Background: Implementing initiatives to achieve the targets of MDG 5 requires sufficient financial resources that
are mobilized and utilized in an equitable, efficient and sustainable manner. Informed decision making to this end
requires the availability of reliable health financing information. This is accomplished by means of Reproductive
Health (RH) sub-account, which captures and organizes expenditure on RH services in two-dimensional tables from
financing sources to end users. The specific objectives of this study are: (i) to quantify total expenditure on
reproductive health services; and (ii) to examine the flow of RH funds from sources to end users.
Methods: The RH sub-account was part of the general National Health Accounts exercise covering the Financial
Years 2007/08 and 2008/09. Primary data were collected from employers, medical aid schemes, donors and
government ministries using questionnaire. Secondary data were obtained from various documents of the
Namibian Government and the health financing database of the World Health Organization. Data were analyzed
using a data screen designed in Microsoft Excel.
Results: RH expenditure per woman of reproductive age was US$ 148 and US$ 126 in the 2007/08 and 2008/09
financial years respectively. This is by far higher than what is observed in most African countries. RH expenditure
constituted more than 10-12% of the total expenditure on health. Out-of-pocket payment for RH was minimal (less
than 4% of the RH spending in both years). Government is the key source of RH spending. Moreover, the public
sector is the main financing agent with programmatic control of RH funds and also the main provider of services.
Most of the RH expenditure is spent on services of curative care (both in- and out-patient). The proportion
allocated for preventive and public health services was not more than 5% in the two financial years.
Conclusion: Namibia’s expenditure on reproductive health is remarkable by the standards of Africa and other
middle-income countries. However, an increasing maternal mortality ratio does not bode well with the level of
reproductive health expenditure. It is therefore important to critically examine the state of efficiency in the
allocation and use of reproductive health expenditures in order to improve health outcomes.