Botswana, a country in Southern Africa, has a total population of around 2.3 million people, with women making up 52% of that number. Since gaining independence from Britain in 1966, the country enjoys a stable democracy with an upper-middle-income profile. As of 2017, the gross national income per capita was $16,123. As of 2017, male life expectancy was 67 years, and for females, 71 years.
Tuberculosis, AIDS and other communicable diseases cause a high percentage of the illnesses and deaths in Botswana. Although healthcare in Botswana is improving, the country needs to ramp up its services and improve education. Here are eight facts about healthcare in Botswana.
8 Facts About Healthcare in Botswana
- Decentralized Healthcare System: Botswana comprises 27 health districts, including mobile locations, clinics and hospitals. Healthcare services are available at almost no cost for citizens. In addition to the treatment of common illnesses, the aim is to provide complementary preventive and rehabilitative services.
- Incidence of Tuberculosis: According to a 2016 study in The Lancet, Botswana had a Healthcare Access and Quality Index score–on a scale of 0-100, with the best performance–of only 24 regarding tuberculosis; for diseases such as Diptheria, it scored significantly higher (100). Botswana has some success in reducing cases of TB: in 2018, the incidence rate was 275 per 100,000 people, down from 326 in 2016.
- Targeted Services Needed for HIV/AIDS: Despite giving free antiretroviral treatment (ART) to those living with HIV, Botswana is still one of the most HIV-affected countries, with the fourth-highest HIV prevalence. As of 2018, there were 370,000 people living with HIV in Botswana. The adult HIV prevalence (ages 15-49) is 20.3%. There were 4,800 AIDS-related deaths in 2018 and 8,500 new HIV infections. Low testing rates and low levels of knowledge about the disease have kept the rates high. Only half of the people who are most at risk are able to access targeted services to a lack of them. Forced marriage and gender-based violence are increasing the epidemic in women. Strict laws against homosexuality make HIV prevention difficult. HIV prevalence among young people has seen little improvement, with a 6% prevalence in 2006 in comparison to 5.4% among young men and 10.2% among young women in 2016. In 2018, however, new infections were at an 8,500 count, down from 10,000 in 2010. AIDS-related deaths decreased from a high of 18,000 in 2002 to 4,800 in 2018. The decrease may be due to Botswana’s universal free ART program. The program, which began in 2002, is one of the most successful of its kind in sub-Saharan Africa. In 2016, estimates determined that 298,000 adults in Botswana were receiving ART.
- Mosquito-Borne Illness a Concern: Malaria cases increased in recent years with 283 cases in 2015, 691 cases in 2016 and 232 cases in 2018. However, this is a reduction in cases from 2006, when reports determined there were 2,606 cases. In this regard, healthcare in Botswana has room for improvement. In 2018, along with 15 other countries, Botswana signed the Windhoek Declaration, a proposal to reinvigorate efforts to eliminate malaria. The declaration calls for each country to extend its resource allocation and policies toward eliminating the disease along with improving accountability through tracking progress. A new malaria vaccine called RTS,S/AS01 emerged in June 2019. Botswana’s Ministry of Health is hoping that it will help to eliminate the mosquito-borne illness entirely.
- It Takes a Village: On a positive note, Botswana implemented a free school health program, including a team that tries to visit all public schools regularly. Dental therapists, nutrition officers and social welfare officers offer services. The probability of a child dying under the age of 5 is 37.27 per 1,000 live births in 2018, down from 38.23 deaths per 1,000 live births in 2017.
- A Decrease in Measles Cases: With 8,605 cases, 2010 was a record year for suspected measles–but in 2016, the number fell to 236. This was due to the annual campaign to immunize children under the age of 5 for measles.
- Improvement in Maternal Mortality Rate: Botswana’s maternal mortality ratio dropped from 151.6 per 100,000 live births in 2016 to 133.7 in 2018. The government’s goal is to decrease the ratio to under 70 deaths per 100,000 by 2030. In other good news, estimates determined that 99.8% of all births have taken place in a health facility with the supervision of a skilled health professional.
- COVID-19 Update: Botswana is taking strong measures to fight the pandemic. On June 13, 2020, the capital city of Gaborone returned to extreme lockdown after there were eight new COVID-19 cases at one hospital. On June 16, 2020, the lockdown ended. Four additional cases brought the total number of cases in the country to 175, with one death.
Healthcare in Botswana is improving. According to a study that The Lancet conducted, Botswana rose to the fourth decile in Healthcare Access and Quality Index (HAQ) between 1990 and 2000. Botswana now ranks 122 out of 195 countries, with a HAQ index of 52, having risen from an index of 39.7 in 2000. Botswana’s total spending on health per capita (International $, 2014) was $871, and total spending on health as a percentage of GDP was 5.4%. These facts about healthcare in Botswana show that the country should increase spending on healthcare and improve education about communicable diseases. Accomplishing these goals should improve the general health of its populace.
– Sarah Betuel