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Item Assessment of neural tube deffects in two Northern Namibia hospitals: Incidence, seasonal variation, risk factors and prevention strategies for folate sensitive defects(University of Namibia, 2021) Amaambo, FilemonNeural tube defects (NTDs) represent severe congenital abnormalities of the nervous system and are among significant abnormalities associated with a high mortality and morbidity rates. Studies reported that the incidence of NTDs varies worldwide, with the highest found in low-income countries. Most high-income countries have managed to document and the reduce incidence of NTDs through primary prevention strategies. However, inadequate documentation on NTDs is frequent in low and upper-middle income countries including Namibia. This study focused on assessing the incidence, seasonal variation, risk factors, and comparing the postpartum red blood cell folate in cases and controls in Onandjokwe and Oshakati hospitals in the Northern regions of Namibia over 12 months. The aims of the study were to identify evidence that NTDs constitute both a clinical and a societal problem. And, to propose locally adapted prevention strategies for folate –sensitive NTDs. The study objectives were to assess the incidence of NTDs, determine an association between the conception of NTD babies and seasonal variation (rainfall), identify related risk factors, and to compare postpartum maternal red blood cell folate in NTD cases and controls. The study utilised a quantitative approach with a cross-sectional design to assess the incidence of NTDs and descriptive-statistical analysis to evaluate associated risk factors. A case-control design was used to compare postpartum maternal red blood cell folate between mothers of cases and controls. The study population was mothers who gave birth in the two hospitals during the period of 12 months. Non-random consecutive sampling was used to select participants - mothers with and without NTD babies - to minimise bias when studying rare conditions. Participants were informed, counselled and requested to sign consent forms. Questionnaires were administered face to face to participants and blood samples were drawn to determine postpartum red blood cell folate. Data was analysed using Epi-info software. The findings of the study were: a) the combined hospital neural tube defects incidence was 11 per 10000 births; b) there was a seasonal variation in the birth and conception of babies with NTDs, which could be associated with the seasonal rainfall pattern; c) the risk factors possibly related to NTDs were unemployment, low level of education, diet lacking fruits and vegetables, and low maternal red blood cell folate. Other risk factors, such as age, diabetes, HIV, obesity, smoking, alcohol, drugs, exposure to radiation, hyperthermia, family history, marriage, consanguinity, were not shown to play a significant role in NTD incidence. The study found hydranencephaly to be more common than spina bifida. The study proposed recommendations, future research areas and preventive interventional strategies for NTDs in the Northern regions. The study further underscored health education about NTDs, consumption of fruits and vegetables, folate supplementations + Vit B12 and food fortification for all childbearing women in a sustainable way.