18/04/2026
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The Minister of Local Government and Traditional Affairs, Hon. Ketlhalefile F.C. Motshegwa, has announced a major policy shift in Botswanaβs health system, confirming that Primary Health Care (PHC) services have been transferred back to local government structures.
Speaking at a Primary Health Care Roundtable Dialogue in Gaborone yesterday morning, Minister Motshegwa said the reform, formalised under Government Notice No. 742 of November 2024, reassigns responsibility for clinic services, public health, and community-based programmes from the Ministry of Health to the Ministry of Local Government and Traditional Affairs. The transition began in April 2025 and fully implemented in April 2026.
Minister Motshegwa said the restructuring is intended to improve efficiency, strengthen community-based service delivery, and restore closer links between health services and the populations they serve. He noted that Botswana previously transferred PHC services to the Ministry of Health in 2010, but said performance outcomes had βnot met expectationsβ since then.
He argued that decentralised health services had previously delivered stronger results, citing earlier models of home-based care, outreach services, and postnatal support delivered through local councils. He emphasised that PHC remains a cost-effective approach focused on prevention rather than hospital-based treatment of advanced conditions.
Referencing global health frameworks, including the 1978 Alma-Ata Declaration and the 2018 Astana Declaration, Motshegwa reaffirmed PHC principles such as universal access, community participation, integrated services, and multisectoral cooperation.
He also called for stronger partnerships between government, development agencies, civil society, and traditional leadership in shaping Botswanaβs primary health care strategy. The Minister further urged participants to focus on practical implementation, accountability, and service delivery outcomes as Botswana embarks on the restructured PHC model.
In her welcome remarks, Acting Permanent Secretary Ms Tshepo C. Kebakile said the dialogue was intended to bring together stakeholders to share insights and guide implementation. She emphasized the role of participants in advising the βPeopleβs Ministryβ on effective PHC delivery.
Ms Kebakile said the meeting had drawn diverse stakeholders, including community and faith-based organizations, traditional healers, private health providers, multilateral agencies and representatives of the United States government.
The dialogue featured six thematic panel discussions covering service delivery, One Health, commodities and supplies, partnerships, community engagement and digitalization.
