Strengthening health systems from the bottom up: example from Lesotho

ABSTRACT

In Africa, there is frequently an extreme need for nurses and other healthcare professionals. Overcrowding, a lack of administrative oversight, and a lack of resources are all problems in health settings. Health professionals may develop psychological damage referred to as "insufficient resource trauma" as a result of these difficulties, which can lower morale and motivation. Such trauma reduces the standard of treatment provided and causes professional "burn-out," a problem that has become more significant in the wake of the SARS-CoV-2 pandemic. One of the nurses who received training in PSBH-N in 2006 was promoted to the position of MoH Nursing Director by 2019. This nurse reflected on her personal experience and said, "The nurses trained in PSBH are among the top nurses in the country today," when she learned of the new PSBH training for MoH QAU employees. In order to train all 877 registered nurses and 373 licensed practical nurses (LPNs) in the nation during the following three to five years, the director requested that LeBoHA host PSBH-N workshops. The countrywide rollout's training and evaluation are now under progress. Priority setting may result from centralized, "top-down," problem-solving techniques that are not always appropriate for the district. A poll of healthcare professionals in South African hospitals revealed that administrators of hospitals were regarded as effective leaders if their leadership style encouraged engagement and problem-solving. An emphasis on a decentralised and egalitarian (equity-fostering) approach, where problem-solving is the duty of all health workers, is emphasized in a national quality assurance plan that includes PSBH.