Public health can play a critical role in reducing health inequalities in Botswana by combining health equity considerations into policy and programs, as well as collaborating with other sectors to address inequities. Health inequalities are unfair and avoidable. Unfair when poor health becomes a consequence of an unjust distribution of the underlying social determinants of health; and avoidable since policy interventions by the government could drastically improve the health of the population.
Conditions that lead to marked health inequalities in Botswana affect everyone directly or indirectly. Some types of health inequalities among socially disadvantaged groups in Botswana have clear spill over effects on the rest of society, for example, the spread of infectious diseases.
In Botswana, healthcare services are more accessible to the rich, while healthcare benefits for the poor remain limited. Government reports, as well as many epidemiological studies, have provided evidence that a wide range of health outcomes and health-related behaviours are socioeconomically patterned, and that the magnitude of health inequalities is even increasing.
Speaking to The Telegraph, a public health official, Tlotlo Seboni said in order to reduce health inequalities in Botswana, the country must act across a range of public policy areas, with policies to tackle economic and social inequalities alongside actions with a specific focus on disadvantaged groups and deprived communities.
“This must be a wakeup call because we cannot afford losing too many Batswana, too early and too often, to health inequality which is avoidable,” she says adding that “government can reduce health inequity by guaranteeing the provision of basic services, protecting and promoting human rights such as health care, education, sanitation and safe water, and the right to a decent standard of living.
In almost all low to middle income countries with available data, mortality and morbidity rates are higher among those in less advantaged socioeconomic positions, and as a result differences in health expectancy between socioeconomic groups typically amount to 10 years or more.
There is substantial evidence which validates the fact that social factors such as employment and income level in Botswana plays a difference on how healthy a group of people or individual is.
“As economic inequality in Botswana has deepened, so too has inequality in health. Although data is not immediately available, i am sure that the Covid-19 pandemic has worsened inequalities. Almost every chronic condition, from stroke to heart disease and arthritis, follows a predictable pattern of rising prevalence with declining income,” she says.
Among other things, she says interventions to reduce health inequalities are cost effective.
“Public health programmes that reduce health inequalities can also be cost effective. For example, priority must be given to the improvement of access to cervical cancer screening in Batswana women on efficiency grounds. By reducing health inequalities, we will also be reducing the spillover effects on the health of the population,” says Seboni.
Health inequality is an important indicator of a society’s health and research shows that there is higher risk of Batswana suffering from poor health because of the lower socio-economic position of most citizens. Health inequalities are the methodical differences in the health status of various population groups or individuals that occur mainly because of the uneven distribution of social, environmental and economic conditions within societies. Such differences also play a part in the risk of people getting ill and their ability to prevent sickness.
Health inequality in Botswana is linked to life expectancy and the more there is high health inequality the more ordinary citizens are likely to be deprived and limited in their chances to live longer. The existence of health inequalities in Botswana means that the citizens’ right to the best measure of physical and mental health is not by any chance being achieved.
The idea that a middle-income nation like Botswana is experiencing health inequality just doesn’t seem right. She says this must be a wakeup call because Botswana cannot afford losing too many Batswana, too early and too often, to health inequality which is preventable.
Health inequalities represent thousands of unnecessary premature deaths every year in Botswana. This is not fair because these health inequalities do not occur randomly or by chance, but are socially determined by circumstances largely beyond an individual’s control. These circumstances disadvantage people and limit their chance to live a longer, healthier life. Health inequalities go against the ideology of social justice because they are preventable. They do not occur randomly or by chance. It is time that researchers take into account the need to measure local disease burdens because health problems concentrated in a certain place in a country could be very different from those experienced a couple of hours away from that area.
