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CHAL on the ground



Community sensitization meeting, St. Leonard Health Centre, Semonkong

To address high teenage pregnancy, GBV, early child marriage, child labour and initiation of special groups like children, women & girls and LGBTQI+ community, St Leonard Health Centre hosted sensitisation meeting for community leaders to tackle these issues together and find ways to mitigate them in the community. Among the community leaders who attended were the chiefs, councilors, traditional healers, mahokela and babolotsi. The meeting was held on the 5th of May 2024. This meeting was supported by LPPA, Lesotho Mounted Police Service, Seinoli Legal Services and The People's Matrix Association.

Health facilities across Lesotho are faced with the challenge of high teenage pregnancy across Lesotho, and it is often common for health centres and hospitals to admit them at waiting mother’s shelters. This problem is even more evident in the highlands of the country, where teenage girls experience early child marriage than the lowlands regions of the country. According to UNICEF, in Lesotho, one in five girls marries before the age of 18 (19.4%, 2018). As with unintended adolescent pregnancy, rates of marriage are higher among girls in rural areas (24.9% vs 13.8% urban), and among those who are the poorest and have the lowest levels of schooling. Teenage childbearing is associated with a higher risk of pregnancy and childbirth-related complications. Most teenage girls may not be mature enough for childbearing and childcare. Babies born to teenage mothers may have health problems due to inadequate prenatal care. Lack of prenatal vitamins, minerals, and other forms of care may increase the risk of health issues in both mothers and babies. Most teenage pregnancies are unintended and may have severe consequences for a teenager’s mental and physical health. Social issues and lack of financial support could affect the psychological well-being of a young women, and they may often develop depression and ignorance towards infants.


A pregnant teenager may be vulnerable to developing the following health problems:

  1. Anemia
  2. Depression
  3. Excess or poor weight gain
  4. Undernutrition or malnutrition
  5. Eclampsia (seizures in pregnant women with preeclampsia, that is, organ failure due to high blood pressure)

Babies born to teen mothers may also have certain health risks, such as:

  1. Low birth weight
  2. Premature birth
  3. Congenital malformations
  4. High risk of sudden infant death syndrome
  5. Risk of mental retardation, brain damage and birth injuries


WHO indicates that adolescent pregnancy tends to be higher among those with less education or of low economic status. Further, there is slower progress in reducing adolescent first births amongst these and other vulnerable groups, leading to increasing inequity. Child marriage and child sexual abuse place girls at increased risk of pregnancy, often unintended. In many places, barriers to obtaining and using contraceptives prevent adolescents from avoiding unintended pregnancies. Contraceptives are not easily accessible to adolescents in many places. Even when adolescents can obtain contraceptives, they may lack the agency or the resources to pay for them, knowledge on where to obtain them and how to correctly use them. They may face stigma when trying to obtain contraceptives.

According to UNFPA, the adolescent birth rate is high in Lesotho, at 94 per 1,000 girls aged 15-19 (2003-2018). A 2017 report by the United Nations Education, Scientific and Cultural Organization (UNESCO) listed Lesotho among the leading countries on early and unintended pregnancies. Six out of 10 girls (60 per cent) aged 15 to 19 are mothers or pregnant with their first child, which places Lesotho second to Namibia (seven out of 10 girls) for high rates of unintended pregnancies among the East and Southern African countries, the report stated. Pregnant adolescent girls are at greater risk of complications such as cephalopelvic disproportion (CPD), which leads to difficulties in the unborn baby descending and usually have to go through caesarean section, if necessary, because their bodies are not fully developed.


Early child marriage and teenage pregnancy also have a relationship with Gender Based Violence (GBV). A WHO report published in 2021 estimates that 120 million girls aged under 20 years were subjected to sexual violence by someone other than a partner. This abuse is deeply rooted in gender inequality; it affects more girls than boys, although many boys are also affected. Estimates suggest that in 2020, at least 1 in 8 of the world’s children had been sexually abused before reaching the age of 18, and 1 in 20 girls aged 15–19 years had experienced forced sex during their lifetime.

Child labour was one of the key social issues addressed. Bureau of International Affairs on the Findings on the Worst Forms of Child Labor - Lesotho indicates that children in Lesotho are subjected to the worst forms of child labor, including in commercial sexual exploitation, sometimes because of human trafficking. Children also perform dangerous tasks in animal herding. Lesotho's compulsory education age of 13 is below the minimum age for work, which is 15, leaving children between these ages vulnerable to child labor. Child labour is very common in the rural areas of the country, where children are often delayed starting school at a young age. Young boys are often deprived education and expected to take care of animals while girls are exposed to early child marriage or work as domestic workers. Child labour is a form of BGV, where the right to education for the child is taken away at a young age.

According to Stakeholder Report by World Vision Lesotho and World Vision International (2010), Shepherd boys have traditionally lived on the edge of society, living in high-risk circumstances. The herding of animals involves long hours, night work (looking for lost stock, guarding against thieves) and an unhealthy environment with poor accommodation, no clean water and frequent exposure to harsh elements. Children are also vulnerable to attack by armed stock thieves, fights over ownership of animals between rival villagers and missed opportunities for education.

Poverty is a determining factor of child labour. Poor families send their children to work (or ask them to work in the family business), because they don’t have enough income. Most times working children are a cheap workforce reservoir. In most instances, informal work encourages the development of child labour as it lacks both regulation and inspection. Lack of quality education limits the chances of the child worker to escape from the cycle of poverty. Educational gaps impact on child labourers as they move into adulthood as low levels of literacy and vocational qualifications deprive them of decent work opportunities, not allowing them to get out of poverty. Discrimination in terms of gender and socio-economic status can be identified as one of the main causes of Child Labour. Armed conflict is another important cause of child labour. Children are more vulnerable and can be enlisted as child soldiers or used in military operations. These are the key causes for child labour identified by International Labour Organisation (ILO), 2015.

Seinoli Legal Services and the Lesotho Mounted Police Services was also part of the meeting to provide legal advice and background on the National Act regarding early child marriage in Lesotho. The Children’s Protection and Welfare Act (2011) states that marriage before the age of 18 is unlawful, and that a child who is being forced to marry is in need of urgent protection. International and regional conventions to which Lesotho is a signatory also fix 18 years as the minimum age of marriage.

The good news is that the Government of Lesotho is committed to criminalizing early and child marriages to reduce all forms of violence against women and children. Lesotho’s commitment is to accelerate the promise of the International Conference on Population and Development (ICPD). The government intends to harmonize all laws in line with the International Gender Equality Protocols and Conventions to prevent gender-based violence and protect women, girls, and children. In upholding the right to Sexual and Reproductive Rights Care even in humanitarian and fragile context, Lesotho commits to operationalize the Emergency and Vulnerability Preparedness Plan considering the recurring Elninos in the country particularly in the recent years because of climate change. (LENA 13/11/2019: The Government of Lesotho has ratified several international instruments which protect the rights of children, including the Convention on the Rights of the Child, the African Charter on the Rights and Welfare of the Child, International Labour Organisation (ILO) Convention 138 on the minimum age for employment and ILO Convention 182 on the worst forms of child labour.

Community gatherings and outreaches, therefore, are the best mechanisms to address public health issues and other social problems in the communities. Adolescent pregnancy, early child marriage, child labour and GBV are not only public health issues but also social and societal problems, so society also plays pivotal role in preventing eliminating these issues, spreading awareness among community including young people. Addressing teenage pregnancy requires a major effort by families, service providers, schools, faith-based and community organizations, supportive groups, policymakers, and youth. Teenagers need to be educated about the negative consequences of teenage pregnancy, especially by their parents and at school. The Education system can play a key role in addressing these social issues that affects the youth.