Through a new $12 million award from the US Agency for International Development, IntraHealth International will partner with the government of Namibia to enhance health workers’ abilities to deliver high-quality HIV services, to improve integrated HIV care and treatment services, and to build the capacities of local nongovernmental organizations (NGOs) and public-sector facilities to deliver high-quality integrated HIV services in Namibia.

HIV is a major contributor to maternal and child mortality in Namibia, where it contributes to 59% of maternal deaths in the country, and 14% of infant deaths. About 250,000 people live with the virus in Namibia. The country also has the fourth-highest prevalence of tuberculosis in the world, and almost half of those infected are HIV-positive. This is why integrating HIV services into maternal and child health, family planning, and tuberculosis services is key.

The Namibia National Strategy aims to reduce new infections and AIDS-related deaths by 50% each by 2017. But the country’s chronic scarcity of physicians and maldistribution of nurses makes these goals a challenge. Namibia’s public health sector has fewer than two health workers per 1,000 people, and even fewer in the northern rural regions where HIV prevalence is highest.

The maldistribution of health workers could prevent the country from achieving its goal of an AIDS-free generation.

HIV Clinical Services Project

IntraHealth’s new USAID HIV Clinical Services Technical Assistance Project (UTAP) aims to strengthen public health and NGO facilities’ contributions to Namibia’s national HIV response through strategic use of President’s Emergency Plan for AIDS Relief (PEPFAR) investments.

The four-year project focuses on regions with the highest HIV prevalence rates: Kavango, Khomas, Ohangwena, Omusati, and Oshikoto.

Using IntraHealth International’s signature Optimizing Performance and Quality (OPQ) approach, the project will work with health workers and officials to identify and address gaps in service delivery and administrative performance.

OPQ encourages creativity and shared decision-making, allows users to measure changes to ensure improvement, and allows for sharing about lessons learned and adapting best practices. The process brings greater transparency, fosters local ownership and sustainability, and helps create a culture that values quality.

IntraHealth will work with districts to institutionalize OPQ within routine performance monitoring processes.

Stigma and health equity

Health workers’ attitudes toward clients have a great impact on the care they provide. Through peer support and positive mentoring, IntraHealth will work closely with district health officials to proactively address health workers’ attitudes and any practices—such as disrespect and abuse of pregnant women—that may diminish quality of care and prevent women from seeking health care.

Through the project, health workers will become more aware of the many stumbling blocks that can prevent clients from getting the care they need—including gender inequality, HIV status, and religious barriers, to name a few—and learn to provide care in a way that is sensitive to those challenges.

Health workers will also learn to recognize victims of gender-based violence and to address the issue in the services and referrals they provide.

IntraHealth’s USAID HIV Clinical Services Technical Assistance Project is funded by the US Agency for International Development. The project builds on the achievements of the Namibia Capacity Building for Country Owned HIV/AIDS Service Project. IntraHealth Namibia will execute activities related to health information systems and data use for improved human resources management and service delivery, as well as transfer skills related to human resources for health to health workers within the Ministry of Health and Social Services and NGOs.