Quality of Care
BCMCF-L takes a holistic approach to HIV care and treatment. Although most of our patients are HIV-infected children, we also serve their HIV-infected family members.
Prevention of mother-to-child transmission of HIV infection is the cornerstone in the fight against pediatric HIV. BCMCF-L continues to support the Lesotho Ministry of Health in providing all HIV-infected pregnant and breastfeeding women ART treatment for life. This new strategy for PMTCT benefits the woman, her child, and her family.
Early Infant Diagnosis
Without treatment, one-third of HIV positive infants will die before their first birthday and one-half will die before their second birthday [Source: UNAIDS 2013]. Early infant diagnosis is essential for reducing infant mortality. BCMCF-L proactively tests exposed infants using HIV DNA PCR technology in collaboration with Lesotho’s national reference laboratory.
Antiretroviral Therapy (ART)
ART is the cornerstone of HIV treatment, and BCMCF-L provides life-saving therapy to children of all ages. Monitoring of treatment success and potential medication side effects is provided on a scheduled basis. BCMCF-L clinicians are local experts in pediatric ART care and often consult on complicated patients receiving care at other facilities. BCMCF-L also provides 2nd-line and 3rd-line treatment options for those who have failed therapy, in consultation with the Ministry of Health ART Advisory Committee.
Consistent adherence to ART is essential for treatment success and prevention of unnecessary morbidity and mortality. Before initiation of ART, patients receive thorough adherence counseling to prepare them for their treatment regimens. BCMCF-L always has a social worker on duty for ongoing adherence counseling and psychosocial support based on referrals from our health professionals.
HIV can be an overwhelming diagnosis for children and family members alike. BCMCF-L has full-time treatment literacy staff to support our patients and their caregivers in understanding how to take their medications. They also help parents gradually disclose their children’s HIV status to them as they grow and become better able to understand their diagnosis and treatment. Visual aids comparing CD4 cells to soldiers keeping them healthy are used to help children understand why their medication is important.
TB Diagnosis and Treatment
Since HIV and TB are inextricably linked, BCMCF-L actively screens patients for TB and provides prophylaxis. Infection control procedures have been strengthened, and patients receive a daily briefing on TB prevention and diagnosis. BCMCF-L provides TB treatment for children regardless of their HIV status. Recent efforts have improved the care of HIV-uninfected children suffering from tuberculosis, and many children are referred to the COE and SCOEs for this care.
BCMCF-L has a full-time nutritionist who provides consultations to parents whose children have been diagnosed as malnourished. Therapeutic foods are provided to children with severe malnutrition through Ministry of Health programs. We have also partnered with other organizations to support the establishment of Nutrition Corners across Lesotho where health professionals educate mothers on proper nutrition for infants and young children monthly. Sessions are interactive with a hands-on demonstration of nutritious food preparation using readily available local ingredients and gardening. Through a generous donation from AIDS Orphan Care, children with mild malnutrition are provided with peanut butter to improve their diet and nutritional status. Infants and children are also provided with routine vitamin A supplementation and regular deworming – national strategies to improve nutritional status.
BCMCF-L also has full-time psychological staff to consult patients presenting with mental health problems or concerns. Some common referrals are related to depression, learning disabilities, and behavior problems. Children who have been victims of sexual abuse are often referred for counseling from nearby facilities as few facilities have full-time psychologists.
The COE is proud to participate in the Lesotho Expanded Programme for Immunizations (EPI) and provides routine childhood vaccines for our HIV-exposed and infected infants and young children.