How does healthcare work in Lesotho, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in Lesotho?

Lesotho has a largely public system with additional private care. NGOs also play a major role in the country and often work in partnership with government institutions.
Since independence, the government has been working to establish a healthcare system, but challenges remain.
Limited financial resources, poor infrastructure, and a shortage of healthcare workers make access to healthcare difficult.
Most foreigners choose to travel to Bloemfontein (South Africa) for healthcare.
The government provides basic care through Health Service Areas and a network of health centers.
Access and quality of care vary by region due to geographical barriers (mountains), staff shortages, and limited resources.
Locals also rely heavily on alternative care, such as traditional herbal medicine.

Public care is provided through Health Service Areas and consists of different levels:
- Local clinics and health posts across the country for primary care, vaccinations, and pregnancy support.
- District hospitals for more extensive care.
- Referrals to larger centers (in Maseru) for specialized treatment.
Community/village health workers play a big role in remote areas.
Travel times for people in rural mountain areas are often long.
There are frequent shortages of essential medicines and equipment.

Private clinics and a few private hospitals are located mainly in Maseru, offering faster and often better service, though quality varies.
These clinics are important in Lesotho because they can provide broader care compared to public facilities.
Foreigners and locals who can afford it usually choose private care or go to South Africa. For complex or specialized care, referral to South Africa is common.
Some private clinics also focus on alternative medicine, such as traditional herbal treatments.

There is no real GP system. Primary care goes through clinics and health centers.
For routine consultations, local clinic or private GP in the city are the best options.
Many expats and frequent visitors probably have a regular private doctor in Maseru as their “go-to.”

Dental care is mainly found in Maseru. There are regular dentists and clinics, but specialist dental care is limited.
For general and complex dental treatments, most foreigners go to South Africa.

Prenatal care is available, and many women attend antenatal consultations.
However, maternal mortality and serious complications remain a major issue.
Challenges include long travel times from mountain villages, poorly equipped facilities for emergencies, and a lack of qualified staff.
There are programs and projects (such as m-mama) that focus on faster support for mothers in need.
In short: pregnancy care in Lesotho is limited, and better options are usually found abroad.

In cities, petty crime occurs.
Unfortunately, violence against women is relatively common, often within domestic settings.
Going hiking? Mobile coverage is patchy. Cultural tip: wearing a Basotho hat and good hiking boots is instant respect.

HIV and Tuberculosis are major problems in Lesotho. The country has one of the highest HIV/AIDS rates in the world.
Malaria is not widespread but does occur, along with other infectious and seasonal diseases.

Roads in the mountain areas are often unpaved, full of potholes, and very narrow, aka a true adventure. Best to hire a local driver and a 4x4.
Traffic in Maseru is busier, but still manageable compared to larger African cities.
Driving at night is strongly discouraged, especially in remote areas.

Is the trip to Lesotho and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

A good international health insurance is essential in Lesotho because the likelihood of medical evacuation or even repatriation is high, and most people travel to South Africa for quality care.
If you have private insurance, you can choose your own doctor in Lesotho.
Read more about insurances for abroad on Expatinsurances.org.

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