<p>Smallholder households across rural sub-Saharan Africa often rely on goats to support their livelihoods, food security, and financial security, and as a risk mitigation strategy. Across the region, goat health and performance outcomes vary greatly, and it is often difficult to quantify the impact of the animal health-nutrition nexus on livelihood outcomes. Two socio-economic surveys were conducted to this end in Botswana. Firstly, a general cross-sectional survey of 787 rural households to assess the correlation between food and/or financial security and livestock practices. Secondly, a more nuanced survey of a sub-group of 44 goat-owning smallholders to understand the systemic interlinkages between livelihood outcomes, veterinary care, and goat management. While the importance of livestock to rural communities was confirmed by a positive association with improved food, financial and asset security, household variation was explained more by herd size and self-reported importance of goat ownership to households, than to goat health condition. Four main barriers were identified which negatively influenced goat ownership and herd survivability patterns: (1) low turnover rates and poor access to capital investment; (2) Limited use of supplementary feeds; (3) Poor access to veterinary services; and (4) Age and gender. Strategies to improve the productivity and sustainability of goat enterprises within the region should focus on overcoming these barriers, with the potential in doing so to improve food and financial security, and equality outcomes.</p>