The paper explores strategies to enhance the efficiency of Botswana’s health system as part of the country’s Health Care Financing Strategy. This comprehensive report assesses current inefficiencies in Botswana’s health financing, resource allocation, and service delivery, offering targeted reforms and recommendations. It covers system-wide efficiency improvements, including financial management, health workforce distribution, hospital and primary care management, and drug procurement. The document aims to support Botswana in aligning health financing policies with the goal of achieving universal health coverage (UHC) while maintaining financial sustainability, especially as donor funding for HIV and other programs declines.