Namibia: Ministry Can't Afford 322 TB Health Workers

Globally, the TB incidence rate is falling, but not fast enough to reach the 2020 milestone of a 20% reduction between 2015 and 2020.

THE Ministry of Health and Social Services lacks the financial means to employ 322 tuberculosis (TB) community health workers countrywide.

This was revealed by executive director of health and social services Ben Nangombe after 27 health workers from the Erongo region wrote to his office asking for their employment conditions to be reviewed to be offered permanent positions in the ministry.

Many of the health workers have been with the TB programme since 2004 as volunteers at the height of the disease outbreak at Walvis Bay, Omaruru, Swakopmund, Karibib and Usakos.

Nangombe attributes the lack of financial resources to the reduction in donor support to the country and continuing global economic challenges.

"It is becoming increasingly pressing for Namibia to move to a more sustainable, domestically resourced health response. The provision of community-based health services is a key factor in this, as it is an area where significant development partner resources have been utilised over a long period," he says.

The community health workers were initially recruited under the TB programme through Dutch non-governmental organisation Koninklijke Nederlandse Centrale Vereniging (KNCV).

KNCV handed the TB community health workers to the development cooperation partner of theGlobal Fund in 2015, which offered them a contract with a salary and housing allowance.

The workers still resort under the global fund programme.

In their letter to Nangombe, they claim at the beginning of the programme they were paid an allowance of N$50 daily for lunch.

"We enjoyed our work and loved helping our people. That is why we did not give up. We continued doing our work and saving the lives of our people," the volunteers said in a three-page letter.

They claim they are expected to work normal working hours and weekends.

"All those years we were happy and enjoyed our job even though we are at high risk of getting TB, as each year a colleague of ours is diagnosed with this disease. Some of our colleagues were also infected with Covid-19, but no risk allowance benefits are offered," the volunteers said.

The TB community health workers have given the ministry until 16 November to attend to their demands.

Nangombe said the health workers' employment contracts spell out their conditions of service, which are tied to available funding from the development cooperation partners. He says they are not part of the ministry's staff complement.

"The purpose of such development partner support is precisely to fill financial gaps in national disease strategies that the government would otherwise be unable to close," Nangombe said.

He says some health workers, who were permanently employed by the ministry, were recruited at a time when resources allowed it.

"In 2017, the ministry reviewed its staff establishment, and additional positions of health assistants were proposed to cater for a possible transition of TB health workers. This proposal has been halted due to budgetary constraints," Nangombe says.

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