Find Health and Medical expertise in Namibia

Namibia has a large, dispersed and complex health system made up of around 1,150 outreach points, 265 clinics, 44 health centres, 30 district hospitals, three intermediate hospitals and a national referral hospital – Windhoek Central Hospital – as well as some social welfare service points. The public health sector has a three-tier structure with central, regional and district levels.

The public and private not‐for‐profit health care system serves 85% of the population. Private health care serves the richest 15% of the population.

While there is some local pharmaceutical manufacturing, this is mostly small scale and the majority of the country’s pharmaceutical requirements are imported. The Namibia Medicines Regulatory Council is a statutory body established by the Medicines and Related Substances Control Act 2003 to regulate the use of medicines in Namibia.

Geographical accessibility barriers

The sheer size of the country versus the sparseness of the population causes geographical accessibility barriers to health care. A 2010 WHO exit survey from a range of health facilities found that 13% of patients had travelled more than 21 km to receive treatment. Another major barrier is cost, with fees chargeable for most health services. Some social groups are exempt from payment, including those receiving certain preventive services, and for vulnerable groups, such as children under 5 and pregnant women. However, government policy is not to turn away patients who cannot afford to pay, with a waiver mechanism in place for this purpose.

The San face particular problems accessing health care as they live in remote areas and frequently go into the bush on long hunting expeditions. In addition, few health staff speak their language.

There is an insurance scheme providing health insurance for public sector employees, while private insurance companies provide health insurance policies for private sector employees.

The Ministry of Health and Social Services, with support from development and implementing partners, has initiated Namibia’s National Strategy and Action Plan for the Elimination of New Paediatric HIV Infections and Keeping Their Mothers Alive 2012/13–2015/16. The plan, developed through a series of consultations with internal and external stakeholders, aspires to eliminate mother-to-child transmission of HIV in Namibia.

The WHO’s strategic agenda for Namibia’s second Country Co-operation Strategy cites strengthening the health system as one of its priorities, with a focus on financing, human resource development, vaccines and service delivery.

Health is a priority area of support from donors, accounting for 79% of all donor payments to Namibia. A large proportion of this goes towards treatment and prevention of AIDS.

Communicable diseases together with maternal, perinatal and nutritional conditions accounted for an estimated 47% of all mortality in 2012. The prevalence of HIV in Namibia, amont people aged 15–49 years, was 16% in 2014. HIV prevalence has fallen slightly since 2002. There were 194 reported cases of malaria in 2012. There has been a significant overall reduction in confirmed cases of malaria and deaths from the disease in the period 2006–12. There has also been a notable overall decline in estimated incidence of and estimated mortality (when mortality data excludes cases comorbid with HIV) from tuberculosis (TB) in the period 2003–12, although both figures are presently higher than they were in 1990. Non-communicable diseases (NCDs) accounted for an estimated 43% of all mortality in 2012. The most prevalent non-communicable diseases (NCDs) in Namibia are cardiovascular diseases, which accounted for 21% of total deaths across all age groups in 2012. Cancer, non-communicable variants of respiratory diseases and diabetes contributed, 5%, 4% and 4% to total mortality, respectively (2012).

Government expenditure

In 2013 government expenditure on health was 4.7% of GDP. In the most recent survey, conducted between 1997 and 2010, there were 37 medical doctors, and 278 nurses and midwives per 100,000 people. Additionally, in the most recent year for which data was available in the period 2007–12, 81% of births were attended by qualified health staff and, in 2013, 82% of one-year-olds were immunised with a dose of measles. In 2014, 90% of the Namibian population had access to improved water sources and 34% had access to adequate sanitation facilities. In the most recent survey, conducted in the period 2000–11, Namibia had 18 pharmaceutical personnel per 100,000 people.

Almost two-fifths of health care in Namibia (38%) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 8.3% of GDP in 2012, of which 62% was covered by the government.

Namibia was not an original signatory to the International Covenant on Economic, Social and Cultural Rights, but acceded to it in 1994 and has written the covenant into law. It includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination.