Transforming the Health System

Although Namibia is widely hailed for having good health service delivery with an increase in health facilities and treatment over the years, the increase and change in disease patterns since independence have brought about the question whether Namibia is a healthier nation 24 years after independence.

It is a question that the country’s first post-independence minister of health Dr Nickey Iyambo answers in the affirmative even though he is quick to add that the health and social services ministry is prone to criticism because of its status in society.

Nevertheless, much has been done to improve health service delivery and access to treatment compared to the pre-independence era. Many of the strides in the health sector came about because at independence Cabinet took a decision then to make health, along with education, agriculture and housing the priority areas for the country’s development.

“We had no choice but to improve our health system. I have no doubt that even the future government will have them as priorities and do more vigorous work to improve the conditions of those four chosen priority areas than perhaps what has been the case now,” said Iyambo.

However, immediately after independence new patterns emerged to besiege the health sector. “The disease pattern changed immediately after independence. When we got independence, records show that there were six people who were infected with HIV in the country. That was 1990, but today as we speak we have plus-minus 280 000 [infected people] throughout the country,” Iyambo said in an exclusive interview with New Era on the eve of the 24th independence anniversary last week. Tuberculosis also increased as the number of people infected with HIV increased.

Iyambo is a physician by training who obtained his medical doctor qualification in Finland, and was responsible for the health services at Kwanza Sul, a major Swapo settlement in Angola prior to independence. He served as Minister of Health and Social Services from 1990 until 1996. He is currently the Minister of Veteran Affairs.

The successes of the health system are however visible in the current figures that indicate a drop in a number of the trends that emerged at independence, and an elimination of diseases that were common then.

Bubonic plague which was endemic, particularly in the northern regions of the country, has been eliminated. Equally, polio is something of the past. Although the recorded malaria deaths were high at independence, the recorded deaths have reduced significantly.

“Today as we speak tuberculosis infections have tremendously gone down thanks to the rapid treatment people are getting today,” Iyambo said, adding that the country is now striving towards eliminating malaria.

He did note though that certain health problems that plagued the country at independence such as maternal health persist while chronic diseases such as diabetes, high blood pressure, tuberculosis, cancer and pulmonary diseases also increased after independence.

He noted that when patients are admitted in hospital they stay longer in the health facilities compared to when the country attained its independence. However, Iyambo argues that does not mean that Namibia is not a healthier nation now compared to independence.

“It would look like people were healthier before independence than now but it’s only to say that it’s the disease patterns that have changed and increased,” Iyambo said. As for the health infrastructure, Iyambo says the infrastructure has increased when compared to the pre-independence era.

“So in a way health service delivery has improved but the problems are still there and they will be there – let’s be realistic they will be there but we have improved because health service delivery is now more available than it was at independence,” argues Iyambo.

Source : New Era