Lesotho Health Systems Strengthening and Counter Gender Based Violence Support

Overview and Objectives

Through the Millennium Challenge Corporation (MCC) and the Government of Lesotho, the Lesotho Health and Horticulture Compact began on March 30, 2024. Within this Compact, the Health System Strengthening (HSS) project engages local accountable entities to provide the necessary technical services and support to the Ministry of Health (MoH) and other partners/stakeholders. The aim is to improve health outcomes through strengthening Lesotho’s primary health care (PHC) system by:

• Providing quality PHC, including gender-based violence (GBV) prevention and response, through an integrated approach that includes support to stakeholders at the national, district, and village levels
• Improving the capacity of district health management teams to address local priorities and deliver high quality PHC services to the populations they serve
• Making health data systems across Lesotho interoperable and improving data availability, confidentiality, analysis, and usability at all levels of the health system, as well as equipping the government to improve its current and future workforce capacities to analyze and use health data.

Lesotho faces challenges in several health indicators compared to its Sub-Saharan Africa income group peers. While current HIV-focused donor funding supports the MoH in delivering HIV/TB services, expanding access to comprehensive primary health care remains a priority to improve public health and attract private sector investment. Additionally, strengthening governance and resource management at the central level and increasing fiscal autonomy at the district level would empower local authorities and health facility managers to better respond to the demand for quality health care.

URC provides technical assistance to MCC by using its team of experts in HSS, GBV, digital health, health financing, and monitoring and evaluation. This work builds on URC’s efforts in Lesotho since 2018 under the Reducing the Burden of HIV/AIDS and Health Systems Strengthening project. URC supports MCC to ensure:

• Local accountable entities are well oriented and coordinating across projects and with other HSS donors in Lesotho to ensure maximum efficacy of the HSS project 
• The scopes of work and request for proposals for procurements and grants are evidence based and relevant to the Lesotho context
• Quality issues are identified before they arise, and solutions are provided to the MCC
• Gender solutions are integrated across all components of the Compact, including those related to GBV, sexual exploitation and abuse, and counter trafficking in persons

Achievements

Under the HSS project, URC has provided the following technical support to MCC:

• Revised and simplified the monitoring and evaluation plan for the HSS project
• Developed the scope of work and request for proposals to add two new contractors to the HSS project
• Completed a functional analysis of Lesotho’s Central MoH, and the Minister of Health has committed to implementing the recommendations from the report
• Supported the Lesotho Demographic and Health Survey 2023-2024
• Reviewed assessments, work plans, M&E plans, and reports submitted by local accountable entities