School of Nursing & Public Health

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Browsing School of Nursing & Public Health by Advisor "Iita, Hermine"

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    A health in all policies (HIAP) conceptual framework to facilitate the profiling of public servants’ health statuses in the Namibian public service
    (University of Namibia, 2024) Amutenya, Kaarina N.; Iita, Hermine
    Background: The Namibian Public Service (NPS) makes no provision to profile the health statuses of its employees/public servants, despite being a legislative requirement. As a result, government will not be able to, for instance, predict work incapacities due to ill-health absence which is a major measurement of performance/productivity. Worldwide, governments have instituted different approaches, within/outside the Occupational Health and Safety continuum, to profile employees ‘health/ill health to inform promotion of health in workplaces. Aim: This study sought to develop a conceptual framework and an implementation guide to enable the profiling of Namibians public servants’ health statuses entrenched in the principle of the Health in All policies (HiAP) approach. Methods: A multi-phased pragmatic study was conducted. Phase 1 employed an explorative descriptive convergent parallel mixed method design using document reviews, a Focus Group Discussion, a Discourse Analysis, a Cross sectional and a Knowledge, Attitude and Practice (KAP) surveys. Max Weber Qualitative Data Analysis and the Statistical Package for Social Sciences enabled analysis of data, respectively, herein synthesised by means of triangulation. Findings: Documents reviewed revealed the existence of public servants’ health information sources such as the employees’ health recruitment questionnaires, sick leave systems and medical aid, appropriate for profiling. Key Informant’s perspective that the HiAP framework was appropriate to facilitate profiling of public servants’ health statutes was further echoed by result of the Discourse Analysis. The cross-sectional survey, conducted among 346 public servants’ participants established that 83.3% of the survey participants self-reported ‘a good’ health status. The remainder 16.7% self-reported ‘a poor’ health status citing the prevalence of Hypertension (27%), Musculoskeletal disorders (30.6%), Stress (55%), Physical in-activeness (38%) and a High Body Mass Index (BMI) (27%). A Chi-square logistic regression test, pegged to a p-value of less than 5% and using: 1. Good health = self-reported score for Excellent/Very Good/Good; 2. ii Poor health = Fair/Poor/Very Poor: reveals significant statistical associations to poor health in relation to Hypertension (p-value=0.001), Mental conditions (p-value=0.009) and access to electricity (p-value=0.045). No significant statistical association was observed with elevated blood sugar (p-value=0.258≤5%), BMI and income. The KAP study, conducted among 51 Wellness Officers, reported very low HiAP knowledge citing a lack of information and henceforth no application of the HiAP approach, overall. Phase II focussed on the design, and development of the above-mentioned framework using results emanating from Phase I; enlisting elements of the World Health Organization’s (WHO) HiAP Analytical framework alongside elements of the Systems and Practice Oriented Theories, namely: [input (procedures, agent, recipient and dynamics); output (terminus); synergies (agent, recipient, procedures and dynamics) and feedback (context, inputs, outputs, terminus)]. Five purposely selected subject experts who validated the suitability of the developed conceptual frame recommended amongst others aligning it to the legislative provisions of the Public Health and Environmental Act. Phase III enlisted the WHO’s Handbook on developing guidelines and the Public Service Staff Rule format to inform the design of an implementation guide. Conclusions: The study encapsulates evidence that proofs the gap identified as well devised approach to fill the gap: a conceptual framework to profile Namibian public servants’ health statuses embedded in the HiAP principles. Evidence of poor HiAP knowledge could implicate successful implementation. Henceforth a recommendation that the NPS adopts the designed conceptual framework, the introductory and ensued implementation guide using a policy brief, attached hereto, to ensure compliance with the law
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    Exploring the experiences of patients on coronary artery disease treatment at Roman Catholic Hospital-Cardiac center, Windhoek, Namibia
    (University of Namibia, 2025) Amapindi, Letta; Iita, Hermine
    Coronary artery disease (CAD) is a significant global health concern, contributing to high mortality and disability rates. In Namibia, CAD accounts for 7.20% of total deaths, driven by urbanization, lifestyle changes, and rising comorbidities such as hypertension, diabetes, and obesity. This study explored the experiences of CAD patients receiving treatment at the Roman Catholic Hospital-Cardiac Centre in Windhoek, Namibia, to inform improved management strategies. Qualitative approach with a descriptive, exploratory, and phenomenological design was used. A qualitative phenomenological approach was used. Participants were purposefully sampled until data saturation was achieved, which occurred with a final sample of six participants. Data was collected through unstructured interviews and analyzed using Tesch's qualitative data analysis method. The findings revealed two (2) main themes that are positive and negative experiences of patients on the treatment of CAD; five (5) themes and eleven (11) sub-themes. The positive experience being support system comprising family, friends and health care system, and lifestyle modification. Lifestyle changes and strong family support were found to be crucial in improving patient outcomes. The negative experiences are emotional factors including stress and pain; risk factors including comorbidities; and the consequences such as physical limitations and financial crisis. The study findings will inform the policy makers and stakeholders to develop preventative and management strategies that will enhance patient outcome. Patients on coronary artery disease treatment have both negative and positive experiences that affect various aspects of their life and influence outcome. The study recommends educational programs and nationwide public health campaigns to raise awareness about CAD symptoms, risk factors, and prevention strategies
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    Knowledge, attitude and practices of mothers on the prevention and management of Diarrhoea in children under five years, Otjiwarongo district, Otjozondjupa region, Namibia
    (University of Namibia, 2025) Shilongo-Munenguni, Wilikka; Iita, Hermine
    This study aimed to assess knowledge, attitudes, and practices regarding diarrhea prevention and management among mothers of children under 5 years in Otjiwarongo district in the Otjozondjupa region, Namibia. The specific objectives were to assess the general knowledge, attitudes and practices of mothers about diarrhea prevention, and management; to determine mothers' attitudes towards diarrhea prevention and management; and to explore mothers’ practices towards the prevention and management of diarrhea in children under five years in Otjiwarongo district, Otjozondjupa region. Employing a quantitative approach using a cross- sectional study, the study utilized simple random sampling to select 390 mothers from Otjiwarongo district clinics and Health Centers. Responses were analyzed using one-sample chi square tests. The findings revealed significant gaps in knowledge and practices regarding the prevention and management of diarrhea. Approximately 39.1% of mothers lacked understanding of diarrhea as a condition, and 61.1% were unaware of common causes, impacting their ability to prevent and manage diarrhea effectively. Additionally, 49.2% did not recognize the role of hygiene, while 41.2% underestimated the importance of hand washing. Knowledge of oral rehydration therapy (ORT) was deficient in 43.6% of the respondents. Furthermore, 40.4% did not prioritize medical attention, and 45.6% were unaware of the benefits of exclusive breastfeeding. Poor dietary practices were evident as 42.6% had limited knowledge about appropriate nutrition during diarrhea episodes. Vaccination knowledge was lacking in 42.2% of mothers, with substantial gaps in understanding proper waste disposal (42.6%) and clean water importance (48.9%).These findings underscore the need for enhanced education and interventions by the Ministry of Health and Social Services and the Otjozondjupa Region Health Directorate. Strategies should include targeted mothers education programs, improved access to i clean water, and promoting breastfeeding and vaccinations. Education on hygiene, sanitation, and child nutrition is crucial to improve health outcomes for children under five years. Addressing these gaps can significantly reduce the incidence of diarrheal diseases and improve child health in this vulnerable age group