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ICAP has partnered with the Government of Lesotho since 2005, providing technical leadership to accelerate and expand access to HIV and TB prevention, care, and treatment.

We work at the national level with the Ministry of Health and with district health teams and health facilities in Berea, Leribe, Quthing, and Qacha’s Nek. Additional partners include: the Global Fund for AIDS, TB and Malaria, WHO, UNICEF, universities and educational institutions providing nurse and midwife training, and corporate partners addressing HIV and TB through the private sector.

Current Projects

HIV Impact Assessment Survey (PHIA)

ICAP is providing technical assistance and support to Lesotho’s MOH to conduct a population-based HIV impact assessment (PHIA) survey to assess HIV prevalence, incidence, and access to prevention, care, and treatment services. Survey findings will be used to evaluate the impact of Lesotho’s HIV response at a national level and to help guide and target future investment and programs. (funded by PEPFAR through the CDC)

Strengthening Strategic Information for Health

ICAP provides technical assistance to strengthen national health information systems and support data use and data management to inform health programs and policy. Activities aim to enhance the coordination of health management systems and surveillance activities and support the implementation of an electronic medical records system. (funded by PEPFAR through the CDC)

Nursing Education Partnership Initiative

Expanding the role of nurses and midwives is critical to meet Lesotho’s national healthcare needs. ICAP is partnering with all six nurse training institutions in Lesotho to enhance teaching and learning in the classroom and clinical settings and ensure an adequate number of well-trained and qualified nurses and midwives. Online at nepinetwork.org. (funded by PEPFAR through HRSA)

Research on Integrated TB/HIV Care for Miners (the PROMISE Study)

ICAP is conducting implementation science research to evaluate an intervention strategy to improve early detection of HIV and early initiation of antiretroviral therapy (ART) and concurrent isoniazid preventive therapy (IPT) among migrant miners and their families. This prospective cohort study is evaluating the effectiveness, feasability and acceptability of family-focused, integrated TB and HIV services provided six-days per week in miner-friendly service venues, compared to the standard of care in public health facilities. This intervention leverages ICAP’s partnership with TEBA Limited, an employment agency for miners, and includes structural, clinical, and psychosocial components, including service provision at TEBA offices and real-time adherence support using SMS text messaging and lay counselors. (funded by PEPFAR through the CDC)

Research on Prevention of Childhood TB (PREVENT Study)

ICAP is conducting an innovative mixed-methods cluster-randomized implementation science study that aims to evaluate the effectiveness and acceptability of a combination community-based intervention (CBI) versus standard of care (SOC) to identify and screen child contacts of adult TB cases in Berea District, Lesotho, and provide those eligible with IPT. This CBI leverages ICAP’s partnership with the Lesotho MOH, and holistically addresses the complex provider-, patient-, and caregiver-related barriers to prevention of childhood TB through: nurse training and mentorship; health education for caregivers and patients by village health workers; adherence support using text messaging and village health workers; and multidisciplinary team meetings. (funded by NIAID)

Global TA: TB in Miners

ICAP is partnering with the MOH and local partners in Lesotho to strengthen monitoring and evaluation systems in order to improve linkage of pediatric patients to HIV care and treatment. This includes supporting data collection, ensuring data quality, and developing an analysis plan, and disseminating results. (funded by PEPFAR through the CDC)

Global TA: TB/HIV Evaluation

ICAP is partnering with the MOH to conduct a comprehensive TB and HIV program evaluation that is assessing: 1) intensified TB case finding among all people living with HIV and provide treatment for those diagnosed with TB, and isoniazid preventive therapy (IPT) to those without active TB; 2) HIV testing for all TB patients and patients with presumptive TB, and provide antiretroviral therapy (ART) for those who are HIV-positive; 3) TB infection control measures at facilities to decrease TB transmission among people living with HIV; and 4) linkage and retention of patients between TB and HIV programs. (funded by PEPFAR through the CDC)

Global TA: Accelerating Children’s HIV/AIDS Treatment (ACT) Initiative

ICAP is partnering with the MOH and local organizations in Lesotho to strengthen monitoring and evaluation systems with the aim of improving linkage of pediatric patients of HIV care and treatment services. (funded by PEPFAR through the CDC)

Recently Completed Projects

The START Study (2012 – 2016)

The START Study was a cluster site-randomized trial that evaluated a combination intervention package versus the standard of care with the goal of improving early antiretroviral therapy (ART) initiation and retention rates during TB treatment, as well as TB treatment success, among HIV-infected TB patients in Lesotho. (funded by PEPFAR through USAID)
Read the project brief.

Strengthening TB/HIV Integration under PEPFAR (2009 – 2015)

ICAP provided technical leadership to support health systems strengthening to mitigate the impact of the dual epidemics of TB and HIV. ICAP The scope of work included: building the capacity of the MOH to develop and expand access to HIV and TB prevention; supporting comprehensive HIV care and treatment services; establishing an effective and sustainable network of laboratories and; supporting the development, dissemination, and implementation of TB/HIV related policy, guidelines, registers, and tools. (funded by PEPFAR through CDC)
Read the project brief.

The EPIC Study (2013 – 2015)

EPIC was a feasibility research study focused on HIV prevention among serodiscordant couples. (funded by the NIH)

TB Care and Treatment for Miners (2009 – 2015)

To address high rates of TB among Lesotho’s migrant workers, ICAP forged a public-private partnership with TEBA, the country’s largest mining recruitment company. The project established clinics at TEBA offices in Maseru, Mafeteng, and Leribe as non-traditional points of care providing TB rapid testing, same-day diagnosis, and treatment. ICAP-trained TEBA care providers to conduct TB contact tracing and support retention in care among miners and their families. (funded by TB Reach/WHO) Read the project brief.