One of the aims of the third National Development Plan (NDP 3) is to turn Namibia into a health- and food-secured and breastfeeding nation. New Era reports.
By Catherine Sasman
To better the quality of life for all Namibians, the Namibian Government’s National Development Plan 3 (NDP 3) aims at putting tight controls on all preventable, infectious and parasitic diseases, and in so doing, raise the quality of life of Namibians.
This would mean greater access to quality education, health and other services.
It further translates into a situation where poverty and inequalities are minimised, where all are living healthy lives, and are provided with safe drinking water and served with a comprehensive preventative and curative health service.
The Government has committed itself to achieve health for all Namibians, making healthcare facilities accessible, affordable and equitable.
This has meant a reorientation of the health sector towards preventative care and an increasing decentralised approach to the implementation of health services.
The HIV/AIDS pandemic, and other diseases like tuberculosis, pneumonia, gastro-enteritis and malaria have wreaked havoc in the country.
Namibia is regarded as the country with the second highest rate of TB cases after Swaziland. People between the ages of 24 and 34 are most affected by this disease. It is reported that tuberculosis – often as a result of HIV/AIDS infection – has risen from 652 for every 100 000 people in 2001 to 678 the following year.
An estimated nine percent of TB patients die before completing the long-term treatment required to deal with the disease.
Among children, the most prevalent diseases are diarrhoea and gastro-enteritis, as well as acute respiratory infections among children younger than five years.
Malaria is also reported to be the leading disease that leads to death among children of less than five, where 67 percent of the population lives in malaria endemic areas.
Malaria has caused an average caseload of 400 000 outpatients, 30 000 inpatients, and 1 000 deaths nationwide.
Pneumonia has been responsible for the death of 11% of patients at health facilities around the country.
HIV/AIDS has become the leading cause for deaths reported in the country since 1990. The 2006 sentinel survey among pregnant women showed a 19.9 percent prevalence of this disease, which is a grave cause of concern.
An aggravating factor is that most HIV/AIDS related deaths are among the productive adult population, which is viewed to have a direct influence on the impoverishment of many.
During 2003/04, an estimated 28 percent of all households lived in relative poverty, and four percent in extreme poverty.
The Government indicated that while the country may be food-secured at national level, the situation is different at household level, where many rural households fall prey to chronic or acute food insecurity due to low agricultural production, droughts, low incomes and limited off-farm employment opportunities.
The urban poor are equally hard hit, and food insecurity is evident among under-nourished children under five. A whopping 29 percent of these children are reported to be “stunted” due to chronic malnutrition.
Hence, says the Ministry of Health and Social Services, breastfeeding is vitally important to make a difference in the infant nutritional status.
However, during the NDP 2 period, a decrease in malaria morbidity has been reported, and the TB treatment success rate has improved from 58 percent in 1996 to 69 percent in 2001.
Equally, it has been reported that more people have access to safe drinking water, with 100 percent in urban areas, and 80 percent of rural dwellers in 2003.
Improved sanitation has also been recorded: from 15 percent in 1992 to 21 percent in 2003. However, the rural/urban discrepancy on this count is glaring: one in five rural households have access to safe sanitary facilities, as opposed to 85 percent in urban areas.
Immunisation has also improved dramatically; most notably, was the health ministry’s military-precision styled polio vaccination campaign of last year.
Government’s anti-retroviral treatment campaign has also been rolled out to 36 hospitals, targeted at those people living with HIV/AIDS eligible for the programme.
In 2005/06, an estimated 58 775 people in the public and private sectors received ARV treatment, and it is projected that 140 399 people will receive treatment by 2012.
During NDP 2, the health sector was negatively affected particularly as a result of the demands on the overall system due to HIV/AIDS and other communicable diseases.
A well-known fact is that Namibia is regarded as the most skewed in terms of income levels, with a gini-coefficient of 0.06. A marginal improvement has been registered on this count.
Further, the 2003/04 Namibia Household Income and Expenditure Survey showed that 38 percent of the population spend more than 60 percent of their income on food; in 1993/94, 28 percent of the population spent 60 percent of their total expenditure on food.
Extreme poverty (where people spend more than 80 percent of their income on food) has been reduced from nine percent in 1993/94 to 4 percent in 2003/04.
And in 2003, a third of the population was identified as being in need of humanitarian food assistance.
The main cause of poverty in the country is ascribed to the low economic growth rate, high levels of income disparities, gender inequality, the devastating effects of HIV/AIDS and other diseases, lack of access to quality education and environmental destruction.
To alleviate grinding poverty, some of the NDP 3 goals aim at strengthening and diversifying the agricultural base through improved agricultural production measures, and thereby ensure food security.
Of great importance is for rural communities to be able to broaden their income base by participating in non-farming activities.
Any strategy for rural development, the Namibian Government states, should be two-pronged, with the involvement of policy makers and service providers. Moreover, the Government says, rural development should be very focused on each region’s peculiarities. A common thread that runs through the various approaches to be adopted is the role of rural women and their empowerment.
Also of importance is the building of a strong SME sector, and the improvement of Namibia’s safety nets for the protection of temporarily and chronically vulnerable people, including those with HIV/AIDS.
One of the most vulnerable food-insecure groups are the San, who have through successive battles for land and regimes, become desperately marginal.
The 1993/94 household survey indicated that 75 percent of the San lived in poverty. Some improvement was registered ten years later, where it was recorded that 63 percent of the San lived in poverty, but states the Government, the San remain the most poor of all language groups.
Since Deputy Minister Libertina Amadhila took on the fight to improve the situation of the San, some development initiatives have been introduced. These initiatives focus, among others, on securing land rights and traditional ways of living for the San, to make basic services available, to create income generating opportunities and skills training, and to aggressively address social problems that beset the San community.
Access to Safe
To improve the overall quality of life, the Namibian Government has recognised the importance of access to safe drinking water – meaning water treated and supplied from a pipe, a borehole or closed tank – as a prerequisite.
During NDP2, a Water Resource Management Bill (2005) was promulgated, with water quality guidelines and standards completed.
During the five-year period of NDP 2, the institutes responsible for the provision of water targeted rural areas and the provision of water to those who do not yet have access.
The result was an increase in access from 79.9 percent in 2001 to 90.9 percent in 2006 for rural communities through the establishment of 1 407water points.
In urban areas, 98.4 percent of the population has access to safe drinking water.
Of concern, however, is that there is no water quality-monitoring network. NamWater, local authorities and mines do test their own water, but a need was identified for the Ministry of Agricultural, Water and Forestry to be the regulator and facilitate such a monitoring process.
NDP 3 aims to increase the percentage of rural dwellers to access clean water by five percent. It further envisages an increase in water purification treatment, and an increase in the percentage of compliance with set water quality standards of water samples at the distribution systems.