Social Determinants of Maternal and Newborn Health: Engaging Communities in Botswana for Better Outcomes

Social determinants of health are social, economic, and political factors that influence health outcomes, including the circumstances in which people are born, live, grow, and work. Because of their profound effect on people’s lives, it is very critical to understand them in order to influence change to reduce the negative impact. This chapter presents an analysis of the contextual social determinants of maternal and newborn health in Botswana. Specifically, we focused on the most relevant social determinants to Botswana such as geographic location, transport, security, access to health, age at marriage, gender inequity, health worker attitude, and reliance on community networks. Approach: A scoping review of literature on determinants of health for mothers and their newborn babies was conducted and contextualized to Botswana to identify gaps and suggest strategies to improve health outcomes for the target population. The review explored assessment of the problem in past and current scientific and gray literature and unpublished reports and other documents internationally, nationally, and regionally. Personal experiences with women in maternal and child health and community practice also contributed to the discussion. Findings: Geographic location, transport, security, access to health, age at marriage, gender inequity, maternal education and health literacy, health worker attitude, and reliance on community and societal networks are important social determinants of maternal and newborn health. Conclusion: Community factors are prominent and are often attributable women’s education and health illiteracy. Recommendations were made at each point during the discussion of each of the determinants affecting maternal and newborn outcomes in Botswana.