Budget Vote 13 Motivation-Ministry of Health

8/9/2019 Budget Vote 13 Motivation-Ministry of Health

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REpUBLIC OF NAMIBIA

MOTIVATION FOR BUDGET VOTE 13:MINISTRY OF HEALTH AND SOCIAL SERVICES

FINANCIAL YEAR: 2010/2011

BYDR RICHARD NCHABI KAMWI, MP

06 MAY 2010


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Honourable Chairperson of the Whole House CommitteeHonourable Members

First of all I wish to thank the Hon. Minister of Finance, theformer and current Deputy Ministers and former Director Generalof the National Planning Commission, Prof Peter Katjavivi andtheir teams for the consideration made in the allocation of therequested funds to address pressing needs of the health sector.

Honourable Chairperson

We have just celebrated 20 years of independence whilecommemorating SWAPO Party's 50 years of Tested Leadershipfor Independence Struggle, Reconstruction and Development.

Whilst acknowledging the advances made since independence,the Health Sector continue to face numerous challenges related toemerging and re-emerging disease outbreaks. Amongst suchchallenges, the following deserve special highlights:

1. The measles outbreak in Kunene, Oshikoto and Kavangoregions during the last financial year uncovered many of the

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systemic issues that we have been battling with for the past 20years. At independence, our young nation inherited afragmented and skewed health system. Nevertheless, theoutbreak gave us a bold opportunity to re-think and build betterand robust systems that will address the challenges ofimmunization, nutrition, sanitation, and other healthdeterminants and risk factors of ill health.

2. The outbreaks of Influenza A, HINI 2009, the first pandemicof this century, Cholera, Measles and MeningococcalMeningitis in some regions and the floods affected servicedelivery in the northern areas of our country.

3. Maternal and child health continue to present senouschallenges in our journey to addressing the MillenniumDevelopment Goals 4 & 5.

4. HIV/AIDS, Tuberculosis and malaria remains serious threats tothe objective of health for all and pose incredible burden on ournational health system.

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Honourable ChairpersonHonourable Members

To address these and other challenges during the financial year2009/2010 an amount of two billion, four hundred and fourteenmillion five hundred and eighty seven thousand Namibiandollars (N$2,414,587,000) was allocated to the Ministry ofHealth and Social Services. This budget consists of theoperational budget amounting to a sum of two billion, eightymillion five hundred and eighty seven thousand Namibiandollars (N$2,080,587,000) and the development budget, of threehundred and thirty four million Namibian dollars(N$334,000,000) mainly for capital projects development.

Allow me to report some important milestones accomplishedduring the 2009/2010 financial year.

1. During 2009 the world experienced an outbreak of HINIInfluenza A. Namibia confirmed a total of 72 cases with onefatality. I am glad to report that a comprehensive response planwas put in place and the epidemic was contained until quiterecently as reported from Swakopmund and Walvis Bay where8 cases had been reported since 9th April, 2010.

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2. The Ministry developed and adopted its 5 year Strategic Plan:2009-2013 which was cascaded to all Regional, NationalDirectorates and to the Intermediate Hospitals. Theprogrammes and activities in the MTEF are aligned to thisstrategic agenda.

3. The operationalisation of the Cardiac Unit:Three (3) specialists have been recruited, while Namibiandoctors, nurses and radiologists were sent to Groote Schuurhospital, South Africa for attachment as part of on the jobtraining.

4. Establishment of the Medical School:Much progress was made in strengthening institutional capacityin collaboration with the University of Namibia when werecently established the Medical School for Namibia, whichenrolled its first intake of 59 medical students in February 2010.The Hon. Members may wish to know that of this number, 57medical students are Namibians of which 35 are females and 22males. One of the male students is from the formerlydisadvantage group, the San.

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5. Human Resources and Capacity Development:The Ministry of Health and Social Services has a total numberof nine thousan d four hun dred an d five (9 405) staff m em bers;of this number six thousand eight hundred and thirteen arefemales and two thousand five hundred and ninety-two aremales.

A total number of two hundred and seventy eight (278)health related students completed their training at theMinistry's Health Training Centers at the end of 2009. Thisnumber includes enrolled nurse midwifes, radiographyassistants and pharmacy assistants. A total number of 94 out of148 newly qualified registered nurses who graduated at theUniversity of Namibia were employed in the Ministry.

A total number of 15 Medical students completed their trainingand commenced with their internship at Windhoek CentralHospital. Meanwhile, a total number of 17 Namibian medicaldoctors are pursuing medical specialization trainingprogrammes outside Namibia.

6. Increased number of patients on ART:As of February 2010, the number of persons receiving ART inthe public sector stood at 86,539. Accessibility to services has

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also increased as the number of sites providing ART increasedfrom 34 hospitals to 62 health facilities inclusive of HealthCentres and Clinics.

7. HIV IAIDS Implementers Meeting:The Ministry hosted the 2009 HIV/AIDS Implementer'smeeting at which approximately 1500 health practitioners fromaround the globe participated. The meeting is a result ofNamibia being recognized internationally for the great stridesmade with regard to HIV/AIDS management. The meetingprovided a platform to share information that will directlyimpact HIV/AIDS program implementation. Hosting the eventhad positive spinoffs for the country as economic activitiesboosted the tourism and hospitality industry.

8. Campaign for Accelerated Reduction of Maternal Mortalityin Namibia (CARMA):The campaign was launched by the First Lady of the Republicof Namibia as the Patron. This campaign is aimed at creatingawareness in the communities on maternal and child health andforms part of the African Union efforts to reverse the trends.The African Union Commissioner for Social Affairs, AdvocateBience Gawanas graced the occasion. The campaign is

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supported by the UN and other partners. The slogan forCARMA is, "No woman should die while delivering".

9. Accessibility to health care services:Accessibility to health care services improved throughconstruction of new health facilities such as Anti - Retroviralclinics, Primary Health Care Clinics and Regional ManagementTeam offices.Furthermore, with the assistance of the Government of theRepublic of China a district hospital is being constructed atOmuthiya. The practical completion is expected to be inFebruary, 2011 thus increasing the number of district hospitalsto 35.

10. Collaboration with Cuba:Namibia and Cuba have excellent bilateral relations. As aresult, Cuba continued to provide health professionals to thehealth sector. In addition, Namibia and Cuba are entering intoother areas of cooperation including the purchase ofpharmaceutical items during this financial year.

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11. Tobacco Products Control Bill:In order to comply with the Framework Convention onTobacco Control, this August house unanimously and withoutfurther delay passed the Tobacco Products Control Bill andwhich also sailed through the National Council.

12. Amendments to the Hospitals and Health Facilities Act:The regulations on adjustment of tariffs and revision ofclassification of state hospitals under the Hospitals and HealthFacilities Act (No. 34 of 1994) have been revised and amendedwith effect from 1S \ April, 2010. The regulation makesprovision for among others the exemption of user fees at statefacilities for vulnerable groups including older persons,persons with disabilities, orphans and vulnerable children, warveterans and prison inmates.

13. Resource Mobilization:The Country Coordinating Mechanism submitted a proposalfor the Round Continuation Channel with the Global Fund. Iam pleased to report that the Global Fund approved theapplication with disaggregated allocation as follows:HIVIAIDS and health systems strengtheningN$1,694,424,496, TB N$14,215,808 and malariaN$138,911,344 for the next 6 years. It is important to note

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that these funds are outside the State Revenue Funds and thusare not included in the total Budget Ceiling. However, I wishto inform the Hon. Members that we were informed that theCCM is considering cutting the approved budget by 10 % fromeach disease area.


Inow have the honour and privilege to present before youVote 13 for 2010/2011 for your consideration and approval.

An amount of two billion, five hundred and ninety threemillion thirty nine thousand (N$ 2,593,039,000) has beenallocated to the Ministry of Health and Social Services. Thisbudget consists of the operational budget amounting to a sum oftwo billion, three hundred and four million ninety onethousand (N$2,304,091,000) and the development budget, of twohundred and eighty eight million nine hundred and forty eightthousand (N$ 288,948,000). The allocation translates to 10.82%of total estimated expenditure of Government for the financial year2010/2011. The significant increase by contrast to the last financialyear of 8.37 0 / 0 is a step in the right direction towards achieving the

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Ahuja Declaration target. The current allocation is from staterevenue funds and as I said earlier is not inclusive of resourcesfrom the Global Fund to fight HIV/AIDS, TB and malaria(GFATM), President's Emergency Fund for AIDS Relief(PEPFAR) and or any other development partners.


Let me address individual programmes.

Programme 1: Tertiary Health Care

This programme deals with the provision of specializedclinical and diagnostic services for patients referred from regionaland district hospitals. The activities include outpatient, inpatient,intensive care services and specialised services, bulk provision ofpharmaceuticals and other commodities, including blood products,and the patient referrals and transportation, human resourcedevelopment by strengthening the skills and knowledge of healthworkers through clinical training. In addition, it addresses theinfrastructure maintenance and capital development of referralhospitals as well as for specialized equipment.

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The cost for operational activities under this programmeamounts to eight hundred and fifty five m illion seventy fivethou sand Nam ib ian dolla rs (N$855,07 5,OOO).

The upgrading and renovation of the Katutura, Oshakati andRundu Intermediate hospitals, Windhoek Central, and theMaternity ward at Windhoek Central Hospital are allocated a sumof eighty four m illion six hundred and twenty two thousandNamib ian dolla rs (N$84 ,622 ,OOO) .

Iwish to thank the Hon. Minister for Finance for theadditional sum of N$ 16 million. The resources will therefore beallocated for the acquisition of computerized tomography (CTScan Machines) to enhance diagnostic capabilities for injuries.

In addition, we remain grateful for the consideration madefor additional allocation to the renovation and upgrading ofOshakati Intermediate Hospital. This hospital needs extensiveupgrading and these funds will make a significant difference.

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Programme 02: Regional and District Health Services


The regional and district health services programmeobjective is to promote, protect and improve the health of families,especially women and children. Activities includes outpatient andinpatient services, control of communicable and non -communicable diseases. health information systems and outreach- - ~ ~services.

Particular emphasis will however be placed on activities forthe reduction of maternal and child mortality; the provision ofART and PMTCT services, the strengthening of outreach mobileservices, the expanded programme on immunisation as well as onthe prevention of other communicable diseases (TB and malaria)and non - communicable diseases.

For this programme to be realised a sum of One billion,three hundred and ninety six million, four hundred and fortyeight thousand Namibian dollars (N$1,396,448,OOO) is allocatedfor the operational expenditure. 13


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For the upgrading, renovation and construction of clinics,health centres and district hospitals a sum of two hundred andtwo million three hundred and twenty six thousand Namibiandollars (N$202 ,326 ,OOO) is allocated.

The additional allocation for this programme amounting toN$103 million is for the acquisition and maintenance of medicalequipment for district hospitals, the allocation for the filling of keyprofessional vacancies and for the treatment of state patients withuncommon diseases. Furthermore, in keeping with the PartnershipAgreement in Health with the Anglican, Lutheran (ELCIN) andRoman Catholic Churches an allocation for the 1 2 0 / 0 salaryincrease for Mission Facilities has been provided for.

Programme 03: Disease Control

The programme objective is designed to manage and directpolicy development, strategic planning, resource mobilization, co-ordination, facilitation, monitoring and evaluation of the nationalresponse across all sectors to reduce the impact of HIV/AIDS, TBand Malaria. The activities for the programme include amongothers the policy and guideline formulation for HIV/AIDS, TB andMalaria and the technical backstopping of regional and district

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health services in the treatment and prevention of communicablediseases.

The funds required for the operational activities under thisprogramme is twenty seven million seven hundred and fortyseven thousand Namibian dollars (N$27,747,000).

Programme 04: Social Development


The programme has two main objectives namely to providebenefit and services that help people meet socio-economic needsand to provide support and social relief services to families andindividuals with special welfare needs particularly the vulnerableand those living with disability. Through these endeavours, thegovernment expands its service delivery to the most vulnerablegroups in society by ensuring appropriate, sustainable andaccountable community-based responses and interventions.

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financially. Last but not least, my appreciation goes to the bilateralpartners among others the Government of the Republic of Cuba,the G overnments of the Peop les R epublic of C hina and of S painfor their ongoing financial and technical support.


It remains a challenge to deliver quality health care given thescarcity of resources but efforts are being made to achieve ourgoals as stipulated in Vision 2030, NDP3, MDGs and the SWAPOParty Election Manifesto of 2009.

Honourable Chairperson,Iwish to thank His Excellency Cde. Hifikepunye Pohamba,

President of the Republic of Namibia for according me and mydeputy, Cde Petrina Haingura a second term to continue with ourprogrammes for improving the health service delivery in thecountry.

Ialso wish to thank my team, the Hon. Deputy Minister, thePermanent Secretary, and the entire staff at the Ministry of Healthand Social Services for their tireless efforts towards the realization

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in the provision of an integrated, affordable, accessible, qualityhealth and social welfare services that is responsive to the needs ofthe population.Inow have the honour and privilege to present before you a

sum of two billion, five hundred and ninety three million thirtynine thousand (N$ 2,593,039,000) for Vote 13 for yourconsideration.Io move.

Thank you.

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The funds for the operational activities under thisprogramme are twenty four million, eight hundred and twentyone thousand Namibian dollars (N$24,821,000).

The development budget for programme 04 activities hasbeen allocated an amount of two million Namibian dollars(N$ 2,000,000) for the upgrading of the rehabilitation centre.

The additional allocation for the programme amounting toN$ 4 million is for the National Disability Council, which has beenestablished in terms of the National Disability Council Act No. 26of2004.

Development Partners' contributionsOur development partners have committed an amount of

three hundred and fifteen million and five hundred and fivethousand Namibian dollars (N$313,505,000) towardsprogrammes in the health sector which are funded outside the StateRevenue Fund. The funds committed by the development partnersare targeted towards the prevention of communicable diseases inparticular HIV/AIDS, TB and malaria.

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Furthermore the funds are targeted towards development ofphysical infrastructure, human resource development,strengthening of health systems management mechanisms andfamily health services. These contributions will therefore continueto make a significant contribution to the development of the healthand social welfare sector.

In this regard I wish to acknowledge with thanks theimmense financial support from the US Government, through thePresidential Emergency Programme for AIDS Relief (PEPFAR).Funding from PEPFAR allowed us to put thousands of Namibianson ARV treatment, recruit more health personnel, renovate andbuild CDC clinics and other health facilities country-wide.

Similarly, we are also grateful to the substantial resourcesreceived from the Global Fund to fight AIDS, Tuberculosis andMalaria (GFATM). It goes without saying that financial resourcescan only be successfully employed if the right strategies andpeople are in place. I would therefore like to acknowledge theimmense support received from the United Nations partners, inparticular from the World Health Organization (WHO), the UNAgency in charge of health matters and acts as my technicaladvisor on public health related matters. I would also like to thankUNICEF and UNFPA for their ongoing support both morally and17

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Budget Vote 13 Motivation-Ministry of Health

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