Health in Namibia

The health status of Namibia has increased steadily since the 1950s, and the government does have focus on health in the country and seek to make health service upgrades, fx. by introducing Universal Health Coverage in the years to come [1] As a guidance to achieve this goal, The Institute for Health Metrics and Evaluation (IHME) and World Health Organization (WHO) recently published the report "Namibia: State of the Nation's Health: Findings from the Global Burden of Disease.[2]

The report backs the fact that Namibia has made steadily progress in the last decades when it comes to general health and communicable diseases, but despite this progress, HIV/AIDS still is one of the big reasons for health loss in the country. This article will take a closer look at different indicators showing the health trends of Namibia, and also comparing these health trends to the world average 2016.

Namibia Is a Upper Middle Income country. The country has a dual system of public (serving 85% of the population) and private (15%) health care providers. In the financial year 2013/2014 Government and private health expenditure combined accounted for 8.9% of the country's Gross Domestic Product.[3] Compared to the world average of 9,9 % of GDP in 2014. [4]

Medical infrastructure

Namibia has 343 hospitals and clinics, as well as 1,150 smaller service points.[3] Health care facilities in the country are sophisticated but not always affordable to the poorer part of the population. Certain services like dialysis and organ transplantations are only available from private medical centres, putting them out of reach for the majority of Namibia's citizens. The situation got wide coverage in 2010 when Jackson Kaujeua, Namibian singer and liberation hero, died from renal failure[5] after not being able to afford private medical care, and thus not being put on dialysis.[6]

The capital Windhoek has cardiac theaters at two different hospitals, the Windhoek Central State Hospital and the Roman Catholic Hospital. Both units were opened in 2010 and 2011, respectively, and have been used to perform open-heart surgery, partly with the assistance of foreign personnel.[7]

Medical personnel

In 2004, the country had 598 physicians - 0.3 per 1,000 inhabitants, and 6,145 midwives and nurses - 3 per 1,000 inhabitants. This number is significantly larger than in the rest of Africa[8] and slightly exceeds the minimum density recommended by the World Health Organisation. The total numbers do not reflect that the private health care facilities are luxuriously staffed while there is a shortage in the public sector.[3]

Health status

Namibia conducted a third Demographic and Health Survey in 2013 (NDHS) which can be used for national and international comparison health wise. It is done every 5 years map the generel health status. As for now, the country has one of the most skewed distributions of income pr. capita in the world which is the result of years of colonisation and war in the past, which gave an unbalanced development throughout the country. [9] The results provide insights into the overall health status of Namibians and is disaggregated to a regional level. Below is a barchart comparing Namibia to the world in basic health indicators. As shown, Namibia compared to world average is nearly similar coming up 2016, except for Life expectancy where Namibia is still lacking behind with 64,7 compared to world average of 71,7.

Health indicators Bar chart

Life expectancy

Life expectancy (LEY) has increased from 40,3 years in 1950 to 64,2 years in 2015, which means Namibia as a country has improved, but is still far behind some of the countries in the world with longest LEY of 83,3.[10]

Under 5 infant mortality

Under 5 infant mortality (U5IM) rate has decreased in Namibia from 280/1000 live births in 1950 to 46,7/1000 live births in 2015 and ranks number 52 in the world.[11] Namibia does have a low level of U5IM compared to other sub-Saharan countries as the regional level was 84/1000 live births in 2015. However it is still too high according to the Sustainable Development Goals (SDG 3) made by the United Nations (UN), which declares that the global amount of U5IM should not exceed 25/1000 births by 2030.[12]

Fertility Rate

In 1950 Namibia had a fertility rate of 5,96 children pr. woman. In 2015 the number has decreased to 2,95 children pr. woman. Putting together LEY, U5IM and Fertility (previous chapters) shows how well Namibia as a country is doing by itself since 1950 but also globally. Namibia seems to be better of than most other Sub Saharan countries, when looking at this data, but still needs to improve to meet the SDGs made for 2030.[12]

Specific illnesses

Albinism

There are approximately 1,800 people living with Albinism. They need to make specific lifestyle adaptations because of the extreme weather conditions with about 300 days of sunshine annually. Children are regularly teased at school, and despite outreach activities some parents hide their affected children from society.[13]

Due to high prevalence of alcohol abuse, 8% of adult Namibians suffer from related illnesses. Alcohol consumption is increasing particularly in the north of the country (the four regions of Ohangwena, Omusati, Oshana, and Oshikoto).[14]

Cancer

Due to exposure to sunshine and prevalence of albinism, the most widespread cancer in Namibia is skin cancer, with 581 cases reported in 2010 and 417 cases in 2011. The second most prevalent cancer is Kaposi's sarcoma, a disease related to HIV/AIDS, with 251 reported cases in 2011.[15]

Cholera

There are occasional Cholera outbreaks in the north of the country, particularly in the Kunene Region.[16]

HIV/AIDS

Just over a decade ago, in 2003, Namibia were one of the countries in the world with the highest HIV burden. 15.000 new cases of HIV each year, and 10.000 yearly deaths due to AIDS – and more than 30 % of babies born to HIV-positive mothers were infected. The Namibian government began a cooperation with PEPFAR (U.S. President's Emergency Plan for AIDS Relief) which have shown significant improvements on the HIV/AIDS areas. UNAIDS chose Namibia as destination for the Worlds AIDS Day report in 2016, which was the first national AIDS conference in Namibia. In the last decade, the Namibian government has taken leadership and shown commitment in the national fight against HIV/AIDS, which is probably why Namibia stands to be one of the few countries in Sub Saharan Africa having a realistic chance of achieving the UNAIDS targets for HIV epidemic control by 2020.[17] In 2016, more than 70% of Namibians have been tested for HIV and know their status HIV treatment is widely available across the country, and 67% of adults and 90% of children are on HIV treatment. As there is quite an inequality throughout the Namibian population, it's important to mention that for the HIV treatment, the Namibian government funds 65% of the national HIV response. Pepfar has supplied the Namibian government with different types of AID; such as economic aid to comber HIV, providing Mobile ART clinics, and by hiring more health care personnel to urban and rural areas with a high amount of HIV incidents throughout Namibia.[18]

Leprosy

There is a small group of approximately 60 leprosy sufferers in the Kavango and Caprivi Region, most of them concentrated at Mashare, east of Rundu. Until the early 1980s this settlement contained a leprosarium of considerable size for thousands of patients from South-West Africa and its neighbours Angola and Botswana.[19]

Malaria

The malaria problem seems to be compounded by the AIDS epidemic. Research has shown that in Namibia the risk of contracting malaria is 14.5% greater if a person is also infected with HIV. The risk of death from malaria is also raised by approximately 50% with a concurrent HIV infection.[20]

Tuberculosis

Namibia has a high rate of tuberculosis sufferers with approximately 0.7 cases reported per 1,000 inhabitants. Of particular concern are multi and extensively drug-resistant bacteria strains.[3]

About a third of all children are stunted, which impacts on their overall development and health.[21]

References

  1. ↑ "GBD data informs progress toward universal health coverage in Namibia | Institute for Health Metrics and Evaluation". www.healthdata.org. Retrieved 2017-09-08.
  2. ↑ "Namibia: State of the Nation's Health | Institute for Health Metrics and Evaluation". www.healthdata.org. Retrieved 2017-09-08.
  3. 1 2 3 4 "Country Health System Fact Sheet". World Health Organisation. 2010.
  4. ↑ "Health expenditure, total (% of GDP) | Data". data.worldbank.org. Retrieved 2017-09-08.
  5. ↑ Ekongo, John (2010-05-31). "Hamba kahle, Jackson Kaujeua". New Era. Archived from the original on 2011-07-16.
  6. ↑ Isaacs, Denver (16 February 2010). "False rumours about Kaujeua". The Namibian.
  7. ↑ Smith, Jana-Mari (5 April 2011). "RC Hospital makes history". The Namibian. Archived from the original on 27 May 2012.
  8. ↑ "Country Health System Fact Sheet". World Health Organisation. 2006.
  9. ↑ "Namibia Demographic and Health Survey 2013" (PDF). Government of Namibia. 2014. Retrieved 27 August 2017.
  10. ↑ "Life expectancy, years: Namibia". gapminder.org. Retrieved 27 August 2017.
  11. ↑ "The State of the World's Children 2016". UNICEF. Retrieved 27 August 2017.
  12. 1 2 "Progress on Goal 3 in 2017". United Nations. 2017. Retrieved 27 August 2017.
  13. ↑ "Eva Ndatipo comfortable in her own skin". New Era. 30 October 2015.
  14. ↑ Xoagub, Francis (4 August 2011). "Alcohol abuse up". New Era. Archived from the original on 9 May 2012.
  15. ↑ Kapitako, Alvine (7 February 2013). "Skin cancer rife in Namibia". New Era. Archived from the original on 13 April 2013.
  16. ↑ Tjihenuna, Theresia (10 January 2014). "Cholera death toll rises to eight". The Namibian.
  17. ↑ "Know your response | UNAIDS". www.unaids.org. Retrieved 2017-09-08.
  18. ↑ "National AIDS Conference in Swakopmund | U.S. Embassy in Namibia". U.S. Embassy in Namibia. 2016-11-28. Retrieved 2017-09-08.
  19. ↑ Smith, Jana-Mari (1 April 2011). "Leprosy: the reality in Namibia". The Namibian. Archived from the original on 27 May 2012. Retrieved 1 April 2011.
  20. ↑ Korenromp, E.L., Williams, B.G., de Vlas, S.J., Gouws, E., Gilks, C.F., Ghys, P.D., Nahlen, B.L. (2005). Malaria Attributable to the HIV-1 Epidemic, Sub-Saharan Africa. Emerging Infectious Diseases, 11, 9, 1410–1419.
  21. ↑ Tjihenuna, Theresia (2 April 2014). "More than 1 million Namibians defecate in open". The Namibian.
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