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Part 1: Opening the Umbrella of Primary Care to Include HIV Services in Namibia—Background & Context

Namibia finds itself where many countries in the region may find themselves over the next several years—on the brink of graduating from United States Government (USG) funding. This milestone comes in part due to Namibia’s middle-income country status as well as economic realities that are constraining donor funding at the global level.  

As a result, the Government of Namibia must absorb all USG-funded positions supporting HIV/AIDS services in the next 12–18 months. This mandate provides the added push to ensure indigenous organizations integrate HIV staff and programs under a primary health care umbrella to operate more effectively and efficiently. 

With one of the highest rates of HIV in the world, Namibia was one of the first PEPFAR focus countries.  Emergency responses like PEPFAR are designed to reach large numbers of people with services quickly, and in Namibia, PEPFAR led to the development of a vertical, or standalone, national HIV/AIDS program. Vertical programs are faster to implement and can reach people with treatment and other services quickly, but in the long run, they are not generally the most cost-effective or sustainable.

In Namibia, a single health facility may offer both HIV/AIDS services and primary health care, but the staff running these programs is hired, paid, and managed separately. Similarly, HIV/AIDS and primary health care programs are supported by parallel and duplicative administrative systems. As Namibia moves from an emergency response to an integrated approach to HIV/AIDS services, it has begun to move its longstanding vertical HIV/AIDS services under the umbrella of primary care. The country is already making progress. In fact, in January 2012, Namibia absorbed all USG-supported medical doctors into the public health service.

IntraHealth Namibia is supporting the process of integration. Our role is to build capacity and ensure consistent quality of care while supporting our local partners, faith-based hospitals, to absorb donor-funded positions. So how did we start to move forward? 

On the project, we all agreed it was unnecessary to re-invent the wheel and should learn from previous organizational development work. We agreed that in order to measure our progress we must provide our partners with a baseline assessment of how prepared they are to integrate services, and we identified Pact’s Organizational Development Toolkit as a promising resource.

Learn how we used the toolkit, and specifically the Organizational Capacity Assessment tool, to help us conduct these assessments in part two of this blog.

Part 2: Organizational Capacity Assessments