An audit of licenced radiological equipment and personnel in Botswana

Abstract

Background: The United Nations encourages national audits of diagnostic imaging equipment and personnel. The World Health Organization (WHO) estimates that 20 X-ray and ultrasound units per million people will meet 90% of global imaging needs. This study assessed registered diagnostic imaging resources in Botswana, a high middle-income, sparsely populated African country. Methods: Details of registered diagnostic imaging equipment and personnel were extracted from the Botswana Radiation Protection Inspectorate and the Botswana Health Professions Council databases and stratified by imaging modality, professional category, and by geographical region and healthcare sector. Findings were presented as absolute numbers and resources per million people. Results: Botswana has 130 diagnostic imaging equipment units. General radiography (GR) (n = 79) 60%, mammography (n = 15; 12%), fluoroscopy (n = 13; 10%), computed tomography (n = 13; 10%), magnetic resonance (n = 6; 5%), digital subtraction angiography (n = 3; 2%) and radioisotope (n = 1; 0.7%). General radiography is the only modality where overall public sector resources (n = 44/79, 56%) exceed those of the private sector. Overall GR meet WHO guidelines, while it exceeded WHO guidelines (42–63 units/106 people) in most sparsely populated districts. There are 171 registered radiation workers; 88% (n = 152), radiographers, 9% (n = 15) radiologists and 2% (n = 4) medical physicists. Fifty three per cent of radiographers (n = 80) and 20% of radiologists (n = 3) work in the public sector. Conclusion: This study provides novel insights into the provision of radiological resources to sparsely populated rural communities. Contribution: The study demonstrates a comprehensive analysis of Radiological resources in an upper-middle-income country in Africa, highlighting important data for medium/long term planning towards achieving an equitable imaging access.

Keywords

• botswana
• high- middle-income country
• radiologic resources
• sparsely populated
• public health sector
• private healthcare sector