The following was published on The Borgen Project’s Magazine. Read it here. 

GABORONE — Botswana, a landlocked country in Southern Africa, has historically enjoyed one of the highest economic growth rates in the world. According to the World Bank, Botswana is an upper middle-income country with a stable democracy since its independence from Britain in 1966. The economic and political stability of the country contribute to its ability to invest in programs designed to improve health. There are four main areas where there have been huge health successes in Botswana.

Healthcare Infrastructure

Public sector primary healthcare is the main source of healthcare in Botswana. There is an extensive network of health facilities throughout Botswana’s 17 districts, including hospitals, clinics, mobile stops and health posts. The public sector healthcare is free for citizens, while it is common for foreigners to pay for private healthcare.

In a study, the performance of Botswana’s public hospital system was analyzed utilizing the World Health Organization Health System Performance Assessment Framework (WHO HSPAF). This study concluded that while there are challenges to healthcare infrastructure in Botswana (e.g. inadequate distribution of inpatient beds, inadequate resources and quality of care), the physical access to health services are high and the organizational structure of Botswana’s public hospital system and decision-making are centralized.

To improve the healthcare system, the government of Botswana seeks to develop human resource services, medical and surgical equipment, pharmaceutical production capacity and technology. While there is room for improvement, healthcare infrastructure is recognized as one of the health successes in Botswana.

Disease Epidemic Control

Botswana continues to face major challenges in terms of disease control, specifically of HIV/AIDS, malaria and tuberculosis. Though Botswana has made huge strides in the past decade regarding epidemic control, it is still listed as having one of the highest rates of HIV prevalence and infection in the world. However, there are many organizations and programs working to combat disease in Botswana.

For instance, Human Resources for Health in 2030 (HRH2030) is funded by the U.S. Agency for International Development (USAID) through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The HRH2030 program is a partnership with the government of Botswana intending to strengthen the country’s health workforce and align the community-based resources with innovative service delivery models. Since most people with HIV in Botswana are already on treatment, they interact with the health system on a regular basis. Simplifying and de-cluttering current healthcare facilities is, therefore, crucial to the patients’ well-being.

HRH2030 will work with the Ministry of Health and Wellness, USAID and PEPFAR to examine the existing service delivery models and adapt them to improve the quality of healthcare services.

Additionally, Botswana has demonstrated a strong commitment to combatting the HIV epidemic due to its status as the first country in Southern Africa to provide Universal Free Antiretroviral Treatment (ART) for people with HIV. The impact of this program has been widespread with a decrease in new HIV infection rates — 15,000 in 2005 to 9,100 in 2013. Additionally, AIDS-related deaths have dramatically decreased from 14,000 in 2005 to 3,900 in 2016. Programs such as HRH2030 and ART are considered one of the many health successes in Botswana.

Food Security and Nutrition

Food security entails ensuring the quality and continuity of food access. The Minister of Agricultural Development and Food Security, Mr. Patrick Ralotsia stated at the International Fund for Agricultural Development (IFAD) in March 2018 that there is a global burden of malnutrition, especially in Africa. Investing in nutrition, according to Ralotsia, is critical towards improving human capital.

To meet the challenge of poor nutrition and health, Botswana is improving the efficiency of its operations in the Ministry of Health (MOH). For instance, two MOH nutrition programs are being merged into one: the Nutrition Rehabilitation Program and the community-based management of acute malnutrition program have been combined into the Integrated Management of Acute Malnutrition and Underweight in Children and Adolescents program (IMAMU).

The goals of IMAMU are to optimize service delivery for malnourished children, and the implementation of programs such as IMAMU are seen as one of the health successes in Botswana.

Modern Agricultural Practices

The state of food security, nutrition and overall health of a population is influenced by the productivity of the agricultural sector. Historically, Botswana has been agricultural-based. Though the contribution of the agricultural sector to Botswana’s GDP has declined in recent years, the Ministry of Agriculture is currently implementing projects and initiatives to diversify the sector.

In April 2018, Mr. Ralotsia argued that modernizing Botswana’s agricultural techniques will have the greatest impact on the country’s food production. Ms. Mmadima Nyathi, Director of Research Statistics and Policy Development of the Botswana Ministry of Agricultural Development and Food Security, stated in November 2017 that, given Botswana’s climactic conditions, the country has had an advantages in the livestock — especially beef — industry.

Both Mr. Ralotsia and Ms. Nyathi argue that Botswana should begin implementing the creation of a sustainable, technology-driven agricultural sector. This modern approach to agriculture would optimize the use of land for agriculture and promote the sustainable development of agro-food subsectors.

Solutions and Advancements

Mr. Ralotsia stated that technologies have been developed to help farmers cope with challenges, and that the utilization of science-based solutions can further increase the productivity of the agricultural sector. The advancements in the agricultural sector are recognized as one of the health successes in Botswana.

With advancements in Botswana’s healthcare infrastructure, disease epidemic control, food security and nutrition, and agricultural sector, the health of Botswana’s population can continue to improve.

– Kara Roberts