Less than a year after the launch of a project that uses mobile phone apps to help give HIV-positive women and children in two Lesotho districts better access to treatment, the initiative has proved so successful that it’s due to expand across the country by June.
The Vodafone M-Pesa Mobilising HIV Identification and Treatment (MHIT) program – dubbed the Moyo project (“close to my heart” in Swahili) – aims to identify people with HIV and help them ensure they get a regular supply of antiretroviral drugs.
Part of an $8 million campaign to mobilize pediatric HIV/AIDS care in Lesotho, the Moyo project is a joint initiative by the Vodafone Foundation, the Lesotho Ministry of Health and several aid partners, including USAID and the Elton John AIDS Foundation.
In his address at the project’s launch, Lesotho minister of health Molotsi Monyamane said that with 212 clinics and 18 hospitals serving a population of more than 2 million, too many patients were falling through the gaps. “We could not encourage people enough to take pills and swallow them because we became too regimental, we did not listen to people. We asked people to test and come back three more times, while they walk half a day only to be told ‘We are closed’ when they get to the clinics.”
Started in the Maseru and Leribe districts in April 2016, and now integrated within the country’s primary healthcare strategy, the Moyo project combines Vodafone’s M-Pesa mobile money service with mobile clinics and a smartphone app that lets healthcare providers track the progress of HIV patients in remote areas. The traveling clinics provide on-site HIV testing and treatment in villages and towns that are too far from a regular clinic or hospital. And when healthcare providers identify someone as HIV positive, they immediately register the patient with the M-Pesa mobile money service.
Healthcare providers can see where their HIV-positive patients live and figure out which areas are too far from the nearest hospital or clinic. They can then send patients money through M-Pesa to pay for transportation to the nearest clinic, or send mobile clinics and treatment out to them.
At the same time, the patients’ details are put into a central database so that their future treatment and care can be planned and documented. Healthcare professionals working in the field can then recall those medical details in real time using the MHIT smartphone app.
The program primarily targets pregnant women, mothers and young children who are among the most vulnerable groups of people living with HIV in Lesotho, which has the world’s second highest HIV prevalence after Swaziland. According to the Lesotho Demographics and Health Survey 2014, one-quarter of adults aged 15–49 in Lesotho are infected with HIV. Among the country’s women, the HIV prevalence rate is 30 percent, compared with 19 percent among men. The NGO AVERT, which focuses on HIV/AIDS education, attributes the disproportionate impact of HIV on women to gender-based violence and gender inequality.
And while women in Lesotho bear the brunt of the country’s HIV epidemic, many can’t access the healthcare services they need due to the country’s terrain and the distances between their villages and healthcare centers. According to a report by Medecins sans Frontieres (MSF), 40 percent of all pregnancy-related deaths in Lesotho are caused by HIV and AIDS. MSF says the high death toll is a result of low adherence to HIV treatment – much of that due to lack of access to services.
By helping bridge the gap in Lesotho’s services, the Moyo project has already made a difference to the lives of HIV-positive women like Maboe. In a video about the project, Maboe, 43, says she learned she was HIV positive six years ago, when she was pregnant with her son Motsamai. It used to take her a whole day of walking to get to her nearest clinic and pick up medication for herself and her son. “If I left the house at 8 a.m., I would sleep over somewhere, otherwise I would get back at dark,” she said.
Now as part of the Moyo program, the clinic comes to her. And that means she feels safe enough to envision a bright future for her son.
“The nurses have really helped by coming nearer to us,” she said. “I hope [Motsamai] grows up and is healthy.”