Dr. Richard Kamwi
ONE of the biggest challenges the Ministry of Health and Social Services (MoHSS) faced at independence was to unify the fragmented health care and social welfare system it inherited from the previous regime.
Apart from begin fragmented, the preindependence approach to health care was curative rather than preventative. Another reality Namibia was and is still faced with, is the huge number of people the state has to provide medical care for.
Only 14,7 per cent of the Namibian population can afford the luxury of a medical aid fund. That includes the public servants and their families who are members of PSEMAS. This means that 85,3 per cent of the population relies on the state for health care. The following figures further demonstrate this skewness: In 2008 the four open and five closed medical aid funds paid out claims of more than N$1,57 billion.
If Psemas’ N$725 million is added to this, private health care providers in Namibia raked in almost N$1,9 billion last year.
The Ministry of Health and Social Services received N$2,1 billion during the 2008/2009 budget year from the state coffers. That is why the new government adopted the primary health care approach which is based on the principles of equity, affordibility, involvement of communities and the participation of other sectors in the provision of services.
New structures were created shortly after independence including new directorates that enabled the MoHSS to harmonise services and to pay special attention to disadvantaged regions and difficult to reach communities. All these changes were first embodied in the Policy Satement of 1990 and then subsequently in the Policy Framework of 1998.
The overall obejectives of the MoHSS is to improve and maintain the physical and mental health status of all Namibians and to improve and maintain the social well-being, self-reliance and coping capabilities of individuals, families and communities.
Although the Minister of Health and Social Services, Dr Richard Kamwi, recently acknowledged that Namibia’s contributions to the health-related Millennium Development Goals (MDGs) are still “fragmented” and yielding “mixed results”, he is confidant that the country’s public health sector can reach its target to become the leading public provider of quality health and social welfare services in Africa.
The Ministry made great efforts to construct, upgrade and renovate health facilities since independence. Although Namibia’s vastness is a challenge, about 80 per cent of the population lives within 10 kilometres of public health facilites.
In 1990 there were 246 hospitals, health centres and clinics in the country. In 2008 the figure stood at 544. The number of doctors grew from 324 in 1990 to 850 in 2008 and nurses from 4 471 to 7 881.
Namibia today also prides itself on a state-of-the art cardiac unit at the Windhoek State Hospital.
Last year, three specialists were recruited for this unit, while Namibian doctors, nurses and radiologists have been sent to Groote Schuur hospital in South Africa for training.
The University of Namibia (Unam) has already enrolled its first intake of students at the new medical school.
Another remarkable achievement is the number of patients receiving antiretroviral treatment. This figure has grown to 64 637, which is far above target. The number of sites in the country providing this treatment has also increased to 64. Where the HIV/AIDS prevelance rate stood at 22,0 per cent in 2002, it came down to 17,8 per cent in 2008.
This is clear evidence that Namibia’s intensified efforts to prevent and manage this pandemic are yielding positive results.
And, says Kamwi, Namibia is recognised worldwide for its strides in the battle against HIV/AIDS. Namibia has recently been invited to the 17th Conference on Retroviruses and Opportunistic Infections in San Francisco where Kamwi, as the only health minister from Africa, was a participant on a panel with the PEPFAR Global Coordinator, Ambassador Eric Goosby. Last year, the Tobacco Bill was endorsed by the National Assembly, and will be ready for National Council before the end of the first quarter in all likelihood.
While the public health sector is “doing very well”, there remain worrisome areas, says Kamwi. The outbreak of pandemic influenza A (H1N1), cholera, measles and meningococcal meningitis and flooding in northern Namibia put a strain on health care delivery. A continual concern for Namibia is the high maternal mortality and infant and childhood health.
And although malaria related mortality was significantly reduced over the past few years, the Ministry cannot afford to rest on its laurels with this disease as HIV/ AIDS and tuberculosis still cause many deaths annually. Although a lot has been achieved, the MoHSS remains cognisant of the challenges that lie ahead.
