The health ministry is faring well in ensuring that essential quality health services are available, but the unprofessional conduct by some healthcare professionals derails those efforts.

Health executive director Ben Nangombe expressed this concern while addressing the Universal Health Coverage (UHC) Policy Validation Meeting    yesterday.  “Whilst we have made good strides in improving the quality of our health services through investments in training health workers, procuring equipment and ensuring medicines are available, we are cognisant that significant gaps still exist,” he said. He expressed disappointment in the poor services that Namibians visiting public health facilities are at times subjected to.

“We need to look at issues individually, take into consideration the suffering of our fellow citizens, and act compassionately because the quality of services cannot be meaningful if it lacks the human touch, compassion and empathy,” stressed Nangombe.

He added that UHC concentrates disproportionately on issues of cost, but there is a need to equally focus on issues of humanity.

“This lack of compassion where our healthcare workers would rather be on their cell phones than attending to patients is disheartening,” Nangombe lashed out, adding that more complaints about the conduct of healthcare workers have been brought to his attention lately.

“I was notified of an elderly lady who required assistance from one of our healthcare facilities. She wanted to use an ablution facility, but our healthcare workers, instead of being helpful and attentive, refused to assist this old lady. How she was spoken to ignited tears in her eyes. The elder generation’s dignity which would accompany that private moment cannot be violated,” he recalled disappointed.

He said if in that moment of vulnerability health workers do not demonstrate the necessary level of compassion, then “we need to go back to the drawing board and address the issues of the conduct of healthcare workers, otherwise we are going to have a policy with beautiful provisions that is not going to have the required impact”.

Nangombe reminded health workers that they have taken oaths to take care of patients regardless of who they are, and that approach needs to be revisited as discrimination in any form is unacceptable.

Progress

He told the gathering about the progress government has made to help most people reasonably and easily access health services, as 76% of Namibians live within the World Health Organisation (WHO) - recommended 10km radius of a health facility.

“There is high service readiness at the facility level, with the overall health worker-to-population ratio consistently above 3.0 health workers per 1 000 people in most regions. This is above the WHO- recommended benchmark,” boasted Nangombe.

He said progress towards UHC will depend on good quality services which are people-centred, effective and safe.

To ensure affordable access to
healthcare for all, the Namibian government is committed to meeting the obligations under the Abuja Declaration for member states of the African Union to allocate at least 15% of their national budgets to health. 

For the 2023/24 financial year, the ministry’s budget is N$9.6 billion, the second-highest allocation after the education ministry.

The health ministry recently
submitted a cost plan to Cabinet for the mobilisation of additional funding for critical activities and interventions for health system strengthening over the period of the 2023/24 to 2027/28 financial years.  Amongst others, this plan includes the construction of new hospitals such as the Khomas District Hospital, and the upgrading of various other district hospitals. 

The proposal also includes recruiting an additional 6 000 healthcare workers to improve staffing and service delivery.

The plan is estimated to cost N$16 billion over five years.

Inequality

He then moved to Namibia’s ranking as the second-most unequal society in the world by the World Bank.

“This means that the considerationsof equity must be central to the development of the policy framework. We need to ensure that every Namibian or everyone in the country should have the same chance and opportunity to access healthcare services without having to face any form of discrimination, based on socio-economic considerations.”

Relief

On his part, senior medical superintendent at the Oshakati Intermediate Hospital, Dr Ruben Kanime told New Era thatthey turn to the Public Service Act and code of conduct to deal with any unprofessional conduct of staff members.

“Several factors contribute to this behaviour: different training backgrounds, supervision within our institutions - are they doing their work, and providing proper induction and orientation of members joining the facilities? We also have issues of the remuneration of public servants. That hasn’t been increased in a while, and that is a demoralising factor,” he stated.  Kanime too complained that several facilities are confronted with severe staff shortages.

“If you find a unit with a severe shortage of staff, they are overwhelmed, and they are not in a state of mind to listen to whatever you tell them. That hampers compliance, but as managers, we are charged with implementing government policies and guidelines. We are doing that while considering the feedback we are getting,” he shared. 

Kanime said as a healthcare worker, the realisation and full implementation of the UHC would mean relief “if it is supported with the necessary resources. Now, we are only working with the policy, and having a policy is not enough.”

Possible

A proponent of the equitable provision of quality healthcare for all Namibians is Popular Democratic Movement leader McHenry Venaani, who tabled a motion to that effect in parliament last year.

“It is possible and can be achieved - to ensure that all Namibians, irrespective of their income level, lead socially and economically productive lives. We cannot afford to have a situation where a poor mother from the informal settlements with a sickly son who is suffering from a tumour is turned away by a private hospital because of a lack of funds to pay for such an operation to keep her son alive,” he said at the time.

Venaani strongly reasoned that having universal healthcare coverage will foster equitable access to health services, while preventing people from being pushed into poverty when they must pay for such services.

The politician cited Rwanda, a country with a per capita income of merely US$644 (as opposed to Namibia’s US$4 328), as having achieved near-universal coverage within eight years by using a modified version of social health insurance.

-       psiririka@nepc.com.na