WINDHOEK – Despite making significant strides in the health sector, Millennium Development Goal (MDG) 4, which is targeted at reducing child mortality is one of the goals that Namibia will not achieve as the agenda concludes this year.
The other MDGs are MDG1 for eradicating hunger and extreme poverty, MDG2 for achieving universal primary education, MDG3 for promoting gender equality, MDG5 for improving maternal health, MDG6 for combating HIV/AIDS, malaria and other diseases, MDG7 for ensuring environmental sustainability and MDG8 for developing global partnership for development.
Namibia enjoys admiration from the international community in its political will to positively contribute towards the health sector. As a matter of fact, the Ministry of Health has over the years enjoyed a great share of the budget pie, often in second or third place.
Not only that but Namibia has made progress in reducing child mortality and stunting rates, according to the 2013 Demographic Health Survey results.
The fact that most MDGs are unlikely to be met, including goal four, is reflective of deep-seated structural issues, including the legacy of apartheid and human resource capacity constraints, says Fillemon Nangonya, the spokesperson of the National Planning Commission (NPC).
United Nations Children’s Fund (UNICEF) country representative, Micaela Marques de Sousa also notes that Namibia would not be able to meet the MDG4 target. She points out that diarrhoea and respiratory infections are two of the leading causes of child mortality.
Marques de Sousa says progress on a number of fronts, which include the elimination of maternal and neonatal tetanus as well as the significant reduction in malaria cases and deaths, have resulted in an increase in child survival.
In addition, over 88 percent of mothers now deliver at health facilities, she notes. “Progress would have perhaps been even faster if it were not for the impact of HIV,” Marques de Sousa points out.
Even though HIV/AIDS remains a problem in Namibia, the response has been “impressive”, she says.
“The chance of transmission of the virus from HIV-positive mothers to their children has reduced from 33 percent to currently less than 4 percent due to enormous expansion of antiretroviral treatment for those who are HIV positive,” say the UNICEF representative.
Furthermore, she points out that many children in Namibia die from preventable diseases. Many children are suffering from illnesses caused by poor nutrition, lack of access to sanitation and limited access to health care services, she states. Malnutrition remains a problem in children. In order to address this problem, Marques de Sousa notes that the country needs to complement its investment in health by simultaneously addressing the direct and indirect cause of malnutrition.
This, she says, will break the cycle of malnutrition. One sector alone cannot address the malnutrition problem in Namibia, she adds.
Marques de Sousa is also quick to point out that all relevant sectors such as agriculture, education, water, sanitation, education, social and child policy, among others, have to work together in order to achieve the country’s targets to reduce malnutrition.
“Agriculture can make a difference by focusing on production and promotion of nutrient-rich foods and by supporting small-scale household and community farming initiatives that improve food security,” says Marques de Sousa.
Similarly, water, sanitation and hygiene promotion have a huge role to play in reducing stunting. This is based on evidence that there is a link between open defecation as a direct cause of stunting, she adds.
“With an open defecation rate as a high as 52 percent in Namibia, this is one area that exposes children to diseases and is making a significant contribution to stunting among children under 5. The elimination of open defecation could, therefore, contribute to a significant reduction in stunting,” says Marques de Sousa.
The other MDGs
The 2013 Africa MDG Report indicates that Namibia is on course towards meeting most of the MDGs.
Free primary school enrolment, improved gender parity, stabilisation of the HIV prevalence rate, decreased incidences of HIV, the extensive roll-out of antiretroviral therapy and the prevention of mother-to-child transmission of HIV, near elimination of malaria, improved management of the environment and reversal of biodiversity loses and expanded global partnerships are some of the achievements the country has recorded, Nangonya notes.
While it is equally true to say the progress attained thus far is a result of national efforts and commitment, it cannot be denied that the articulation of these goals at global level had enormously contributed towards approaching development with more urgency and fortitude, he notes.
“In Namibia, the MDGs agenda greatly influenced the manner in which we planned and implemented development initiatives over the past years,” Nangonya adds. One example is the development of the Road Map for Accelerating the Reduction of Maternal and Neonatal Morbidity and Mortality, which specifically had 2015 in mind.
“Some MDGs were used to set priorities and to enhance the accountability of ministries and development partners,” says Nangonya.
As the MDGs agenda period comes to an end, negotiations for a post-2015 Development Agenda, underpinned by principles adopted globally at the 2012 Rio+20 Conference on sustainable development, are underway.
The 22nd Ordinary Session of the Assembly of the African Union held in Addis Ababa, Ethiopia, in January 2014 adopted, as the single negotiating instrument for the African region, the Common African Position on the Post-2015 Development Agenda, with six broad priority areas.
The Assembly further mandated the High Level Committee (comprising 10 African member states of which Namibia alongside South Africa represents the southern African sub-region), supported by the African Union Commission in collaboration with member states, to commence engaging in the negotiation process with the rest of the world and build regional and inter-continental alliances on the priority areas under the CAP and ensure that they are fully integrated into the post-2015 development agenda, including intergovernmental deliberations related to the work of the Open Working Group on Sustainable Development Goals, the Intergovernmental Committee of Experts on Sustainable Development Financing and the final Global Post 2015 Development Agenda.
In Namibia, this process started with a consultative review and planning exercise, at all levels of government, on the achievements and shortcomings of the MDGs, says Nangonya.
Asked what Namibia could do differently to address some of its challenges, Nangonya says: “There is little that Namibia can do at the moment other than making the unfinished social challenges of the MDGs an integral part of the national planning frameworks.”
He adds that Namibia is at a fortunate position since “most of the unfinished MDGs are absorbed in the post-2015 agenda, although it is still in negotiations process.”