In 2009, members of Lesotho’s LGBTQIA+ community founded a non-governmental organization (NGO) to advance the human rights of themselves and their peers. Matrix serves this priority population with a diverse set of programs that span health promotion, clinical services, and political advocacy.
Chief among its services are TB prevention and screening and gender-based violence (GBV)/ intimate partner violence (IPV) interventions. All its efforts are framed by the larger organizational mission to create an environment in which LGBTQIA+ persons enjoy safe and meaningful engagement with society.
Technical Capacity Assessment
Matrix’s Technical Capacity Assessment revealed gaps in both clinical and non-clinical areas. These gaps included competencies that the organization itself knew to be lacking based on the major challenges it faced.
Lay workers’ technical understanding of various TB symptoms and case presentations limited their ability to use national screening tools. This resulted in low confidence about their skillsets and their roles as health educators. These factors had a tangible influence on programmatic success.
Training of Trainers
EGPAF held theoretical and practical training sessions that focused on TB screening for adults and children. The theoretical training was informed by EGPAF’s signature approach of intensive case finding for TB, directly addressing Matrix’s need to scale-up screening for this demographic.
In the practical sessions, participants applied their newly acquired knowledge by practicing their screening skills, determining TB preventive therapy (TPT) eligibility, and educating clients about their risk of TB infection. Matrix staff then conducted step-down training sessions at the community level for lay staff in all 10 districts.
Ultimately, the tailored technical training helped lay counselors:
- Understand potential presentations of TB infection
- Use screening tools to identify adults and children eligible for TPT
- Educate clients about TB prevention methods (e.g., cross-sectional ventilation)
- Remain cognizant of the need to discuss TPT with children below age 15 and clients who are newly HIV diagnosed and/or not virally suppressed
Prior to EGPAF’s TB training, Matrix did not initiate clients on TPT. Now Matrix ensures that every client who tested positive for HIV is referred to health centers to initiate on TPT. Immediately after the training, 7 clients tested positive for HIV and all were placed on TPT at their drop-in center.