Analytical summary - Risk factors for health
The main risk factors for health in Namibia include alcohol consumption, tobacco use, unhealthy or nutrient deficient diets, escalating overweight and obesity, sedentary lifestyles, risky sexual behaviour and inadequate hygiene.
Evidence shows that non-communicable diseases (NCDs) such as cancer, diabetes, cardiovascular diseases and chronic respiratory illnesses, long thought to be the burden of high-income populations, are affecting more low- and middle-income countries, including Namibia. According to the demographic health surveys, NCDs are among the top 10 diseases and top 15 causes of death in Namibia. Health facility-based data indicate hypertension and diabetes as the first and second causes of disability among adults respectively.
The 2008 estimated prevalence of raised blood pressure was 43.4%. HMIS data are used for surveillance of blood pressure, blood glucose and cholesterol measurements. To date, the major focus of health interventions has been on strengthening the prevention and control of communicable diseases, with little attention paid to noncommunicable diseases (NCDs) and their associated risk factors, such as tobacco use, poor diet and unhealthy lifestyles. In 2010, an NCDs Committee was established to advocate, mobilize resources and plan for NCDs prevention and control programmes.
Alcohol abuse is prevalent, and presents a growing problem among the youth. In January 2011 the MoHSS and Coalition on Responsible Drinking established the National Alcohol Traders Programme to help ensure compliance with regulations on alcohol sales and advertising. The last survey of drug use was in 2002. The 2008 Namibia Global Youth (ages 13-15) Tobacco Survey gives cause for concern, with 31.1% of students reporting use of tobacco products.
The Namibia Tobacco Products Control Act (2010), parts of which are already being enforced, provides for, among others, the reduction of demand for and supply of tobacco products and protection from exposure to tobacco smoke.
While detailed data on food intake patterns in Namibia are scarce, it is estimated that few people regularly consume legumes, vegetables and fruit. Obesity is on the rise and is linked to cardiovascular diseases as well as increased risk of diabetes. The Strategic Plan for Nutrition 2010-2014 aims to reduce the prevalence of obesity from 12% to 8% and overweight from 16% to 10% in women of reproductive age. An assessment of the prevalence and causes of obesity, overweight and NCCD is essential to ensure that interventions are properly targeted.
The findings from the 2003 World Health Survey, STEP 2 Survey in 2005, and Namibia Global School-Based Student Health Survey in 2004 indicate that 41% of study population were physically inactive, 31% lead sedentary life, 41% of school students did not do any physical exercise. The Non-communicable Diet-related Diseases Programme of the MoHSS was initiated in 1994 but has not yet been implemented due to lack of capacity at national level. The current Food and Nutrition Guidelines for Namibia are outdated and due for revision in 2013, along with a social mobilisation campaign.
Risky sexual behaviour is known to increase vulnerability to STDs, including HIV. According to UNICEF figures, knowledge about HIV/AIDS among the youth is high at 95-99%. However, the majority of youth have multiple sexual partners, which is thought to be a driver of the HIV epidemic. Other risky behaviours include the exchange of alcohol for sex, which is a well-known practice in Namibia.
The high prevalence of diarrhoea in Namibia is largely due to poor sanitation and hygiene practices. According to 2004 Namibia Global School-Based Student Health Survey, only 51.0% males and 51.3% females always, wash their hands before eating. The Namibia National Sanitation Strategy 2010/11-2014/15 states that 370 new sanitation facilities have to be built to clear the sanitation backlog in schools, and hygiene promotion must be improved.
Despite growing awareness and concern about all these risk factors within the health sector, current interventions are hampered by a lack of adequate surveillance, especially where NCDs are concerned.