Botswana

Botswana’s Integrated Health Service Plan (IHSP) 2010–2020 aimed to improve healthcare accessibility, equity, and efficiency through universal health coverage (UHC), enhanced governance, and service delivery reforms. The plan emphasized primary healthcare expansion, health workforce development, financial sustainability, and digital health integration to strengthen the country’s health system. Key achievements included the expansion of the Essential Health Service Package (EHSP), which improved access to maternal and child healthcare, infectious disease control, and chronic disease management. Investments in health infrastructure, human resource capacity-building, and public-private partnerships supported service delivery improvements. However, challenges persisted in health financing, workforce shortages, and disparities in rural healthcare access. The shortage of trained professionals, high staff turnover, and supply chain inefficiencies affected service quality, while weak referral systems and fragmented health information systems hindered effective monitoring and evaluation. The IHSP also focused on disease prevention, occupational health, and lifestyle changes to reduce non-communicable diseases (NCDs). Measures to strengthen procurement, logistics, and medicine availability were implemented but faced operational hurdles. Governance and leadership reforms sought to increase transparency, improve regulatory oversight, and enhance coordination between stakeholders. Despite progress, Botswana struggled to meet certain Millennium Development Goals (MDGs), particularly in reducing maternal mortality, improving child health, and addressing the HIV/AIDS burden. Future success will depend on sustained investments, better resource allocation, and enhanced digital health systems to improve service efficiency and long-term sustainability​.