Increasing affluence among Batswana might sound like a good thing but the World Bank has revealed the downside.
“A relatively high percentage of adults were objectively assessed as overweight (20.11 percent) or obese (14.59 percent). The probability of reporting above normal weight increased among the non-poor (up 2.71 percentage points) and residents of Gaborone and Francistown. Among adults, 16.37 percent reported current smoking, and 21.36 percent reported current alcohol consumption. Higher socioeconomic status was correlated with greater consumption of beer and tobacco and lower consumption of traditional beer (and vice versa). The probability of consuming alcohol and tobacco was higher among males than females,” says the Bank adding that the health risks of being overweight are particularly serious in women (53.4 percent) compared to men (22.1 percent).
The source of this information is a report in which the bank assessed Botswana’s poverty. The report also raises alarm about a corresponding increase in non-communicable diseases (NCDs) in BotswanaÔÇönamely, hypertension, cancers, and diabetes. It quotes previous studies that also noted that risk factors for NCDsÔÇösuch as smoking, physical inactivity, and high blood pressureÔÇöwere increasing among Botswana’s adult population. Healthy eating might counteract these problems to some extent but on the whole, consumption of fruits and vegetables is low, with about 97 percent of adults eating less than five servings a day.
As the rest of Sub-Saharan Africa, Botswana’s health focus is directed toward communicable diseases, particularly HIV/AIDS and less toward the growing problem of NCDs. The latter already account for about 30 percent of the region’s deaths, are expected to become the leading cause of ill health and death by 2030 and in Botswana, “could threaten to overwhelm the health system.” The Bank’s advice to the government is to adopt an integrated health system strengthening approach for addressing the double burden of disease. This approach would at once capitalize on inter-linkages between conditions and on their common determinants, focus on common care needs rather than disease categories and capitalise on existing resources and capabilities.
Giving an example of how the first measure can be implemented, the Bank says that the human papilloma virus (HPV) causes cervical cancer, a leading killer of women in Botswana, and that HPV-associated cancers occur more frequently in HIV-infected patients.
“Some interventions to prevent such NCDs as cervical cancer are straight out of the communicable disease toolbox. Immunization programs could be expanded to provide HPV vaccines for young girls and protect them against HPV strains that cause 70 percent of cervical cancer cases. Collaboration with reproductive and sexual-health programs, including HIV/AIDS, could help raise awareness of early signs and symptoms of cervical and breast cancer and increase coverage of low-cost cervical-cancer screening and treatment programs,” it proposes.