From 2007 to 2010, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported Lesotho’s Ministry of Health and Social Welfare (MOHSW) to improve the nutrition of mothers and their children younger than two years of age, with a focus on those affected by HIV. The project strengthened national nutrition and prevention of mother-to-child transmission of HIV (PMTCT) policies and programs and conducted supportive activities at health facilities and within communities.

As a result of the project, there is now a strengthened referral system, which allows community health workers to refer mothers and children to providers at facilities and providers to refer their patients back to community health workers for follow-up. Building the capacity of a wide range of community workers resulted in supportive networks, including village chiefs, traditional healers, and men’s groups, for improved feeding practices in many communities.



  • IYCN helped to set a country-wide standard for improved feeding practices by supporting the revision of Lesotho’s National Infant and Young Child Feeding Policy and incorporating the World Health Organization’s guidelines on HIV and infant feeding into national PMTCT guidelines.
  • IYCN and the MOHSW co-facilitated a workshop with key nutrition and PMTCT stakeholders to develop a new national curriculum, counseling cards, and take-home brochures reflecting the updated national policy and international recommendations on infant feeding and HIV. In March 2010, the MOHSW rolled out the curriculum to begin training health workers across the country.
  • The project fostered collaboration among three government ministries to develop joint training and supervision activities and implemented a cascade-style approach to train community workers to reach more caregivers with nutrition support. For example, IYCN supported the MOHSW to train 29 trainers at the Ministry of Agriculture, who then conducted “step-down trainings” of 496 home economists and other workers.
  • IYCN supported the training of nearly 750 community health workers to counsel mothers on infant and young child feeding, which increased community support for optimal infant feeding practices and improved social norms, individual attitudes, and infant feeding behaviors.

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Photo: PATH/Christine Demmelmaier