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“We are now aware that everyone has rights, including sex workers and LGBTI”- What’s changed in Lesotho since 1994

26 June 2019
Parliamentarians with pregnant women at Mohale'shoek hospital, where they viewed facilities and improvements that have contributed to an overall reduction in maternal deaths in Lesotho. © UNFPA Lesotho/Violet Maraisane

MASERU, Lesotho—“We are now aware that everyone has rights, including key populations such as sex workers and the LGBTI (lesbian, gay, bisexual, transgender and intersex people),” said Chairperson of the Parliamentary Social Cluster Portfolio Committee Moshoeshoe Fako.

Mr Fako was speaking during an oversight tour of health facilities by Lesotho’s parliamentarians to inspect delivery of health services and discuss what has changed since the ICPD Programme of Action was put in place 25 years ago.

Parliamentarians in Lesotho are now aware that everyone is entitled to sexual and reproductive health and rights – marking a huge leap forward for the country since the landmark International Conference on Population and Development (ICPD) in Cairo in 1994, which placed individual dignity and human rights, including the right to plan one’s family, at the heart of development.

We are cognizant of the need to not just ratify but promulgate laws that ensure the sexual and reproductive health rights of our people.

“We are cognizant of the need to not just ratify but promulgate laws that ensure the sexual and reproductive health rights of our people,” he added.

The Parliamentary Social Cluster Portfolio Committee intends to ensure that the health sector gets a substantive budget to enable universal health access and get to zero new HIV infections by 2030.

The committee joined communities around the world in discussing what has changed since 1994, under the theme ‘Essential SRHR package of interventions and Universal Health Coverage’. The MPs observed and inspected the quality and provision of integrated sexual and reproductive health (SRH), HIV and sexual and gender-based violence (SGBV) services, and other health services in targeted health facilities, with the support of UNFPA.

The oversight tours will culminate in a high-level conference, at which the MPs will present their findings and commit to accelerating efforts to make good on the Cairo promise. They will also present their report to Parliament and call for necessary action, including enactment of laws and passing of relevant motions.

Women now have a wide choice in contraceptives

But it is not only parliamentarians who were involved in conversations on “What’s changed?” since 1994 – community members and health professionals also spoke out.

The choice [in contraceptives] is wide for today’s young women.


"There was a time when we had only two types of contraceptives to
choose from; now there are short-term and long-term methods."
- Community health worker 'Makhutsitseng Lerotholi.
© UNFPA Lesotho/Violet Maraisane

What has changed is the wide choice of contraceptives now available to women, said community health worker ‘Makhutsitseng Lerotholi.

“There was a time when we had only two types of contraceptives to choose from; now there are short-term and long-term methods. The choice is wide for today’s young women.”

Ms. Lerotholi started working as a community health worker in 1979. In those days the staff walked a long distance from their village at Phamong, in Mohale’shoek district, to get medical supplies from a store in another village. “We would carry the boxes on our heads and bring them to the clinic, which was a very small building then,” she said.

For ‘Marethabile Lydia Kalane, a nurse midwife at Nts’ekhe hospital in Mohale’shoek, what has changed is that delivery of maternal health programmes has improved, which has resulted in a reduction in maternal deaths – from 1024 deaths per 100,000 live births to 618 per 100,000 (Lesotho Census 2016).

There was vigorous advocacy for pregnant women to deliver at health facilities. Also, men were encouraged to accompany their wives to seek services at health facilities.

This followed an Emergency Obstetric and Newborn Care (EmONC) assessment, which was undertaken with the support of UNFPA when Lesotho’s maternal mortality ratio was very high at 1055 deaths per 100,000 live births.

“There was vigorous advocacy for pregnant women to deliver at health facilities. Also, men were encouraged to accompany their wives to seek services at health facilities. Now they do so and they are very supportive of their wives during pregnancy and post-delivery. Furthermore, many nurses were trained on administering long-term family planning methods, which has resulted in proper child spacing,” Ms. Kalane added.

These days, we offer them family planning when they come and this has reduced the number of unsafe abortions.

Another significant improvement is that most health facilities now have adolescent-friendly health corners that offer SRHR services dedicated to young people.

‘Manthati Mokautse, who has been working at the Adolescent Health Corner in Mohale’shoek since 2000, said that prior to the establishment of this service the staff would not offer family planning services to girls without the consent of their parents.

“These days, we offer them family planning when they come and this has reduced the number of unsafe abortions,” she said.

- Violet Maraisane