In my earlier Sunday Standard article, “Sixty Years of Health for All?”, I argued that insurance cannot place medicines on empty clinic shelves or replace health professionals who are not there. With Parliament having adopted Botswana’s National Health Insurance (NHI) Policy in August 2026, attention now turns to the next critical stage, the enactment of the National Health Insurance Act, which will establish the legal and institutional framework for implementing the reform. At this important juncture, a fundamental question arises: What can Botswana learn from African countries that have already embarked on similar reforms?
Ghana provides an instructive example. Its National Health Insurance Scheme (NHIS), established more than two decades ago, has expanded access to healthcare and strengthened financial protection. However, its implementation has also encountered difficulties involving provider payments, financing sustainability, institutional coordination and service quality.
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