The Ministry of Health in Lesotho has identified key milestones and timelines that set the roadmap for establishing the country as the recognized and accredited Centre of Excellence (CoE) on Community-based management of TB in Africa. 

The CoE will help Lesotho to increase TB diagnosis and treatment at community level, targeting the most vulnerable. Furthermore, the CoE will enable Lesotho to become the epicentre of information and knowledge on community-based management of TB for other countries to learn best practices and innovative approaches aimed at eliminating the scourge of TB.

One of the milestones identified is the purchase of digital mobile X-rays that will be useful in improving the delivery of TB diagnosis services in the communities where the people reside. The digital mobile X-rays will also play a critical role in delivering on the planned TB Prevalence Survey to estimate the number of people living with active TB in Lesotho in 2018. 

The digital mobile X-rays will move around the communities at regular intervals to increase coverage. It is expected that the digital mobile X-rays shall also include OMNI equipment for testing and confirming TB diagnosis. In addition, the digital mobile X-rays will initiative TB treatment and refer the patients to the local clinics and hospitals. This approach has been made possible by the Southern Africa Tuberculosis and Health Systems Support (SATBHSS) project funded by the World Bank (WB) at a total cost of USD 122 million.

The project is implemented in four countries; Lesotho, Malawi, Mozambique and Zambia with technical support provided by NEPAD Agency and East Central and Southern Africa Health Community (ECSA-HC). The aim of the SATBHSS project is to improve coverage and quality of key TB control and occupational lung disease services in targeted geographical areas of the participating countries and strengthen regional capacity to manage the burden of TB and occupational diseases in the Southern African Development Community (SADC).

In order to achieve this and implement innovative approaches, the Ministry of Health in Lesotho has drafted Terms of Reference (TORs) and a concept note for engaging a local NGO that shall be closely supervised to implement the community TB approaches. In addition to managing the digital mobile X-rays at community level on a day-to-day basis, the local NGO will also be strategically engaged to accelerate education and community outreach activities. 

These activities shall hugely involve the participation of local community structures and leaders i.e. chiefs, headmen, etc. A combined team from World Bank, NEPAD Agency and ECSA-HC undertook a country project support mission to Lesotho to review the TORs and concept note, as well as provide technical backstopping on the key milestones and timelines. The feedback will now be incorporated by the Ministry of Health as they finalize the documents.  

The procurement process for the digital mobile X-rays has already commenced and operations are expected to start in 2018 after the local NGO has been engaged.

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