General country health policies
Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities. They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).
The following policies must be in place:
- Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
- Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
- Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.
This section on General country health policies is structured as follows:
Overview of major policy reforms The Namibia health and social services sector since independence was guided by the Policy Statement of 1990 and the 1998 Policy Framework. The National Health Policy Framework 2010-2020 was developed to keep pace with changes in the health sector and is aligned to the National Development Plan 3, the Ministry of Health and Social Services Strategic Plan 2009–2013, and the Millennium Development Goals. (MoHSS, July 2010)
The main reform initiatives that have taken place since independence include the restructuring and re-orientation of the health sector in line with the Primary Health Care (PHC) approach; the shift in orientation of social services from curative and remedial social work to a developmental approach with emphasis on prevention of social ills and empowerment of individuals, groups, and communities; the performance improvement of the civil service through the establishment of the Wages and Salaries Commission (WASCOM) and the introduction of the Public Service Charter; the broadening of health financing options through the introduction of user-fees policy at all facilities; and the introduction of the principle of managed competition in the area of buying-in support services. (MoHSS, 2008)
Public health policies
- Community Based Health Care 2007 (draft)
- Mental Health Policy 2005/06
- National Blood Policy (2007)
- National Malaria Policy (1995)
- Integrated Health Care Delivery: The Challenge of Implementation. A Situation Analysis and Practical *Implementation Guide (Otjiwarongo Document) (undated)
- Family Planning Policy (1995)
- National Policy and Strategy for Malaria Control (1995)
- Infant and Young Child Feeding (2003)
- National Tuberculosis Control Programme (NTCP) Policy Document (undated)
- National Policy for Reproductive Health (2001)
Health system policies
- The Patient Charter of Namibia (1998)
- Transport Policy, MOHSS (2000)
- Research Management Policy (2003)
- Fellowship Management Policy
- National Drug Policy for Namibia (undated)
- National Health Policy Framework (2010)
- Waste Management Policy (2010)
- Policies in other sectors and intersectoral policies
- Namibia OVC Policy (undated)
- Food and Nutrition Policy for Namibia (1995)
Priorities and ways forward Among the policies that need to be updated is the Public Health Act (as the country is currently using that of 1919) to provide guidance for sanitation and hygiene, amongst others. Policies which need to be amended include the policy and guidelines on working hours of clinics. Policies which need to be developed include a clear national policy and strategy for health promotion and for behaviour change communication. (MoHSS, 2008)