usaid/nambia environmental threats and opportunities assessment
usaid/nambia environmental threats and opportunities assessment
usaid/nambia environmental threats and opportunities assessment
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Infant mortality as well as under-five mortality, which declined noticeably between 1990 <strong>and</strong><br />
2000, has been on an upward trend since then – mostly as a result of HIV/ AIDS <strong>and</strong><br />
inadequate nutrition.<br />
Maternal mortality has been on the rise since the beginning of the 1990s – also as a result of the<br />
HIV/AIDS epidemic.<br />
Access by urban households to safe drinking water in 2008 was almost 100%, but has slightly<br />
decreased. Access by rural households to safe drinking water is increasing <strong>and</strong> currently st<strong>and</strong>s at<br />
80%.<br />
Access of urban households to basic sanitation has declined in recent years <strong>and</strong> st<strong>and</strong>s at 58%.<br />
For rural households, access is estimated to be 14%.<br />
<br />
The prevalence of TB has declined since 2004 <strong>and</strong> current programmes <strong>and</strong> policies are likely to<br />
further contribute to the lowering of TB cases.<br />
Cases of malaria have declined over the past 15 years to the current ratio of 48 cases per 1,000<br />
people. However, the profile of this disease – as with all other vector-borne diseases – may<br />
change with changing climates <strong>and</strong> prove to become more (or less) problematic in the future.<br />
The HIV/AIDS epidemic is the primary driver of falling life expectancy 5 in Namibia <strong>and</strong> is discussed in<br />
more detail below.<br />
2. THE HIV/AIDS EPIDEMIC<br />
The 2010 National HIV Sentinel survey of prevalence rates in pregnant women aged 15-49 (MoHSS<br />
2010) reports that:<br />
National prevalence of the disease in this group of Namibians is estimated at 18.8%.<br />
<br />
<br />
<br />
There is little difference in HIV prevalence between rural <strong>and</strong> urban areas, but the disease is<br />
concentrated amongst mobile populations (e.g. those linked to the mining industry <strong>and</strong> at border<br />
entry/exit points).<br />
The incidence of orphans <strong>and</strong> vulnerable children (OVCs), a major consequence of the<br />
HIV/AIDS epidemic, is highest in Namibia’s rural areas with the lowest wealth quintiles. The<br />
highest incidence of OVCs in Namibia occurs in the Omusati, Oshana, Oshikoto, <strong>and</strong> Kavango<br />
regions which all report between 31 <strong>and</strong> 37% incidence (MoHSS 2008).<br />
There has been successful rollout of anti-retroviral treatment (ART) to all 36 hospitals<br />
countrywide, with 58,775 people receiving ART in 2005/06 (GRN 2008).<br />
<br />
The number of HIV/AIDS cases in Namibia is expected to increase for several years.<br />
Evidence of the difficult issues surrounding the planning, funding, <strong>and</strong> treatment of the HIV/AIDS<br />
epidemic was seen on several occasions during the two-week mission. Several USAID-funded HIV<br />
clinics were being closed as of the end of the fiscal year (September 30, 2010) due to a shift in program<br />
strategy, a result of careful coordination <strong>and</strong> planning between the USG <strong>and</strong> the Ministry of Health <strong>and</strong><br />
Social Services (MoHSS). The expectation is that the GRN would assume responsibilities for the<br />
5 Life expectancy fell by 11 years (men) <strong>and</strong> 13 years (women) to 48 <strong>and</strong> 50 respectively between 1991 <strong>and</strong> 2001.<br />
20 USAID/NAMIBIA ENVIRONMENTAL THREATS AND OPPORTUNITIES ASSESSMENT