United Nations in Lesotho Delivering as One 2013 - 2014 Note The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries.
2015 United Nations
All worldwide rights reserved
Cover photo credits: UN CONTENTS
FOREWORD ...... 03
WHAT IS DELIVERING AS ONE? ...... 04
What prompted the reform? ...... How is the reform structured? ...... The One UN Programme ...... The One Office ...... The One Leader ...... The Communicating as One ...... What are the major achievements of the DaO reform to date? ...... What is the Lesotho Government’s role in the reform? ...... Partnering with Civil Society Organizations ......
INVESTMENT CLIMATE, MANUFACTURING AND TRADE & FINANCIAL SERVICES ...... 08
AGRICULTURE & FOOD SECURITY, ENVIRONMENT, NATURAL RESOURCES AND CLIMATE CHANGE ...... 12
GOVERNANCE & INSTITUTIONS ...... 16
HEALTH AND NUTRITION ...... 20
HIV AND AIDS ...... 24
SKILLS AND INNOVATION ...... 28
SOCIAL PROTECTION ...... 32
CONTENTS 1
FOREWORD
Since 2008, Lesotho has supported the entire United Nations reform process, known as “Delivering as One.” Lesotho was not one of the few pilot countries, yet the then-Government endorsed the process and embraced it nationally as a “self-starter” partner that has helped the UN in Lesotho speak in one voice and operate more effectively. Recent years have seen the UN in Lesotho work with the Government to develop new ways of cooperation, enabling partners to achieve greater impact on the ground by being more results-oriented, efficient, and by harmo- nizing business practices across agencies. What follows is an overview of that reform-process cooperation and what it has so far achieved through the Lesotho UN Development Assistance Action Plan (LUNDAP, 2013-2017).
With only few months left for the culmination of the Millennium Development Goals (MDGs), Lesotho has recorded a considerable progress in MDGs relating to access to universal education and gender equality and women’s empowerment. Although some progress was made in promot- ing environmental sustainability and building partnerships for development, more still needs to be done to achieve sustainability. There is a need to increase efforts in transforming lives and reducing vulnerabilities among Basotho, especially women and children to tackle persisting inequalities and poverty. As in many other countries, some of the MDG agenda remains un- finished, Lesotho is well off the target on the goals relating to eradication of extreme poverty and hunger and the health-related MDGs including reducing child mortality, improving maternal health and Combating HIV and AIDS and Tuberculosis.
The lessons learnt from Lesotho’s MDG experience can help inform and lay the foundations for a smooth transition from the MDGs to the Sustainable Development Goals (SDGs) and ensure the continuation of existing efforts– the Post-2015 development agenda, which sets out the new global framework for development for the next 15 years.
The UN helps address Lesotho’s development challenges by providing evidence-based policy advice and sharing innovation and international best practices. The UN continues to support the Government in addressing the development agenda, strengthening national capacities and using its convening role to bring together different stakeholders and facilitated multi-sectoral processes to inform policies and programmes. This publication provides a comprehensive overview of the development results achieved under the United Nation’s Delivering as One work during the period 2013-2014 in all six thematic areas that include Investment Climate, Manufac- turing and Trade and Financial Services, Agriculture, Food Security, Environment, Natural Re- sources & Climate change, Governance and Institutions, Skills and Innovation, Health, Nutrition and HIV and AIDS and Social Protection.
The UN in Lesotho is keen to continuously adapt and improve the way results are delivered and measured, working closely with the Government, civil society and other partners. Only by working in partnership with multiple stakeholders and by delivering results cross-sectorally will the UN be able to support the Post-2015 development agenda in Lesotho.
KARLA HERSHEY Resident Coordinator in Lesotho
FOREWORD 3 The Delivering as One
4 United Nations in Lesotho Delivering as One What is Delivering as One?
What is Delivering as One? are effectively applied as an operational standard across the world to maximize the impact on the ground. The Delivering as One reform involves streamlining pro- grammes, focusing on areas where the UN can have a What prompted the reform? greater impact, reducing duplication of efforts, and more effective use of human and financial resources. The Delivering as One reform comes in response to the changing aid environment - an attempt to translate the Par- Delivering as One involves a bottom-up approach to re- is and Accra principles of aid-effectiveness into practice. form: evidence from change in the field influences the It also aims to reaffirm the UN’s position as a key actor in agenda and the political process at UN Headquarters level. the field of international development with its unique global The support of UN Member States including Lesotho is cru- reach and potential for coordinated responses to develop- cial to ensure that the best practices from DaO countries ment challenges. How is the reform structured?
THE DELIVERING AS ONE REFORM HAS FIVE PILLARS One Programme One Leader One Budget One Office Communicating as One
HERE’S WHAT EACH PILLAR MEANS
The One UN Programme approach House brings together all seven UN resi- The Communicating as One aproach calls for effective collaboration between dent agencies operating in Lesotho: Food enhances UN coordination, capacity and UN agencies and its various partners, re- and Agriculture Organization (FAO), Joint impact in the area of communications. The quiring joint work-plans, joint budgets and United Nations Programme on HIV and Delivering as One communication strategy the definition of common results. The UN AIDS (UNAIDS), United Nations Develop- enhances programme delivery through Country Team works “as one” to support ment Programme (UNDP), United Nations harmonized messaging and advocacy to Lesotho in achieving the Millennium Devel- Children Fund (UNICEF), United Nations the partners and Basotho people. opment Goals (MDGs), Lesotho’s National Population Fund (UNFPA), World Health Strategic Development Plan (NSDP) and Organization (WHO) and World Food Pro- One Budget One Budget calls for agreed the new Post-2015 Development Agenda gramme (WFP) including the World Bank. costed results presented in one financial through a people-centered, rights-based The common operations strategy strength- framework, showing each agency’s planed approach to development as outlined in ens joint procurement, information and input together with the funding source. the Lesotho United Nations Development communication technologies, human re- Unfunded results are also identified. Each Assistance Action Plan, the combined sources and financial management – all participating UN agency identifies the re- planning Action plan for all the UN orga- with the aim to more effectively deliver UN source it expects to provide-whether in- nizations – whether they be resident and development programmes. kind or monetary - subject to funds being operating in Lesotho, or non-resident. The available. At the end of the year, agencies DaO reform has put in place programming The One Leader refers to the empower- and government departments provide in- and operational principles that today pro- ment of the UN Resident Coordinator and formation on progress made against the mote the harmonized delivery of UN agen- the UN agency heads. An effective and planned results and actual expenditures, cies programmes in Lesotho. committed UN Country Team under the to give governments a clear picture of UN leadership of the Resident Coordinator, fa- support. The results in the financial frame- The One Office agenda focuses on both cilitates the coordinated implementation of work can be funded by agencies’ core harmonizing business processes and de- all UN interventions. resources, national government contribu- veloping common services, in order for tions, direct contributions from donors, and all UN agencies to increase operational a specific country coherence fund estab- efficiency and financial savings. The UN lished for interested donors.
United Nations in Lesotho Delivering as One 5 What are the major achievements al, regional and district. To facilitate cooperation under the of the DaO reform to date? LUNDAP, the UN’s planning cycle has been aligned with the National Strategic Development Plan, enabling compliance The UN’s strategic framework for Lesotho, UNDAF, articu- with requirements for the national processes in addressing lates in detail the UN system’s contribution to national-de- the development agenda. velopment priorities and international commitments – en- hancing Lesotho and Development Partners. It pushes the Partnering with Civil Society Organizations reform further by deepening the harmonization of business practices and improving cost effectiveness. The United Nations is both a participant in and witness to an increasingly global civil society and cooperation among LUNDAP implementation is supported by interagency Civil Society Organizations (CSOs). CSOs play a key role at thematic working groups, UN Theme Group on Gender, major UN conferences and are indispensable partners for Human Rights and Youth, UN Theme Group on Monitor- UN efforts at the country level and at the grass-roots. Leso- ing and Evaluation, Joint UN Team on AIDS, Operations tho CSOs are routinely consulted about the latest UN poli- Management Team, Disaster Management and Response cy and programme atters. The UN organizes and hosts on a Team, UN communications Group, UN Nutrition Team cor- regular basis, briefings, meetings and conferences for CSO responding to the key priority areas of the National Strate- representatives accredited to UN offices, programmes and gic Development Plan. The LUNDAP incorporates a Results agencies. Matrix and a complementary Monitoring and Evaluation Matrix, which include specific indicators, baselines, targets and means of verification.
What is the Lesotho Government’s role in the reform?
The Government of Lesotho has shown leadership and ownership in the Delivering as One reforms, as far back as 2008, when it supported the launch of the process. Tra- ditionally, all UN agencies in Lesotho have enjoyed close cooperation with government partners at all levels: nation-
6 United Nations in Lesotho Delivering as One LESOTHO UN DEVELOPMENT ASSISTANCE FRAMEWORK (2013-2017) RESULTS GROUPS
Investment Climate, Manufacturing, Trade and Financial Services
Agriculture, Food Security, Environment, Natural Resources & Climate Change
Governance and Institutions
Skills and Innovation
Health, Nutrition & HIV and AIDS
Social Protection
United Nations in Lesotho Delivering as One 7 INVESTMENT CLIMATE, MANUFACTURING AND TRADE & FINANCIAL SERVICES
8 United Nations in Lesotho Delivering as One INVESTMENT CLIMATE, MANUFACTURING AND TRADE & FINANCIAL SERVICES
Challenges and Opportunities
More than half of Lesotho’s people (57.1%) live below the national poverty line and Lesotho is classified among the low human development countries at an HDI of 0.486, ranking 162 out of 189 countries in 2013. While many factors contribute to poverty, the lack of employment, especially among youth and women, is a major contributing factor. The national unem- ployment rate is estimated at 25.3% (BOS, 2008), with more than 30% attributed to the youth. To boost employment and job creation, Lesotho needs job-creation initiatives and improved access to finance as well as spur private-sector growth.
Programme at a Glance
UN assistance (2013-14) National Implementing Partners US$ 1,184,760 Ministry of Development Planning, National Development Ministry of Home Affairs, Ministry of Local Goals NSDP 2013-2017 Governance, Ministry of Finance, Duration Ministry of Public Service, The Independent Electoral Commission, High, shared and The Office of the Ombudsman, 2013-2017 employment economic Directorate on Corruption and Economic growth Offencesive Bureau of Statistics, Ministry of Trade & Industry Cooporatives & Marketing, Ministry of Gender, Youth, Sports and Recreation. Funding partners
UNDP, ILO, UN participating Agencies IFAD, UNCDF.
UNCTAD, ITC, UNDP, UNECA, UNIDO, ILO, UNCITRAL, IFAD, UNCDF. Geographical coverage
NATIONAL Beneficiaries
Government, Women and youth, Workers’ associations, Private sector.
United Nations in Lesotho Delivering as One 9 Unites Nations in Action Moreover, by the end of 2014, 1,857 Basotho had gained fresh access to previously inaccessible finance, through The cluster on Investment Climate, Manufacturing and the UN-supported microfinance initiatives. By 2017, the UN Trade & Financial Services contributes to the realization of in Lesotho aims to help increase access to formal financial the National Strategic Development Plan, particularly the services by 10% in urban areas and 15% in rural areas. In objectives to promote accelerated, ‘shared and employ- partnership with responsible institutions, the UN continues ment-creating economic growth’ as well as the promotion to support policy development as well as explore opportu- of institutions effective for policy formulation, execution nities that enhance access to finance and financial resourc- and monitoring. The UN in Lesotho works to facilitate de- es in Lesotho. velopment of sustainable partnerships that promote pri- vate-sector participation, diversification of industry of job The UN also continued to support economic research and sectors and competitive economic development. It does evidence for policy formulation , execution and monitoring so by nurturing micro, small and medium-enterprise skills, leading to a better investment and business climate. entrepreneurship development, improved investment cli- mate, and trade integration. In 2014, the UN specifically contributed to the development of the mining and investment policies, research for employ- ment creating options in Lesotho, as well as support to the Between 2011 and 2014, joint production of data and statistics. The Government of Le- sotho was also supported in the efforts to improve trade UN efforts had cumulatively facilitation and doing business indicators, through support to the OBFC; specifically targeting ranking on days taken to contributed 2,451 new jobs register a business in Lesotho. The UN continues support- (over 60% for women). This ing capacity building programmes and the development of effective institutions. represents almost 49% against a five-year target of creating 5,000 jobs by the end of 2017.
10 United Nations in Lesotho Delivering as One INVESTMENT CLIMATE, MANUFACTURING AND TRADE & FINANCIAL SERVICES
UN INVESTMENT CLIMATE, MANUFACTURING AND TRADE AND FINANCIAL SERVICES ACTION PLAN OUTCOMES
Outcome: By 2017, public and private institutions will have promoted increased investments, manufacturing, trade and financial services and create decent employment in an inclusive sustainable manner.
Increased capacities of industry and commerce operators to provide decent employment opportunities, particularly for vulnerable Basotho in Key Planned Results: manufacturing, trade and services industries. Mechanisms to enhance regional and national trade development a strengthened and increased competitiveness.
Improved national statistical system to produce timely, reliable and relevant data for evidence- based policy formulation, execution and monitoring.
2013-2014 UN assistance US$ 1,184,760
United Nations in Lesotho Delivering as One 11 AGRICULTURE & FOOD SECURITY, ENVIRONMENT, NATURAL RESOURCES AND CLIMATE CHANGE
12 United Nations in Lesotho Delivering as One AGRICULTURE & FOOD SECURITY, ENVIRONMENT, NATURAL RESOURCES AND CLIMATE CHANGE
Challenges and Opportunities
About three-quarters of Lesotho’s population resides in rural areas, and the vast majority of this population depends to a large extent on agriculture and natural resources for their livelihoods. Unfortunately, these sectors have long performed poorly. The low output has made those who depend on livelihoods vulnerable to poverty and food insecurity. Key issues include the deteriorating environmental conditions, especially extensive land degradation, low agricultural production – which has caused great food insecurity – and lack of access to energy in rural areas. For instance, domestic cereal production only satisfies between 30% and 40% of the national cereal requirements. Furthermore, only 27% of Lesotho’s households have access to electricity.
The impacts of climate change have further worsened these conditions, jeopardizing the livelihoods and resilience of too many Basotho families – especially their children and most vulnerable groups. It is therefore not surprising that chronic malnutrition as measured by the level of stunting (low height for age) has over the last twenty years consistently stayed above the problem threshold (30%) set by the World Health Organisation. This type of malnutrition has serious adverse consequences for the country. Once stunting has developed in young age it is irreversible and has lasting negative impact on the physical and mental capabilities of children and adolescents.
Programme at a Glance
UN assistance (2013-14) National Implementing Partners US$ 31,583,300 Ministry of Agriculture and Food Security, Ministry of Forestry, National Development Range and Soil Conservation, Goals NSDP 2013-2017 Ministry of Tourism, Arts and Culture, Duration Ministry of Gender, Youth, Sports and Recreation, Reverse environmental Ministry of Energy and Meteorology, 2013-2017 degradation and adapt to Ministry of Water Affairs, climate change Disaster Management Authority, National University of Lesotho, NGOs and CBOs.
Funding partners
European Commission, UN participating Agencies USAID, DFID, GEF, COMESA Common FAO, WFP, UNDP, IFAD, Market For Eastern and ITC, UNEP Southern Africa.
Beneficiaries
Geographical coverage Agriculture, environment and NATIONAL natural resources sector, Vulnerable households.
United Nations in Lesotho Delivering as One 13 Unites Nations in Action The UN family continues to build multi-faceted resilience among the most vulnerable segments of Lesotho’s popula- In line with the NSDP, the UN in Lesotho seeks to help the tion. In 2014 alone, the UN in Lesotho provided access to people and Government of Lesotho achieve increased fortified food commodities to more than 25,000 beneficia- and sustainable agricultural growth, food security, access ries through the UN Food-For-Assets Programme. These to energy, and resilience to climate change, while also en- resilience-building programmes were accompanied by suring sustainable usage of natural resources and protect- technical assistance to strengthen the capacity of key in- ing the environment. stitutions for emergency earlywarning, preparedness and Lesotho lags behind in achieving the Millennium Develop- responses to food crises. The UN is also working towards ment Goals (MDGs) targets of reducing poverty and hunger integrating social protection with agriculture, through by half. Given the country’s landscape and socio-economic promotion of home gardens and nutrition education conditions, agriculture, environment and natural-resources amongst recipients of social grants. management have a significant role to play in whether Le- sotho is able to achieve these MDG targets. Unfortunate- Recognizing how important environmental and naturalre- ly, the overall performance of these relevant sectors has sources management are to improve and sustain the live- failed to live up to expectations, fueling the pervasive pov- lihoods of local communities, the UN system continues erty and chronic food insecurity, and worsening the health to mobilize and train communities on sustainable land- of many Basotho. management, conservation-based agricultural production techniques/practices, and how to apply renewable-energy Despite the troubling performance of this sector, some pos- technologies. itive results have been delivered in selected areas – and if scaled-up and consolidated, they can bring about the de- sired impact. In the area of crop production, the nation- al average yield for maize has increased from a ten-year The UN successfully promotes average of 0.5 tonnes/hectare, to 0.82 during the 2012/13 innovation, research, technology agricultural year, and 0.7 during 2013/14. development and transfer as a This improvement is largely attributed to improved access to productivity-enhancing technologies (e.g. Conservation contribution towards “greening” Agriculture) and inputs (seeds and fertilizers). Furthermore, farming communities seem to be embracing the govern- Lesotho’s economy and building ment policy on transforming agriculture, from its predom- inantly subsistence base to more market-oriented under- resilience to climate change. taking. To date, a sizeable number of progressive farmers have established smallto medium-sized agribusiness ven- Some highlights of these innovation platforms and partner- tures, with the support of different UN agencies. These ships include: the increased use of renewable energy; pro- businesses are predominately in horticulture (green hous- viding energy access to 10,000 people in the rural areas; es), while there is little focus on small-livestock production successful research and demonstration of biofuel produc- (poultry, piggery and other). tion using algae; and production of tiles from waste paper and plastic.
14 United Nations in Lesotho Delivering as One AGRICULTURE & FOOD SECURITY, ENVIRONMENT, NATURAL RESOURCES AND CLIMATE CHANGE
UN AGRICULTURE, FOOD SECURITY, ENVIRONMENT, NATURAL RESOURCES & CLIMATE CHANGE ACTION PLAN OUTCOMES
By 2017, national institutions (public and private) to deliver quality services for increased agricultural growth and food security; Outcome: By 2017, Lesotho to adopt environmental-management practices that promote a low-carbon climate-resilient economy and society, sustainably manages natural resources and reduces vulnerability to disasters
Selected national institutions and farmer organizations to improve capacity to deliver and respond to potential agriculture and food-insecurity risks.
Agricultural policy environment for commercialization is strengthened.
Capacity for M&E, agricultural research, extension and education services strengthened. Key Planned Results: Food and nutritional products, non-food items, cash transfers and vouchers distributed in sufficient quantity and quality and in a timely manner to targeted beneficiries.
Increased capacity of government, civil society institutions and private sector to integrate Climate Change (CC) into policies, planning frameworks, budgets and implementation strategies.
Innovative low-GHG technologies deployed and successfully demonstrated at the community level, community centres and schools, and their access improved.
Plans and systems to be established and training capacity of DMA increased to mitigate hazards and prepare for potential disasters for vulnerable people and DRR incorporated into sectoral policies.
Increased community participation in environmental protection and natural resources conservation.
2013-2014 UN assistance US$ 31,583,300
United Nations in Lesotho Delivering as One 15 GOVERNANCE & INSTITUTIONS
16 United Nations in Lesotho Delivering as One GOVERNANCE & INSTITUTIONS
Challenges and Opportunities
For Lesotho to thrive as a stable, prosperous and democratic country, it needs institutions that promote, accountability, human rights, gender equality, access to justice and rule of law, while also providing equitable, high-quality services. The UN in Lesotho continues to work closely with the Government of Lesotho, development partners, civil society organizations and the private sector to advance good governance to the benefit of all Basotho.
Programme at a Glance
UN assistance (2013-14) National Implementing Partners US$ 2,661,466
Ministry Development Planning, National Development Ministry of Home Affairs, Ministry of Local Governance, Duration Goals NSDP 2013-2017 Ministry of Finance, Ministry of Public Service, 2013-2017 Promote peace, The Independent Electoral Commission, democratic governance The Office of the Ombudsman, and build effective Directorate on Corruption and Economic institutions Offences; Bureau of Statistics.
Funding partners
European Union, USAID UN participating Agencies
UNDP, UNFPA, UNICEF, ILO, UNCDF
Beneficiaries
Geographical coverage All sectors of the economy NATIONAL including individuals, Local entities.
United Nations in Lesotho Delivering as One 17 Unites Nations in Action to support national statistical surveys, such as the 2014 Lesotho Demographic Survey, current preparations for the Working in partnership with the Government of Lesotho to 2016 Population and Housing Census, and the strengthen- implement its National Strategic Development Plan, the UN ing of vital statistics Programme at a Glance through the system focuses on good governance through strengthen- National Identity and Birth Registration. ing democratic institutions, electoral support, human rights, peace building, gender equality and evidence-based ap- The UN in Lesotho continues to support the One Stop proaches to governance challenges. Centre for Gender-Based Violence (GBV), where 500 gen- The United Nations remains committed to sustainable der-based violence survivors were recently trained on ba- peace and security in Lesotho. For example, the UN pro- sic developmental counseling, and equipment and support vided considerable technical assistance to the Indepen- services provided for GBV surviving women and children dent Election Commission (IEC) prior to the February 2015 who sought shelter at the facility. For the two Houses of national elections. The UN conducted an electoral-needs Parliament, the UN has also provided technical and finan- assessment in late 2014 to assess the IEC’s capacity, and cial assistance to help develop Strategic Plans, guidelines immediately responded with technical assistance on logis- on Interpretation of New Standing Orders, Orientation and tics, public outreach, voter education and training for IEC Public Participation Manuals. These instruments have been polling staff, chiefs, party agents and journalists for ethical institutionalized and will benefit Parliament for years to elections coverage. come.
Progress continues toward public-sector reform and de- The UN also provided technical assistance in 2012 and centralization of services. The major UN contribution to 2013 to develop Lesotho’s Human Rights Policy, draft the developing the capacities of local authorities sets the foun- National Human Rights Commission Bill and Action Plan, dation to deliver better-quality, more-accessible services to drafting and submission of Lesotho’s State Party Reports, Basotho society by 2017. including the first submission of the Universal Periodic Re- view (UPR) in January 2015 to ensure the country complied Women empowerment in Les otho has made considerable with its international obligations. UN support was provid- gains since 2004. Evidence according to the 2013 MDG re- ed for human rights trainings for Judges of the High Court, port, suggests that the percentage of Basotho women who Members of Parliament, Members of the Security Establish- make decisions regarding their own health has increased ment and primaryschool teachers. from 37% to 44% according to the MDG progress report. Meanwhile, the percentage of women who have a say in all The UN in Lesotho supported the development and imple- areas of decision-making increased from 30% in 2004 to mentation of an Investigations Procedure Manual, which 53% in 2009. The UN in Lesotho has helped strengthen the has transformed the way Office of the Ombudsman inves- capacity of National ID Registration and Bureau of Statistics tigators conduct their field inspections. The streamlined, staff, by providing technical knowledge and skills through standardized process has greatly contributed to a more study-tours and technical assistance. This will enable to efficient, effective Office of the Ombudsman. Furthermore, more effectively produce and manage the 2016 Census, vi- the national Anti- Corruption Strategy was developed with tal statistics and other national surveys. The UN continues the UN support.
18 United Nations in Lesotho Delivering as One GOVERNANCE & INSTITUTIONS
UN GOVERNANCE AND INSTITUTIONS ACTION PLAN OUTCOMES
By 2017, national and local governance structures deliver quality and Outcome: accessible services to all citizens, while respecting the need to protect human rights, provide access to justice, and resolve conflicts peacefully. By 2017, both national and all lower-level institutions make evidence-based policy decisions.
Strengthen the capacity of key national institutions to promote gender equality, while reducing sexual violence, gender-based violence, and the exploitation of women and children.
National Peace Architecture in place.
By 2017, national and lower-level institutions make evidence-based policy decisions.
Put in place a national statistical, monitoring and evaluation system, with timely, reliable and relevant data for evidence-based polices and plans.
Better equip key national institutions to formulate and review evidence-based policies and plans.
Key Planned Results: Enhance the capacity of national institutions to collect, analyse, disseminate and utilize national HIV&AIDS M&E disaggregated data for evidence-based planning and programming.
Establish and keep functional a research and knowledge-management system for HIV&AIDS – and maintain all its mechanisms.
Establish and operate effective national and district, coordination and management structures that focus on HIV&AIDS and HIV&AIDS forums.
Review the effectiveness of policies and laws connected to the HIV&AIDS response.
Build capacity of key stakeholders to mainstream HIV&AIDS in all sectors.
Establish and operationalize financing mechanisms to ensure the sustainability of the national HIV&AIDS response.
Effectively coordinate and support the management and implementation of the Joint UN Programme of Support on AIDS (JUPSA).
2013-2014 UN assistance US$ 2,661,466
United Nations in Lesotho Delivering as One 19 HEALTH AND NUTRITION
20 United Nations in Lesotho Delivering as One HEALTH AND NUTRITION
Challenges and Opportunities
Health, nutrition and HIV/AIDS are predominant development challenges in Lesotho. Lesotho is off-track for hitting its Millennium Development Goals (MDGs) targets on maternal and child health, and HIV. Maternal deaths represent 11 per- cent of all deaths among women aged 15-49. One in every nine children born in Lesotho dies before reaching his or her fifth birthday. A third of children are stunted. The persistently high HIV prevalence in the adult population remains the most significant threat to the achievement of health and nutrition outcomes for adults and children, now and in the future. Although communicable diseases are predominant, a worrying new trend is the rise of non-communicable diseases such as diabetes and hypertension. Rural households where 75 percent of the population resides and impoverished households, also suffer poorer health outcomes than wealthier and/or urban households. While the country has made progress in improving health and nutrition outcomes in recent years when stunting has reduced from 39% to 33% and under five child mortality rate has reduced from 117 to 85 deaths per 100 live births, it fell short of meeting the MDGs and is insufficient to attain the goal of having a healthy and productive population by 2020.
Programme at a Glance
UN assistance (2013-14) National Implementing Partners
US$ 13,364,289 Ministry of Health; Ministry of Gender, National Development Youth Sport and Recreation, Lesotho Network of People Living with Duration Goals NSDP 2013-2017 HIV and AIDS (LENEPWHA), Lesotho Network of AIDS Service 2013-2017 Improve health, combat Organizations (LENASO), Lesotho Inter- Religious AIDS HIV and AIDS and reduce Consortium (LIRAC). vulnerability
Funding partners
UNICEF, UNFPA, UN participating Agencies UNAIDS, UNDP, WHO
WHO, UNICEF, WFP, UNFPA
Beneficiaries
Geographical coverage Adult men and women, Pregnant women, NATIONAL Children, Young People.
United Nations in Lesotho Delivering as One 21 Unites Nations in Action With UN support, the MOH conducted a comprehensive review of Expended Programme of Immunization (EPI), The UN is partnering with the government, which identified ways to strengthen the health system to nongovernmental organisations, and donors to combat the deliver vaccines to children. spread of HIV and ensure equitable access to highimpact, cost-effective health and nutrition interventions for vulner- In 2014, the UN supported 27,059 Basotho beneficiaries able populations. To realize the strategic objectives within in a massive intervention to prevent stunting in the districts the LUNDAP Health and Nutrition sectors the UN in Lesotho of Mokhotlong, Berea, Qacha’s Nek, and Thaba-Tseka: works with the Government to formulate policies, develop 17,438 were children 6 to 23 months old, while 6,622 were strategic documents and technical guidelines. The UN also pregnant or lactating women. Moreover, the UN supported works to strengthen the capacity of all health-related in- 15,410 beneficiaries – comprised of 2,679 children under stitutions and civilsociety organizations at national, district the age of five; 10,622 people l iving with HIV (PLHIVs) and and local/community levels to improve service delivery. 2,109 pregnant and lactating women –with specialized nutrition commodities like for children from 6 to 59 months This is achieved through evidence-based planning, old super cereal plus and from 5 years upwards super cere- budgeting, monitoring and evaluation, as well as by devis- al for the treatment of moderate acute malnutrition. ing and implementing disaster-risk-reduction plans. The UN provided technical and financial support to the With UN advocacy and support, the King of Lesotho, His MOH to procure lifesaving medicines (particularly for Majesty King Letsie III, was appointed as Nutrition Champi- maternal health and safe deliveries) worth US$155,000, on for Africa. In June 2014, the King delivered an advocacy in line with WHO guidelines. In addition, verbal autopsy speech to African leaders at the AU Heads of State Summit tools were developed and printed to capture maternal to advance Africa’s nutrition agenda. His Majesty highlight- deaths at community level. The verbal autopsy tool is used ed the high prevalence of malnutrition on the continent, its to collect information on the causes of maternal deaths in impact on children, as well as on the economy, and advo- Lesotho. This information is required for policy making and cated for increased investment in food- and nutrition-se- targeting of health services. curity programmes. In addition, the King led the Lesotho In order to strengthen national capacity in the area of Ma- delegation’s participation in the Second International Con- ternal Death Surveillance and Response, the UN continues ference on Nutrition (ICN2), jointly organized by FAO and to support the efforts of the Lesotho Committee on Confi- WHO in Rome, Italy, in November 2014. His Majesty’s com- dential Enquiry into Maternal Deaths including the reviews mitted involvement was jointly acknowledged by both Di- of maternal deaths. By strengthening capacities of health rector-Generals of FAO and WHO, through their joint letter providers and providing equipment, training manuals and to the King in December 2014. The United Nations Lesotho IEC materials, the UN continues to support twelve health fa- welcomes the commitment and support from the highest cilities, including district hospitals, to foster the provision of level concerning this crucial issue for the country. integrated HIV and Sexual and Reproductive Health (SRH) services. The UN in Lesotho provided technical and financial support to the Ministry of Health (MOH) to develop: the Health Under the leadership of Her Majesty the Queen Masenate Promotion Policy and Strategic plan; the Procurement and Mohato Seeiso, the UN has initiated high-level advocacy to Supply Chain Strategic Plan for Medicines and Medical prevent maternal and neonatal deaths in Lesotho. During Products; the Non-Communicable Disease Action Plan; and the reporting period, Principal Chiefs, their wives, and se- the Drinking Water Quality Surveillance Strategy. These lected female religious leaders were trained on how to in- documents will provide strategic direction in the identified form, educate and motivate families to use maternal health areas. services.
22 United Nations in Lesotho Delivering as One HEALTH AND NUTRITION
Unites Nations in Action
With World Bank support, the MOH is conducting a pilot of performance-based financing for maternal, neonatal and childhealth services in health facilities in two districts. The project strengthened health-sector capacity at the central and district levels to plan and implement Disaster Risk Reduction (DRR) plans. The capacity-development exercise resulted in development of a DRR business-continuity plan for all sectors –including the health sector and establishment of a health-sector DRR Technical Team to guide programme managers in how to plan and implement DRR management.
The UN supported the development of a business plan for health promotion, which played a crucial role in the devel- opment of the consolidated NCD Policy and Strategic Plan. Furthermore, to provide Basotho with baseline information on the magnitude of non-communicable diseases (NCD) such as diabetes and hypertension, the UN published the 2012 STEPS survey of chronic disease risk factors.
UN GOVERNANCE AND INSTITUTIONS ACTION PLAN OUTCOMES
By 2017, achieve equitable access to and utilization of high-impact, cost-effective health and nutrition interventions for vulnerable populations. Outcome: By 2017, persons living with HIV have access to and benefit from integrated service delivery, including nutrition support; ART and care; and HIV/TB co-infection management.
Strengthen capacity of Government at all levels, including supply-chain management and the human-resource base, to deliver integrated child-survival interventions.
Strengthen the system to promote healthy behaviours.
Increased capacity of health institutions in 10 districts, to provide skilled, Key Planned Results: high-quality delivery care; emergency obstetric care; and familyplanning services.
Strengthen capacity of districts, health facilities and communities to improve maternal nutrition, child-feeding practices, and provide quality Integrated Management of Acute Malnutrition (IMAM) services.
Strengthen capacity of health and nutrition managers at the central and district levels, to do evidence-based planning, budgeting, monitoring and evaluation, in order to attract more resources to their units.
2013-2014 UN assistance US$ 13,364,289
United Nations in Lesotho Delivering as One 23 HIV AND AIDS
24 United Nations in Lesotho Delivering as One HIV AND AIDS
Challenges and Opportunities
Knowledge of how HIV is transmitted is crucial to enabling more Basotho to avoid HIV infections. This is especially true for young people who are often at greater risk, because they may have shorter relationships, with more partners, or engage in other risky behaviours. Although knowledge about HIV is universal in Lesotho, comprehensive knowledge about HIV prevention among young people remains stubbornly low: 34.8% in 2014, down from 35.2% in 2009. According to the Lesotho Demographic Household Survey (LDHS) 2014, an estimated 35% of Basotho men and 15% of women living with HIV do not even know their status. Nevertheless, Lesotho has made significant progress. Between 2004 and 2014, the percentage of adults who have tested for HIV has increased dramatically: among women, from 12%
in 2004 to 66% in 2009, and now up to 84% by 2014; among men, from 9% in 2004, to 37% in 2009, to 63% in 2014. While the number of people getting tested has more than doubled– from 221,000 in 2009 to 553,000 in 2014 – the per- centage of adults tested in the past 12 months is still far below the national target of 80%. Lesotho has made particularly strong progress in testing, treatment and prevention of motherto- child transmission (PMTCT). The strong progress has been made because of innovations such as the “motherbaby pack” and new PMTCT & ART guidelines have accelerated the scale-up of treatment services to a greater proportion of Basotho living with HIV, including pregnant women, new borns and adults who would otherwise not receive antiretroviral to improve life expectancy. Currently, more than 111,000 Basotho are receiving treatment, compared with fewer than 2,000 a decade ago.
Programme at a Glance
UN assistance (2013-14) National Implementing Partners US$ 5,750,000
Ministry of Health, Ministry of Gender, National Development Youth Sport and Recreation, Goals NSDP 2013-2017 Ministry of Education, Duration Ministry of Local Goverment Lesotho Network of People Living with HIV and AIDS (LENEPWHA), Improve health, combat 2013-2017 Lesotho Network of AIDS Service HIV and AIDS and reduce Organizations (LENASO), Lesotho vulnerability Inter-Religious AIDS Consortium (LIRAC)
Funding partners UN participating Agencies UNICEF, UNFPA, UNAIDS, UNDP, WHO UNICEF, UNFPA, UNAIDS, UNDP, WHO
Beneficiaries Geographical coverage Adult men and women, NATIONAL Pregnant women, Children, Young People.
United Nations in Lesotho Delivering as One 25 Unites Nations in Action behaviour change, including women and girls, couples, and Basotho. The UN in Lesotho supported an advocacy workshop for 30 Parliamentarians who are members of the HIV & AIDS In addition, the UN enhanced capacity of civil-society or- and MDG committees – then jointly developed a plan of ganisations to accelerate implementation of high-impact action with an associated budget. HIV interventions- as well as for demand-creation to in- crease uptake of HIV prevention and treatment services – The UN also supported: an assessment of the legal and by mobilizing communities such as people-living-with-HIV regulatory framework related to Lesotho’s HIV and AIDS (PLHIV) networks, community-based organisations (CBOs) burden; the US$48 million Interim Application for Global and faith-based organisations (FBOs). Fund New Funding Model for HIV and Health Systems Strengthening; the production of key country reports, in- The UN also helped develop a joint-cost action-plan, mon- cluding the 2014 Global AIDS Response Progress Report, itoring framework and key indicators, in line with the East- 2013 ANC Sentinel Surveillance, Stigma Index Study, In- ern and Southern Africa Commitment for Young People. vestment Case, the 2013/2014 Annual Joint Review TB and Treatment areas focus on strengthening the central and HIV report; the 2014 HIV and AIDS estimates and projec- sub-national levels, to offer comprehensive HIV treatment tions; and training 30 programme and M&E officers in the and care services, integrated with nutrition and home- twelve based care services.
The UN also supported the MOH to: develop, adapt and rollout the 2013 WHO Revisions and Recommendation of “Components of the ART guidelines; revise the national TB guidelines; undertake PMTCT bottleneck analysis, whose results help Strengthening M&E ease the challenges of poor access to services in preven- tion, treatment and care services among Basotho women System”. and children; procure and distribute supplementary feed- ing-food packages to more than 50,000 ART and TB pa- tients; and procure and distribute nutrition-assessment In the area of prevention, the UN in Lesotho supported tools (scales, MUAC tapes, etc.) to health facilities in the 10 the reestablishment of the national HIV prevention techni- districts of Lesotho. cal working group; and reinvigoration of the national pre- vention agenda; an Integrated Life Skills-based Sexuality Education (LBSE) curriculum now being taught in all 1,500 primary schools nationwide; the design, promotion and distribution of 5 million Vibe condoms for young people in non-traditional outlets like dispenses in public places such as the big malls; launching the Safeguard Young People Programme; development of the Social and Behavioural Change Communication (SBCC) strategy for 2014-2017, targeting all population groups with specific messages for
26 United Nations in Lesotho Delivering as One HIV AND AIDS
UN AGRICULTURE, FOOD SECURITY, ENVIRONMENT, NATURAL RESOURCES & CLIMATE CHANGE ACTION PLAN OUTCOMES
By 2017, multi-stakeholders in the country contribute to the reduction of new annual HIV infections, especially among Basotho youth. Outcome: By 2017, persons living with HIV have access to, and benefit from, the integrated delivery of services, including nutrition support; ART and care; and HIV/TB co-infection management.
Fully functional national and district coordination and referral mechanisms, for HIV prevention among young people.
Effective implementation of HIV-prevention interventions to change risky sexual behaviours among young people.
Key Planned Results: Increased provision of comprehensive PMTCT services in local, community health facilities.
Scale-up and delivery of youth-friendly health services.
Government and partners respond more effectively to HIV and AIDS in the workplace.
2013-2014 UN assistance US$ 5,750,000
United Nations in Lesotho Delivering as One 27 SKILLS AND INNOVATION
28 United Nations in Lesotho Delivering as One SKILLS AND INNOVATION
Challenges and Opportunities
Lesotho has made considerable progress in education, where it boasts one of the highest literacy rates and primary enrollment rates in all of Sub-Saharan Africa. However, while access and enrollment have improved, many severely dis- advantaged children remain largely outside of school, including herd-boys, learners with disabilities, orphans and other vulnerable children who together represent roughly 20% of the entire population of Basotho children. Without attending to the needs of the most vulnerable, Lesotho will be unable to achieve the goal of educating 100% of all children at the primaryschool level. The UN in Lesotho is working with the government to increase the quality of education, as well as access to higher levels of education, by developing new education policies
Programme at a Glance
UN assistance (2013-14) National Implementing Partners US$ 5,764,880 Ministry of Education and Training, Lesotho Association for Non-Formal National Development Education, The Good Shepherd, Goals NSDP 2013-2017 Food Management Unit of the Prime Duration Minister’s Office, The Juvenile Training Centre. Enhance the skills base 2013-2017 and foundation for innovation
Funding partners UN participating Agencies GPE Secretariat South African Government UNICEF, WFP, World Bank
Beneficiaries
Geographical coverage Children aged 3-13 and youth NATIONAL
United Nations in Lesotho Delivering as One 29 Unites Nations in Action ministers and was officially launched on October 6 2015. With the UN support, an IECCD unit was created within the The main areas of intervention are: Early Childhood Care MOET, after the IECCD policy was finalized and and Development (ECCD), primary school education, disseminated. Moreover, the UN supported the drafting non-formal education, and school feeding. The UN in of Early Learning and Development Standards. Lesotho aims to improve both the access to education and quality of that education. The combination of The UN supports training, inspection, and a new child- UNsupported activities – such as teacher training, policy friendly curriculum. Inspection is critical, as it supports work and curriculum reform – aim to improve quality of teachers to provide quality education in schools, so the education, while school-feeding improves access and UN Skills and Innovation Action Plan Outcome: By 2017, attendance. Progress has been made in providing access learners at ECCD and Primary levels have equitable access to education, evidenced by a net enrolment rate, which in- to quality and relevant education Key Planned Results: creased from 60.2% in 1999 to 81.1% in 2012. The percent- Enhanced access to quality IECCD services, enrolment and age of qualified teachers in primary schools also increased learning outcomes, especially for the most vulnerable, pri- from 58% in 2011 to 68% in 2013, which was slightly above maryschool-age and over-aged children. the target of 66%. This increase is a result of UN efforts in stepping up the teacher training. Enhanced MOET capacity to coordinate, plan, implement, and monitor the provision and quality of both basic and The UN exceeded its target of 50,000 children at the Early targeted, non-formal education. 2013-2014 UN assistance Childhood Care and Development (ECCD) centers with US$ 5,764,880 UN supported the MOET with the decen- 55,000 children now enrolled which represent 33% of the tralization of the inspectorate of the MOET. The UN is sup- total, and 50,858 children are being reached by school porting the rollout of a new integrated curriculum across feeding. The provision of school meals to 300,000 pre- the country, a programme that is child-centered, and part and primary-school children led to more children being of the enrolled. The school meals ensure that children stay in school and prevents early drop-outs. These young children received morning porridge and a lunchtime meal that helps build stamina and improve their concentration. The UN also supported 23 schools in mountainous areas by equipping facilities with kitchens and storerooms. Overall, the UN as- “Child Friendly sisted the Government to develop its national school-feed- ing policy, while also piloting a local food-purchase pro- gramme for school feeding, with the potential to boost both School” the rural economy and household incomes.
At more than 10 resource centers across the country, pre-school teachers were trained on practical classroom approach which is a UNICEF concept adopted by the MOET. instruction, lesson-planning, and how to develop and Of the 11,007 non-formal education (NFE) learners, 2,778 implement daily programmes, by following the UNsupport- are under the age of 18. NFE learners are Basotho who ed curriculum and learning materials. In 2014, dropped out of school and now receive alternative ways 6,104 teachers received at least six full days of training on of learning. With more than 60,000 children, between the practical approaches to teaching young children. The UN ages of 6-13, out of school, there is much more to be done. supported the Ministry of Education and Training (MOET) The vast majority of NFE youth learners are enrolled in the to develop the Integrated Early Childhood Care and Devel- literacy programme of the Lesotho Distant Teaching Cen- opment (IECCD) policy, which has now been signed by line ter, which has a total of 7,922 learners.
30 United Nations in Lesotho Delivering as One SKILLS AND INNOVATION
UN SKILLS AND INNOVATION ACTION PLAN OUTCOMES
Outcome: By 2017, learners at ECCD and Primary levels have equitable access to quality and relevant education
Enhanced access to quality IECCD services, enrolment and learning Key Planned Results: outcomes, especially for the most vulnerable, primaryschool-age and over-aged children.
Enhanced MOET capacity to coordinate, plan, implement, and monitor the provision and quality of both basic and targeted, non-formal education.
2013-2014 UN assistance US$ 5,764,880
United Nations in Lesotho Delivering as One 31 SOCIAL PROTECTION
32 United Nations in Lesotho Delivering as One SOCIAL PROTECTION
Challenges and Opportunities
Poverty and inequality continue to increase in Lesotho. The percentage of people living below the poverty line has increased from 56% in 2003 to 57% in 2010 (Bureau of Statistics). One in four Basotho adults are HIV-positive and the resulting AIDS-related deaths fuels the growing number of widows and orphans in Lesotho. The epidemic often affects the family breadwinner, undermining the ability of people to feed and care for themselves, while eroding the capacity of communities and institutions to provide basic services to those in need. Without adequate social protection, poor and vulnerable groups face uncertainty – even death. According to the mapping and assessment of vulnerability, the total number of Orphans and Vulnerable Children (OVCs) is 356,000 (approximately 19% of total population). The loss of parents sometimes forces children to become the heads of households – depriving them of a normal childhood.
Social protection has been considered as a national priority for the Government of Lesotho and is reflected in the National Strategic Development Plan 2013-2017. The National expenditure for the key social safety nets programmes represents 4.5% of GDP, which is well above 1-2% spent by most developing countries. In 2012, the Ministry of Social Development was created to deliver implement Government’s Vision on social protection as stipulated in the NSDP 2013-2017.
Despite the strong commitment by the Government of Lesotho, the sector grapples with challenges including the weak lack of coordination, and both overlap and gaps in coverage and spending between social protection schemes.
Programme at a Glance
UN assistance (2013-14) National Implementing Partners US$ 4,580,000
Ministry of Social Development, Ministry of Health, National Development Ministry of Education and Training, Duration Goals NSDP 2013-2017 Ministry of Labor and Employment, Ministry of Finance, 2013-2017 Ministry of Development Planning, Improve health, combat Catholic Relief Services, HIV and AIDS Bureau of Statistics, and reduce vulnerability Disaster Management Authority, World Vision International. Funding partners
UNICEF, WFP, UN participating Agencies World Bank, EU
UNICEF, WFP, FAO, WB, ILO
Beneficiaries Geographical coverage Children NATIONAL Women Poor Families
United Nations in Lesotho Delivering as One 33 Unites Nations in Action of HIV Orphans and Vulnerable Children. The programme aims at reducing malnutrition, improving health status and increasing school enrolment. From its inception as a do- nor pilot-project, the Government assumed responsibility for the CGP in 2013, officially included in the Medium Term Expenditure Framework (MTEF). By the end of 2014, the CGP – now offered in 43 councils, across all 10 districts – had reached 25,600 households; 2,026 pre-schools; and “A social protection strategy provided benefits to roughly 65,000 Basotho children na- tionwide. that uses the life-cycle CGP has contributed significantly to the development agen- approach to reduce poverty da: improving access and retention of children to schools, morbidity and birth-registration (“UNICEF, OPM, CGP im- and vulnerability” pact evaluation follow-up research, 2014); food security, as 60% of the grants are used for food; a multiplying effect of 2.23 in local economic and the affordable expansion of the CGP nationwide.
Because of high vulnerability among its people, the Gov- The UN’s social protection programmes, including cash ernment of Lesotho, through its National Strategic Develop based transfers and food based safety net activities, pro- ment Plan, adopted Social Protection as one strategy to vide a means for integrating the Strategic Development address these challenges. To reduce vulnerability and pov- Goal 2 erty, the Government recently adopted the National Social Protection Strategy (NSPS), to guide the country’s entire so- (End hunger, achieve food security and improved cial-protection sector. The Strategy was officially launched nutrition and promote sustainable agriculture) in February 2015 by the Right Honorable Prime Minister. and other elementsof the agenda into a broader framework The UN in Lesotho, in partnership with European Union that channels investment derived from rising levels of pros- advocates for and provides support to social-protection perity to support national goals for reducing hunger and mechanisms by improving and expanding the social-pro- undernutrition. Through the School Meals Programme, the tection services through and improved targeting and de- UN is supporting the Government of Lesotho in providing livery mechanisms, as well as increasing the coverage of two meals per day to 250,000 students in primary schools social-protection programmes, particularly the Child Grants and 50,000 preschool learners throughout the country. Programme (CGP), food assistance and school-feeding i ntervention The UN is also providing cash and food to 4,050 people frequently affected by climate change in the districts of The Child Grants Programme, in particular, targets poor Mafeteng and Mohale’s Hoek. and vulnerable households through an unconditional so- cial cash transfer aimed to improve the living standards
34 United Nations in Lesotho Delivering as One SOCIAL PROTECTION
Between March and August 2015, the 4,050 beneficia- tion. Since 2015, Government with the support of the UN ries had created assets including dams, water tanks and agencies and in partnership with the European Union is community gardens in an effort to increase their ability to reforming the NISSA in order to improve targeting efficien- withstand shocks. Throughout the country UNis targeting cy and promote better harmonization and integration be- 43,750 pregnant and lactating women, children under five tween social safety nets. years of age and vulnerable patients on HIV therapy and TB treatment. These are given specialised nutritious food Through an integrated community development model, UN including super cereal and super cereal Plus (Corn Soya in partnership with the European Union is supporting Gov- blend), and pulses, vegetable oil and maize meal. ernment to strengthen linkage between social protection and other sectors in order to promote livelihood. The UN in Meanwhile, the UN in Lesotho also supported the devel- partnership with GIZ is also supporting the Ministry of Lo- opment of a national registry for social assistance (NISSA), cal Government to implement a One Stop Shop pilot which which would cover 45 Community Councils in all districts aim to strengthen service delivery at local level linking with – encompassing roughly one-quarter of Lesotho’s popula- social protection.
UN SOCIAL PROTECTION ACTION PLAN OUTCOMES
Outcome: By 2017, vulnerable groups have access to adequate and effectively managed (HIV-AIDS, Child and Gendersensitive) social protection systems
Policy and legal environment for HIV-AIDS, child and gender sensitive social Key Planned Results: protection is improved. Strategic and operational plans, policies and services for Vulnerable Children (VC) that include social cash transfers and food aid reviewed and utilised.
2013-2014 UN assistance US$ 4,580,000
United Nations in Lesotho Delivering as One 35 www.unlesotho.org