In Lesotho, childhood stunting remains a persistent challenge. In 2014, about one in three children were stunted, and a decade later the rate increased to 35.6%. Stunting is primarily caused by chronic undernutrition during the first 1,000 days of life, compounded by poor maternal nutrition, limited access to clean water and sanitation, frequent infections, and inadequate healthcare. Addressing these factors is crucial for physical growth, cognitive development, and long-term economic productivity.
The Lesotho Nutrition and Health System Strengthening Project (LNHSSP), implemented in collaboration with the government, is working to improve access to essential nutrition and health services while promoting behaviors known to reduce stunting. The project trains frontline and village health workers (VHWs), conducts behavior change campaigns, monitors child growth, and distributes nutrition commodities. To date, 8,363 VHWs have been trained, supporting over 580,000 women with maternal, child, and reproductive health services.
Community outreach illustrates the program’s impact. For example, Duduzile Zilehlangalala from Tlhonolofatso Letnsohla Village brought her 18-month-old daughter for growth monitoring and immunization, receiving guidance from VHWs on proper nutrition and child development. Initiatives like these ensure that children grow healthily and help prevent long-term learning and economic disadvantages associated with stunting.
The project also focuses on adolescent health and nutrition, particularly for herd boys and other hard-to-reach youth. Peer educators have been trained in Comprehensive Sexuality Education and established clubs to deliver health and nutrition education, including sexual and reproductive health awareness. Across four districts, 168 peer educators have reached nearly 6,000 adolescents, while over 22,400 adolescents nationwide have received at least one health and nutrition session.
To enhance healthcare quality, the project provides Quality Improvement Grants (QIGs), training, and equipment to primary and secondary facilities, emphasizing reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N) services. Facilities demonstrating high performance receive annual bonus payments based on coverage, efficiency, and service quality. This approach encourages output-based performance, improves equity, and strengthens health systems. Hospitals like Seboche Mission Hospital report marked improvements in service delivery thanks to these initiatives, with digital monitoring platforms like Shahidi ensuring transparency and accountability.
By combining community outreach, adolescent education, and health system strengthening, the LNHSSP is taking a comprehensive approach to reduce stunting and improve health services in Lesotho. Its integrated strategy aims to create sustainable improvements in nutrition, health outcomes, and overall well-being for Basotho communities.
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