National Health Policy - Gov

1 National Health Policy Towards a Healthier Botswana Ministry of Health , GaboroneDecember 2011 National Health Policy Towards a Healthier Botswana Ministry of Health , GaboroneDecember 2011 The revised National Health Policy : National Health Policy : Towards a Healthier Botswana, December 2011 Ministry of Health , 2012 Design and layout: Bay Publishing (Pty) Ltd, GaboronePrinting: Printing & Publishing Company Botswana, Gaborone, 2012 Table of 1:Introduction .. Need to Revise the National Health Policy (NHP).. Context for Health Development .. Context for Health Development .. Description of the Process of Policy Review ..8 Chapter 2: Situation and demographic determinants of determinants of Health Status in Botswana .. Causes of Disease Burden in Botswana .. Organisation and Management of the Health Sector .. The Ministry of Health .. The Ministry of Local Government (MLG) .. Service Providers and and Coordination of the Health Sector.

2 Of the Health Sector .. and Utilisation of Health Services .. Resources for Health .. Financing .. , Vaccines and other Health Technologies .. Information Management System .. towards Attainment of the Health MDGs ..16 Chapter 3: Vision, Mission and Guiding Principles .. of the Policy ..20 Chapter 4: Policy Thrusts / Principle Areas of and .. Resources for Policy Financing .. , Vaccines and Health , Vaccines and other Medical .. Information and .. determinants of Health .. Food Habits and Increased Physical .. and Substance .. , Health and 5:Implementation Framework .. Roles and Responsibilities for Implementation of the and Management of Service and Budgeting ..40 Chapter 6:Monitoring and Evaluation ..414 NATIONALHEALTHPOLICY: TOWARDSAHEALTHIERBOTSWANA, DECEMBER2011 ForewordThe first National Health Policy for Botswana, formulated in 1995, guided the development of thehealth sector.

3 Since the Policy was adopted,many changes occurred in epidemiological, socio - economic and demographic situations as well as Health technology development. The mostimportant epidemiological change affecting Botswana is the advent of the HIV/AIDS epidemicand related opportunistic diseases. In order to improve access to quality Health care, the Government of Botswana investedsubstantially in building Health facilities all over the country. However,quality of Health care andservice utilisation remain a challenge as a result of inadequate skilled Health the Ministry of Health is the steward in the provision of quality Health care to the nation,social and economic policies have a determining impact on Health . The overall development ofBotswana can be judged by the quality of its population s Health , how fairly Health is distributedacross the social spectrum, and the degree of protection provided tothe disadvantaged as a resultof ill- Health .

4 The Policy thus encompasses all the social determinants which impact the Health ofthe National Health Policy bearsthe slogan Towards a Healthier Botswana ,implying that theprovision of Health services is not just merely curing the sick but also promoting healthy lifestylesin order to prevent diseases/ill-conditions for all people living in Botswana. The Policy covers all the six building blocks of Health systems, with specific direction for each ofthem. It also provides the platform for well-coordinated planning, financing, monitoring andevaluation. The Policy will be implemented through an Integrated Health Sector Plan which willincorporate not just the public sector s effort but also those of the non-government organisations,community based organisations and the private sector. The National Health Policy is the product of several stakeholder consultations which makes it morecomprehensive. Similarly, it also providesfor stakeholder involvement in the continuous monitoringof the implementation of the Policy as well as its future revision.

5 Rev. Dr. John G. N. SeakgosingMinister of Health5 Abbreviations AIDSA cquired Immuno Deficiency SyndromeARTA ntiretroviral TherapyBDFB otswana Defence ForceBNDPB otswana National Drug PolicyCBOC ommunity Based OrganisationCSDHC ommission on Social determinants of HealthCSOC entral Statistics OfficeDHBD istrict Health BoardDHMTD istrict Health Management TeamDPHCD epartment of Primary Health CareDRSAD rugs and Related Substance ActDRUDrug Regulatory UnitEDLE ssential Drug ListEHSPE ssential Health Service PackageEIAE nvironmental Impact AssessmentGDPG ross Domestic ProductHHAH armonisation for Health in AfricaHIVH uman Immunodeficiency VirusHRHH uman Resources for HealthIMRI nfant Mortality RateITNI nsecticide Treated NetsIHSPI ntegrated Health Service PlanMDGM illennium Development Goals M&EMonitoring and EvaluationMFDPM inistry of Finance and Development PlanningMISM anagement Information SystemMJDSM inistry of Justice.

6 Defence and SecurityMLGM inistry of Local GovernmentMMRM aternal Mortality RateMOHM inistry of HealthMRSAM edicine and Related Substance ActMTIM inistry of Trade and IndustryNACAN ational AIDS Coordinating AgencyNDPN ational Development PlanNGONon-Governmental OrganisationNHPN ational Health PolicyNHCN ational Health CouncilPHCP rimary Health CareSRGS takeholder Reference GroupTBTuberculosisTHET otal Health ExpenditureTORT erms of ReferenceTT2+Tetanus Toxoid 2+U5 MRUnder-Five Mortality RateUNUnited NationsUNDPU nited Nations Development ProgrammeUNFPAU nited Nations Population Fund VDCV illage Development CommitteeVHCV illage Health CommitteeWHOW orld Health Organisation6 NATIONALHEALTHPOLICY: TOWARDSAHEALTHIERBOTSWANA, DECEMBER2011 Chapter 1: Introduction Need to Revise the National Health Policy (NHP) enjoyment of a level of Health that allows every citizen to lead an economically andsocially productive life is widely accepted as a basic necessity in any population.

7 The WorldHealth Organisation (WHO) defines Health as a state of complete physical, mental, andsocial well-being and not merely the absence of disease or infirmity . Botswana has beentrying to attain this level of Health status through improvements in the Health sector over theyears. Since 1995, the first National Health Policy has guided the Health sector towardsattaining of the highest level of Health status for all people living in Botswana. the development of the first National Health Policy , there have been major changes inboth Health status and in the organisation of the Health sector in the country. Changes includethe disease burden, demographics and the socio - economic determinants of that Health is a right to be enjoyed by all Batswana has also grown over major reorganisation of the Ministry of Health , as well as the management of PrimaryHealth Care within the Ministry of Local Government, began in 2002 and is still in the last National Health Policy was developed, the number of Health sector stakeholdershas increased, the population has grown and lifestyles have changed.

8 There have also beenmany changes in Health technologies for Health promotion, prevention and treatment and therehabilitation of people - including those with disabilities. developments and changes have rendered the 1995 National Health Policy outdatedand have necessitated the need for a review and revision of the Policy to make it morerelevant and Context for Health DevelopmentThe overall guiding document for National development in Botswana is Vision 2016, abroad-based National approach adopted in 1996 which focusses on the aspiration of theNation. The principles and objectives of Vision 2016 guide the formulation andimplementation of revolving 6-year National Development Plans (NDP). In pursuit ofVision 2016, Health -related goals are set which contribute to the National development ofBotswana,mainly through one of the pillars A compassionate, just and caring nation . Context for Health international community has adopted eight Millennium Development Goals to beachieved by the year 2015 through the 2000 United Nations Millennium Declaration1.

9 In theAfrican context, the Ouagadougou Declaration on PrimaryHealth Care and Health Systems27_____1. UN, Millennium Declaration. 2. WHO, Ouagadougou better Health in this millennium beyond attainment of the Health MDGs. In orderto increase the pace toward the attainment of the Health MDGs, the Paris Declaration3urgescountries to ensure aid effectiveness through country ownership, harmonisation, alignmentand mutual accountability, and to focus on measuring results. Harmonisation for Health inAfrica (HHA)4ensures that all partners support countries in the sector through a singlepolicy, a single National plan, a single implementation framework, and a single monitoringand evaluation framework under the leadership and ownership of government. that social and economic determinants of Health go beyond the Health sector,the Commission on Social determinants of Health (CSDH)5has published a reportproposing multisectoral interventions that can help reduce the negative impact of socialstratification, illiteracy, insecurity (food, material, financial and otherwise), unemployment,poor housing, social exclusion, deprivation, malnutrition, addiction, poor workingenvironment and lack of social support on Health .

10 This National Health Policy recognisesthe need for working closely with other sectors so as to ensure better and sustainable healthstatus through concurrent and consistent strategies that will impact on the key socialdeterminants of Health in Description of the Process of Policy into account the country, regional and global contexts, the Ministry of Health , incollaboration with all the Health stakeholders, mapped out a process to develop this revisedpolicy. It started with a situational analysis of the current Health status, Health determinants ,and organisation, management and functionality of the Health system. Based on the resultsof the situational analysis, a framework was prepared to assess the gaps within the 1995 National Health Policy . Policy review process was done through a management structure consisting of theStakeholder Reference Group (SRG) and six thematic groups (Leadership and Governance; Health Service Delivery;Human Resource; Health Financing; Health Information; andHealth Technologies; Medicines and Vaccines).