Responding to the human resource crisis in Namibia’s health service

In 2000, Namibia committed itself to the ambitious Millennium Development Goal (MDG) to reduce maternal and child mortality and disease by 2015.  However, without appropriate human resources, achieving the MDGs will be impossible.

Namibia is an upper-middle-income country with a relatively good health infrastructure.  However, the health status of a large part of its population is closer to that of much poorer countries, life expectancy has dropped to 42 years and one in ten people has HIV and AIDS or tuberculosis. Consequently the country’s health infrastructure is under pressure. A tension exists between the need for an urgent response to the crisis and achieving the country’s long-term vision for a robust health care system.

Researchers with the name="OLE_LINK1"Institute for Development Policy and Management, University of Manchester (UK) and the World Health Organisation’s Africa Regional Office conducted a study of Namibia’s health service. The study examines the integration of staff management systems with overall health system objectives and the control and input that health care managers have in human resource issues. It focuses on three human resource activities: employee selection, performance management and training. The researchers interviewed 22 health workers and held three focus groups for more junior staff.

The study findings include:

• Training provision is good and the employee selection system is relatively sophisticated, but efforts to manage staff performance have not succeeded.
• Namibia’s response to HIV and AIDS has been slow, reflecting a need to act without damaging the strategic framework.
• There is an underlying problem of political commitment to tackling HIV and AIDS and tuberculosis: no target has been set for reducing the scale of infection.
• Namibia’s low dependency on aid puts it into a strong position with donors. The ministry of health is therefore able to resist pressure to accept freestanding projects and so assert its preference for recruiting and training more staff.

Namibia needs to estimate the staffing levels required to scale up its response to HIV and AIDS and tuberculosis and achieve the MDGs. It is likely that extending the current staffing structure will be impractical in terms of both cost and availability of health professionals.

Implications for future policy include:

• A new approach must be accommodated within the existing strategic framework.
• The skills needed for new treatments should be taught to trainees at the lowest possible level in the health system, with recruitment and training provision for new staff that may have only basic qualifications.
• Middle and low level health workers will require professional supervision, so staff at higher levels should be trained to take on more supervisory duties. A performance management framework is needed within which they can use their new managerial skills.
• There is scope for creativity in organisational arrangements, such as Namibia’s delegation of some service provision - its AIDS counselling scheme - to a non-governmental organisation.

Source(s):
‘Addressing the human resource crisis: a case study of the Namibian health service’, Human Resources for Health 5(1), by Willy McCourt and Magda Awases, 2007 Full document.

id21 Research Highlight: 19 July 2007

Further Information:
Willy McCourt
Institute for Development Policy and Management (IDPM)
School of Environment and Development
University of Manchester
PO Box 88
Manchester
M60 1QD
UK

Contact the contributor: willy.mccourt@manchester.ac.uk

Institute for Development Policy and Management, University of Manchester, UK

World Health Organization - Regional Office for Africa

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