Over P400m transferred to Local Govt. from Health Ministry
An amount of over P490 million has been transferred to the Ministry of Local Government and Traditional Affairs for operations, and P155 million for development projects.
This was revealed by the Minister of Local Government and Traditional Affairs, Ketlhalefile Motshegwa, who stated that personnel emoluments for transferred staff are, however, still being paid by the Ministry of Health pending finalisation of their transfer.
He indicated that discussions are ongoing regarding equitable sharing of the fuel budget, given that the Ministry of Local Government and Traditional Affairs now manages a significant portion of the fleet and incurs more transport-related costs at the local level.
In his statement to Parliament on the transfer of Primary Health Care functions from the Ministry of Health to that of Local Government, Motshegwa said the decision forms part of the Government’s broader commitment to decentralisation of service delivery and realignment of sectoral functions to strengthen community–level governance and bring services closer to the people.
He told Parliament that the Ministry of Health structure provides for the delivery of Primary Health Care services through both Primary hospitals and clinics.
Under the new arrangement, clinics, along with public health and community-based programmes, have been transferred to the Ministry of Local Government and Traditional Affairs, while Primary Hospitals remain under the Ministry of Health.
“This repositioning is consistent with the 1978 Declaration of Alma-Ata, which identifies Primary Health Care as a comprehensive People-centred approach to health.
Primary Health Care encompasses promotive, preventative, curative, rehabilitative, and palliative services delivered as close as possible to people’s everyday environment.
The 76th World Health Assembly, held in May 2023, resolved to re-orient national health systems towards PHC as a foundation for Universal Health Coverage (UHC) health security and cost efficiency,” Motshegwa said.
The minister stated that in alignment with these global priorities, the Government of Botswana has adopted Primary Health Care as the cornerstone of its health strategy, affirming its relevance to community empowerment, equity, and sustainability.
The minister revealed that Botswana adopted the PHC Strategy in 1978, operationalised jointly through the Ministry of Health and the Ministry of Local Government.
Before April 2010, the Ministry of Health was solely responsible for national health policy formation and oversight, while the Ministry of Local Government and Traditional Affairs, through District and
Town Councils, provided community–level health services, employed health workers, and developed necessary infrastructure.
Motshegwa stated that all clinics, health posts, and mobile stops were under the Ministry of Local Government and Traditional Affairs, which also housed the Department of Primary Health Care Services for coordination of services in line with national policies.
Thus, the current relocation is re-establishing and streamlining institutional roles in line with Botswana’s decentralisation.
“To ensure a seamless transition, the Ministry of Health and Ministry of Local Government and Traditional Affairs agreed on key principles including: Equitable distribution of resources (financial, human and infrastructural); Protection of staff accommodation and office accommodation during the transition period; Alignment of budget lines to operational needs; Designation of PHC heads as Deputy
Council Secretaries or Deputy Town Clerks; A Phased approach to transfer staff from April 2025 to March 2026; Cross – Ministry career development, promotions and joint recruitment; Centralised procurement of medicines through Central Medical Stores (CMS) complemented by local-level micro-procurement; and Outstanding grievances and dispute resolution are to be concluded by 31st March 2026,” the Minister assured.
He revealed that Medicines and Medical Commodities continue to be supplied by Central Medical Stores. However, stock-outs and underfunding of the drug vote remain a challenge.
The Ministry of Local Government and Traditional Affairs has been allocated P2.1 million for emergency procurement for the 2025/2026 financial year, an amount which remains inadequate, Motshegwa added.