Increasing OVC’s Access to Health Care through Expansion of Mobile Clinics in Namibia
DHS data in Namibia, as well as anecdotal evidence, suggest that OVC have inferior access to health care compared to other children. In running a mobile primary clinic on a rural route from October to December 2010, PharmAccess Namibia found that 8% of children at a primary school and 9% on remote farms had incomplete vaccinations. A third of children at an orphan feeding program had not completed the immunization protocol for their age. This is consistent with findings in other countries.
The Namibian Government runs a health service that is essentially free except for modest user fees that can be waived for OVC, but the geography of Namibia provides a formidable obstacle to routine medical care in childhood. Many children live at a great distance from public health facilities. There is no public transport to these facilities, and parents or guardians of OVC may be unable (or unwilling) to take them for medical care. Alternatives to increase OVC access to health care include bringing health services to the communities where OVC live through mobile primary care clinics, and providing access to private health care through medical scheme membership. If OVC are enrolled in health insurance schemes, this would increase the number of service points where they might be treated by removing the financial barrier to accessing private providers.
Boston University (BU) has been working with PharmAccess Namibia for over five years in attempting to expand and evaluate low cost medical scheme coverage. PharmAccess also purchased and operates mobile clinics (fully licensed by MOHSS). The purpose of the current activity is to evaluate the impact and estimate the costs for an expanded mobile clinic program to improve health care access for OVC. These research findings can be used in deciding if mobile clinics are an effective way of addressing health needs among OVC living in rural areas, and in targeting a primary clinic program to meet these needs.
Identify the unmet need for primary care in the OVC population studied (vaccinations, well child care, curative care for common conditions).
Evaluate the impact of mobile primary care clinics in reducing health care unmet need for OVC (vaccinations, untreated common infectious and non-communicable diseases, delayed development or malnutrition).
Estimate the total program and unit (per OVC) cost of providing regular primary care clinic services to OVC through mobile clinics.
Identify operational elements of a mobile clinic program that will maximize the effect on OVC health status.
In urban areas (and some remote mining towns), there are private providers who could offer additional sites for OVC care if the children had medical scheme coverage. We will determine the current extent to which OVC within households with medical scheme coverage may be covered under the schemes:
• At no additional cost
• With additional premium payments
This project is one activity of the CGHD’s Orphans and Vulnerable Children—Comprehensive Action Research project (OVC-CARE).
|Principal Investigator||Rich Feeley|
|Dates of Research||March 1, 2011 – July 31, 2012|