07 May 2015

Minister of Health, Ms Dorcas Makgato, says her ministry is going to work tirelessly to transform Botswana’s health care system.

Adressing the media in Gaborone this week, Ms Makgato said there had been challenges in her ministry, but promised that they will reshape the country’s health care system.

Ms Makgato, nevertheless, highlighted that the ministry continued to make progress towards achievement of the health related MDGs and had recorded significant performance in the under-five mortality as it has been reduced from 76/1000 (2008) to 28/1000.

She attributed the significant performance to an increased community uptake of high impact interventions, such as an increased immunisation coverage and introduction of new vaccines into the national immunisation schedule.

Ms Makgato also stated that the maternal mortality had also been reduced from 189/100K in 2008 to 134/100K, due to establishment of quality improvement project for maternal health, increased training of health care workers on emergency obstetric training, excellent and proactive management of HIV/AIDs, which led to the reduction of HIV incidence from 1.5 percent (2010 BAIS) to 1.35 percent (2013 BAIS).

Ms Makgato also pointed out that scaling up national HIV response efforts had also borne 96 percent of PMTCT uptake, saying PMTCT rate was 1.3 per cent lower than global target of 5 per cent and that 94 percent (247,157) eligible patients are enrolled on ARV treatment.

Regarding tuberculosis, Ms Makgato said, introduction of community tuberculosis care with current coverage of 76 per cent and utilisation of more rapid diagnostic technology for HIV and TB including drug resistant forms such as Gene Xpert has led to the reduction of TB notification rates.

Furthermore she said the implementation of the Malaria Elimination Strategy had resulted in a significant decline in the number of malaria cases over the years sighting from 13.5 percent in 2006 to 0.62 percent in 2014.

Ms Makgato highlighted that some efforts to improve provision of quality of services are currently ongoing such as the accreditation program against COHSASA standards that has been rolled out to 16 facilities.

She said Mahalapye District, Nyangabgwe Referral and Scottish Livingstone hospitals have achieved entry level of recognition and are accredited. She also highlighted that they have developed a National Health Quality Standards for all health facilities including hospitals, clinics, mortuary / autopsy, environmental health services, Emergency Medical Services, which put more emphasis on patient safety, patient experience and clinical effectiveness.

She stated that specialist services have been rolled out to remote areas to meet patients’ needs, adding that other specialized services such as Cardiology (PMH); Nephrology (SLH & PMH), Organ transplant (PMH in partnership with India & RSA); Athroplasty (PMH & MDH), Spinal Cord Injury Rehabilitation (PMH), Ophthalmology (SMH& SLH), Hypertensive Disorders of Pregnancy (PMH): diabetes centres (PMH - Block 9 & NRH - Donga) have been introduced to referral and upgraded district Hospitals.

Ms Makgato said government has continued to ensure that health care services are accessible to all people living in Botswana, saying to date, 84 percent of Batswana have access to as they live within 5 kilometres to health facility.

She said all that has been achieved through construction of new facilities, expansion of services in the existing facilities, outreach services to areas without fixed health facilities adding that there are 1239 mobile stops in place and have also expanded hours of service from 8 to 24 hours service in some health facilities.

Ms Makgato admitted that despite the achievements, the ministry is also experiencing some challenges, the major ones being rise in non- communicable conditions such as, cancer, cardiovascular diseases and diabetes.

She said there has been an increasing customer complaints and compromised quality services in some of the facilities due to negative attitude of some health workers, critical shortages of qualified staff particularly in the rural areas, medical equipment, transport, drugs and supplies.

She also said there is a high staff turnover, dilapidated health facilities and poorly managed facilities as well as centralised management structure. Ms Makgato stated that in an effort to finding solutions to the existing challenges faced by her Ministry, they held a Leadership summit in March 2015, and came up with resolutions.

She stated that a clear plan of action plan road map to address the challenges and reshape Botswana’s Health Care System has been developed and that implementation has started.

“As a ministry going forward we shall focus our efforts on the following key focus areas, organizational transformation, quality health care services, Paradigm Shift of Health care approach from Curative to Preventative and Economic Diversification Drive” she stated.

She said they would be transforming MOH to become an employer of choice through implementation of an excellent attraction and retention strategy adding that they would work on transforming health workers culture to restore the dignity of the Health Profession and also adopting a paradigm shift towards training and skills development and also improving accountability at district level.

Among the other Ms Makgato stated that they would empower District management, organizational restructuring that advocates for decentralization (lean headquarters and autonomous district management teams) and separation of policy development and regulatory functions from service delivery functions.

She also said to improve accountability, the ministry had adopted management by walk about particularly at district /hospital level and contact for Hospital heads will be published by end of May 2015. Ends