More than 2 600 nursing and midwifery graduates have failed the national exam to practise in Namibia since last year, adding to widespread concerns about the quality of nursing training in the country.
The figures, which the Health Professions Councils of Namibia (HPCNA) recently presented the parliament’s standing committee on education, cover evaluation sessions held since the exam became compulsory for locally trained nurses and midwives in January 2025.
According to the statistics, 2 743 of the 5 427 graduates evaluated passed, while 2 683 failed, including candidates who were recorded as failures after not attending the examination.
The statistics show 1 523 nurse and midwife practitioner graduates were expected to be evaluated.
Of these, only 600 passed.
A further 60 candidates did not sit for the evaluation and were regarded as having failed, bringing the total number of failures to 923. This resulted in a 39% pass rate and a 61% failure rate.
Among 3 904 staff nurse graduates assessed during six evaluation sessions, 1 984 passed and 1 820 failed, resulting in a 51% pass rate and a 49% failure rate.
The parliamentary committee did not provide a breakdown of the candidates who were absent or explain the reasons for their failure classification beyond indicating that those who did not write the examinations were regarded as having failed.
“There are different factors that contribute to failure, including those who did not complete the course and those who did not show up for the exams,” member of parliament Lilian Lutuhezi said during the presentation.
Committee chairperson Marlyn Mbakera said the figures raise questions about the quality of training offered by health training institutions.
“That is a concerning number. We have to ask ourselves what quality of graduates we are producing. If a student graduates but fails the HPCNA assessment, what are parents paying for? Shouldn’t we all be worried about that?” she asked.
The committee has now asked the HPCNA to single out institutions to identify where improvement is needed.
“We have requested the HPCNA to provide statistics for each institution. We want to know which institutions are producing graduates who pass the assessment,” Mbakera said.
She said the committee is calling for higher standards, not the closure of institutions.
“We should all be concerned when students complete their training but fail the national assessment. These are issues that require urgent attention,” Mbakera said.
REGULATOR
The HPCNA during the presentation said the June 2025 evaluation session recorded the highest number of failures.
It said most staff nurse graduates who failed struggled with the ethos and professional practice component, where the average score was 30%.
The results improved in October 2025 and March 2026, when most staff nursing candidates passed the evaluation.
However, many nursing and midwifing practitioners continued to struggle in the general nursing science domain, recording an overall average score of 35%.
‘VERY CONCERNING’
The Namibia Nurses Union (Nanu) says the results point to problems in the way nursing institutions prepare students.
“The failure rate is very concerning. What we want is quality graduates. We are not happy to see graduates failing the national examination,” Nanu secretary general Junias Shilunga says.
He says the union wants the HPCNA to release institutions’ respective results.
“We now have many health training institutions, and all of them have their own curriculum. When students write the national examination set by the health professions councils, it becomes difficult for some because their curriculum is not aligned with the national standard,” he says.
Shilunga says all nursing institutions should follow one national curriculum.
He questions the method of drafting national examination papers.
“If exam setters come from one institution, they may set questions based on what they teach there. We need evaluators from different training institutions to ensure fairness.”
Shilunga says nursing graduates have in the past complained to the union about the way in which examinations are conducted.
He says examination fees are too high, adding that travel and accommodation costs put additional pressure on graduates.
“Some graduates travel long distances and do not have relatives in Windhoek to stay with. Those are some of the challenges that can contribute to the high failure rate,” he says.
QUALITY OVER QUANTITY
The assessment became compulsory for all locally trained nursing and midwifery graduates in January 2025, before they can register as practitioners.
The measure was introduced to ensure only competent graduates enter the profession.
Last year, nearly 2 000 nurses protested against the introduction of the assessment for enrolled nurses, seeking registration as professional nurses.
According to the HPCNA annual report for 2024/25, nurses remain the largest group of healthcare professionals in the country.
The report shows 13 856 nurses are registered with the Nursing Council of Namibia, representing 57% of the country’s 24 142 registered healthcare practitioners.
‘URGENT REVIEW’
Labour expert Herbert Jauch says the high failure rate should lead to an urgent review of nursing education, but warns against lowering standards.
“Namibia, together with South Africa, has traditionally been known for producing highly qualified nurses. Our nurses have been respected and their qualifications recognised internationally,” he says.
