28 Aug 2025

A reduced health grant from government has left the Bamalete Lutheran Hospital (BLH) with no funds for other critical operational needs, a situation that threatens the hospital’s ability to maintain efficient services.

This was highlighted by BLH superintendent, Dr Tshibelu Mwanza during a presentation to the full council session of the Ramotswa District Council on the current state, challenges and strategic proposals for sustainability for the hospital.

“BLH operates primarily through the ministry of health grant which has been capped at P75.5million annually for five years and now been reduced to P74million for the 2025/26 financial year despite rising costs, personnel emoluments alone amount to approximately P74.74million leaving no funds for other operational needs,” said Dr Mwanza.

He said the hospital’s proposed budget for 2025/2026 was P116.6 million which left a shortfall of P42.6million.

Dr Mwanza said the hospital’s operations had been badly affected by reduced government funding, delayed disbursement of subvention and very low patient fee collection which was usually less than P400 000 per year.

“This has made it even difficult to cover basic hospital operations such as medical equipment servicing, payment of utilities, procurement of critical supplies not available at Central Medical Stores (CMS), staff salaries are sometimes delayed even patient food is sometimes unstable,” he said.

Frequent stock outs at CMS which often forced the hospital to postpone or cancel elective procedures, outdated infrastructure and ageing medical equipment which compromised service delivery and patient safety, Dr Mwanza said were among the challenges the hospital was grappling with.

“There is severe shortage of health care professionals particularly nurses and healthcare assistants. ,” said Dr Mwanza.

On key interventions and proposals, Dr Mwanza said BLH guarantors and board were engaging with government to secure an urgent supplementary budget to cover essential operations.

He said they were also requesting renewal of the expiring grant agreement with increased budget support sufficient to meet the hospital’s optimal operational needs.

Dr Mwanza said restructuring was also essential to realign BLH with its core mandate of specialised healthcare services.

On restructuring actions, he said they proposed to discontinue walk in general outpatient department, family planning and low risk antenatal and postnatal care.

He said they planned to strengthen specialist clinics such as high risk obstetrics and gynaecology, paediatrics surgery, ear, nose and throat and internal medicine.

He added that they would redistribute medical officers and nurses to high demand units such as casualty neonatal care.

Dr Mwanza said with the level of underfunding at the hospital, it would not be able to remain operational as the current budget did not even cover minimum operational needs.

The hospital is a 128-bed mission district hospital operating under a grant agreement with government.

It is legally registered as a private company with three guarantors and owners, the Evangelical Lutheran Church in Botswana, the Evangelical Lutheran Church of Southern Africa (Botswana Diocese) and the Ba-Gamalete tribe. ENDS