Project: The African AIDS Pandemic

Botswana health system contains six levels of care

by John Carr

Gaborone is the capital and largest city in Botswana and the country center for health care. With a population of approximately 200,000 people. It was here I met Dr. Wingi, a general practitioner with his own small clinic in central Botswana.

Dr. Wingi was very knowledgeable on the structure of the health care system. “It is very well organized,” he said. “There are six levels to the system. The lowest level is called a mobile stop.” These are one-day clinics that come to a specific place each week or month to provide services to the locals. Several signs were posted throughout Botswana in the rural areas detailing the location and date of these clinics. “These are temporary clinics where patients can see a professional quickly and conveniently,” Dr. Wingi said.

A hyena relaxes, yet remains alert by the side of the road.

The second level is a health post. “These are run by a general nurse and/or a midwife and a family welfare educator,” he said. “The purpose of these clinics is to diagnose patients and tell them where to seek help, not so much any treatment.”

The next level is the health clinic. "The health clinic will have a general practitioner and sometimes a nurse. These may or may not have a maternity section." This is where Dr. Wingi works. These clinics are similar to urgent care clinics in the United States.

A primary hospital with 30 to 90 beds is the next level and is run by three to five general practitioners. “The most common surgery they do is a cesarean section,” said Dr. Wingi.

The next level is called a district hospital. "District hospitals have 5-9 general practitioner doctors and up to 300 beds,” he said, counting aloud. There are nine district hospitals in Botswana.

The most sophisticated level is the referral hospitals. “These are for special cases and do not accept people just walking up to them,” according to Dr. Wingi. “There are two psychiatric referral hospitals; one in Francistown and one in Maun.”

There are also two surgery referral hospitals — Princess Marina Hospitals in Gaborone and Nyangabgwe Hospital in Francistown,” he said. “These have specialized doctors and do lots of surgeries.”

“Anything more advanced goes to Johannesburg," concluded Dr Wingi.