Perceived Patient Safety in Public Healthcare Facilities in Namibia: Findings from a Community-Led Monitoring (CLM) Program

A safe and hygienic healthcare facility environment is fundamental to protecting patients and healthcare workers and to sustaining public trust in health systems. Evidence on patient-perceived healthcare facility safety in low- and middle-income countries (LMICs), including Namibia, remains limited. This study assessed participants’ perceptions of healthcare facility safety within a national community-led monitoring (CLM) programme, and identified factors associated with these perceptions. Data were collected using a questionnaire comprising 37 items addressing participants’ sociodemographic characteristics, their experiences with the received services, and their perceptions of safety within healthcare facilities. The questionnaire covered several dimensions, while the outcome was assessed with a single dichotomous question. We analysed routinely collected CLM data from 15,066 individual beneficiaries of care aged ≥18 years accessing healthcare services across Namibia between January 2024 and November 2025. Data were analysed using IBM SPSS version 30. Descriptive statistics were used to summarise participant characteristics and safety perceptions. Associations between perceived facility safety and selected factors were assessed using chi-squared tests and bivariable and multivariable logistic regression models. Among 15,066 participants, 87.9% (95% CI: 87.4–88.4) perceived healthcare facilities as safe, with national rates increasing from 86.8% in 2024 to 88.9% in 2025. Negative experiences such as inadequate healthcare workers, poor attitudes, discrimination, and dissatisfaction with services were statistically significantly associated with lower perceived safety (p < 0.05). Potential policy considerations like structural workforce strengthening and facility-level infrastructure improvements to improve patient experience, safety culture, and quality of care require further research.