DOWNWARD SPIRAL: Namibia’s independence regime inherited good health infrastructure, but 30 years later, things are falling apart. PHOTO: FILE
DOWNWARD SPIRAL: Namibia’s independence regime inherited good health infrastructure, but 30 years later, things are falling apart. PHOTO: FILE

Namibia’s health system: 30 years later

Four hospitals built since independence
At the moment, Namibia has about 30 district hospitals, 43 health centres, 279 clinics, one national referral hospital – Windhoek Central - and three intermediate hospitals.
JEMIMA BEUKES
Namibia’s independence regime inherited good health infrastructure, however, 30 years later, it has turned into a tale of misery laced with devastating shortages of critical health equipment, staff and chronic medication.

Ministry of health executive director Ben Nangombe confirmed that only four hospitals have been constructed since the country gained independence.

At the moment, Namibia has about 30 district hospitals, 43 health centres, 279 clinics, one national referral hospital – Windhoek Central - and three intermediate hospitals.

“There have been several improvements to service delivery since 1990, including the provision of more clinics and hospitals and introduction of new services, such as cardiac services in referral hospitals and nuclear medicine capabilities in the north. The ministry has constructed 64 clinics, six health centres and four district hospitals since 1990. Government has, however, continued to upgrade and renovate the existing facilities in order for them to be responsive to the needs of the population.

“The maintenance of these facilities are, however, challenging, taking into account the lifespan,” health ministry spokesperson Walter Kamaya said.



Falling apart

Meanwhile, a report by the Parliamentary Standing Committee on Health found that hospitals around the country are dilapidated, with cracked walls, peeling paint and ceilings falling in, posing a grave danger to patients.

The report highlighted that some hospitals - such as at Onandjoke, which is one of the oldest in the country - are literally falling apart and are in need of urgent intervention. This while the Outapi hospital and Okalongo health centre are bursting at the seams with an influx of Angolan patients.

“Maternity wards at some hospitals, such as the Outapi district hospital, have admitted more patients than the bed capacity allows, thus at times, patients were accommodated on floors and in corridors. The construction of the maternity ward at Onandjoke Intermediate Hospital came to an abrupt standstill in 2016,” it noted.

Currently, the Onandjokwe hospital has five neonatal intensive care unit (ICU) beds, but is in urgent need of 20 additional neonatal ICU beds as the hospital is currently leading in the number of deliveries per annum countrywide.



Challenges

In a response to Namibian Sun, Kamaya said they are faced with the emerging and re-emerging disease outbreaks, including Covid-19, hepatitis E, malaria and measles, while sustaining the management of communicable disease such as HIV/AIDS, malaria, tuberculosis (TB) and leprosy.

The ageing infrastructure, introduction of new methods of treatment, increasing population and urbanisation and cross-border patients make up some of the challenges they face.

The country has, however, made strides in the fight against HIV/Aids, and is now on track to achieve the 95-95-95 treatment targets.

“It was estimated that 92% of those living with HIV know their status, 99% of those who know their status are on treatment and 93% of those on treatment are virally suppressed.”

Kamaya also highlighted that the TB disease prevalence survey of 2018 confirmed Namibia's position among the top TB burden countries. This burden has, however, been on a downward trend from approximately 1 000 per 100 000 in 2009 to around 450 in 2020, translating to a 52% reduction.

“The ministry aims to meet the requirements in the prevention, diagnosis and treatment of prevailing diseases through the use of high quality, safe and cost-effective pharmaceutical products. Namibia’s essential drug list has been implemented to satisfy the healthcare needs of the population. The procurement system in the public sector is carried out by the Central Medical Stores based on the tender system. The ministry has also commenced with pooled procurement in order to reduce costs.”

Furthermore, the ministry is haunted by a critical shortage of health staff and this has led to a skewed distribution of health workers between urban and rural areas.

“A majority of doctors work in the private sector, and distribution is inequitable across service settings when considered against the background of needs and workloads. A major recommendation was to innovate and find ways to ensure private health professionals offer part-time services in public healthcare facilities,” the report read.



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Katima Mulilo: 19° | 37° Rundu: 17° | 33° Eenhana: 18° | 33° Oshakati: 20° | 31° Ruacana: 19° | 33° Tsumeb: 17° | 29° Otjiwarongo: 16° | 28° Omaruru: 18° | 31° Windhoek: 17° | 28° Gobabis: 17° | 28° Henties Bay: 16° | 19° Wind speed: 24km/h, Wind direction: S, Low tide: 10:54, High tide: 04:57, Low Tide: 22:58, High tide: 17:16 Swakopmund: 15° | 17° Wind speed: 29km/h, Wind direction: SW, Low tide: 10:52, High tide: 04:55, Low Tide: 22:56, High tide: 17:14 Walvis Bay: 16° | 22° Wind speed: 33km/h, Wind direction: SW, Low tide: 10:52, High tide: 04:54, Low Tide: 22:56, High tide: 17:13 Rehoboth: 18° | 29° Mariental: 22° | 32° Keetmanshoop: 21° | 34° Aranos: 21° | 31° Lüderitz: 15° | 29° Ariamsvlei: 23° | 34° Oranjemund: 15° | 21° Luanda: 27° | 30° Gaborone: 20° | 32° Lubumbashi: 17° | 24° Mbabane: 15° | 23° Maseru: 12° | 28° Antananarivo: 16° | 27° Lilongwe: 17° | 29° Maputo: 20° | 28° Windhoek: 17° | 28° Cape Town: 17° | 23° Durban: 21° | 25° Johannesburg: 18° | 28° Dar es Salaam: 26° | 32° Lusaka: 18° | 30° Harare: 15° | 31° Currency: GBP to NAD 23.85 | EUR to NAD 20.41 | CNY to NAD 2.62 | USD to NAD 18.93 | DZD to NAD 0.14 | AOA to NAD 0.02 | BWP to NAD 1.33 | EGP to NAD 0.39 | KES to NAD 0.14 | NGN to NAD 0.01 | ZMW to NAD 0.74 | ZWL to NAD 0.04 | BRL to NAD 3.8 | RUB to NAD 0.2 | INR to NAD 0.23 | USD to DZD 134.32 | USD to AOA 832.63 | USD to BWP 13.71 | USD to EGP 47.35 | USD to KES 130.98 | USD to NGN 1415.13 | USD to ZAR 18.94 | USD to ZMW 25.01 | USD to ZWL 321 | Stock Exchange: JSE All Share Index 74536 Up +0.85% | Namibian Stock Exchange (NSX) Overall Index 1528.69 Up +0.84% | Casablanca Stock Exchange (CSE) MASI 12986.94 Up +0.04% | Egyptian Exchange (EGX) 30 Index 27559.35 Down -2.36% | Botswana Stock Exchange (BSE) DCI Same 0 | NSX: MTC 7.75 SAME | Anirep 8.99 SAME | Capricorn Investment group 17.34 SAME | FirstRand Namibia Ltd 49 DOWN 0.50% | Letshego Holdings (Namibia) Ltd 4.1 UP 2.50% | Namibia Asset Management Ltd 0.7 SAME | Namibia Breweries Ltd 31.49 UP 0.03% | Nictus Holdings - Nam 2.22 SAME | Oryx Properties Ltd 12.1 UP 1.70% | Paratus Namibia Holdings 11.99 SAME | SBN Holdings 8.45 SAME | Trustco Group Holdings Ltd 0.48 SAME | B2Gold Corporation 47.34 DOWN 1.50% | Local Index closed 677.62 UP 0.12% | Overall Index closed 1534.6 DOWN 0.05% | Osino Resources Corp 19.47 DOWN 2.41% | Commodities: Gold US$ 2 233.12/OZ UP +1.93% | Copper US$ 3.99/lb UP +0.12% | Zinc US$ 2 455.50/T UP 0% | Brent Crude Oil US$ 87.57/BBP UP +1.36% | Platinum US$ 908.62/OZ UP +1.53% Sport results: Weather: Katima Mulilo: 19° | 37° Rundu: 17° | 33° Eenhana: 18° | 33° Oshakati: 20° | 31° Ruacana: 19° | 33° Tsumeb: 17° | 29° Otjiwarongo: 16° | 28° Omaruru: 18° | 31° Windhoek: 17° | 28° Gobabis: 17° | 28° Henties Bay: 16° | 19° Wind speed: 24km/h, Wind direction: S, Low tide: 10:54, High tide: 04:57, Low Tide: 22:58, High tide: 17:16 Swakopmund: 15° | 17° Wind speed: 29km/h, Wind direction: SW, Low tide: 10:52, High tide: 04:55, Low Tide: 22:56, High tide: 17:14 Walvis Bay: 16° | 22° Wind speed: 33km/h, Wind direction: SW, Low tide: 10:52, High tide: 04:54, Low Tide: 22:56, High tide: 17:13 Rehoboth: 18° | 29° Mariental: 22° | 32° Keetmanshoop: 21° | 34° Aranos: 21° | 31° Lüderitz: 15° | 29° Ariamsvlei: 23° | 34° Oranjemund: 15° | 21° Luanda: 27° | 30° Gaborone: 20° | 32° Lubumbashi: 17° | 24° Mbabane: 15° | 23° Maseru: 12° | 28° Antananarivo: 16° | 27° Lilongwe: 17° | 29° Maputo: 20° | 28° Windhoek: 17° | 28° Cape Town: 17° | 23° Durban: 21° | 25° Johannesburg: 18° | 28° Dar es Salaam: 26° | 32° Lusaka: 18° | 30° Harare: 15° | 31° Economic Indicators: Currency: GBP to NAD 23.85 | EUR to NAD 20.41 | CNY to NAD 2.62 | USD to NAD 18.93 | DZD to NAD 0.14 | AOA to NAD 0.02 | BWP to NAD 1.33 | EGP to NAD 0.39 | KES to NAD 0.14 | NGN to NAD 0.01 | ZMW to NAD 0.74 | ZWL to NAD 0.04 | BRL to NAD 3.8 | RUB to NAD 0.2 | INR to NAD 0.23 | USD to DZD 134.32 | USD to AOA 832.63 | USD to BWP 13.71 | USD to EGP 47.35 | USD to KES 130.98 | USD to NGN 1415.13 | USD to ZAR 18.94 | USD to ZMW 25.01 | USD to ZWL 321 | Stock Exchange: JSE All Share Index 74536 Up +0.85% | Namibian Stock Exchange (NSX) Overall Index 1528.69 Up +0.84% | Casablanca Stock Exchange (CSE) MASI 12986.94 Up +0.04% | Egyptian Exchange (EGX) 30 Index 27559.35 Down -2.36% | Botswana Stock Exchange (BSE) DCI Same 0 | NSX: MTC 7.75 SAME | Anirep 8.99 SAME | Capricorn Investment group 17.34 SAME | FirstRand Namibia Ltd 49 DOWN 0.50% | Letshego Holdings (Namibia) Ltd 4.1 UP 2.50% | Namibia Asset Management Ltd 0.7 SAME | Namibia Breweries Ltd 31.49 UP 0.03% | Nictus Holdings - Nam 2.22 SAME | Oryx Properties Ltd 12.1 UP 1.70% | Paratus Namibia Holdings 11.99 SAME | SBN Holdings 8.45 SAME | Trustco Group Holdings Ltd 0.48 SAME | B2Gold Corporation 47.34 DOWN 1.50% | Local Index closed 677.62 UP 0.12% | Overall Index closed 1534.6 DOWN 0.05% | Osino Resources Corp 19.47 DOWN 2.41% | Commodities: Gold US$ 2 233.12/OZ UP +1.93% | Copper US$ 3.99/lb UP +0.12% | Zinc US$ 2 455.50/T UP 0% | Brent Crude Oil US$ 87.57/BBP UP +1.36% | Platinum US$ 908.62/OZ UP +1.53%