School of Nursing & Public Health

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Browsing School of Nursing & Public Health by Advisor "Shilunga, Anna"

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    Factors affecting age-appropriate timeliness of measles vaccination among children aged 9 to 59 months in Rehoboth urban, Hardap region, Namibia
    (University of Namibia, 2025) Burger, Gertruida Fransina; Shilunga, Anna
    Measles remains a significant public health concern among children, particularly in low- and middle-income countries, where high vaccination coverage may mask delays in vaccine administration. This study aimed to assess the timeliness and determinants of measles-containing vaccine (MR) administration among children aged 9–59 months in Rehoboth Urban, Namibia. A convergent parallel mixed-methods design was employed to provide a comprehensive understanding of the issue. In the quantitative phase, an intervieweradministered questionnaire was used to collect data from caregivers on vaccine timeliness and associated factors. Quantitative data were analyzed using SPSS v.26, with Kaplan-Meier survival analysis, Fisher's exact test, Mann-Whitney U test, and logistic regression. Statistical significance was set at p<0.05, with a 95% confidence interval. In the qualitative phase, key informant interviews were conducted with healthcare workers, and data were analyzed thematically using Atlas.ti version 24. The study revealed high measles vaccination coverage - 99.1% for MR1 and 88.6% for MR2. However, timely administration was suboptimal, with only 69.9% of children receiving MR1 and 31.3% receiving MR2 within the recommended age window. Multivariate analysis identified several significant predictors of delayed vaccination, including being aged 13–24 months (AOR = 4.54; 95% CI: 1.80–11.44; p = 0.001) and residing in blocks B (AOR = 3.85; 95% CI: 1.42–10.42; p = 0.008) and D (AOR = 5.07; 95% CI: 1.49–17.28; p = 0.009). Qualitative findings highlighted key barriers such as long waiting times at health facilities, caregiver forgetfulness, child illness at the time of scheduled vaccination, and geographic inaccessibility. ii These findings underscore a critical gap between vaccination coverage and timeliness. Delayed administration of MR vaccines compromises herd immunity and heightens the risk of measles outbreaks. To address these challenges, the study recommends the implementation of electronic or manual reminder systems, community-based outreach services, and continuous caregiver education to promote timely vaccination and strengthen routine immunization performance
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    Factors associated with increased number of abortions among women at Katima Mulilo State Hospital, Zambezi region
    (University of Namibia, 2025) Simasiku, Lynn M.; Shilunga, Anna
    Background: In low- and middle-income countries, abortion is one of the leadingcauses of maternal mortality. According to reports, abortion is a common causeofmaternal death in Namibia. This study described and probed factors associatedwiththe high number of abortion cases and aimed to better understand, in an exploratorymanner, the knowledge and awareness of abortion implications amongwomenexperiencing abortion at Katima Mulilo State Hospital. Methodology: A qualitative approach with an exploratory, descriptive, andcontextual design was used. The study's population consisted of womenwhounderwent abortions at Katima Mulilo State Hospital. Purposive samplingwasemployed to select ten participants until data saturation was reached. Asemi-structured interview guide was the sole means of data collection, and the collecteddata were analysed following the six steps proposed by Braun and Clarke (2013). Ethical considerations of institutional clearance, informed consent, the principleofjustice, beneficence, privacy, and the principle of autonomy were adhered to. Findings: Findings showed key reasons for abortion , including financial insecurityand dependence, being unprepared for pregnancy and motherhood, pregnancy-relatedmental and physical conditions, feelings of control over dismissal, influencesonemployment and education, personal assurance regarding termination, lack of partnersupport, lack of family support, risks of negative effects on family relationships, institutional and organizational support services, termination services availableat private clinics, government clinics, and illegal termination services, as well as ii societal norms and community socio-cultural beliefs surrounding terminationandpregnancy. Conclusions: There are factors associated with an increased number of abortionsinwomen at Katima Mulilo State Hospital in the Zambezi region. Therefore, thestudyrecommended that nurses offer comprehensive counselling to women onfamilyplanning, sexual health, and contraception options, promote better accesstoreproductive healthcare, and advocate for policy changes to ensure accessiblecontraception and supportive work environments