LESOTHO: WORSENING PERFORMANCE IN HEALTH SECTOR

UNCLAS SECTION 01 OF 02 MASERU 000012 SIPDIS SIPDIS DEPT FOR AF/S, AF/EPS,S/GAC E.O. 12958: N/A TAGS: ECON KWMN TBIO LT SUBJECT: LESOTHO: WORSENING PERFORMANCE IN HEALTH SECTOR MASERU 00000012 001.2 OF 002 ¶1. SUMMARY: In an effort to coordinate its response to widespread poverty, the Government of Lesotho launched its Poverty Reduction Strategy (PRS) in 2004. The recently released review of progress under the PRS between 2004 and 2007 revealed troubling data indicating declining health sector performance. Deteriorating healthcare outcomes in Lesotho since 2000 demonstrate the tough road ahead for the nation's efforts to improve public health. We are optimistic that U.S. involvement, including the large forthcoming Millennium Challenge Corporation investment in health infrastructure, as well as ongoing PEPFAR programs, will prove critically important in reversing this disturbing trend. END SUMMARY. -------------- What is the PRS? -------------- ¶2. The Lesotho Poverty Reduction Strategy was a three-year development framework formulated by government, development partners, the private sector, and civil society organizations in 2004 aimed at ameliorating widespread poverty. The PRS is merely a strategy document - not a funded program or bureaucratic organization. The PRS was created through a consultative process in which Basotho were interviewed on poverty in the Lesotho context, how it affected them, and what could be done to reverse the situation. The process designated nine priority areas for poverty reduction, of which one is healthcare. A review of the progress towards the targets set in the PRS was publicly released in late 2007. -------------- The Numbers, the Decline -------------- ¶3. In this PRS review, the indicators selected to monitor progress in the health sector were evaluated as follows: -- The maternal mortality rate is now at 762/100,000 live births, an increase of 81% from 2001 to 2006. The main contributing factors to the startling high maternal mortality rate are the low level of Basic Emergency Obstetric Care (BEmOC) and the impact of HIV/AIDS. -- The number of births attended by skilled professionals decreased from 60% to 55% between 2002 and 2006 due to human resource shortfalls in the health sector -- one of its most critical challenges. The review paints a similarly bleak picture of the immediate future. However, tentative hopes for improvement in the healthcare situation are pinned on the World Bank's 20-year "Human Resource Development Strategy," which aims to provide Lesotho with of a minimum level of trained healthcare professionals. -- The infant mortality rate rose by 10% between 2001 and 2006. This is also largely attributable to the impact of HIV/AIDS and the lack of BEmOC. -- The mortality rate of children under five remained constant at 113/1000 live births. -- The proportion of children immunized against measles improved marginally from 77% to 78% from 2000-2006. In November 2007, Lesotho completed a nationwide measles immunization campaign which likely brought the nation's children closer to full vaccination. -- The percentage of children receiving full immunization against all major childhood diseases prior to age one decreased from 77% to 68%. This has contributed to infant and under five mortality rates remaining high at 91 and 113 deaths per 1000 live births, respectively. A recent survey indicated that most of the nation's hospitals had exhausted their vaccine supplies for one month or more during the past year. However the most frequent single cause of institutional deaths in children are diarrhea (22%),pneumonia (21%),malnutrition (13%),and HIV/AIDS (11%). -------------- Progress in HIV/AIDS Treatment, But Not in Infection Rate -------------- ¶4. The review indicated significant progress regarding the treatment of HIV/AIDS and TB. The number of people enrolled in antiretroviral treatment doubled between 2005 and 2007. The PRS Review specifically cited the infrastructure support of Baylor University in this success. Despite improvements in HIV/AIDS treatment, however, the prevalence of HIV/AIDS (the world's third highest at 24%) and the new infection rate remains high, indicating a lack of behavioral change. -------------- Discouraging, But Help Is On the Way -------------- ¶5. COMMENT: The PRS Review statistics on health are MASERU 00000012 002.2 OF 002 discouraging. Deteriorating healthcare outcomes in Lesotho since 2000 demonstrate the tough road ahead for the nation's efforts to improve public health. We are highly optimistic, however, that the substantial U.S. involvement in the healthcare sector, including the large forthcoming Millennium Challenge Corporation investment in health infrastructure, as well as ongoing PEPFAR programs, will reverse this disturbing trend. END COMMENT. NOLAN