People with disabilities (PWDs) are often subjected to economic and social exclusion. Despite the Government of Botswana's efforts to uplift marginalised and vulnerable groups, PWDs remain disenfranchised as a result of social, physical, and legislative barriers. This paper assesses policy and institutional factors that contribute to and or hinder the implementation of Botswana's national disability policy. Data were collected using secondary data sources and analysed using thematic analysis. The analysis of determinants of policy impact (ADEPT) approach, which aims to explain and influence policy development and policy impact implementation with four determinants (goals, obligations, resources, and opportunities), was adopted. The study's findings show that 22 years after its adoption, the National Policy on Care for People with Disabilities has not resulted in the desired policy outcomes, let alone achieved its objective of improving the lives of PWDs. Although the policy has the potential to be an important tool in achieving social inclusion and protecting the rights of PWDs, implementation gaps remain, essentially limiting its effectiveness.