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Lesotho is a small mountainous kingdom landlocked by the Republic of South Africa. The total population in 2020 was projected to be 2.1 million people, of which 7.5 per cent are people aged 60 years and over (United Nations Department of Economic and Social Affairs, 2019). Like elsewhere in the region, the population is experiencing rapid demographic change, and the population of older persons is projected to rise to 10.3 per cent by 2050.

The country’s health expenditure was 4.6 per cent of Gross Domestic Product (GDP) in 2019 (World Health Organization, n.d.), while service coverage of essential health services was 48 per cent. Lesotho provides an example of a low-income country which has made universal pensions available to older persons and is working to develop a policy framework around ageing despite very constrained resources.

This report provides an overview of population ageing and health trends in Lesotho, and assesses the readiness and responsiveness of health, social welfare and long-term care systems to ageing and the needs of older people in the country. It assesses the state of frameworks and structures in place to support healthy ageing and provides a set of recommendations to inform policy development and strategic interventions going forward.