Namibia’s journey to achieving Universal Health Coverage (UHC) is at a tipping point. Although the country has taken major strides in policy development for UHC, its implementation of this framework remains incomplete.
This delay is not just bureaucratic—it has dire consequences. Comprehensive health coverage is needed urgently as almost half of Namibia’s population experiences food insecurity and malnutrition rates increase.
The dire state of hunger and malnutrition
A drought report by the Office of the Prime Minister indicates that 1.4 million people in Namibia will be faced with food insecurity between July and September this year. The World Food Programme (WFP) data shows that over 40 percent of Namibians have insufficient nutritional intake, meaning more than one million people are undernourished.
These grave circumstances are further compounded by high levels of stunting, wasting and underweight children; with almost 2000 reported cases of malnutrition this year alone, coupled with one of the greatest HIV prevalence rates within southern Africa.
In the 2023 Global Hunger Index, Namibia was ranked 78th out of 125 countries. However, it has become a great concern that increases in food prices have greatly affected the buying power of Namibians, making it worse for a country which is already grappling with food insecurity, and further triggered by escalating global fuel prices that are affecting both food and non-food items.
The link between UHC and malnutrition
Universal Health Coverage (UHC), aims at making sure that all individuals have access to quality health services without going through financial hardships. These include health promotion, prevention, treatment, rehabilitation, and palliative care. The Sustainable Development Goals, which include Goal 3: “Ensure healthy lives and promote well-being,” explicitly includes a target to achieve UHC by 2030. However, the path to achieving UHC in Namibia is challenging because the population is sparsely distributed, with healthcare concentrated in urban areas.
According to the Minister of Health and Social Services, Kalumbi Shangula, Namibia has been actively developing a policy framework with extensive stakeholder involvement since 2018. A series of workshops have been conducted to prioritise health services for inclusion in the Essential Health Services Package (EHSP), which will define the services available to Namibians at various levels of care, with a focus on meeting the needs of vulnerable populations.
Health equity means the elimination of social barriers that prevent people from enjoying good health up to their full potential. The food insecurity in Namibia reveals how wide these gaps can be, and the 1835 reported cases of malnutrition have serious health implications on children and vulnerable groups who happen to bear the maximum brunt of lack of access to essential health services.
To bolster its Universal Health Coverage (UHC) policy, Namibia must develop a dynamic healthcare system where all stakeholders, institutions, and resources collaborate efficiently and adapt swiftly to improve healthcare services. This necessitates having enough healthcare professionals, strong health data monitoring systems, proper infrastructure, and effective management of medical supplies.
Government efforts and challenges
To address immediate needs arising out of the current food shortage situation in the country, the government of Namibia has come up with a N$1.3 billion drought-intervention program. It involves food aid, support to animals, seed and horticulture distribution, water supply and health and nutrition interventions. However, these measures require additional N$482m in order to be fully implemented.
Though these instant actions are necessary, long term resilience against droughts and food insecurities calls for sustainable strategies. These include water governance tactics, agriculture diversification and more importantly; a strong primary health care system (PHC). In fact PHC is the most effective method of attaining UHC as it makes healthcare service available, affordable and addresses the needs.
Next step: It’s time we acted
The Namibian government’s dedication towards improving the lives of its people is reflected by its allocation of N$10 891 017 000 towards the health sector, which constitutes roughly 11% of the National Budget for the 2024/2025 Financial Year; almost meeting the 15% Abuja declaration target. Despite this, poor health outcomes persist compared to other upper-middle income countries with high under-five mortality rates as well as maternal mortality ratios.
If robustly implemented, a UHC framework can respond urgently to the emergent health challenges resulting from hunger & malnutrition while cultivating long-term health resilience. However, Namibia has not yet implemented UHC completely; meaning it cannot enjoy some of these improved health outcomes
Conclusion: A call to urgency
Namibia has serious food shortages, which expose the need for holistic health insurance. As the country strives to implement its UHC framework, it must prioritise the health needs of its most vulnerable populations. Investing in primary health care and ensuring that essential health services are accessible to all Namibians are critical steps in this journey.
It is therefore upon the policy makers and implementers to bridge the gap between policy and practise for Namibia’s future health. The cost of waiting is very high. By hastening the implementation of UHC, Namibia can not only address the immediate health implications of hunger and malnutrition but also build a healthier, more resilient future for all its citizens.
*Michael Petrus is a final year Bachelor of Medicine and Surgery student at The University of Namibia with an interest in global health and a goal to actively contribute to the establishment of resilient and adaptable healthcare systems. Connect on michaelpetrus77@gmail.com or LinkedIn: https://www.linkedin.com/in/michael-petrus-06966a1b9/
