Lesotho provides a digital lifeline for mothers and newborns

Lesotho is taking steps to improve maternal and newborn health with the acquisition and management of the m-mama platform, a mobile application for emergency referral to ensure timely pregnancy and childbirth care in communities.

According to the latest WHO estimates, the maternal mortality rate in Lesotho has dropped by almost 10% between 2020 and 2023, from 529 to 478 per 100 000 live births, with an estimated 267 maternal deaths in 2023. While this progress is encouraging, it is still above the average maternal mortality rate for Sub-Saharan Africa of 454 per 100 000 live births. Much remains to be done to achieve the global target of less than 70 per 100 000 live births by 2030.

The leading causes of maternal mortality in Lesotho are severe bleeding (postpartum haemorrhage), pregnancy-related hypertension and complications due to unsafe abortion, all of which being preventable if early care is available and accessible. However, the country does not have enough ambulances to respond to community-based emergencies in hard-to-reach areas, especially those that are maternal and neonatal related.

In 2020, the Vodafone Foundation, in partnership with the Ministry of Health and communities, launched m-mama, an affordable emergency transport service that connects mothers and newborns to life-saving health care. In January 2025, the programme was acquired by the Government of Lesotho.

In 2024, WHO supported Lesotho’s Ministry of Health develop a Digital Health strategy (2025‒2030). Part of WHO’s multipronged approach to support implementation of the strategy is to ensure that m-mama is fully integrated into national digital health frameworks and that governance and ownership of the initiative is strengthened. 

A routine trip to purchase supplies for her small grocery store ended up in an unexpected turn of events for 46-year-old Mantoa Moleli from Phatsoe Ha Josefa village in Lesotho’s northern Leribe district. While enroute, she came across a gathering at a local clinic and heard about m-mama, an initiative that uses community-based transport for pregnant women and newborn babies during emergencies. This chance encounter convinced Moleli to become a volunteer driver for the initiative. “What motivated me to volunteer is my passion for childcare,” says Moleli.

 “I feel that the programme saves lives and raises a lot of awareness among pregnant women to attend antenatal care.” 

Alongside 19 other community drivers, Moleli received training in traffic rules and regulations, first aid, and infection prevention and control, to ensure that they can provide safe and effective emergency transport. Equipped with her car and the m-mama app on her mobile phone, Moleli is ready to respond, day or night. She joins 3800 volunteers nationwide, who either use their personal vehicles, their taxis, or when the terrain is more unforgiving, boats or horses, to provide fast and affordable transport to women all over the country.

When a user places a free call to the 24-hour toll free number, a dispatcher evaluates their condition using the m-mama app, which is built to function both online and offline, making it suitable for rural settings.

If medical assistance is needed, the app locates the nearest community driver, who then receives a request to transport the patient to a health facility for stabilization or care.
The dispatcher contacts the facility in advance to confirm its readiness to provide treatment, and if unavailable, redirects the patient to an alternative facility. Upon the patient’s safe arrival at the destination, the driver is compensated for the trip via M-Pesa mobile money app or another approved payment method, at no cost to the user.

"Before m-mama, we faced critical transport shortages, causing severe maternal and neonatal complications and even deaths," says Puseletso Matšela, a nurse dispatcher from Leribe district. "We do not want a single life to be lost and m-mama is making this possible.”

Mamasekoane Nkhasi, a mother of five children from the same village as Moleli, experienced first-hand the life-saving impact of m-mama. After a bad fall at home which caused complications, she alerted her sister who called m-mama.

"I was scared, but 'Mantoa arrived quickly and took me to the hospital,” she says. While hospital staff were only able to save her and one of the twins she delivered, they continued to provide essential care to her and her baby, Lineo, and they were discharged a month later. “If it wasn't for m-mama, I don't know what would have happened,” says Nkhasi.

While every district hospital in Lesotho has an ambulance and regional hospitals have an average of two, they respond to all emergencies and are insufficient to address those that are maternal and newborn related.
According to the Vodafone Foundation, the US$ 130,000 annual cost of the programme is more affordable than the purchase and operational costs of one ambulance over the same period.

M-mama is a model of sustainable public-private partnership. Implemented for four years by the foundation, the programme became fully funded and operated by the Government of Lesotho in 2024 and was officially handed over by the foundation to government in January 2025, at a colour function presided over by Her Majesty the Queen in the presence of the Hon Minister of Health and several other dignitaries.

“The success of m-mama stands as a shining example of what we can achieve through unity and shared purpose,” says Her Majesty Queen Masenate Mohato Seeiso. “With our government's steadfast commitment and the proven effectiveness of the m-mama model, lives of countless mothers and babies in Lesotho are secured.”

"The m-mama programme has had a remarkable impact on maternal and newborn health in Lesotho,” says Lesotho’s Minister of Health Selibe Mochoboroane. “We have seen a good reduction in maternal mortality rates, which is in no small part attributable to this life-saving initiative.”

Since its inception in 2020, m-mama has handled over 8800 maternal emergencies and almost 650 neonatal emergencies. Results from the pilot in selected districts have shown a 50% reduction in response time to these emergencies.

“WHO is proud to support the Ministry of Health in bolstering its health systems through viable digital health strategies that support innovations like m-mama,” says Dr Innocent Nuwagira, WHO Representative in Lesotho. “Together, we are building a future where access to emergency healthcare is not a privilege, but a right for all people in Lesotho."