Lesotho currently experiences high rates of HIV/AIDS, high unemployment and poverty, with children the most vulnerable. HIV/AIDS has devastated the productive adult population. The country has the third highest HIV prevalence in the world, estimated at 23.2% of people between 15 and 49. There are more than 180,000 orphaned children, of whom 55% lost one or both parents to AIDS-related diseases.

In 2009, the Government of Lesotho launched the Lesotho Child Grants Programme. This is a groundbreaking initiative to improve the wellbeing of children, including those orphaned or otherwise affected by HIV/AIDS and those who live in poor families where food insecurity and under-nutrition prevail. Child-headed households and poor households caring for orphans and other vulnerable children are provided with quarterly payments. 5,000 children in 1,250 households are reached initially.

Although cash transfers do not replace other forms of assistance, they are a welcome complement to investments in services. When poor households access services, they are better able to utilize the cash effectively for the child. One grandmother from Lesotho, Mampepuoa Nkane, 67, talked about the hardship of taking care of her five orphaned grandchildren and the impact of the Child Grants. “It’s hard to put food on the table every day” she said. “After my son passed away I was left to raise his children alone. Now I have more hope and I will not have to worry every day.”

Child grants are attracting growing interest for their role in improving human development, reducing hunger and tackling extreme poverty and vulnerability. They are increasingly recognized as an element of an overall care package for children affected by AIDS.