The document provides a summary of key findings from a national and local service delivery survey conducted in Lesotho. Some of the main findings include: - Access and satisfaction levels for key services like education, health, water and sanitation, agriculture, and civil registry. Challenges included distance to facilities, lack of infrastructure and supplies. - Educational access was high but quality was lacking, especially for early childhood programs. Health services had good utilization but long wait times and medicine shortages were issues. - Agricultural support had low satisfaction due to poor quality seeds and inputs, as well as lack of irrigation and marketing assistance. Civil registry services also had long wait times.

1. National and Local Service Delivery Survey for
Lesotho
Draft Report Presentation
Melody Niwamanya
FEI CONSULTING & EFICON CONSULTING
2nd July 2015

2. Contents
1. Introduction
2. Methodology
3. Key Survey findings
4. Institutional Constraints
5. Challenges and Recommendations
6. Best practices and lessons learnt

3. INTRODUCTION

4. Introduction
1. The DDP is a four year programme (2012-2016)
2. Main partners ( GoL, UNDP, UNCDF, EU)
3. Main purpose is to: promote decentralized service
delivery for social economic growth through the
development of transparent funding mechanisms and by
improving the accountability of local authorities.
4. Main Components of the DDP
a) Improving development funding through local authorities
b)Promoting decentralization and accountability systems at the
local level
c) Enhancing capacities of line ministries and local authorities to
decentralize functions

5. Introduction
Objectives of the Baseline Survey:
• To assess the accessibility and quality of service delivery
• To ascertain the level of satisfaction with services (in terms
of accessibility, quality, timeliness etc.)
• To identify the institutional capacity needs to support
decentralized service delivery;
• To identify challenges faced by community members in
demanding and accessing services;
• To examine the existing oversight mechanisms for quality
assurance in service delivery and accountability; and
• To document best practices and provide recommendations
for improving service delivery.

6. Service Areas
1. Education
2. Health
3. Agriculture
4. Energy
5. Water & sanitation
6. Roads
7. Civil registry
8. Forestry/lands
9. Social protection and
child protection
6 districts
Botha- Bothe
Maseru
Mafeteng
Mohale’s Hoek
Quthing
Thaba Tseka
Key Service Ministries
Public Works and Transport, Roads Directorate
Social Development
Forestry
Energy, Department of Energy
Health
Water, Department of Water Affairs, Water Commission
Development Planning
Education
Agriculture & Food Security
Civil Service Registry , Ministry of Home Affairs

7. METHODOLOGY

8. Approach and Methodology
Our Approach &Methodology:
• Qualitative and Quantitative methods
• Four stages of our approach (Inception, Data collection, Data
analysis and Reporting)
Inception Stage:
• Inception meetings with partners
• Review of critical documents
• Writing the survey questionnaires
• Sample size selection
• Training of research teams
• Review of the Inception report by the partners
• Presentation of the inception report
• Approval of inception report and commencement

9. Approach and Methodology
Sample size and Scope
• Six districts (selected based on poverty levels &
distribution between Low and high lands)
• 1,116 House holds surveys in the six districts
• 12 Focus Group Discussions
• Sectors covered: Health, Education, Water & Sanitation,
Agriculture, Energy, Roads, Civil registry, Forestry and Land
reclamation, Social protection, Child protection.

10. Data collection
• Household interviews
• Key informant interviews (KIIs)
• Focus group discussions, 2 per district, over 120 discussants
• Review of various reports
Data analysis
• Data cleaning
• Data entry using Epidata
• Data analysis using SPSS version 17
Report writing and presentation

11. KEY SURVEY FINDINGS

12. Findings- Education
Integrated Early Childhood Care and Development (IECCD)
• 63% of households had children between age of 3 and 5
years
• 59% of these households, had the children attending IECCD
• 47% in Urban and 73% in the rural areas
Main reasons for not sending children to IECCD
 Not reasonable to at that age (28%)
 No facilities for IECCD (227%)
 Poor Care (26%)
 No money to facilitate children to attend IECCD (17%)

13. Education
Quality of IECCD schools
 Less than 1% of the national budget is spent on IECCD

14. Education
Free Primary
Education
 About 20% of National
budget
 59% had children of
School Primary going age
 48 minutes to reach
school
 42 mins (Urban) and 51
(Rural)
 85% walked to school
Types of schools attended

15. Education
• Quality of FPE

16. Education
Satisfaction with various
aspects:
Satisfied:
 Quality of teachers (64%)
 Quality of education (57%)
 Taking care of children (51%)
Un satisfied:
 school feeding (45%)
 quality of infrastructure (33%)
 distance to school (31.6%)
Quality of Education

17. Education
Factors limiting access to education services
 Inadequate service infrastructure (IECCD mainly)
 Some parents cannot afford the IECCD 40 Maloti monthly facilitation
for teachers
 Shortage of food supply at the IECCDs and primary schools
 Inadequate portions or poor food quality in FPE schools
 Hidden costs that hinder FPE continuity
 Long distances to schools ( 48 Minutes)

18. Health
Un satisfied
clients
 Waiting time (31%
urban and 49%
rural)
 distance to health
facilities (18% urban
and 46% rural)
 Emergency services
(19% urban and 39%
rural)
Those that Accessed Public health services in last
12 months

19. Health
Satisfaction with services
(good or very good)
• 84% Urban
• 81% Rural
• All HIV AIDS counselling
services (90% and
above) ,
• TB treatment and
support services (92%),
• Child immunisation
services (90%)
Waiting time
• 50% waited between 1-4
hours) for services
• 29% waited for 5 to 12
hours for services
Perception on Quality of services

20. Health
Factors limiting access
 Low health workers staff levels
 Poor supervision
 Long distances to health facilities (64 minutes)
 Lack of Confidentiality in handling client information
 Shortage of Medicines and supplies
 Expired Medicines
 Inadequate facilities and equipment
 Inadequate emergency and ambulance services

21. Water and Sanitation
• The most important natural resource in Lesotho!
• 77% have access to water sources (NDP 2012)
• 83% had access to water in the Rural areas (Survey)
• 88 % had access to water in the Urban areas (Survey)
• About 52% in the rural and 35% in Urban areas rated the
water as being safe
• about 20% in the rural and 35% in the urban rated the water
as being Unsafe
• About 16% in rural and 81% in urban paid money for the
water they used

22. Water and Sanitation
Main source of water

23. Water and Sanitation
Main type of sanitation facility Rural Urban Overall
Sewerage system 0.42 12.88 7.55 %
Septic tank 5.94 42.93 27.09 %
VIP Latrine 74.95 20.99 44.09 %
Others type of latrines 18.88 23.21 21.27 %
Types of Sanitation facilities used

24. Water and Sanitation
Picture: Different types of Latrines
VIP Latrine Ordinary Latrine

25. Water and Sanitation
Factors limiting access to water and Sanitation services
• Contaminated or un-safe water
• Long Distances to water sources, takes over an hour on
average
• Irregular Water supply especially in Urban areas
• Slow response to repair broken pipes and taps
• Increasing water costs by WASCO
• Poor community response to protection of water sources
• Poorly planned and built toilets
• Lack of pit latrine emptying facilities and resources

26. Agriculture
• 0ver 70% depends directly on Agricultural
• Services provided included:
• About 45% of the surveyed households were engaged in
agricultural
Main services accessed:
 injections for pets;
 subsidies on seeds/fertilizers;
 food and nutrition training;
 training in good farming practices (demonstration farms);
 training on soil conservation and land management.

27. Agriculture
Satisfaction with Agricultural services- Rural areas
Subsidy on
inputs
Food and
nutrition
sensitisation
Good
Farming
practices
training
Crop and
Livestock
Marketing
Livestock
programme
support
Management
of animal
theft
Satisfied 33 36 41 12 24 55
Neutral 13 26 18 40 30 6
Not satisfied 54 38 41 48 46 39
0
10
20
30
40
50
60
%percentage
Aspects of Agricultural services

28. Agriculture
Subsidy on inputs
Food and nutrition
sensitisation
Good Farming
practices training
Crop and Livestock
Marketing
Livestock
programme
support
Management of
animal theft
Satisfied 14 14 18 3 8 19
Neutral 19 22 26 23 25 14
Not satisfied 67 64 56 74 66 67
0
10
20
30
40
50
60
70
80
%percentage
Aspects of Agricultural services
Satisfaction with Agricultural services- Urban Areas

29. Agriculture
Factors Limiting access to services
• Poor quality Seeds
• Due to hunger, some communities eat seeds meant for
planting
• Late arrival of tractors (after the planting season)
• Lack of irrigation facilities
• Illegal importation of cattle from South Africa

30. Civil Registry
Rural (%) Urban (%) Overall (%)
75
83 80
25
17 20
% percent
Accessed services in Civil registry
Yes No
Access to Civil registry services

31. Civil Registry
Rural (%) Urban (%)
Services
1day
2-5day
2weeks
1
month
>1
month
1day
2-5day
2weeks
1
month
More
than1
month
Birth certificate 44.4 32.8 3.9 8.7 10.3 23.3 40.0 18.7 11.8 6.1
Death certificate 66.2 28.1 4.3 0.7 0.7 53.2 29.5 13.7 3.2 0.5
Marriage
certificate
60.6 29.4 7.3 1.8 0.9 82.8 7.7 7.7 1.0 1.0
National ID 47.9 36.4 4.9 1.0 9.8 40.0 38.2 11.7 8.0 2.1
Passport 15.9 17.8 3.8 40.6 21.9 16.8 13.7 5.0 45.7 18.8
AVERAGE 47 28.9 4.8
4
10.5
6
8.72 43.2 25.8 11.4 13.9
4
5.7
Time taken to access the different services

32. Civil Registry
Rural (%) Urban (%)
Services
Veryunsatisfied
Unsatisfied
Neutral/Un
decided
Satisfied
VerySatisfied
Veryunsatisfied
Unsatisfied
Neutral/Un
decided
Satisfied
VerySatisfied
Birth certificate 15.9 17.8 3.8 40.6 21.9 16.8 13.7 5.0 45.7 18.8
Death certificate 8.7 7.7 34.1 36.1 13.5 5.8 8.9 24.9 33.8 26.7
Marriage certificate 6.7 6.2 48.2 33.2 5.7 5.9 1.3 13.9 32.5 46.4
National ID 16.1 5.5 11.9 43.4 23.2 10.2 10.2 8.1 45.6 26.0
Passport 17.4 17.0 25.4 32.6 7.6 26.2 16.9 8.3 34.8 13.8

33. Civil Registry
• Awareness of Grievance handling

34. Civil Registry
Factors limiting access
• Long queues
• Limited staff
• Lack of adequate information
• Frequent breakdown of equipment
• Poor customer care

35. Social Protection
• House hold’s Access to various services

36. Social protection
Satisfied clients %
Child Grants Programme
Free Primary Education
Public Assistance
OVC Bursary
Old Age Pension
Agricultural inputs
Public Works
School Feeding
68.2
50.8
55.6
41.6
66.8
51.5
24.4
14.7
53.6
83.7
48.9
61
75.5
24
55.9
42.8
% of satisfied clients with services
Urban Rural

37. Social Protection
Old age pension
Child protection services/Child Grants Programme
OVC Bursary
Public Assistance (poor Families-destitute)
69.6
15.4
9.1
7.2
69.2
10.1
14.9
11.2
Satisfaction with regularity of payment %
Urban Rural
Satisfaction with regularity of payment

38. Awareness of grievance handling mechanisms

39. Factors limiting access
 A high age limit for Old age pension (70 years)

40. Social Protection
Factors limiting utilisation
 Long distances to collect the payments
 Lack of awareness about these programmes;
 Lack of clarity on selection criteria for some programmes;
 Orphaned children lack the support to register and access
funds
 Poor records management

41. Child protection
0
10
20
30
40
50
60
70
80
90
100
Prevention and
response to child
sexual, physical,
emotional abuse
Prevention and
response to neglect,
exploitation, and
child labour.
Prevention and
response to
Property grabbing.
Life skills training
for children and
youth
Average
Yes (%) 9.7 7.5 9.5 16.7 10.9
No (%) 90.3 92.5 90.5 83.3 89.2
%Access
Child protection services accessed
Whether a member of a household accessed services

42. Child Protection
Prevention and response
to child sexual, physical,
emotional abuse
Prevention and response
to neglect, exploitation,
and child labor.
Prevention and response
to Property grabbing.
Life skills training for
children and youth
76
70 66.6
37.4
78.2 82.4 80.8
86.4%
P
e
r
c
e
n
t
% Satisfied with child protection services
Rural Urban

43. Child Protection
Factors Limiting Access
• Corruption in the handling of cases
• Lack of Information on Justice dispensation process
• Lack of Witness protection services

44. Energy
Main Source of Lighting

45. Main source of heating

46. • Satisfaction with Electricity Services

47. Factors limiting accessibility
• Bio mass fuel sources are dwindling
• Limited affordable alternatives

48. Road Infrastructure
• Main means of transportation
1.8 0.4
45.9
9.9
42
19
0.2
40.8
1.4
38.6
11.7
0.3
43
5
40
Rural Urban Overall

49. • Main type of Road used

50. Quality of Roads

51. • Satisfaction with various aspects of roads
0 5 10 15 20 25 30
Quality of roads constructed
Road maintenance
Care and action taken during winter
Responsiveness to complaints on roads
24
14
12
24
29
11
12
14
% of satisfied clients
Urban Rural

52. Factors limiting access to roads
• Timeliness of road maintenance or road restoration after
damage;
“After roads are reported damaged; 69% of respondents
estimated that it takes more than
6 months to repair a road.”
• Water logging;
• Very Narrow roads
• Rocky and mountainous terrain hard to construct roads
• Flying rocks

53. Forestry and Land reclamation
Awareness of services
Tree planting-
Water conservation
Proper range management
Control of soil erosion
Water harvesting infrastructures
49.7
54.7
46.7
52.3
56.6
10.2
25.3
15.3
14.6
21.8
40.1
20
37.9
33.1
21.6
Percent (%)
Yes Neutral No

54. • Satisfaction with service aspects
Tree planting-
Water conservation
Proper range management
Control of soil erosion
Water harvesting infrastructures
5.9
3.6
12
1.6
4.5
0.7
0.6
2
3.3
2.1
% Percentage
Service Aspects
Urban Rural

55. • Limited awareness of government programmes
• Increased Deforestation
• Tree planting campaigns are loosing momentum

56. INSTITUTIONAL CONSTRAINTS

57. General findings
• Planning Framework and capacity are still weak in particular sector
and district planning processes are disjointed making it difficult to
support service delivery in local governments appropriately
• Areas of disharmony between sector based legislation and policies
with decentralisation framework; many of sector based legislation pre-
date the LG Act or the Decentralisation Policy for example, under
forestry, water, roads, forestry
• Roles between CG and LGs have not been very clear or understood and
LGs do not often have the capacity to execute their roles affecting
programme supervision. Ministries continue to undertake most of
programme supervision
• The distinction between roles of chiefs and local politicians provided in
the Decentralisation Policy, is yet to be fully acknowledged. Conflicts
between Chiefs and local politicians (councillors) were cited widely as a
hindrance to services delivery.

58. General Findings Continue ..
• Management of local government budgets affects service
delivery; budgets of LGs are scattered across
deconcentrated units; transfer of funds is often slow and
unpredictable. LGs find it difficult to finance recurrent
operations involving maintenance and supervision.
• Continued delay to form technical structures under LGs is a
major limitation to the execution and supervision of service
delivery operations
• Capacity of coordinating institutions is key: concerns that
role of MLGC in the facilitating the relations with LGs was
not properly played

59. Water
The water supply function is assigned to LGs
• Need harmonisation of laws between LG Act and Water Act to
minimise risk in the management of water resources;
• Improve coordination of actors in relation to the access and
management of water resources; waste disposal, land mgt, etc.
• Capacity, both at the Water Commission / Water Affairs Dept. to
supervise the development and management of water sources within
communities is limited.
• Capacity of LGs for the management of integrated water catchment
areas – these are degrading rapidly as they are poorly protected
• Easier sources of water are drying up, due to Climate change effects,
making the unit cost for service delivery high.
• Contributions from local populations do not always come readily (due
to affordability or cooperation issues) under the water committees so
maintenance and operations of systems, e.g. provision electricity of fuel
for pumps, is often impacted.

60. Civil Registration
Civil Registration is not decentralized but at NICR
• Budget resources are inadequate to expand services to
community level
• Delays in service are also caused by the significant backlog
in registration ( - only 33% captured; temporary issue)
• Chiefs are not remunerated for the verification services
they render and may not be always available. This is a risks
to the integrity of the system as users may resort to giving
inducements to Chiefs to obtain a service.
• Limitations on bandwidth and the reliability of the
network negatively effects the operations and is a source
of frustration for clients.

61. Roads
Roads Directorate is for management of all roads; LGs are
development and maintenance of access roads
• Capacity of Roads Directorate (RD) for technical support
and enforcement of standards and quality assurance is not
enough to cover the entire country
• Districts / LGs budgets are often small and not adequate
for maintenance of community roads and are often delayed
and are un-predictable.
• Although contractors are being trained, they often have
limited resources (financial, technical staff, and equipment)
and inadequate implementation experience and capacity.

62. Forestry
LGs has a role to control and protect natural resources. Main role is
with Ministry of Forestry, Range and Soil Conservation
• Conflict in different policies confuse local leaders; for example,
under range management, differing charges are prescribed for
grazing outside designated ranges by the Ministry of Forestry
and by the Ministry for Local Governments
• Reducing sector budgets have limited staff recruitment leading
to the major HR gaps at the Ministry and in districts for key
positions such as Forest Rangers and Grazing Control
Supervisors.
• Local councils are not playing their role of supervision and
protection effectively; there is rampant vandalism of forestry
resources and other program interventions

63. Agriculture
Ministry of Agriculture is central. Agriculture Functions to LGs are broad.
• Wide spread capacity gaps limiting ability to monitor farmers and
farmer programmes; districts do not have staff of their own
• Information flow from districts to the national level however has
remained a major challenge; for example reporting on the breakout of
epidemics / disease.
• Commitment to agriculture programs by farmers is not always assured;
cases of the diversion of inputs (seeds) / medication are cited
• Major weakness in the extension and monitoring services; as a result,
production does not always meet expected yields because farmers do
not often put enough effort into looking after their gardens.
• Subsidies have created a dependence syndrome; inputs provided by
Government are often taken for granted, leading to the inefficient
utilisation of resources by farmers.

64. Energy
Energy function is not decentralized - assigned to Energy Ministry
• Limited funding makes it difficult to extend the national grid to
communities. Only 35% of households are connected.
• Lesotho is a net importer of electricity. High dependency on
external sources (South Africa) is a risk in the pricing of electricity
and limits the opportunities to reduce the costs of electricity as
the FGDs wanted.
• Private companies often have limited capital for investments
and are unable to significantly participate in the distribution /
supply of energy.
• Poor standards control is affecting reliability of the energy
services; uncontrolled energy related products are found
everywhere on the market affecting the services

65. Social Protection
SP is lead by MSD and other central Govt units. Role for LGs is not
clear. Policy assigns a coordination functions to Districts
• Getting local communities to participate in social protection
programs is a challenge as their role is not backed by legislation.
• There are many players in the area of social protection services
including government agencies / ministries, NGOs, and need to
strengthen coordination mechanisms
• Limited staff capacity at MSD; MSD faces major human resource
gaps as a number of positions remain vacant
• Coordination at LG; oversight and management committees for
the programs at district level include elected members, chiefs
and politicians (councillors). Neither of these committees nor
their processes is backed by law or policy but is only a creation of
MSD
• No administrative structures at LGs for social protection

66. Education
LGs has role primary and secondary education – but not devolved
yet; LGs provide location and participate in governance of schools
• Resources are insufficient to maintain / expand school
infrastructure as demand grows.
• Some teachers above 60 years are still kept and some are un-
trainable. Retiring them from the system requires a lot of funds
(retirement packages) which are not available.
• Members of schools boards are volunteers with tenure of 3
years. It is difficult to obtain the required commitment of
members without some form of compensation.
• Capacity for supervision / inspection of schools is low. As a
result, rural schools in particular tend to start the academic term
late due to high absenteeism and find it difficult to complete the
curriculum on time

67. KEY CHALLENGES /
RECOMMENDATIONS

68. General Challenges
These challenges has largely been identified before
• Participation of LGs in the planning, management and supervision is
very limited. This is affected by delay to implement technical and
administrative structures among others.
• LGs have no structures and therefore capacities to carry out their full
mandate. At the same time, central sector are often stretched because
they have to fill in gaps left by the absence of LGs
• There is a need for policy consistency on cost sharing across all
services so that users are well aware about their obligations.
• There will be need for better regulation of LG programs to minimise the
effect of dependency
• Infrastructure maintenance roles and responsibilities must be clarified
and resources assigned to them as the Decentralisation Policy is
implemented.
• Roles and mechanisms for information sharing and dissemination
need to be clarified as the new Decentralisation Policy is implemented.

69. Key Recommendations
• Expedite the implementation of the Decentralisation Policy so
that LGs can begin to participate more effectively in service
delivery
• Issue guidelines to all sector institutions on streamlining their
legal and policy frameworks to embrace decentralisation.
• Formulate and implement a change management and capacity
building plan to prepare LGs and central government sector
institutions for their roles under the new dispensation based on
the decentralisation policy.
• As provided in the 2012 Decentralisation Diagnostic Study,
formulate and implement a plan to reorient the MoLGCP and
MoF so that their coordination roles under the Decentralisation
Policy are effectively played.
• Re-establish the previously closed Community Councils or set-up
satellite centres to bring services closer to people

70. THANK YOU - Q&A