THE MINISTRY OF HEALTH IS RESPONSIBLE FOR THE PROVISION OF PUBLIC HEALTH CARE WHICH IS BASED ON THE PRINCIPLE OF PRIMARY HEALTH CARE. IT IS ALSO RESPONSIBLE FOR THE REGULATION OF HEALTH-CARE SERVICES AND PROFESSIONS AND MEDICAL AND HEALTH-CARE PRACTITIONERS ARE REQUIRED TO REGISTER WITH STATUTORY BODIES TO ENSURE PROFESSIONAL CONDUCT AND SERVICE. NAMIBIA ALSO HAS A VIBRANT PRIVATE HEALTH-CARE SECTOR.
The health sector has been one of the government’s top priorities since independence and continues to be one of the sectors that receive the largest slice of the annual budget. The Ministry of Health and Social Services was allocated N$8,1 billion for the 2021/2022 financial year, representing 13,6% of total non- interest expenditure. The budget allocation will be used for the continued provision of health services in the country, as well as to support the government’s response to Covid-19. This includes the vaccination roll-out plan and acquisition of pharmaceuticals.
SHRINKING HEALTH DEVELOPMENT BUDGET
Concern has been expressed about the development budget for health which has declined for four consecutive years – from N$485 million in the 2015/2016 financial year to N$187 million in the 2019/2020 financial year. As a result there has been no progress with several capital projects, including the construction of a district hospital at Ondangwa and the national health public laboratory at Okahandja. On the positive side, development budget expenditure for 2020/2021 was projected to increase to N$238 million, N$361 million in 2021/2022 and N$524 million in 2022/2023.
PUBLIC HEALTH SECTOR
Close to 80% of the population is reliant on the public health system which requires Namibian patients to pay nominal fees, while certain categories of patients are treated free of charge. Foreigners making use of public health facilities pay considerably higher fees. Public health care facilities are provided at 27 hospitals, 37 health centres and some 290 clinics and mobile clinics countrywide.
Several general public health and social services priorities were identified in the ministry’s National Health Policy Framework which ended in 2020, among them:
• sexually transmitted diseases (STIs)
• maternal, neonatal and child health
• adolescent health and school health
• endemic diseases
PRIVATE HEALTH-CARE SECTOR
Healthcareofaninternationalstandardinvarious fields,includingspecialisedfieldsisprovidedby the private health-care sector for patients who are members of medical aid schemes.
In the absence of a national health insurance fund, less than 20% of the country’s population is covered by medical aid schemes. Private medical aid funds are regulated in terms of the Medical Aid Funds Act of 1995 and are required to register with the Namibia Financial Institutions Supervisory Authority (NAMFISA).
The nine private medical-aid societies registered with the Namibia Financial Institutions Supervisory Authority had close to 202 000 beneficiaries in 2019. Hospitalisation, treatments and medicine accounted for 63% of health care expenditure.
The Public Service Medical Aid Scheme (PSEMAS) provides cover to government employees and their dependants. Various measures have been implemented by the Finance Ministry to reform the scheme, which has been plagued by fraud, abuse, waste, mismanagement and false claims by some practitioners which has cost the government up to N$900 million a year. An audit conducted during the 2019/2020 financial year found that there were nearly 37 000 ‘ghost’ beneficiaries registered on the PSEMAS system, but who were not on the public service payroll system and were deregistered. It was also found that over 32 000 members were not contributing to the scheme but were enjoying full benefits.
NAMIBIA’S COVID-19 RESPONSE
Namibia reported the country’s first two confirmed Covid-19 cases on 13 March 2020 and a state of emergency came into effect for six months on 18 March. The government adopted five levels of restrictions to manage the pandemic – ranging from a full lockdown (Stage 1) to more moderate and gradually relaxed precautions under Stages 2, 3 and 4. Stage 5 envisages a ‘new normal’ with minimal or no restrictions.
After reaching a peak of new infections at the end of December 2020, the number of new infections decreased until around mid-May when there was a steep increase and surpassed the 1 000 mark on 11 June 2020. By mid-June 2021, the total number of confirmed cases stood at 64 205, while just over a thousand deaths were reported.
The government aims to have 20% of the population vaccinated. The vaccination campaign was rolled out on 19 March 2021, but has been hampered by a delay in the delivery of vaccines and a reluctance of people in some of the country’s regions to be vaccinated. By mid-June, close to 15 000 people had been fully vaccinated, while nearly 88 000 people had received their first vaccination.
Catholic AIDS Action
P O Box 159, Windhoek
Tel: +264 61 276 350
Drug Action Group
P O Box 20490, Windhoek
Tel: +264 61 226 706
P O Box 11822, Klein Windhoek
Cell: +264 81 322 6834
Health Industry Forum Namibia
Tel: +264 61 375 090
Cell: +264 81 124 6401
*For medical associations, contact HIFN
ICRC – International Committee of the Red Cross
P O Box 3970 Harare, Zimbabwe
Tel: +263 470 2440
MAN – Medical Association of Namibia
P O Box 3369, Windhoek
Tel: +264 61 22 4455
*For medical associations, contact MAN
NAMAF – Namibia Association of Medical Aid Funds
P O Box 11974,Windhoek
Tel: +264 61 25 7211
Namibia Network of Aids Services Organisations
P O Box 23281, Windhoek
Tel: +264 61 261 122
Namibia Institute of Pathology (NIP)
P O Box 277, Windhoek
Tel: + 264 61 295 4000
Namibia Red Cross Society
P O Box 346, Windhoek
Tel: +264 61 413 7501
WHO – World Health Organisation
P O Box 3444, Windhoek
Tel: +264 61 25 5121