – Phenny Hanssen

By Maryanne W. WAWERU Mrs. Phenny Hanssen is the immediate past President of the Lesotho Planned Parenthood Association (LPPA), which is IPPF’s Member Association in Lesotho. In this interview with Maryanne W. Waweru, she shares insights about her motivation for joining LPPA, and some of the highlights during her leadership. When did you become an LPPA Volunteer? I joined LPPA as volunteer in 2004. At that time, I was working in a development organization where I was managing an HIV/AIDS project. One of the organizations that we were working closely with was LPPA, which was at the forefront in pioneering certain health interventions that other institutions were reluctant to get into. Some of these interventions included those around family planning and HIV/AIDS. LPPA’s work was felt all the way from the national to the grassroots level. I wanted to be associated with such an organization that was renowned for bringing positive change in the community. What are Some of the Notable Contributions that Volunteers made to LPPA During your Tenure? As volunteers, we were instrumental in securing various LPPA’s assets such as land. To ensure that LPPA was in possession of all required legal documents proving ownership of its properties, the Board set up a taskforce and volunteers, led by branch officials, worked closely with Municipal Councils to successfully secure LPPA’s assets. LPPA volunteers were also involved in resource mobilization and fundraising activities for the organization. We offered our time, expertise and experience in supporting the organization to write winning proposals that helped it secure funding for some of its projects. Some volunteers were also able to stand in as good references for LPPA. I remember once being called by an international donor agency that was enquiring about LPPA’s capacity to implement a certain project that targeted women at-high-risk for HIV. I assured the donor that LPPA was fully capable of implementing the project and delivering results. LPPA went on to receive the grant and successfully implement the project.     During my tenure, I led processes that contributed to supporting the organization execute its functions well. These included the development, review and update of various statutory documents such as the LPPA constitution, Human Resource policy, the Financial Management policy and other workplace guidelines. The fact that our volunteers are drawn from diverse backgrounds greatly contributed to the success of our mandate. During our volunteer recruitment drives, we ensured that we targeted individuals drawn from various professional backgrounds such as lawyers, engineers, doctors, nurses, social workers, teachers, Human Resource specialists, accountants and IT experts, among others. What do you Find to be Exceptional about LPPA’s Volunteer program? One aspect that stands out about LPPA’s volunteer program is the fact that the organization places high regard in its volunteers. The voices of the volunteers hold weight when it comes to all aspects of the organization; right from its leadership, program design, implementation, community mobilization and even service provision. With LPPA, volunteers (including young people) are encouraged to express their thoughts, share ideas and offer suggestions on different issues pertaining to the success of the organization. They are all welcome and highly considered – something that you won’t easily find in many organizations. The LPPA volunteer program also allows individuals to utilize their skills and realize their potential by serving in different capacities -including in leadership positions. Additionally, being an LPPA volunteer accords members the opportunity to network with each other and grow as individuals. LPPA’s youth volunteer programme is also like no other. The Youth Action Movement (YAM) program gives young people the platform to increase their knowledge and build their capacity not only in sexual reproductive health issues, but also enhance their leadership skills and prepare them for the labor force. YAM members have acquired a wide range of skillsets that have helped them in their career growth. I can confidently say that some former LPPA YAM members today hold influential positions in organizations in the health and development sector in Lesotho - with some of their capacities having been significantly built at the time they volunteered with LPPA.   I am proud to be associated with LPPA and I am greatly honored to have served in the LPPA leadership. I continue to support the organization fully.    Learn more about Lesotho Planned Parenthood Association (LPPA) here. For more information about the work of IPPF Africa Region, follow us on Facebook and Twitter.   Maryanne W. Waweru is the Governance and Compliance Officer, IPPF Africa Region.

Lesotho Planned Parenthood Association (LPPA)
11 December 2018

Awarding the Best Performing Clinics: Lesotho Planned Parenthood Association (LPPA)

In order to enhance the quality of care and discipline among its service providers, the Lesotho Planned Parenthood Association (LPPA) has developed a system that strives to promote and maintain a culture of excellence in service provision. This is through the practice of rewarding its best-performing clinic. Each year, during LPPA’s Annual General Meeting (AGM), the best-performing clinic is feted, with the award being presented to the Chairperson of the related branch by the LPPA President. LPPA has established that this annual practice helps in ensuring that each service provider is committed to delivering on LPPA’s mandate; that of offering quality sexual and reproductive health services to the Mosotho people and more so the vulnerable, poor, most-at-risk and hard-to-reach populations. The practice helps in ensuring that each LPPA client receives the highest standards of quality care and delivered to them in the best conditions; wherever they are. Good quality of care enhances clients’ satisfaction and their use of services -a status that LPPA endeavours to achieve for all its clients. Key elements in the judging criteria for LPPA's best-performing clinic include: Overall cleanliness of the clinic Adherence to service delivery and infection prevention guidelines Initiative in outsourcing Sexual Reproductive Health (SRH) information for both service providers and clients Integration of HIV and AIDS with SRH information and services Number of clinic-based health talks Information dissemination to the community through various media Adequacy and timely reporting e.g. service statistics Adequacy in reporting of finances Adherence to supplies logistic management guidelines Adequacy in reporting commodities Percentage change in the amount of income raised through clinic services Percentage change in number of new acceptors Percentage change in Couple Year of Protection (CYP) Award Recipients The clinics that have been recipients of this award include: Botha-Bothe clinic in the Northern Branch Maseru clinic The Male clinic  Healthy Competition The award system has been noted to influence positive competition and growth at the clinic level, which has helped make LPPA’s facilities the clinics of choice for many people in Lesotho. LPPA’s Program Director Ms. Makatleho Mphana says the practice has challenged clinics to be more innovative. “The awards system has spurred clinics to engage in income generation activities -which are undertaken in an accountable manner. As the MA clinics compete for the annual award, they ensure that they give their best performance all year round. It encourages them to be innovative in their service delivery approaches. The awards system assures clients, LPPA volunteers, partners and donors that our service providers are committed to providing quality services to all,” she says.  This initiative was identified as one of LPPA’s Good Practices during the 3rd Cycle of Accreditation. A Good Practice is an activity or practice that has been proven to work and yields positive results. The sharing of Good Practices by IPPF Member Associations offers learning experiences for their counterparts. Learn more about Lesotho Planned Parenthood Association (LPPA) here.  Also Read:  What’s in a Game? ABUBEF’s use of Playing Cards for Youth SRHR Education Mobile Clinics in Cape Verde: Taking Services Closer to the People For more information about the work of IPPF Africa Region, follow us on Facebook and Twitter.

Accreditation_IPPF_Africa_Region
20 July 2018

Reproductive Health Uganda and Lesotho Planned Parenthood Association Receive Accreditation Certificates

By Maryanne W. Waweru Two IPPF Africa Region Member Associations; Reproductive Health Uganda (RHU) and the Lesotho Planned Parenthood Association (LPPA) have been recognized for their success in the 3rd IPPF Accreditation cycle. About IPPF’s Accreditation Process As a global sexual and reproductive health and rights movement, IPPF is guided by key Standards and Responsibilities of membership. IPPF expects all Member Associations who wish to be a part of the Federation to uphold and promote the well-defined 10 Principles of Membership, and to comply with the different Standards associated with each Principle. The ‘Accreditation Process’ is based on these 10 Principles and Standards. Accreditation is an important tool for every Member Association’s self-reflection and improvement. It also serves as an effective means of improving communication between Member Associations and the IPPF Secretariat. The Accreditation process further helps in ensuring Member Associations’ accountability to the clients they serve, and to the donor community. The 10 Membership Principles and their associated Membership Standards require that a Member Association is: Open and democratic Well governed Strategic and progressive Transparent and accountable Well managed Financially healthy A good employer Committed to results Committed to quality, and A leading SRHR organization in its country When full compliance is achieved, Member Associations are recognized as fully accredited members of the Federation by the Governing Council; IPPF’s highest decision-making body. The 3rd cycle Accreditation certificates for Reproductive Health Uganda (RHU) and Lesotho Planned Parenthood Association (LPPA) were awarded during an awards cocktail ceremony held in Nairobi, Kenya on 29 June 2018 -on the sidelines of the 48th Session of the IPPFAR Regional Council. The awards were presented by the IPPF Africa Regional Chairperson Hon. Antonio Niquice. We congratulate the MAs of Uganda and Lesotho for their success in the 3rd cycle of Accreditation (2016 – 2020). Read more about Reproductive Health Uganda here and Lesotho Planned Parenthood Association here. For more information about the work of IPPF Africa Region, connect with us on Facebook and Twitter. Story by Maryanne W. Waweru, Governance and Compliance Officer, IPPF Africa Region

Lesotho Planned Parenthood Association

One of IPPF’s central beliefs is that processes and approaches need to be adapted to meet the specific needs of a country. In Lesotho, a country with one of the highest HIV prevalence rates in the world, LPPA is very active in finding new ways to address neglected needs.

LPPA provides a comprehensive range of sexual and reproductive health including: family planning, the  management of sexually transmitted infections (STIs),  screening for cancers of the reproductive system, the distribution of contraceptives and emergency contraceptives, pregnancy testing, post-abortion care, voluntary counselling and testing (VCT) and the management of infections. Clients are referred to other centres for CD4 tests and ARV treatment. 

LPPA reaches out to the communities it serves through 47 service points: 10 permanent clinics, 9 private providers, 30 associated agencies, 90 peer educators and 14 community-based distributors (CBDs). There are 54 permanent staff who are supported by over 200 volunteers.

An estimated 75% of LPPA's clients are poor, marginalized, socially excluded and/or under-served. Target groups include cattle herders, prisoners, rural populations, factory workers, university students, police trainees and people living with HIV and AIDS. 

LPPA targets out-of-school children, and disseminates SRH information through drama, puppetry, sports for life, and facilitated discussions. Other education programmes include health talks, workshops, performances and radio and TV shows.

In advocacy, LPPA reaches out to teachers, religious leaders and government leaders to promote favourable approaches to, and legislation on, SRH. 

LPPA has influential partnerships with government health and population departments, and it partners with major non-governmental organizations (NGOs). Donors include Irish Aid, UNDP, the Japan Trust Fund, and IPPF’s Korea Africa Fund. The Member Association has strong linkages with other organizations across the country, particularly in relation to HIV and AIDS.

Website: www.lppa.org.ls

 

Nurse Mabohlokoa Monyane (L) with male young client Thabile Janele (R)
12 January 2024

Step on the Red Carpet: Lesotho’s Youth Receiving Premium SRHR Services through IPPF’s Member Association

By Maryanne W. WAWERU Lesotho, a country situated in Southern Africa and landlocked by the Republic of South Africa, has an estimated total population of 2.1 million people. The small country is still heavily affected by HIV and AIDS, with high prevalence rates of 24.3% among women aged 15-49, and 14.2% among men in the same age bracket. The Lesotho government, in partnership with various non-governmental organizations, continues to address these alarming rates, including among adolescents and youth. One of the government’s key partners in the country is IPPF’s Member Association in Lesotho, Lesotho Planned Parenthood Association (LPPA). One of LPPA’s strategy aimed at increasing HIV linkage and retention in care and treatment among adolescents and young people living with HIV, is through an initiative known as the ‘Red-Carpet model’. The initiative, started in May 2023, is being piloted in LPPA’s youth clinic located in the capital city, Maseru. The ‘Red-Carpet model’ is aimed at providing adolescents and young people with a VIP experience as they access quality youth-friendly services at the facility. The model fast tracks services and reduces barriers for adolescents to access and utilize integrated HIV/SRH services. We had a chat with Ms. Mamojela Koneshe, LPPA’s Executive Director, who sheds more light on this initiative. How exactly does the ‘Red-Carpet’ model work? The model serves all adolescents and young people who visit the clinic, regardless of if they are first time or returning clients. For the new clients, they first report to the reception area upon arrival at the clinic. They are then referred to the waiting area where an LPPA Youth Ambassador gives them information about the model, how it works and its benefits. Youth Ambassadors are young people seconded to LPPA clinics by one of our partner organizations - Elizabeth Glaser Paediatric AIDS Foundation (EGPAF). Their duties include ensuring that adolescents in the clinic are linked to appropriate HIV prevention methods and treatment. They also hold scheduled peer support groups, and in collaboration with the Youth Nurse, link vulnerable youth to various organisations depending on their needs –for example linking sexual and gender-based violence survivors to shelters. The Youth Ambassadors also ensure that red carpet model is well implemented. While at the waiting area, the Youth Ambassador gives the adolescent or young client access to free wi-fi, which enables them to access the internet. After this, the client is enrolled in the model and given a VIP card. When their turn arrives, the Youth Ambassador escorts them to the relevant consultation or counselling room depending on the service they need. The expected time spent in the facility by the young person is 45minutes. This is the maximum time expected to be spent by young people while accessing services and was informed by the various services that young people access in our facility. Telephone follow-up interviews are then done with the clients on a weekly basis. On their return visit, upon arrival at the facility, adolescents report to the reception where they present the VIP card they were given at their first visit. They are then referred to the waiting area where once again, the Youth Ambassador gives them a free wi-fi voucher and links them to the appropriate service. Similarly, the expected time spent in the facility is 45minutes. Why is the provision of free internet to adolescents and youth at the clinic important? This is because it enables young people to access a vast amount of health information online. By connecting to the internet, they search for health-related information. It also gives them access to educational resources that can help them make informed decisions about their health. Going online also helps them to connect with their peers within established peer support groups. In addition, most of our clients are students at colleges, universities, and other learning institutions, so facilitating their free internet access helps them to continue studying and researching while waiting for services. They like this since they don’t have to use their own internet bundles, which can be quite expensive for them. The ‘Red-Carpet model’ is aimed at providing adolescents and young people with a VIP experience as they access quality youth-friendly services at the facility. The model fast tracks services and reduces barriers for adolescents to access and utilize integrated HIV/SRH services. Considering that LPPA endeavours to provide a holistic approach to our clients, the Youth Ambassador also assists the adolescents to explore online opportunities such as employment, school, etc. Client testimony “A thumbs up to LPPA for the services they offer to young people. When I first arrived at the clinic, I met a friendly lady at the reception who welcomed me and gave me information about the services they have for adolescents and young people aged 10-24 years. She handed me a free wi-fi voucher as we continued with our conversation. When it was my turn to get into the consultation room, she escorted me to the door where I was received by a kind nurse. I really loved my experience at the facility. Interestingly, a few days later, they called to tell me that they were just checking up on me, asking if I was still taking my medication as prescribed and if I was experiencing any challenges. That was very impressive. I have since recommended the services at the clinic to many of my friends as I know that they too will receive good services.” -Thabile Janele, male, 24 years. Were adolescents and youth involved in the design of this initiative? Yes, they were centrally involved as young engagement is at the heart of our work as LPPA. We factor in their input in all our programmes, right from the design, implementation, monitoring and evaluation of projects and programmes. 24-year-old Ntseiseng Moloko expounds more on youth engagement of the Red-Carpet model. “I was part of the young people who volunteered to participate in the design of the Red-Carpet model, which strives to address the various challenges that adolescents and youth face in their quest to access SRH services. Our input included the ideal time we should spend at the facility, and how LPPA can create a fully supportive environment for young people while at the clinic, especially for those who receive a positive HIV diagnosis. This is usually a life-changing and critical time for them, and we were able to offer our suggestions which were incorporated by the LPPA team. As a young client who accesses services at LPPA and who has benefited from the ‘Red-Carpet model’, I have talked to other adolescents and youth who appreciate it, because it ensures we receive services that are precisely tailored to our needs. We also like the colourful posters at the gate of the facility which inform us about the range of services we can get, as well as the arrows directing us to the reception. Inside the facility, there are many posters, booklets and other printed material offering SRH information and which have young people on them, which we find very relatable. The presence of the Youth Ambassadors who share more information, give us wi-fi access and accompany us to the consultation rooms is nice. I remember a few days after my visit to the clinic, they called me to check up on me, which made me feel special. The services at LPPA are splendid!” Which are the most frequently accessed services by adolescents and youth at the clinic? The most frequently accessed services include family planning services, HIV testing and counseling services, provision of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), antiretroviral (ART) services and STI management. How has the update of services by adolescents and youth since this initiative began been? Even though the model is still in its pilot phase, we have noted an increase in the number of clients served. Last year, from May- October 2022, we served 163 clients. For the same period this year, which is since the inception of the model (from May-October 2023), we have served 258 young clients. One of our nurses who has been trained on this model is Ms. Mabohlokoa Monyane, who speaks more about it. “There has been improved retention of newly initiated ART clients since the model started. There has also been a notable increase in the number of adolescents seeking SRH/HIV services. I would say the increase in clientele served in the clinic is significantly due to peer-to-peer referrals (word of mouth referrals) from clients enrolled in the model.” Is the Red-Carpet model meeting your expectations? Yes! In addition to the increased uptake of adolescents and youth who access SRH services, there has been retention of PrEP and ART clients in care. There has also been an improved rapport between the clients and service providers due to frequent communication following access to services. What are your sustainability plans with this model? LPPA plans to incorporate this model in the next financial year and outsource funding to support it. The plan is to scale up the model to other LPPA clinics following the report that will be obtained after the pilot phase. We expect to put in place more initiatives that will support the model. We will also provide ongoing refresher trainings to service providers. By Maryanne W. Waweru Banner image shows nurse Mabohlokoa Monyane (L) with male young client Thabile Janele (R)

sexual-reproductive-health-and-rights-in-Africa-IPPF-Africa-Region
01 March 2022

Zero Discrimination Day: Spotlight on Lesotho’s MSM Community

By Maryanne W. Waweru 1 March 2022, Zero Discrimination Day. Celebrated every year, Zero Discrimination Day underscores the right of everyone to live a full and productive life—and live it with dignity. The day promotes inclusion, compassion, peace and, above all, a movement for change. It helps to create a global movement of solidarity to end all forms of discrimination. On Zero Discrimination Day this year, IPPFAR highlights the work of it's Member Association in Lesotho -The Lesotho Planned Parenthood Association (LPPA) in providing services to men who have sex with men (MSM). We tell this through the experience of Tsepo Mokoena. Tsepo Mokoena, 36, is a volunteer peer educator at the Lesotho Planned Parenthood Association (LPPA) clinic in the capital city of Maseru. This is an activity that Tsepo, who identifies as a gay man, has been engaging in for the last five years. “I was inspired to be a volunteer after realizing that many men who have sex with men (MSM) face various challenges regarding their sexual health, yet they are hesitant to seek help from health facilities. These challenges include treatment for sexually transmitted infections (STIs), access to condoms and lubricants, as well as HIV counseling and testing. The fear of being ridiculed, stigmatized and condemned by clinicians because of their sexual orientation holds them back from visiting health facilities. However, having been a beneficiary of LPPA’s services, I could attest to the professionalism of the staff and the quality of services, so I had no reservations about referring MSM to LPPA,” he says. UNAIDS considers gay men and other men who have sex with men, sex workers, transgender people, people who inject drugs and prisoners and other incarcerated people as the five main key population groups that are particularly vulnerable to HIV and frequently lack adequate access to services. Gay men and other men who have sex with men are 27 times more likely to acquire HIV than the general population. Their vulnerability is heightened due to various behavioural factors including unprotected receptive anal sex, multiple sexual parters, sexual violence, and use of recreational substances such as drugs and alcohol. Despite having a small population of 2.1 million people, Lesotho has the second highest HIV prevalence in the world. Lesotho’s HIV prevalence rate in the 15-49 age group is 21.1%. While HIV prevalence is high among the general population, it particularly affects sex workers, men who have sex with men and women. Operating in an environment where homosexuality is decriminilized in Lesotho, the awareness of MSM’s heightened vulnerabilities to negative sexual health outcomes led LPPA to initiate programmes targeting this group. “LPPA provides services to MSM in all its clinics. Some of these services include distribution of condoms and lubricants for free, treatment services for STIs, HIV testing services (HTS), Pre-exposure prophylaxis (PrEP), Isoniazid Preventive Therapy (IPT) for the prevention of tuberculosis in people living with HIV, and antiretroviral therapy (ART) for those who are HIV positive. We offer services in our clinics and during targeted outreaches in the community. Our work is boosted by community health workers and peer educators, who have been trained by LPPA to offer non-discriminatory information and services to all people, regardless of their sexual preferences,” says Ms. Mamojela Koneshe, LPPA’s Executive Director. One of these trained peer educators is Tsepo, whose activities see him visit MSM hotspots where he shares information about sexual health and safe sex practices. Some of these hotspots include bars, lodgings, restaurants and popular streets where they hang out. Some of the MSM are sex workers, while others are married to women. While educating them, Tsepo also gives them condoms and lubricants for free, which he gets from LPPA. Studies have shown that lubricants help to lower the risk of HIV transmission by minimizing potential skin tears. “Reaching out to MSM with sexual health education is a passion for me. It is my desire to see all gay, bisexual and trans men in Lesotho receive quality sexual reproductive health services in a manner that meets their needs are are respectful of their rights. The LPPA service providers have expertise in sexual health and so when I refer MSM there, I know they are in good hands,” says Tsepo. At the LPPA Maseru clinic, Tsepo utilizes one of the counseling rooms for his volunteer services. MSM know the days and times of the week he is available there, so they ensure to come see him then. The room is well stocked with condoms and lubricants, with the walls plastered with posters about safe sex practices. “The main entry point for most MSM who come here is HIV testing and STI treatment. I have particularly found that their knowledge about issues surrounding HIV and AIDS is low, so I educate them on the same before referring them to LPPA clinicians for respective services. Afterwards, many pass by this room for a chat. This room is a safe space for MSM, where conversations are held openly and freely. For those who test negative for HIV, we talk about safe sex practices. For those who test positive, I encourage them and emphasize the importance of protecting their partners. We also discuss about the need for a healthy diet and adherence to their drug regimen,” explains Tsepo. Many times during their discussions, the clients offer Tsepo their feedback about LPPA’s services. “They tell me they feel protected and understood by the clinicians. They don’t feel judged and are treated just like any other client. This makes them happy, and this motivates them to come back for services again,” he says. In 2020, a total of 247 MSM accessed HIV self-test kits from LPPA’s clinics. A further 413 received HIV testing services, while 13 MSM were placed on Pre-exposure prophylaxis (or PrEP), which is medicine taken to prevent getting HIV. PrEP is highly effective for preventing HIV when taken as prescribed. PrEP reduces the risk of getting HIV from sex by about 99% (CDC). In the same year, 16 MSM were initiated on antiretroviral therapy (ART), while 22 were put on Isoniazid Preventive Therapy (IPT) for tuberculosis prevention. Lessons learned LPPA’s Executive Director says the organization strives to addresses the various barriers that hinder MSM’s enjoyment of their sexual rights and access to health services. “MSM require special care and friendly services as they are sensitive to cultural and societal discrimination. We ensure that we offer services that are tailored to their unique healthcare needs and are delivered in an ethical and person-centered manner. We are always happy to receive MSM in our clinics, where they are treated with respect and utmost professionalism,” she says. Ms. Koneshe notes that the number of MSM in the community are higher than is recorded, since many are still closeted. Some are married with children, or have female partners in their attempt to hide their sexual identity. “One strategy that has led to LPPA’s success in reaching MSM is including them as partners. We involve MSM at all stages of our interventions that target them; right from the design, planning and implementations. We do not impose anything on them but work with them as partners. We listen to them, adjust accordingly and work together to achieve positive health outcomes,” she says. Tsebo remains grateful to LPPA for the role it continues to play in helping MSM realize their sexual reproductive health rights in Lesotho, through provision of information and quality services that are tailored to their needs. “As a volunteer, I’m happy to be a part of the LPPA team that does this great work in the community and for the good of our country’s health goals, especially towards addressing the HIV scrouge.” Maryanne W. Waweru is the Communications Officer, IPPF Africa Regional Office. For more updates on our work, follow IPPF Africa Region on Facebook, Twitter, Instagram and You Tube.

LPPA
07 May 2019

“What I Find to be Most Unique about LPPA’s Volunteer Program” – Phenny Hanssen

By Maryanne W. WAWERU Mrs. Phenny Hanssen is the immediate past President of the Lesotho Planned Parenthood Association (LPPA), which is IPPF’s Member Association in Lesotho. In this interview with Maryanne W. Waweru, she shares insights about her motivation for joining LPPA, and some of the highlights during her leadership. When did you become an LPPA Volunteer? I joined LPPA as volunteer in 2004. At that time, I was working in a development organization where I was managing an HIV/AIDS project. One of the organizations that we were working closely with was LPPA, which was at the forefront in pioneering certain health interventions that other institutions were reluctant to get into. Some of these interventions included those around family planning and HIV/AIDS. LPPA’s work was felt all the way from the national to the grassroots level. I wanted to be associated with such an organization that was renowned for bringing positive change in the community. What are Some of the Notable Contributions that Volunteers made to LPPA During your Tenure? As volunteers, we were instrumental in securing various LPPA’s assets such as land. To ensure that LPPA was in possession of all required legal documents proving ownership of its properties, the Board set up a taskforce and volunteers, led by branch officials, worked closely with Municipal Councils to successfully secure LPPA’s assets. LPPA volunteers were also involved in resource mobilization and fundraising activities for the organization. We offered our time, expertise and experience in supporting the organization to write winning proposals that helped it secure funding for some of its projects. Some volunteers were also able to stand in as good references for LPPA. I remember once being called by an international donor agency that was enquiring about LPPA’s capacity to implement a certain project that targeted women at-high-risk for HIV. I assured the donor that LPPA was fully capable of implementing the project and delivering results. LPPA went on to receive the grant and successfully implement the project.     During my tenure, I led processes that contributed to supporting the organization execute its functions well. These included the development, review and update of various statutory documents such as the LPPA constitution, Human Resource policy, the Financial Management policy and other workplace guidelines. The fact that our volunteers are drawn from diverse backgrounds greatly contributed to the success of our mandate. During our volunteer recruitment drives, we ensured that we targeted individuals drawn from various professional backgrounds such as lawyers, engineers, doctors, nurses, social workers, teachers, Human Resource specialists, accountants and IT experts, among others. What do you Find to be Exceptional about LPPA’s Volunteer program? One aspect that stands out about LPPA’s volunteer program is the fact that the organization places high regard in its volunteers. The voices of the volunteers hold weight when it comes to all aspects of the organization; right from its leadership, program design, implementation, community mobilization and even service provision. With LPPA, volunteers (including young people) are encouraged to express their thoughts, share ideas and offer suggestions on different issues pertaining to the success of the organization. They are all welcome and highly considered – something that you won’t easily find in many organizations. The LPPA volunteer program also allows individuals to utilize their skills and realize their potential by serving in different capacities -including in leadership positions. Additionally, being an LPPA volunteer accords members the opportunity to network with each other and grow as individuals. LPPA’s youth volunteer programme is also like no other. The Youth Action Movement (YAM) program gives young people the platform to increase their knowledge and build their capacity not only in sexual reproductive health issues, but also enhance their leadership skills and prepare them for the labor force. YAM members have acquired a wide range of skillsets that have helped them in their career growth. I can confidently say that some former LPPA YAM members today hold influential positions in organizations in the health and development sector in Lesotho - with some of their capacities having been significantly built at the time they volunteered with LPPA.   I am proud to be associated with LPPA and I am greatly honored to have served in the LPPA leadership. I continue to support the organization fully.    Learn more about Lesotho Planned Parenthood Association (LPPA) here. For more information about the work of IPPF Africa Region, follow us on Facebook and Twitter.   Maryanne W. Waweru is the Governance and Compliance Officer, IPPF Africa Region.

Lesotho Planned Parenthood Association (LPPA)
11 December 2018

Awarding the Best Performing Clinics: Lesotho Planned Parenthood Association (LPPA)

In order to enhance the quality of care and discipline among its service providers, the Lesotho Planned Parenthood Association (LPPA) has developed a system that strives to promote and maintain a culture of excellence in service provision. This is through the practice of rewarding its best-performing clinic. Each year, during LPPA’s Annual General Meeting (AGM), the best-performing clinic is feted, with the award being presented to the Chairperson of the related branch by the LPPA President. LPPA has established that this annual practice helps in ensuring that each service provider is committed to delivering on LPPA’s mandate; that of offering quality sexual and reproductive health services to the Mosotho people and more so the vulnerable, poor, most-at-risk and hard-to-reach populations. The practice helps in ensuring that each LPPA client receives the highest standards of quality care and delivered to them in the best conditions; wherever they are. Good quality of care enhances clients’ satisfaction and their use of services -a status that LPPA endeavours to achieve for all its clients. Key elements in the judging criteria for LPPA's best-performing clinic include: Overall cleanliness of the clinic Adherence to service delivery and infection prevention guidelines Initiative in outsourcing Sexual Reproductive Health (SRH) information for both service providers and clients Integration of HIV and AIDS with SRH information and services Number of clinic-based health talks Information dissemination to the community through various media Adequacy and timely reporting e.g. service statistics Adequacy in reporting of finances Adherence to supplies logistic management guidelines Adequacy in reporting commodities Percentage change in the amount of income raised through clinic services Percentage change in number of new acceptors Percentage change in Couple Year of Protection (CYP) Award Recipients The clinics that have been recipients of this award include: Botha-Bothe clinic in the Northern Branch Maseru clinic The Male clinic  Healthy Competition The award system has been noted to influence positive competition and growth at the clinic level, which has helped make LPPA’s facilities the clinics of choice for many people in Lesotho. LPPA’s Program Director Ms. Makatleho Mphana says the practice has challenged clinics to be more innovative. “The awards system has spurred clinics to engage in income generation activities -which are undertaken in an accountable manner. As the MA clinics compete for the annual award, they ensure that they give their best performance all year round. It encourages them to be innovative in their service delivery approaches. The awards system assures clients, LPPA volunteers, partners and donors that our service providers are committed to providing quality services to all,” she says.  This initiative was identified as one of LPPA’s Good Practices during the 3rd Cycle of Accreditation. A Good Practice is an activity or practice that has been proven to work and yields positive results. The sharing of Good Practices by IPPF Member Associations offers learning experiences for their counterparts. Learn more about Lesotho Planned Parenthood Association (LPPA) here.  Also Read:  What’s in a Game? ABUBEF’s use of Playing Cards for Youth SRHR Education Mobile Clinics in Cape Verde: Taking Services Closer to the People For more information about the work of IPPF Africa Region, follow us on Facebook and Twitter.

Accreditation_IPPF_Africa_Region
20 July 2018

Reproductive Health Uganda and Lesotho Planned Parenthood Association Receive Accreditation Certificates

By Maryanne W. Waweru Two IPPF Africa Region Member Associations; Reproductive Health Uganda (RHU) and the Lesotho Planned Parenthood Association (LPPA) have been recognized for their success in the 3rd IPPF Accreditation cycle. About IPPF’s Accreditation Process As a global sexual and reproductive health and rights movement, IPPF is guided by key Standards and Responsibilities of membership. IPPF expects all Member Associations who wish to be a part of the Federation to uphold and promote the well-defined 10 Principles of Membership, and to comply with the different Standards associated with each Principle. The ‘Accreditation Process’ is based on these 10 Principles and Standards. Accreditation is an important tool for every Member Association’s self-reflection and improvement. It also serves as an effective means of improving communication between Member Associations and the IPPF Secretariat. The Accreditation process further helps in ensuring Member Associations’ accountability to the clients they serve, and to the donor community. The 10 Membership Principles and their associated Membership Standards require that a Member Association is: Open and democratic Well governed Strategic and progressive Transparent and accountable Well managed Financially healthy A good employer Committed to results Committed to quality, and A leading SRHR organization in its country When full compliance is achieved, Member Associations are recognized as fully accredited members of the Federation by the Governing Council; IPPF’s highest decision-making body. The 3rd cycle Accreditation certificates for Reproductive Health Uganda (RHU) and Lesotho Planned Parenthood Association (LPPA) were awarded during an awards cocktail ceremony held in Nairobi, Kenya on 29 June 2018 -on the sidelines of the 48th Session of the IPPFAR Regional Council. The awards were presented by the IPPF Africa Regional Chairperson Hon. Antonio Niquice. We congratulate the MAs of Uganda and Lesotho for their success in the 3rd cycle of Accreditation (2016 – 2020). Read more about Reproductive Health Uganda here and Lesotho Planned Parenthood Association here. For more information about the work of IPPF Africa Region, connect with us on Facebook and Twitter. Story by Maryanne W. Waweru, Governance and Compliance Officer, IPPF Africa Region

Lesotho Planned Parenthood Association

One of IPPF’s central beliefs is that processes and approaches need to be adapted to meet the specific needs of a country. In Lesotho, a country with one of the highest HIV prevalence rates in the world, LPPA is very active in finding new ways to address neglected needs.

LPPA provides a comprehensive range of sexual and reproductive health including: family planning, the  management of sexually transmitted infections (STIs),  screening for cancers of the reproductive system, the distribution of contraceptives and emergency contraceptives, pregnancy testing, post-abortion care, voluntary counselling and testing (VCT) and the management of infections. Clients are referred to other centres for CD4 tests and ARV treatment. 

LPPA reaches out to the communities it serves through 47 service points: 10 permanent clinics, 9 private providers, 30 associated agencies, 90 peer educators and 14 community-based distributors (CBDs). There are 54 permanent staff who are supported by over 200 volunteers.

An estimated 75% of LPPA's clients are poor, marginalized, socially excluded and/or under-served. Target groups include cattle herders, prisoners, rural populations, factory workers, university students, police trainees and people living with HIV and AIDS. 

LPPA targets out-of-school children, and disseminates SRH information through drama, puppetry, sports for life, and facilitated discussions. Other education programmes include health talks, workshops, performances and radio and TV shows.

In advocacy, LPPA reaches out to teachers, religious leaders and government leaders to promote favourable approaches to, and legislation on, SRH. 

LPPA has influential partnerships with government health and population departments, and it partners with major non-governmental organizations (NGOs). Donors include Irish Aid, UNDP, the Japan Trust Fund, and IPPF’s Korea Africa Fund. The Member Association has strong linkages with other organizations across the country, particularly in relation to HIV and AIDS.

Website: www.lppa.org.ls