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Key Determinants

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The Government of Botswana recognizes that the social development of the people is key to improving their health status. Education is seen as a foundation for life and is therefore one of the areas that has been targeted, as can be evidenced in the Ministry of Education having the largest share of government funding. In addition, 5% of health funding goes to education.

The Early Childhood Development Programme ensures that children are stimulated to prepare them for primary and subsequent education. The Early Childhood Development Programme is followed by 10 years of education, which every child must go through. Although the Government has introduced cost sharing at secondary schools, funding for education is still primarily provided by the Government.

Owing to the Government’s commitment to universal education, a national literacy rate of 81.3% was reported in 2003–2004, being higher for females than males (81.8% and 80.4%, respectively). The second area of focus is health itself. The Government has ensured that health care is accessible to the population at a highly subsidized fee, with the sexual and reproductive health programme being more inclusive of men and adolescents.

Employment is another area that is important for human health and development. Recognizing the disturbing rates of unemployment among young people, the Government has come up with income-generating programmes not only to provide young people with income but also to provide them with life skills so they can sustain themselves and generate employment for others. The Citizen Entrepreneurial Development Agency, small, micro and medium enterprises and the National Master Plan for Arable Agriculture and Dairy Development are some of the programmes that benefit young people.

The privatization policy strives to reduce the Government's dominance in the employment sector and to encourage the private sector to take up some services, including those provided by the Government. This enhances private sector development and has the potential to reduce poverty. One of the most fragile health determinants in Botswana is food security; this is mainly because of the country’s erratic and poor rainfall as well as the poor soils that compromise food production.

However, poor agricultural yield has also been attributed to the people’s reluctance to adopt modern farming methods. This leaves the country almost entirely dependent on the mining sector, the viability of which is determined by the global economic environment and therefore unreliable.

A survey carried out in 2008 showed that factors such as alcohol and drug abuse, tobacco smoking, unhealthy food habits and inadequate physical activity are common among adults in Botswana.[1] Therefore health promotion, provided mainly through the media such as television and radio, sensitizes the public on the importance of healthy lifestyles.

There are acts and policies in place to protect the environment from pollution and contamination and to control disease vectors. Challenges that face the country include shortage of human resources that compromises quality of services and problems that come with urbanization, such as rural–urban migration that leads to poor housing, crime and other social ills.


  1. Chronic disease risk factor surveillance report. Gaborone, Government of Botswana, Ministry of Health, 2008