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Item Factors associated with low birth weight among babies born at Oshakati intermediate hospital, Oshana region, Namibia(University of Namibia, 2022) Ndjengwa, Roswitha M.Low Birth Weight (LBW) is a preventable public health concern. By 2015, the global prevalence of LBW was estimated at 15% - 20% with Sub Saharan Africa standing at 13%. The 2013 Namibia Demographic Health Survey recorded a 13% LBW prevalence, with Oshana region leading by 16%. LBW is coupled with serious health problems e.g., impaired mental development and increased risk of morbidity and mortality. We investigated maternal and sociodemographic factors associated with LBW new-borns in Intermediate Hospital Oshakati, to develop recommendations aimed at reducing LBW. We conducted an unmatched 1:2 case-control study between September and November 2020. Cases were mothers who delivered singleton full term babies weighing less than 2500g. Controls were mothers who delivered singleton full term babies weighing 2500g or more. An interviewer administered structured questionnaire was used for data collection. We reviewed maternal records for clinical information. We used multivariable logistic regression to identify risk factors of LBW and reported odd ratios with 95% Confidence Intervals (CI). A total of 103 cases and 206 controls were interviewed. The mean age of mothers was 27.13 ±7.23 years and the mean birth weight of babies was 2875.13±570.88g. Independent risk factors for delivering LBW new-borns were gestation age <38 weeks (aOR 4.1, 95%-CI 1.86-9.35); history of LBW or prematurity (aOR 2.4, 95%-CI 1.12-5.43) as well as rural residence (aOR 2.5, 95%-CI 1.44 – 4.57). LBW is more associated with some socio demographic and obstetric factors than socio-economic and nutritional factors. Expecting mothers with known risk factors (e.g., history of prematurity or LBW) need close monitoring during Ante Natal Care (ANC). Maternal health services in rural areas needs strengthening in terms of skilled personnel, equipment, and awareness creation at community level.Item Assessment of death notification and registration process: Case study of Rundu district in Kavango east region, Namibia(University of Namibia, 2022) Egumbo, HenokMortality 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.Item 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 MuudikangeTobacco 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.Item Factors associated with the unsuccessful Tuberculosis treatment outcomes of the DOTS programme in Kunene and Oshana regions, Namibia(University of Namibia, 2022) Mondjila, AmkongoTuberculosis (TB) is among the leading causes of death globally. In Namibia, the disease has a huge burden, with a case notification rate of at least 442 per 100,000. To date, Namibia is still among the countries with the highest global TB burden, despite all efforts in place to reduce it. The purpose of this study was to determine the factors associated with the unsuccessful treatment outcomes of the Directly Observed Therapy or Directly Observed Treatment (DOTS) programme in the Kunene and Oshana regions. The study utilised a mixed-methods explanatory-sequential design to collect data from all TB patient records as well as healthcare workers who work directly with the DOT strategy for TB patients. The relationship between independent variables and dependent variables was analysed using multiple logistic regression analysis, while interviews were analysed using inductive thematic analysis. The overall treatment success rates of Kunene and Oshana regions throughout the entire review period were 50.6% and 43.9%, respectively. The type of DOT used (OR=1.67, 95% CI:1.15-2.42, p=0.007) and age group (OR=1.12, 95% CI:1.05-1.19, p=0.001) were the only factors found to be statistically significant with unsuccessful treatment outcomes in Kunene and Oshana region, respectively. The study further revealed that patients in Kunene region are difficult to reach owing to their nomadic lifestyle, adversely affecting their ability to directly observe therapy. Furthermore, lack of transport also affected the direct observation of therapy. In Oshana region, it was found that mixing anti-TB medication with alcohol among adult patients was a prevalent issue affecting TB therapy. Moreover, stigma and poor TB awareness among adult patients were also found to adversely affect possibilities of direct therapy observation, impacting the overall treatment outcome of the Oshana region. The main recommendations that arose from the study include the need for the regional heath directorates to establish a robust patient tracing system to enhance inclusive access to all health services, particularly among nomadic patients. Moreover, it is recommended that the regional management should improve their patient monitoring methods, particularly for those who do not take anti-TB medication under healthcare workers' observation, to ensure adherence. Lastly, extensive TB health education should be regularly conducted in both regions to increase awareness among the affected, to educate patients and their guardians about their responsibilities, as well as the TB management process and the dangers of using alcohol while on treatment.Item The assessment of the University of Namibia student risky behaviour such as sexual multiple and concurrent partnerships(University of Namibia, 2019) Indongo, IndongoThe 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.Item Non-communicable diseases risk factors among adults in Oshikoto region, Namibia(University of Namibia, 2019) Ashipala, Emilia ShiwaNon-Communicable Diseases (NCDs) such as cardiovascular disease, cancer, diabetes and chronic respiratory diseases continues to be the major development challenges in the 21st century and causes more than 40 million deaths every year global. NCDs count for 43% of total deaths in Namibia 2014, and in Oshikoto Region they are among top10 causes of mortality. The risk factors for NCDs in Namibia needed to be evaluated, therefore, this study was conducted to determine the NCDs (diabetic mellitus and hypertension) risk factors among adult in Oshikoto region, Namibia. A quantitative, descriptive, community population-based, cross- sectional survey was conducted using WHO STEPwise approach among 375 adults in Oshikoto region between November 2018 to January 2019. A stratified cluster random sampling method was used to select household. Demographic and behavioral risk factors were obtained using interview administered questionnaire. The researcher measured body weight, height, blood pressure and random blood glucose and calculated Body Mass Index (BMI). Body weight was classified as overweight (BMI 25kg/m2 – 29.9 kg/m2), obese (BMI ≥ 30kg/m2). BP ≥140/90 was classified as hypertension and RBG > 11.1mmol/l as diabetes mellitus. Univariate analysis determines the prevalence of NCDs risk factors. Bivariate and multivariate analysis for Odds Ratio and 95% CI was done to determine the association between risk factors and NCDs based on p-value <0.05. Out of a total of 375 participants, 279 (74.4%) were female. Mean age was 42.9 ±15.0 standard deviation (SD), range: 18-101. Most participants 244 (65.1%) were residing in rural areas while in urban area were 131 (34.9%) and 8.2 in semi-urban areas. Overall prevalence for risk factors were: physical inactivity (25.3%), unhealthy diet (75.7%), tobacco use (9.1%), harmful use of alcohol (40.8%). Overall, 20.5% were overweight with majority (85.7%) of them females. Obesity was 9.1% in which 91.2% were females. Hypertension prevalence was 24.3% and for DM was only 3.2%. Four percent individuals were having two multiple risk factors for NCDs, 2.4% with four risk factors and 1.1% with more than four risk factors. Age group (OR=2.48,95%CI=1.44-4.26, P=0.001), Obesity (OR=3.48,95%CI=1.55-7.79, P=0.003), and overweight (OR=2.34,95%CI=1.31-4.19, P =0.004) were significant risk factors for NCDs. This study revealed a high prevalence and burden of Non-communicable diseases risk factors such as obesity and overweight among adult in Oshikoto region, thus, these results highlight the need to evaluate and strengthen the existing interventions towards the prevention and control of those NCDs risk factors in Oshikoto region, Namibia.Item Incedence of Malaria in relation to residual efficacy of 2017 indoor residual spraying during 2018 Malaria season in Engela district, Ohangwena, Namibia(University of Namibia, 2020) Ngenokesho, Padelia N.ntroduction: Malaria remains a public health problem in Africa and other countries of subtropical. In 2017, an estimated 219 million cases of malaria occurred worldwide (95% confidence interval [CI]: 203–262 million), compared with 215 million malaria cases in 2016. Most malaria cases in 2017 were in the WHO African Region (200 million or 92%), followed by the WHO South-East Asia Region with 5% of the cases and the WHO Eastern Mediterranean Region with 2%. In 2017, there were an estimated 435 000 deaths from malaria globally, compared with 451 000 estimated deaths in 2016. In 2017, Namibia recorded high number; (66141 (27.3%) of malaria cases as compared to 2016 (24869 (10.3%) and 2018 (36451(14.8%). Primary malaria prevention on a large scale depends on two vector control interventions which are indoor residual spraying (IRS) and insecticide treated mosquito nets (ITNs). In 2017, Engela district, Ohangwena region used only Deltamethrin in both structures because of unavailability of DDT at the moment of spraying season. The duration of Deltamethrin effectiveness (residual efficacy) is 6 months as per WHO guideline. Therefore, the researchers determined the residual efficacy of insecticide (Deltamethrin) used in 2017 Indoor residual Spraying program in relation to incidence of malaria in Engela district, Ohangwena region. Methods: The researchers conducted an analytic quantitative cross sectional study to determine the residual efficacy of insecticide used in 2017 Indoor residual Spraying program in relation to incidence of malaria in Engela district, Ohangwena region. Malaria line list for 2018 was used to identify the villages affected by Malaria. The researchers collected mosquito larva for wild mosquitoes at mosquito breeding sites around Engela district and grew them into adult mosquitoes at the Oshakati Insectary laboratory. Wild common malaria vectors, which were unfed adult female anopheles’ mosquitoes were transported in the cage to the field at the time of testing. The WHO bioassays cone was used during testing of Deltamethrin residual efficacy which was used for both traditional (rough) and modern (smooth) sprayed walls. Four cones (high, middle and low surface level) per surface with twenty mosquitoes per cone were used. Three cones were experimental cones and one was control cone per structure. The study was done during 2018 malaria season after five and six months (April to May 2018) from 2017 IRS to find out the residual efficacy of 2017 IRS insecticide used. Bi-variate analysis was calculated to determine the statistical significant between mortality rate and types of the walls as well as time interval. Statistical significant was calculated at P-value < 0.05 and odds ratios at Confident Interval (CI) 95% confidence level to determine significant associations. Results: The district recorded 460 malaria cases from January –July 2018, of which 65 (14%) were local transmission and did not travel outside the district for about one incubation period (2-14 days) before the onset of symptoms. The peak months were March (23%), April (26%) and May (25%). The district had the total of 376 villages of which 156 (41%) were managed to be sprayed in 2017 and 220(59%) were not sprayed. Malaria local transmission cases were reported in 44 (10%) villages; of which 30/44 (68%) villages received IRS while 14/44 (32%); Odd ratio=3.8 CI 1.9-7.5; P value=0.0006). Only villages reported cases in the last 3 years were part of spraying campaign. In 2017, Engela district, Ohangwena region used only Deltamethrin in both structures because of unavailability of DDT during spraying season. Residual efficacy was tested in 23 malaria affected villages and on 50 sprayed structures. The time interval was one month, five to six-month time interval between IRS and testing of residual efficacy. The overall mortality rate (residual efficacy) was 46%. There is statistically significant between mortality rate and traditional structures with OR 1.66 CI 1.42-1.95 (P0.001), painted modern structures OR 0.77 CI 0.65 – 0.91 (P 0.002), time interval with OR 0.35 (0.29 – 0.41) P 0.001 and high position of the cone on the wall OR 0.76 CI 0.65 -0.88 (P 0.001). Conclusion: In conclusion, it is worth noting that villages that were sprayed during 2017 IRS program recorded many cases as compared to non-sprayed villages and it were found to be significant. This can be influenced by areas with source of infection, travelling, evening activities, and age. The effectiveness (residual efficacy) of 2017 IRS during malaria peak months was 46% and it was found that it was direct proportional with time interval. Therefore, the researchers recommended active case detection team to consider other control intervention such as use of Long Lasting Insecticide Treated Nets, increase community malaria awareness and early seeking of treatment, early contact tracing of malaria cases to cut-of the infection and behavioral community change.Item 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 NdapandulaExcessive 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.Item Assessing risk factors associated with primary hypertension among military personnel at Peter Mweshihange Military Heakth Centre in Windhoek(University of Namibia, 2021) Muleya, Lilian NjahiHypertension 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.Item Relationship between climatic factors and respiratory diseases in information settlement in Windhoek(University of Namibia, 2019) Amunime, JuliaThis study focuses on the correlation between climatic factors and health in informal settlements in Windhoek, Namibia, to investigate if climatic factors have a role to play in respiratory disease occurrences. The objectives are to identify climate-related disease trends in Windhoek informal settlements and explore the association between respiratory diseases and changes in temperature, humidity, and rainfall patterns in these settlements. A quantitative retrospective methodology was employed as the study design. Amongst the diseases, Nose/Throat constituted 36.39% of all the respiratory disease, Other Respiratory System Disease accounted for 32.29%, Common Cold accounted for 28.74%, Pneumonia with 1.69%, Asthma/Bronchial Spasm 0.82%, and Tuberculosis 0.11%. Forty-five percent of patients were in the age category older than eighteen years, 38% in the age category 0-5 years, and 17% in the age category 5-17 years. Females accounted for the majority of cases with 52% in comparison to males that accounted for 48%. The study found that there is a significant (p<0.01) variation in the morbidity pattern of respiratory diseases among age groups. A negative correlation at the 0.01 probability level between respiratory diseases (Asthma/bronchial spams, Common Cold, Nose/Throat Disease/Disorder, Other Respiratory System Disease, Pneumonia) and maximum and minimum temperature was established. Only Nose and throat disease had a significant correlation with rainfall and humidity at the probability level 0.05. There was No association established between tuberculosis and the climatic factors. The study highlights the existence of a relationship between respiratory diseases and changes in temperature, humidity, and rainfall patterns in Windhoek’s informal settlement. Even though these relationships were weak, it was evident that climatic factors do play a role in the occurrences of respiratory diseases. It is recommended that measures to prevent or mitigate the occurrence and prevention of respiratory infections be included in the preparation and handling of harmful human health effects of climate change.Item Factors associated with maternal deaths at Intermediate Hospital Oshakati (IHO): Oshana region, Namibia(University of Namibia, 2018) Kornelius, LidwinaMaternal death is a major health problem in Namibia, and in particular, at Intermediate Hospital Oshakati (IHO), Oshana region. Despite the introduction of several interventions by the Ministry of Health and Social Services to prevent the maternal deaths, IHO had reported the highest percentage (32%) of maternal deaths between January 2008 and May 2010 (MoHSS, 2011). It was against this background that this study was conducted to determine the factors associated with maternal deaths at IHO, Oshana region. A quantitative, cross-sectional retrospective research method was used to assess each maternal death at IHO, by reviewing patient records. Data was collected from 1 January 2011 to 31 December 2014. Patients’ socio-demographic characteristics were described. Different factors associated with maternal deaths were identified and analysed using Microsoft excel and Epi Info 7. Data was collected from deceased maternity patient records, maternal death register and DHIS2 hospital computer. A total of 74 maternal deaths out of 22840 live births were recorded at IHO for the four years study period (1 January 2011 to 31 December 2014). The leading factors associated with maternal deaths were identified as: antepartum haemorrhage 12 (16.22%), hypertension 9 (12.16%) and ‘other’ causes 33 (44.59%). Most of the deaths 61 (782.4%) occurred in the age group of 25-44 years. Amongst that number, twenty-six (35.1%) were HIV positive women. About 87.8% of maternal deaths were of rural residents and 54.1% of those who died were single women. The provision of targeted, improved basic obstetric care is crucial to make pregnancy safer and reduce maternal deaths at IHO, Oshana region.Item Factors associated with adherence to Anti-Retroviral Treatment (ART) among adolescent clients at Katutura Intermediate Hospital, Khomas region(University of Namibia, 2019) Shivute, Emmi N.The study was conducted at Katutura Intermediate Hospital in Windhoek, Khomas region, in Namibia. It focused on adolescent clients receiving ART who attended their monthly teen club meetings during the time of the data collection. The main purpose of the study was to determine levels of adherence amongst adolescents as well as the factors associated with adherence amongst adolescents receiving ART at Katutura Intermediate Hospital. The data was collected from 58 study respondents, using structured questionnaires. The research findings revealed that most adolescents (70.7%) were school-going, and at Secondary School level. Most adolescents receiving ART at Katutura Intermediate hospital have been on treatment for 10-15 years with 60.3% living with their biological parents. The respondents’ most used mode of transport to the clinic is a taxi (78.9%) and there are those that walk to the clinic (17.5%). It is worth noting that there were no homeless/street children adolescents recorded receiving ART at Katutura Intermediate Hospital in this study. At least (63.8%) adhered to their dose in the past seven (7) days, while (36.2%) of the study respondents reported missing ART medication in the past (7) days. The most common reasons for missing HIV medications among adolescent clients in the past six (6) months were forgetfulness (34.1%), lack of transportation to ART clinic (23.3%), shortage or/no food (17.1%), and peers laughing at them (stigma) (9.1%). This study recommends strengthening on-going counselling and psychosocial support of adolescents, developing a written plan to address adolescent needs, including medical, psychosocial, and financial aspects of antiretroviral treatment. The study recommends that the Ministry of health strengthens provider communication between paediatric/adolescent clinics by identifying adult care providers who have expertise in providing care to adolescents and young adults. It is further recommended that future research should explore addressing patient or family barriers caused by lack of information, stigma or disclosure concerns.Item Investigation of risk factors of musculoskeletal disorders among building construction workers, Windhoek Namibia(University of Namibia, 2019) Kanahole, Honratus JalombweleniMusculoskeletal disorders are the most cause of injuries and disabilities among construction industries around the globe. The purpose of this study was to investigating risk factors of musculoskeletal disorders (MSDs) among building construction workers in Windhoek. This will help companies to develop ergonomic analysis tools to prevent pain and injuries among workers. The study was conducted through assessments, whereby a researcher assesses participants through questionnaires. This was an observational epidemiological study, whereby the researcher used a cross-sectional analytic study design. The study population of this study was 1836 workers who were working for 125 construction companies registered to operate in Windhoek and were operational during data collection. The sample size of the study was 408, calculated using Epi Info™ version 7 statistic software. Data were analysis using Statistical Package for Social Sciences (SPSS) version 25 and Microsoft excel. The statistical significance analysis was carried using a Chi-square test set at Alpha level of 0.05. The Prevalence Ratio (PR) was also determined on the 95% confidence interval (CI). Furthermore, conclusions and recommendations based on the findings were made. The study findings indicated the high prevalence of MSDs among building workers, which stand at 91%. The high prevalence shows that there are no measures in place and urgent interventions are required. The 91% MSDs prevalence found among building workers, 56% were female and 44% were male. Building construction workers in Windhoek were found to be more exposed to MSDs risk factors such as extreme temperature (chi-square=1.7265, P-value=0.0000 and PR=1.72; 95%CI=1.4442, 2.0639), vibration (chi-square=5.1538, P-value=0.00007 and PR=2.01; 95%CI=1.6220, 2.4945) as per the statistical analysis. It was concluded that MSDs prevalence among building workers in Windhoek is high than MSDs prevalence of other countries, base on the literature findings. As a result, it was recommended that the construction companies should implements ergonomic measures which can prevent pain and injuries among workers.Item 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, ElmarieCervical 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.Item Knowledge, attitudes and practices on food safety among food handlers in Opuwo district, Kunene region, Namibia(University of Namibia, 2019) Hakwenye, Helena LamangulukaFood safety is a key component of food security as food can only be considered to exist, if it is safe for human consumption. Food handlers play a massive role in food safety, it is for this purpose we conducted a study to determine knowledge, attitudes and practices of food safety among food handlers in Opuwo District. An analytical cross sectional study was conducted, using a multi-staged probability sampling method. A total of 137 food handlers participated in the study from 24 kitchens in the district. The majority of participants 65% (89/137) were females and 57.7% (79/137) were from state kitchens. The level of knowledge on food safety was inadequate as there were only 36% (49/137) respondents with adequate knowledge, with an average score of 45% (13.5/30). The levels of knowledge were significantly associated with levels of education (P-value of 0.03). Respondents had good attitudes towards food safety, with only two (1.5%) respondents with a negative attitude. Most food handlers (91%, 125/137) were found to be practicing food safety. Food handlers from private kitchens were more likely to always wash their hands with soap before handling food (OR= 4.89, 95% CI = 1.58 – 15.16. All kitchens had portable water, but only 33% (8/24) of the kitchens had hot water. About 17% (4/24) of the kitchens were found with clean washing sinks while about 37.5% (9/24) kitchens did not have washing sinks and 71% (17/24) of the kitchens did not have a hand washing basin. Food handlers in Opuwo District had limited knowledge on food safety, with positive attitudes towards food safety and good food safety practices. Poor hygiene levels of food preparation area was observed in most kitchens. One of the recommendations from this study is thus, in-service training of food handlers on food safety.Item A household survey to assess knowledge, attitudes and practices regarding Rabies among dog owners in Omusati region(University of Namibia, 2020) Kanutus, Benediktus ShiikufeniRabies is a viral zoonotic disease of warm-blooded animals caused by Lyssavirus of the Rhabdoviridae family that attacks the Central Nervous System, provoking fatal acute encephalitis. Domesticated dogs are the main vector, responsible for almost 99% of human rabies cases. Namibia with the rest of the world is engaged in fight to eradicate dog mediated rabies. There is a need to explore the knowledge gaps, attitudes and practices regarding rabies control among dog owners. The purpose of this study was to perform a household survey, assessing knowledge, attitudes and practices regarding rabies control among dog owners in the Omusati region, Namibia. The researcher applied a quantitative, cross-sectional, descriptive, household survey on residents of five constituencies in Omusati region. The researcher employed a structured questionnaire translated in the local language (Oshiwambo). Participants were selected through a simple random sampling method, and one questionnaire was completed per selected household. The data was analysed through Epi-Info 7 and Microsoft Excel and arranged in descriptive statistics such as frequencies, percentages and proportion to determine the Knowledge, Attitudes and Practice levels. The Chi-square test on categorical variable was used at p-value 0.005 statistical significance. A total of 342 respondents took part in the study; more than half (53%) were male and 50% had secondary education level and only 18% were employed. At least 98% of the respondents knew that rabies is a zoonotic disease and could identify the disease through local names; 55% had no knowledge that rabies is caused by a virus even though 67% were certain the diseases could be transmitted to human through rabid animal bites. Ninety percentages (90%) of the respondents knew that vaccination is the only form of prevention against rabies, and 96% would seek medical help at the hospital after an animal bite. Ninety-five percentages (95%) of the respondents kept guard dogs yet only 29% would report or take a suspected rabid dog to the nearest animal clinic. Sixty-eight percentage (68%) of the respondents consumed dog meat and 71% have had their dogs vaccinated during the last vaccination campaign. Employed respondents were more likely to keep dogs in an enclosure away from stray dogs, significant at chi-square 5.0514, p-value 0.0241. Employment status does not influence dog’s vaccination status at household level, non-significant at chi-square 0.7086, p-value 0.3999. Household knowledge and attitude levels with regards to rabies control in the five constituencies of Omusati region are well above average; however there are gaps in practices in the community. Despite the right knowledge, communities engage in practices that predispose them to rabies infection and others that are hampering and jeopardising efforts towards rabies control.Item 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, EliaserGlobally, 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.Item Assessment of knowledge, attitudes, practices and responsiveness to medical male circumcision among males in Zambezi region, Namibia(University of Namibia, 2020) Nairenge, RosaliaMale 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.Item The perception of teenagers regarding teenage pregnancy in the Rehoboth district(University of Namibia, 2011) Nsengimana, FerdinandTeenage pregnancy is a worldwide problem. Some of the consequences associated with teenage pregnancy are restriction in educational opportunities, reduced quality of life, exposure to sexually transmitted infections, social discrimination, and complicated labor and abortions. Regardless of the universal effort made by governmental and non-governmental agencies to prevent teenage pregnancies, teenagers still get pregnant. In Namibia the overall teenage pregnancy rate is 15% while in some regions this rate can be as high as 30% (Ministry of Health and Social Services & Macro International, 2008, p.50). In Rehoboth District, more than half of primigravida who gave birth in a period of six months were teenagers (Ministry of Health and Social Services, 2008). It is however unclear how teenagers perceive teenage pregnancy and what factors influence this perception. The purpose of this study was to explore and describe the perceptions of teenagers regarding teenage pregnancy in the Rehoboth District. The objectives for this study were to explore and describe the perceptions of teenagers regarding teenage pregnancy and to identify factors influencing the teenagers’ perceptions regarding teenage pregnancy in the Rehoboth District. A qualitative, exploratory, descriptive, contextual research design was used. The target population for this study was teenagers, males and females, in the Rehoboth District. The sample comprised 45 Grades 9 and 11 learners from two purposefully selected schools in the town of Rehoboth. Data were gathered using focus group discussions. Discussions were recorded and field notes taken until data were saturated. Data were analyzed using the Tesch’s open coding method. Throughout the data coding and analysis, the researcher was guided by supervisors who are experienced in the field of qualitative research. The study revealed that teenagers were aware of factors contributing to teenage pregnancy and the prevention thereof. Factors influencing the teenagers’ perception regarding teenage pregnancy are parental role modeling, the need to maintain a relationship with someone of opposite sex, sexual pleasure, self respect, discipline and integrity, responsibility, and individual decision on when to start sexual activities and/or to get pregnant. It is recommended that church leaders and other influential leaders in the community should establish social clubs that foster the prevention of unwanted or unplanned teenage pregnancies. It is also recommended that, together with social clubs, church leaders and other influential leaders in the community should establish a program that provides support to teenagers who fall pregnant or plan to get pregnant.Item Factors that influence communication between registered nurses and patients at Intermediate Hospital Katutura, Khomas region, Namibia(University of Namibia, 2019) Kambonde, ClaudiaCommunication is the ideas and information exchanged and actions or reactions that arise from that exchange and contact. What really defines the communication is the relationship between the communicator and the recipient. Therefore, for a good nurse-patient relationship to be established, nurse patient communication must be effective. The study described in this paper was to thoroughly investigate the factors influencing communication between registered nurses and patients at Intermediate Hospital Katutura, Khomas Region, Namibia. With a cross sectional research study design, simple random sampling technique, the researcher sought to discover factors perceived by registered nurses and patients that influence nurse-patient communication and how these affect the quality of nursing care. The tools for data collection used by the researcher were a close-ended questionnaires and an observational checklist, self-administered for registered nurses and the researcher filled in the one for patients. The main research problem was that; communication problems have been raised by various stakeholders against the registered nurses which is resulting in poor nurses-patient relationship. Sample characteristics were analysed using data collected from 67 registered nurses, 92 patients and 24 observed registered nurses. Based on the information given by respondents, statistical technique Epi Info software version 3.5.4. was employed to reduce, summarise, evaluate and communicate numerical information by presenting them in the form of tables and charts. Findings revealed that the level of nurse-patient communication and relationship was influenced positively by good human relations, a friendly hospital environment and respect for both nurses and patients alike among others. Factors which were found to be hindering effective communication between registered nurses and patients were seen to be staff shortages, routine centred activities, shift work, non-supportive management, language, culture, fear, anxiety and level of noise. The study also brought to light the poor communication strategies which are used by registered nurses. Based on these findings some recommendations were made. Among these were, development of a checklist on ward orientation, nursing education and continuous professional development and cultural sensitive nursing.