Assessment of Botswana’s Health and Development in Relation to Millennium Development Goals


Botswana is one of the low-income countries in Africa. This assessment aims to present a critical analysis of the country’s health and development status while looking at the key health indicators and the relevant development indicators as well. It also discusses its achievements and the remaining challenges about millennium development goals.


Botswana is a landlocked country located in the middle of southern Africa and adjoining South Africa, Namibia, Zimbabwe, and Zambia. It is a sparsely populated country with a population of approximately 1.8 million. A larger part of the country is covered by Kalahari sands with limited natural water reservoirs (African Economic Outlook 2011). Therefore the country is not suitable for arable farming but instead is extremely endowed with minerals. The country’s eastern region is densely populated resulting in a sparse population in the western part. These geographic, climatic, and demographic circumstances greatly influence the development status of the country (UNGA 2008).

Since independence in 1966, Botswana has been transformed from a low-income to a middle-income country. This has been enabled by its production and exportation of diamond products which has raised its economic situation (MFDP 2008). Nevertheless, poverty rates are still enormously high though it has been steadily falling as the economy continues to grow (BIDPA 2006). Botswana has also registered laudable advances in social indicators over a long period even though the impacts of the HIV and Aids epidemic whose prevalence was rated as 24% of the adult population in 2004, keeps reversing some of this progress (Econsult 2007).

Moreover, Botswana has made a significant advancement regarding gender inequality. Many of the previous laws that used to discriminate against women have been rectified to give equal access to job opportunities, healthcare, and education. However, women are still experiencing high rates of poverty and joblessness as compared to the male population. They are lowly paid for a similar job and are more and more becoming victims of rape, partially as a result of the slow change from cultural beliefs that hamper women’s development, to refined legal environs (CSO, The Wage Gap Between Men and Women in Botswana’s Labor Market 2000).

Orphans are especially the most vulnerable group and their totals have continuously risen due to the prevalence of HIV and AIDS in the adult population. However, the government through its programs has supported them and their caretakers thus decreasing but not completely brought to an end their vulnerability to ill-treatment and impoverishment. The government has also introduced free primary education thus the orphans and children from poor backgrounds can access basic education. A major problem though is that, there are limited career chances for the youths after school hence leading to an increase in rates of crime (CSO, Education Enrolment Projections, 2004-2016 2005).

In terms of the environment, Botswana is slight with extremely low water resources. Huge tracts of land have undergone environmental degradation increasing the country’s susceptibility to drought and climate change. Environmental sustainability is primal to its fundamental development issues which include; mineral resource exploitation, water recycling, and expansion of pastoral and crop farming (Botswana Government 2006). Botswana’s future of tourism depends on its maintenance of wildlife resources and ecological zones such as the Okavango Delta and the Kalahari Desert. Its income generation and hence poverty reduction depends on how these different economic activities are managed to make environmental sustainability a requirement (UNPF 2002).


During the 1990s world summit, a comprehensive human development agenda was originated and its objective was to clearly and simply respond to key development challenges of the world. The developing nations promised to improve the lives of their citizens with the support of the developed nations (World Bank 2009). In 2000, the United Nations consented to a development guideline that articulated eight development goals. This came to be referred to as the Millennium Development Goals (MDGs) and was ratified by a total of 189 countries, among them Botswana. It addressed the issues of poverty, education, gender equality, health, environment, and global partnership (UN &B. R. 2010).

Monitoring and evaluation of advancements toward achieving these goals and seeing to it that there is continued commitment are necessities of the development plan. Initially, the United Nations had agreed to 18 targets and 48 indicators for assessing s country’s progress but has since been shifted to 21 targets and 60 indicators (UN 2007). Even so, targets and indicators have been altered to suit a country’s conditions and make meaningful ownership. Botswana’s government has taken many steps to make MDGs a national subject and has called for the civil societies, public and private sectors as well as any other sector. The under-mentioned sections assess the Health and Development Status of Botswana by the MDGs (Merafhe & Michel 2007).

Botswana’s Development Situation

At independence, Botswana was among the poorest nations in Africa. During the next forty years after its independence, Botswana made noteworthy progress following the discovery of mineral resources (African Economic Outlook 2011). In addition, Botswana assumed complete ownership of the MDGs and has since made substantial advancements following its ratification. Furthermore, its development process is guided by six yearly National Development Plans (NDPs). As of 1997, every NDP had been guided by the long-run vision of the country commonly referred to as Vision 2016. This vision toward “prosperity for all”, adopts five national principles; democracy, development, self-reliance, unity, and humaneness. The aspirations of Vision 2016 and the MDGs complement one another (CSA 2006).

Some noteworthy achievements that have been made towards the realization of the MDGs and Vision 2016 include; high rate of enrollment for primary schools, the decline in the percentage of people living below the poverty line, achievement of gender parity in primary and secondary schools, involvement of women in managerial positions in both private and public sectors, significant dropping in maternal mortality due to improvements in the maternal mortality monitoring system, improved antenatal care services, access to safe drinking water and safe waste disposal among others (Botswana Women’s NGO Coalition 2005).

Assessment of Key Indicators about MDGs

Education Policies

The education policy of Botswana has focused on accomplishing universal primary education. Its objective is to eliminate gender disparities and provide the skills required to satisfy current economical demands (UN 2007). Primary enrolment has risen from 96.7% in 1995 to 98.5% in 2004. In terms of gender, more female students have progressed further as compared to the males. For example, from 1998 to 2004 the percentage of females who completed standard seven was 84% and that of males was 75%.

This shows a good trend in female education. However, there are increasing concerns about females who are dropping out of secondary schools as a result of teenage pregnancies. Generally, the literacy level has gone up from 68.9% in 1993/94 to 81.2% in 2003/04 with a somewhat higher literacy rate for females than males. In terms of MDG two, Botswana has already accomplished universal access to primary education and is making significant attempts to better the quality and relevancy of basic education (Dorrington, Moultrie, & Daniel 2006).


Botswana is one of the countries that have been heavily hit by the HIV and AIDS pandemic. Its response measures included widespread awareness and behavior change campaigns through the media and, formal and informal education (MFDP 2008). Focusing on prevention, the response received political support with no endeavors to conceal the seriousness of the pandemic. Voluntary HIV testing and counseling have also been part of the response measures.

Additionally, Prevention of Mother to Child Transmissions (PMTCT) and supply of Anti Retroviral Therapy (ART) interventions was availed to all who required it through the public health system. The stabilization of HIV rates is an indicator of health development in the fight against HIV and AIDS. Mothers have increasingly participated in PMTCT programs which have highly contributed to the decline in the spread of the pandemic. Other prevention measures such as the use of condoms and increased age of sexual debut have also been reported (Malinga & Ntshwarang 2004).

Maternal and Reproductive Health

The health care system of Botswana has improved around 95% of the population lives around a health facility. Public health services are minimum charged and in some cases, they are free. Maternal morbidity and mortality are registered in clinics. Between 1991 and 2005, Botswana achieved a national target and remains to achieve the global target as well. A drop in Maternal Mortality Ratio (MMR) from 326/1000 in 1991 to 135/1000 in 2005, was recorded (WHO 2009).

Child Health

Botswana has strongly invested in the health and survival of its children. For this reason, child mortality has sharply decreased despite the prevalence of HIV and AIDS. Botswana’s records indicate that 80% of the children are taken to Child Welfare Clinics (CWC). PMTCT has been reduced by an estimate of 40% to 4% and children under the age of two who test positive are put on ART. Generally, Botswana uses its demographic survey to track child mortality (WHO 2009).


Poverty is still a major challenge in Botswana as nearly a third of the population still lives below the poverty line. This is attributed to high rates of unemployment, adverse climatic conditions and climate change, and the prevalence of HIV and AIDS. What Botswana needs to eradicate poverty, is robust Poverty Monitoring and Information Systems (PMIS) (UNDP, Millennium Development Goals 2011).

Access to Water and Sanitation

Dams have been constructed to meet the pressing water demands in Botswana. For rural communities, groundwater is of much import due to an insufficient supply of surface water. In 2005, 80% of the population was approximated to be relying on groundwater and this presented some challenges such as pollution and high extraction costs. Despite the mentioned challenges, Botswana remains to have one of the greatest standards of the population access to bettered sources of water. In 2008, it was 96.2% which is higher as compared to other middle-income countries. Notable progress has also been made to realize better sanitation. In 2007, 79% of the population had access to bettered sanitation, thus according to the MDGs, this target had already been achieved (UNDP, Mid-Term Review Plan 2009).

The health indicators about the MDGs are summarised in the table below;

Table 1: Progress toward the MDGs- Selected indicators.

MDG 1990-94 2002-2006 Target by 2015
2. Net enrolment rate in primary schools 96.7 98.5 100
1. Poverty rate(% of population below PDL) 47 30 23 (Reduce by ½)
6. HIV prevalence in adults N/A 25 Falling
1. Underweight children (under 5) 17 5.9
2. Literacy rates 15-24 year olds 89.5 93.7 100
4. Infant mortality rate( per 1000) 48 56 16 (reduce by 2/3)
5. Maternal mortality rate(per 100 000) 326 150-190 81 (reduce by ¾)
7. Population with access to safe drinking water 23 4 12 (reduce by ½)
6. Access to ART(% clinically eligible) N/A 95 Approximately 100
3. Ratio of males to females in primary school N/A 0.98 Approximately 1.0


From the assessment it can be nooted that Botswana has made considerable steps toward the achievement of the MDGs. However some problems such as HIV and AIDS and poverty rates among thepopulation remains to be solved. The issue of prevalence of HIV and AIDs needs to be critically looked into as it can reverse the economic and health sutuations of the country. On the other hand, the country should make good use of the available resources in order to raise the economic and health levels of the population. In conclusion, Botswana is seen to achieve the MDGs in the near future only if all the relevant development policies are taken into consideration.

List of References

African Economic Outlook 2011, Botswana. Web.

BIDPA 2006, Study of Poverty and Poverty Alleviation in Botswana, Gaborone, BIDPA/MFDP.

Botswana Government 2006, Draft Community Based Natural Resource Management Policy, Gaborone.

Botswana Women’s NGO Coalition, S.-W 2005, Beyond Inequalities: Women in Botswana, Harare, SARDC.

CSA 2006, Vision 2016 and Millenium Development Goals Indicators Report.

CSO 2005, Education Enrolment Projections: 2004-2016, Gaborone, CSO.

CSO 2000, The Wage Gap Between Men and Women in Botswana’s Labor Market, Gaborone, CSO.

Dorrington R. E., Moultrie, T. A., & Daniel, T 2006, The Demographic Impact of HIV and AIDS in Botswana, Gaborone, NACA/UNDP.

Econsult 2007, The Economic Impacts of HIV and AIDS in Botswana, Gaborone: NACA/UNDP.

Malinga, T., & Ntshwarang, P 2004, Alternative Care for Children in Botswana: a Reality or Idealism? Social Work and Society , 277-593.

Merafhe, M., & Michel, L 2007, Country Strategy Paper and National Indicative Programme, Lisbon, Botswana Government.

MFDP 2008, Annual Poverty Monitoring Report 2007/2008, Government of Botswana.

UN 2007, Second Common Country Assessment for Botswana, United Nations System.

UN, B. R 2010, Millenium Develoment Goals: Botswana Status Report, Gaborone, Ministry of Finance.

UNDP 2009, Mid-Term Review Plan.

UNDP 2011, Millennium Development Goals. Web.

UNGA 2008, Report by the Republic of Botswana, Geneva, United Nations.

UNPF 2002, State of World Population, People, Poverty and Possibilities.

WHO 2009, Health and Development, World Health Organization.

World Bank 2009, World Development Indicators.

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