Department of Community Health Science

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The accessibility of HIV/AIDS related health information to people living with HIV/AIDS in khomas region (Windhoek)
(2008) Angula, Penehafo; ;
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.
An analysis of the implementation of the school supplementary feeding programme in Windhoek, Namibia
(2012) Sibanda, Dumisani G.; ;
Abstract provided by author
Assessing risk factors associated with primary hypertension among military personnel at Peter Mweshihange Military Heakth Centre in Windhoek
(University of Namibia, 2021) Muleya, Lilian Njahi
Hypertension 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.
Assessing the effectiveness of Tuberculosis infection control in public healthcarefacilities in the Khomas region
(University of Namibia, 2019) Mulokoshi, Theopolina
Emerging 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.
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, Eliaser
Globally, 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.
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 Muudikange
Tobacco 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.
Assessment of death notification and registration process: Case study of Rundu district in Kavango east region, Namibia
(University of Namibia, 2022) Egumbo, Henok
Mortality 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.
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.
An assessment of hygiene knowledge and practices: A case study of Choto informal settlement in Katima Mulilo
(2013) Mundia, Nevia N.
About 2.4 billion people globally live under highly unsanitary conditions and practice such poor hygiene that the risks of their exposure to the spread of infection are enormous. The World Health Organization (WHO) has been at the forefront of environmental sanitation over the past years and has developed key materials for the edification of policy makers and technical people dealing with these issues. These materials include sanitation guidelines, “best practices” in hygiene documentation, and general health promotional materials (WHO, 2011). There is no documented evidence which describes either the practice of hygiene by people in the Namibian informal settlement of Choto, in Katima Mulilo, or their knowledge of the subject. The purpose of this study was an exploration and description of the knowledge and the practice of hygiene among these residents. An explorative, qualitative study was done. The research sample was comprised of residents of Choto, 18 years of age and older. Face-to-face interviews were conducted and the participants’ statements were recorded by the researcher. The following research ethics were observed during the study: informed consent, permission from authorities, confidentiality and voluntary participation. References from existing literature were also sought. Forty (n=40) Choto residents participated in the study, with 21 females and 19 males interviewed as subjects. The following themes emerged during the analysis: household hygiene and in the surroundings; disposal of human waste; household refuse removal; personal hygiene, including hand washing, water source knowledge and knowledge of hygiene-related diseases. The researcher’s conclusion is that, although the people in the Choto informal settlement have some general knowledge about hygiene, the extent of that knowledge is quite limited. The knowledge of hygiene is usually not carried out in practice by the residents for various reasons, which include poverty, insufficient water supply, insufficient knowledge and lack of access to sanitation facilities. The following training is therefore recommended:  home cleaning maintenance, including the proper disposal of domestic and human waste,  the practice of proper storage and handling of water,  proper hand-washing techniques,  how these practices relate to the prevention of hygiene-related diseases. The Katima Mulilo Town Council should be advised to formulate strategies that will address issues of water, sanitation and hygiene in the Choto informal settlement.
Assessment of knowledge, attitudes, practices and responsiveness to medical male circumcision among males in Zambezi region, Namibia
(University of Namibia, 2020) Nairenge, Rosalia
Male circumcision is one of the popular intervention methods that is fully supported by modern health practitioners to curb the spread of HIV/AIDS with estimate of 60%. About 58 % of men are estimated to have been circumcised globally. In southern Africa male circumcision is less common. Sub-Saharan Africa has the highest prevalence of HIV/AIDS, with Zambezi region of Namibia plagued with high HIV/AIDS prevalence in association with low male circumcision. The purpose of this study was to assess the knowledge, attitude, practice and responsiveness of males towards voluntary medical male circumcision in Zambezi Region. This was a cross sectional study among men from 15 years and older in five randomly selected constituencies of Zambezi Region. Participants were selected using probability sampling method. Data was collected using structured questionnaires and was entered into Microsoft excel sheet and analyzed with Epi-info 7.2 software. Frequencies and proportions were generated and bivariate analysis were performed to determine associations. A total number of 379 participants were involved in the study. Most participants were between the age group of 20-29 years 124 (33%). Majority of participants 292 (77%) resides in rural area, mostly in Linyanti constituency 144(38%). Most participants indicated being single 256 (68%), and a total of 365 (95%) can read and write. Majority had adequate knowledge 354(95%) and positive attitudes 330 (87%) towards VMMC. Association of circumcision status with level of knowledge (OR=0.1, CL=0.08-0.50) p-value=0.0004, type of attitude (OR= 0.1, CL= 0.07-0.29) p-value= 0.0001 and this was all significant. This study concluded that participants had adequate knowledge and positive attitudes towards VMMC, however there are some men with lack of knowledge and negative attitudes towards the VMMC program. Therefore, the study recommends for more education and awareness campaigns on VMMC in order to facilitate behavior change among this group and enhance the performance of the VMMC program in the region.
Assessment of risk factors associated with Cervical cancer amongst women attending the oncology centre and health facilities in Windhoek, Khomas region
(University of Namibia, 2020) Eiman, Elmarie
Cervical Cancer is one of the leading causes of cancer related deaths in women worldwide. These deaths are unnecessary, as there is evidence that Cervical Cancer is preventable and treatable if detected early and managed effectively. Human Papilloma virus (HPV) is a well-known cause of Cervical Cancer with HPV genotypes 16 and 18 are responsible for 70% of all Cervical Cancer worldwide. However, there are other risk factors. Current estimates indicate that every year 527,624 women are diagnosed with Cervical Cancer and 265,653 die from the disease. In Namibia with a population of around 2.1 million, 632,000 women aged 15 years and above are at risk of developing Cervical Cancer. This study aimed to determine the risk factors associated with Cervical Cancer among women in Khomas region, Namibia. The researcher conducted an unmatched 1:1 case control study. A sample size of 402; 201 cases of Cervical Cancer and 201 appropriate controls were chosen using a simple random sampling method. Data was analysed using Epi info 7. Bivariate analysis was done using odds ratio to determine association between suspected risk factors and Cervical Cancer. Significant associations at 5% on bivariate analysis was loaded into a logistic regression model to determine predictors of Cervical Cancer. The multivariate logistic regression analysis found that after adjusting for HIV status, the following variables were significant risk factors of Cervical Cancer: family history of cancer (AOR:2.55; 95% CI, 1.64-3.95; p = 0.0004), unemployment (AOR: 2.56; 95% CI, 0.26-0.59; p = 0.0001), marital status (AOR: 1.90; 95% CI, 1.25-2.89;p=0.003), living in rural areas (AOR: 2.77; 95% CI, 1.26-4.21; p= 0.000002), use of contraceptive (AOR: 1.64; 95% CI, 1.08-2.49; p = 0.03), lack of secondary education (AOR: 2.49: 95% CI, 1.50-4.13; p = 0.0005) and not attending Pap smear screening (AOR: 1.92; 95% CI, 0.33-0.82; p = 0.007). These risk factors associated with Cervical Cancer in our environment could be the basis for targeted screening and treatment programme. The introduction of routine HPV vaccination could reduce Cervical Cancer.
An Assessment of the Adolescent Participation, Adolescent Friendly Health Service Providers, and Adolescent Friendly Environment components of the AFHS Standards by Nurses in Otjozondjupa Region of Namibia
(University of Namibia, 2017) Muyenga, Marry L.
Adolescents are sensitive people who can easily get derailed by a number of challenges which can sometimes lead to detrimental results if they are not taken care of appropriately. Despite the existence of the National Standards for Adolescent Friendly Health Services which is supposed to assist in reducing teenage pregnancy, disturbing figures of adolescents getting pregnant continue to rise. This study aimed at assessing the implementation of the Adolescent Active Participation, Adolescent Friendly Health Care Provider and the Adolescent Friendly Environment components of the Adolescent Friendly Health Services by nurses in Otjozondjupa Region, Namibia. A quantitative descriptive, analytical cross-sectional study design was done. The study triangulated data from three data sources. The first population was the 38 nurses at the health centres and clinics who implement the Adolescent Friendly Health Services in Otjozondjupa Region. The second study population were all the 3 health centres and 16 Clinics where the Adolescent Friendly Health Services are implemented. The third study population was the 4 995 school-going teenage girls as potential users of the Adolescent Friendly Health Services in the 21 Secondary Schools of Otjozondjupa Region. Data for the teenage girls and the nurses was collected using self-administered structured questionnaires of open and close ended questions. A sample of 540 from the teenage girls’ population and universal sampling of 38 nurses and 19 health facilities was applied. The data on the third component-the health facilities was collected through a checklist. Variables which are related to either the use or the provision of Adolescent Friendly Health Services were selected from the questionnaires and the checklist. A multivariate, analytical descriptive method was followed to analyse the data from the three data sources, using SPSS Version 16 data base. Variables from each of the three components were analysed and described. The relationships of the selected variables were analysed. The findings indicated that there was limited active involvement and participation of the adolescents in the Adolescent Friendly Health Services as the majority of the adolescents as users of this service did not know about the service. The findings further indicated that almost half of the nurses in the service were not formally trained in Adolescent Reproductive and Sexual Health issues. Additionally, health facility environments were not adolescent friendly. In conclusion, this study revealed that although the standards for the implementation of AFHS exist, they are not being effectively implemented by Nurses in Otjozondjupa Region. Based on the conclusions which were drawn from this study, recommendations were made with regard to the improvement of adolescent active participation, marketing strategies for Adolescent Friendly Health Services, training of current and prospect adolescent health care providers in matters of adolescent friendly health services and improvement of the adolescent friendly environment in health care facilities.
Assessment of the compliance of private health care providers to guidelines for antiretroviral therapy in the management of HIV and AIDS patients in Windhoek, Namibia
(2007) Pereko, Dawn;
Since the identification of the first human immunodeficiency virus (HIV) case, developments have been underway to find treatment for the virus. Antiretroviral agents, especially when used in highly active antiretroviral therapy (HAART) regimens, have produced dramatic decreases in morbidity and mortality of HIV infected people and has made HIV a potentially treatable chronic disease. The success of HAART depends on the correct combination of drugs and on adherence to treatment regime. In April 2003, the Ministry of Health and Social Services published the first antiretroviral treatment guidelines which form the basis of HIV management in Namibia. However the actual availability of these guidelines and their application in the private sector was not known
The assessment of the knowledge of surgical patients and their understanding of informed consent for elective surgical interventions in operating-rooms at public training hospitals, Windhoek, Khomas region, Namibia
(University of Namibia, 2019) Ngaujake-Kavari, Colleen
A majority of patients do not fully understand their health, diagnosis, proposed treatment/procedure and possible risks because of limited knowledge on the importance of informed consent according to previous studies. It has been noted at Windhoek Central Hospital operating rooms that patients may sign informed consent form without knowledge and understanding of what they have signed for. The aim of this study was therefore to assess surgical patients’ knowledge and understanding of the informed consent process for elective surgical interventions in operating rooms at public training hospitals in Windhoek. A quantitative, descriptive and analytical study was conducted among surgical patients using structured questionnaires and data was analysed numerically through statistical procedures. A total of 80 participants were recruited using systematic random sampling method at Windhoek Central Hospital and Intermediate Hospital Katutura operating rooms. Regarding surgical patients’ knowledge and understanding of informed consent process for surgical interventions, findings revealed that the majority of surgical patient (45%) indicated they did not understand the information written on the informed consent form. Most of the patients just signed the informed consent form without understanding its function. Furthermore, regarding ethical concept, the study revealed that a majority of surgical patient (87.5%) did not receive appropriate information on the nature, risk, alternatives and benefits of the operation to be performed. The level of education of the participants was shown to significantly affect the knowledge and understanding of the informed consent process. The study concluded that the surgical patient knowledge is limited which seems to contributes to poor understanding regarding the informed consent process. The level of knowledge and understanding was not different between the two state hospitals. The study also revealed incorrect and incomplete recordings on the informed consent form which is regarded as illegal, unethical and an act of misconduct because the form is regarded as a legal document. The study recommends drafting of a policy to guide the informed consent process which will improve patients’ knowledge and understanding of the process. The study also recommends improvements and standardisation of the informed process in the two hospitals to improve patient knowledge and understanding. Regular refresher courses on informed consent process including how to complete the form are also recommended for all healthcare workers.
Assessment of the knowledge, attitudes and practices of female secondary school learners on emergency contraception in Ongwediva, Oshana Region
(2014) Magesa, Emmanuel Salvatory
Emergency contraception (EC) has been available in Namibia for many years; however, there has been little research on knowledge, attitudes and practice of female learners about it. The aim of this study was to assess the knowledge, attitudes and practices of secondary school female learners towards emergency contraception. A cross sectional descriptive study of 294 secondary female learners was conducted at Mweshipandeka and Gabriel Taapopi secondary schools in Ongwediva, Namibia, during January 2013. A self-administered questionnaire was distributed to female learners who agreed to participate in the study. The findings indicated that only 4.4% of female learners had heard and used emergency contraception. About 48% of them reported that oral contraceptive pills are used for EC, 6% mentioned implants as EC and 9% mentioned intrauterine device (IUD) as an EC. Only 7.8% mentioned the correct time (within 72hrs) of taking ECs in case of unprotected sex. More than 29% of female learners mentioned friends/family as the source of information about EC. About 86% of female learners who heard EC know the mechanism of action of EC pills and 8.5% believed that EC worked by inducing abortion. More than 80% of students had positive attitudes towards EC. The level of knowledge of female learners in secondary schools about EC appears low; hence there is a need for more awareness creation and education among the learners on EC. This could be done through peer education in the schools and a possible incorporation of EC issues in secondary school curriculum.
Assessment of the knowledge, attitudes and practices of young adults on alcohol consumption and its effects on their health- Windhoek, Namibia
(University of Namibia, 2021) Nghitongo, Aina Ndapandula
Excessive alcohol consumption has been on the rise globally and Namibia is no exception, thus making the rise thereof and its adverse effects a public health concern. Various studies indicated that excessive alcohol consumption leads to a great deal of health and social consequences. The main purpose of the study was to determine the knowledge, attitudes and practices of young adults on alcohol use and its effects on their health. The study applied a quantitative approach, using a cross-sectional, descriptive and exploratory design to obtain data from 383 participants aged 18 – 30 years. A cluster random sampling method was employed, data was compiled and analysed using SPSS version 25. Questionnaires were used to determine the knowledge, attitudes and practices relating to alcohol consumption. Descriptive quantitative statistics were used to present the results. The mean age of the respondents was 22.9, ±40.05SD. 134 of the respondents (male and female) were from the age of 21 -23 whereby females made up most of the respondents in the study from all age groups with 58.5%. This study found that most of the respondents had a good knowledge with more than 67.6% describing the awareness and dangers of alcohol (e.g. stomach ulcers, liver damage and increased risk of motor vehicle accidents). Furthermore, 58.7% of respondents agreed that alcohol is a drug, and 87.7% agreed that 10% of road accidents are alcohol-related. Respondents showed inadequate knowledge regarding the term “standard drink” and the recommended number of standard drinks. Overall, respondents had a good attitude and safe practices towards alcohol consumption and its effects on their health. 71.3% of the respondents indicated that their alcohol consumption was enquired during visits to a health facility. This study, therefore, recommends that there is a need to increase knowledge, improve attitudes and maintain practices towards alcohol consumption and its adverse effects among the youth by creating new platforms to increase awareness and intensify alcohol education. This can be achieved by establishing a multisectoral approach between the Ministry of Health and Social Services (MoHSS), Ministry of Education (MoE) and other relevant stakeholders in Namibia.
An assessment of the Measles immunisation status and management in Engela district, Ohangwena region
(University of Namibia, 2016) Nangobe, Ruth
Immunisation is one of the most cost effective public health interventions that provide protection against infectious diseases. The purpose of this study was to assess and describe the measles immunisation status and vaccine management in the Engela district. A descriptive, cross-sectional study was conducted using a proportionate and systematic sampling technique. A structured administered interview to participants, supplemented with an observational checklist to assess measles coverage, vaccine and cold chain management. The data was analysed using Epi Info.7 software and setting p-values of 0.05 for statistical significance. A total of 162 parents/caregivers of the children aged between 9-59 months were interviewed and 17 public health facilities were assessed. The median age of children was 24.5 months and 88 (54.3%) were males. The majority of children 155 (95.7%) had been vaccinated against measles, with a 95% confidence interval of (91.3% - 98.3%). More unvaccinated children were diagnosed with measles compared to the vaccinated (28.6% vs 6.5%, p=0.029), and this could be attributed to vaccine failure or improper management of vaccines and the cold chain. Receiving information on immunization was associated with vaccination (p = 0.0001). Fifteen (88%) of the health facilities had functional cold chain equipment and vaccines that were stored at temperatures ranging between +2°C and +8°C. The storage management of the vaccines however did not meet the minimum storage requirements as backup systems were flawed in the sense that gas cylinders or generators were not available for the refrigerators in case of power outages. The coverage was also sub-optimum as 13 (76%) of the health facilities had a measles coverage of less than 80%, and 8 (47.1%) had a dropout rate of more than 10%. Recommendations were submitted to the Ministry of Health and Social Services. The more important recommendations focused on reviving the health education sessions, increasing the routine measles coverage and reducing the dropout rate as well as improving the vaccine and cold chain management.
Assessment of the needs of student nurses regarding critical thinking in nursing practice
(2016) Pretorius, Louise; Van Dyk, Agnes; Small, Louis F.; Amukugo, Hans J.
This study involved a quantitative, quasi-experimental and contextual design. The target population for this phase was senior student nurses registered at the University of Namibia, in their fourth year of nursing studies in the training hospitals of Windhoek and Oshakati. A total of 46 fourth-year nursing students, registered at the Faculty of Medical and Health Sciences in the Department of Nursing, were included for phase 1 except for the two students who took part in the pilot study. The students were from both campuses, namely the Windhoek and Oshakati campuses, doing the four-year Diploma in Comprehensive Nursing curriculum, which incorporates the principles of critical thinking. An imaginary case scenario was developed for students to analyse and answer some relevant questions to enable the researcher to determine the level of understanding and integration of critical thinking. In this study each student’s answers were deductively analysed by calculating central values, more specifically the mean for each question, to determine their application of critical thinking skills in the management of a nursing problem The researcher has, with literature support, arrived at “umbrella” concepts, namely the most important concepts that nurses in Namibia need and without which they cannot practice. These umbrella concepts are to be included in the educational programme.
The assessment of the University of Namibia student risky behaviour such as sexual multiple and concurrent partnerships
(University of Namibia, 2019) Indongo, Indongo
The risky behaviours such as concunent sexual partnerships is increasingly recognised as important in the transmission of sexually transmitted infections (STis), particularly of heterosexual Human Immunodeficiency Virus (HIV) transmission in Africa. Modelling and empirical evidence suggest that concunent partnerships - compared to serial partnerships - can increase the size of an HIV epidemic, the speed at which it infects a population, and its persistence within a population. The purpose of this study was to assess the risky behaviours such as multiple and concunent sexual partners among students. The study further determined the level of condom use and voluntary counselling and testing (VCT) as mitigating factors of risky behaviours. A descriptive quantitative approach was used while a structured questionnaire was deployed in collecting primary data from participants. The study used stratified simple random sampling and involved 580 students. Findings of the study revealed that most students - 440 (76%) - were sexually active. The average age at first sex was found to be 19 years. This is above the national average age at first sex which is 16.3 years. The study findings further revealed that out of the 440 sexually active respondents, 369 (84%) had sexual partners in the last six months prior to the study and only 71 (16%) did not have sexual partners. Out of 369 respondents, 154 (42%) were involved with more than one sexual partner in six months before the study while 215 (58%) respondents had one sexual partner. These 369 students had between one and three partners within six months, the study found. The study further revealed that 286 (76%) respondents were involved with regular partners while 87 (24%) were sexually involved with casual partners. Of the 286 respondents, 171 (61 %) were females, indicating that more females had regular partners compared to males. On casual partners, more females (64%) were involved sexually with casual partners compared to males. Condom use among regular and casual partners varied significantly, the study revealed. For regular partners, 202 (72%) "always" used condoms while 79 (28%) "sometimes" used condoms. Condom use among casual partners was high, with 82 (95%) "always" using condoms and 5 (5%) "sometimes" using condoms. The study further revealed that intergenerational sex was common among students, with 105 (28%) respondents out of 369 involved. Of the 105, more females (80%) were involved compared to males. Utilisation of voluntary counselling and testing services was found to be high with 431 (74%) ever tested. However, further analysis revealed that most of the tests were not recent. Those who were tested in the last six months were only 50 (12%) while 174 (40%) results were more than two years old. A majority of 179 ( 42%) of the respondents got tested at the New Start Centres, followed by 137 (32%) tested at public hospitals or clinics. Of the 149 respondents who said they were never tested, the highest number (23 (37%) females and 14 (16%) males) cited fear of knowing HIV status as the reason; while 16 (26%) females and 25 (29%) males indicated they were not interested in knowing their HIV status. The study concluded that students were involved in tisky behaviours of multiple and concurrent sexual parinerships and that condom use was low and inconsistent. Utilisation of VCT was high but not recent, hence the study recommends that students should be encouraged to visit VCT services more frequently.

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