Academic journal article Africa Policy Journal

Equity and Core Concepts of Human Rights in Namibian Health Policies

Academic journal article Africa Policy Journal

Equity and Core Concepts of Human Rights in Namibian Health Policies

Article excerpt

Abstract

Delivering health services to vulnerable populations is a significant challenge in many countries. Groups vulnerable to social, economic, and environmental challenges may not be considered or may be impacted adversely by the health policies that guide such services.We report on the application of EquiFrame, a novel policy analysis framework, to ten Namibian health policies, representing the top ten health conditions in Namibia identified by the World Health Organization. Health policies were assessed with respect to their commitment to 21 Core Concepts of human rights and their inclusion of 12 Vulnerable Groups. Substantial variation was identified in the extent to which Core Concepts of human rights and Vulnerable Groups are explicitly mentioned and addressed in these health policies. Four health policies received an Overall Summary Ranking of High quality; three policies were scored as having Moderate quality; while three were assessed to be of Low quality. Health service provision that is equitable, universal, and accessible is instigated by policy content of the same. EquiFrame may provide a novel and valuable tool for health policy appraisal, revision, and development.

Introduction

The delivery of healthcare to vulnerable populations is a significant challenge in many countries. Groups vulnerable to social, economic, and environmental challenges may not be considered or may be adversely impacted by the policies that guide health services. The elderly, migrants,refugees, and people with disabilities and chronic illnesses are some groups that experience social vulnerability due to the shared resource and capacity shortages generated by their common ethnic, racial, cultural and geographical position (Allotey et al. 2012). 'Regarding access to and equity in health, these populations are still underprivileged due to their status and identity' (Mannan n.d.).There is an urgent need to evaluate what health policies actually state and to what they commit with regard to social inclusion and human rights (Mannan, Amin, et al. 2012).

The Republic of Namibia is amongst Africa's largest, though least populous nations (U.S. Global Health Initiative n.d.). With an estimated population of 2.2 million and a landmass equaling that of France (824,292 square kilometers), Namibia's population is sparsely and unevenly distributed in urban centers and rural communities across vast distances, with a population density of 2.6 people per square kilometer (U.S. Global Health Initiative n.d.). On March 21, 1990, Namibia realized its independence subsequent to a century of colonial rule, first by Germany and then by South Africa, following the successful implementation of United Nations Resolution 435 (Ministry of Health and Social Services [Namibia] and Macro International Inc. 2008). Namibia's governance under the South African apartheid regime has resulted in substantial social and economic disparities and consequential socioeconomic challenges, including high poverty, illiteracy, poor access to sanitation, and so forth, which are still evident today (World Health Organization 2009). Although Namibia's per capita income of US$4,700 (2011, Atlas method) positions it in the World Bank's upper-middle income classification, Namibia's income distribution is amongst the most unequal in the world with a Gini coefficient estimate of 0.5971 by the 2009/2010 household survey (World Bank 2012). Since independence, health has remained a priority for the Government of Namibia, substantiated by the number of health sector reforms and developments that have been realized under the Primary Health Care strategy, including a substantial increase in coverage of and access to health and social welfare services (Republic of Namibia Ministry of Health and Social Services and World Health Organization 2010). Total expenditure on health per capita (Intl S, 2010) isS436; and total expenditure on health as percentage of GDP (2010) is 6.8/6(Worid Health Organization 2012). …

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