1. Pact Lesothon AGYW Program Presentation
Civil Society Meeting
Speke Munyonyo
26th June 2019

2. Name of Grant
Stepping up universal access: multi-sectoral partnership response to TB/HIV at the community level
Country Office
Lesotho
Name of Prime Award Donor
The Global Fund
Grant Start Date
01 July 2018
Grant Completion Date
30 June 2021
Period of Grant Performance
3 Years
Award Amount
$12, 347, 559
AYP Allocation
$2,841,681 (23%)
Catalytic Funding $

3. Program Goals and Objectives
To Fast Track Test and Treat Cascade to attain targets by 2023
Program Goals:
Reduced HIV incidence by at least 75% from current baseline, by 2023
Reduced AIDS Related deaths by 50% from current baseline, by 2023
TB mortality and incidence reduced by 75% and 50% respectively
Mother to child transmission of HIV eliminated, (from 6% less than 2%), by 2023
To achieve 95% access to combination prevention by 2023
To ensure that at least 40% of the HIV/TB response is community-led and sustained by 2023
To remove Gender and Human Rights Related Barriers to service delivery, accessibility and utilization by 2023
To Eliminate Mother to Child Transmission and have 95% of children living with HIV on treatment by 2023
To ensure that 75% if PLHIV, at risk of and affected by HIV benefit from HIV-sensitive social protection by 2013
To ensure that Health System is people-centered, and sustainably integrates HIV, TB, and other infections by 2023
To increase efficiencies and financial investments in HIV and TB programs from 60% to 90% of the NSP budget by 2023

4. Program Areas under GF- by module
Prevention programs for Gen Populations
Comprehensive prevention programs for FSW and their Clients
Comprehensive prevention programs for Men who have sex with other men and TGs
Prevention programs for adolescents and youth- In and out of school (ages 10 to 24)
Prevention programs for other vulnerable populations
Treatment, care and support
ESSH: Community Response and Systems
Program Management
Programs to reduce human rights-related barriers to HIV services
Cut -across
Cut- across

5. Program Interventions by Module (Core Packages)
Module and/or Target groups
Package of Services
Prevention programs for General Populations
SBCC- “be wise” manual (Integrating HIV, TB, GBV and Human rights using HIV related laws), Condoms, and HTS ( index testing and linkages to ART), Other Health referrals and Linkages (VMMC, PMTCT, STI)
Comprehensive prevention programs for people in prisons and other closed settings;
SBCC (Integrating HIV, TB, GBV and Human rights), Condoms, and HTS
Comprehensive prevention programs for FSW and their Clients
Comprehensive Prevention programs for Vulnerable Populations (Factory Workers and Inmates)
Prevention Programs for Adolescents and Young People (In and Out of schools)
SBCC- “CSE Manual” (Integrating HIV, TB, and Human rights), Condoms education, , and HTS, RMNCH and SGBV, Community Mobilization and Parental engagement, Socio-Economic approaches

6. Comprehensive/core package of services for AYP
SBCC: CSE sessions {Comprehensive knowledge
health care services demand
creation}
Condom education
Condom distribution
Parental engagement
Community mobilization
HIV counselling and testing services
SRHR services (biomedical)
- ve
CAGS for adherence support
+ve
Post violence care
SGBV screening (risk)
Herd boy activities
Return to school
Worth groups (opt in)
CSE in school
Action Youth clubs (opt in)
Be Wise
Dignity packs

7. Program Geographic coverage
Pact –TGF Supported districts
Butha-Buthe
21%
Leribe
25%
Berea
25%
Thaba-Tseka
25%
TGF
Mokhotlong
17%
Maseru
28%
Mafeteng
25%
Qacha’s Nek
21%
Quthing
21%
Moahle’s Hoek
20%

8. Implementation Arrangement
Sentebale ((Comprehensive/ core package of services for AYP)
Skillshare (Comprehensive/ core package of services for AYP)
LENASO (Index and targeted testing for adults
LENASO:
Prevention Programs for General Populations:
a. Social and Behaviour Change Communication ( Couples Counselling on HIV related issues, Positive Prevention )
b. Linkages HTS and other Health care services;
c. Pre ART mop-up and
d. ART defaulter tracing.
Baylor (biomedical services for AGYW)
MoSD:
Social Protection program
USAID/PEPFAR:
DREAMS Initiative
Dual Track (MoF-PMU & Pact) and other National programs and Initiatives
Linkages for AYP Mothers and their partners
Linkage s for AYP
Linkages to Youth action clubs, Network clubs and livelihood and Economic opportunities
MoH:
a) Technical Support, supervision & quality assurance of services;
NAC & MOH: Coordination;
a) KP-TWG;
b) AYP-TWG;
c) Partners meetings

9. Skillshare in consortium with LNOC
Prevention programs for Adolescents and young People (In and Out of School)
Mafeteng
Mohale’s Hoek
Quthing
Qacha’s Nek
Skillshare in consortium with LNOC
Leribe
Butha-Buthe
Mokhotlong
Thaba-Tseka
Sentebale

10. Program evolution trajectory (Experience)
Siloed and parallel interventions;
Independent program detached from the National program with its on tools and Materials;
A gigantic amount of cash handling and inherent risks
Blanket approach to services delivery
More Integrated National program;
Well coordinated and nation owned program;
A well established cash management system
Targeted and tailored services delivery
Redesigning the program
Transitioning the SRs
Building relations with shareholders

11. Key achievements and or/ the promosing practices
The development of nationally recognised core package of interventions with all the partners;
Securing Government (MoH) support and strong coordination role and technical support ( success in setting up 2 TWGS- AYP and KP)
Implementation of Score card as the accountability mechanism for the AYP services delivered through the Global Fund support;

12. Challenges
Managing relations for the SRs that implement the same module under different PRs presents a challenge to the PRs to be intentional and have a clear coordination mechanism to avoid competition.
Working with the Ministry of Health as the SR and the custodian of Health services can be a challenge and has the tendency to stifle progress, at times.
Sub recipient compliance very challenging at the beginning
Adolescents and young people are very mobile and they do not report to any program when they have to leave a village or/ a community.
Limitted control on In school delivery for Comprehensive sexuality education.

13. Thank you