School of Nursing & Public Health

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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 assessment on the knowledge, facilitators, and barriers to the uptake of cervical cancer screening among allied health science female students at the University of Namibia, Hage Geingob campus
(University of Namibia, 2024) Kamunima, Petronela
Cervical cancer is the leading cause of cancer-related deaths in the world. In Namibia, cervical cancer ranks as the second most frequent cancer following cancer. The purpose of this study was to assess and describe knowledge, facilitators, and barriers to the uptake of cervical cancer screening among female allied health science students at the University of Namibia (Hage Geingob Campus). A quantitative, cross-sectional, and analytical study was conducted with the use of a self-administered questionnaire. A sample size of 97 female allied health science was obtained using a systematic random sampling method. Binary logistic regression analysis was used to establish the relationship between the independent and dependent variables of the study. The findings of the analysis depicted an abnormal pap smear test (OR=84.056, 95% CI: 4.316-1636.911, p=0.003), age (OR=0.625, 95% CI: 0.441-0.886, p=0.008) to be statistically significant with female students having a Pap smear test. Results from the study further revealed that 12(13%) female students have had a Pap smear test in their lifetime. The most common barriers to cervical cancer screening included no signs and symptoms of cervical cancer (33%), fear of outcome (15%) and difficulty accessing screening services (15%). Facilitators to cervical cancer screening were reported as own decision to undergo screening (39%) and upon doctors’ requests (6%).The findings of the study showed that there is a poor level of cervical cancer screening uptake among allied health science female students at the University of Namibia. It is recommended that the University of Namibia in consultation with the Ministry of Health and Social Services tailor cervical cancer screening programs to assist in educating female students about the risk factors of cervical cancer as well as the importance of cervical cancer screening uptake
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.
Analysis of factors contributing to non-adherence to highly active antiretroviral therapy in selected facilities in Namibia: A development of adherence improvement Programme for health professionals
(University of Namibia, 2023) Katjiuanjo, Maazuu Zauana
Health professionals are faced with challenges of ART non-adherence in patient enrolled on HAART. This study was aimed at developing a programme to assist health professionals to improve ART adherence at the facilities in Oshikoto and Kavango West regions. The study was carried out in four phases i) phase 1: situational analysis ii) phase 2: conceptual framework development iii) adherence programme development and iv) programme evaluation. Phase 1 involved carrying out a situational analysis using a mixed-method design to understand magnitude of adherence problem in the study area. In the quantitative part of the study a descriptive and analytic cross sectional study was conducted to collect data using structured interview, with HIV infected persons (n=296) under antiretroviral treatment in Oshikoto and Kavango West regions. Medication adherence was measured with the Adult AIDS Clinical Trial Group (AACTG) method and the Morisky Medication adherence Scale (MMAS-8) In depth Interviews (IDIs) of health professionals (n=43) and four Focus Group Discussions (FGDs) with (n=32) individuals who received ART at a primary health care clinics were conducted at four facilities in the selected regions. Overall adherence levels was 76 % with AACTG and 36 % with MMAS-8. Factors contributing to non-adherence were Type of House, Region and Health Facility, the relationship was a negative one with beta < 0. Other factors were forgetfulness and regimens missed during the weekends as reported by the MMAS-8. Determinants of non-adherence using the AACTG adherence were found to be Confident of regularly taking medicine, Intention to regularly take medicine over the next year, Treatment support in taking medicine available and Cues to Action with beta >0.5). ART potency, that is Doses per day, ART Regimen and Dose each time per day ii with beta >0.5). The factors contributing to non-adherence with Morisky scale that showed strong positive relations with beta <0.5 were the medicinal barriers, perceived barriers, more likely to get ill than others, concerned about becoming seriously ill and barriers based on Infection severity. Determinants of non-adherence using the MMAS 8 were benefits of efficacy (r = 0.143, p <0.05), perceived barriers (r = -0.194, p <0.05) and social support in taking medicine (r = -0.127, p < 0.05). Four themes emerged of factors influencing non-adherence to antiretroviral therapy, these were: patient-related factors, health system, therapy-related factors, and condition related factors. In the qualitative data analysis, health professionals reported reasons for ART non-adherence. The subthemes included Unemployment and being poor; forgetfulness; lack of knowledge due to negative beliefs; side-effects, health system challenges; workload, inadequate training, lack of skills, and poor adherence reporting systems; stigma. The HAART participants reported several barriers that negatively influenced their medication experience and adherence. These barriers included the following subthemes: financial burden; side-effects, psychological factors, such alcohol use and stigma. The facilitators included social support, treatment support and positive patient-provide relationship. In Phase 2, the development of the conceptual framework was based on the theory of Dickoff et al. (1968) using the findings of the mixed method. Phase 3 addressed the development of the Adherence Improvement Programme (AIP) for the health professionals (1). The programme was developed within the concepts of Intervention mapping framework suggested by Bartholomew et al. (2006), which outlines the processes of developing a theory-based health promotion programme. Finally, the programme was evaluated in Phase 4 using the Centre for Disease Control (CDC) iii ‘Framework for programme evaluation in public health’ (2). A pool of public health experts was utilised for this purpose. The AIP has four programme components consisting of four objectives. Key performance areas based on the intervention strategies to improve adherence were elaborated under each objective. Tasks to be performed under each key performance areas were stipulated accompanied by indicators to measure programme performance
An analysis of the implementation of the school supplementary feeding programme in Windhoek, Namibia
(2012) Sibanda, Dumisani G.; ;
Abstract provided by author
An analytic and evaluative study of the post-registration competency of registered nurses/ midwives who obtained the University Diploma in Nursing Science and Midwifery Science at the University of Namibia from 1990-1992
(1994) Haoses, Lischen; ;
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.
Assessing the perceptions of clients and nurses regarding integration of the primary health care services, okuryangava and Wanahenda clinics Windhoek, Namibia
(University of Namibia, 2022) Paulus, Bertha
The successful implementation of the Integrated of Primary Health Care (PHC) services is major challenge for health systems internationally. This research study aimed to explore the perception of clients and nurses regarding integration of primary health care services between the two clinics (Okuryagava and Wanaheda clinics). The study objectives were to assess the perceptions of clients regarding integration of PHC services; To assess the perceptions of nurses regarding integration of PHC Services; and suggest possible recommendations that can be adopted to improve integration of PHC Services based on the perceptions of Clients and Nurses. The research was conducted using qualitative research methodology. The study used an interview guide to collect data through in-depth interviews. A total of 20 participants who include both nurses and clients were purposively sampled. Data is presented using the thematic approach while content analysis was used to analyse data. Research results show that integration of PHC services has improved relationship between nurses and clients, integration of PHC services is convenient, integration of PHC services enhances competence and PHC makes nurses assessment of clients made easier. On the other hand, integration of PHC services has led to the mixing of services that do not go along, it prolongs time a client is served, integration of PHC services does not resonate with the structure as well as the resources of the clinics and stigmatises clients. On the basis of the findings, it is recommended that there is need for resources, consultation rooms and instruments to be addressed so as improve the integration of PHC services at the clinics. If more infrastructure could be provided it would ease the problems that the nurses are currently facing. The study recommends that there is need to restructure the processes of the PHC provision at the clinics as the current ones seem to be out of sync with the available resources. The study suggests that immediate actions towards patient-centred care are necessary in order to operationally integrate all provided services and existing functions of the PHC system at the clinics. Participants were also of the view that health policymakers should adopt an evidence-based action plan that ensures and safeguards patient-centeredness, comprehensiveness, sound coordination, and continuity of services at the clinics.
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, attitude and practices of male adults regarding the uptake of HIV counselling and testing in Opuwo district, Kunene region, Namibia
(University of Namibia, 2022) Tjipundi, Sewako Thekela
Human Immunodeficiency Virus (HIV) voluntary counselling and testing (VCT) are one among the different approaches implemented to curb the spread of HIV infections and minimise the impact on individuals and families. VCT are considered effective strategies in risk reduction among sexually active individuals, hence, the involvement of men in HIV services is critical to ensure the success of such services. Efforts by government and civil society organisations to get more men involved in HIV services in Namibia over the years have yielded little benefits. This research focused on determining the knowledge, attitudes, and practices of male adults regarding the use of VCT services in Opuwo District, Kunene Region, in Namibia. Data were collected in Opuwo town, Otuzemba and Katutura locations. The aim was to determine the role played by the male adults’ knowledge, attitudes, or practices in the uptake of HIV testing. The purpose of this research was to appraise the level of knowledge, attitude, and practice of VCT and to determine their association with demographic data on HIV uptake of the male adults in Opuwo district. The study employed a descriptive cross section study, method was used to select the respondents from a population which was done from September to November 2019. The simple random sampling of men aged between 15-50 years and above. The sampling formular used was EPI-INFO version 7 with a confidence interval of 95% and a power of 80%, which gave a sample of 113 participants. Data were gathered from 113 participants using a structured questionnaire that was distributed by the researcher and with the help of two people. The theoretical framework that was utilised in this study was the Health Belief Model, which submits the way beliefs guide individual actions and the process that people go through to change their behaviour The study was guided by ethical principles of beneficence, principle of respect for person and principle of justice. The research sought to determine the degree of knowledge regarding attitude and ii consumption of VCT services by male participants. The association between the data of the participants and other variables was tested using a Chi square. The participants in the study were men who had an average age of 30years. While 95.5% of the participants were knowledgeable about HIV/VCT, 60% had a negative attitude towards VCT, and 60% of the participants had never tested for HIV. The fear of positive results, stigma and discrimination, and confidentiality of test results if they were positive was reported as the main barrier for VCT uptake among men. Arguably, if male participation in accessing VCT services is to be enhanced, VCT programme should reduce, HIV stigma and improve access and trust towards VCT in the district. Other possible interventions are the setting up of regular home-based VCT programmes and the mainstreaming of HIV Testing Services in community development programmes. The chi-square test showed that the type of occupation has an influence on the knowledge of HIV. Finally, the study concluded that outreach programmes that target the testing of men should be encouraged or introduced by Community Based Organisations, and the Ministry of Health and Social Services.
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 management of newborn babies with neonatal asphyxia at maternity units of a state hospital in Windhoek
(University of Namibia, 2018) Hanyanya, Johanna
Despite guidelines on essential and obstetric emergency care devised by the Ministry of Health and Social Services to address obstetric and neonatal related challenges in Namibia, the report on perinatal and neonatal death review of April 2010 - March 2012, indicated that birth asphyxia is in first position contributing 49.4 % to neonatal deaths. This reflects the severity of asphyxia as a public health concern in Namibia (MoHSS, 2014). The aim of the study was to assess the management of newborn babies with neonatal asphyxia at maternity units of a hospital in Windhoek. A quantitative, descriptive and retrospective study was used on a total population of 90 patients’ files who died due to asphyxia. The sample and the population were the same (90 numbers of patients’ files). Data were collected by means of a structured checklist, analyzed with Epi info 7, as software computer package for statistical analysis purpose and presented as descriptive statistics. The results of the study showed that there was a delay with early recognition and timely decision-making on the safer method of delivery especially for cases of breech presentations, cephalopelvic disproportion (CPD) and prolonged first stage of labour. Referral of patients from district and regional hospitals to a national referral hospital takes too long. The results of the study further showed that many deliveries were conducted by registered midwives in the absence of a pediatrician or medical doctor. Recommendations were made with regard to improvement of knowledge and skills on maternal and neonatal care by health care providers in order to provide quality antenatal care to pregnant women, conduction of safe deliveries and provision of efficient care to the new-born babies who are at risk of asphyxia. Deliveries of cases at risk to be conducted with the presence of a paediatrician for expert resuscitation. Regulations of the referral system on maternal care should strictly be put in place regarding the hours mothers have to stay in labour after complications have been detected to prevent avoidable neonatal deaths especially due to asphyxia
Assessment of quality of midwifery care during labour at maternity departments of intermediate and refferral hospitals in Namibia
(University of Namibia, 2021) Nghifikwa, Jonia
Quality of midwifery care can be defined as care delivered by midwives, which is safe, effective, efficient, accessible, acceptable, patient-centred, equitable, and results in a positive pregnancy outcome. This research aims to assess the quality of midwifery care rendered during labour at the intermediate and referral hospital in Namibia. In Namibia, the Ministry of Health and Social Services (MoHSS) in particular, has come up with many interventions aiming to reduce maternal and neonatal mortality and morbidity. Even though these programmes were implemented, the programme reviews conducted by MoHSS in 2016 identified some gaps in the quality of midwifery care and recommended the conduct of a second nationwide Emergency Obstetric and Neonatal Care (EmONC) assessment. The main objectives of this study therefore were to describe the demographic profile, conclude the standard of midwifery care rendered during the first, second, third and fourth stages of labour by reviewing maternity records and analysing the standard of midwifery care rendered during the first, second, third and fourth stages of labour of the women who gave birth at intermediate and referral hospital from 01 January to 31 March 2018. The study was a retrospective study with a descriptive quantitative design conducted on 653 maternity records at the above mentioned hospitals. The findings revealed the age group from twenty to thirty-five to be the highest age group that gave birth i.e. (78.6%), while (10.7%) were adolescents and (10.7%) of the women aged above 36 years of age. This study indicated that (95%) of these women attended antenatal care. However, obstetric history indicates that the majority of the women who had delivered 391 (59.9 %), had two to four children, followed by those who gave birth for the first time 197 (30.2 %), while the lowest were those who had five or more children 65 (10.0%). Early opening of a partograph could lead to early identification of problems and plans for interventions. This study further shows that 402 (61.6%) partographs were mostly opened with women in the active phase of labour. Few partographs 33 (5.1%) were opened in the latent phase of labour. However, partographs that were opened, the study results revealed that not all were managed according to the WHO guidelines. Poor documentation of midwifery interventions and care was noted, suggesting poor midwifery care. Most of the deliveries 499 (76.4%) were normal vaginal deliveries, followed by 151 (23.1%) who had caesarean section deliveries. The rest had assisted deliveries with one breech delivery. According to the findings of this study it can be concluded that midwifery care rendered during labour at the studied hospitals was of substandard.
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.