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Khotla : ‘Where Men Gather’ for male friendly health services in Lesotho

Khotla : ‘Where Men Gather’ for male friendly health services in Lesotho. By Tsebiso Maphasa. 23 July 2018 22nd International AIDS Conference Amsterdam. Background. Lesotho has a population of 2.2million, an HIV prevalence of 25% among 15-49 year olds and a TB incidence of 724 per 100 000

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Khotla : ‘Where Men Gather’ for male friendly health services in Lesotho

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  1. Khotla: ‘Where Men Gather’ for male friendly health services in Lesotho By TsebisoMaphasa 23 July 2018 22nd International AIDS Conference Amsterdam

  2. Background • Lesotho has a population of 2.2million, an HIV prevalence of 25% among 15-49 year olds and a TB incidence of 724 per 100 000 • Anecdotal and DHS evidence points out that generally Basotho men do not go for healthcare services and often attend facilities only when condition is severe. • Jhpiego has provided VMMC services to over 150,000 Basotho men and boys since 2012 • Basotho men perceived VMMC sites as their only platform for addressing their health issues. • In July 2016, Jhpiego, in collaboration with MOH and Scott Hospital management, expanded services at the ‘VMMC clinic’ to include other health services targeting men.

  3. The Khotla Model • Improved health and well-being of Basotho men • Provide comprehensive male-friendly health services under one roof. • Employ male nurses • Great environment conducive to men • Reduce stigma through avoiding ‘HIV only’ services

  4. Khotla visits by quarter since integrated services began (not including VMMC)

  5. HIV testing among men attending servicesJuly 2016 – June 2018 98.2% of all clients have a known status

  6. Number of men initiating ART by quarter

  7. Same-day ART initiation among the 101 men who tested HIV positive between Jan and Jun 2018

  8. Where chronic care clients come from X

  9. TB Cascade

  10. Co-morbidity is common: ~15% of PLHIV seen at Khotla have at least one other chronic disease Of 995 men seen, 516 were PLHIV, 78 with additional chronic disease(s)

  11. Lessons learned / Next steps • Men will travel vast distances for quality client-centred care • Men appreciate having all clinical and psychosocial needs addressed during one visit, by one provider • Male-only CAGs proving effective • Scale up by MOH and other implementing partners underway • Primary care based EMR (OpenMRS) to be installed in all consultation rooms and pharmacy

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