Toggle Main Menu Toggle Search

Open Access padlockePrints

Improving equity in the provision of primary health care: lessons from decentralized planning and management in Namibia

Lookup NU author(s): Dr Ruth Bell


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


This paper draw's lessons from a review of primary health care services in Windhoeki the capital of Namibia, undertaken by a regional health management team. The review was carried out because of perceived increases in workload and inadequate staffing levels, arising from the rapid expansion of the city associated with inward migration. A survey of the utilization of government clinics was used to develop a more equitable allocation of primary health care services between localities. The survey revealed disparities between patterns of utilization of the Services and the allocation of staff: the poorer, localities were relatively underprovided. Decisions made centrally on resource allocation had reinforced the inequities. On the basis of the results of the review, the regional health management team redistributed nursing and medical staff and argued for a shift in the allocation of capital, expenditure towards the poorer communities. The review demonstrates the potential for regional and provincial health management teams to make effective assessments of the needs of their populations and to promote the equitable delivery of primary health care services. In,order to achieve this they need not only to, become effective managers, but also to develop population-based planning skills and the confidence and authority to influence the allocation of resources between and within their regions and provinces.

Publication metadata

Author(s): Bell R, Ithindi T, Low A

Publication type: Article

Publication status: Published

Journal: Bulletin of the World Health Organization

Year: 2002

Volume: 80

Issue: 8

Pages: 675-681

Print publication date: 01/01/2002

ISSN (print): 0042-9686

ISSN (electronic): 1564-0604

Publisher: World Health Organization


DOI: UNSP 01-1337


Altmetrics provided by Altmetric