Briefing Paper

Privatisation of Health and Education Services In Lesotho

Privatization is the process of expanding the sphere of the market through a host of regulations that create an enabling environment for free enterprise to operate as a strategy for sustainable economic development in areas that have traditionally been government run. When properly conceived and implemented, privatization is assumed to be a mechanism that fosters efficiency and encourage investment in infrastructure and services. The privatisation of education and health services in, Lesotho as in the Southern Africa region has been on a rising trend. Private actors have been assuming the role of governments in providing these two essential services. Non-state provision of education and health is delivered by several actors including NGOs, faith-based organisations, philanthropic organisations, community care-giving and private companies. These are in the form of low-fee private schools, hospitals and clinics; for-profit private schools and health centres; education and health public private partnerships. The impacts of privatisation in Lesotho have been both positive and negative. The negative impacts have been the unaffordability of user fees charged by private sector service providers triggering inequality on access to services; the reluctance of the Sotho government to adequately fund the sectors and effectively regulate private actor activities and the disenfranchisement of poor and unemployed citizens of their human right entitlements to enjoying access to education and health care. Privatisation has had a net negative impact on the fiscus as privatisation arrangements have costed the state more compared to public service provision through public procurement option. On a positive side, private players have been filling the gap that government facilities have been failing to adequately resource and administer. This has to some degree promoted and upheld rights of access to health care and education albeit higher user fees and limited positive health and education outcomes.