Health in Botswana

The national health ministry (Ministry of Health) and district health management teams (District Health Management Teams) organize a large part of public healthcare in Botswana. In addition, there are private providers, mission hospitals, hospital services operated by mining companies, nonprofit facilities, and services for specific groups provided by Botswana's defence force (Botswana Defence Force), the police and the correctional system. Environmental Health is also the responsibility of the ministry responsible for local government (Ministry of Local Government). Depending on the location, care begins at a mobile outreach stop (Mobile Stop), a health post (Health Post) or a clinic. Clinics commonly treat general complaints and minor injuries and offer, among other services, vaccinations, child and adolescent health, family planning, sexual and reproductive healthcare, HIV and STI services, pregnancy care, mental healthcare, rehabilitation, health counselling, laboratory services and dispensing of medicines. A maternity clinic (Clinic with Maternity) additionally provides midwifery care. Primary hospitals (Primary Hospitals) and district hospitals (District Hospitals) provide more extensive outpatient and inpatient treatment; complex or serious cases are referred to referral hospitals (Referral Hospitals) or quaternary hospitals (Quaternary Hospitals). Depending on the facility, hospitals offer services including emergency care, paediatrics, surgery, intensive care, pharmacy, laboratory services, X-rays, dentistry, ophthalmology and orthopaedics. Specialized services such as psychiatry, oncology, rehabilitation, audiology, and obstetrics and gynaecology are available mainly at referral or larger sites. According to current government information, public hospitals operate around the clock. Clinics generally open Mondays to Fridays from 7:30 a.m. to 16:30; outside these hours, a nurse may be reachable, but the specific duty arrangement depends on the facility. Key health concerns of particular nationwide relevance include HIV, including testing, antiretroviral treatment and prevention of mother-to-child transmission, tuberculosis, malaria, maternal and child healthcare, diabetes, high blood pressure, cardiovascular disease, cancer, mental illness, and injuries and accidents. Vaccination, disease surveillance, outbreak control, nutrition, breastfeeding counselling, tobacco and alcohol prevention, and school health services complement the treatment of individual conditions. Depending on the location, examinations and follow-up care may include clinical laboratories, pathology, blood transfusion, X-rays, ultrasound, mammography, dental and eye examinations, physiotherapy, occupational therapy, speech and hearing therapy, psychological support, social work, palliative care, and community- or home-based care. The availability of diagnostics, referrals, medicines and follow-up care differs between facilities and districts. Pharmaceutical Services dispense prescription medicines; Botswana's medicines regulator (Botswana Medicines Regulatory Authority) registers and monitors medicines and controls, among other things, manufacturing, licences, imports and the market, as well as reports concerning undesirable products. In the event of a life-threatening illness or serious accident, the emergency service can be reached on 997. The control centre calls back when needed and prioritizes the most serious cases. The emergency service takes people to the definitive care they require, but does not provide every type of transport, such as transport for stable follow-up appointments, non-urgent transfers or people who can safely arrange transport themselves. According to official government information, the public sector provides about 80 percent of care, and around 95 percent of the population is said to live within five kilometres of a healthcare facility. These figures do not, however, demonstrate the current capacity of every facility. Mobile Stops, Health Posts and District Health Management Teams remain particularly important for rural areas. Public general consultations cost 5 Pula for local residents (locals), according to the Ministry of Health; children under five and people over 65 are exempt. Any additional fees, medicine costs and private prices must be checked with the relevant facility. Patients are entitled to information about their illness and treatment, confidentiality, privacy, informed consent, participation in decisions, culturally sensitive care and refusal of treatment. Complaints can be submitted through the facility management or the Customer Complaints process (Customer Complaints Procedure). Patients should provide accurate health information, cooperate with treatment and attend agreed follow-up care. Traditional medicine is widespread in Botswana; it is not automatically government-provided or evidence-based treatment and should not be equated with public healthcare.