Browsing by Author "Nangombe, Julia P."

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    Description of a model to facilitate male involvement in the reproductive health context by the registered nurses
    (2016) Amukugo, Hans J.; Jooste, Karen; Nangombe, Julia P.
    The aim of this article is to describe a model to facilitate male partner involvement in the RH context. The findings in chapter 3, step1 – concept analysis – which comprised the identification, definition and classification of concepts and the construction of an interrelationship between concepts and statements (chapter 4), formed the basis for the development of this model. This model to facilitate male partner involvement in RH is based on the theory generation of Chinn and Kramer (1991). The central concepts are defined by using the rules described by Rossouw (2000/1,) and Copi and Cohen (1996). Lastly, the model evaluation has been done in accordance with the method of Chinn and Kramer (1991).
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    Description of a quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia
    (2016) Nangombe, Julia P.; Amukugo, Hans J.
    The aim of this paper is to describe the quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia. The Practice Oriented Theory of Dickoff (1968) was used as practical guidelines to develop the conceptual framework. This framework was employed during the research and the educational programme development process. During the research process, the agent was the researcher; recipients (Managers/leadership and health professionals); the context (MoHSS head office and healthcare facilities); dynamics (findings for objective one and two); Procedure (research process) and terminus (foundations for development of educational programme). For the educational programme developing process, agent (quality specialist), recipients (health professional), context (health facilities), procedure (training programme for health professionals), dynamics, (challenges hampering successful implementation of the programme) and the terminus (knowledge, skills and abilities acquired through the training programme). During the development of the quality improvement training programme, two main theories were adapted. The most prominent one was a model by Meyer and Van Niekerk (2008), which was adapted to guide the process of developing the training programme. Kolb’s experiential learning theory was used to explain the learning process and styles of developing knowledge through experiences. The content of the training programme was derived from five main themes, 17 sub-themes and the conceptual framework based on the situation analysis about challenges faced by the health care facilities. The five themes were lack of implementation of policies and guidelines; inadequate resources; lack of interpersonal relationships; inadequate understanding of quality assurance and quality improvement; and inadequate research to provide evidence-based information during treatment and patient care. The educational programme consisted of the purpose / aim, objectives, structure / design, facilitation process, implementation process, and evaluation of the programme.
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    Development for a quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia
    (2016) Nangombe, Julia P.; Amukugo, Hans J.
    The paper describes the steps followed in the development of a quality improvement training programme for health professionals. This was echoed by the facts that the health professionals are facing in their quest for quality health care delivery. In Namibia, most health care facilities have not been yielding good results in response to patients’ health care needs. Health care dynamics are complex and inundated with several factors; among others new methods, speed of improving medical science and technology, as well as increasing demands of the clients to address emerging and re-emerging diseases. In order to achieved that the five phases of programme development by Meyer and Van Niekerk (2008) were modified to facilitate the programme development. Quality improvement training for health professionals. Those five phases were situational analysis; conceptual framework; developing of the training programme; development of the guidelines for the implementation; and Evaluation of training programme.
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    Development of the conceptual framework for a quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia
    (2016) Nangombe, Julia P.; Amukugo, Hans J.
    This article describe the process followed by the researcher in the development of the conceptual framework for a quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia. The conceptual framework of this study was based on the Practice Orientated Theory of Dickoff (1968) that assisted with explaining the concepts used in developing the quality improvement training programme for health professionals at the health facilities. Dickoff’ s (1968) practice orientated theory consists of the agent, recipients, context, procedure, dynamics, and the terminus. In this study, the agent was a quality specialist, the recipients were health professionals, the context was the health facilities, the dynamics were challenges that health professionals were experiencing; the procedure was the training programme, while the terminus was knowledgeable and skillful health professionals in quality health care delivery.
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    Guidelines for implantation of a quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia
    (2016) Nangombe, Julia P.; Amukugo, Hans J.
    This paper is focuses on the description of the guidelines for implantation of a quality improvement training programme for health professionals. The formulation of the guidelines also borrowed the CDC (2001) steps and UNFPA phases of developing the guidelines for successful implementation of the training programme at the health care facilities in the MoHSS. The facilitator(s) and implementers of the training programme are advised to first understand the background and the development process of the training programme for successful implementation. These guidelines have been developed to assist quality manager(s) and facilitator(s) with the implementation of the quality improvement training programme for health professionals at the health care facilities (MoHSS). The guidelines enhance consistency in steps and methods to be followed during the implementation of the programme. The guidelines were derived from the conceptual framework that was developed during the exploratory and situation analysis of quality health care delivery at the health care facilities. Two prominent theories were adapted in developing these guidelines. Firstly, Deming’s PDSA model of quality improvement and secondly, Kolb’s experiential learning theory. These theories were used to understand the teaching and learning styles. The guidelines outlined the process, activities, and elements required to implement the such programme.
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    Guidelines to operationalize a model to facilitate male involvement in the reproductive health context by the registered nurses
    (2016) Amukugo, Hans J.; Neshuku, Hanna; Nangombe, Julia P.
    The purpose of this article is to describe the guidelines for operationalising a model to facilitate male partner involvement in RH. Guidelines were developed for the implementation of the model to facilitate male partner involvement in RH through the management of a partnership environment. These guidelines may be implemented in those health facilities that provide RH services, namely, clinics, health centres and hospitals. The nurses, in collaboration with significant stakeholders from the community, representatives from the line ministries and NGOs, will be able to facilitate male partner involvement in RH. These guidelines and strategies were derived from the conceptual framework which was generated by means of deductive reasoning and analysis. The guidelines and strategies at each level are aimed at facilitating male partner involvement in RH through the management of the partnership environment by enabling male partners to become actively involved and participate and to eliminate those factors that impede the full participation of male partners in the RH context. The chapter will focus on these guidelines which are expressed in terms of the aims and strategies of each of the four phases in facilitating male partner involvement in RH.
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    Migration of health professionals in Namibia
    (2004) Nangombe, Julia P.;
    None provided. The following is taken from the author's Introduction:
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    Paradigmatic perspective for a quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia
    (2016) Amukugo, Hans J.; Nangombe, Julia P.
    This article focuses on the paradigmatic perspective facilitate the development of a quality improvement training programme for health professionals in the ministry of health and social services in Namibia. The study of this nature requires a paradigmatic perspective; this is a collection of logically linked concepts and propositions that provide a theoretical perspective or orientation that tends to guide the research approach to a specific. Assumptions are useful in directing research decisions during the research process. The study adopted a constructivism and interpretivism approach, since it involved understand the current situation of quality health care/service delivery at health care facilities, and explore and describe the of the health professionals; experiences at the health care facilities. The study was based on the specific information that was accepted as true, as obtained from those lived the experiences of challenges and constraints of providing quality health care at the health care facilities. The paradigm perspectives in this study include Meta – theoretical assumption which consisted ontological, epistemological, axiological, methodological and rhetorical assumptions. Theoretical basis of the study includes Dickoff (1968), Practice Oriented Theory; Programme development by Meyer and Van Niekerk; Kolb’s Theory of experiential learning; Demining’s model of quality improvement, Quality improvement policy of the Ministry of Health and Social Services (MoHSS) and Centre for Diseases control (CDC) framework for programme education.
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    Quality health care delivery at health facilities in the Ministry of Health and social services in Namibia
    (2017) Amukugo, Hans J.; Nangombe, Julia P.
    A quantitative and descriptive study was used to determine quality health care delivery at health facilities in the Ministry of Health and Social Services in Namibia (MoHSS). The purpose of the study was to identify the challenges within the health facilities as basis for development of quality improvement training programme for health professionals. A checklist was administered to determine the present situation of quality health care / service delivery at health care facilities. The target population were the managers in leadership positions, such as deputy permanent secretary, undersecretary, directors, pharmacist, medical superintends, principle medical officers, medical officers, health programme officers, matrons, senior officers and others. A total of twenty-one (n = 21) participants were purposively selected, which comprised managers in leadership (n=6) from the MoHSS head office and regional health directorates (regional management teams). (n=15) from the health facilities, Apart from the demographic data, participants were given opportunity to rate quality health care delivery on Likert’s scale with scores ranged from strongly disagree; disagree, agree and do not know on the following variables, such as policies and guidelines; leadership; human, physical, material and financial resources; patient safety, information as well as monitoring and evaluation. The Statistic Package for Social Sciences (SPSS) software was used for data analysis. Data were presented in percentages, figures and tabular formats. To ensure reliability, items in the checklist were tested using the Cronbach alpha coefficient for multiple items measured on the Likert’s scale. It was indicated that the items from one to forty (1-40) provided a value of 0.95 while the rest of items (measures) was 0.88. For validity, content, criterion and construct were used. The findings of this objective revealed some ambiguities in the availability of policies and guidelines, leadership to facilitate care delivery, health system infrastructure, patient safety, as well as research and information to facilitate quality health delivery.
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    A quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia
    (University of Namibia, 2015) Nangombe, Julia P.
    A quality improvement training programme is important to address the challenges that the health professionals are facing in their quest for quality health care delivery. In Namibia, most health care facilities have not been yielding good results in response to patients’ health care needs. Health care dynamics are complex and inundated with several factors; among others new methods, speed of improving medical science and technology, as well as increasing demands of the clients to address emerging and re-emerging diseases. Health professionals are often criticised for unsatisfactory results due to several challenges sometimes beyond their capacity and knowledge to mitigate and manage. The difficulties experienced cannot be ignored, since there is no specific quality improvement / management training programme to prepare health professionals. Without appropriate training and empowerment of health professionals, health care delivery would continue to yield unsatisfactory results. Thus quality improvement training programme seeks to empower health professionals with knowledge, skills, and aptitudes with the aim of enhancing quality health care delivery. The nature of this study required a clear paradigmatic perspective thus constructivism and interpretivism approaches were adopted. Assumptions such as ontological, epistemological, axiological, methodological and rhetorical were used. Further Practice theory of Dickoff (1968), programme development by Van Niekerk; Kolb’s theory of experiential learning, Deming’s model of quality improvement, quality improvement management policy of the MoHSS and Centre for disease control (CDC) framework for programme evaluation in public health formed a theoretical basis of the study. The research process was carried out in five phases: Phase 1: A mixed method which is a quantitative, qualitative, exploratory, descriptive, and contextual was used. This was done to achieve the objective one (1) and two (2) as part of situational analysis (phase 1). Objective 1: A checklist was used in order determine the present situation of quality health care / service delivery at health care facilities. The target population were the managers in leadership positions, such as deputy permanent secretary, undersecretary, directors, pharmacist, medical superintends, principle medical officers, health programme officers, matron senior officers and others. A total of twenty-one (n = 21) participants which purposively selected comprised of managers in leadership (n = 6) from the MoHSS head office, while (n = 15) were drawn from the health facilities in the Khomas, Kunene, Erongo and Omusati regional health directorates. A part from the demographic data, participants were given opportunity to rate themselves on Likert’s scale with scores ranged from strongly disagree; disagree, agree and do not know on the following variables such policies and guidelines; leadership; human, physical, material and financial resources; patient safety, information as well as monitoring and evaluation. Further participants were given a statements of “yes”, “no” and don’t know on research ethics and utilization of data. SPSS software was as used tool for data analysis. Data were presented in percentage, figures and tables. To ensure reliability, items in the checklist were tested using the Cronbach alpha coefficient for multiple items measured on the Likert’s scale. It was indicated that the items from 1-40 provided a value of 0.95 while the rest of items (measures) was 0.88. For validity, content, criterion and construct were used. The findings of this objective revealed some ambiguities in the availability of policies and guidelines, leadership to facilitate care delivery, health system infrastructure, patient safety, as well as research and information to facilitate quality health delivery. Objective 2: Concentrated on the exploration and description of the experiences of managers in leadership positions and health professionals with regard to quality health care / service delivery at health care facilities. Individual interviews (n = 12) from twenty-one managers in leadership position, as well as focused group discussions (n = 5) that consisted of eight participants for each FGD were implemented. In addition, field notes were conducted. Participants in the FGDs were 40 from health facilities in the above four regional health directorates as indicated above. The regions were selected based geographical location, population density and services delivery namely referral, intermediate and district hospital. Participants were purposively selected. To achieve that exclusion and inclusion criteria were used. Both individual and FGD data were collected until saturation. Data from the transcription of the recorded audiotapes and field notes were analysed using Tech’ steps methods. Independent coder assisted with coding of the results. Various reasoning strategies such inductive, deductive, inferences, reflective and bracketing not only in this objective were used. Five themes and 13 sub- themes were identified that were a basis for the development of the educational programme for health professionals. The themes revealed that the participants’ experienced unavailability of guidelines and structure to facilitate QI and QA; inadequate management of resources; inadequate interpersonal relationships amongst the health workers; an inadequate understanding of QI and QA; as well as poor research and information, monitoring and evaluation, and indicators of monitoring and evaluation. Phase 2: The Practice Oriented Theory of Dickoff (1968) was used as practical guidelines to develop the conceptual framework. This framework was employed during the research and the educational programme development process. During the research process, the agent was the researcher; recipients (Managers / leadership and health professionals); the context (MoHSS head office and healthcare facilities); dynamics (findings for objective one and two); Procedure (research process) and terminus (foundations for development of educational programme). For the educational programme developing process, agent (quality specialist), recipients (health professional), context (health facilities), procedure (training programme for health professionals), dynamics, (challenges hampering successful implementation of the programme) and the terminus (knowledge, skills and abilities acquired through the training programme). Phase 3: During the development of the quality improvement training programme, an adopted version of two main theories was used. The most prominent one was a model by Meyer and Van Niekerk (2008), which was adapted to guide the process of developing the training programme. While Demining’s PDSA model of quality improvements well as quality improvement policy of the MoHSS focused on the content to enhance the findings. Further, Kolb’s experiential and Knowles adult learning theories were used to facilitate the teaching and learning process. The educational programme included the name, purpose / aim, objectives, structure / design, facilitation process, implementation process, and evaluation of the programme this was done inline n with Namibia Qualification Authority (NQA) framework. Phase 4: This phase, focused on developing the guidelines for implementing based on UNFPA while the evaluating the training programme were done in line with CDC framework. These guidelines outlined the process, activities, and elements required for implementing as well evaluating the educational programme for health professionals in Namibia. The study achieved trustworthiness by applying the criteria of dependability, transferability confirmability and credibility (Guba & Lincoln, 1994; Babbie, 2008; Lincoln & Guba 1986; Schwandt, Lincoln, & Guba 2007). Based on the study findings, it was clear that a need existed for a quality improvement training programme to empower health professionals with knowledge, skills, and aptitudes (KSAs) in quality assurance standards and quality improvement processes to facilitate quality health care delivery at the health care facilities (MoHSS). Specific recommendations of the study were highlighted with reference to the responsibilities and roles of different stakeholders for the successful implementation of the programme, as well as the purpose of improving quality health care goals in the MoHSS. The management, health professionals, education, profession of quality improvement, and research have vital roles in contributing to the sustainability of the training programme.