Although research assessing the role of self-efficacy in health behaviors in sub-Saharan Africa remains limited, recent research in Botswana suggests that travel time, frequency of visits, and sexual violence influence women's health-seeking. This study used cross-sectional data from 479 women collected in 2012 in Botswana to test the psychometric properties of the Generalized Self-Efficacy Scale (GSE) in Setswana, the local language, as a measure of self-efficacy. Findings confirm the GSE's validity as a unidimensional measure of self-efficacy in this population. Regression analyses suggest that each additional point increase on the Setswana GSE reduces by one third the odds that a woman would forego a clinic visit. Frequency of clinic visits and experiences of sexual violence were also significant predictors. Interventions that enhance self-efficacy may contribute to Botswana's health promotion efforts but will be limited if they fail to address sexual violence and how it is viewed in this setting.