The Essential health care package development was held in Gaborone, from 24th October – 4th November, through phased consultations and stakeholder engagements. The workshop was attended by 50+ delegates representing national and subnational units (districts), program management, partners, government bodies and other stakeholders.
The Universal Health Coverage (UHC) Agenda is a global, regional as well as specific countries priority. UHC is meant to ensure that “all people receive quality health services that meet their needs, without being exposed to financial hardship in paying for the services.” The essential health care package (EHCP) is a key component of the strategy to reach Universal Health Coverage and the SDGs. It can facilitate and enhance the sectors’ ability towards attainment of UHC and contribute towards achievement of the health-related SDGs. It aims to define the set of interventions that the country aspires to deliver, becoming the central anchor around which health investments are guided by.
Botswana has been implementing the 2010 Essential health package which was aligned to the National Health Policy 2010 and the Integrated health services plan (IHSP) -the 10-year strategic plan for the sector. The 2010 EHSP focused broadly on interventions for conditions on sexual and reproductive health, child health, communicable and non-Communicable conditions. Since 2010, major and critical changes have happened in the health environment at the country, regional and global level. The burden of disease landscape in the country shows persistence of communicable conditions such as HIV/AIDs, Tuberculosis, NTDs whilst noting increasing trends in Non communicable conditions such as cardio-vascular diseases, cancers, diabetes, and mental health conditions. The emerging and re-emerging health threats such as the global COVID-19 pandemic, the viral hemorrhagic fevers and other health security threats warrant a shift in the overall policy and strategic direction.
It is against this background that the health sector through the stewardship of the Ministry of Health and with support from stakeholders, has purposed to develop the Essential health care package (EHCP) to guide service delivery in the country. The new package takes into account the changing demography and epidemiology as well as current technological advances, economic growth, and public expectations of health services.
The development process was technically led by working groups, covering different age cohorts. These include (Pregnancy and New-born (up to 28 days); Early Childhood (29 days – 59 months); Late Childhood (6 -13 Years); Adolescent and Youth (14 – 29 Years); Adulthood (30 – 64 Years) and Elderly (65+ Years).
The EHCP development can be summarized under 5 key thematic areas. Initially, the TWGs support selection of leading conditions/risk factors to be addressed in the EHCP, based on evidence and information applicable to the local context. Secondly, each team identified interventions across the public health interventions (promotion, prevention, curative, rehabilitative and palliative care) most appropriate for the age cohort of focus. Third, the interventions were mapped to the different levels of care as deemed appropriate for the country aspiration. Fourth, the interventions were harmonized across different age cohorts by the Ministry of health teams, to ensure language, scope and content are in sync across the teams. Lastly, the teams plan to commence appraisal processes with different stakeholders, including line ministries and communities, to ensure holistic reflection of country priorities.
The workshop was fruitful, yielding a robust EHCP draft owned by the ministry of health teams. This is partly attributed to the workshop methodology, encouraging active engagement of participants, plenary, group work, and peer reviews, which allowed rich discussions and exchanges of knowledge across programs. The EHCP is expected feed into the health sector strategy and policy governing tools, to fully foster health systems investments for attainment of UHC. Furthermore, the strategic shift of EHCPs – focused on defining interventions the population needs – is an instrumental foundation for the service delivery systems, aiming to achieve and maintain highest level of health and well-being in Botswana.
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