KEY FACTS Joined Commonwealth: 1966 Population: 2,074,000 (2013) GDP p.c. growth: 2.8% p.a. 1990–2013 GNI p.c.: US$1,550 (2013) UN HDI 2014: World ranking 162 Life expectancy: 49 years (2013) Under-five mortality rate (per 1,000 live births): 98 (2013) Largest contribution to mortality: HIV/AIDS Government health expenditure: 9.1% of GDP (2012) General information The Kingdom of Lesotho is a small landlocked country entirely surrounded by South Africa. It is known as the ‘Mountain Kingdom’, the whole country being over 1,000 metres in altitude. The country is divided into ten districts, each named after the principal town: Berea, Butha Buthe, Leribe, Mafeteng, Maseru, Mohale’s Hoek, Mokhotlong, Qacha’s Nek, Quthing and Thaba Tseka. Climate: The climate is temperate with well-marked seasons. The rainy season (receiving 85 per cent of total precipitation) is October–April, when there are frequent violent thunderstorms. 196 Commonwealth Health Partnerships 2015 Rainfall averages 746 mm p.a. Temperatures in the lowlands range from 32.2°C to -6.7°C; the range is much greater in the mountains. From May to September, snow falls in the highlands with heavy frosts occurring in the lowlands. Environment: The most significant issue is overgrazing, resulting in severe soil erosion and desertification. Population: 2,074,000 (2013); 26 per cent of people live in urban areas. The population growth rate stood at 1.1 per cent p.a. between the years of 1990 and 2013. In 2012 the birth rate was 27 per 1,000 people (43 in 1970) and life expectancy was 49 years (49 in 1970 and 59 in 1990). The people are mostly Basotho, with a few thousand expatriate Europeans and several hundred Asians. Economy: Lesotho is classified as a lower-middle-income economy by the World Bank. Health Child and maternal health: Infant mortality in Lesotho was 73 deaths per 1,000 live births in 2013, with an under-five mortality rate of 98 deaths per 1,000 live births in 2013. The under-five mortality rate peaked in the period 2004–05 and remains above the rate recorded for 1990. As a result, the under-five mortality rate has not yet reached the country’s target of 29 deaths per 1,000 live births, as defined by Millennium Development Goal 4 (MDG 4). In 2010 the most prominent causes of death for children below the age of five years were HIV/AIDS (19 per cent), prematurity (16 per cent), intrapartum-related complications (14 per cent) and acute respiratory infections (12 per cent). Other contributory causes were neonatal sepsis (eight per cent), diarrhoea (seven per cent) injuries (four per cent), congenital anomalies (four per cent) and measles (one per cent). In 2013 Lesotho had an adjusted maternal mortality ratio of 490 deaths per 100,000 live births (this figure was estimated at 620 deaths per 100,000 by UN agencies/World bank in 2010). Burden of disease: Communicable diseases along with maternal, perinatal and nutritional conditions in Lesotho accounted for an estimated 64 per cent of all mortality in 2012. The prevalence of HIV in Lesotho, as a percentage of people aged 15–49 years, stood at 22.9 per cent in 2012. HIV prevalence rapidly increased during the 1990s and has remained at approximately 23 per cent since the early 2000s. Lesotho is a non-endemic country for malaria, as a result of its high altitude. In the period 1990–2003 the estimated incidence of tuberculosis (TB) in the country saw a dramatic increase, decreasing slightly in 2003–12, with the 2013 rate recorded at 916 cases per 100,000 people. In the period 1990–2012 there was a slight overall decrease in estimated mortality from TB (when mortality data excludes cases comorbid with HIV). Lesotho
Commonwealth Health Partnerships 2015
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