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Lesotho: Lesotho Health Profile




Health Development: Lesotho is a developing country with a high prevalence of HIV and tuberculosis (TB) which has affected amount the development areas of the country including human resource. This pandemic has as well negatively affected the economy of the country. Therefore, there are declining and poor health indices in the country. In order to well address this problem, which is systemic in nature, the Government and partners with WHO as the major technical partner have embarked on a far reaching strategy in its PRSP for the country for 2010/11 which has clearly indicated health as of the major pillars for poverty reduction in the country. In addition to the above, the Government has taken the issues of the environment and water and sanitation very seriously as 95% of urban dwellers have access to portable water supply and waste disposal. WHO has in addition supported the country develop a Human Resource for Health strategy for the country.

Health system reforms which aim to tackle the issues that surround stewardship in the health sector are being strongly addressed. Human resource issues remain a centre piece of this reform. Health Indicators: The health indicators for Lesotho are not improving as rapidly as possible. For example, the life expectancy at birth is 42 years (2006), the infant mortality rate is 106/1000; the under mortality rate is 113/1000; and the maternal mortality ration is over 700/100000 live births. With the majority of the people living in hard to reach areas, inequalities exist part the different parts of the country. For example in the rural areas, during the winters, there are increases in deaths due to inaccessibility of the people. In the HIV/AIDS prevalence of the country has been estimated to be about 23.2%. This has fuelled a rise in the prevalence of TB. Unfortunately, MDR-TB has been described in the country making the control of the current TB epidemic additional challenging than before.

Burden of Diseases: Lesotho is of the developing nations that are facing an increasing double burden of diseases. There are increases in the burden of noncommunicable diseases, inclunding a very high burden of communicable diseases. Thus diabetes and hypertension accounted for 7% of female admissions, while diabetes and road traffic accidents accounted for 8% of male hospital admissions in a recent survey. Stoke, depression, myocardial infarction, epilepsy and heart failure are amount on the rise.

At the same time, the relentless increase of burden of disease that is imposed on the country by HIV, continues to weaken the human resource base of the country. In addition to HIV, diarrheal diseases are not unknown in the rural areas. Thus in conclusion there is a high burden of disease in the country, with great needs for service delivery. Coverage of Essential Interventions: The coverage of services in Lesotho is varied. The attendance of skilled workers at birth is estimated to be 55%, while antenatal care coverage is 70%. Immunization coverage at the end of 1 year is about 80%, but contraceptive prevalence rate is only 37%. Despite the high burden of HIV and the attention paid to it by government, ARV coverage is only 25%.

Health System Challenges: Lesotho with the help of technical partners has recently seen decentralization in its health system. Additional autonomy has been given to the districts but the center has retained the policy and planning elements of the system. Although the country has a central referral hospital in the capital, it is beleaguered by a dearth of experts and human resource to simply run the significant programmes. Therefore, for the meantime, critical emergencies have to be referred to neighboring South Africa. On the other hand, the decentralization of the health system has benefited some public health programmes such as the EPI which has scaled up vaccination for children, and as well make the HIV know your status initiative successful. However, these are not enough to face the large challenges of the health system.


• Stable Government
• Good infrastructure
• Newly developed PRSP document
• National Vision 2020 for Lesotho
• Donor interests increasing
• Declining people growth
• Weak health systems
• Critical human resource crisis with increasing human resource drain to greener pastures
• In equalities and in equities in service delivery
• Most of the country is in hard to reach areas.

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