UN flags mixed progress on Lesotho’s health front

A recent United Nations Population Fund (UNFPA) report, State of World Population 2025, themed “The Real Fertility Crisis”, highlights both the progress and persistent challenges facing Lesotho in the areas of maternal health and sexual and reproductive health (SRH).

While the country has made commendable strides, particularly in the rate of skilled birth attendance, critical gaps remain, especially in reducing maternal mortality and expanding access to comprehensive sexual and reproductive health education.

Lesotho continues to face a high Maternal Mortality Ratio (MMR), recorded at 478 deaths per 100,000 live births in 2023. The uncertainty range suggests this figure could be as high as 725 or as low as 298, underlining the urgent need to strengthen maternal health services and address systemic healthcare gaps.

On a positive note, 89 percent of births in Lesotho are attended by skilled health personnel, indicating that most pregnant individuals are receiving professional care during delivery, a key factor in reducing risks to both mother and child. The challenge now lies in improving the quality of care and tackling the underlying causes of maternal deaths.

In the domain of sexual and reproductive health, Lesotho reported 3.00 new HIV infections per 1,000 uninfected people in 2023. While this reflects a continued struggle with the epidemic, it also reinforces the need for sustained investment in prevention, education, and treatment programs.

In terms of family planning, the contraceptive prevalence rate among women aged 15–49 stands at 50 percent for any method and 67 percent for modern methods. Although this reflects reasonable uptake, there remains an unmet need for family planning, nine percent for all women and 13 percent for married or in-union women.

Encouragingly, 83 percent of demand is satisfied by modern contraceptive methods.

Lesotho’s Universal Health Coverage (UHC) service coverage index is currently at 53 percent, signaling room for improvement in making essential health services more widely available and affordable.

According to the report, which includes data from 2001 to 2024, Lesotho’s adolescent birth rate is 53 births per 1,000 girls aged 15–19. However, progress has been made in reducing child marriage: the proportion of girls married before age 18 has declined to 13.4 percent in 2024, down from 20.7 percent in 2004 and 24.2 percent in 1999.

Nonetheless, intimate partner violence remains a significant concern. As of 2018, 16.5 percent of women aged 15–49 reported experiencing physical and/or sexual violence from a current or former intimate partner within the previous 12 months.

The report paints a complex picture of progress and persistent inequality. While advances have been made, urgent and sustained efforts are required to improve maternal outcomes, reduce HIV infections, expand reproductive health services, and combat gender-based violence in Lesotho.

Newsday

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