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Mission
To provide good quality and affordable services to every Mosotho
The vision of the MOHSW is based on three key
principles:-
Universal coverage
Ensuring optimal access to basic healthcare services to all
members of society including
those in hard to reach places
Social justice
Ensuring that those in greatest need have easy access to care
Equity
Ensuring that access to care is based on need rather than
ability to afford
The broad mandate of the MOHSW seeks to:-
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Contribute to increased life expectancy as well as quality of
life
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Reduce infant and child morbidity and mortality rates
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Reduce the maternal mortality rate
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Contribute to universal access to safe drinking water and
sanitation
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To control and prevent communicable diseases such as
tuberculosis, acute respiratory infections, diarrhoea and AIDS
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Minimise the impact of deteriorating socio-economic conditions
on marginalized groups such as geriatrics, children, paupers and
disabled persons
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Empower community based structures in the delivery of preventive
and basic curative services for health and social welfare
The strategies pursued towards this mandate can be summarised as
follows:-
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Promote access to quality preventive, curative, rehabilitative
and referral services
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Implement the sector policy
Health & social welfare as priorities in the national poverty
reduction strategy
Given that good health is an essential element of individual
productivity and general socio-economic development it is not
surprising that the health sector has been cited as one of the
key areas of focus under the national poverty reduction
strategy. Lesotho has taken part in various strategies to
provide affordable and accessible Primary Health Care (PHC) to
the poor and for this reason the primary health care strategy
has often been called the cornerstone of health service delivery
in this country. PHC was an attempt to decentralise serviced
delivery right down to the community level by training volunteer
community health workers. Over the years the government has
sought to strengthen this system by emphasising broad-based PHC
and strengthening services at the levels of district hospitals
and the referral hospital.
As a result of the PHC strategy the health system was
restructured into health service areas HSA’s with the hospital
being the focal point supported by a number of health centres,
health posts and community health workers. Currently the health
system is divided into 17 health service areas spread throughout
the country 9 of which are government owned and 8 fall under the
umbrella of the Christian Health Association of Lesotho (CHAL).
For further details see Facilities &Services.
In a context of a diminishing resources base and rising costs of
delivery, the key challenge facing the health sector is to meet
the growing demand for health and social welfare services with
minimal resources In particular one is referring to the
increase in non-communicable diseases such as hypertension and
diabetes, the resurgence of communicable diseases such as TB,
which are directly linked to the HIV/AIDS pandemic as well as
the increase in the number of orphans and marginalised
children. Factors such as insufficient numbers of health
personnel especially in rural areas have aggravated the
effectiveness of the health system in realising its stated
objectives.
Sector budget and financing
The health sector is one of the top three sectors in the overall
government budget, after education and Finance and Development
Planning (MOFDP). Patients at government hospitals are expected
to pay a maximum of M20 while children’s fees are M10. In
government health centres the fee is M10 for adult and M5 for
children. All revenue collected is reverted to the MOFDP.
Hence the government facilities have no other source of revenue
besides the budget allocated by the Finance Ministry. Fees
charged at CHAL facilities vary according to the discretion of
the management of that facility. CHAL fee revenue is retained
and used by the facilities.
On average the sector receives 8.1% of total government
expenditure. Of the total budget, the average from government
based on the past three years is 82%, while grants from donors
are estimated at 13% and loans at 5% The average per capita
public expenditure on health has been estimated at M197.3, with
distinct variations between the rural highlands and the urban
and peri-urban areas.
Recurrent budget
The recurrent budget is financed solely through government
funding which in 2004/05 was M261,277,920 or 81% of the total
health budget. 37% of the recurrent budget was for District
Health while 20% was Queen Elizabeth Hospital II, 15% was
subventions to CHAL, Blue Cross and Red Cross, 7% was
administration, 8% central public health programmes and 13 % was
divided among other programmes. The five categories of the
recurrent budget are personnel emoluments 35%, travel &
transport 7%, operating costs 40% (which includes drugs, patient
upkeep, medical supplies etc) and grants and subsidies 18%.
Development budget
The development budget is financed
by both the government and external development partners. On
average government contribution to the capital budget is 19%,
while grants are 55% and loans are 26%. In 2004, the main foci
of the development budget were primary health care including
support to HIV/AIDS, capacity building, refurbishment of rural
clinics and staff housing at health centre level; upgrading of
the National Health Training College and Mohlomi Hospital;
health sector reform programme, community based management of
disability and strengthening of social welfare services
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