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Key findings
  • Only one in 50 Basotho (2%) say they have medical aid coverage. o Among those who don’t have health insurance, the largest share (60%) say it’s because they can’t afford it.
  • Nearly two-thirds (65%) of Basotho say they worry “somewhat” or “a lot” about obtaining or affording medical care when they need it.
  • Seven in 10 citizens (71%) say the government should ensure universal access to health care, even if it means higher taxes.
  • Half (50%) of citizens say they or a family member went without medicine or medical treatment at least once during the preceding 12 months, including 16% who say this happened “many times” or “always.”
  • Among respondents who had contact with a public clinic or hospital during the year preceding the survey, three-fourths (74%) say it was easy to obtain the medical assistance they needed, though 4% say they had to pay a bribe. o Majorities report encountering long wait times (74%) and inadequate medical supplies (62%), while more than one-third say they found facilities in poor condition (38%) and absent medical staff (34%).
  • A narrow majority (55%) of citizens think the government is doing a good job of improving basic health services, but 42% disagree. o Three-fourths (74%) say they trust the Ministry of Health “somewhat” or “a lot.”
  • Almost nine out of 10 Basotho (86%) say parents should be required to vaccinate their children against infectious diseases such as measles and polio.

Universal health coverage (UHC) aims to ensure that all individuals have access to  affordable essential health services. It encompasses a comprehensive range of services, from  health promotion and disease prevention to treatment, rehabilitation, and palliative care.  Despite some progress, many people globally still face significant barriers to accessing these  services, including cost and service disruptions exacerbated by the COVID-19 pandemic. As  of 2021, an estimated 4.5 billion people worldwide lacked access to at least some essential  health services (World Health Organization, 2023). 

Lesotho’s health sector faces significant challenges, including a high disease burden,  inadequate health infrastructure, and a shortage of health care workers. The World Bank  (2018) is working with the Lesotho government to improve health outcomes by strengthening  health systems, enhancing service delivery, and expanding access to essential medicines  and medical supplies. Focal areas include supporting maternal and child health, combating  communicable diseases, and improving health financing to ensure sustainability and equity  in health care access. 

This dispatch reports on a special Afrobarometer Round 10 survey module focusing on health  care. In Lesotho, findings show that only a tiny share of Basotho have medical aid coverage.  Among those who lack medical aid, a majority cite unaffordability as the main reason.  

Most Basotho say they worry about being unable to obtain or afford medical care when they  need it, and they think the government should ensure universal access to health care, even  at the cost of higher taxes.  

Exploring citizens’ experiences with the health care system, we find that half of Basotho say  someone in their family went without needed care during the past year. Among those who  sought care at a public clinic or hospital, most say it was easy to get the services they  needed, but many encountered problems such as long wait times, a lack of medicine or  supplies, facilities in poor condition, and absent medical personnel. 

Even so, trust in the Ministry of Health is high, and a majority of citizens approve of the  government’s performance on improving basic health care. 

Richard Adjadeh

Richard Adjadeh is a data analyst for Afrobarometer and a master of public policy student in the Department of Political Science at MSU