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Centralisation crippled health care system

Member of Parliament for Tati East, Samson Guma Moyo

Member of Parliament for Tati East, Samson Guma Moyo has urged the Ministry of Health to concede that the country’s health system is on crisis mode, owing to unsolved issues piling up over the years.


Moyo said this at the opening of the sitting of the Public Accounts Committee (PAC) to examine Government accounts for Financial Year that ended 31st March 2014, earlier this week.


The committee which is chaired by MP for Kanye South, Abraham Kesupile is also made up of Ndaba Gaolathe, Kosta Markus, Biggie Butale, Dithapelo Keorapetse, Shaun Ntlhaile, Guma Moyo, Paulson Majaga and Ignatious Moswaane.  


Moyo said the fact that year after year the ministry is unable to resolve crucial issues confirm that there is indeed a crisis in Botswana’s health care system.


Moyo stated that issues like shortage of drugs including for critical illnesses like high blood pressure is a call for help. “What are the implications of this shortage?”He asked, further adding, “Some patients are dying as a result of this shortage.”


The Ministry of Health Acting Permanent Secretary, Tebogo Banamile acknowledged that the ministry is faced with challenges but denied that there was a crisis, as Moyo implied.


Banamile said that some of the challenges were brought on by the transition from decentralisation to centralisation after the 2009 general elections. Government has said that due to the economic situation of that time, health services were better managed at central government under the health ministry.  


According to Banamile centralisation resulted in the ministry taking over the responsibilities which were initially tasked to local authorities. She alleged that, when nurses were moved to central government, some resources they used like accommodation facilities and vehicles could not be transferred since they already belonged to the Ministry of Local Government, thus contributing to the web of problems the ministry is faced with.


The PAC was also not impressed that there over 50 doctors who do not have accommodation, it submitted that it is one of the factors that have resulted in Botswana not being able to attract and retain doctors.  


MP for Maun East, Kosta Markus expressed concern over the remuneration of Cuban doctors in Botswana. There is an understanding that they are unhappy with Botswana’s working conditions. The PAC heard this week that Cuban doctors are entitled to meagre allowances ranging from $600-$800 (P5878.00- P7838.00) depending on their area of speciality.


The Cuban doctors are also only transported to and from work, and government does not provide them with personal vehicles.


Botswana’s low wages have also been pointed out as the problem in the health care system as the country is unable to attract specialists to work in Botswana. Botswana is also unable to retain its medical professionals due to limited incentives in allowances. Failing to rectify the current situation means Botswana will continue losing doctors to greener pastures as they remain the most sought after professionals in the world.


MP for Gaborone Bonnington South Ndaba Gaolathe advised the Ministry of Health to develop a method which they will use to measure preventative care to see if the ministry is achieving its objectives.  


Gaolathe advised that the ministry should also have an effective supply chain management which is critical in management of the drugs to ensure that the supply is adequate and reaches the destinations where they are needed. While Botswana has never short of drugs, it is common for some health posts, especially those in rural areas to go experience a shortage of drugs.


Botswana infant mortality rate remains one of highest in the world for an upper middle income country, with an average of 36 deaths per 1000 live births. While the mortality rate for children under 5 years is at 28%.
Banamile announced that the Ministry of Health is reverting to decentralisation and the District Health Management Teams (DHMT) will be given more authority in order to improve efficiency. The Acting PS contended that a lot of issues were overlooked a few years ago when other health services were centralised.  


The Ministry of Health will also seek an arrangement where health professionals will be de-linked from public service so that there are certain benefits which health professionals are able to access that are in line with international practices.


Parliament has previously rejected a motion by Dithapelo Keorapetse to consider delinking health workers from civil service and setting up an independent Health Commission to be in charge of the health sector.

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BAC graduates 727 students this year

9th December 2022

Botswana Accountancy College (BAC) last week held its 2022 graduation where 727 students graduated after spending the last two years of their academic studies navigating through the effects of the Covid-19 pandemic.

It is said that during the pandemic, BAC provided students with laptops, tablets and data sim cards to facilitate virtual learning and blended learning. The Acting Minister of Education and Skills Development at the ceremony, Wilhemina Makwnja noted that the students managed to create connections and build bridges to reach their ultimate goals, therefore their graduation is not only testimony of their strength and resilience, but it also demonstrates their commitment to excel by facing the challenges they encountered head on to break through the barriers and focused on their success.

“I trust that the graduates will build onto these qualities and competencies as they venture into the industry to impart their skills in the various sectors of the economy,” said Makwinja. She also shared that she strongly believes that the graduates will become agents of change and that they will take advantage of the spectrum of opportunities available in the market both locally and internationally.

Living in an era of digital economies, e-commerce, fin-tech and many other new eco-systems that have been created as the world continues to evolve, it is said to be inevitable that we all need to be steadfast and adapt to the rapid changes experienced before the pandemic. “As part of the transformation agenda, the Ministry of Entrepreneurship has been established with a mandate to drive development of sustainable industries and trade, and this can be achieved through ‘accelerated transformative investments in Botswana’,” said Makwinja.

She further noted it is through the Ministry that youth entrepreneurship projects will be supported including administration of the Youth Development Fund that facilitates funding commercialization of various youth projects. “There are other Government incentives in Agriculture which are aimed at supporting Batswana farmers with commercialization of their produce to supply both the local market and exporting to other markets,” added Makwinja.

The BAC Executive Director, Serty Leburu on the other hand enunciated that it was important to recognise that the past years they have gone through a lot of changes and mostly life defining moments as the school lost some valuable staff members and students during the Covid-19 pandemic. “The environment within which we operate has been changing rapidly and as an institution we have to constantly come up with some interventions and pivot ourselves in order to rise to the test and adapt,” said Leburu.

Leburu also renowned that they were also launching the BAC 2022-2027 Institutional Strategy focusing on key areas for Teaching and Learning, Research, Innovation and Entrepreneurship, Transition to University Status and Internationalization, Asset Mobilisation and Optimization as well as Student and Staff experience. “It is our ambition to continue to expand into other markets to provide access to our programs through partnerships and collaborations with both local and international private and public entities,” added Leburu

In addition to this, she reflected that research, innovation, and consultancy are some of the areas they are making strides to develop and grow in partnership with various stakeholders. Through the schools there are projects that are being worked on at various levels. “As BAC we continue to work with the industry and our partners, we assess the market to identify training and development needs to capacitate employees to meet the demands of the new and evolving economies,” concluded Leburu.

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Media have a Role in Accelerating Harm Reduction Adoption

8th December 2022

African Scientists and Experts Call for the adoption of a Harm Reduction in approach in Public Health Strategies and Tobacco Control. Media have a critical role to play in accelerating Harm Reduction efforts by informing and sensitizing cigarette smokers on the availability and benefits of alternative, potentially lower risk products to cigarretes. Traditional cessation and smoking prevention norms are not the only ways that smokers who cannot or don’t’ want to quit can make healthier choices that cause less harm to themselves and those around them.

This was said during the 2nd Harm Reduction Exchange conference for African journalists held in Nairobi, Kenya on the 1st of December 2022. Speaking at the Harm Reduction Exchange Conference, Integra Africa Principal Dr. Tendai Mhizha emphasized the role that journalists and media houses should play in handling misinformation and disinformation in tobacco harm reduction discourse that is actually perpetuating the death and disease caused by people continuing to smoke combustible cigarettes. “There has been a lot of disinformation surrounding the topic of nicotine and the alleged negative effects that e-cigarettes have on public health.

This has led to policies that disfavour risk reduces products and narratives that completely deny their benefits. The media have the difficult responsibility to curb the scourge of disinformation and misinformation on harm reduction just like on other socio-political stances that are prescriptive and do not uphold consumers’ right to healthier lifestyle choices,” Dr Mhizha said.

The Harm Reduction Exchange cast a spotlight on alternative ways to reduce harm among tobacco smokers. Held under the theme Harm Reduction: Making a difference in Africa, the conference focused on the progress being made through harm reduction strategies in all fields related to public health such as drug and alcohol abuse, excessive sugar consumption, skin lightening and other addictive and behavioral practices. A wide array of harm reduction strategies and initiatives that are deployed towards reducing unnecessary deaths through non-communicable diseases were presented and discussed.

On his part, Prof. Abdoul Kassé, a world renowned and awarded Oncologist and a Professor of Surgery at the Cancer Institute in Senegal, said that Harm Reduction is a powerful public A Summary of the HR Exchange 30th November  1st December 2022 health tool that has the potential to reduce cancer by 30% and should be at the centre of all public health development strategies. Harm reduction, he said, has already benefited many people in public health and is the most viable alternative in tobacco control.

It applies to areas where there is a need to reduce the harm associated with a practice or consumption of a substance that is overused in society leading to increased morbidity and mortality. “Innovative Harm Reduction initiatives will help to keep more Africans alive. Tobacco Harm Reduction initiatives, including the use of popular e-cigarettes, nicotine patches and chewing gums, have continued to generate a lot of misunderstanding in both the public health community and in the media. However, there is evidence that the use of potentially less harmful alternatives than cigarettes for those who are not willing or cannot give up smoking with currently approved methods may be a solution, not necessarily the best for everyone but by far better than continuous smoking.

Where cessation repeatedly fails, switching to less harmful products is expected to result in benefits for many smokers,” Prof. Abdoul Kassé said. Similarly, views were expressed by Kenya’s Dr. Vivian Manyeki who said tobacco Harm Reduction has a solid scientific and medical basis, and it has a lot of promise as a public health measure to assist millions of smokers. “Many smokers are unable, or at least unwilling, to achieve cessation through complete nicotine and tobacco abstinence. They continue smoking despite the very real and obvious adverse health consequences and against the multiple public health campaigns. Conventional smoking cessation proposals should be complemented with alternative but more realistic options through Harm Reduction,” Dr. Manyeki said.

Tobacco Harm Reduction was introduced to mitigate the damage caused by cigarette smoking—the most dangerous form of tobacco use, and the leading cause of preventable diseases, including cardiovascular disease, lung cancer, and chronic obstructive pulmonary disease. “Nicotine has an addictive potential but plays a minor role in smoking-related morbidity and mortality. Across the world, there is growing interest among experts in novel approaches towards tobacco control and there is an ongoing discussion that reducing the negative effects of smoking can be also achieved by tobacco harm reduction,” Dr. Kgosi Letlape, an ophthalmologist and President of Africa Medical Association and the president of the Association of Medical Councils of Africa, said.

Tobacco cessation is a key factor in the prevention of cardiovascular diseases and cancer. Abstinence from tobacco smoking is one of the primary goals for health promotion and management globally but it is unachievable in a huge amount of cases. This task remains unaccomplished despite extensive public campaigns on the health dangers of tobacco smoking. Thus, the development of novel strategies to reduce smoking is imperative. Moreover, the use of innovations in smoking products has been currently adopted by several smokers to reduce the health risks of smoking.

“The Harm Reduction approach prevents drug-related deaths and overdose fatalities and is the only way out for addicts. In the same way these alternative technologies can reduce tobacco harm and accelerate the journey to a smoke-free world as they reduce exposure to toxicants,” Bernice Apondi, A Policy Manager at Voices of Community Action and Leadership Kenya (VOCAL-Kenya), said.

During the Harm Reduction Exchange, journalists drawn from Southern, West and East African countries, including: Nigeria, Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Eswatini, Tanzania, Uganda, South Africa, Zambia, and Zimbabwe debated and set forth several resolutions in regards to the present and future as well as the challenges and progress made in Harm Reduction,and science-led regulation.

The Harm Reduction Exchange brought together high-level policy makers, physicians, scientists and health policy experts with media stakeholders from Africa in a lively mix of speeches, presentations, and panel discussions. The key note speakers included Prof Abdoul Aziz Kasse, Ms Bernice Opondi, Joseph Magero, Jonathan Fell, Chimwemwe Ngoma, Clive Bates, Dr. Kgosi Letlape, Dr. Vivian Manyeki and Dr. Tendai Mhizha.

 

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Over 2 000 civil servants interdicted

6th December 2022

Over 2,000 civil servants in the public sector have been interdicted for a variety of reasons, the majority of which are criminal in nature.

According to reports, some officers have been under interdiction for more than two years because such matters are still being investigated. Information reaching WeekendPost shows that local government, particularly councils, has the highest number of suspended officers.

In its annual report, the Directorate on Corruption and Economic Crime (DCEC) revealed that councils lead in corrupt activities throughout the country, and dozens of council employees are being investigated for alleged corrupt activities. It is also reported that disciplined forces, including the Botswana Defence Force (BDF), police, and prisons, and the Directorate of Intelligence and Security (DIS) have suspended a significant number of officers.

The Ministry of Education and Skills Development has also recorded a good number of teachers who have implicated in love relationships with students, while some are accused of impregnating students both in primary and secondary school. Regional education officers have been tasked to investigate such matters and are believed to be far from completion as some students are dragging their feet in assisting the investigations to be completed.

This year, Mmadinare Senior Secondary reportedly had the highest number of pregnancies, especially among form five students who were later forcibly expelled from school. Responding to this publication’s queries, Permanent Secretary to the Office of the President Emma Peloetletse said, “as you might be aware, I am currently addressing public servants across the length and breadth of our beautiful republic. Due to your detailed enquiry, I am not able to respond within your schedule,” she said.

She said some of the issues raised need verification of facts, some are still under investigation while some are still before the courts of law.

Meanwhile, it is close to six months since the Police Commissioner Keabetwe Makgophe, Director General of the Directorate on Corruption and Economic Crime (DCEC) Tymon Katlholo and the Deputy Director of the DIS Tefo Kgothane were suspended from their official duties on various charges.

Efforts to solicit comment from trade unions were futile at the time of going to press.

Some suspended officers who opted for anonymity claimed that they have close to two years while on suspension. One stated that the investigations that led him to be suspended have not been completed.

“It is heartbreaking that at this time the investigations have not been completed,” he told WeekendPost, adding that “when a person is suspended, they get their salary fully without fail until the matter is resolved”.

Makgophe, Katlholo and Kgothane are the three most high-ranking government officials that are under interdiction.

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