In Lesotho, the coming together of two important ministries – education and health – has had a major impact on learners’ access to health services. At the centre of this ground-breaking development are Lesotho’s 10 FutureLife-Now! schools.

In 2021, the FutureLife-Now! team, in consultation with the Ministry of Education and Training and the Ministry of Health, developed a two-way referral tool that linked schools with their health centres. The aim of this initiative was to overcome barriers and make it easier for adolescents to obtain the health services they need by strengthening the linkages between health and education.

By September 2021, all 10 FutureLife-Now! schools had started using these referral forms, and learners were finding it easier to access health services, especially sexual reproductive health (SRH) and HIV services. One of the central goals of FutureLife-Now! is to reduce HIV infections amongst adolescents and increase ART adherence.

In fact, the strengthened linkage has resulted in such good relations between schools and clinics that both learners and teachers can now access health services without queuing. Added to this, other services, such as vaccinations and health talks, are now being held on school premises.

Rantsane Kuleile, country manager for the FutureLife-Now! programme in Lesotho, said the aim of the innovation was to overcome many of the challenges schools and learners faced in accessing health services. “Before, learners would spend hours trying to get services and thereby miss out on hours of education. Having the form gives them priority. It means they will be rapidly assisted and get back to school quickly.”

The form requires the school to fill in the time the learner left school for the clinic, while the nurse at the clinic fills in the time the learner was asisted.

The referral system has been extremely successful, as demonstrated by the increase in the number of young people seeking help at their health centres.

There are further developments. Likotsi Health Centre, for example, now plans to dedicate a specific area, with its own medical staff, for adolescent use only, in a bid to increase the number of young people accessing healthcare services. The working relations between the schools and the health services are smooth which makes communication easy and enables the referral of learners needing regular counselling around mental health-related issues.

Thetsane High School is linked to the Likotsi Health Centre and the school’s principal, Tsoanelo Seboka, has applauded the referral system, saying it is now possible to track the students’ movements between the school and the health centre. Students are also very happy with the service they get. Morena Mona, a 19-year-old learner, said, “I went to Likotsi Clinic with my referral form. It allowed me to be assisted quickly so that I was able to go back to school. I did not have to queue, and I was treated with respect. I wish this could happen at every school.”

The referral system has been so effective that health centres not affiliated to the FutureLife-Now! programme are also willing to fill in and stamp the form when a learner presents it.

“It was an important innovation because it has created a formal working relationship between two government ministries that is not based on a ‘gentleman’s agreement’,” says Kuleile. “We are hoping to soon roll out this system to all schools in Lesotho.”