Cardiovascular Journal of Africa: Vol 31 No 4 Supplement (July 2020)

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Cardiovascular Journal of Africa • Volume 31, No 4 August 2020 S11 AFRICA
Namibia Country Report
PASCAR and WHF Cardiovascular Diseases Scorecard
project
Fenny Shidhika, Tangeni Auala, Wihan Scholtz, Oana Scarlatescu, George Nel, Jean M Fourie
Cardiac Unit, Windhoek Central Hospital (WCH), Windhoek,
Namibia
Fenny Shidhika
Tangeni Auala
Pan-African Society of Cardiology (PASCAR), Cape Town, South
Africa
Wihan Scholtz,
George Nel
Jean M Fourie
World Heart Federation (WHF), Geneva, Switzerland
Oana Scarlatescu
Abstract
Data collected for the World Heart Federation’s
Scorecard project regarding the current state of CVD
prevention, control and management along with related
non-communicable diseases in Namibia are presented.
Furthermore, the strengths, threats, weaknesses, and
priorities identified from these data are highlighted
in concurrence with related sections in the attached
infographic. Information was collected using open-
source data sets available online and relevant government
publications.
On behalf of the World Heart Federation (WHF), Pan-
African Society of Cardiology (PASCAR) co-ordinated data
collection and reporting for the country-level Cardiovascular
Diseases Scorecard for Africa.1,2 Namibia does not yet have a
cardiac/heart society that could assist PASCAR in collating
the data. However, a paediatric cardiologist at Windhoek
Central Hospital (WCH) assisted with information on
rheumatic heart disease (RHD), along with an adult
cardiology fellow in training, who aided the adult data. These
specialist cardiologists verified their respective data fields.
A consultant cardiologist, Dr Simon I Beshir (SIB), from
the Namibia Heart Centre of the Roman Catholic Hospital
provided information on the adult CVD data.
Based on the data collected, we summarise the strengths
(achievements), threats, weaknesses and priorities identified,
which need to be considered in conjunction with the associated
sections in the accompanying infographic. Datasets that
were used included open-source data from the World
Bank, World Health Organization (WHO), Institute for
Health Metrics and Evaluation, the International Diabetes
Federation and government publications. Although
Namibia has made some progress toward the provision of
comprehensive cardiovascular care, there are still gaps,
probably as a result of fragmented and unco-ordinated
responses, with limited funding, human resources and
technical capacity. Staff shortages and a lack of essential
equipment and support at state and private cardiac centres
are some of the reasons for the dearth of published research-
related activities in Namibia.
Part A: Demographics
With a population of 2.3 million people and spanning
825 419 km2, Namibia is a sparsely populated country.
According to the World Bank (2018), Namibia is an
upper-middle-income country with 50% of its people
predominantly in northern Namibia living in rural areas.3
In 2015, 13.4% of the population were living below the
US$1.9-a-day ratio. Life expectancy at birth in 2018 was
60 years for men and 66 years for women. The general
government health expenditure was 3.9% of the gross
domestic product (GDP) in 2017, while the country GDP
per capita was US$5931.5 in 2018.3
Part B: National cardiovascular disease epidemic
The national burden of cardiovascular disease (CVD)
and non-communicable diseases (NCD) risk factors
Namibia’s premature deaths attributable to CVD (30–70
years old) in 2012 were 12%, which is slightly lower than
neighbouring country, South Africa, at 14%, but higher than
Mozambique’s at 8%. In 2017, the age-standardised total CVD
death rate was 17.7%, which was higher than that of South
Africa and Mozambique at 16.1% and 11.6%, respectively.
However, compared to the 31.8% for the Global Burden of
Disease (GBD) data, Namibia’s total CVD deaths were lower.4
The percentage of disability-adjusted life years (DALYs)
resulting from CVD for men was 7.1 and 6.2% for women,
which is lower than the GBD at 14.7% for both genders. The
prevalence of atrial fibrillation (AF) and atrial flutter was
0.2%, while that of RHD was 0.94% compared to the GBD
data of 0.53%. The total RHD mortality was 0.27% of all
deaths, which is lower than the GBD data (0.51%) (Table 1).4
DOI: 10.5830/CVJA-2020-033