Botswana is currently working towards achievement of the Millennium Development Goals. To achieve the targets for the reduction of child mortality, which forms MDG 4, Botswana should reduce under-five deaths per 1,000 live births to 16 and increase measles immunisation to 100 per cent by 2015. In 2011 under-five mortality stood at 53 deaths per 1,000 live births, and measles immunisation at 94 per cent. This suggests that while Botswana is on track to chieve the measles immunisation target, serious action to reduce under-five deaths is required if Botswana is to achieve MDG 4 by 2015.
The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by three quarters between 1990 and 2015. When applying this target to Botswana, the maternal mortality rate should fall to 35 cases per 100,000 live births. In the period 2007-11 Botswana had a reported maternal mortality ratio of 160 deaths per 100,000 live births, which matched the figure estimated by UN agencies/World Bank in 2010. Based on the data reported by the country, there is a long way to go in achievement of this target. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In the period 2007-12 this figure stood at 95 per cent, and thus this target is close to achievement.
In 2013, the Delegation of the European Union to Botswana released a press statement congratulating Botswana on the good progress made towards achievement of the Millennium Development Goals. The only two goals that are reported by the European Union (EU) to have shown little progress towards the 2015 target are those relating to under-five and maternal mortality.
Consequently, as part of the European Union’s Millennium Development Goals Initiative, Botswana was allocated €11.6 million to help address these issues. Further work was carried out by the EU, with the Ministry of Health in Botswana, to identify potential issues in the health system that will need to be addressed. Firstly, it was found there is a serious need to increase health services and facilities within communities across the country. As well as increasing health care, procedures for providing neonatal care need to be assessed and strengthened to improve the overall quality of care. Emergency obstetric skills need to be enhanced at a large number of maternal health facilities across Botswana and maternal deaths, where they occur, should be audited in order to assess the cause and highlight potential solutions. Success in reducing maternal and child mortality will depend on further improvements throughout the health system as a whole.
MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. HIV prevalence is very high and has shown significant overall increase since 1990. While there has been an encouraging decline in estimated incidence of, and mortality from, both malaria and TB (when TB mortality data excludes cases comorbid with HIV), dramatic progress in all of these areas is required if the country is to come close to achieving MDG 6 by 2015.
