By Johannes Hangula
THE Namibian health system is at present not fully developed to be classified as efficient and offering quality health care for all, as only a minority of the population has access to decent quality private health care by means of medical insurance.
The majority has to make do with the public facilities, which are often stretched to capacity due to high demand and another hindrance to quality health care for many is physical access, as often facilities are far from where people reside especially in the rural areas, compounded by the vastness of this country. Given this scenario, the implementation committee set up by the Social Security Commission (SSC) is to develop policies and guidelines that would result in the majority of Namibians having access to quality care at affordable costs and on demand. Furthermore the SSC committee has been set up to also administrate the Commission’s projects such as the National Pension Fund (NPF), Universal Health Coverage Advisory Committee of Namibia (UHCAN) and maternal shelters. The Government in its effort to improve access to health services to all of its citizens has embarked on a universal health coverage (UHC) project. The implementation of the project commenced early 2014 with the establishment of the UHCAN. UHCAN is constituted by different stakeholders including relevant Government ministries, parastatals, private sector, and civil society, among other development partners. SSC has been spearheading the activities of UHCAN since 2014 as per the delegated mandate by the Ministry of Health and Social Services. The work plan activities include a review of the health insurance context in Namibia comparing with other countries with regard to UHC and the identification of countries for study tours to draw lessons for Namibia.
The goal of UHC is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them. This requires a strong, efficient, well-run health system; a system for financing health services: access to essential medicines and technologies and sufficient capacity of well trained, motivated health workers. Although Namibia has already had significant achievements on UHC in terms of public health service albeit of questionable quality, the greater challenge remains on how to improve the status quo. More than 200 000 working Namibians are contributing to privately-managed retirement arrangements and some 40 000 are drawing pensions from retirement funds. Assets of these funds totalled some N$84 billion at the end of 2012. Government, through the Government Institutions Pension Fund provided for public-sector employees; a very important participant in this market. One of the significant challenges for Namibia is that the retirement industry is focused on employees, which in practice means those working in the formal economy. Unemployment and labour in formalisation rates are difficult to measure but are undoubtedly high in Namibia. A very specific effort is required to meet the long-term needs of those working, or merely surviving, in the country’s informal economy.
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