TSA-KHOLO, Lesotho – A nurse assistance training school in this southern city graduated its first 24 students just recently, beginning to recreate a cadre of professionals whose training had been neglected since the 1970’s. They had just fallen off – the government was no longer producing these people,” said Mohato Qhobela, senior program officer with the USAID- supported Capacity Project, a five year, $1 million effort, funded by the US Presidents Emergency Plan for AIDS Relief (PEPFAR).
Qhobela’s team began working with the Lesotho Ministry of Health in August 2005, a year after USAID completed a rapid needs assessment for the health sector. One main problem was the shortage of medical professionals. This is critical, Qhobela said, because the shortage of staff comes at a time when some 24 percent of Lesotho’s 2.2 million people are HIV-positive. “The needs are astronomical,” he said Lesotho has an estimated nationwide shortage of 1,400 nurses, while the main government hospital last year reported that only 35 percent of its posts were filled.
“Lesotho has a highly studied medical system – there are many drafts of documents. But this is the first time that anyone is actually implementing anything,” said Dr. Kelello Lerotholi of the Capacity Project.
The project is helping the Ministry of Health carry out a human resources strategy that it had drafted but lacked the resources and capacity to implement.
The ministry is also being assisted in updating laws as old as 80 years to cope with new challenges like the HIV/AIDS epidemic. The project has trained officials and medical staff in HIV awareness, testing, and counseling.
“We are helping with things like, what would be the shape of the Ministry of Health under decentralization,” said Dr. Lerotholi. “The human resources strategy calls for giving more power to the local government [to provide health services] and we are providing technical assistance for that process.”
Training and technical assistance is also provided to the National Health Training College (NHTC), which produces all of Lesotho’s nurses, lab technicians, and pharmacists below the degree level. The project has helped update curriculums, train lecturers, and provide computers and medical equipment.
The Tsa-Kholo school, which was created to fall under the auspices of NHTC, is one of the project’s early successes.
“Everyone that requires a degree goes out of the country,” Qhobela said. “Everyone else trains for up to two years. But we can’t wait for two years for nurses to be produced – we need people now.”
Aside from increasing the number of newly trained medical staff, the Capacity Project is helping Lesotho’s Health ministry update job descriptions, hire, retain, and improve the conditions for existing nurses. An often lengthy and cumbersome hiring process leads many medical professionals to change fields. For instance, Lesotho is considered to have a mental health nursing shortage, but only 12 percent of qualified mental health nurses work within their profession.
