Aching for development
As government struggles on its fiscal consolidation path, health infrastructure remains on shaky ground.
Jo-Maré Duddy – For every dollar government spends in 2021/22, only half a cent will go towards the development of health infrastructure in Namibia.
Total government expenditure for 2021/22 is estimated at about N$67.95 billion, of which around N$360.5 million has been set aside for the ministry of health and social services in the development budget. That is 0.53% of government’s total budget for the current fiscal year.
Development has been the casualty of government’s fiscal consolidation strategy it started embarking on in 2016 to try and ensure macroeconomic stability. The chunk allocated to the development budget as a whole and the health sector in particular has been shrinking as a result.
DWINDLING
In 2015/16, about 15.4% of total government expenditure was allocated to the development budget. This dropped to 10.6% in 2016/17. From 2017/18 to 2019/20, the development budget on average made up 8.5% of total expenditure.
In 2020/21, an estimated 9% of the total budget was spent on development. This year, the projected figure is 8.2%, followed by an estimated 10.4% in 2022/23 and 9.9% in 2023/24.
In 2015/16, about 0.75% of total expenditure was allocated to the development of health infrastructure. Health’s share reached a low of 0.28% in 2019/20.
Finance minister Iipumbu Shiimi’s latest budget - tabled in March under the theme, “Boosting Resilience and Recovery” – shows 0.68% of total expenditure will be geared towards the development of the public health sector over the medium-term framework (MTEF) from 2021/22 to 2023/24.
NO MONEY
A national public health laboratory (NPHL) for Namibia has been on the budget cards since 2013.
The NPHL will be a centralised laboratory in Okahandja that coordinates all public health tests including disease surveillance, outbreak detection, response and integration of laboratory data among other specialised reference testing, according to budget documents.
The development budget for 2021/22 states: “Currently Namibia does not have a national public health laboratory that safeguards the country from outbreak detection and threats and other events of public health importance.”
Yet, despite the Covid-19 pandemic which has already claimed the lives of more than 570 people in Namibia, government allocated no money for this project in 2020/21 or 2021/22.
Only N$1.3 million was spent on the NPHL project up to 2019/20. The current development budget shows government intends to spend N$5 million on the project both in 2022/23 and 2023/24. The funds will be for the “documentation on the construction” of the project.
‘KAPENA OSHIMALIWA’
According to the latest development budget, government also doesn’t have money for seven hospital projects this year, some of them dating back to 2007.
The construction of a district hospital in Ondangwa, to provide relief to the overwhelmed Oshakati Intermediate Hospital, has been part of the development budget since 2014. Not a single cent has been spent on the project so far though.
The project has once again been put on the back burner in 2021/22.
When the minister of health and social services, Kalumbi Shangula, was asked about it in parliament last week, he referred to the small development budget allocations in the past three years, saying the money was mainly spent on constructing new and upgrading clinics, upgrading health centres and various components of hospitals.
“Since 2016 the ministry has been in consultation with the finance ministry on financing the projects. Investments from the private sector into the health sector is challenging with regards to return on investment,” Nampa quoted Shangula as saying. Shangula said the ministry will continue to engage the finance ministry to find a funding model for the social sector for the projects to be realised.
LIFELESS
The upgrading and renovation of the Lüderitz hospital too has been on the budget books since 2014. As with previous budget years, no money has been set aside for the project in the current fiscal year.
Upgrades and refurbishments at the referral hospital in Otjiwarongo have been in the pipeline since 2018, but no funds have been allocated yet, including in 2021/22.
A project to upgrade and renovate the hospital in Walvis Bay has been on government’s books since 2007, but has only received N$54 000 up to 2019/20. This year, as last year, there is no money for it.
A similar project for the district hospital at Outapi has been on the development list since 2010, but up to 2019/20 only about N$1.4 million was made available. This year, as last year, no budgetary provision was made for it.
Upgrades to and renovation of the district hospital at Engela will come to a standstill this year as no budgetary provision was made for it. Government has spent about N$5.5 million on the project, which started in 2010.
Upgrades to the district hospital have also been planned since 2010, and nearly N$4.7 million was spent up to 2019/20. No budget was approved for 2020/21, 2021/22 or 2022/23.
ALLOCATIONS
The following hospitals received money for 2021/22: Oshakati Intermediate (N$22 million); Onandjokwe and Swakopmund District (N$20 million each); Katutura Central (N$15 million); Windhoek Central, Keetmanshoop, Mariental and Otjiwarongo District (N$10 million each); Nkurenkuru (N$7 million); Khomas District, Okakarara, St. Mary’s in Rehoboth and Rundu (N$5 million each); Katima Mulilo (N$4 million); Okahao and Omuthiya (N$3 million each); Okahandja (N$2 million); and Gobabis (N$1 million).
Nearly N$10.8 million is available for a new infectious disease and tuberculosis hospital in Okahandja.
N$74.7 million was budgeted for of primary health care centres nationwide, while N$60 million will be spent on the maintenance and repairs of all the health ministry’s buildings, plants and equipment in all regions.
Total government expenditure for 2021/22 is estimated at about N$67.95 billion, of which around N$360.5 million has been set aside for the ministry of health and social services in the development budget. That is 0.53% of government’s total budget for the current fiscal year.
Development has been the casualty of government’s fiscal consolidation strategy it started embarking on in 2016 to try and ensure macroeconomic stability. The chunk allocated to the development budget as a whole and the health sector in particular has been shrinking as a result.
DWINDLING
In 2015/16, about 15.4% of total government expenditure was allocated to the development budget. This dropped to 10.6% in 2016/17. From 2017/18 to 2019/20, the development budget on average made up 8.5% of total expenditure.
In 2020/21, an estimated 9% of the total budget was spent on development. This year, the projected figure is 8.2%, followed by an estimated 10.4% in 2022/23 and 9.9% in 2023/24.
In 2015/16, about 0.75% of total expenditure was allocated to the development of health infrastructure. Health’s share reached a low of 0.28% in 2019/20.
Finance minister Iipumbu Shiimi’s latest budget - tabled in March under the theme, “Boosting Resilience and Recovery” – shows 0.68% of total expenditure will be geared towards the development of the public health sector over the medium-term framework (MTEF) from 2021/22 to 2023/24.
NO MONEY
A national public health laboratory (NPHL) for Namibia has been on the budget cards since 2013.
The NPHL will be a centralised laboratory in Okahandja that coordinates all public health tests including disease surveillance, outbreak detection, response and integration of laboratory data among other specialised reference testing, according to budget documents.
The development budget for 2021/22 states: “Currently Namibia does not have a national public health laboratory that safeguards the country from outbreak detection and threats and other events of public health importance.”
Yet, despite the Covid-19 pandemic which has already claimed the lives of more than 570 people in Namibia, government allocated no money for this project in 2020/21 or 2021/22.
Only N$1.3 million was spent on the NPHL project up to 2019/20. The current development budget shows government intends to spend N$5 million on the project both in 2022/23 and 2023/24. The funds will be for the “documentation on the construction” of the project.
‘KAPENA OSHIMALIWA’
According to the latest development budget, government also doesn’t have money for seven hospital projects this year, some of them dating back to 2007.
The construction of a district hospital in Ondangwa, to provide relief to the overwhelmed Oshakati Intermediate Hospital, has been part of the development budget since 2014. Not a single cent has been spent on the project so far though.
The project has once again been put on the back burner in 2021/22.
When the minister of health and social services, Kalumbi Shangula, was asked about it in parliament last week, he referred to the small development budget allocations in the past three years, saying the money was mainly spent on constructing new and upgrading clinics, upgrading health centres and various components of hospitals.
“Since 2016 the ministry has been in consultation with the finance ministry on financing the projects. Investments from the private sector into the health sector is challenging with regards to return on investment,” Nampa quoted Shangula as saying. Shangula said the ministry will continue to engage the finance ministry to find a funding model for the social sector for the projects to be realised.
LIFELESS
The upgrading and renovation of the Lüderitz hospital too has been on the budget books since 2014. As with previous budget years, no money has been set aside for the project in the current fiscal year.
Upgrades and refurbishments at the referral hospital in Otjiwarongo have been in the pipeline since 2018, but no funds have been allocated yet, including in 2021/22.
A project to upgrade and renovate the hospital in Walvis Bay has been on government’s books since 2007, but has only received N$54 000 up to 2019/20. This year, as last year, there is no money for it.
A similar project for the district hospital at Outapi has been on the development list since 2010, but up to 2019/20 only about N$1.4 million was made available. This year, as last year, no budgetary provision was made for it.
Upgrades to and renovation of the district hospital at Engela will come to a standstill this year as no budgetary provision was made for it. Government has spent about N$5.5 million on the project, which started in 2010.
Upgrades to the district hospital have also been planned since 2010, and nearly N$4.7 million was spent up to 2019/20. No budget was approved for 2020/21, 2021/22 or 2022/23.
ALLOCATIONS
The following hospitals received money for 2021/22: Oshakati Intermediate (N$22 million); Onandjokwe and Swakopmund District (N$20 million each); Katutura Central (N$15 million); Windhoek Central, Keetmanshoop, Mariental and Otjiwarongo District (N$10 million each); Nkurenkuru (N$7 million); Khomas District, Okakarara, St. Mary’s in Rehoboth and Rundu (N$5 million each); Katima Mulilo (N$4 million); Okahao and Omuthiya (N$3 million each); Okahandja (N$2 million); and Gobabis (N$1 million).
Nearly N$10.8 million is available for a new infectious disease and tuberculosis hospital in Okahandja.
N$74.7 million was budgeted for of primary health care centres nationwide, while N$60 million will be spent on the maintenance and repairs of all the health ministry’s buildings, plants and equipment in all regions.
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