113.104, 113.110, 114.23, 114.24)
89. The National Aids Commission (NAC) has been re-established. It was inaugurated on 10 December 2015 and NAC is expected to provide strategic leadership and governance, efficient and effective coordination and management of the National Multi-Sectoral and decentralized HIV/AIDS response, towards ending HIV/AIDS by 2030. It is currently operating under the National AIDS Commission Act No. 8 of 2005. A new National AIDS Commission Bill 2019 is yet to be tabled before the National Assembly for enactment.
90. The Ministry of Health has come up with strategies such as the Lesotho National Health Strategy for Adolescents and Young People 2015-2020 which accords adolescents and young people to have a right to access information, skills and services concerning their health. The Strategy also addresses issues of prevention; contraception and education programmes for young people. There is also a Revised Action Plan for Women and Girls and HIV and AIDS 2012-2016. The Plan addresses issues of access to health care services, particularly in the area of HIV/AIDS and Antiretrovirals (ARVs). The Government has also developed a Sexual and Reproductive Health Strategic Plan 2015-2020 which covers sexual and reproductive rights of women and girls.42
91. The Ministry of Health has taken the following measure to protect sex workers, factory workers, Lesbian Gay Transgender Bisexual and Intersexual (LGBTI) and prison inmates from discrimination and to guarantee them adequate access to HIV/AIDS care and other related services:
• Social and Behavior Change communication has been introduced through the peer education model using Interpersonal communication manual.
• Condoms education, promotion and distribution integrated within the delivery of Social and Behavior Change communication messaging.
• HIV testing and Counseling Services at community level which is primarily referral and linkage to care to the nearest facility.
• Self-testing has also been introduced to increase number of HIV testing especially for people who are not comfortable to use existing facilities.
• Pre exposure Prophylaxis administered to discordant partners, key populations and young people as HIV prevention strategy.
• Post Exposure Prophylaxis is also offered to all eligible clients including those who are sexually abused.
92. In order to improve rural women’s access to sexual and reproductive health rights, the Ministry of Health in collaboration with NGOs, CSO and development partners have taken the following measures:
• Recruitment and capacitation of village health workers whose mandate include distribution of family planning commodities and provision of information on Family Planning at community level.
• Ministry of Health also updated the Community based Distributors’ manual on distribution of Family Planning.
• With the aim of improving access to Family Planning and reducing missed opportunities to Family Planning, the Ministry of Health updated family planning guidelines in line with the latest WHO Medical eligibility criteria and also to promote human based approach to Family planning.
• Ministry of Health also launched the supply Chain strategic plan with the aim of improving accessibility and availability of Health commodities including reproductive Health Commodities.
• Review and updating of the Condom strategy was also done with the aim of improving access to condoms and social marketing of condoms.
• Mobile clinics which rove in villages, they provide all services including family planning services.
• Frequent outreach programs whose teams made up of a nurse, counselor, and young person to mobilize adolescents and young to utilize the services.
• The Ministry has also launched the Midwifery Services Framework with the objective of strengthening the ownership and involvement of the community in the prevention of maternal mortality.
• In order to address the challenges of cultural stereotypes around sexuality education, the Ministry of Health has developed the Parenting Manual on Sexuality to guide parent/child communication around sexuality.
93. In order to ensure a human rights based response to HIV, the Ministry of Health in collaboration with the development partners, CSOs and NGOs conduct social mobilization activities to raise awareness on HIV and AIDS, distribution of condoms with key social behavioral change messages, identification of gender based violence clients, referral and linkages to care and support especially the key populations and young people at community level to health facilities for clinical services.
94. The Legal Environment Assessment (LEA) 2016 report demonstrated need for several policies and laws review, including the National HIV and AIDS Policy 2006. The Joint United Nations Program on HIV/AIDS (UNAIDS) supported NAC to formulate National HIV and AIDS Policy 2019 to meet fully the rights and needs of People Living with HIV and vulnerable groups and address effectively challenges for fast tracking HIV response towards ending AIDS by 2030, reflect strategic directions reaffirmed in the 2016 Political Declaration on Ending AIDS adopted to Fast-Track the AIDS response and accelerate progress towards achieving the SDG target of ending AIDS by 2030. The 2019 Policy is under the Cabinet review.
95. A National Action Plan for HIV/AIDS and Law was endorsed by the Ministry of Law, Constitutional Affairs and Human Rights in August 2018. Informed by a robust assessment of HIV Legal Environment, the plan was developed with the support of UNAIDS and UNDP. Lesotho Joint team on AIDS has started to support implementation of the Action Plan for HIV/AIDS law and policy in 2018 and Women and Law in Southern Africa was selected to build the capacity of law enforcement agencies (police, magistrates etc.) to address human rights, GBV and HIV/AIDS related issues.
96. Lesotho is reinvigorating Faith-Based Organizations’ (FBO) effective engagement in the HIV and AIDS response. A Faith Leaders Statement of Commitment to End HIV and AIDS and the Faith Sector Implementation Framework to address HIV, Sexual and Gender Based Violence, Sexual and Reproductive Health Rights and Adolescent Girls and Young Women was finalized in 2018 and waiting for the His Majesty’s endorsement. FBO leaders plan to use their leadership to engage men and boys and to advocate for protection of adolescent girls and young women.
97. With the aim of improving the Health Sector, the Government has secured 36 Cuban doctors to be engaged in hospitals and clinics around the country. The Ministry of Health will further employ thirty-five 35 Basotho doctors and 252 nurses. To effectively tackle the cancer burden, the Ministry has developed a comprehensive National Cancer Control Plan.
In the meantime, the Ministry has expanded cancer and renal care services by sending patients for treatment at Apollo Hospital in India. To date, 3 kidney transplants have been performed on Basotho patients in India. Health professionals (doctors, nurses and pharmacists) have been trained in India to facilitate the establishment of the National Chemotherapy Centre in Lesotho.
98. In July 2017 the 12th Stop Cervical, Breast and Prostate Cancers in Africa Conference and Exhibition was held in Lesotho and as the way of marking that important event Lesotho’s first-ever cervical cancer screening and prevention facility, the Senkatana Centre of Excellence was launched. The facility offers comprehensive gynaecological
services, with an emphasis on cervical cancer screenings, diagnoses, pre-cancer treatment services, and referrals to facilities for cancer treatment.
99. Provision of health services has increased to reach more women in factory and hard to reach places. The provisions of services include in a large extend provision of sexual and reproductive health (SRH) services including family planning. Efforts to reach out to these women that do not provide family planning services included mobile clinics and other outreach intervention.
100. As a means of ensuring that health centres and health service providers reach all districts of Lesotho, in 2017, it was estimated that there were approximately 236 health facilities in the country, including one referral hospital, two specialized hospitals, 18 general hospitals, four primary hospitals, four filter clinics and 207 health centres.
101. Lesotho has not yet been to meet the target of allocating 15% of the budget to health services. However, it has allocated 11%.43
I. Right to education (Recommendations 113.105, 113.106, 113.107, 113.108, 113.109, 113.110, 113.112, 113.111, 113.115)
102. Notwithstanding the existence of the compulsory attendance provision in the Education Act 2010 and several provisions in its subsidiary laws providing for access of all children regardless of their circumstances, the Education Act is currently under review and the amendment thereof contain provisions that intensify and fortify compulsory attendance in the sense that penalties and sanctions have been increased. Thus all parents and guardians are compelled to send children 6 years and above to school.
103. The following policies and strategies have been put in place in order to effectively implement free and compulsory education and also to ensure inclusive education of learners with disabilities:
• School Nutrition Policy makes provision for school feeding programmes to all primary schools. This policy is meant to lower the rate of school dropout due to hunger.
• School Improvement Plan Manual is meant to mainly retain learners in schools. 150 facilitators were engaged with the aim of implementing the manual in 2017.
• Non formal education policy approved and launched in 2018 enables the Ministry of Education to make arrangements for informal education for people who cannot afford to attend schools at formal times of school. Such individuals include herd boys and shepherds who normally look after animals during normal school hours.
104. In pursuit of administration of child-friendly justice, UNICEF supports the Ministry of Justice and Correctional Service in promotion of the Justice for Children programme aimed to support child victims, perpetrators, witnesses and others in need of justice services. The programme is in line with the CRC, the ACRWC and the CPWA, all of which guide law enforcement officials on appropriate procedures in administration of child justice at community and national levels.
105. The US$2.1 million Lesotho basic Education improvement Project financed by the International Development Association aims to address challenges with basic education service delivery and student retention in targeted primary and junior secondary schools. In particular, the project aims to strengthen numeracy and literacy education at the primary level and mathematics and science education at the junior secondary level through in-service teacher training, better teacher support networks and supervision, supply of teaching and learning materials, and piloting of a new mathematics and science education model.
The project targets the 300 poorest-performing primary schools44 across all districts in Lesotho and 65 junior secondary schools in their catchment areas45. The project will be implemented from 2016 to 2021.
106. The Ministry of Education utilizes various forms of media such as radio, television and newspapers to disseminate information about the importance of educating a girl child
and boy child as they are disadvantaged especially in the remote mountain areas. Public gatherings are also used as the most convenient platforms where community members are actively engaged through direct dialogue and sensitized on the importance of affording both a girl child and boy child similar educational opportunities under the theme ‘Education for All”. This method is particularly employed in remote rural areas where other medium of communication such as radio, television and newspapers are scarce.46
107. There are ongoing sensitization campaigns aimed at encouraging both teachers and parents to allow pregnant girls to remain in class for as long as the condition of their pregnancy permits. This effort is often stifled by the fact that such girls drop out as a result of stigma and do not subsequently re-enroll due to parenting responsibilities. Socio-economic factors contribute significantly to the phenomenon of school drop-out, especially in relation to herd boys thus the adoption of informal education as already mentioned.
108. Human rights education is part of the school curriculum. The content of the curriculum includes topics such as HIV/AIDS prevention, gender equality, human rights, life skills, alcohol and substance abuse and sexual and SRH. The curriculum is offered from upper primary from grade 4 to grade 10. Further, human rights education is also offered as course at intuitions or higher leaning particularly the National University of Lesotho for law students.
109. As a means of taking appropriate measures to address the disadvantage situation of girls concerning access to education and addressing reports of sexual violence committed in schools, the Ministry of Education under Lesotho Education Quality for Equality Project is currently developing a School Related Gender Based Violence programme.
110. There is also in place as part of integrated curriculum comprehensive life skill education where learners are taught of their identity, sexuality and its incidental activities.
Further, the UNFPA empowered Adolescents and Young People with knowledge and skills to improve their SRH status through a range of activities where the Comprehensive Sexuality Education (CSE) Manual for young people out of school was validated.
111. 33 Master trainers were capacitated on the delivery of the CSE and out of school young people, 160 Health Providers were trained on Adolescents and Youth Friendly Health Services, 247 teachers were trained on the delivery of the CSE in schools, 7500 adolescents and young people out of school were reached with the CSE, 6800 adolescents and young people were reached with SRH Services. A youth mobisite “tune me” providing information on Sexual and Reproductive Health and Rights was launched and has been viewed more than 6000 times.47
112. The Government is partnering with CSOs and independent women support groups to provide sanitary towels to young school girl. This is meant to curb the number of girls who miss school during their menstrual cycle; and they are taught of maintenance and management of hygiene including the disposal of the towels provided.