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Onandjokwe hospital decentralising health care

Onandjokwe hospital decentralising health care

IntraHealth International is helping the remote Onandjokwe Hospital become a national model for bringing health care to the people.

IntraHealth’s USAID HIV Clinical Services Technical Assistance Project has helped add 42 new health workers to the region through its rapid hiring approach, in the process helping Onandjokwe solve its staff shortage by recruiting additional nurses, health assistants, administrative staff, and drivers.

A nurse at the hospital, Ruusa Shipena, who supervises antiretroviral therapies (ART) at Onandjokwe’s Shanamutango HIV clinic said that they now have more time to spend with their clients.

Margarite Nathe from IntraHealth International said that the project in Namibia is funded by the US Agency for International Development through the President’s Emergency Plan for AIDS Response (PEPFAR).

“Visiting Onandjokwe Hospital to get a refill on your HIV medication means waiting in line for an average of 8 or 9 hours. You had to wait for your name to be called at reception, then to have your BMI measured, then to have blood drawn, then HIV counseling, and then wait up to five hours at the pharmacy,” Shipena said.

“People would turn up at the clinic the night before and sleep on the sidewalks just to be at the front of the line the next morning, she added, as she and her colleagues were seeing up to 80 clients per day.

But according to her, today that number has dropped to around 40. “The waiting room is not crowded. Things are running smoothly. And the few people who sit waiting in the reception area are called up within a few minutes of taking their seats, their entire visit now taking about an hour,” she said.

Two major reasons for Onandjokwe’s former overcrowding were it was the only place to get HIV-related services for over 81,000 people in a region that suffers high rates of HIV infection (reaching 22.6% in Onandjokwe district as it was severely short on staff.

In 2012, the Shanamutango clinic had just one doctor and five nurses to care for over 10,000 clients per month. IntraHealth has now helped it decentralize ART services to eight clinics throughout the district.

Onandjokwe is now number one in the country for decentralization, that is, making services available beyond the central hospital location. It’s become a model for providing high-quality care to remote populations that are spread out over vast geographic areas.

“And best of all, people who live far from the hospital no longer have to walk for days or spend precious money on transport to get the care they need. Now the mothers who used to come get their services here, they have started going to clinics that are closer to where they live,” Shipena said.

IntraHealth also set up ART services at 20 of the hospital’s 45 community outreach points, which provide general care to communities in the district. Before the newly hired drivers and donated cars were available, Shipena and her staff could only provide outreach services when the opportunity struck.

(Photograph by Morgana Wingard for Intrahealth International).

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