AB582         THE CHALLENGES TO HEALTH CARE PROVISION AMONG THE UNDER-PRIVILEGED BASARWA (SAN) LIVING AND WORKING IN THE FREEHOLD FARMS OF GHANTSI DISTRICT IN NORTH WESTERN BOTSWANA.

Author(s): 
Moyo A*, Fugelli P**, Johnsen N**
* Health Research Unit, Gaberone, Botswana
** Institute of General Practice and Community Medicine ofOslo, Norway
Text: 
Basarwa, an indigenous nomadic hunter-gatherer population living mostly in the north - western part of the country, have over the years, not been able to acquire any wealth and basic assets. They are economically disadvantaged and form the bulk unskilled labour force within the private farms of the Ghantsi district.
Aim: To explore the impact of living conditions and health service utilisation on the health status of Basarwa in the farms, and identify gaps for future action.
Method: Review of literature and reports from different departments and research projects dealing with the welfare and health of Basarwa.
Results: The main factors influencing the health status in this population are culture, poverty, poor nutrition and low levels of education. The leading causes of morbidity and mortality among this population are pulmonary TB, malaria, ill-defined intestinal infections, pneumonia, acute upper respiratory infections and malnutrition. Very little is known about the impact of HIV/AIDS. health care provision to this population is through outreach services. Major limitations are documented. The use of alternative medicine and the vernacular languages is a barrier in the delivery of care in this population.
Conclusion:
It is important to acknowledge that while living conditions have had an impact on the health status and the quality of health care provided, health care is dispensed in a pluralistic setting, and the challenges that arise should be addressed accordingly. Creating for this population a health service that is sensitive to cultural differences, poverty, access and equity of care remains the greatest challenge.