To achieve MDG 4, Botswana should have reduced under-five deaths per 1,000 live births to 17 and increased measles immunisation to 100 per cent when the 2015 data is analysed. In 2013 under-five mortality stood at 47 deaths per 1,000 live births and measles immunisation at 99 per cent. This suggests that, while Botswana is on track to achieve the measles immunisation target, the goal for under-five deaths is unlikely to be met. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. The maternal mortality rate in Botswana, therefore, should fall to 35 cases per 100,000 live births. In 2013 Botswana had an adjusted maternal mortality rate of 170 deaths per 100,000 live births. Based on the data reported by the country to date, this target is unlikely to be met when the final data is analysed. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In 2013 this figure stood at 99 per cent, meaning that this target is close to being achieved. EU funding has been given to Botswana to help train health care professionals in emergency obstetric skills, while causes of maternal deaths are to be carefully monitored in order to help the country improve its record in maternal and child mortality. 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. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Nearly half of health care in Botswana (44 per cent) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 5.3 per cent of GDP in 2012, of which 56 per cent (US$217 per capita) was covered by the government. Botswana has yet to implement a health insurance plan providing equal access to its citizens. The country faces challenges in terms of determining different needs versus costs. However, under the current policy, no one is turned away from health care if they are unable to pay and there are some free services available, such as for antiretroviral therapy. Children under the age of 12 years are able to access health care for free. The WHO Country Co-operation Strategic Agenda (2008–12) identifies strengthening health systems as one of its priorities ‘with a focus on the organisation of integrated service delivery and financing to achieve universal health coverage. Botswana is not a signatory to the International Covenant on Economic, Social and Cultural Rights, the covenant that commits signees to the ensuring ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. Care for the elderly: Approximately 70,000 people in Botswana are over the age of 65 – four per cent of the total population. At the age of 60 a person living in Botswana can be expected to live for an additional 16 years on average. Botswana’s state old-age Botswana Nurses Union Delivering quality nursing services The Nurses Association of Botswana had been in existence since 1968 and after its dissolution the Botswana Nurses Union (BONU) was duly registered as a trade union in June 2012. In accordance with the Trade Unions and Employers’ Organization Act of 1983, from which BONU derives its mandate, the Union was offi cially launched in October 2012 in Francistown. BONU is engaged in: Q Advocacy for improved conditions of service for nurses and midwives Q Establishing the Department of Research and Continuous Education for the professional advancement of its members Q Improving members’ socio-economic status by designing inter alia funeral schemes, subsidised loan grants, counselling services and support for ailing members through ‘Thusa Mooki’ (Help-a-nurse project) Q Hosting the fi rst Nurses and Midwifery International Nursing Conference in partnerships with AVIWE Healthcare Resource and Training Institute in November 2015 As the national mouthpiece for nurses in Botswana, BONU – in its pursuit to deliver quality-nursing services – is committed to improving the conditions of all nurses. Through establishing a reliable social media network, the Union hopes to improve communication to its members. BONU is affi liated to regional and international nursing organisations to retain its professional identity among nursing unions. ‘Nurses provide an essential service and yet are not always adequately compensated or valued by society. We intend to sensitise members of the public about the importance of our union, as well as establishing union structures around the country.’ Contact Ms Ruth S. Mokgethi, CEO Plot 2684, Phiri Crescent, P.O. Box 126, Gaborone, Botswana Tel: +267 395 3840 Q +267 718 8492 Email: ceo@nab.org.bw Q info@nab.org.bw www.nab.org.bw
Commonwealth Health Partnerships 2015
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