05 Aug 2026

Government has taken a significant step toward achieving universal health coverage through the proposed National Health Insurance (NHI) Reform, a comprehensive transformation in health sector to ensure equitable, accessible and sustainable healthcare for all citizens.

Speaking during a media engagement in Gaborone on Wednesday, acting Permanent Secretary in the Ministry of Health, Dr Tshepo Machacha described the initiative as one of the country’s most ambitious healthcare reforms.

“The National Health Insurance Reform is not merely establishing another health insurance scheme, rather, it is a comprehensive health system reform designed to help Botswana achieve universal health coverage,” he said.

Dr Machacha said the reform sought to ensure every person in Botswana had access to quality healthcare services without suffering financial hardship. 

He added that despite government remaining the primary healthcare financier, many households still incur substantial out-of-pocket medical expenses.

He said it would modernise healthcare financing, organisation and service delivery while creating an equitable, efficient and sustainable health system.

Although Botswana has made significant progress in improving life expectancy and controlling communicable diseases, Dr Machacha said the sector now faced challenges including unequal access to healthcare, inconsistent service quality, rising healthcare costs, increasing non-communicable diseases, technological advances, demographic changes and growing public expectations.

Dr Machacha reaffirmed the ministry’s commitment to transparency and stakeholder engagement throughout the reform process.

Senior Consultant for NHI, Ms Lydia Andries, reiterated that the reform fulfils government’s commitment to universal health coverage by ensuring every Motswana can access quality healthcare regardless of financial status.

Ms Andries said the proposed system would strategically purchase healthcare services and reinvest public funds to improve service delivery and patient outcomes.

“We want to fund health outcomes rather than simply funding people to move through the system,” she said.

Ms Andries said the healthcare system faced fragmented financing, weak cost controls, rising costs, healthcare worker shortages, drug stock-outs, delayed diagnostics and long waiting times. 

She noted international studies estimate that between 20 and 30 per cent of healthcare expenditure was lost through fraud, waste and abuse.

Ms Andries said both public and private healthcare providers would be accredited against national standards under a phased approach.

She said the reform would strengthen primary healthcare, promote disease prevention, expand the use of digital technologies and make NHI compulsory for all citizens by pooling healthcare funding to ensure equitable access to quality services without financial hardship.

Ms Andries said consultations would continue throughout implementation to ensure the policy reflects stakeholders’ needs.  ENDS