Namibia makes strides in health delivery over the past 30 years

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Sharon Kavhu

Windhoek - As Namibia celebrates its 30 years of independence from the South African apartheid regime, the country is also celebrating its strides in the health infrastructure.

Information compiled by the National Planning Commission shows that the country has improved the health sectors by constructing more health facilities, establishing health training institutions, and reducing maternal and infant mortality rates, among other achievements.

Since 1992, the government constructed 64 clinics nationwide, six health centres and four district hospitals. These were achieved in phases between 1992 and 2001, 35 clinics were built nationwide, 19 more between 2007 and 2013, and 10 were built between 2013 and 2018.

However, there has been no construction of intermediate or national referral hospitals since 1992. The country still has one referral hospital and three intermediate hospitals.

In the absence of more referral hospitals, the country has at least 1 150 outreach and various social welfare service points and the Ministry of Health and Social Services functions are decentralised to all the 14 regions.

The strengthening of the health infrastructure has improved access to health care of the people as to date 33. 1% households in Namibia travel less than one kilometre to the nearest hospital or clinic, while 32% travel between two and five kilometres. The report shows that people in urban areas have more access to health care facilities as compared to the ones in the rural areas.

“On the other hand, 13. 3% of the households travel between 11 to 40 kilometres to the nearest health facility, while 4. 6% are more than 40 kilometres away from health facilities,” said the report.

The doctor-patient ratio declined in 2019 compared to 1990 when the country attained its independence.  In 1990, the ratio was 1: 38 936 and in 2019 it declined to 1: 1 920. Although it is still considered still high, the health workforce in Namibia is three health workers per 1 000 population, which is above the WHO benchmark of 2. 5 health workers per 1 000 population.

However, the statistics show that there is unequal health force in the country as more health workers are in the urban areas as compared to the rural areas.

Since independence, one of the country’s significant achievements in the health sector is the training of doctors, pharmacists, dentists and other related professions which was in the past done outside Namibia which made the country rely on recruiting expatriate doctors from other countries like Cuba and Zimbabwe. The development was made possible by the establishment of the national medical schools. Registered nurses, social workers, doctors and radiographers are being trained locally at the University of Namibia (UNAM) and the International University of Management (IUM). Similarly, the Namibia University of Science and Technology (NUST) trains environmental health officers and medical laboratory technicians.

While efforts have been to train health personnel locally and the country and the doctor-patient ratio has declined; information shows that 26. 9% of positions in the public sector are vacant, with vacancies standing at 36% for doctors, 21% for registered nurses and 42% for workers.

Combating diseases, saving lives

The first case of HIV was detected in Namibia in 1986 before independence and the virus spread through heterosexual and mother-to-child transmission.

In the early stages, the prevalence rate was escalating, however, between 2004 and 2016, the government put in place measures, policy frameworks, advocacy, awareness, prevention and mitigation. As a result of these efforts, the HIV rate in Namibia decreased from 19. 7% in 2004 to 17. 2% in 2016. The decline is also attributed to the establishment of various institutional and policy frameworks by the government. These include the National Aids Control Programme which was established in order to coordinate the country’s efforts to deal with the epidemic.

In maternal and infant mortality, Namibia has reduced its infant mortality rate from 50% in 1990 to 29% by 2018 as reported by the world development indicators 2019.  The maternal mortality rate in Namibia accelerated between 1992 and 2007, when it reached its peak of 508 deaths per 100 000 live births. However, the rate gradually declined to 358 deaths per 100 000 live births by 2020. The country is targeting 200 deaths per 100 000 live births by 2022.

 

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