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Five years in Namibia’s public health engine room: Leadership, turnaround and accountability lessons

by reporter
September 24, 2026
in Opinions
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Smiling woman with short hair and round glasses seated in an office setting, resting her chin on her hand.

By Kapena Tjombonde

When I joined the Namibia Institute of Pathology (NIP) in February 2021, I returned to a principle that has shaped my professional life: leadership is ultimately measured by its impact on people.

During my tenure, that principle guided difficult decisions about laboratory capacity, institutional resilience and the speed at which patients could access results on which their care depended.

I began my career as a professional nurse after four years of studies at UNAM, a trade that taught me skills required in leadership i.e. teamwork (doctor, nurse, patient, family collaboration), listen (hear the whisper of the patient), remaining composed when circumstances are difficult (be objective to save a life), making decisions based on evidence (ascertain the symptoms of the patient) and, above all, to remember that behind every case, statistic or diagnosis is a human being whose life depend on one critical decision and getting things right.

Those lessons followed me through subsequent roles at the Legal Assistance Centre, the Attorney General’s Office, Namibia University of Science and Technology, the Motor Vehicle Assistance Fund, Business Intellectual Property Authority and, ultimately, the Namibia Institute of Pathology (NIP). Each institution gave me a different perspective of leadership, governance, service delivery and institutional resilience, preparing me for the demands of CEO at NIP.

In between my career progression, I continued to broaden my horizon, pursued an LLB, Master’s degree in Law & Business and other postgraduate qualifications, which strengthened my understanding of governance, risk, compliance, business strategy and the legal environment within which organisations operate. The disciplines may appear very different, but together they have shaped the leader in me.

At NIP, the experience I had accumulated over the years was tested in circumstances I had never anticipated. I took office at CEO, in February 2021, at the height of the COVID-19 pandemic, when NIP had no substantive executive leadership team and laboratories around the world were under immense pressure.

At the time, Namibia depended on international laboratory capacity for COVID-19 sequencing and some critical tests. For other tests, blood samples sometimes had to leave the country before results could return to clinicians, delaying decisions about a patient’s course of care.

I kept returning to one question: Why should a patient have to wait for another country to confirm what their own health system needed to deliver?

“In those early days, I carried the patient’s waiting with me into every meeting.”

During my tenure at NIP, we remained relentlessly focused on saving lives. We expanded and stabilized regional diagnostic capability, introduced new tests, decentralized more tests, improved sample transportation & logistics, and established genomic sequencing capacity.

Ageing infrastructure was renewed, supply chain & logistics overhauled, turnaround times improved substantially, ICT infrastructure & systems overhauled to ensure that clinicians receive results in the fastest possible time.

But the real measure of progress was not found in hard targets. It was whether patients across the country could access laboratory services wherever and whenever, whether a doctor could decide treatment with greater certainty, and whether the country was becoming less dependent on external capacity. We set the state and the work continues.

The public often sees the healthcare system through its hospitals, doctors and nurses. Yet behind most successful diagnosis is an intricate network of scientists, medical technologists, transport systems, quality controls and laboratories.

NIP is part of that critical infrastructure: although much of its work happens out of sight, its impact reaches virtually every part of the health system.

I worked with an exceptional team of professionals who understood the urgency of NIP’s service and its role in saving lives. Together, we enhanced institutional performance which resulted in testing turnaround-time improving from 59% to 93%.

This was a mammoth task that we managed to execute swiftly through phenomenal teamwork and effective strategy execution.

We strengthened leadership development, provided scholarships for targeted specialist training and introduced a graduate development programme to support 13 laboratories that had operated with one employee before my time.

Through collaboration with the University of Namibia, pathology and medical science specializations are also expected to be offered locally soon.

The COVID-19 pandemic exposed how vulnerable countries can become when essential supplies and expertise lie beyond their borders. That lesson informed the establishment of NIP’s Medical Innovation Hub in Swakopmund to build local medical manufacturing capacity. The hub represented an important step towards greater resilience while creating opportunities for

Namibian skills, employment, innovation and readiness. Its objective was straightforward: “Namibia must locally produce commodities and develop expertise required to sustain its own health system for a better tomorrow.”

I am proud of what we accomplished, though institutional leadership inevitably involves difficult decisions and public scrutiny.

Public institutions exist to serve the public interest, and their leaders must be ready to explain and account for the decisions they make. Accountability is not separate from leadership; it is part of the responsibility that comes with occupying a position of trust.

My years at NIP reinforced another lesson from nursing: you cannot treat what you are unwilling to diagnose. Institutions, like patients, require an honest assessment of what is working, what is not and what must change.

Sustainable improvement demands the courage to confront those realities and the discipline to act—particularly in a public health system on which more than 80% of Namibians rely for medical care.

NIP should not merely be viewed as another parastatal, but as a catalyst for Namibia’s national development and its contribution to the United Nations’ third Sustainable Development Goal: ensuring healthy lives and promoting well-being for all. In doing so, NIP demonstrates that public health is not only a service obligation, but a central pillar of sustainable development.

*Kapena Tjombonde is the former Chief Executive Officer of the Namibia Institute of Pathology and a transformationalist. She writes in her personal capacity

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