Bridging gender gaps in healthcare to improve men’s access to care

Leribe - In Lesotho, many men face silent struggles regarding their health. They are less likely to seek medical help, get tested for Human Immunodeficiency Virus (HIV), or stay on treatment, often due to stigma, harmful gender norms, and limited access to male-friendly services. These barriers have left men behind in key health outcomes, putting their lives and the well-being of their families at risk.

To address this, the Ministry of Health, with support from the World Health Organization (WHO), has validated a new framework that aims to break down these barriers and make healthcare more accessible, inclusive, and responsive to the needs of boys and men across the country.

The Men's Integrated Health Services Core Package and Implementation Framework (2025-2030) is designed to close the health gap between men and women, particularly in areas such as HIV testing, treatment, and long-term care.

Men in Lesotho continue to face serious health challenges and are more likely to get sick or die from common illnesses compared to women. In 2022, data showed that fewer men were getting tested for HIV, starting treatment, or successfully managing the virus than women. These gaps are made worse by harmful beliefs about masculinity, low use of protection during sex, and limited involvement of men in family and reproductive health matters.

Dr. Lerato Mothae, Key Population Coordinator at the Ministry of Health, emphasized the need to address these disparities urgently.

"Men experience increased risk of morbidity and mortality across all ten major contributors to poor health and continue to lag behind women regarding HIV services and other health outcomes," he said.

Dr. Mothae explained that the framework is designed to increase male engagement in health services between 2025 and 2030.

"The plan focuses on treating each person as an individual, making sure services are easy to access, respectful, and meet the specific needs of men at different stages of life. The framework defines core health services for three key age groups, with adolescents and young men aged 10 to 24 years requiring a strong focus on preventive care, sexual and reproductive health, and mental health; adult men aged 25 to 49 years needing emphasis on occupational health risks, care for HIV and Tuberculosis (TB), and chronic disease prevention; and older men aged 50 and above requiring targeted services for non-communicable diseases such as hypertension, diabetes, and prostate cancer."

The framework also focuses on reaching vulnerable groups such as herders, miners, transport workers, uniformed services, men who have sex with men, people who inject drugs, and prisoners. It also recognizes the important role that women, partners, and families play in influencing men's health decisions.

Dr. Sirak Hailu, the WHO Public Health Officer, spoke on the critical need to strengthen HIV services tailored for men:

"Men are about twice as likely to present with advanced HIV disease compared to women. Enhancing the reach and quality of HIV services for men is essential for improving public health outcomes and achieving control of the HIV epidemic. This includes expanding access to Antiretroviral Therapy (ART) and ensuring sustained viral suppression."

He also pointed out the importance of making services more accessible and responsive:

"Men require health services that are easy to access, delivered with high quality, and provide positive experiences. In addition, supportive services must be designed to meet men's specific needs and encourage consistent engagement with care."

The validation workshop, which took place in Leribe District from the 24th to 25th September, brought together stakeholders from civil society organizations, including Baylor, Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Crime Prevention Rehabilitation and Reintegration of Ex Offenders Association (CRROA), Lesotho Network of People Living with HIV/AIDS (Lenepwha), and the Ministry of Health. Participants expressed their support for the framework and its potential to transform men's health outcomes in the country.

Tharollo Mosanteli, Maternal and Child Health Officer at EGPAF, noted the framework's broader impact.

"This framework gives us a powerful tool to reduce new HIV infections among women and children. We have learned that by improving access to health services for men, we can significantly lower the risk of transmission to their partners and families."

Lehana Justice Mateka, Project Manager at Lenepwha, welcomed the framework's practical approach.

"I'm excited about this validation exercise because it offers a complete and practical package tailored to men's realities. It means men will finally have better access to Primary Health Care services that speak to their needs."

Motlatsi Letsika, Project Manager at Baylor, praised the framework's potential to close longstanding gaps.

"This guideline helps us identify and close the gaps that have kept men from accessing health services. It is a major step forward in making sure men of all ages get the care they deserve."

Nkalimeng Mothobi, Chief Director at CRROA, emphasized the framework's relevance to community outreach.

"This guideline will facilitate our HIV/AIDS intervention to men and boys in the community in all the districts. Through this workshop, we have been empowered to carry out our work in the community, reaching out to men, especially ex-offenders."

Khotso Mahlalafa, Quality Assurance Officer at the Ministry of Health, highlighted the framework's role in improving service delivery.

"This guideline will improve access to men to health services. As a Quality Assurance Officer, this will help me to assess how men are accessing health services in the communities."

The framework includes key components such as community involvement, improved service delivery models, progress tracking, awareness raising, and resource mobilization. It represents a significant advancement in Lesotho's public health initiatives, paving the way for improved health outcomes not only for men but also for families, communities, and the country as a whole.