News Analysis


Lesotho, a country which its head of state His Majesty King Letsie III is an African Union (AU) Champion for Nutrition, is experiencing a triple burden of malnutrition – under-nutrition, over-nutrition, and micronutrient deficiency across all age groups.

By Palo Lekhooana

Low birth weight also remains a critical challenge.

Food insecurity and malnutrition remain chronic challenges and are key obstacles to Lesotho’s development agenda.

This is according to the National Development Strategic Plan 2018/19 to 2022/23.

King Letsie III is also Food and Agriculture Special Ambassador on Nutrition and Human Capital Champion of the World Bank.

The nutrition sit­uation in Lesotho is characterised by wasting, high stunting rates in children under the age of five years, wide-spread micro-nutrient deficiencies in children, adolescents and adults and the growing incidence of diet related non-communicable diseases (NCDs) which are costing lives and imposing a burden on the health system.

Malnutrition does not only threaten children’s survival, it undermines their ability to thrive and achieve their full potential.

The Lesotho Demographic and Health Survey 2014 found that one-third or 33.2 percent of children under-five were stunted.

Stunting is above the World Health Organisation (WHO) public health threshold of 29 percent for moderate prevalence.

About 45 percent of the adult population in Lesotho is stunted.

This is a sign of chronic malnutrition that compromises not only children’s growth but also their cognitive development, education and employment chances.

These loses in human potential cost the country millions a year – and contribute to an integrational cycle of poverty and deprivation.

Lesotho ranks 160 out of 187 countries on the 2015 United Nations (UN) Human Development Index, falling into the category of low human development with a score of 0.497.

Lesotho ranks lower than all other Southern African Customs Union (SACU) countries on human development.

The immediate causes of malnutrition are linked to chronic food insecurity, primarily affecting women, and vulnerable groups from poor households.

This also undermines overall population productivity.

In 2017/18, according to the NSDP II, an estimated 15 percent of the population was food insecure, with 78 percent (224,664) in rural areas, despite implementation of agricultural support programmes, including input subsidy schemes and crop sharing schemes by the government.

Lesotho’s Voluntary National Review (VNR) on the Implementation of the Agenda 2030 report of 2019 shows that chronic malnutrition is high across all districts, espe­cially in Butha-Buthe (40.3 percent), and the mountain districts of Mokhotlong (47.7 percent) and Thaba-Tseka (40 percent).

The voluntary national reviews aim to facilitate the sharing of experiences, including successes, challenges and lessons learned, with a view to accelerating the implementation of the 2030 Agenda.

They also seek to strengthen policies and institutions of governments and to mobilize multi-stakeholder support and partnerships for the implementation of the Sustainable Development Goals.

According to Prime Minister Thomas Thabane, this year is the first time that Lesotho participated in the formal voluntary review process. Thabane said he was grateful that Lesotho was selected to be among the cohort of 51 countries under review in 2019.

The review shows that the population density varies by districts with the largest num­ber of children chronically malnourished in the higher population districts of Maseru, Leribe and Mohale’s Hoek.

“Two of the districts with the highest stunting rates (Mokhotlong and in Tha­ba-Tseka) have extreme concentrations of pov­erty. The majority of the population in these dis­tricts is in the lowest wealth quintile (53 and 55 percent, respectively),” the report reads

Micro-nutrient deficiencies

According to the VNR, 2019 Report, half of all children have some form of anaemia whilst more than one in four women (27.3 percent) of age 15-49 years have anaemia. The report states that the prevalence of anaemia in women and children has remained a critical public health issue since 2004 and has in­creased in recent years.

It reads: “Vitamin A deficiency among pre-school aged children was identified as a severe public health problem in 2005, with 32.7 percent of these children being affected. However, updated data is missing. The same applies to iodine deficiency in all school-aged children as one-fifth were deficient in 2002 but more recent statistics are not available.”

Lesotho is failing its children. It is unacceptable that children should go hungry and be denied their full potential in a country with a constitution that states that: “Lesotho shall adopt policies aimed at ensuring the highest attainable standard of physical and mental health for its citizens, including policies designed to provide for the reduction of stillbirth rate and of infant mortality and for the healthy development of the child.”

Strong leadership and concerted inter-sectoral action are essential if Lesotho is to address the root causes of malnutrition and stunting, and so promote children’s optimal development and unlock the country’s human potential.

The fact that these are – to a significant extend – either absent or weak highlights the importance of civil society. It is urgent that child health advocates come together and establish a broad social movement for child health. NW

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