Community Home-Based Care (CHBC) is a program that offers health services to support the terminally ill in the home (WHO, 1999). The program has come into force as a result of a high rate of HIV/AIDS infection in Least Developed Countries (Itano, 2003). Rapid increase in HIV/AIDS and other terminal illnesses has implications for the National Health Systems ability to cope with the provision of health care services for both the HIV/AIDS and other patients. This paper is an extended literature review and it identifies and discusses challenges facing CHBC programs in Botswana. The review gives attention to issues like poverty, inadequate medical facilities, poor infrastructure and socio-cultural factors which affect quality of services in the CHBC programs in Botswana. The findings indicate that poverty, high cost of community care, inadequate medical facilities, poor infrastructures and socio-cultural issues have threatened the sustainability of CHBC programs in Botswana. The recommendations and the options given can provide basis for further research aimed at getting solutions to CHBC challenges.