Windhoek

Namibia / Windhoek

OVERVIEW

Generally speaking, Namibia is a country where health care options will vary widely, depending on someone's social status and geographic location. In urban areas, like Windhoek, you can find higher quality and modern medical facilities, though these private facilities are unaffordable to much of the populace. However, in more rural areas, women may depend on small clinics, which are run by the government or church associations, or sometimes traditional healers. In cities, there are many responsive and high-quality pharmacies, which sell a variety of contraceptive options, though most contraceptive methods, including birth control pills, do require a prescription. Furthermore, emergency contraceptive pills (morning after pills) are legal and, while some official sources may state that they are by prescription-only, they appear to be sold over-the-counter. The fertility rate, as of 2017, is 3.29 children born per woman.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Namibia, you need a prescription to purchase most contraceptive methods, such as oral contraceptives (birth control pills), at pharmacies. However, you can access condoms (male and female) without a prescription.

In 2015, it was estimated that about 57% of Namibian women (who were married/in unions and of reproductive age) used some form of birth control, including traditional methods, which was a bit lower than the Southern African average (64% of women using contraceptives). Furthermore, it was found that about 17% of women had unmet family planning needs, which was higher than the Southern African average (13% had unmet needs). The most common forms of contraception for Namibian women was contraceptive injectables (28%). This was followed by male condoms (12%), birth control pills (7%), and female sterilization (6%). There were low rates of usage for IUDs (1%), contraceptive implants (less than 1%), and male sterilization (less than 1%). There were practically no users of vaginal barrier methods (0%). Traditional methods, such as the rhythm method or withdrawal, had low usage as well (less than 1%, respectively).

While there has historically been a culture of stigma and shame around many women purchasing contraceptives, the mood has begun to shift as more people share information and resources online. To read more about cultural attitudes as related to condom purchases in Namibia, you can read an article here from the Namibian Newspaper.

What to Get & Where to Get It

• TIP: You can visit the Namibia Family Planning Association for free family planning services and support for both individuals and couples. You should contact them to find which location is closest to you. Telephone: +264-61-230-250. Fax: +264-61-230-251. Email: info@nappa.com.na
• In Namibia, you can find condoms at a variety of venues and stores, including pharmacies and service stations, and no prescription is required. They are also available for free (male and female condoms) from the Namibia Family Planning Association. You can expect to see a variety of international brands sold in stores, though they will typically be much more expensive than going through specialized clinics or social initiatives.
• You can find oral contraceptives (birth control pills) sold at pharmacies and available at the Namibia Family Planning Association (NAPPA), but a prescription is required. Some brands that you can expect to see include Biphasil, Diane, Femodene, Ginette, Marvelon, Melodene, Mercilon, Minesse, Minulette, Nordette, Ovral, Triphasil, Yasmin, and Yaz. Please note that certain birth control pills, such as Cerazette, are not available in Namibia, as of August 2018.
• You can find contraceptive rings (Nuvaring) in Namibia, though the pharmacy may not have them in stock and will need to special order them. For this reason, it's recommended to contact the pharmacy in advance before looking to obtain a contraceptive ring.
• You can find contraceptive patches, such as Evra, sold in pharmacies in Namibia.
• You can find intra-uterine devices (IUDs), and you can get them inserted at hospitals or clinics in Namibia, including copper IUDs.
• You can find contraceptive shots/injectables. You can receive the injections at hospitals, clinics, or from specialized providers, like the and you can get them injected at hospitals, clinics, or from specialized providers, like the Namibia Family Planning Association (NAPPA). From the NAPPA website: "It is preferable to have the injection during menstruation (bleeding) so the Service Provider can be sure you are not pregnant. However if you attend at a time when you are not menstruating the Service Provider will ask you to have a pregnancy test – the injection should not be given to women who are already pregnant!"
• You may be able to find find contraceptive implants, but they are extremely rare. Some brands you may see are Jadelle and Implanon.
• You can find hospitals that perform sterilization (male and female) in Namibia. If you contact the Namibia Family Planning Association (NAPPA), they can refer you to a hospital that provides such services in your area.

Costs

• At a pharmacy, you can expect to pay the following prices, as of August 2018: Oral contraceptives ranging from N$100.00 to N$250.00. Condoms range from N$20.00 to N$150.00.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex to prevent pregnancy. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Namibia, you can access emergency contraceptive pills (morning after pills) at pharmacies. While some brands may require prescriptions, others do not. According to a 2016 article by a Namibian pharmacist, you do not need a prescription for brands like NorLevo or Escapelle. Furthermore, while pharmacists may ask you questions (such as when you last took emergency contraception), the pharmacist clarified that this is to understand your health situation rather than pass a moral judgment.

Generally speaking, emergency contraceptive pills are not commonly used in Namibia. While the data is old, in 2006-07, it was found that 1.6% of women had ever used ECPs and about 21% had knowledge of ECPs. Furthermore, for many Namibians, there is embarrassment or shame related to asking for emergency contraception, despite the fact that it is completely legal to do so.

What to Get & Where to Get It

• You can access emergency contraceptive pills from pharmacies and certain social marketing programs. You may be able to access them from the Namibia Family Planning Association. You should call them to get more info (+264-61-230-250) or email them (info@nappa.com.na).

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

In Namibia, there are no travel or residency restrictions related to your HIV status. This means that, if you are a foreigner who plans to visit Namibia, you will not be asked for a medical certificate or proof of your HIV status upon entry in the country. Furthermore, you will not be required to be HIV-negative in order to obtain various visas, such as a work visa or student visa. If you test as HIV-positive when you are in Namibia, you will not be deported or expelled from the country either. While there were previously restrictions on foreigners who were HIV-positive, they have been repealed by the government.

For many years, Namibia has struggled to contain an HIV epidemic. However, the country has begun to show progress regarding the prevention of new HIV infections. In 2017, it was estimated that about 12% of the adult population (ages 15 to 49 years old) were living with HIV in Namibia. Women are disproportionally impacted by HIV, as 14.5% of women are living with the virus (as opposed to 9.5% of men). There are an estimated 34,000 orphans (ages 0 to 17 years old) due to HIV/AIDS in the country. Yet, since 2010, HIV infections have decreased by 24% and HIV-related deaths have decreased by 21%. Furthermore, it is estimated that about 90% of people living with HIV in Namibia know their status, 74% of people living with HIV have suppressed viral loads, and 84% of adults and children with HIV are receiving ART. Finally, over 95% of pregnant women in Namibia received ARV for PMTCT, in 2017.

You can receive STI tests in many places, including doctor's rooms, hospitals, clinics, community health centers, family planning clinics, STI/STD clinics, and laboratories.

Testing Facilities

• Some people choose to take HIV tests through self-test kits that you do at home. They are sold in pharmacies, such as Langerhans and Medisun, and they are reportedly very popular.
• Namibia Family Planning Association (NAPPA): They offer free HIV testing, counseling, and support. "Once pre-counselling is given, the test for HIV is carried out. The test involves a simple needle prick on the finger so blood can be collected for the test. Rapid HIV tests are used at NAPPA clinics. This means the result can be given after approximately 15 minutes waiting time. Following testing the client will receive his/her result, and this can be positive or negative. Positive means there is HIV present in the blood: negative means there is no HIV present at this particular time. Post test counselling is then given to all clients. This is very important to help the client discuss how they feel about their result, what support is available if the result is positive, or how to remain negative. If the client tests positive for HIV, blood for a CD4 count will be taken by a Service Provider. CD4 count is a blood test that measures how far HIV has progressed in the body, and if treatment (anti-retrovirals - ARVs) is required." Telephone: +264-61-230-250. Email: info@nappa.com.na
• Catholic AIDS Action: They provide voluntary HIV Testing and counsellng services (through community outreaches and door-to-door implementation modalities). Contact them for more details: National Telephone: 061 276 350. Email address: info@caa.org.na

Support

• The Namibia Networks of AIDS Service Organisations (NANASO): "The Namibia Networks of AIDS Service Organisations (NANASO) is a National network comprising of national networks of AIDS Service Organisations (ASOs). NANASO’s supports a 1000-strong affiliate network of AIDS Service Organisations and individuals. Services include Training, Advocacy, Libraries, Distribution hubs, Community fora and networks, building AIDS Competent communities and bridging the gap between local and national, communities." Address: 30, Liter Street, Windhoek Namibia. Phone: +264 61 261122. Email: nanaso@nanaso.com
• PEPFAR Namibia Information from the US Consulate: "The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Namibian government are in partnership to meet joint priorities, to build capacity and systems needed to ensure the sustainability and effectiveness of the national HIV/AIDS program. We work in close collaboration with the Ministry of Health and Social Services (MoHSS) and partners to plan, implement and monitor co-investments to achieve epidemic control and foster a sustainable response." Address: U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), Sanlam building, 3rd Floor, Independence Avenue, Windhoek, Namibia. Office: +264 61 295 8520. Fax: +264 61 400 663.
• Project Hope - Namibia: "Project HOPE began strengthening health care services and providing health education in Namibia in 2002 while implementing HIV/AIDS workplace education programs. HOPE's programs have since grown to include TB treatment and education, strengthening the coping capacities of households and communities caring for OVC, working to prevent HIV/AIDS among young women and village health banks."
• I-TECH: "I-TECH has worked in Namibia since 2004 to support a robust and sustainable health care system, and to address key health challenges including high HIV prevalence and a critical shortage of skilled healthcare workers. Based in the capital city, Windhoek, I-TECH Namibia has a long history of successfully supporting the Ministry of Health and Social Services (MoHSS), the University of Namibia, and the Ministry of Defence/Namibia Defence Force to improve the health of all Namibians." Tel: + 264-61-310-200. Fax: + 264-61-310-216. Email: norbert@itech-namibia.org
• Catholic AIDS Action: "Acting in the Spirit of Christ, Catholic AIDS Action challenges the AIDS pandemic in Namibia with the Courage to Fight and the Strength to Care for the benefit of all." National Telephone: 061 276 350. National Office fax: 061 276 364. National Office physical address: No12, Adler Street, Windhoek West, Windhoek. Email address: info@caa.org.na
• IntraHealth Namibia: "Since 2006, we've partnered with the Namibian government and NGOs (including faith-based health organizations) to make HIV services for counseling, testing, prevention, care, and treatment more widely available to communities throughout Namibia. We provide training, mentoring, and supportive supervision to help Namibia's health workers deliver high-quality, comprehensive health services. And together with our local partners, we strengthen institutions’ financial, human resources, and management systems."
• AIDS Care Trust of Namibia: "Aids Care Trust of Namibia is an organization that amis at providing holistic services in HIV/AIDS prevention, care and support through greater coordination, better partnerships and livelihood support programs resulting in an empowered community capable of self sustenance." Email: info@aidscaretrust.org
• Namibia Women's Health Network: "Namibia Women’s Health Network (NWHN) is a organisation of women living with HIV created by 14 women that participated in the Parliamentarians for Women’s Health project in 2005 to 2008."

Costs

• The costs for an STI test will vary, depending on the tests you get and where you go. For example, the Namibia Family Planning Association (NAPPA) gives free HIV tests. However, if you go to a private clinic, you can expect to pay a fee for an HIV test. Furthermore, for STI tests that are not HIV, you may need to pay a fee at a avriety of clinics, though we will need to collect more information about this.

Medications & Vaccines

What to Get & Where to Get It

• In Namibia, you can access pre-exposure prophylaxis (PrEP). It is available to any sexually active HIV-negative person at substantial risk of acquiring HIV. For more information about PrEP in Namibia, you can visit the PrEPWatch Namibia page. You can also contact PEPFAR, EQUIP PrEP Demo in Namibia, or I-TECH DREAMS Project to learn about how you can access PrEP in Namibia.
• While you can probably find the HPV vaccine in hospitals and clinics, there is no nationwide HPV vaccination program in Namibia, as of 2017.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

• You can find pads/pantyliners in supermarkets and pharmacies.
• You can find tampons in supermarkets and pharmacies, though selection may be limited. You may be most likely to see brands like OB, which do not have applicators.
• You can find menstrual cups sold in pharmacies. For example, menstrual cups were being sold for N$110.95 at Clicks Pharmacy in 2017.

Local Organizations/Initiatives

• Sister Pads: "SisterPADS offers a sustainable solution to a monthly reality. Through our cost-effective, eco-friendly, washable and re-usable sanitary pads we aim to improve girls’ menstrual health hygiene and welfare. SisterPADS is focused on effecting increased school attendance and subsequent academic performance. Instead of fearing embarrassment and therefore being held back by something as natural as menstruation, SisterPADS promotes agency and mobility."

Gynecological Exams

What to Get & Where to Get It

• Mediclinic Windhoek: "Mediclinic Windhoek is based in the capital of Namibia, offers local and international patients a broad spectrum of professional medical services, including; professional consultations, quality medical care and well-equipped operating theatres staffed by highly trained and professional nursing, medical and other personnel." Address: Heliodoor Street, Eros, 9000. Phone: +264 61 433 1000. Email: Ehospmngrwindh@mediclinic.co.za
• Roman Catholic Hospital: This private hospital, established in 1907, has been recommended by a Windhoek local. However, you should remember that it is a Roman Catholic Hospital, run by the Roman Catholic Church, so they may or may not approve of certain decisions related to sexual and reproductive health care. Address: Mandume, Windhoek, Namibia. Phone: +264 61 270 2911

Pregnancy

What to Get & Where to Get It

• Windhoek IVF Clinic: "The WINDHOEK IVF clinic opened it’s doors in January 2017 and is situated at Mediclinic hospital, Windhoek. It make use of state of the art equipment in the IVF lab section. The personnel consist out of top quality professionals, surgeons and scientists. We will be working in close relationship with the AE VITAS CLINIC in Cape Town, endorsing their ethical standards and protocols. With the input from AE VITAS, our patients will benefit from having access to the combined knowledge and expertise of the whole team for a collective opinion, so you can be assured we are exploring every possible option to help you conceive." The following services are offered: Evaluation of male and female infertility, Evaluation of recurrent pregnancy losses [miscarriages], Referral centre for treatment of endometriosis, Endoscopic and microsurgery, Ovulation induction, Assisted reproductive technology [ART ]. Address: Windhoek, Khomas, Namibia. Email: windhoekivf@gmail.com
  • Dr. Alex Vandendael at Windhoek IVF Clinic: Recommended by a Windhoek local.
  • Dr Melanie Smith at Windhoek IVF Clinic: "For anything really specific, Dr. Melanie Smith, is really great, but good luck to get an appointment." Address: 8 Akwamaryn Street, Eros,

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Namibia, abortion is not legally available upon request. It is only legally permitted in certain circumstances, which include: if the pregnancy endangers the life of the pregnant person, if the pregnancy causes endangerment to the pregnant person's physical or mental health, if the pregnancy is the result of rape or incest, or if there is serious risk of fetal impairment. However, you cannot legally obtain an abortion for economic or social reasons, or simply because you request it.

For an abortion to be legally performed, the operation must take place in a government hospital or in an approved medical facility. Furthermore, two other physicians (in addition to the woman's primary physician) must approve of the abortion by certifying the grounds on which the abortion is being performed.

The abortion laws in Namibia come from the Abortion and Sterilization Act of South Africa (1975), which Namibia inherited as its own law when it became an independent state. This law is a product of the country's colonial past, when it was managed by apartheid South Africa. During that time, the apartheid government actively sought to promote a high birth rate of white babies, which was seen as a way of preserving white rule. Thus, the abortion policy of Namibia reflects the repressive and troubling history of apartheid rule, both over Namibia and South Africa. For this reason, some have argued that the abortion policy should be amended, and that it reflects an overly conservative and regressive approach to reproductive health. However, Namibia is an overwhelming Christian country, and many Christians consider abortion to be a sin. FYou can read articles from here and here, where people wrote some of their thoughts on its legal status.

What to Get & Where to Get It

• Supposedly, "Misoprostol is available under the brand name Cytotec. It is difficult to obtain," according to Women on Web.
• You can receive post-abortion care from the Namibia Family Planning Association (NAPPA). "NAPPA attends to the needs of women who have had a miscarriage or an unsafe abortion... It is important for women to have support and care after this type of experience. NAPPA Service Providers and Social Workers can provide support to women and their families to cope through such an emotional time." Telephone: +264-61-230-250. Email: info@nappa.com.na

Advocacy & Counseling

Laws & Social Stigmas

• If you have been raped or experienced sexual violence, the Legal Assistance Centre has prepared a guide (What To Do if You are Raped). This guide lets you know what steps you can take to seek medical and legal assistance.

What to Get & Where to Get It

• If you have experienced or feel that you are at risk of gender-based violence, such as domestic violence or sexual violence, you can contact the Namibia Family Planning Association. "SGBV counselling is available for anyone who has been, is currently, or feels they are at risk of SGBV. NAPPA also works with SGBV perpetrators as we believe some people can change their behaviour if given appropriate support to do so." Telephone: +264-61-230-250. Email: info@nappa.com.na
• Legal Assistance Centre-Namibia: "The LAC's main objective is to protect the human rights of all Namibians. It is the only organisation of its kind in Namibia. It has an office in Windhoek, Namibia's capital. It is funded primarily by national and international donor organisations. Its work is supervised by the Legal Assistance Trust, whose trustees include legal practitioners, other professionals and community leaders." Address: 4, Marien Ngouabi St, Windhoek, Namibia. Phone: +264 61 223 356.
• Lifeline: They provide counseling and interventions for children and families. Address: 45 Bismarck Street, Windhoek, PO Box: 5477, Ausspannplatz, Namibia. Telephone: +264 61 226889. Fax: +264 61 226894. Email: info@lifeline.org.na
• Namibia Red Cross Society: They have multiple offices throughout the country, and they focus on gender-based violence, including in refugee settings. Mailing Address: Namibia Red Cross Society, PO BOX 346, Windhoek, Namibia. Tel:061-413750. Fax:061-228949. email: enquiries@redcross.org.na
• Move Namibia (Movement for Overcoming ViolencE): Move Namibia (Movement for Overcoming ViolencE) is a movement that was formed in October 2012 to prevent and hopefully eradicate gender-based violence and particularly passion killing in Namibia. With supporters and members all over Namibia, Move Namibia aims to be a community movement that works from the bottom up.
• Friendly Haven: We don't know if this organization is still active, but it's been around since the 1990s and it focuses on providing services to women and children survivors of gender-based violence. "Established in 1996, this shelter is a project of the Ecumenical Social Diaconate Action (ESDA). Friendly Haven provides safe housing to women and their children in Windhoek. All staff members receive GBV sensitization training." Mailing Address: Friendly Haven Khomasdal, WINDHOEK PO BOX 10081. Cell: 081-1243010. Mail: esda@iway.na
• Interim Night Shelter: We don't know if this organization is still active. They focus on helping child survivors of gender-based violence. "The shelter run by Ms Mbaukua welcomes the child victims of GBV, street kids or any OVC and provides counselling as well as daily help (school support, food,) but no specific GBV training is provided to the workers of the shelter." Address: Interim Night Shelter, Safari Street, Grysblock, Windhoek. Tel: 061-212962.
• Namibian Sex Workers Alliance (NAMSWA): This organization focuses on: Empowerment, Universal health care system & Justice system – Partnership development, Capacity building, Advocacy, Communication, and Resource mobilization. Address: 131 Johan Albrecht Street, Windhoek North, Windhoek

List of Additional Resources

• Ministry of Health and Social Services: You can visit the website to learn more about the Ministry.
• Namibia Planned Parenthood Federation: "Mission: To lead, advocate for Sexual Reproductive Health and Rights (SRHR) and provide accesible, quality integrated SRH services especially for young people and underserved groups." Address: Namibia Planned Parenthood Association (NAPPA) - NAPPA House, 7 Best Street, Windhoek West, P.O. Box 10936, Windhoek, Namibia. Telephone: +264-61-230-250. Fax: +264-61-230-251. Email: info@nappa.com.na
• Click here to learn about LBTQ rights and laws in Namibia. It is important to note that homosexuality is illegal in Namibia, and there are no laws prohibiting the discrimination against LGBTQ people. It is also illegal to change gender.
• Namibian Women's Association (NAWA): They focus on issues related to women and children. Address: Namibian Women’s Association (NAWA), John Knox Street, Maroela, Katutura, Windhoek, P.O. Box 3370. Tel: 061-262461. Fax: 061-213379. Email: nagirlch@iway.na
• Sister Namibia: "Sister Namibia is a feminist and women’s rights organization located in Windhoek, Namibia. Since our establishment in 1989 we have been a constant voice for women and women’s equality throughout the lifespan of independent Namibia." 163 Nelson Address: Mandela Avenue, Eros, Windhoek, P.O Box 86753, Windhoek. Tel: +264 (0) 61 230 757. Fax: +264 (0) 61 236 371
• The International Women’s Association Namibia (IWAN): "The International Women’s Association Namibia (IWAN) is a sisterhood of women of all nationalities and ethnicities based in Windhoek, Namibia. IWAN is a non-profit association which aims to support and welcome new arrivals (expats) to Namibia."
• MenEngage Namibia: Boys and men for gender equality. "Lifeline/Childline Namibia coordinates the Namibia MenEngage Network country activities .This includes holding consultative meetings with individuals and organizations to build a fully functioning MenEngage country network in Namibia."
• MISA - Media Institute of Southern Africa (Namibia: "We focus on achieving sustainable, lasting change to make southern Africa a safer place for media workers. We envision a world where everyone, including netizens, citizen journalists, activists, scholars and artists can practice their fundamental right of free expression." Email: director@misanamibia.org.na. Tel: 061232975