Department of Public Health

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Browsing Department of Public Health by Advisor "Alfeus, Anna"

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    Factors influencing the uptake for postnatal HIV re-test among breastfeeding mothers in Nkurenkuru district, Kavango West region, Namibia
    (University of Namibia, 2025) Andreas, Saara; Alfeus, Anna
    Postnatal mother-to-child transmission (MTCT) of HIV can occur breastfeeding. About 90% of children living with HIV acquired it through their mothers. Postnatal MTCT of HIV from breastmilk is one of the concerns placing a burden on paediatric HIV infection elimination efforts. Therefore, postnatal HIV re-testing is crucial in the detection of acute infections among breastfeeding mothers to prevent avoidable MTCT of HIV. This study aimed to investigate factors influencing postnatal HIV retesting uptake among breastfeeding mothers in Nkurenkuru district. The study was carried out among breastfeeding mothers who were HIV-negative at delivery from 7 participating health facilities in Nkurenkuru district (Gcaruhwa Clinic, Mbambi Clinic, Mpungu H.C, Nankudu Clinic, Nkurenkuru H.C, Rupara H.C, and Tondoro H.C) with a sample size of 342 in October 2023. A cross-sectional quantitative design was employed. All respondents consented in writing and the researcher used a questionnaire to collect the study data. The data was cleaned and analysed using Epi Info 7.2 version. Dependent and independent variables association was tested using Chi-square test, with the statistical significance acceptance of p-value ≤0.05. This study found a declining HIV retest uptake among breastfeeding mothers. Out of 342 mothers enrolled, 280 (82%) were tested 3 months after delivery, and only 22 (7%) were tested by month 12. Education level (χ2 = 18.25, p < 0.001), ANC visits count (χ2 = 18.25, p < 0.001), and parity (χ2 = 36.44, p < 0.000) were associated with HIV retesting among breastfeeding mothers. Factors influencing the uptake of postnatal HIV retesting among breastfeeding mothers are the mother’s education level, ANC visits, and parity. The study recommends the Ministry of Health to strengthen awareness and on-going health education on the importance and benefits of consistent postnatal HIV retesting among breastfeeding mothers, as well as ensuring testing accessibility through outreach programs
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    The association between disclosure and adherence to Antiretroviral Therapy among adolescents living with HIV in Windhoek, Khomas region, Namibia
    (University of Namibia, 2024) Manvwali, Martha Kachana; Alfeus, Anna
    The study was conducted in Windhoek, Khomas region, Namibia, focusing on adolescents living with HIV aged 10-19 who had been receiving antiretroviral therapy (ART) care for at least six months between 2010 and 2021. It also included healthcare workers who had worked in the ART department for at least six months during the data collection period. The primary objective was to assess the association between disclosure (the process of revealing one's HIV-positive status) and adherence to ART among adolescents living with HIV. A mixed method approach with an explanatory sequential design was employed. The quantitative component used an unmatched case-control design with a 1:1 ratio, while the qualitative component utilized an exploratory design to complement the quantitative analysis. The study participants included 20 healthcare workers and 37 adolescents living with HIV who were on ART care. Findings revealed that among adolescents with good adherence (≥90%), 76% had been fully disclosed about their HIV-positive status, while 20% were partially disclosed. In contrast, among adolescents with poor adherence (<90%), 92% had not been disclosed about their HIV-positive status. Some adolescents who were fully disclosed learned about their status accidentally. Caregivers of the adolescents and healthcare workers were the key informants in disclosure and adherence aspect. The study recommends strengthening disclosure programs through enhanced efforts by the Ministry of Health and Social Services. This includes training healthcare providers involved in the disclosure process, educating parents/caregivers or guardians about the disclosure process and the skills required to conduct it at home, ensuring equitable distribution of disclosure tools and equipment among health facilities, and implementing standardized disclosure processes through Standard Operating Procedures (SOPs) and guidelines consistently across all health facilities nationwide. Future research should explore factors that enable adolescents to accept their HIV-positive status with reduced distress and examine their experiences during and after disclosure sessions, including their psychosocial support needs. In summary, this study aimed to understand the relationship between disclosure and adherence to ART among adolescents living with HIV in Namibia and provided recommendations to improve the disclosure process and support for these adolescents