28 Oct 2025

Health financing remains constrained with limited fiscal space as government contributes about 80 per cent of total health expenditure, leaving the sector vulnerable to economic shocks.

Presenting the health sector chapter of the National Development Plan 12 (NDP 12) in Parliament on Monday, Minister of Health Dr Stephen Modise said Botswana’s hospital-centric funding model, with about 70 per cent of recurrent spending directed to hospital curative services, limits investment in preventive and primary health care.

He said health insurance coverage was also low and fragmented, reaching only 17 per cent of the population in the formal sector and five per cent in the informal sector.

Dr Modise indicated that the health financing model was heavily reliant on government, which covered about 80 per cent of total health expenditure, largely through taxes thus the fragmented insurance market left the majority of citizens without protection.

“Botswana’s health financing remains constrained by an over­ reliance on tax revenues, weak cost-recovery mechanisms and limited revenue mobilisation,” he said.

This, he said, undermined the ability to ensure predictable and sustainable long-term funding for the health sector and addressing these challenges required a comprehensive financing and efficiency reform agenda.

To address this, Dr Modise said government would develop, pilot and implement a National Health Insurance (NHI) scheme that was financially sustainable and socially equitable. He said the scheme aimed to expand universal access to healthcare while ensuring fiscal sustainability and responsible resource management.

Dr Modise thus said the focus during NDP 12 was on developing critical infrastructure and optimising existing health facilities to support the realise the ‘True North’ for health.

“The sector will prioritise refurbishment and expansion of existing infrastructure, maintenance, and limited construction of new health facilities where necessary to enhance service quality,” he said.

He said another initiative would comprise upgrading and modernisation of medical equipment. This, he said would be achieved through strengthened equipment management systems, incorporating preventive maintenance, lifecycle planning and timely replacement of obsolete technologies.

Similarly, Dr Modise said the country’s health system continued to grapple with staff shortages, high turnover and uneven deployment, which constrain progress in service delivery. He said government would  implement a comprehensive Human Resources for Health strategy supported by digital transformation.

Notwithstanding the challenges, Dr Modise highlighted that Botswana had made commendable progress in expanding access to health services and demonstrating high levels of effectiveness in service provision.

Dr Modise however cautioned of the pressing need to enhance the quality of care to achieve better health outcomes for the people. ENDS