Central hospital operates beyond bed capacity - report

Windhoek Central Hospital operated at 104% bed occupancy during the 2025/26 financial year, exceeding its 85% target as overcrowding, staff shortages and limited critical-care facilities continued to place pressure on Namibia's main national referral hospital.

The government's 2025/26 Accountability Report reveals that the hospital recorded 43 175 admissions and 88 789 outpatient visits during the reporting period, while patients spent an average of 6.2 days in hospital against a target of five days or less.

The report also identifies delayed emergency obstetric interventions, difficulties managing complications, overcrowding and shortages of healthcare personnel among the challenges affecting maternal health services.

Maternal mortality remained above the hospital's stated target, although the report does not provide the actual mortality figure in the section discussing the institution's performance.

The hospital's limited critical-care capacity and gaps in infection prevention and control were also identified as contributing challenges.

The average hospital stay of 6.2 days was 1.2 days longer than the stated target, while bed occupancy exceeded the target by 19 percentage points.

The hospital's outpatient department also recorded a significant proportion of repeat visits.

First outpatient visits accounted for 12% of consultations against a target of 30%, while follow-up visits accounted for 88% against a target of 70%.

Maternal health concerns

The report identifies maternal health as one of the areas where the hospital experienced mixed performance.

Although maternal mortality remained above the stated target, neonatal mortality was recorded at 32 deaths per 1 000 live births against a target of 40.

The hospital also reported that 100% of babies covered by its HIV-status performance indicator were born HIV-negative, exceeding its target of 98%.

Infection control challenges

The hospital also reported shortcomings in infection prevention and control, despite maintaining its hospital-acquired infection rate below 1%.

Average compliance with infection prevention and control requirements stood at 61%.

The report identifies inadequate isolation space, overcrowding, waste-management gaps, inconsistent hand-hygiene practices, shortcomings in the use of personal protective equipment, resource constraints and infrastructure limitations among the challenges.

The hospital nevertheless reported progress in outbreak containment, infection surveillance, staff training and the functioning of infection prevention and control committees.

Its overall healthcare quality compliance score increased from 66% in June 2023 to 83% in August 2025.

Of the 30 service elements assessed, 20 were fully compliant and 10 partially compliant.

The hospital was consequently assessed as compliant and ready for accreditation activities, despite the continuing operational challenges identified elsewhere in the report.

More surgeries, but unused theatre capacity

Windhoek Central Hospital performed 10 864 surgical procedures during the reporting period, exceeding its target of 10 200 by 664 operations.

Elective surgery cancellations were maintained at 4%, below the acceptable threshold of 10%.

However, theatre utilisation reached 75%, compared with an optimal benchmark of 85%, indicating that available operating-theatre capacity was not being used at the desired level.

Medicine supply problems

The hospital's challenges form part of wider pressures identified in the Ministry of Health and Social Services' performance report.

The ministry recorded a 90% on-time delivery rate for main pharmaceutical orders, but overall service-level performance averaged only 65%.

The report attributes the low service level primarily to high demand and frequent stock-outs caused by supplier delivery constraints.

The ministry says it strengthened procurement planning, supplier monitoring and forecasting systems, including the preparation of a three-year national quantification plan for 2026 to 2028.

It also used central procurement contracts, direct sourcing from international manufacturers, emergency procurement and pooled purchasing arrangements to improve the availability of medicines and clinical supplies.

However, the reported service-level performance indicates that supply constraints continued during the financial year.

The ministry's development budget also recorded a substantial shortfall.

Of the N$622.2 million allocated to health development projects in 2025/26, N$470.1 million was spent, representing an execution rate of 75.6% and leaving approximately N$152 million unspent.