Lesotho New Referral Hospital

The Lesotho New Referral Hospital is a US$100 million Build-Operate-Transfer PPP established in 2009 between the Lesotho government and the Tsepong Consortium. The project provides a 425-bed referral hospital and three satellite clinics, funded by the Development Bank of Southern Africa, government contributions, and private equity, with technical assistance from Sweden, the Netherlands, and the Global Partnership for Output Based Aid. Implementation faced significant barriers, including a lack of national PPP policy in Lesotho, limited government capacity to manage such deals, and public skepticism regarding profit motives in healthcare. To mitigate financial risks and ensure profitability, the agreement utilizes a unitary payment system and includes a 35-bed private facility where profits are retained exclusively by the private partner.

• The project cost approximately US$100 million and was financed through a combination of private equity, government contributions, and the Development Bank of Southern Africa, supplemented by technical assistance from the Global Partnership for Output Based Aid and the governments of Sweden and the Netherlands.
• The infrastructure consists of a 425-bed referral hospital, divided into 390 public beds and 35 private beds, along with three satellite clinics; the clinics opened in May 2010 and the hospital in late 2011.
• The Lesotho government faced several institutional barriers at the start of the project, including a lack of a promulgated national PPP policy and limited capacity to understand or manage the long-term risks and structuring of PPP models.
• To address concerns regarding the profitability of the unitary payment system, the private partner established a 35-bed 'top-end' private hospital facility, built with a state subsidy, from which all profits are retained exclusively by the private partner.
• The project encountered social and sector-specific challenges, including public skepticism about profit motives in healthcare, the relative lack of PPP data in healthcare outside of South Africa, and complex financial modeling necessitated by the AIDS pandemic in Southern Africa.

APA

South African Institute of International Affairs (2012). Lesotho New Referral Hospital. https://saiia.org.za/saiia-toolkit/lesotho-new-referral-hospital/

Chicago

South African Institute of International Affairs. Lesotho New Referral Hospital. 2012. https://saiia.org.za/saiia-toolkit/lesotho-new-referral-hospital/.

Wikipedia

{{cite report |author=South African Institute of International Affairs |title=Lesotho New Referral Hospital |date=24 July 2012 |url=https://saiia.org.za/saiia-toolkit/lesotho-new-referral-hospital/ |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{southafricaninstituteofinternationalaffairs2012lesotho, author = {{South African Institute of International Affairs}}, title = {{Lesotho New Referral Hospital}}, institution = {South African Institute of International Affairs}, year = {2012}, month = jul, url = {https://saiia.org.za/saiia-toolkit/lesotho-new-referral-hospital/}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }