Botswana's Minister of Local Government and Traditional Affairs, Mr Ketlhalefile Motshegwa, has addressed several persistent challenges facing rural healthcare, including the shortage of medicines and consumables, the retention and motivation of healthcare workers in remote areas, and the integration of digital health solutions.

Regarding the critical shortage of medicines and consumables across all health facilities, particularly in rural areas, Minister Motshegwa acknowledged the issue. He referenced the President's State-of-the-Nation-Address (SONA), which indicated an expected significant increase in medicine supply in the coming weeks. While the Central Medical Stores (CMS) handles bulk procurement and distribution, the ministry is committed to re-distributing and rationalising medicines within local authorities, as well as ensuring timely ordering and diligent tracking of supplies at the CMS.

To address the retention and motivation of healthcare workers in hard-to-reach areas, the minister highlighted the existing Remote Area Service Allowance. This allowance is designed to incentivise and retain public officers serving in remote locations. Additionally, these officers are provided with free accommodation. However, the ministry recognises the need to develop specific deployment plans that account for the unique circumstances and challenges faced by certain districts to further improve retention.

The integration of digital health solutions remains a key priority, aligning with Botswana's goal to transform its health system to match the global Universal Health Coverage average by 2036. This transformation is envisioned through stronger care, a robust workforce, and digital innovation. Currently, various systems such as the Patient Information Management System, Integrated Patient Management System, District Health Information System 2, and E Pulse are actively in use across health facilities. A notable challenge, however, is that these systems are not yet interfaced to permit seamless data sharing or access across all facilities.

Progress on connectivity for health facilities is underway, with 223 clinics already connected through the ongoing village connectivity programme. An additional 60 clinics are targeted under the current phase, bringing the total expected online clinics to 283 by the end of the financial year. The ministry is also proactively tackling challenges like power surges, which often damage equipment, by installing power surge protectors in affected facilities.

Furthermore, the ministry is advancing the development of integrated systems. The Electronic Medical Records system is currently being piloted in two districts, and the Clinic Information Management System is under development to ensure access to specialist care. These new systems are designed to link to the Botswana Health Information Exchange, which will support a Master Patient Index. This index aims to maintain comprehensive medical histories for citizens across both public and private health facilities, bridging the urban-rural divide in access to healthcare.