Improving the retention of mother-baby pairs at Seshote Health Center in Leribe District, Lesotho

Seshote Health Center is a small facility in the rural, mountainous area of Leribe District in Lesotho. In August 2016, with support from USAID, Seshote's eight-member quality improvement (QI) team established an improvement aim: to increase retention of mother-baby pairs seen at the facility from 0% in August 2016 to 55% by February 2017.

Although mother-to-child transmission accounts for 90% of new HIV infections among children in Sub-Saharan Africa, risks are reduced to below 5% when prevention of mother-to-child transmission interventions are implemented. Three change ideas were tested:

  1. create an appointment book dedicated to mother-baby pairs;
  2. schedule mothers and their babies for appointments on the same day; and
  3. track mothers who did not show up for appointments.

The Seshote Health Center team was able to improve mother-baby pair retention from 0% to 14% between August 2016 and February 2017, and then with a greater sense of ownership, accountability, and motivation, from 14% to 69% between February and August 2017. This improvement contributes to Lesotho's work under the Partnership for HIV-Free Survival. In addition, the Seshote Health Center QI team has implemented structures and processes to sustain their commitment to ongoing improvement.

Read this case study.

Report Author(s): 
Lerato Hlehlisi and Khotso Mahlalefa
USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project/URC
ASSIST publication: 
ASSIST publication
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