04 Feb 2025

The move to decentralise clinics and health services is part of a broader trend towards local governance and autonomy.

Interacting with the public to gather opinions, feedback and suggestions on how to improve services in Gaborone today, the Minister of Local Government and Traditional Affairs, Mr Ketlhalefile Motshegwa said the shift had the potential to reshape the healthcare landscape by empowering local governments to take charge of healthcare management, ultimately creating a more dynamic, equitable and responsive system.

Mr Motshegwa further highlighted that Botswana could forge a more flexible healthcare system capable of responding to emerging health issues.

“Empowering local governments to manage healthcare services presents an opportunity to build a system that is more responsive to the needs of the population," he said.

Mr Motshegwa said local systems could better address public health crises, shifting disease patterns and demographic changes in ways that national structures might struggle to match.

With decentralised healthcare management, local authorities will be able to tailor services to fit the specific needs of their communities, ensuring greater accessibility and relevance.

To maximise the benefits of the shift and minimise the challenges, Mr Motshegwa emphasised the importance of strong collaboration between local governments, national health agencies, private sector partners and community stakeholders, saying such cooperation were vital for addressing resource gaps, maintaining consistent quality of care and fostering a cohesive healthcare network that prioritizes the health and wellbeing of all citizens.

“Ultimately, the success of the transition will depend on strategic planning, adequate funding and the ongoing commitment of both local authorities and citizens to collaborate for better health outcomes,” Mr Motshegwa added.

He stressed that bringing healthcare services closer to communities would be a key milestone in making the country's health system more effective, inclusive and responsive health care system.

Outlining some of the benefits of localising health services, he said it included improved access to healthcare.

Mr Motshegwa said local governments, being closer to the people, were better positioned to understand and address the unique health challenges of their communities.

Another benefit highlighted by the minister was faster response times.

“With decision-making processes located at the local level, local governments can act swiftly to allocate resources, implement public health programmes and address healthcare needs.”

Mr Motshegwa also confirmed that the implementation of the decentralisation plan would begin in April, as significant step toward enhancing healthcare delivery system.

He pointed out that in recent years, there has been an ongoing global conversation about the necessity of universal healthcare systems that provide equitable access to healthcare services for all citizens.

He said one of the most compelling solutions was the establishment of National Health Insurance (NHI) programmes, and government was on the way to process a design to ensure that every individual, regardless of income, geographic location, or employment status, has access to the healthcare they need.

“The right to health is considered a fundamental human right by international organisations, such as the World Health Organization (WHO),’’ he said, adding that access to essential health services without financial hardship should not be a luxury but a universal standard.

Mr Motshegwa said without universal health coverage, disparities in access to healthcare were rampant, saying those inequities often lead to worse health outcomes, as individuals from marginalised group were less likely to seek care due to the cost, leading to preventable illnesses, hospitalisations or even deaths.

 Having access to national health insurance, he said all would be entitled to the same level of care, ensuring that no one was left behind. ENDS