Scale-Up Assessment for the Mphatlalatsane Project—“Early Morning Star”—in Lesotho

Author(s): MEASURE Evaluation

Year: 2019

Abstract:

The HIV epidemic has a profound effect on children in sub-Saharan Africa, where more than 15.1 million children have lost one or both parents. In 2014, as part of its orphans and vulnerable children (OVC) programming, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) announced a special initiative for children under five years old affected by the epidemic.

The initiative funded interventions and research in southern Africa (Lesotho, Eswatini [formerly Swaziland], and Zimbabwe) to generate data on successful approaches that result in improved health, to establish evidence to improve and inform programming, and to determine the potential for program scale-up.

The programs integrated OVC programming with pediatric treatment and prevention of mother-to-child transmission (PMTCT) of HIV. Evaluations of each intervention generated data on successful approaches that improve health and early childhood development outcomes; the evaluations also established evidence to improve programs. However, evidence of effectiveness is not enough to ensure
that interventions become part of routine program implementation elsewhere. Achieving that end requires early planning and strong advocacy from multiple stakeholders. To prepare for potential scale-up after the results of the evaluation become available (scaleup pertains to efforts to reach more people with a proven practice, more quickly and more effectively), the United States Agency for International Development (USAID) asked its funded project—MEASURE Evaluation—to assess the scalability of the ECD-integrated intervention in each country.

This document outlines intervention and assessment results in Lesotho. The Mphatlalatsane project, or “Early Morning Star,” was implemented by Management Sciences for Health (MSH), in partnership with Stellenbosch University, University College London, and Oxford University. The aim was to increase HIV testing and treatment while improving early childhood development outcomes in the mountainous Mokhotlong District. The project was implemented through existing early childhood care and development (ECCD) centers to evaluate the intervention in a remote and hard-to-reach region.

This brief summarizes the background, data collection methods, analysis, findings, and recommendations of this scale-up assessment.