“Preventive & Integrative Social Protection Schemes in Namibia – A Case Study on

Disability Management in Namibia”

Presented by Phillip Nghifitikeko

07July 2015

Presentation Outline

1. Mandate of the MVA Fund

2. Benefits of the Fund

3. Value chain

3. Crash Statistics

4. Rehabilitation Programme

5. Spinal cord Injury rehabilitation unit

6. House Modifications

5. Challenges and Future outlook

Mandate of the MVA Fund

“to design, promote, and implement crash and injury prevention measures;

to provide assistance and benefits to persons injured in motor vehicle accidents /crashes and to dependents' of persons killed in such accidents/crashes”

Benefits of the Fund

• Injury Grant – Up to N$100,000

• Funeral Grant– N$7000

• Loss of Income – Up to N$100,000 per annum

• Loss of Support– Up to N$100,000 per annum

• Medical treatment and rehabilitation– Up to N$1,500,000

Value Chain

Injury Prevention

Service awareness

Emergency care

In hospital treatment

Financial Support

Rehabilitation

Crash StatisticsTable 1: Crashes, injuries and fatalities per month

2014   2015

 Months Crashes Injuries Fatalities

 

 Months Crashes Injuries Fatalities

Jan 248 463 63 Jan 309 509 66

Feb 253 477 40 Feb 303 480 39

 Mar 296 492 66 March 375 633 67

 Apr 245 526 46 April 335 595 66

 May 312 507 63 May 310 594 43

 June 283 468 53 June 321 603  46 

July 298 501 64        

Aug 325 594 82        

Sep 257 420 46        

Oct 299 545 41        

Nov 300 501 49        

Dec 356 820 61        

 Total 3472 6314 674  Total 1953 3414 327

Rehabilitation Programme

Rationale•Motor Vehicle Accident Fund (MVAF) Strategy 2014-2019 specifies ‘Rehabilitation goal attainment’ as one of its key institutional objectives.

•Deemed as worth investment as there are:– Benefits to employers– Benefits to employees and their families

•National benefits– NDP4, economy and health indices

Develop rehabilitatio

n plan

ActImplement

rehabilitation plan

Review rehabilitation progress

Take actions to improve rehabilitation success

Implement the plan

Establish the rehab goal and the interventions necessary to deliver the

desired outcome

Monitor and measure rehabilitation progress

MVAF REHABILITATION CORE PROCESS

Rehabilitation: Before and After

Rehabilitation: Before and After

Measuring Outcomes

KPI = % customers achieving goal within 6 months of accident

30 April 2014

31 Oct

2014

30 Nov 2014

31 Dec 2014

31 May 2014

30 June 2014

Quarterly result = average

1April 2014

Measuring outcomes (2014)

MONTH RETURNED TO WORK

RETURNED TO SCHOOL

RETURNED TO

COMMUNITY

TOTAL % GOAL ATTAINMENT FOR THE MONTH

April 19 7 15 41 77%

May 21 7 12 40 76%

June 14 3 18 35 71%

July 13 2 10 25 64%

August 15 6 11 32 73%

September 1 6 11 18 75%

October 12 1 17 30 71%

  95 32 94 221 72% Average

Deciding eligibility for rehab programme

Does Claimant require Rehabilitation post-discharge?NO:

– Condition does not have any impact on claimant’s functional performance

– Claimant can return to work immediately post discharge or after a few days leave

YES:– Condition renders significant functional limitations even after

discharge from health facility– Risk of prolonged absence from work due to ill health– Foreseeable challenge with returning to pre-injury duties– Needs assistive devices to improve functional performance

Spinal Cord Rehabilitation Unit

• Unit operational since 2013• Collaboration between the Ministry of Health , MVA Fund, Spinalis

Foundation in Sweden• Capacity of 8 Beds• Patients are trained to be independent in:

- Bowl and bladder management

- Sexual Education

- Daily Living (Washing/eating /dressing)

- Wheelchair Skills training

- Transfer from bed and wheelchairs• Rehabilitated 85 patients successfully by the unit

House Modification

• Part of the Rehabilitation continuum is to ensure that injured persons are able to move freely in their homes.

• Rehabilitation plans cover house modification requirements such as:– Ramps/Landing– Widening of house entrance– Height adjustable shower– Handrails – Bathroom modification

House Modification cont.

• Seriously injured portfolio equals 158

• Of the total 43 persons’ houses need to be modified.

• The MVA Fund managed to modify 18 houses since 2014

• Plan for 2015 is to modify 25 homes

House Modification cont.

House Modification cont.

House Modification cont.

House Modification cont.

House Modification cont.

Challenges• Lack of enabling legislation to fully support persons with

disability e.g. public transport, access to buildings and sanctions for non- compliance

• Lack of Incentives to hire persons with disability• Limited rehabilitation facilities in Namibia and centralized

services e.g. rehab facilities• Limited access to basic needs such as water.• Land/home ownership• Rehab professions are generally not well known in the Namibia,

hence many learners opt to pursue the most common health professions

Challenges

• Limited awareness among community members on early identification of disabilities, and courses of action to take

• In low income earning families rehabilitation is often not prioritized as they focus on getting basic needs for survival (majority of people with disabilities are in poverty and are trapped in the Poverty-Disability Cycle

• Absence of functional/coordinated community based rehabilitation services (CBR)

• The Geographical vastness of Namibia makes it very difficult but not impossible for Rehab services to reach all PWDs.

Future outlook• Legislation– ensuring responsive legislation that supports persons

with disability with sanctions (e.g. access to building, access to public transport)

• Incentives for Employers to hire persons with disabilities e.g. Tax cuts

• Establishment of more rehab centres across the country

• Prioritise land and home ownership for persons with disability ( cheaper housing options such prefabricated houses)

• Capacity building for RTW e.g. Physiotherapist and Occupational therapist etc.

• Vocational training options

• Establish a Traumatic Brain Injury Rehabilitation unit

• Awarding bursaries for allied health professionals and creating awareness

Future outlook

• Closer collaborations between MVA Fund, SSC, Disability council

Thank you.