Department of Midwifery Science

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    An educational programme for fascilitating adolescent motherhood in Oshana region, Namibia.
    (2013) David, Sabina Aishe-Oiwa
    Adolescent motherhood is presented in the literature as today’s challenge both nationally and internationally. The World Health Organization (2007) also indicated the encountered problem on adolescent motherhood world-wide. Many countries documented the vicious sequence of early motherhood such as poverty and poor education. Accordingly, adolescent motherhood is regarded as a social health concern owing to its socioeconomic consequences, which affect the young mothers, their babies, their families and their communities at large. As a developing country, Namibia is no exception to the problem of adolescent motherhood, high rate of early sexual activity prevails among adolescents, with consequently unwanted pregnancies and early motherhood. The increase in the births of babies to adolescent mothers is happening throughout the country. The adolescent pregnancy rate in Namibia is estimated to be 15.4%, with approximately one out of every five pregnant women being an early adolescent (Ministry of Health and Social Services, (MOHSS 2006/2007). The reality is that when adolescents discover that they are pregnant and the realities and responsibilities of motherhood dawn on them, they tend to feel shocked, frightened, hopeless, angry and frustrated. They may even become depressed and feel that they have failed themselves, their families and society at large. Adolescent mothers seem to be thrown into an adult world with no preparation for being a parent. This may increase the risk of child neglect or maltreatment and a loving-caring relationship between baby and mother may never develop. The following question arises: What needs to be done to assist and support adolescent mothers in the transition from adolescence to motherhood? Although the prevalence of adolescent pregnancy in Oshana region is not the highest recorded in the country, it does contribute to the high percentage in the country.According to the reports from the 2006 birth registers of the Oshakati Intermediate Hospital, a referral hospital in Oshana, there is an increased number of births from adolescents with the birth records indicating that 42% of the births that took place in January 2006 and 43% in August 2006 were from young adolescent mothers aged 15−17years.Thus, this study aimed atexploring and describing the experiences of adolescent mothers in the Oshana regionof Namibia as regards motherhood and developed an educational programme directed at preparing, assisting and supporting adolescent mothers during the period of motherhood. Adolescents should be able to manage their lives without back street abortions and baby dumping which usually occur when they don’t want to have babies. A qualitative, explorative, descriptive and contextual research approach was followed to study the experiences of adolescent mothers in Oshana region of Namibia. The study draws on a thematic analysis following Tesch’s analysis process. The study was conducted in four phases. Phase I entailed a situational analysis which explored and described the adolescent mothers’ experiences of motherhood. The results of the transcribed in-depth-interviews conducted indicated that adolescent mothers experienced the following: 1) 1) diverse diverse feelings towards motherhood,2feelings towards motherhood,2feelings towards motherhood,2feelings towards motherhood,2 feelings towards motherhood,2feelings towards motherhood,2feelings towards motherhood,2 feelings towards motherhood,2 feelings towards motherhood,2 ) various challenges related to motherhood, 3) lack of effective interpersonal relationships with families and friends, 4) the burden of caring for and bringing up a baby, and 5) future ambitions for support and relationships.In Phase II a conceptual framework was developed,described according to the concepts in the survey list as suggested by Dickoff, James and Wiedenbach (1968). Phase III was concerning the programme development and implementation and lastly Phase IV,the evaluation of the educational programme. The overall insight obtained was that attaining motherhood prematurely has a severe impact on adolescent mothers’ lives, on their families and also on their communities. As a consequence, adolescent mothers are exposed to physical, social and psychological misery, dependency syndrome and socioeconomic hardships. However, an educational programme can be effective in assisting adolescent mothers to overcome the challenges experienced during motherhood. To conclude, the study accentuates the ongoing need for research on adolescent motherson challenges they are facing related to education andalso regard the experiences of the parents of adolescent mothers when they accept the care of their grandchildren while their mothers continue with their education.
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    Factors associated with neonatal deaths in Katima Mulilo state hospital
    (2006) Liomba, Christina M.
    The neonatal mortality rate is the most essential indicator of obstetric care as well as overall socio-economic development in any given country. It is also a sensitive indicator of the impact of programme intervention and for monitoring changes in quality care (MOHSS, 1996: 2). The Health Information System (HIS) at Katima Mulilo State Hospital reported an increase in neonatal deaths of 8/1000 live births (0,8%) in 2001 to 39/1000 live births (3,9%)in 2002. Based on this problem, factors associated with neonatal deaths were investigated in an effort to improve mother and child health in Katima Mulilo Hospital. In reviewing the literature, factors such as prematurity, low birth weight, infection, high parity/gravida, maternal age, birth intervals, hypothermia, lack of equipment, asphyxia and some obstetric related conditions such as placental pathologies, pregnancy-induced hypertension and birth injuries were identified. After applicable validation, these factors were also included in the instrument construction of this study. A comparative, descriptive and retrospective study was conducted from cases and controls selected from the total population. Cases referred to mothers and their diseased neonates, while controls referred to mothers and their surviving neonates. Some statistically significant differences were found between the case group and the control group with regard to certain variables that could be regarded as factors associated with neonatal deaths. Recommendations that were formulated based on this research report include emphasis on improved maternal and child health education, in-service training for registered nurses, regular audits of patient records and discussion of audit results. In addition it is proposed that the in-service training of traditional birth attendants be enhanced. It is recommended that these traditional midwives be instructed in the early detection of complications and the correct referral to health facilities. Extension of outreach services to all corners of the region should be implemented. Revision of national policy guidelines with regard to treatment protocols is also proposed. Consideration should also be given to the establishment of hospital facilities to improve the care of premature babies, which should accommodate mothers for Kangaroo Mother Care.
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    Factors influencing the follow-up visits of mothers registered with prevention of mother to child transmission (PMTCT) of HIV/AIDS programme at the Katutura State Hospital
    (2005) Nashandi, Hilde-Liisa
    The Ministry of Health and Social Services (MOHSS) has launched a comprehensive programme for the prevention of mother to child transmission (PMTCT) in March 2002. This programme was introduced for the prevention of mother-to-child HIV transmission in Namibia using Nevirapine (an Antiretroviral drug). The programme was initiated at two pilot sites i.e. Katutura State Hospital Antenatal Clinic (KSH-ANC) and Oshakati State Hospital. This programme was aiming to reach 500 HIV positive women, 250 from each site, but this number has been exceeded
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    Investigations into experiences of mothers who delivered and are caring for preterm babies in nothern Namibian state hospitals
    (2013) Velikoshi-Indongo, Eva-Angelina N.
    Prematurity has become a major global cause of death in neonates. The number of preterm babies has increased significantly in the past ten to fifteen years, creating a public health crisis in the financial and social fraternities. While prematurity has become a public health crisis, delivering and caring for a preterm baby also affects the emotional and social well-being of the mothers who delivered preterm babies. Most preterm infants are born ill, or have difficulties in adapting to extra-uterine life because of immature body systems and organs. As a result, preterm birth and caring for a preterm baby becomes a stressful and worrisome situation for parents. However, some preterm babies do survive, and they can quite soon be discharged home with their mothers. But, although mothers may experience excitement and happiness at discharge, many are anxious and insecure about how to take care of their tiny babies at home. This creates another burden for the mothers, because they will be carrying on with the baby care at home without assistance. Therefore, nurses should be prepared to assist the mothers in this transitional period, by providing instructions and interventions that will give the mothers the necessary knowledge and skills to confidently and effectively care for their babies at home. This research was conducted in the Neonatal Intensive Care Unit (NICUs) of the Pediatric and Maternity Wards of Intermediate Hospital Oshakati. The study was undertaken as a qualitative, exploratory, descriptive and contextual study, aimed at understanding lived experiences of mothers regarding giving birth to a preterm baby and caring for him or her. In-depth interviews were conducted on eight mothers, who had been caring for their preterm babies for at least two weeks in the mentioned units. The researcher observed ethical implication pertaining to research conducting. Permission to conduct the study was sought from the concerned institutions. Ethical principles of informed consent, anonymity, confidentiality were adhered to. The study revealed that mothers who delivered preterm babies experienced emotional challenges, manifested in shock, fear, despair and sadness. It also showed that the mothers relied mainly on their religion in an attempt to cope with preterm birth. In addition, mothers experienced difficulties in bonding with their babies as well as apprehension in the care of their babies because they had inadequate information about preterm birth and preterm baby care. This caused them to have no foundations to build the discharge care planning at home after discharge from the hospital. Hence, a discharge health educational-support programme was developed, to address their emotional challenges in the care of their preterm babies as well as to address their educational needs. The programme aimed to empower the mothers with knowledge and skills to enable them to effectively and confidently continue caring for their babies at home, as well as to address the emotional challenges brought about by prematurity. The programme was implemented in seven sessions using demonstrations and group discussions as teaching strategies. For programme evaluation, three unstructured interviews were conducted with mothers caring for preterm babies on the discharge day of each preterm baby. Mothers said that they had found the programme useful to them, had gained knowledge and skills, were more confident in their abilities to continue with baby care at home, and they obtained emotional relief upon using the programme.
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    A survey to determine factors that influence the utilization of maternal and child health services by working women of child bearing age with specific reference to family planning
    (University of Namibia, 1995) Black, Sofia; Van Dyk A. S. B.
    A descriptive study was done to gather information which is directed at factors that influence the utilization of family planning services by working women in child bearing age.it concluded that occupational health services are almost non-existent in Namibia and need to be addressed by health care policy makers; * family planning services and the distribution of information on these services (are not sufficient for working women in Windhoek; * strategies should be designed to improve the attitude of health providers towards clients so as to improve utilization of health services especially family planning services
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