FERTILITY AND MORTALITY OF LESOTHO
Fertility trends in Lesotho are continuously declining with the effect of HIV/Aids. HIV/Aids is assumed to have an inhibiting effect on women's fertility. The total fertility rate among HIV negative women is 3.9 births per woman, 20 percent higher than the rate of 3.1 births among HIV positive women. Looking at urban-rural residence, rural HIV positive women have markedly lower total fertility rate (TFR) than rural HIV negative women (3.5 compared with 4.5 births). On the other hand HIV positive women living in urban areas have a high TFR than the urban HIV negative women (2.2 compared with 2.0 births). Considering the age specific patterns, fertility is higher among HIV negative in all but the youngest and the oldest age group.
FERTILITY TRENDS
Fertility levels in Lesotho can be tracked over time by examining fertility estimates from various surveys and Census, spanning the last three decades. The TFR of Lesotho declined significantly during the last three decades of the 20 th century, changing from a high of 5.4 children per woman in the mid 1970's and 5.3 in the mid 1980's to 4.1 in the mid 1990's, 4.2 in 2001 and 3.5 children in 2004.
The fertility trends can also be examined by looking at the trend in age specific fertility rates for successive five year period before the survey, using the histories obtained from 2004 Lesotho Health and Demographic Survey(LHDS).the results of the investigation have confirmed that fertility has fallen substantially among all age groups, with the most rapid relative decline among women in their 30's
With regard to teenage fertility the percentage of women aged 15-19 were pregnant with their first child at the time of 2004 LHDS. One in five women in the age 15-19 has had at least one birth (15 percent of the total population) or are pregnant with their first child (5 percent). The percentage of teenagers who have began child bearing increase from 2 percent at age 15 to 44 percent at age 19. Thereby, Lesotho is experiencing high fertility rates peaking at the age 15-44 with relative a high proportion of young people who have already began child bearing.
CURRENT FERTILITY
The difference in current fertility (assessed by the TFR and the percentage currently pregnant) by urban-rural residence district, educational attainment, and wealth quintile, shows that the current fertility is lowest in the lowlands zone and the highest in the mountains zone. By district the TFR ranges from low of 2.5 births in Maseru to a high of 5.1 births per women in Thaba- Tseka. Butha-Buthe and Mafeteng have the lowest proportions of women reporting they are pregnant while Mokhotlong 9 percent and Thaba- Tseka (8 percent) have the highest proportion. As expected a woman's education is strongly associated with fertility. For Example the TFR decreases from 4.2 births for women with primary incomplete education to 2.8 births for women with at least some secondary education. Fertility is also closely associated with wealth whereby the lowest quintile displays higher fertility (5.2 births) and the highest quintile displays lower fertility (2.0 births).
LEVELS AND TRENDS OF IN INFANT AND CHILD MORTALITY
The content shows the variation in the neo natal, post neo natal, infant and child mortality and under five mortality rates for three successive five year periods preceding the survey. For most recent five year period preceding the survey, infant mortality is 91 deaths per 1000 live births and under-five mortality is 113 deaths. This means that one in every nine children born In Lesotho dies before attaining his or her fifth birthday. The pattern shows that the deaths occurring during the neo natal period and the post neo natal period each account for 41 percent of all deaths under the age of five.
There is also an upward trend in the early childhood mortality rates overtime. Example infant mortality rates increased form 75 deaths per 1000 live births in the 5-9 year period preceding survey (1995-1999) to 91 deaths per 1000 live births during 2000-2004. Under-five mortality has increased form 90 to 113 deaths per 1000 live births over the same time period. The increase may be a result of several factors including
1. The effect of HIV/Aids epidemic in Lesotho and
2. The tendency of mothers to under report child deaths particularly those that happened several years ago. The under-five mortality rate estimated by 2001 Lesotho Demographic survey is 113 deaths per 1000 live births, virtually identical to the estimates of 2004 LHDS report
HIV/Aids Prevalence in Lesotho
Lesotho is faced with the problem of HIV/Aids. The levels of these pandemic are exacerbated by the incidence of poverty n the country. The Demographic Health Survey of 2004 shows that the HIV/Aids Prevalence by Socio economic reflects 24 percent of adult age 15-49 in Lesotho who are infected with HIV/Aids. HIV/Aids Prevalence in women aged 15-49 is 26 percent while for men 15-49, it is 19 percent. Both sexes, rates of infections rise with age, peaking at 43 percent among women in the late 30's and 41 percent among men aged 30-34. HIV/ Aids prevalence is substantially higher among women than men under age 30, while at age 40-49, the pattern reverses and prevalence among men exceeds the level among women. The predicted HIV/Aids prevalence shows that the infection will continue to increase with 26.9 percent of non tested women and 23.3 percent of non tested men.
Because few HIV- infected children survive into their teenage years, youth presents the more recent cases of HIV infections. Youth of this Country are also not likely to have a long standing history of engaging in behaviour associated with risk of HIV/Aids infections therefore the HIV/Aids status is a proxy for newly infected individuals. With numbers of socio economic Characteristics, prevalence in urban women is high with 33 percent compared to 24 percent for rural women. Although lower levels of infection is associated with high levels of education achievement categories ,one third of employed women and one forth of employed men are infected, compared with 23 percent unemployed. The variation of HIV/Aids by religious denomination is not large. Example 25 percent of the population infected for Roman Catholic, 28 percent among Anglicans and 17 percent of those who do not have a religious affiliation. As we have shown that fertility in Lesotho is high, the prevalence presupposes that most women in Lesotho are exposed to the risk of child bearing. Thereby young and old women of this country are highly vulnerable to infection of HIV/Aids and leaves new born babies infected while some end up as orphans because of HIV/Aids.
Statistics of Doctors, Nurses and Clinics
Government Hospital
Hospital |
Doctors |
Registered nurses |
Butha-Buthe hospital |
7 doctors |
31 nurses |
Berea hospital |
4 doctors |
21 |
Machabeng hospital |
4 doctors |
14 |
Mafeteng |
4 doctors |
23 |
Makoanyane Military |
2 doctors |
0 |
Mokhotlong |
1 doctor |
22 |
Motebang |
12 doctors |
38 |
Ntsekhe |
4 doctors |
25 |
Q.E. II |
35 doctors |
162 |
Quthing |
2 doctors |
25 |
Christian Health Association Lesotho hospital
Hospitals |
Doctors |
Registered nurse |
Maluti Hospital |
6 |
39 |
Mamohau Hospital |
2 |
9 |
Paray Hospital |
3 |
11 |
Scott hospital |
4 |
45 |
Seboche |
3 |
16 |
St James |
3 |
17 |
St Josephs |
5 |
34 |
Tebellong |
3 |
6 |
There are 184 Clinics which are owned by Government those which are private and a total number of 482 nursing assistance. Inclusive of these there are 5 Nursing colleges which are offering Diploma in General Nursing, Mid wife and other nursing courses.
