Last week, the Namibian Ministry of Health and Social Services launched the 2018-2022 National Strategic Plan and held the inaugural National Health Assembly. The National Health Assembly is a forum to discuss health issues and challenges in the country, including the development of the UHC framework which is presently underway. National Health Assemblies have been utilised as inclusive and participatory platforms to discuss health issues and possible solutions in South Africa and Thailand; participation of all health stakeholders (government, academic, civil society, the people) has been a central tenet. A meaningfully inclusive health platform of this nature has significant potential in Namibia.
During the launch of the NSP, the Ministry of Health emphasised a number of NSP priorities including: ensuring good governance; review of existing legislation and developing new legal frameworks to better address health; improving access to essential medicines and technologies; and enhancing human capital development and utilisation.
While Namibia is an upper-middle income country, high levels of inequity persist post-apartheid—Namibia remains one of the most unequal countries in the world with a low Human Development Index ranking, at 125 of 188 countries. While life expectancy was 61 for men and 66 for women in 2016, the NSP aims for an overall average of 67.5 by 2022.
The Ministry of Health and WHO emphasised that implementation of the NSP and UHC frameworks were means to address Namibia’s significant health challenges, including health inequity. One indicator of health equality included disparity in health system; 18% of the population enjoys 36% of the public expenditure on health whilst approximately 80% benefit from 64% of health expenditure. Increasing investment in quality primary health services for all was cited as a goverment priority.
The Minister also highlighted significant capacity gaps, including the inadequate number of health specialists, inadequate funding of the health system (less than 10% of budget is allocated to health), and weak communication at all levels of the Ministry. In 2014, there was a significant shortage of health professionals, especially specialists with .9 physicians per 1,000, 1 psychiatrist per 100,000, and 14 surgeons per 100,000.
Like other upper-middle income countries in Southern Africa, Namibia faces high prevalence rates of both communicable and non-communicable diseases. While there has been significant progress in addressing communicable diseases, Namibia still has very high prevalence rates of TB (489 per 100,000), HIV (374 per 100,000), and malaria.[1] Indeed, WHO considers TB prevalence rates of 250 per 100,000 population to be epidemic, while Namibia’s rates are significantly higher. Meanwhile, non-communicable diseases account for 43% of mortality in Namibia with cardiovascular disease accounting for 21% of deaths.
While the UHC framework aims to ensure that no one is left behind due to poor health in line with the Sustainable Development Goals, a concerted focus and accompanying action to address inequity in health and beyond will be essential to achieving this goal, as well as specific SDG 3 and NSP targets concerning health service coverage and reductions in morbidity and mortality from maternal mortality, communicable diseases and non-communicable diseases.
*Learn more about our initiative on Health Equity Plans of Action (previously NHES)*
[1] Namibian National Strategic Plan (2018-2022), Baseline Data, at 10.
