Thoboloko Ntšonyane
MASERU – Different stakeholders are calling for the anchoring of the Sexual and Reproductive Health and Rights (SRHR) in the National budget.
In a recent forum convened under the Southern African Development Community-Parliamentary Forum (SADC-PF)’s SRHR and HIV/AIDS Governance Project, Deputy Chairperson of its National Working Committee (NWC), Mamello Makoae, underscored the urgent need for SRHR to be embedded in national budget programming.
SRHR encompasses maternal and newborn health, family planning, prevention of mother-to-child transmission (PMTCT) of HIV, adolescent health, sexual and gender-based violence (GBV), and sexual and reproductive health cancers.
Makoae highlighted the far-reaching impact of SRHR services, pointing out that issues like teenage pregnancies and limited access to family planning underscore the need for heightened attention to SRHR in Lesotho.
The stakeholders argue that without direct financial commitments from national governments, progress on issues such as access to reproductive health services and HIV/AIDS prevention remains limited, undermining broader health and development goals.
By integrating SRHR into the national budget, stakeholders believe that long-term funding will enable the successful rollout of programmes that address critical issues affecting children, women, youth, and vulnerable populations. This move is seen as vital to overcoming funding shortfalls, improving service delivery, and ultimately achieving the Sustainable Development Goals (SDGs) related to health, gender equality, and human rights.
Budget inclusion, Makoae said, is crucial to ensure that resources are appropriately directed to address these pressing challenges. She stressed that such allocation would enable more structured, effective interventions and improvements in SRHR outcomes across the country.
From the Family Health Division within the Ministry of Health (MoH), ‘Makhotso Tšotetsi expressed dismay at the country’s high maternal and neonatal mortality rates, despite calls from the United Nations (UN) to end these preventable deaths.
The UN directive aligns with the Sustainable Development Goals (SDGs), which set ambitious targets for lowering maternal and neonatal mortality globally. The World Health Organisation (WHO) advocates for the reduction of maternal and neonatal mortality, with the SDGs targeting fewer than 70 maternal deaths per 100,000 live births by 2030.
Currently, she said Lesotho’s mortality rate stands at 1,024 per 100,000 live births, a statistic that does not augur well to the country.
She noted that the sector faces challenges such as a lack of continuous training and skills development in essential maternal and neonatal healthcare. It was further reported that there is a significant shortage of specialists, with only six obstetricians (including those in private practice), nine pediatricians, and nine advanced midwives available, along with other healthcare cadres working alongside these specialists.
Although progress has been made as maternal mortality was sitting at 46% in 2004, the 2023/24 figures are reportedly showing a decline. Tšotetsi reported about the two recent maternal deaths in a district she did not name, pointing to the continued need for improved reproductive health services.
On the matter of adolescents, the Family Health official called for enhanced efforts to promote informed reproductive choices among youth, especially in light of persistent teenage pregnancy rates.
She also noted that there is education out there, but the challenge is that of “behavioral change” amongst the people.
The Country’s HIV and AIDS Programme Manager Dr Tapiwa Tarumbiswa highlighted that Lesotho is heavily reliant on donor support in the fight against HIV. “The national HIV response is highly donor-dependent, which threatens sustainability,” he cautioned. He emphasised the need for a “renewed focus on scaling up combination prevention, retention, and mortality reduction to achieve zero new infections and AIDS-related deaths by 2030.”
He, however, indicated that the country is on track to achieve the 95-95-95 targets by 2025, with current figures showing 95-94-99, according to data released last year. The 95-95-95 targets refer to the goal that by 2025, 95% of people living with HIV know their status, 95% of those diagnosed are on their medication, and 95% of those on therapy have their viral load suppressed.
The President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest contributor, accounting for 68% of funding, followed by the Global Fund at 20%, and the government at 12%. In monetary terms, PEPFAR contributes M1.2 billion, the Global Fund M376 million, and the government M225 million.
Senior Inspector Teke Petje from the Children’s and Gender Protection Unit (CGPU) within the police force highlighted the severe resource constraints hampering their operations. He disclosed that, due to a lack of resources, the unit struggles to mobilize the community effectively, particularly young people.
Senior Inspector Petje revealed that a number of CGPU officers have been reassigned to other duties, further depleting the unit’s manpower. He noted the missed opportunity for police-led youth boot camps, which could address issues like substance abuse and instill positive values.
The CGPU, he added, is unable to provide essential services for vulnerable populations, and without adequate support, issues such as backstreet abortions remain unchecked.
Resource limitations within the CGPU highlight the importance of cross-sectoral collaboration and funding to protect vulnerable people.
The increased collaboration, as championed by different participants during the meeting, would mark a step forward in addressing these long-standing issues.
The Chairperson of the Pandemics Committee, Rev. Paul Masiu expressed optimism about the forum’s ability to foster shared understanding among the various stakeholders present.
He observed, however, that skilled personnel are being frustrated by insufficient resources and lack of coordination. Masiu went on to question the inaction of previous years despite expertise within the different fields by the personnel.
The meeting concluded with a focus on prioritizing key issues ahead of budget presentation. It was also regarded as a positive development that, unlike in the past, MPs will now have the opportunity to review the budget before the Minister of Finance and Development Planning presents it in the House.
“It’s now up to us, as lawmakers, to drive change and demand accountability,” he asserted.