CONSOLIDATED RESULTS REPORT. Country: The Kingdom of Lesotho Programme Cycle: 2008 to 2012

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1 CONSOLIDATED RESULTS REPORT Country: The Kingdom of Lesotho Programme Cycle: 2008 to 2012 Key Results Expected (restate, 1.1 PCR 1 A comprehensive package of high-impact maternal, neonatal and child survival interventions is accessible to at least 90% of women and children 1.2 Number of new paediatric infections reduced by 50% Routine measles coverage B:78% (2006 MOHSW) Vitamin A Coverage among under five, B:55% (DHS 2004) TT2 + coverage in pregnant women B: 58% (2006) Proportion of new paediatric HIV infections B: 40% Proportion of HIV infected mothers receiving ART for their own health B: (no data available) Measles coverage: 67% (MOHSW AJR 2010) Vitamin A Coverage among under five: 34% (DHS 2009 TT2 + coverage in pregnant women B: 60% (2009) Proportion of new paediatric HIV infections ( no current data) Proportion of HIV infected mothers receiving ART for their own health B: (70%) Constraints: Outreach sites were closed due to lack of transport for outreach team. Mothers have to travel long distances to health facilities, Families do not have money for transport to health facilities Facilitating Factors: Government pays for all traditional vaccines Constraints: Poor access to service in rural areas Facilitating Factors: Introduction of Minimum PMTCT Package by government Integration of services into MCH settings 1.3 : Quality PMTCT and paediatric AIDS care services will be available to 80 per cent of affected and infected mothers and children PMTCT Uptake B: 15% Proportion of eligible HIV positive PMTCT Uptake (Proportion of HIV positive pregnant women receiving ARVs for PMTCT): 81% Proportion of eligible HIV positive

2 children who receive ART B: 29% children who receive ART B: 51% (AJR 2009) Proportion of HIV positive children who receive co-trimoxazole at 6 weeks of age B: (no data) Proportion of HIV positive children who receive co-trimoxazole at 6 weeks of age: (no data) Key Results modified or added (IF modified or added to the original Matrix by the Mid Term Review or by other formal agreements with Government) status: show baseline and the latest contained in column 2) 2.1. PCR1: At least 85% of school age children are enrolled in primary school in 2012 academic year. Net Primary enrolment and attendance rates disaggregated by sex Baseline: 82% - 79,9% boys and 84,1%girls (2008) Latest value: 83.2% girls, 78.6% boys (2009) % of primary schools implementing CFS Latest value: 33% ( 2010) Education Act 2010 in place through advocacy efforts and primary education is free and compulsory. Free and compulsory education was launched by the Prime Minister in June Schools Management Regulations have been developed for smooth implementation of the Education Act. Early Learning and Development Standards have been developed and content validation conducted. 2,786 children provided with bursaries to access ECCD education to promote early learning and school readiness in 5 selected districts Constraints: The NER has been stagnating around 80%. It s therefore unlikely to reach 90% in two years. CFS Minimum Standards not yet developed which would be a standard tool for monitoring all schools. CFS Standards/Indicators not part of Education Monitoring and Information System so difficult to report on CFS Facilitating Factors: Political Will of Government to advance CFS agenda. CFS initiative has been

3 6,195 ( 2,177 girls & 4,018 boys) received school uniforms in an effort to remove barriers to schooling Teachers guidelines for disabled children were developed integrated into pre-service teacher training and CFS Indicators have been integrated into Inspection and Supervision Tool for Education Inspectors. Availability of funds from EU targeting the most vulnerable children 2.2. PCR 2: At least 70% of girls and boys enrolled in grade 1 in 2008 have successfully completed grade 5 by By 2012, at least 20% of outof-school children aged 6-16 enrolled in NFE Cohort survival rate to GR5 Baseline: 60% completed grade 5 in 2005 Latest value:62.8% (2009) % of NFE learners who could not access formal education accessing NFE Early Learning and Development Standards have been developed and content validation conducted. 2,786 children provided with bursaries to access ECCD education to promote early learning and school readiness in selected 5 districts 6,195 ( 2,177 girls & 4,018 boys) received school uniforms in an effort to remove barriers to schooling Teachers guidelines for disabled children were developed. CFS indicators integrated into Inspection and Supervision Tool used by Education Inspectors To improve quality or teaching in NFE centres, 413 NFE teachers (called Learning Post Administrators - LPAs) have enhanced NFE teaching skills after Constraints: High repletion rates in the first three grades 42% of teachers are unqualified and most of them teach lower classes Facilitating Factors: Education Act of 2010 prohibits repetition in the first three grades and regulates it in the subsequent grades. Availability of Schools Management Regulations which help to implement the Act. Constraints: It is difficult to get national data on time. Enrolment is decentralised and collecting and collating disaggregated data

4 B: 3,476 children under 18 years enrolled (2011) % not known New value: 3,476 enrolled NFE learners Number of new NFE centres established B : 250 (2007) New value: 351 NFE centres (new 101 NFE centres have been established) their training. Children who were entirely out of formal schooling are now enrolled in NFE; 100 % of Non-Formal Education centres has all teachers trained to teach Life Skills Education; is still a major challenge Facilitating Factors: Financial support by EU; volunteers who teach as LPAs Key Results Expected (restate, 3.1. At least 80% of schools & NFE Centres implement life skills education for HIV prevention % of schools and NFE centres teaching life skills education Baseline 1: 60 primary and 20 secondary schools Development of syllabus, teacher s guides and textbooks for students of grades 4-7 and form A-C Procurement and distribution of Sara Communication Materials The approach for revision of life skills curriculum remains unclear (stand-alone vs integration model) at MOET and no policy has

5 piloting life skills education (2006) Most Recent Status: (MTR Report 2010) 76% of schools and 79% of NFE centres introduced to LSE At least one teacher from 76% of primary schools and 79% of NFE centres has trained on LSE 60 teachers provided refresher training on LSE with special focus on sexuality and gender education 200,000 girls and boys of grades 1 3 in 1500 primary schools were given the copies of the extracurricular materials 50,000 newsletters on LSE were produced, printed and distributed to primary schools. About 6000 learners (herd boys, learners of literacy and numeracy) were reached HIV and life skills education through NFE centres Revision process of LSE curriculum has been started with NCDC/MOET, UN and CSO partners by development of roadmap, validation of curriculum scan report conducted by Pop Council Capacity development on sexuality education to curriculum developers of NCDC Peer-led HIV-responsive LSE activities in 34 schools developed on implementation of LSE at school According to SACMEQ HAKT study, there is a big knowledge gap between teachers and the pupils Grade 6. However, not much strategy has been developed to fill the gap There is no coordination and quality assurance mechanisms for implementation of LSE at school setting by partners

6 3.2 At least 60% girls and boys (10-19) including the most at risk have an enabling & supportive environment, to acquire correct information comprehensive knowledge and risk reduction skills to prevent HIV % of girls and boys (10-19) who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission Baseline 1: (DHS 2004) 25.6% among females and 18% among males (15-19) have comprehensive knowledge about HIV and AIDS Most Recent Status: (DHS 2009) 35.2% among females and 28.1% among males (15-19) have comprehensive knowledge about HIV and AIDS % of girls and boys (12-19) reporting the use of a condom during last sexual intercourse Baseline 2: (DHS 2004) 46.8% of sexually active females and 48.6% of sexually active males (15-19) reported using condom at last Report on situation analysis and needs assessment of youth in three districts in Lesotho Study on stigma and discrimination in relation to HIV with a documentary featuring people s testimonies Review of existing policy and legal frameworks on adolescent sexual and reproductive health, HIV prevention, stigma and discrimination Informative studies for the operationalization of young people s component of the National BCC strategies Development of Minimum Package Guide on HIV Prevention Programming Development and dissemination of tools on risk reduction and avoidance skills, IEC materials on HIV prevention and DVD Tsasa through various channels and media Over 176,000 young people were reached on HIV prevention and life skills education through various campaigns and intervention including sports-based or faith- HIV prevention has not been given sufficient attention and resources compared with HIV treatment and care. This neglect, although on its way to being rectified, has hindered the work of this programme (MTR Report). There are considerable policy gaps with regard to the years age bracket that are compounded by a lack of data on this group and the government definition of youth which only focuses on individuals aged years. Collection of data about sexual behaviour remains an ethical issue and adults also express discomfort talking about these issues with young people (MTR Report). There is no coordination and quality assurance mechanisms for implementing activities on HIV prevention and LSE education by partners.

7 high risk intercourse Most Recent Status: (DHS 2009) 62.3% of sexually active females and 62.5% of sexually active males (15-19) reporting use of condom at the last intercourse in the past 12 months based activities, community drama, peer-to-peer education and SMS campaign. Over 8,200 parents and care givers sensitised on SRH and HIV prevention to create enabling environment for young people Cumulative 4,200+ Adolescents Living with HIV (ALHIV) reached through teen clubs in 8 districts 91 ALHIV participated a week camp 840 caregivers of ALHIV reached through caregiver day events A national forum for HIV prevention among young people and district youth consultations organised Establishment and operationalization of the Child Help Line in three regions for subjected to violence, abuse, and exploitation and awareness creation campaigns through mass media Over 5,300 calls received at Child Help Line and about 200 cases (mostly neglect and abuse) reported (70%+ happened in Maseru, 60%+ were females, 40%+ were aged There is no standardised set of indicators for monitoring of activities implemented by various partners

8 between 13-17) 3.3 At least 30% of national and district level health facilities provide adolescent friendly HIV counselling & testing services, supported with comprehensive sexual and reproductive health support services % of health facilities providing adolescent friendly sexual and reproductive health services Baseline 1: 2.1% of females and 1.6% of males (15-17) accessed HIV Counselling & Testing services in 2004 Most Recent Status: (DHS 2009) 45.8% of females and 7.2%of males (15-17) who have been tested for HIV and received results in the past 12 months % of health facilities providing HIV testing and counselling services for adolescents according to national standards Baseline 2: Among 186 health facilities in the country only 11% have adolescent friendly health corners Study on capacity assessment of adolescent friendly health services in Lesotho Over 16,000 young people tested for HIV in three districts (Maseru, Leribe and Berea), which are equivalent of 20% of youth population Development of training manual for adolescent-friendly HIV services including HTC 67 service providers and 86 health care workers were trained on youth friendly HIV health services including HTC Over 1250 community and church leaders, teachers and parents reached to strengthen community linkages with service providers including promotion of youth friendly HTC Adolescent-friendly services in Lesotho are not functioning effectively to be attractive and accessible to young people The approach for the service provision is still unclear (stand-alone vs integration) and coordination mechanism of stakeholders is not established Delays in endorsement of national guidelines and frameworks such as the young people s behaviour change communication (BCC) operational guidelines and in development of standards of youth friendly health services have hindered efforts to address deficits in adolescent friendly services. Weak linkage and referral

9 Most Recent Status: (MTR Report 2010) 14% are identified and there is no systematic follow-ups after HTC Key Results Expected (restate, 4.1 Orphans and other vulnerable children made vulnerable by HIV and AIDS epidemic receive quality family, community and government support, and access and utilize basic services without discrimination by Capacity of Government institutions, CSOs and other service providers strengthened to design and implement social welfare and protection legislation and structures for OVC, youth and women. Cash grants: 27,737 children in the five pilot districts Child health days: 10,000 Education(NFE): 1777 HIV prevention: 18,000 Indicator: Existence and implementation of policies Baseline: Some policies exist but not enacted Status: Review of National OVC Strategic Plan and development of National Strategic Plan on Vulnerable Children ,737 children from poor vulnerable households were reached with cash grants of M per quarter. MIS developed and operational for the CGP programme The Department of Social Welfare has been provided in with Organisation Development technical assistance to improve its performance and ultimately its delivery system for vulnerable groups of populations (e.g. children, destitute people, and people living with disabilities). It is too early to see the results of the organisation development technical assistance provided to DSW. Despite the support provided by UNICEF, there remain serious challenges, including:

10 2016 Indicator: Percentage of orphans registered in the District registry Status: No registration of orphans has taken place. Indicator: Percentage of community councils reporting on welfare and protection Status: No reporting by community councils has taken place since there is no single registry of orphans The Office of the Master of the High Court and the Child and Gender Protection Unit of the Police have been supported to protect the inheritance rights of orphans and to protect children from abuse respectively. The Ministry of Justice was also assisted to scale up Restorative Justice across the country (diversion of juvenile offenders). 1. Insufficient human resource capacity of the units and the need to improve the functioning of staff through human rights and genderspecific training 2. Need to equip units with vehicles for effective and quick response 3. Need to improve data collection systems within units The sustainability of the results achieved through UNICEF substantial support provided to Government institutions over the past four years is uncertain due to insufficient financial commitment by Government to take over and sustain the interventions and also due to persistent shortage of qualified staff. 4.3 Capacity of communities strengthened to monitor and evaluate social welfare and protection legislation and structures for OVC Indicator: Mechanism for cash transfer is in place and implemented Systems for targeting, enrolment, payment, and M&E developed and is operational for the child grants programme. Lack of sufficient local capacity and technical expertise in area of social cash transfer.

11 Indicator: Proportion of orphaned children attending school disaggregated by sex Status: 31% (girls % ; boys 50.13) Indicator: Proportion of OVC eligible for immunization receive the services Status: 61.7% (2009 DHS, all basic vaccinations 2.1. The Children s Protection and Welfare Bill is enacted and implemented in harmonisation with related laws and policies through effective enforcement systems countrywide and improved national protection and response capacity Indicator: Proportion of orphans receiving psychosocial support Status: 3,110 Baseline: Child protection and Welfare Bill 2005 CPW Act in place CPW Act was enacted and gazetted in March Slow process of enactment and delayed operationalization of the Act due to inadequate political will National commissions and other mechanisms for the protection and promotion of human rights, children s rights, rights of people Baseline: Child protection and Welfare Bill 2005 CPW Act enacted in March 2011 CPW Act 2011 will ensure establishment Slow process of enactment

12 living with HIV, and gender equality in place and operational by Policy, evidence-based advocacy, national budget allocation, research and programming are informed by regularly collected and analysed strategic information on the situation of children, youth, and women, particularly in relation to new and emerging issues 3.2 Enhanced institutional and technical capacity of government and civil society organisations to advocate for, and to plan, implement and monitor child related policies and programmes. Indicator: Annually qualitative report Indicator: Programmes supported by national budgets Baseline: 80 per cent of allocation of the National Plan for Children comes under Government support Indicator: Leveraging on programming for children Child Poverty Study and OVC Situational Analysis conducted. Government produces annually a qualitative report on realization of children s and women s rights 80% allocation of the National plan for children comes under government support Evidence-based advocacy, dialogue and leveraging on programming for children by 2012