Mobile primary healthcare services and health outcomes of children in rural Namibia
This article assessed the health changes of orphans and other vulnerable and non-vulnerable children visiting a mobile clinic in rural Namibia.
- Sep 30, 2013
On the 10th of September 2013, Ingrid de Beer and co-authors published an article in the International Electronic Journal of Rural and Remote Health Research, Education, Practice and Policy, entitled ‘Mobile primary healthcare services and health outcomes of children in rural Namibia.‘
Over a six month period, information on immunization status, diagnosis of anemia, skin and intestinal disorders, nutrition, dental disorders and referrals was collected from the records of the Mister Sister mobile clinic serving farms and surrounding areas in parts of Namibia. Included in the study were children defined by the Ministry of Gender, Equality, and Child Welfare as orphans or vulnerable and children who are neither orphaned nor vulnerable. Data was compared for all children with visits in 1 or 2 months (baseline) and a visit in months 5 or 6 (follow-up).
Results show that for all children there was significant reduction in outstanding immunizations (5% to 1%), skin and intestinal parasites (15.5% to 0.2%), and stunting (26.9% to 14.2%) between baseline and follow up. Within the longitudinal group, reductions were observed in the prevalence of anemia (1.9% to 0.5%), incomplete immunizations (6.5% to <1%), and parasitic infections (16.9% to 0.2%) between the two time points. At baseline, orphans were more likely to have incomplete immunizations and parasitic infections. Among orphans, incomplete immunizations declined from 25% to 0, while parasitic infections decreased from 22.7% to 0. Among other vulnerable children incomplete immunizations declined from 5% to 1%, as did skin and parasitic infestations (17.2% to 0.3%).
The study also points out that in rural areas of Namibia, with its large landmass, difficult terrain, and sparse population, access to health care is particularly difficult. On average, a one-way distance to a clinic is 63.6 km which has a large impact on vulnerable populations, particularly women and children. Mobile clinics are seen as an effective intervention for hard-to-reach, resource-limited settings, however usually used in vertical-approach; focusing on one disorder or public-health problem. In an effort complement these services, the Mister Sister mobile health clinic was set up through a unique public-private partnership, to provide affordable preventative and basic curative care. The first Mister Sister mobile clinic on which this study was conducted, was funded by the Heineken Africa Foundation with technical assistance for operations, and donor funding for vulnerable communities provided by the Health Insurance Fund and USAID. The service received positive response, as being one of the few providers offering comprehensive primary healthcare services. This study shows that regular mobile clinic visits improved health indices of all child attendees, with the highest amongst orphans and vulnerable children.