MPs raise alarm over rural health challenges
Pini Bothoko | Monday November 24, 2025 06:00
Boteti West MP, Samuel Digwa, asked the Minister of Local Government and Traditional Affairs, Ketlhalefile Motshegwa, to outline concrete plans to address the recurring challenges that continue to undermine service delivery in rural clinics and health posts.
In response, Motshegwa acknowledged that shortages of essential medicines and consumables continue to be a nationwide concern, including in remote facilities.
He reminded Parliament that during the State of the Nation Address (SONA), President Duma Boko had assured the nation of a “significant increase” in medicine supplies in the coming weeks.
While procurement is handled by the Central Medical Stores (CMS), the Minister said his ministry is prioritising redistribution and rationalisation within local authorities, as well as timely placement of orders and tighter tracking of supplies to prevent stockouts.
On the challenge of retaining healthcare workers in hard-to-reach areas, Motshegwa said the government currently provides Remote Area Service Allowance (RASA) and free accommodation to incentivise staff. However, he acknowledged the need for district-specific deployment strategies that reflect the unique local conditions, stating that current measures are insufficient to halt high attrition rates.
Turning to digitisation, the Minister said optimising digital health solutions remains a key priority in efforts to modernise Botswana’s health system in line with the nation’s Universal Health Coverage targets for 2036.
He said systems such as the Patient Information Management System (PIMS), Integrated Patient Management System (IPMS), District Health Information System (DHIS2), and E-Pulse are already in use, though they are not yet interfaced for seamless data sharing across facilities.
“To date, 223 clinics have been connected under the ongoing village connectivity programme, with 60 more targeted in the current phase. By the end of the financial year, 283 clinics are expected to be online,” he said.
Motshegwa also noted challenges, including damage to equipment caused by power surges, which the ministry is addressing by installing surge protectors. He added that Botswana is advancing the development of integrated systems such as Electronic Medical Records, currently piloted in two districts, and a Clinic Information Management System intended to improve access to specialist care.
He added that the systems will eventually link to the Botswana Health Information Exchange, allowing a unified Master Patient Index for both public and private sectors.
Still on health issues, Maun East MP, Goretetse Kekgonegile pressed the Ministry of Health for updates on the establishment of the Emergency Medical Services (EMS) department, raising questions about staffing, employment of temporary personnel, recruitment policies and expansion of EMS bases.
Responding to Kekgonegile’s questions, Assistant Minister of Health, Lawrence Ookeditse, informed Parliament that the Ministry has 154 paramedic positions, including 17 for degree-holding paramedic officers and 137 for diploma-holding Advanced Emergency Medical Technicians (AEMTs).
Currently, 109 AEMTs and one principal paramedic officer are employed permanently, leaving 28 AEMTs and 16 degree-paramedic posts vacant positions which have already been advertised.
Ookeditse said 28 temporary AEMTs are still engaged, and in the past three months, the ministry absorbed 78 AEMTs into permanent roles, and an internal advert has been issued to allow temporary staff to apply for available positions.
On recruitment policy concerns, the Minister clarified that the ministry is guided by a DPSM circular issued on 29 July 2024, which prescribes an 80:20 ratio, 80% for new graduates and 20% for internal promotions aimed at reducing graduate unemployment.
“Botswana currently has 16 functional EMS bases situated in major centres, including Gaborone, Mochudi, Molepolole, Lobatse, Kang, Gantsi, Maun, Kasane, Nata, Letlhakane, Francistown, Selebi-Phikwe, Palapye, Serowe and Mahalapye, with the latest addition being Kanye. The ministry plans to construct EMS centres at Dibete and Nata under NDP12, with further expansion dependent on national economic performance,” he said.