A new health covenant

As govt, CHAL renew historic partnership

MPOLOKENG THABANE

MASERU – Government and the Christian Health Association of Lesotho (CHAL) have signed a renewed Memorandum of Understanding (MoU), committing to a new era of collaboration, equity, and improved service delivery for the nation’s most vulnerable citizens – in a step toward mending the country’s fractured healthcare landscape.

The agreement, inked at the State House on March 20, is more than just a renewal; it is a strategic reset of a partnership that first began in 2007. It replaces an expired framework from 2017, a period marked by administrative friction, funding disputes, and growing concerns over the sustainability of health services, particularly in the rural and remote communities that rely most heavily on CHAL’s network.

The signing ceremony was marked by a tone of solemn commitment, with government officials and CHAL representatives acknowledging past challenges while expressing unwavering optimism for the future.

The renewed MoU aims to dismantle the long-standing disparities between government-run and faith-based facilities, promising to fully integrate CHAL into the national health system.

For decades, CHAL has been an indispensable pillar of Lesotho’s healthcare system. Founded in 1971 as an ecumenical body, the association brought together the health services of the Roman Catholic, Lesotho Evangelical and Anglican churches. Its founding principle was rooted in a mission of compassion: to provide quality, accessible healthcare to Basotho, especially in the mountainous and rural hinterlands where government infrastructure was sparse.

For over five decades, CHAL facilities have often been the sole providers of care, embodying a legacy of service that has become deeply woven into the fabric of society. Today, its network comprises a significant portion of the country’s health facilities, including hospitals, health centers, and outreach programmes that serve hundreds of thousands of citizens.

However, the years following the original MoU’s expiration in 2017 were fraught with difficulty. The absence of a formal agreement exposed deep-seated disagreements between CHAL and the government over administration, funding, and the working conditions of healthcare staff.

CHAL repeatedly raised alarms over inconsistent and inadequate funding, which led to chronic shortages of medicines, supplies, and equipment. A particularly contentious issue was the disparity in salaries and benefits.

While government-employed healthcare workers were on a structured pay scale, their counterparts in CHAL facilities often received lower wages and fewer benefits for performing the same critical duties, leading to frustration, low morale, and a brain drain of skilled professionals from mission hospitals.

“The past few years have been a test of resilience,” said Reverend Mojaki Kometsi, speaking on behalf of CHAL. “Our workers have remained dedicated, but the lack of a formal framework created significant challenges in planning, funding, and ensuring fairness. We sincerely appreciate the government for prioritizing the review of this Memorandum of Understanding.”

He added that the renewed partnership reflects a shared commitment to strengthening healthcare delivery and improving services for Basotho, especially those in remote and underserved areas.

The newly signed agreement directly confronts these historical grievances. Central to the MoU is the government’s pledge to ensure parity across the health sector.

Minister of Health Selibe Mochoboroane was unequivocal in his commitment to fairness, stating that the government will ensure that all hospitals in the country – whether CHAL, Red Cross, or government-run – receive adequate medication.

He stressed the need for unity in the sector, emphasizing that “employees in government and CHAL facilities must work under similar conditions,” signaling an end to the two-tier system of employment terms.

A major step toward this goal lies in the restructuring of financial contributions. Minister Mochoboroane revealed that the government is currently reviewing budget allocations to address long-standing disparities in manpower contributions. He noted the current imbalance, where the government covers about 50 percent of certain costs while CHAL is forced to cover up to 65 percent.

“This makes it difficult for CHAL workers to grow,” he said, outlining that the aim is to harmonize contributions and create a more balanced and sustainable system.

Adding weight to the government’s commitment, Deputy Prime Minister Justice Nthomeng Majara announced that the state has taken responsibility for settling outstanding debts within the health system – a significant barrier that has crippled service delivery and strained relationships in the past.

“We have taken it upon ourselves to ensure that all outstanding debts are paid,” she declared. Her focus was on the future of patient care, stating that the goal is to ensure that Basotho no longer face shortages of medication or lack access to healthcare due to administrative or financial hurdles.

“These systems must be handled with care so that no Mosotho is denied help in hospitals,” she said, calling for unwavering efficiency and accountability.

Deputy Prime Minister Majara also offered heartfelt appreciation for the organization’s historical role, noting, “The role CHAL plays in the lives of Basotho cannot be fully explained,” particularly in communities where access to government services is limited.

Her words underscored a fundamental truth: CHAL’s network is not merely a supplementary service but the primary, and often only, healthcare lifeline for a significant portion of the nation.
The structural reforms embedded in the MoU extend beyond funding. The agreement mandates the full integration of CHAL facilities into government planning processes, including annual budget cycles and the Health Management Information System (HMIS). This integration is designed to ensure better coordination, resource allocation, and data-driven decision-making, moving away from the siloed operations that hampered efficiency in the past.

To guarantee accountability, the agreement establishes regular monitoring and evaluation mechanisms to track progress and ensure both parties meet their commitments.

Recognizing that a health system is only as strong as its workforce, the partnership will also focus on human resource development. This includes joint training programs and the inclusion of CHAL staff in government initiatives such as loan bursary schemes, ensuring that workers in faith-based facilities have the same opportunities for professional growth as their government-employed counterparts.

In turn, CHAL has committed to upholding its end of the covenant. The organization has pledged to maintain the highest standards of care across its network by strictly complying with national regulations, strengthening coordination among its facilities, and ensuring fair employment practices.

A key focus will be on harmonizing salaries and improving working conditions for its staff, which will be significantly supported by the government’s new funding model.

Officials have described the MoU as a “living document,” one that will be reviewed regularly to remain relevant and responsive to the evolving needs of the health sector. This flexibility is intended to prevent a recurrence of the stagnation that followed the 2017 expiration.

As the document was signed, it was clear that the stakes were nothing less than the health of a nation. With CHAL facilities serving as the cornerstone of healthcare in Lesotho’s most remote areas, the success of this renewed partnership is essential for national health outcomes. The agreement represents a profound shift from conflict to cooperation, promising to transform a once-fractured system into a more equitable, efficient, and unified front against the health challenges facing the country.

For Basotho, particularly those in the rural highlands, this new covenant offers a promise of healing – not just for their ailments, but for the system designed to care for them.