Queen 'Mamohato Memorial Hospital

Queen ‘Mamohato Memorial Hospital
Geography
LocationMaseru, Lesotho
Coordinates29°20′36″S 27°32′02.7″E / 29.34333°S 27.534083°E / -29.34333; 27.534083
Organisation
TypeGeneral hospital
Services
Beds425[1]
History
Opened2011
Links
Website{{URL|example.com|optional display text}}
ListsHospitals in Lesotho

Queen ‘Mamohato Memorial Hospital is a hospital campus in Maseru, Lesotho. It is named for 'Mamohato Bereng Seeiso, former regent head of state of Lesotho.[2]

In 2013, Finweek reported that the hospital served more than 1.8 million people.[1] According to a Marketline SWOT analysis, during its second year of operation, the hospital provided healthcare services to 146,549 patients.[3]

The hospital was built in 2011 to replace the then-100-year old Queen Elizabeth II hospital.[3][4][3] The hospital was built and administered using both public and private financing (PPP) using a Design-Build-Finance-Operate model.[4][5] The private consortium that worked with Lesotho's government to run the hospital is called Tšepong Ltd. The consortium was led by Netcare, a South African private healthcare company and also included Afri’nnai of South Africa, and Excel Health, Women Investment, and D10 Investments of Lesotho.[4][6][7]

The PPP contract to run the hospital was originally intend to last for 18 years, but was terminated in 2021, approximately five years early.[8][9]

A 2022 PLOS study evaluating the hospital concluded that healthcare outcomes were "substantially higher" than at the former Queen Elizabeth II Hospital.[10]

Financial concerns

The contract for the hospital was negotiated by the International Finance Corporation (IFC), an arm of the World Bank.[11][4] The contract was signed in 2009 and was touted as by the IFC as a flagship model for public/private partnerships in Africa.[6] In 2007, Bernard Sheahan, the IFC‘s Director of Advisory Services, said in a press release:

"This project provides a new model for governments and the private sector in providing health services for sub-Saharan Africa and other regions. The PPP structure enables the government to offer high-quality services more efficiently and within budget, while the private sector is presented with a new and robust market opportunity in health services."[12]

For the construction of the hospital, the costs were split between the government of Lesotho (40%), Development Bank of Southern Africa (which is owned by the Government of South Africa) (almost 60%) and Netcare (less than 4%).[13]

In 2012, the terms of the PPP contract were made public.[13] Lesotho's government paid an annual $32.6 million (US) fee to Tšepong Ltd. consortium for a maximum of 20,000 in patient admissions and 310,000 outpatient attendances.[13] If the number of patients served annually exceed these totals, the consortium would bill extra.[13]

Africa Health reported in 2014 that the government of Lesotho was paying $67 million a year to the private consortium, which amounted to over 51% of its annual health budget.[4] Oxfam reported in 2014 that the new hospital was costing the country at least three times what the old public hospital would have cost to run.[6]

In 2014, the private shareholders were set to receive a 25 per cent rate of return on equity, meaning a cash income that was 7.6 times higher than their original investment.[6] The deal was described by Oxfam as a "dangerous diversion of scarce public funds from primary healthcare services in rural areas".[11] In 2016, a review of the contract in the journal Models of public-private engagement for health services delivery and financing in Southern Africa described the contract design as having "serious flaws"[11]

Labor concerns

In the spring of 2014, hospital workers went on strike for more than three weeks.[14] The striking workers sought a pay review, and the strike included, what was described by the Lesotho Country Monitor as, a "violent confrontation with the police".[14]

In 2021, The Reporter published an account of another strike, this time by nurses, who left their posts in February of that year demanding higher pay.[15] The Lesotho Nurses Association reported that nurses at the hospital were paid about 9,000 South African rand a month, compared to nurses at other government-run hospitals, who were paid at least R13,000 a month.[7] In March of 2021, the hospital dismissed 345 nurses and nursing assistants.[7] This move is cited by The Reporter as the "final straw" that ended the contract between the government of Lesotho and Tšepong Ltd.[15]

In a 2024 study by Annals of Global Health, employees expressed dissatisfaction with worker pay.[9] They voiced concerns that the hospital was unable to recruit and retain experienced employees due to low pay.[9]

References

  1. ^ a b Bateman, Chris (December 19, 2013). "Turbocharge reform in our healthcare sector". Finweek. p. 24.
  2. ^ Reinikka, Ritva (October 24, 2011). "A small country bringing about big change". Nasikiliza, World Bank Blogs.
  3. ^ a b c "Netcare Limited SWOT Analysis". MarketLine: 1. May 2014.
  4. ^ a b c d e "Flagship hospital threatens to bankrupt health budget". Africa Health. 36 (4): 11. May 2014. ISSN 0141-9536. Retrieved February 7, 2026.
  5. ^ Sadeghi, A (November 2016). "Experiences of selected countries in the use of public-private partnership in hospital services provision". The Journal of the Pakistan Medical Association. 66: 1401.
  6. ^ a b c d Marriott, Anna (2014). "A DANGEROUS DIVERSION:Will the IFC's flagship health PPP bankrupt Lesotho's Ministry of Health?". Oxfam Policy and Practice: Private Sector. Lesotho Consumer's Protection Association & Oxfam International. ISBN 978-1-78077-577-7. Retrieved February 8, 2026.
  7. ^ a b c Charumbira, Silence (March 16, 2021). "Lesotho sacks hundreds of striking nurses as doctors warn of dire shortages". The Guardian.
  8. ^ Sadeghi, A (November 2016). "Experiences of selected countries in the use of public-private partnership in hospital services provision". The Journal of the Pakistan Medical Association. 66: 1401.
  9. ^ a b c McGuire, Chelsea; Kaiser, Jeanette; Vian, Taryn; Nkabane, Nkholongo (2024). "Learning from the End of the Public-Private Partnership for Lesotho's National Referral Hospital Network". Annals of Global Health. 90 (1): 1.
  10. ^ Scott, NA (September 28, 2022). "Observational study of the clinical performance of a public-private partnership national referral hospital network in Lesotho: Do improvements last over time?". PLOS One. 17. Public Library of Science. doi:10.1371/journal.pone.0272568. ISSN 1932-6203. PMC 9518856. PMID 36170285.
  11. ^ a b c Whyle, EB; Olivier, J (December 2016). "Models of public-private engagement for health services delivery and financing in Southern Africa: a systematic review". Health policy and planning [Health Policy Plan]. 31 (10). Oxford University Press in association with the London School of Hygiene and Tropical Medicine: 1515.
  12. ^ "New hospital for Lesotho through public–private partnership designed by IFC". African Press Organization. December 18, 2007. Archived from the original on August 3, 2025. Retrieved February 8, 2026.
  13. ^ a b c d Webster, Paul (November 14, 2015). "Lesotho's controversial public-private partnership project". Lancet. 386. doi:10.1016/S0140-6736(15)00959-9. PMID 26841737. Retrieved February 8, 2026.
  14. ^ a b "Country/Territory Report - Lesotho". Lesotho Country Monitor: 1. September 2016.
  15. ^ a b Latela, ‘Majirata; Kajane, Kefiloe (March 22, 2021). "Tšepong split – good riddance". The Reporter. Barumuoa Communications.
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