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New PhD research on Pioneering Public Private Partnerships in the Health sector in Namibia

On Tuesday 19th of December, Ingrid de Beer defended her PhD thesis ‘Engaging the private sector in public health challenges in Namibia’ at the Agnietenkapel in Amsterdam. The studies included were a result of operational and original research conducted on PharmAccess Foundation Namibia programs over a period of 12 years.

  • Jan 18, 2018

In her thesis, de Beer describes interventions developed and applied in Namibia to engage its private sector as an agent to develop and leverage private resources for public health. The studies presented motivate further engagement of the private sector towards addressing public health challenges in Namibia not only for HIV, but also for other chronic and non-communicable diseases.

Healthcare in Namibia

Namibia is one of the least populated countries in the world with a population less than two million on a surface area of over 825,000 square kilometers. Namibia also has one of the highest income inequalities in the world, with approximately 20% of the population earning 80% of the income. The healthcare landscape reflects this inequality, with the majority of the population making use of under-resourced public health services. Therefore, Namibia was in need for better access to healthcare in remote areas. However, due to the vastness of the country and small population size, establishment of healthcare facilities in every remote location was not cost-effective.

In 2004, PharmAccess expanded their operations to Namibia with the ultimate goal to make health markets work more efficiently for low and middle-income groups by raising more money within the healthcare system. In pursuance of achieving this goal, PharmAccess Namibia focused on the private market. By strengthening the private sector, PharmAccess was able to build more sustainable models through the public sector.

Access to health in remote areas

In 2008, based on demand for on-site testing in workplaces, two innovative mobile service provision systems were developed. The first one was the Bophelo! mobile service, which provided mobile wellness screening at workplaces. In response to the needs and the gap in referral services identified in the Bophelo! program, the Mister Sister program was developed. Mister Sister uses mobile clinics to provide primary healthcare services to both remote and underserved people in Namibia.

Mister Sister was the first program in Namibia that leverages both governmental and private sector resources to cover the cost of service delivery and it has played a vital role in upgrading health infrastructure and the quality of services delivered to rural populations in Namibia. In addition, the programs have increased trust between the public and private sector to jointly provide health services using a mixed funding model.

In her thesis, Ingrid declares that public private partnerships such as those demonstrated in Namibia can greatly contribute towards a better healthcare system in dealing with public health challenges. In many ways, PharmAccess Namibia served as the ground zero country to design concepts and tools beneficial to other countries with PharmAccess operations, especially in the development of health insurance, quality improvement, impact assessments and public private partnerships.

Transferring operations to local partners  

PharmAccess Namibia was established in 2004 and for 12 years pioneered innovative healthcare services. By the end of 2016, PharmAccess successfully and sustainably transitioned all programs to the Namibian partner Healthworks. With this transition, the role of PharmAccess in Namibia will come to completion.

Ingrid de Beer declares: ‘’PharmAccess identifies gaps in the healthcare system, develops innovative solutions in partnership, pilots these innovations and demonstrates proof of principle. Once this is done and the innovation works well, we find local partners to continue and grow the operations. The Mister Sister program has reached this stage and PharmAccess is proud to transition the program to our long-time partner- Healthworks.’’

  • Read more on the thesis of Ingrid de Beer ‘Engaging the private sector in public health challenges in Namibia’ here.
  • Read more on the history of PharmAccess’ activities in Namibia here.
  • Read more on the Mister Sister program here.
  • Find a summary of Ingrid de Beer’s thesis here.



    The name Mister Sister came as a result of a male nurse leading the initial pilot of the mobile clinics. In Namibia nurses are mostly female and traditionally referred to as ‘Sister’. When the community where the initial pilot was conducted asked the male nurse, George, what they should call him, he jokingly said – call me ‘Mister Sister’. The word spread and the mobile clinics soon became known as Mister Sister     –