A health worker carries out dried blood spot (DBS) testing to determine HIV viral load at remote clinic in Lesotho. Credit: Phomolo Motsoeneng

Reducing the Burden of HIV/AIDS and Health Systems Strengthening

The Challenge

Health services are inaccessible to much of Lesotho’s mostly rural population. The health system needs support to strengthen the quality of service delivery and equitable distribution of health resources. Primary health care is recognized as the most effective and efficient way to improve the health and economic productivity of rural populations such as those in Lesotho.

Overview and Objectives

The Millennium Challenge Corporation (MCC) awarded URC this five-year contract to support the design and development of a five-year compact intended to provide funding for strengthening the health system and improving primary health care services in Lesotho.

URC’s role in the development of the compact includes assessing constraints and opportunities to inform planning for the MCC-funded health compact’s health system strengthening activities. This includes an assessment of key economic, social, cultural, and system constraints and opportunities that impact Lesotho’s health system and service delivery. The assessment process includes stakeholder consultations, an extensive analysis of the health system’s performance, and identification of gaps in capacity and available support.


The results of URC’s assessments are being used to develop the technical framework for MCC’s support to strengthening primary health care throughout Lesotho.  

In addition to informing the development of this compact, URC’s formative assessment work ensures the future implementation of contextually appropriate evidence-based interventions, including health systems strengthening support in areas including governance, finance, and service delivery.




Health Service Delivery, HIV/AIDS, Infectious Diseases, Quality Health Systems

Millennium Challenge Corporation (MCC)

Bixal, Social Impact, The Manoff Group