“Preventive & Integrative Social Protection Schemes in Namibia – A Case Study on Disability Management in Namibia” Presented by Phillip Nghifitikeko 07July 2015
Dec 29, 2015
“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
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
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