N$16bn health overhaul to modernise public hospitals, expand universal care

The health ministry says it is working to secure funding for a sweeping N$16 billion overhaul of the state healthcare system, including upgrading and constructing hospitals to match private-sector standards, modernising facilities nationwide and fast-tracking staff hires.

To support the plan, it has engaged the ministries of finance, labour, justice and energy, as well as the Social Security Commission and other partners, to secure earmarked and ring-fenced funding for the sector.

Health executive director Penda Ithindi told Namibian Sun that the ministry submitted the N$16 billion proposal to Cabinet in 2024 to upgrade hospitals and clinics.

The funds will be used to recruit additional health workers, modernise equipment and infrastructure and implement reforms to improve quality, efficiency and access to care.

The multi-billion plan includes the construction of the Windhoek District Hospital.

Ithindi said UHC will ensure "that all people in Namibia can access the quality health and social services they need when and where they need them without suffering financial hardship”.

He stressed that UHC is “not a single programme or insurance scheme” but “a system-wide approach” focused on improving healthcare standards, strengthening financial protection and enhancing governance and sustainability.

Ithindi said the push for UHC is grounded in the Constitution.

Although the Constitution does not explicitly mention UHC, he said Article 95 places access to health services firmly within the state’s responsibilities, making universal care a constitutional obligation rather than a discretionary programme.

Steady gains

Namibia’s UHC service coverage index improved from about 40% in 2000 to between 60% and 71% by 2021, placing the country among the stronger performers in southern Africa.

More than 76% of the population now lives within 10 kilometres of a health facility, reflecting long-term investment in clinics, health centres and outreach services, particularly in rural areas.

Most public health services are provided free of charge or at nominal fees at the point of use, keeping out-of-pocket spending at around 8% of total health expenditure.

This level of protection helps prevent illness from pushing people into poverty, Ithindi noted.

Life expectancy has risen from 47 years in 2000 to 56 years by 2019. Namibia has also achieved HIV epidemic control under the 95 95 95 targets – a globally recognised milestone.

The country has been certified for the elimination of mother-to-child transmission of HIV and hepatitis B. Maternal and child mortality rates have declined, supported by expanded immunisation and communicable disease programmes.

Despite these gains, Ithindi acknowledged persistent gaps in the quality of care, availability of medicines, access to non-communicable disease and mental health services, and equitable access to specialised care for remote communities.

The health ministry has completed facility readiness and baseline assessments to guide targeted investments.

Standardised care programmes are being rolled out, while a customer service charter launched in 2025 aims to strengthen accountability and improve the patient experience across public facilities.

Training output

Ithindi said staffing strategies are being aligned to UHC priorities, with filling critical vacancies, incentivising service in rural and hard-to-staff areas, expanding in-service training and aligning training outputs with service needs prioritised.

A costed UHC implementation action plan sets out spending for the first five years, while reforms are underway to align budgets with an essential health services package and shift towards programme-based budgeting and strategic purchasing.

A key reform under consideration is the establishment of a national health equity fund, intended to mobilise additional domestic resources and strengthen solidarity financing.

Ithindi said legislative work is also underway, with a proposed UHC Bill being developed to translate constitutional principles into clear legal entitlements, financing mechanisms and accountability structures aligned with existing health and social security laws.

“The focus now is execution,” he said. “The investment must translate into reliable, accessible and quality care for all Namibians.”

The government has confirmed that public hospitals will be upgraded to operate at standards comparable to private facilities under UHC reforms outlined in Swapo’s 2025–2030 implementation plan, which takes effect in April this year.

Refined vision

Health minister Esperance Luvindao, in a ministerial statement issued on 4 February, said government is confident that selected public hospitals will be ready to implement the Vision April 2026 directive.

“Vision April 2026 is not an abstract policy aspiration but a structured and evidence-driven reform initiative with clear timelines, defined priorities, and measurable milestones,” she said.

Luvindao said implementation would follow “a phased and targeted approach, rather than a blanket rollout across all facilities at once”.

Priority will be given to hospitals that have demonstrated readiness in terms of infrastructure, staffing and management capacity, the minister added.

She said two intensive care units are fully functional at Katima Mulilo District Hospital and Keetmanshoop District Hospital, while additional ICU infrastructure is under construction at Oshakati, Onandjokwe, Rundu, Gobabis and Mariental.

In terms of staff shortages, Luvindao said recruitment has been accelerated.

“Between April 2025 and February 2026, a total of 2 397 health professionals were appointed,” she said.

“These measures demonstrate the ministry’s commitment to addressing current staffing shortages, strengthening specialised medical capacity, and ensuring that the health system is adequately staffed."