GoB-UN POP 2010-2014 - UNFPA Botswana

GoB-UN POP 2010-2014the proportion of people living on less thana dollar a day from 23.5% in 2002/03 to 6.5%.The country is thus well positioned to eradicateextreme poverty. The proportion of poor people,based on the national poverty line, stands at20.7% (down from 30.6% in 2002/03). There havebeen geographic variations in progress withprogress being fast in some areas while past gainshave been lost in others.23. Governance and Human Rights: Thecountry is ranked highly on governanceand economic competitiveness indicators.Botswana, together with Mauritius, sharesthe distinction of having the longest workingliberal democracy in Africa. The countryhas held free and fair elections regularlysince 1965. Key areas in which challengesremain relate to the equal participation andprotection of all citizens through legal andpolicy provisions, institutional reform andcapacity development, enhanced monitoringby civil society, and increased accountabilityfor results. While progress has been madein gender mainstreaming, the efforts havenot been supported by a policy and clearaccountability mechanisms.While Botswana does well in terms of formalindicators of governance, there are someconcerns that administration is over-centralisedand that local government is unable to respondflexibly enough to local interests. While manyfunctions are implemented by local authorities(e.g. large portions of the health, educationand social security systems are run locally), mostpolicies are determined centrally. Furthermore,local authorities have little independent funding,and are dependent upon central governmentsubventions for almost all of their expenditure.Theabsence of a decentralisation policy has led tovaried approaches across sectors and this hastended to undermine efforts to improve citizens’influence over decisions that affect them. Accessto justice has also been uneven with cost being amajor barrier for the relatively poor.24. Health: Botswana continues to demonstratea high level of commitment to address healthissues. Non communicable diseases (NCDs)are increasing in numbers and contributingsignificantly to the socio-economic burdenin the country. HIV and other communicablediseases continue to be of concern. Withthe support of development partners, includingthe UN, Botswana has developed a number ofpolicies, guidelines and pilots to address challengesin child health, maternal health, HIV&AIDS, andTuberculosis. Persistent procurement and supplychain management challenges have seenthe country experience health commoditystock-outs. The roll-out of programmes tooperationalize the policy provisions and scaleuppilot interventions are affected by resourcesconstraints calling for more efficient utilisationof available resources. Both external anddomestic funding for the health sector is onthe decline. While a Health Partnership Forumhas been established to facilitate the sharingof information and coordination of interventions,the opportunities for greater effectivenessand cost reduction offered by integration andcollaborative provision of services remain underexploitedand personnel challenges remain.25. HIV and AIDS: The progress on HIV and AIDShas been encouraging. The incidence of HIVinfections has gone down and prevalenceamong the 15 to 24 year olds has declined. Thedecline in prevalence among the 15-24 yearolds has been greater among females leadingto a decline in the ratio of infected femalesto males from 3.1 females for every infectedmale to 2.2 females for every infected male.With access to treatment, HIV-related mortalityhas declined from 6% in 2003 to 1 % in 2011.The combination of a low mortality rate with arelatively high rate of new infections has seenthe proportion of the adult population that isHIV positive stabilise at a high rate of 24%. Thecountry has further scope to adjust policies toimprove service access among key affectedpopulations and reducing new infections andprolonging lives. Financing of the HIV andAIDS response into the future poses a majorchallenge that should be addressed througha comprehensive health sector financingstrategy.10 GoB - UN POP 2010 - 2014