Thaba-Tseka district faces some of the country’s most serious health and social challenges, including water shortages that have forced the closure of health centres, rising child marriages, inaccessible roads and an urgent cervical cancer burden, a National Assembly report has revealed.
The findings were presented this week by the Portfolio Committee on the Social Cluster following oversight visits to health facilities in Thaba-Tseka from 1 to 4 December 2025. The visits were conducted in collaboration with the Office of the District Administrator and funded by the United Nations Population Fund (UNFPA).
The committee inspected Paray Hospital, Sehong-hong Health Centre and the Child and Gender Protection Unit (CGPU) office, and also held community engagements in Sehong-hong.
According to the committee, Thaba-Tseka District Administrator (DA) said the district experiences more health-related challenges. Most communities lack access to clean water and rely on rivers and streams, exposing residents to serious health risks.
Water shortages have already forced the closure of the Ha-Mokoto Health Centre, while facilities that remain operational continue to struggle with inadequate water supplies, according to the committee.
The committee also heard that Thaba-Tseka remains the only district without a government hospital and depends entirely on Paray Hospital, a Christian Health Association of Lesotho (CHAL) facility, which is often overcrowded and unable to meet growing demand.
The DA cited severe shortages of vehicles and funding, saying the office is sometimes forced to hire transport from Maseru to reach remote communities. Gender-based violence was also described as widespread, with outreach programmes constrained by limited resources and staff shortages.
During a public meeting in Sehong-hong, youth and parents reportedly blamed high unemployment for rising child marriages and teenage pregnancies. Young people told the committee they often marry early to avoid having children out of wedlock, while parents said young people should take greater responsibility for their futures.
The committee heard that weak law enforcement and loopholes in legislation continue to fuel the problem, with many girls entering relationships with older men for financial support.
The report recommends the establishment of youth development centres to keep young people engaged and productive. It also urged parents to speak openly with children about sexual and reproductive health and called on churches to play a stronger role in guiding youth.
“Marriage is only meant for adults,” the report stated.
The committee further recommended that the Ministry of Gender and Youth, Sports and Recreation, together with the Ministry of Education, ensure that all schools provide comprehensive sexual and reproductive health education.
It noted that the District Health Management Team (DHMT) reported that Lesotho achieved the UN-AIDS 95-95-95 HIV targets by the end of 2024. HIV prevalence in Thaba-Tseka stands at 16.1 percent, compared with 18.2 percent in Maseru and 14.6 percent in Butha-Buthe. HIV incidence in Thaba-Tseka is 1.7, lower than Maseru’s 2.2.
Despite progress in HIV management, the DHMT said outreach services remain severely hampered by shortages of transport and personnel. Officials said previous requests for horses to reach remote areas had not been met.
Health workers are sometimes forced to use donkeys to carry medical supplies, although they described them as unreliable and slow. Staff also spend days walking to reach isolated communities, reducing the number of patients they can serve, the committee said.
The shortage of trained midwives means Village Health Workers cannot be deployed effectively in remote areas without additional training and supervision.
At Paray Hospital, management said delays in government subventions continue to disrupt service delivery. The hospital said the memorandum of understanding (MOU) between the government and CHAL directly affects salaries, procurement of medicines and the overall running of the facility.
Management also raised concern that the hospital’s financial statements were last audited in 2022, warning that the delay undermines accountability and planning.
The hospital further reported high rates of cervical cancer in the district, with outreach programmes limited by poor roads and lack of transport. Officials said American donor funding for cervical cancer screening and treatment had been halted, leaving a major gap in services.
Hospital management appealed for urgent government intervention, including a review of the MOU with CHAL, timely release of subventions and investment in roads and health infrastructure. They warned that without immediate support, cervical cancer deaths in the district would continue to rise.
At Sehong-hong Health Centre, the Acting Manager said the facility serves 20 villages and faces a high burden of adolescent pregnancy. Of all women attending the centre, about 30 percent are adolescents.
The manager said many older women refuse cervical cancer screening because they believe they are no longer at risk or feel uncomfortable being examined by younger nurses. Poor nutrition caused by unemployment was also cited as a major challenge, with many patients taking longer to recover from illness. Residents often walk long distances to access healthcare services, the committee noted.
The health centre was previously forced to close temporarily because of low borehole pressure and is currently relying on temporary water supplies. Staff said water shortages compromise infection control, maternity services and hygiene at the facility.
The centre also reported shortages of medicines and medical equipment, with deliveries delayed because of transport challenges.
Meanwhile, the Child and Gender Protection Unit (CGPU) office in Sehong-hong reported seven cases of sexual assault involving girls aged between 12 and 40. Officers said many cases go unreported because of stigma, fear of retaliation and the long distance to police services.
The committee concluded that many communities in Thaba-Tseka remain cut off from essential health services because of poor roads and water shortages. It identified unemployment as the root cause of many of the district’s social problems.
Among its recommendations, the committee urged the Ministry of Health to urgently strengthen cervical cancer screening, treatment and prevention services in the district. It also called on the government and CHAL to resolve disagreements over the MOU and ensure reliable funding for Paray Hospital.
The Rural Water Supply department was tasked with repairing boreholes and water infrastructure at health facilities and in surrounding communities.
The committee further urged government to prioritise youth employment in Thaba-Tseka through public works programmes, skills development and support for small businesses.
It also recommended strengthening outreach health services by providing vehicles, horses or other suitable transport for teams working in remote areas.
The report has now been submitted to the National Assembly for consideration and action as part of Parliament’s oversight role in the social sector.
