Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698749594021.pdf (Namibia)
REPUBLIC OF NAMIBIA MINISTRY OF HEALTH AND SOCIAL SERVICES STATEMENT BY DR. KALUMBI SHANGULA, MP, MINISTER OF HEALTH AND SOCIAL SERVICES ON THE OCCASION OF THE INTRODUCTION OF VOTE 13 (HEALTH AND SOCIAL SERVICES) FOR THE 2021/2022 FINANCIAL YEAR.

22 APRIL 2020 NATIONAL ASSEMBLY *Check Against Delivery.

Honourable Chairperson of the Whole House Committee Honourable Members 1.

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I rise to table the budget for Vote 13, for the Ministry of Health and Social Services.
I am alive to the imperative of time during these deliberations, while doing justice to the assignment at hand.

The Government continues to demonstrate its unwavering commitment to the provision of quality, equitable and accessible public health care services to all our people in all regions and constituencies.
The amount of Eight Billion, Eighty-One Million, and Sixteen Thousand Namibian Dollars (N$8,081,016,000.00) allocated to the Ministry for the 2021/2022 Financial Year, clearly demonstrates this commitment.

I thank the Minister of Finance and the Director General of National Planning Commission for this consideration.

The budget is being presented against the difficult backdrop of the impact of the COVID- 19 pandemic on our societies.

However, as the saying goes, every dark cloud has a silver lining.
Against this backdrop, I will share with this the august House some of the major achievements recorded during the previous Financial Year, as well as the projects and programme outputs completed during the 2019/2020 budget cycle.

I will also share the priority programmes to be implemented during the current budget year.

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Programmes 4.1.
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Programmes 4.1.

Programme 01: Health System Planning and Management Human Resources for Health: Providing adequate human resources is critical to the delivery of public health services.

One hundred and ninety (190) graduates in various fields started Internship Programmes.

These include: 140 Medical, 27 Dental, 21 Pharmacist, and 2 Psychology graduates.
A total of 66 students funded by the Ministry successfully completed their training from Universities abroad in various fields, namely 19 Medical Specialists, 97 Medical Doctors, 38 Pharmacists, 11 Physiotherapists, and 4 Dentists.

For the COVID-19 response, a total of 3 371 staff members were recruited of which 1 703 are in permanent and 1 668 are in temporary positions.
A total of 592 Community Health Workers from nine regions who were jobless for a number of years are employed under COVID-19 funding until the end of September 2021.
Infrastructure development: A number of isolation facilities were constructed at the following hospitals: Windhoek Central, 10 and 12-bed units; Opuwo, 4-bed units; Oshakati and Rundu, 8-bed units each; Okongo and Gobabis, 12-bed units each; Mariental 1 and Keetmanshoop 12-bed units each, Walvis Bay 2 twelve-bed units; 24-beds units were built at Oshikango, Noordoewer and Ariamsvlei Border Post.
Other facilities completed during the reporting period are Katima Mulilo Hospital Paediatric Ward and installation of new incinerator at same Hospital; storm water reticulation at Gobabis Hospital and Otavi Health Centre; Rundu Hospital Maternity Ward and the installation of medical gas network, as well as sealing and waterproofing of the roof at Katutura Hospital.

4.2.
4.2.

Programme 02: Curative and Clinical Health Care Services Specialized services: The Cardiac Unit at Windhoek Central Hospital is fully functional.

A total of 375 cardiac operations and procedures were carried out successfully, including open heart surgeries, thoracic surgery operations, angioplasty/angiography pacemaker implantation, complex devices, renal denervation therapy for treatment of resistant hypertension among others.
Procurement of medical equipment: As part of the COVID-19 response, various high- tech medical equipment was procured and distributed to health facilities.

These include: 26 ECG machines, 98 Ventilators (we still have 13 in reserve for unforeseen situations), 157 patient monitors, 125 ICU monitors and 15 hyper-lights, to name a few.
Other equipment acquired include a CT Scan machine for Windhoek Central Hospital, a fluoroscopy for Oshakati Hospital, digital X-ray machines for Okahao and Luderitz District Hospitals.

4.3.

Programme 03: Public Health COVID-19 Pandemic: We continued to strengthen our anti-COVID-19 response and preparedness, informed by latest scientific and epidemiological data.
I pause to commend all our frontline health workers and response teams for their unwavering dedication since the onset of the pandemic in our country.

Through their hard work, Namibia was able to put in place a robust response and avert the worst-case scenario, in terms of the number of infections, hospitalizations and ICU admissions due to COVID-19.
With the roll out of the COVID-19 vaccination campaign throughout the country, we look forward to bringing down the number of new infections, hospitalizations and deaths due to COVID-19.

As part of the COVID-19 pandemic response an amount of N$727 million was allocated, and utilized according to the costed National COVID-19 Preparedness and Response Plan.

Details on Covid-19 budget expenditure are contained in Annexure 3.
HIV/AIDS: Through evidence-based decisions and implementation of our planned interventions, Namibia has been able to record one the highest success rates globally and continentally, in the fight against the HIV/AIDS pandemic.

The “Test and Treat” policy 2 adopted in 2019 in line with WHO recommendations has significantly boosted our efforts towards achieving epidemic control in our country.

As a result, on the fast tract 95-95-95 cascade, our country is among the best performers in the world.
For the reporting period, progress towards these fast-track targets now stands at 95-90-91, which means 95% of people living with HIV knowing their HIV status; 90% of people who know their status are on treatment; and 91% of people on treatment are virally suppressed.

4.4.

Program 4: Developmental Social Welfare (In the MTEF book, this Programme is erroneously recorded as Information, Adult and Lifelong Learning, which I presume belong to the education sector.)
Psycho-social support: The Ministry continues to provide psycho-social support as an ongoing intervention and specifically to those infected and affected by COVID-19.

Alcohol and Drug Rehabilitation: Since its opening, the Etegameno Rehabilitation and Resource Centre continues to provide the critical services of counselling, rehabilitation and treatment for various forms of afflictions, including substance abuse, attempted suicide, chronic illness, marital problems, mental illnesses, gender-based violence.
Regional social workers conducted therapy up to 2 465 clients per 100,000 population.

4.5.

Programme 99: Policy Coordination and Support Services In this programme particular attention is given to planning in the areas of human recourses and performance management, health financing, policy and legal framework and health service delivery.

It covers activities such as financial and resource management human resources and performance management; policy planning, and health service delivery support.
It is pleasing that the set targets for the selected health worker ratios per population have been achieved.
The ratio for Doctor per population has improved from one doctor per 1 920 people to one doctor per 1 837 people, while ratio for Nurses per population also improved from one nurse per 223 people to one nurse per 220 people, and for Pharmacists from one Pharmacist per 3 536 people to one pharmacist per 2 922people at the end of Financial Year 2019/20.76zz Other aspects under this Programme include: the implementation of the Performance Management System; pursuance of Universal Health Coverage and Infrastructure development.
The list of capital projects is attached as annexure 2.

The burn rate for 2019/2020 stands at 99% while the preliminary budget outcome for 2020/2021 Financial Year stands at 102%.

This figure will change as accounts are finalized.

3 Honourable Chairperson of the Whole House Committee 5.
In terms of our key programmes to be implemented during the budget year 2021/2022 and beyond, focus will be placed on the recruitment of more health workers; the broadening and strengthening of in-patient and outpatient health care services; streamlining the procurement and management of pharmaceutical and related supplies for public health facilities and combating the COVID-19 pandemic.

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Budget for the 2021/2022 Table 1: Budget for the Ministry of Health and Social Services Operational Expenditure Development Expenditure TOTAL: Table 2: Programme and allocation Programme 01: Health System Planning and Management Programme 02: Curative and Clinical Health Care Programme 03: Public Health Programme 04: Developmental Social Welfare Programme 99: Policy Coordination and Support 7 720 526 000.00 360 490 000.00 8,081,016,000 39 899 000.00 7 376 937 000.00 101 919 000.00 22 043 000.00 54 018 000 Details on the operational expenditure are contained in Annexure 1.
Details on development expenditure are contained are contained in Annexure 2.

Hon Chairperson of the Whole House Committee We have just emerged from a difficult and challenging Financial Year that tested our will and our resolve as we fought against COVID-19.

Without any doubt, more needs to be done.

For this reason, we will not tire, we will not relent.
We will persevere and will move forward to make the Namibian public health sector the best that it can be with the resources placed at our disposal through the 2021/2022 appropriation.

In conclusion, I thank the deputy Minister and my staff under the able leadership of the Executive Director for assisting me in the preparation of this motivation.

I ask you Honourable Members to reward their tireless efforts with your support for this budget.

I thank you.

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4 OPERATIONAL BUDGET: Vote 13 (FY2021/2022) DESCRIPTION Remuneration Employers Contribution tom GIPF and MPOBPF Other condition of service Improvement of remuneration Employers contribution to the Social Security Commission PERSONNEL EXPENDITURE - SUBTOTAL Travel and Subsistence Allowance Materials and Supplies Transport Utilities Maintenance Express Property Rental and Related Charges Other Services and Expenses GOODS AND OTHER SERVICE - SUBTOTAL Membership Fees and Subscriptions: International Membership Fees and Subscriptions: Domestic Government Organisations Public and Departmental Enterprises and Private Industries SUBSIDIES & OTHER TRANSFERS - SUBTOTAL Domestic Interest Payments Foreign Interest Payments Operational Equipment, Machinery and Plants Government Organizations Individuals and Non Profit Organizations Furniture and Office Equipment Vehicles Operational Equipment, Machinery and Plants Construction, Renovation and Improvement Government Organisations Individuals and Non-Profit Organisations GRAND TOTAL Annexure 1 ESTIMATE Annexure 2 INFRASTRUCTURE DEVELOPMENT FOR THE FY 2021/22 Region Project Name Amount in N$ Expenditure //Karas Erongo Keetmanshoop Hospital - TB Ward Oranjemund staff accommodation Staff accommodation at Point of Entry Aussekehr Health Centre Swakopmund District Hospital - Neo Natal Unit & mothers lodge's St. Mary's Hospital - Out patient department and Laboratory Mariental District Hospital Outpatient Department Hardap Schlip Primary Health Clinic To be determined 8 460 768.96 To be determined To be determined 7 984 048.10 11 905 812.00 1 550 761.43 To be determined To be determined To be
 determined Mariental Primary Health Care Clinic Aranos Primary Health Care Clinic 20 454 782.05 9 657 993.86 12 046 289.10 9 887 067.20 Aranos Health Centre - staff accommodation To be determined Rundu Hospital – maternity ward 51 543 075.79 49 963 137.03 Kavango East Shamaturu Primary Health Care Clinic To be determined Nkurenkuru District Hospital - Primary Health Care Clinic 4 142 462.15 1 472 387.26 Kavango West Gcaruhwa Primary Health Care Clinic Katutura Hospital - Pharmacy, Katutura Hospital - Paediatric Ward and Casualty Windhoek Central Hospital - electrical reticulation and Paediatric Intensive Care Unit Epupa Primary Health Care Clinic Khomas Kunene To be determined 16 808 575.20 To be determined To be determined To be determined 8 466 787.86 Ohangwena Onanghulo Primary Health Care Clinic Onamafila Primary Health Care Clinic Omaheke Gobabis District Hospital - operating theatres Staff accommodation at Point of Entry Omusati Okahao Hospital - Outpatient Department Oshikulufitu Primary Health Care Clinic Oshakati Intermediate Hospital - Asbestos Ward Demolition 16 227 000.25 8 303 803.27 17 671368.00 3 381 977.00 To be determined To be determined 23 415 270.70 19 473 168.93 19 366 041.04 7 594 634.28 15 154 176.04 7 672 028.30 Oshana Oshakati Intermediate Hospital - Intensive Care Unit, Theatre and Central Sterile Supply Department To be determined Oshana Regional Management Team office To be determined Oshikoto Onandjokwe Hospital - Maternity 59 080 587.00 4 475 885.80 Onandjokwe Hospital mothers lodge and Paediatric Ward 4 306 935.20 3 397 586.88 Onandjokwe Hospital Paediatric Ward 4,065,767.52 2 642 748.89 Omuthiya District Hospital - Electrical and mechanical components To be determined 6 Okakarara District Hospital Laundry & Kitchen Otjozondjupa Okondjatu Primary Health Care Clinic Okahandja Hospital Public Ablution Katima Mulilo Hospital Intensive Care Unit Muzii Primary Health Care Clinic Malengalenga Primary Health Care Clinic 3 033 405.60 1 982
 700.50 9 340 235.03 2 666 496.86 To be determined To be determined 4 440 541.00 2 167 635.98 17 281 387.47 1 242 114 84 Zambezi Linyanti Primary Health Care Clinic To be determined N.B: “To be determined” means that the Ministry is finalizing the bidding documents for advertisement.
Annexure 3 COVID-19 RESPONSE EXPENDITURE AS AT 31 MARCH 2021 Pillar I II III IV V VI VII VII Item description Coordination, Planning, monitoring Risk communication & community engagement Surveillance, response & case investigation Points of Entry National Laboratories Infection Prevention and Control Case management Operational support and Logistics total Budget Expenditure Balance -17 874 042 95 723 -873 895 -13 332 345 598 14 488 158 2 804 490 -152 779 -1 180 078 % expenditure 269% 87% 214% 114% 95% 78% 92% 109% 101% 7