Faculty of Health Sciences and Veterinary Medicine
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Item Adolescent sexuality and reproductive behaviour in Namibia(2005) Hailonga, PanduleniItem Adolescents' adjustment to divorce and living in step-families(2013) Solomon, AmandaThe step-family is no longer the exception in society. Globally statistics reveal the growth in this type of family structure. Divorce and living in step-families is a life-transforming experience; adolescent‟s life is profoundly altered. They encounter differences in feelings over the two-time periods. There is a need to learn more and gain a better understanding of adolescents‟ adjustment and coping with the changes caused by divorce and remarriage. The key question this research aims at answering: “How does divorce and remarriage influence the adolescent‟s life?” And “Do other factors and structures play a role to influence that outcome?” The main purpose of this thesis was to explore how adolescents adjust to their parents‟ divorce and living in step-families. This research was based on information gathered from the adolescent‟s perspective. Participants all attended the Dawid Bezuidenhoudt Senior Secondary School in Khomasdal, Windhoek. The qualitative approach and phenomenological design was applied. Semi-structured interviews were conducted with 20 participants; video and audio recordings as well as field notes were taken. This data was analyzed using content analysis and the information was organized into themes, patterns and trends. For the purpose of answering the research questions in a systematic way, eight themes prominent in the literature on adolescents living in a step-family relationship were focused upon. Eight themes emerged from the study: the demise of the family of origin, the adolescents‟ experiences of their parents‟ divorce and remarriage, the complexities of step-families as compared to the family of origin, coping strategies recommended for the adolescent living in step-families, how the adolescents‟ behaviour is being affected by co-occurring stressful life experiences and distressed relationships, the adaptation patterns amongst adolescents in step-families, support systems needed for adolescents to adapt successfully in step-families, and further research. The findings indicated that adolescents have diverse experiences of their parents‟ divorce and remarriage and they are affected by the dynamics in the step-family. The findings confirm that adolescents cope better with the trauma of divorce and remarriage when they have a strong support network. In conclusion, all parties involved in a step-family household have to work on a new form of intimacy, communication skills, and parent-child relationship, as these factors influences the adjustment of adolescents in step-families.Item An analysis about knowledge, atitutes, beliefs and practices of HIV and AIDS among the Himba people of the Kunene region(2015) Nakakuwa, Pilippine N.The Himba people are a semi-nomadic community with rich cultural beliefs and practices and are unique among other communities in Namibia. The prevalence rate among the Himba community is slightly less than 8%, which is a reflection of the uniqueness of Himba practices and beliefs. However, it is still necessary to establish the levels of knowledge of HIV among the Himba based on factors such as education, family practices that initiate early sexual relations and the role of women in household decision making and safer sex negotiation. The main purpose of the study was to evaluate the knowledge, attitudes, beliefs, practices and risk perceptions with regard to HIV/AIDS among the Himba people of the Kunene region; and to identify its determinant factors. The research study was quantitative, that is, cross-sectional, descriptive and analytical. Data were collected from respondents within the Himba community with an age range of 18 to 60 years and the data were compiled and analysed using SPSS version 21. To measure the Himba people‟s knowledge of HIV/AIDS and evaluate their attitudes, practices and perceptions relating to HIV/AIDS, respondents were posed a number of multiple-choice questions about specific areas: HIV modes of transmission, knowledge on prevention measures, wrong conceptionsof HIV/AIDS, beliefs, attitudes and practices. Each questionnaire section related to knowledge of HIV/AIDS had specific points for an overall score of 30. Descriptive statistics were performed to find the central tendency and variation parameters (mean standard deviation). Inferential statistics were obtained using a chi-square test to identify factors associated with unacceptable levels of knowledge about HIV/AIDS. Interviews were held with 290 respondents – 147 females and 143 males.The minimum age was 15 years and the maximum age was 70. The mean overall age was 29.3 years, with a 95% confidence interval of [28.0; 30.7] years. Considering the gender, the mean age for females was 27.8 years with a 95% confidence interval of [26.2; 29.4] years, whilst the mean age for males was 30.9 with a 95% confidence interval of [29.6; 32.2] years. It was established that 42% of the respondents in this study were aged 24 years or less followed by 26% of respondents who were between the ages of 25 and 30 years. In this study, the mean overall score of knowledge of HIV/AIDS and its transmission modes was found to be 15.8 out of 30 with a 95% confidence interval of [15.1; 16.5]. It was found that the Himba people‟s knowledge on HIV/AIDS does not differ according to the gender of the respondent. In fact, the mean score of knowledge of HIV/AIDS and its modes of transmission among females was 15.9 with a confidence interval of [15.1; 16.8], whilst the mean score of knowledge of HIV/AIDS and its modes of transmission among males was 15.7 with a confidence interval of [14.5; 16.8]. Using a bivariate analysis, factors such as condom use as a safer sex practice, level of education, type of marriage, and the gender of the respondents showed a statistically significant association with HIV knowledge at a 0.05 level of significance. Therefore, in order to increase knowledge that can be translated into change in behaviour and practices among the Himba, the efforts of all stakeholders are required. Such efforts include promoting education through mobile schools, intensifying sex education within the community through outreach programmes and putting in place policies integrated with indigenous cultural practices that will lead to positive attitudes and beliefs.Item Analysis of factors contributing to non-adherence to highly active antiretroviral therapy in selected facilities in Namibia: A development of adherence improvement Programme for health professionals(University of Namibia, 2023) Katjiuanjo, Maazuu ZauanaHealth professionals are faced with challenges of ART non-adherence in patient enrolled on HAART. This study was aimed at developing a programme to assist health professionals to improve ART adherence at the facilities in Oshikoto and Kavango West regions. The study was carried out in four phases i) phase 1: situational analysis ii) phase 2: conceptual framework development iii) adherence programme development and iv) programme evaluation. Phase 1 involved carrying out a situational analysis using a mixed-method design to understand magnitude of adherence problem in the study area. In the quantitative part of the study a descriptive and analytic cross sectional study was conducted to collect data using structured interview, with HIV infected persons (n=296) under antiretroviral treatment in Oshikoto and Kavango West regions. Medication adherence was measured with the Adult AIDS Clinical Trial Group (AACTG) method and the Morisky Medication adherence Scale (MMAS-8) In depth Interviews (IDIs) of health professionals (n=43) and four Focus Group Discussions (FGDs) with (n=32) individuals who received ART at a primary health care clinics were conducted at four facilities in the selected regions. Overall adherence levels was 76 % with AACTG and 36 % with MMAS-8. Factors contributing to non-adherence were Type of House, Region and Health Facility, the relationship was a negative one with beta < 0. Other factors were forgetfulness and regimens missed during the weekends as reported by the MMAS-8. Determinants of non-adherence using the AACTG adherence were found to be Confident of regularly taking medicine, Intention to regularly take medicine over the next year, Treatment support in taking medicine available and Cues to Action with beta >0.5). ART potency, that is Doses per day, ART Regimen and Dose each time per day ii with beta >0.5). The factors contributing to non-adherence with Morisky scale that showed strong positive relations with beta <0.5 were the medicinal barriers, perceived barriers, more likely to get ill than others, concerned about becoming seriously ill and barriers based on Infection severity. Determinants of non-adherence using the MMAS 8 were benefits of efficacy (r = 0.143, p <0.05), perceived barriers (r = -0.194, p <0.05) and social support in taking medicine (r = -0.127, p < 0.05). Four themes emerged of factors influencing non-adherence to antiretroviral therapy, these were: patient-related factors, health system, therapy-related factors, and condition related factors. In the qualitative data analysis, health professionals reported reasons for ART non-adherence. The subthemes included Unemployment and being poor; forgetfulness; lack of knowledge due to negative beliefs; side-effects, health system challenges; workload, inadequate training, lack of skills, and poor adherence reporting systems; stigma. The HAART participants reported several barriers that negatively influenced their medication experience and adherence. These barriers included the following subthemes: financial burden; side-effects, psychological factors, such alcohol use and stigma. The facilitators included social support, treatment support and positive patient-provide relationship. In Phase 2, the development of the conceptual framework was based on the theory of Dickoff et al. (1968) using the findings of the mixed method. Phase 3 addressed the development of the Adherence Improvement Programme (AIP) for the health professionals (1). The programme was developed within the concepts of Intervention mapping framework suggested by Bartholomew et al. (2006), which outlines the processes of developing a theory-based health promotion programme. Finally, the programme was evaluated in Phase 4 using the Centre for Disease Control (CDC) iii ‘Framework for programme evaluation in public health’ (2). A pool of public health experts was utilised for this purpose. The AIP has four programme components consisting of four objectives. Key performance areas based on the intervention strategies to improve adherence were elaborated under each objective. Tasks to be performed under each key performance areas were stipulated accompanied by indicators to measure programme performanceItem An analysis of the implementation of the school supplementary feeding programme in Windhoek, Namibia(2012) Sibanda, Dumisani G.; ;Abstract provided by authorItem An analysis of the moderating effect of emotional intelligence on the relationship between job satisfaction and work-life balance at the University of Namibia's main campus, Namibia(University of Namibia, 2022) Fernandes, AliciaThe world of work has undergone numerous changes. Emotional intelligence, job satisfaction and work-life balance are becoming increasingly important to parties in the employment relationship. The study sought to explore the moderating effect of emotional intelligence on the relationship between job satisfaction and work-life balance among University employees. 206 academic and administrative staff members at the University of Namibia’s main campus in Windhoek were selected to be part in the study. A cross sectional research design was used with information collected through the means of online questionnaires. SPSS version 27 and process macro were used for the analysis of the data. Study findings revealed that emotional intelligence had a positive relationship with job satisfaction (r = 0.56; p = <0.0001). Emotional intelligence had a positive relationship with work-life balance (r = 0.65; p = <0.0001). Job satisfaction had a positive relationship with work-life balance (r = 0.78; p = <0.0001). Emotional intelligence however, did not have a moderating effect on the relationship between job satisfaction and work-life balance, as results revealed a significance level of 5%. Organisations need to invest in positive psychological variables, as a curb to the low levels of emotional intelligence, as well as develop policies which enhance job satisfaction and work-life balance in the institution. The researcher proposes that the University trains its employees on emotional intelligence. The organisation is also advised to constantly review its policies on job satisfaction and work-life balanceItem Antecedents and outcomes of work-related psychological well-being of staff members of the University of Namibia(2013) Marques, Lilita A.The aim of this study was to investigate the antecedents of work-related psychological well-being and the individual and organisational outcomes thereof for staff members of the University of Namibia. Psychological well-being was conceptualized as an interrelated process between antecedent variables, psychological conditions, burnout, and work engagement. Institutions of Higher Education across the world have experience tremendous changes during the past few decades. Academics have been envied for their tenure, light workloads, flexibility and perks, such as overseas trips for study and conference purposes, and the freedom to pursue their own research interests. However, during the past two decades many of these advantages have been eroded and higher education institutions no longer provide the low stress working environment that it once did, thereby threatening the psychological well-being of staff members of these institutions. The potential costs of poor psychological well-being to organisations include low morale, low quality of services and products, and high absenteeism and turnover rates. A structured questionnaire comprising scales from various measuring instruments (Antecedents Scale, Psychological Conditions Scale, Work Engagement Scale, Organisational Commitment Scale, Turnover Intention Scale, and the General Health Questionnaire) was used to collect both quantitative and qualitative data. Research participants included all the employees (n = 306) of the University of Namibia. Making use of SPSS 20.0, the researcher carried out the following statistical analyses: descriptive analysis, factor analysis, correlation analysis, hierarchical regression analysis and indirect effects. Results from the quantitative analyses showed that emotional and physical engagement was significantly predicted by work-role fit (β = .30, p < 0.01), co-worker relations (β = .20, p < 0.01) and psychological meaning (β = .39, p < 0.01). Organisational commitment was significantly predicted by psychological meaningfulness (β = .50, p < 0.01) and emotional and physical engagement (β = .50, p < 0.01). The study further confirmed that work role fit (r = -.31, p < 0.01), psychological meaningfulness (r = -.40, p <0.01), emotional and physical engagement (r = -.41, p < 0.01), and organisational commitment (r = -.37, p < 0.01 are negatively related to turnover intention. The results further demonstrated the significant effect of qualifications (p < 0.01; η2 =0.08) on cognitive engagement. Content analysis of the qualitative data indicated that employment resources played a significant role in work engagement and turnover intention, both as contributing and restraining factors. Work overload and management style were identified as significant restraining factors which detracted from emotional and physical engagement. This study provides important knowledge pertaining to the antecedents and outcomes of engagement and turnover intentions which can be used to develop future intervention strategies to prevent burnout, detachment and withdrawal behaviour of staff members of the University of Namibia.Item Antibiotics’ susceptibility patterns of bacterial isolates causing lower respiratory tract infections in ICU patients at referral hospitals in Namibia(University of Namibia, 2022) Simeon, PiaIntroduction: LRTIs are a particularly important problem in Namibia, as they are rated the second leading cause of death in the country and cause around 300 deaths in children under 5 years in 2016. To reduce the burden of Lower Respiratory Tract Infection (LRTIs) on health systems and ensure appropriate patient management, it is critical to know the most prevalent pathogens leading to LRTIs and the susceptibility patterns of those pathogens in the local setting. Aim: To formulate cumulative antibiograms for ICUs of referral hospitals in Namibia for the period studied. Methods: This retrospective analytical cross-sectional study was conducted over two years: 2017 and 2018. The cumulative antibiograms were constructed according to CLSI guidelines and the chi-square test was used to compare the changes in susceptibility rates from 2017 to 2018. The data used to develop the cumulative antigrams was obtained from NIP. Results: Klebsiella pneumoniae (8.8%, 8.1%) was a predominant pathogen in Windhoek Central hospital ICU in 2017 and 2018. In Oshakati intermediate hospital ICU, Enterobacter sp. (22.2%) and Pseudomonas aeruginosa (37.5%) were the common pathogens in 2017 and 2018. Acinetobacter baumannii isolates were > 90% susceptibility to colistin, carbapenems and tigecycline in 2017. In 2028, Acinetobacter baumannii isolates were highly susceptibility to amikacin, carbapenems and colistin, but moderately susceptible to tigecyclines. In 2017, Klebsiella pneumoniae isolates were more susceptible to carbapenems (imipenem 94% and meropenem 93.8%), amikacin 89.3% and tigecycline 88.7%. In 2018, Klebsiella pneumoniae isolates were 100% susceptible to amikacin, colistin and carbapenems. Stenotrophomonas maltophilia isolates were more than 80% susceptible to all the tested antibiotics. Staphylococcus aureus isolates were 100% susceptible to linezolid, rifampicin, teicoplanin, vancomycin in 2017 and 2018, its susceptibility to these antibiotics did not change. Conclusion: The susceptibility patterns of the common isolated gram-negative pathogens were highly variable. Meropenem combined with gentamicin, is now the recommended empiric therapy for patients with LRTIs in Windhoek Central hospital ICU.Item Appropriateness of the UNAM Bachelor of Pharmacy honours Degree curriculum and its implementation, to meet the perceived health needs of Namibia(University of Namibia, 2023) Lates, Jenmifer A.Since Independence in 1990 Namibia has struggled with a chronic shortage of pharmacists. To address this, a Bachelor of Pharmacy honours degree (BPharm) was developed and the first intake of BPharm students at UNAM was in 2011. This study is the first formal assessment of the appropriateness of the curriculum to the health needs of Namibia. A cross-sectional survey was shared with all registered pharmacists in Namibia, requesting them to rate the appropriateness of the BPharm modules to their field of pharmacy practice. Additionally, respondents rated the competence of UNAM BPharm graduates, if they had worked with them and made further comments on the appropriateness of the current curriculum. Internship assessment marks for 2016-2019 were also analysed. The survey was completed by 210 of 610 pharmacists registered in Namibia (34%). The mean appropriateness rating for 37 different modules ranged from 3.7 to 4.7 (scale: 1- not appropriate at all to 5-very appropriate). The mean rating of graduates’ perceived competence for the different domains ranged from 2.8 to 3.7 (scale: 1-not competent at all to 5-highly competent). Respondents’ comments suggested several enhancements to the current curriculum, with the most frequent suggestions being to strengthen business, management and leadership training. In relation to professional examinations, interns trained at UNAM performed better on the Legal assessment compared to interns trained elsewhere, but there was no significant difference between the two groups for the Calculation or Observed Structured Clinical Examination (OSCE) assessments. Results suggest that the current BPharm curriculum is appropriate for Namibia’s health needs, though more emphasis needs to be placed on some key areas. It is recommended that the results of this study guide the UNAM BPharm curriculum transformation. This study also demonstrates a cost-effective method for critical assessment of health professions training curricula that can be utilised in resource-limited settings.Item Assessing risk factors associated with primary hypertension among military personnel at Peter Mweshihange Military Heakth Centre in Windhoek(University of Namibia, 2021) Muleya, Lilian NjahiHypertension is a preventable major risk cardiovascular non-communicable disease with a prevalence of 57% among adults aged 35 to 64 years in Khomas region, which is the highest in all regions in Namibia. The Health Management Information System (HMIS) database of the Peter Mweshihange Military Health Centre shows a high prevalence of hypertension among the military personnel in Windhoek. This study was conducted to explore non- modifiable and modifiable risk factors associated with hypertension among the military personnel in Windhoek, Namibia. A quantitative, cross-sectional and analytical study was performed using an interviewer-administered questionnaire as a data collection instrument. Simple random sampling was used to select a sample of 450 participants from 3257 military personnel population. However, 458 were distributed to cater for low responses. The study indicates that the majority (69.7%) of the participants were male, which shows that the military is a male-dominated profession. The findings from multivariate logistic regression found age (0.000) and blood relatives with hypertension (0.000), the frequency of tobacco use on a daily basis (0.044) or every 2 hours (0.031) was statistically significantly associated with hypertension and mitigating factors for hypertension such as regular check –ups (0.000) were protective against hypertension. It is recommended that surveillance, prevention, educational and awareness programmes on hypertension risk factors to be introduced and maintained among military personnel. Modification of lifestyle, such as reduction of alcohol consumption, reducing or cessation of tobacco use, eating a healthy diet and maintaining a healthy body weight, especially when above 30 years need to be adhered to by military personnel at Peter Mweshihange Health Centre in Windhoek. Furthermore, military personnel should go for regular blood pressure check-ups especially those who have blood relatives with hypertension whether they are hypertensive or not hypertensive for early detection and control. Further research, particularly with a different study design, such as case control study, is necessary to assess the disease status (cases and controls) of the respondents at the beginning of the study by measuring their blood pressure.Item Assessing the effectiveness of Tuberculosis infection control in public healthcarefacilities in the Khomas region(University of Namibia, 2019) Mulokoshi, TheopolinaEmerging multidrug-resistant tuberculosis (MDR/XDR-TB) has become a major public health concern, placing millions at risk. Moreover, nosocomial transmission of MDR/XDR-TB places both patients and healthcare workers at an even higher risk. For these reason health facilities in high-risk settings need to implement effective tuberculosis (TB) infection prevention and control (IPC) policies/guidelines. Several studies elsewhere demonstrated that organizational processes and employee skills development are key determinants of organizational performance. The effectiveness of TB control thus implies enhanced organizational performance of the healthcare facilities. However, little research has been conducted in the Namibian to see the influence of organizational processes and employee skills development on the effectiveness of tuberculosis infection control in public healthcare setting. The method employed to conduct in the study to address the research question, was the quantitative approach, using an evaluative and descriptive research study design for the period of 2008 to 2012. The study aimed to assess the effectiveness of TB IPC and potential key determinants in public healthcare facilities. The population for this study comprised of nurses and doctors purposively selected from Windhoek Central Hospital and Katutura Intermediate Hospital (TB Hospital, including ten (10) Primary Health care clinics in Khomas region, in the geographical area of Windhoek district. These facilities were selected because of their capacities, as they perform screening, treating, referring and provide DOTS to TB patients. The Donkerhoek clinic will be used for pilot study. The sample was selected using purposive sampling technique. The sample included all categories of the nurses and medical doctors who were willing, available and legible to the study. A total of hundred (100) nurses of all categories and doctors participated in this study. Data collection was conducted with a self-designed questionnaire which was self-administered by consenting study participants. . The duration of data collection took eight (8) months, due to the nature of the work condition of the health care workers. The response rate was 100%. No missing data were recorded. The research instrument was found to be reliable. Data analysis technique involved the use of Statistical Package for the Social Sciences ( SPSS) a statistical software to carry out both descriptive and inferential statistics with significance set at P>0.05. As inferential statistics, the study used Partial Least Squares (PLS) regression analysis to determine the strength of each relationship hypothesized by the study model. Ethical consideration adhered to in the study. The findings revealed a positive influence of organizational processes and employee skills development on the effectiveness of tuberculosis infection control in public healthcare facilities in the Khomas region. In conclusion the recommendations are that the public healthcare facilities should therefore train key personnel in the aspects of TB IPC concepts. It should also implement appropriate organizational process to ensure that the process effectively support TB IPC policy implementation.Item Assessing the impact of floods on food security in the Zambezi region: A case study of the Ikaba area(University of Namibia, 2022) Mabuku, Kennedy KaumbaThe present empirical study was conducted in the Ikaba area of Kabbe South Constituency (KSC) of the Zambezi Region, an area with a long and known history of persistent floods annually. Studies on flood and food security relations primarily focus on four dimensions of food security and have hardly received any attention from researchers, which is the reason that motivated this study. This study was aimed at assessing the impact of floods on food security by reviewing the lived experiences of those affected by flood in the Ikaba area of KSC. The present study used semi-structured interviews to collect data from a sample of 14 households that consisted of 9 to 23 people and 4 key informants in the Zambezi region who occupy keystrategic positions. A qualitative research approach was used, supported by the phenomenological research design. Data was analysed using thematic analysis to make sense of the participants’ accounts of the impact of the floods on food security. The study’s findings reveal that crop damages have been a recurring and uncontrolled phenomenon in the Ikaba area due to prevalent floods causing premature harvest, consequently affecting food availability. Besides, it has been found that accessing markets during flood time for all kinds of food is an unrealised endeavour, mainly due to a lack of proper road infrastructure in the area. In the end, food accessibility has become one of the food security dimensions that have been affected. The study further discovered that insufficient nutritious food has become a recurring trend within the Ikaba community regarding food utilisation. In addition, food utilisation was found to be affected by poor health status caused by contaminated food and water which comes with high health risks due to the floods. While food supply chain disruption affects food stability, the study also concluded that lack of food retailers and failure to access Agri-loans due to a lack of collateral by community members in the area affects food stability. The study concludes that the Ikaba area inhabitants suffer from acute food insecurity. Not all people in the area have both physical and economic access to readily accessible, sufficient and suitable food to meet their dietary needs for a productive and healthy life. In conclusion, the present study recommends the construction of permanent road infrastructure in the KSC to link the residents of Ikaba to the outside world, especially to markets. Also, the construction of a diversion canal, planting of early maturing varieties, improved access to affordable loans have been noted in the study as prospective coping strategies that may ameliorate the impact of floods on food security.Item Assessing the knowledge, attitutes and practices of street food vendors with regard to food hygiene and safety in Tobias Hainyeko constituency Windhoek, Khomas region, Namibia(University of Namibia, 2020) Shaanika, EliaserGlobally, the projected number of foods found to be contaminated from street vendors particularly in developing countries is on the increase. It is however unclear; the contribution unhygienic practices make to food contamination. This study sought to determine the practices of food vendors regarding food hygiene, safety and assessed the level of knowledge of street food vendors with regard to food hygiene and safety, as well as to determine the attitudes of street food vendors towards food hygiene and their food safety practices in Tobias Hainyeko constituency in the Khomas region of Namibia. A cross sectional, descriptive and quantitative study was used. The study recruited 96 food vendors using a stratified sampling method. A structured questionnaire was used to gather data about knowledge, attitude and practices of street foods vendors towards food hygiene and safetyof food vendors. Data was collected on 96 respondents and were analyzed and presented using visual aids which include pie charts. The study used several techniques in analyzing the findings relative to the research objectives. In addition, the study used means and standard deviations derived from the various responses to interpret the results. This was facilitated by the Statistical Package for the Social Sciences (SPSS.). Basically, primary data generated by the study was edited and tested for consistency and reliability. The result indicate that there was statistically significant connection between the adherence to good hygiene practice and food vendors undergone a training on food preparation and vending of food hygiene and safety amongst street food vendors with a p-value of 0.001.Results also show that 47% of the vendors do not have knowledge about food preparation and vending and 58% have never participated in a training on food handling and preparation. Most of the street food vendors which is 58% started food vending without going through any trainings. Results also indicate that there is a habit of poor hand washing practice among vendors, with 47% of the vendors who do not believe in washing hands which could lead to food contamination. The study recommends that intervention should target organizing periodic training on food safety, food preparation and hygiene practices for the street food vendors. Additionally, the study also recommends that the municipal assembly must increase awareness about the benefits of observing proper food hygiene practices by food vendors.Item Assessing the perceptions of clients and nurses regarding integration of the primary health care services, okuryangava and Wanahenda clinics Windhoek, Namibia(University of Namibia, 2022) Paulus, BerthaThe successful implementation of the Integrated of Primary Health Care (PHC) services is major challenge for health systems internationally. This research study aimed to explore the perception of clients and nurses regarding integration of primary health care services between the two clinics (Okuryagava and Wanaheda clinics). The study objectives were to assess the perceptions of clients regarding integration of PHC services; To assess the perceptions of nurses regarding integration of PHC Services; and suggest possible recommendations that can be adopted to improve integration of PHC Services based on the perceptions of Clients and Nurses. The research was conducted using qualitative research methodology. The study used an interview guide to collect data through in-depth interviews. A total of 20 participants who include both nurses and clients were purposively sampled. Data is presented using the thematic approach while content analysis was used to analyse data. Research results show that integration of PHC services has improved relationship between nurses and clients, integration of PHC services is convenient, integration of PHC services enhances competence and PHC makes nurses assessment of clients made easier. On the other hand, integration of PHC services has led to the mixing of services that do not go along, it prolongs time a client is served, integration of PHC services does not resonate with the structure as well as the resources of the clinics and stigmatises clients. On the basis of the findings, it is recommended that there is need for resources, consultation rooms and instruments to be addressed so as improve the integration of PHC services at the clinics. If more infrastructure could be provided it would ease the problems that the nurses are currently facing. The study recommends that there is need to restructure the processes of the PHC provision at the clinics as the current ones seem to be out of sync with the available resources. The study suggests that immediate actions towards patient-centred care are necessary in order to operationally integrate all provided services and existing functions of the PHC system at the clinics. Participants were also of the view that health policymakers should adopt an evidence-based action plan that ensures and safeguards patient-centeredness, comprehensiveness, sound coordination, and continuity of services at the clinics.Item Assessing the role of local authorities in mitigating the effects of climate change: A case of the City of Windhoek(University of Namibia, 2022) Amunkete, AinaThe African continent is faced with critical climate change challenges which need immediate attention. Local Authorities are mandated to play a crucial role in safeguarding the environment for areas under their jurisdictions. They are closer to the people; hence they are the immediate implementers of climate change mitigation activities. This study assessed the role of local authorities in mitigating the effects of climate change. Although there are many studies on climate change focusing on mitigation, there is a dearth of literature that addresses the role of local authorities. A qualitative case study was carried out in the City of Windhoek. Person-centred face-to-face semi-structured interviews were used as the data collection method with an interview guide as the research instrument. Interview questions were structured in a way that captured information for all the objectives formulated. A sample of 22 respondents was purposively selected. Results indicate that the City of Windhoek is doing relatively well in mitigating the effects of climate change. The City of Windhoek is coordinating with other local and international organisations and it has managed to implement various mitigation activities such as water infrastructural development and road improvement amongst others. However, insufficient funds due to budget cuts from the City as well as shortage of experts working at the City, have adversely affected the mitigation efforts relating to climate change. The results also show that the City of Windhoek did not make deliberate budget provision for climate change mitigation due to lack of funds. While this research provides some ground breaking discoveries; a number of limitations exist. These include the use of a purely qualitative methodological approach with a small sample size. In future, research can be conducted using a quantitative research method and a bigger sample size, allowing for more generalisable outcomes and recommendations.Item Assessment of compliance to Tobacco products control Act of 2010 after its implementation at public premises of Oshakati town, Namibia(University of Namibia, 2019) Pangwashime, Ndilimeke MuudikangeTobacco use is a top leading cause of preventable death in the world and a risk factor for several non-communicable diseases including cancer, cardiovascular disease, diabetes, and chronic respiratory diseases. Smoking imposes a heavy economic burden throughout the world and Namibia is not an exemption with a prevalence of 21, 8% of smokers (men) and 5.9% (women).To control the global smoking burden, the WHO introduced measures which will help to reduce tobacco consumption and protect all people from tobacco exposure through provisions that direct countries to implement tobacco control programs. To protect people from Tobacco use epidemic in Namibia Tobacco Product Control Act was signed and passed by the President on 19th of March 2010. The regulation relating to smoking of tobacco products in public places was gazetted and implemented in 2014. This study was conducted to examine and assess compliance level of trade premises with the Tobacco Control Act of 2010 and its regulations in Oshakati Town. A cross sectional descriptive study was employed using a quantitative approach. All 378 trade premises whose license were renewed by 31st March 2017 were included in the study. Data were collected using questionnaires and observational checklist, entered in Microsoft Excel and exported into EPI -info 7.2 software for analysis. The overall compliance level was determined to be 35.98 % and non-compliance was 64.02%. Majority of the respondents (85.19%) indicated they are aware of the existence of the tobacco product control Act but indicated that lack of inspection by local authority as the main challenge affecting them to fully implement and adhere to the act. The level of Adherence compliance with the Acts regulations was found to be very low in trade premises of Oshakati. Despite the premises demonstrating high awareness rate, the town council management need to increase more awareness by doing regular talks using the radio and as well as to do regular inspection and continue strengthening the implementation to ensure high adherence by both premises in charges and clients.Item Assessment of death notification and registration process: Case study of Rundu district in Kavango east region, Namibia(University of Namibia, 2022) Egumbo, HenokMortality information is most directly valuable in the health sector. They help to identify high mortality areas and high-risk groups in the population. They are necessary to determines health services and the mostly needed relevant interventions that are likely to have great impact. Vital registration systems provide an ongoing record of demographic events, such as births and deaths. It is requirement of the country’s law to register all deaths with the Ministry of Home Affairs, Immigration, Safety and Security (MHAISS). The same ministry is the custodian of the National Population Register. The National Population Register contains records of births and deaths. Citizens are to report deaths, which took place outside health facilities to the police at local Forensic Pathology Units. The study used a Case Study methodology whereby Key-Informant Interview mapped out the business processes of death notification and registration in Rundu District. The study reviewed randomly selected notified death cases and assessed them for completeness and usefulness using the ICD-10 criteria. The quality of the data was determined using the Vital Statistic Performance Index (VSPI). The quality of the data determined four data quality attributes namely: completeness, accuracy, consistency and timeliness. The quantitative results shows that the number of registered deaths rose dramatically after the introduction of electronic death notification (e-death notification). Contrary, incompleteness in death reporting and registration systems resulted due to a variety of reasons. Among others includes poor access to serviceable facilities and lack of information on how and where to notify and register deaths. Since the year 2018, district hospitals and the department of Civil Registration (CR) offices were responsible to capture timely records on the electronic National Population Register (e-NPR). The Ministry of Health and Social Services (MoHSS) aggregate information on deaths that occurred at public health facilities. Such records do not include deaths occurred at private hospitals, households, violent and accidental deaths. There is a need to improve the coordinated system in terms of data quality in order to enhance credibility and validity of conclusions drawn from them. An improved law is required to facilitate the creation of a complete and accurate electronic National Population Register (eNPR). The evaluation of the data quality is integral in providing end users with credible understanding from the analysis of notified death in order to improve the CR system.Item Assessment of determinants and levels of adherence to antiretroviral therapy in HIV-infected people in Opuwo district, Kunene region, Namibia(University of Namibia, 2016) Nghoshi, Severen S.Since the beginning of the outbreak of Acquired Immunodeficiency Syndrome (AIDS) epidemic, more than 78 million people have been infected with Human Immunodeficiency Virus (HIV) and 39 million people have died globally (UNAIDS, 2014, p. 123). In Namibia, AIDS is the leading cause of death accounting for 23% of deaths (CDC in Namibia, fact sheet, 2013, & WHO Namibia, 2011). Adherence to medication refers to the extent to which a patient takes a medication in the way intended by a health care provider (Machtinger & Bangsberg, 2006). Very high levels of adherence, taking at least 95% of prescribed doses, are required to achieve sustained suppression of HIV replication over time. Namibia has a national ART coverage of 84%, but the coverage per health district differs (MoHSS, 2012). A quantitative, descriptive, exploratory, cross-sectional, analytical research design was used to assess the levels and determinants of adherence to ART in HIV infected people in Opuwo district. Specific objectives were; to determine the levels of adherence to ART among HIV infected people in Opuwo district and to identify determinants of adherence to ART in Opuwo district. A structured questionnaire was used to collect data for self-reporting method, while the pill count was conducted by subtracting the number of pills left from those given. Pharmacy records were reviewed to determine the appoint keeping. Health workers were also interviewed. The study finds that the levels of adherence to ART measured by pill count and by self-reporting were 73% and 70% respectively. The determinant which is associated with adherence was educational level. Females had higher adherence, beingSince the beginning of the outbreak of Acquired Immunodeficiency Syndrome (AIDS) epidemic, more than 78 million people have been infected with Human Immunodeficiency Virus (HIV) and 39 million people have died globally (UNAIDS, 2014, p. 123). In Namibia, AIDS is the leading cause of death accounting for 23% of deaths (CDC in Namibia, fact sheet, 2013, & WHO Namibia, 2011). Adherence to medication refers to the extent to which a patient takes a medication in the way intended by a health care provider (Machtinger & Bangsberg, 2006). Very high levels of adherence, taking at least 95% of prescribed doses, are required to achieve sustained suppression of HIV replication over time. Namibia has a national ART coverage of 84%, but the coverage per health district differs (MoHSS, 2012). A quantitative, descriptive, exploratory, cross-sectional, analytical research design was used to assess the levels and determinants of adherence to ART in HIV infected people in Opuwo district. Specific objectives were; to determine the levels of adherence to ART among HIV infected people in Opuwo district and to identify determinants of adherence to ART in Opuwo district. A structured questionnaire was used to collect data for self-reporting method, while the pill count was conducted by subtracting the number of pills left from those given. Pharmacy records were reviewed to determine the appoint keeping. Health workers were also interviewed. The study finds that the levels of adherence to ART measured by pill count and by self-reporting were 73% and 70% respectively. The determinant which is associated with adherence was educational level. Females had higher adherence, being employed, being married or cohabitating also favoured higher adherence. Distance to facilities, travelling, alcohol usage, dietary requirements, side effects were identified as barrier to adherence by not statistically significant. The researcher recommended health education on ART, recruitments of more health worker, tracing of defaulters and late comers, a vehicle specific for ART services, and training at health worker at all facilities to enable them to give ART.