Namibia aims to improve the accessibility and quality of its healthcare system. Namibia is an upper-middle-income country located in southern Africa. Unfortunately, as it became an upper-middle-income country, Namibia’s healthcare fell behind. The country must overcome obstacles to continue improving its healthcare system. These obstacles include a shortage of doctors, inadequate funding and income inequality. The country also faces HIV/AIDS and tuberculosis crises. Despite its economic progress, Namibia has the sixth highest HIV prevalence rate in the world. This article covers this nation’s efforts to ensure its citizens have access to quality healthcare.

Healthcare Structure

Namibia gained independence in 1990. In its early years, the government declared healthcare a human right and made systemic changes to its healthcare system. The Ministry of Health and Social Services (MoHSS) formed. The MoHSS is responsible for implementing policy and delivering primary healthcare to Namibians.

Namibia has one of the lowest population densities in the world with about three people per square kilometer. According to The World Bank, 48.9% of Namibians live in rural communities. Therefore, providing access to healthcare is a significant challenge.

Namibia’s healthcare system consists of four distinct components: intermediate and referral hospitals, clinics, health centers and district hospitals. Each component has a unique role and specialized medical staff. For example, nurses staff clinics who provide basic care. People receive referrals to a health center or a district hospital for more serious cases. The most serious cases obtain treatment at intermediate and referral hospitals. Namibia houses “1150 outreach points, 309 health centers [and] 34 district hospitals.”

Namibia’s bed-to-population ratio is equivalent to that of higher-income countries including New Zeland and Norway. However, because of Namibia’s low population density, about 21% of Namibians live more than 10 km away from a health provider. The MoHSS partners with private organizations like USAID SHOPS to provide mobile health clinics. Mobile health clinics help reach rural communities in Namibia. They provide a range of services including immunizations, health education and HIV tests. Both the private and public sectors fund the mobile health network.

Funding Healthcare

In 2014, Namibia spent $200 million to prevent and treat HIV cases. Unfortunately, despite the work of the MoHSS, the leading cause of death is from non-communal diseases like HIV/AIDS and tuberculosis. In 2019, approximately 210,000 adults and children were living with HIV in Namibia; about 11.5% of these adults and children are between 14 and 49. Thankfully, Namibia is not alone in fighting against the virus; organizations including the U.S. Center for Disease Control and Prevention help with technical assistance and workforce recruiting.

The Namibian government aims to spend 15% of its GDP on healthcare. However, Namibia only spent about 8.6% of GDP on healthcare in 2017. Funding from donors has been declining since Namibia’s reclassification in 2009. The decrease is because of Namibia’s reclassification as an upper-middle-income country. In 2008, donors made up 22% of the country’s healthcare funding. In 2017, donors funded 7% of Namibia’s healthcare expenditure.

A variety of other sources fund Namibia’s healthcare system: 19% from the private sector, 11% from households and 63% from the government. Namibia needs additional funding to improve its healthcare system, especially as its GDP growth slows. Additionally, healthcare costs will increase as the country’s population ages.

Healthcare Workforce

Another of Namibia’s largest healthcare problems is the lack of public doctors. There are more private doctors than public doctors in many regions of the country. In Hardap, 80% of the doctors work in the private sector. A shortage of public doctors increases the cost of healthcare. According to The World Bank, there are approximately 1,222 doctors; 784 doctors work in the public sector and 438 work in the private sector. Half of Namibia’s physicians work in Khomas, the region containing Namibia’s capital. In 2018, there were approximately 0.33 doctors for every 1,000 people.

Namibia is working to address the shortage of public doctors; the Namibian government is supporting medical students’ education, hoping doctors and nurses will enter the public sector. In 2019, Namibia sponsored about half of its medical students.

Many issues persist within the Namibian healthcare system. Fortunately, groups like the Namibian government and the U.S. Center for Disease Control and Prevention have dedicated themselves to improving healthcare in Namibia. Hopefully, by making investments like supporting medical students’ education, Namibia will improve its healthcare system.

– Joshua Meribole
Photo: Unsplash