Landmark health investment plan to tackle maternal mortality, gender inequality unveiled

LIAPENG RALIENGOANE

MASERU – In a decisive step toward strengthening its health system and accelerating progress on maternal, new-born, and adolescent health – as well as gender equality – Lesotho has validated its first-ever data-driven Investment Case.

The four-day working session brought together representatives from the government, civil society, UNFPA, and other development partners to ensure the plan reflects national priorities, evidence-based strategies, and consensus-driven solutions.
The country faces stark public health challenges, with a maternal mortality ratio of 530 deaths per 100 000 live births and a neonatal mortality rate of 26 per 1 000 live births.

Among adolescents aged 15 to 19, unmet need for family planning remains high at 21 percent, while 36 percent of women experience intimate partner violence. Child marriage continues to deprive girls of education and opportunities, perpetuating cycles of poverty and inequality.

These figures reveal systemic gaps in care and protection, underscoring the need for smarter, evidence-based investments.
Over a four-day workshop, government officials, civil society representatives, and international partners including UNFPA, collaborated to develop the evidence-based strategy. The Investment Case will serve as a costed, actionable roadmap to increase investment in high-impact health interventions and advance progress toward the Sustainable Development Goals.
Palesa Ramothello, a Ministry of Health Policy and Strategic Planner, stated: “This isn’t just a document – it’s an advocacy tool that will help us mobilize resources and save lives. For the first time, we have a fully costed, nationally owned plan tailored to Lesotho’s realities.”

“This Investment Case is a critical advocacy tool because it is fully costed. It will guide interventions and help mobilize the resources needed to make real change.”

During the workshop, participants validated baseline data, agreed on high-impact interventions, reviewed coverage levels, and set ambitious yet realistic 2030 targets. Special attention was given to child marriage as both a cause and effect of poor health outcomes.

By the end of the session, attendees approved baseline indicators and consensus was reached on a package of interventions to be modelled under various investment scenarios.

An international consultant, working with local experts and supported by UNFPA, will now lead financial modelling and finalize the Investment Case. The final document will include cost projections, expected health and economic outcomes, and benefit-cost ratios for each scenario.

For Lesotho, this represents a strategic turning point. Amid health system constraints and reliance on external aid, the Investment Case offers a credible pathway to mobilize resources, inform policy, and accelerate progress toward global development goals.

As Ramothello noted, it gives Lesotho “the power to advocate for interventions that are not just needed, but fully costed and evidence-backed.”
The plan prioritizes reducing preventable maternal deaths, ending child marriage, eliminating gender-based violence and expanding access to family planning services. Participants agreed on baseline indicators, intervention packages and coverage targets for 2030 under various financing scenarios.

The document will serve as both a technical roadmap and a platform for securing domestic and external financing. It aims to encourage greater government investment in high-impact interventions aligned with the 2030 Sustainable Development Goals. Key focuses include reducing maternal mortality, ending child marriage, eliminating gender-based violence, and addressing unmet family planning needs.

The final version, to be developed with support from UNFPA and international experts, will include detailed financial modelling, cost-benefit analyses and expected health outcomes.

This initiative marks a critical step for Lesotho, which has long relied on external aid for health funding. The Investment Case provides a sustainable, evidence-based pathway to not only improve health systems but also promote gender equality and protect the rights of women and girls.

As one participant emphasized: “This is about more than numbers – it’s about ensuring no woman dies giving life, no girl is forced into marriage, and no survivor of violence is left without support.”

If fully implemented, the plan promises to reduce preventable deaths, expand family planning access, strengthen violence prevention and response, end child marriage, and improve lives across the nation.

Unlike externally imposed solutions, this Investment Case is nationally owned and data-driven, tailored to Lesotho’s realities while incorporating global best practices.