ICAP at Columbia University is supporting Lesotho in strengthening its use and deployment of data to improve HIV and other health-based decision-making across the country.

Since 2019, with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC), ICAP has worked to build the capacity of the National University of Lesotho (NUL) to serve as the technical partner to strengthen digital health systems at all levels of Lesotho’s Ministry of Health (MOH).

Over the course of five years, ICAP’s mentorship has resulted in hundreds of newly trained systems users, setting the foundation for sustained strategic information gains beyond the project period.

In February 2020, ICAP supported NUL in conducting a participatory organizational capacity assessment (OCTA), a tool that helps evaluate an organization’s strengths and weaknesses across various areas to identify opportunities for improvement and development. OCTA results showed that NUL had no staff with advanced public health strategic information systems skills – such as use of the essential data collection and analysis systems – despite having six faculty members who had advanced university degrees in computer science and software engineering. ICAP supported NUL in developing OCTA-informed capacity-building plans for faculty, staff, and students, including health information systems development, administration, and implementation across health facilities.

“By partnering with a local university, ICAP transformed the work that NUL does to provide practical and ongoing support to the ministry, district health management team, and health facility staff to utilize digital health tools to more effectively address their patients’ needs in real time,” said Suzue Saito, PhD, MIA, MA, ICAP’s director of Strategic Information and principal investigator of the project. “More timely care – based on timely and granular data – translates to improved health outcomes for patients and sustaining epidemic control in Lesotho over the long-term.”

ICAP launched a multi-pronged training program for six NUL staff, focusing on the two competencies needed for sustainable national strategic information systems, including systems development and administration and implementation support. The ICAP training program included advanced training and hands-on activities related to public health informatics platforms used in Lesotho, such as electronic health record systems – or eRegisters – for clinic, laboratory, and pharmacy data.

ICAP deployed a number of strategies to bolster NUL’s implementation support skills, such as training on the technologies WhatsApp and Anydesk, a remote desktop application, to respond to technical assistance needs from system users remotely. NUL faculty and project staff were also trained to support health care workers with limited computer literacy through navigation of systems.

From as early as October 2020, ICAP supported NUL with continued on-the-job capacity building to co-lead activities to maintain responsive strategic information systems at 205 health facilities across 10 district health offices and HIV-related programs at the Ministry of Health. In 2021-2022, for example, NUL co-led training on DHIS2 – a software platform for aggregate data collection, reporting, and analysis – for 518 users from across the 10 districts.

“Working as collaborators under the ICAP strategic information project over the past five years has forever changed the National University of Lesotho computer science and mathematics department’s capacity to roll-out advanced public health informatics systems,” said Kopano Moeketsi, the strategic information project coordinator for NUL, “and to provide hands-on learning experiences for computer science students through practicums and internships, providing a strong pipeline as the next generation of informatics specialists to support health programs in Lesotho.”

Find the full end-of-project evaluation here to learn more about the program’s successes.

About ICAP

A major global health organization that has been improving public health in countries around the world for two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 40 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies. Online at icap.columbia.edu