Extending prevention of mother-to-child transmission through postpartum family planning in Lesotho

Recognizing the need to improve the care and follow up of mothers and infants in the postpartum period, the Lesotho Ministry of Health and Social Welfare (MOHSW), with technical support from the Frontiers in Reproductive Health (FRONTIERS) of Population Council and funding from PEPFAR/RHAP/USAID, carried out an operations research project to strengthen the existing postpartum care services. This study had a specific focus on strengthening linkages with existing PMTCT follow-up and family planning services during the postpartum period by changing the number, timing, and content of postpartum consultations that a woman and her newborn should receive. The key findings indicated that facilities were prepared or needed minimal adjustments to provide the postnatal care services. Provider knowledge and practice improved and there were increases in the number of women testing for HIV; the proportion of providers who would recommend the lactational amenorrhea method and condoms to postpartum women; and women who said they intended to use family planning. The report recommends that MOHSW make efforts to sustain this initiative and roll out the package to the rest of the country, and includes policy issues that need to be addressed

Case Study: Primary Healthcare Clinical Placements during Nursing and Midwifery Education in Lesotho

In Lesotho, primary healthcare is the main access point for health services. While nurses and midwives provide most of the care at this level, assessments of the clinical education programs have highlighted gaps in primary healthcare experiences for nursing and midwifery students. This case study examines placement of nursing and midwifery students in primary health clinics alongside preceptors. The placements provide students with varied clinical experience, better preparing them to practice in primary healthcare clinics. To date, more than 700 nursing and midwifery students have been placed in 40 rural health centres and 228 preceptors have been trained. The government is scaling up the program nationally

Student and preceptor perceptions of primary health care clinical placements during pre-service education: Qualitative results from a quasi-experimental study

As a practice discipline, nursing education has a mandate to collaborate with all clinical settings, including primary health care (PHC), to prepare nursing students to function effectively in different settings upon deployment. Prior to 2011, nursing and midwifery students received minimal exposure to PHC settings in Lesotho. In 2010, the Maternal and Child Health Integrated Program began working with nurses' training institutions to support PHC clinical placements. Between April 2013 and June 2014, a multi-methods study was conducted to describe the effect of PHC placements on students and preceptors. The study employed qualitative methods, namely seven focus group discussions (FGDs), held with 69 students and preceptors. Data analysis followed the principles of grounded theory. Students, nurse educators and preceptors perceived PHC clinical placements as appropriate settings for acquisition of a variety of country relevant clinical experiences for nurses and midwives in Lesotho. Students expressed their likelihood to accept deployment at PHC settings post-graduation. Preceptors indicated that PHC clinical placements re-enforced the importance of continuing education for practicing clinicians. The placements supported an increase in competence and confidence of nursing and midwifery students, which will likely aid their transition into the workforce and perhaps increase the likelihood for the young professionals to accept deployment to these areas post-graduation. Given the disease burden in Lesotho and that majority of Basotho people access healthcare at the PHC level, every effort should be taken to ensure that nursing and midwifery students get adequate exposure to health care provision at these facilities