Producing non-communicable diseases(NCD's) as health 'problems' in Botswana: A critical analysis of the NCD strategy (2018-2023)

Abstract

Non-communicable diseases (NCD's) have recently become a focus of attention for policymakers in Botswana. In line with the global community, the country has been intentional about dealing with the challenges posed by NCD's and the potential threat it poses to the population. Although the concern with NCD's is legitimate, it is relatively unknown how NCD's have been constructed as policy 'problems' in Botswana. More importantly, the genealogy of NCD's and the politics of their emergence has largely been outside the scope of mainstream policymaking. This paper draws from Carol Bacchi's 'What's the Problem Represented to Be' (WPR), a poststructural analytic approach to examine how the Botswana Multi-Sectoral Strategy for Prevention and Control of Non-Communicable Diseases (2018-2023) represents the NCD 'problem' in Botswana. The paper argues that the NCD strategy in Botswana is framed from a neoliberal approach that place emphasis on individual responsibility and neglect larger social forces. Furthermore, the paper highlights that the use of international 'experts' and consultants bring along international tropes of evidence that might undermine local knowledge systems. The NCD strategy essentially neglects the socio-cultural factors that shape NCD risk in Botswana. The paper provides a critical analysis of how the construction of NCD 'problems' might undermine the everyday experiences of the people of Botswana. Alternative conceptualisations of the NCD 'problem' identified by the WPR analysis is outlined in the conclusion of the paper.

Keywords: Botswana; NCD’s; WPR: problematisation; health policy.