UNAM Gā-aisib Repository
The UNAM Gā-aisib Repository serves as a central platform to preserve and showcase the university's scholarly output.
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Exploring determinants of learner dropout in Kavango West region rural primary schools
(University of Namibia, 2024) Igonda, Tuwilika Kondjeni; Shaimemanya, C. N. S
The research aims to explore the determinants of dropout among primary school learners
in rural schools and find the strategies that can be applied to retain learners in school until
they complete secondary school. The study employed a qualitative research approach
where data was gathered from the participants through face-to-face interviews and
observations. A purposive sampling method was used to select twenty participants of the
study, which included learners who dropped out of school and returned, parents and
guardians of the learners who dropped out of school and returned, Life Skills teachers,
and Principals. The study found that family/community factors and school/system factors
have a huge impact on dropout rates among primary school learners in rural areas. More
male learners lack motivation and were found to be dropping out of school at an early age
than female learners. More learners faced physical and emotional abuse at home from
their parents. While some parents kept their children at home to take care of their younger
siblings, others left children alone in their houses near the school while they went to work
on their fields in the inland. There was an increase in dropout and absenteeism whenever
there was no food at school. The maize meals arrived late at schools causing learners to
drop out due to hunger, especially those who lived alone and those who stayed far from
school. Teachers have shown to have limited knowledge on how to support learners who
returned to school and those who are at risk of dropping out of school. A major
collaboration between stakeholders is encouraged to address the factors that influence
primary school learners in rural areas to drop out of school
Percieved perceptions of registered nurses on task-shifting of male circumcision in public health facilities in the Khomas region of Namibia
(University of Namibia, 2024) Mwanyangapo, Ester Ndazilepo; Kamenye, E.
Task-shifting in the context of Voluntary Medical Male Circumcision (VMMC) refers to
enabling well-trained clinical personnel who are not Medical doctors to perform all steps
of the male circumcision procedure. Since 2009, over 200 000 Voluntary Medical Male
Circumcision surgical procedures have been performed throughout Namibia. This
performance has been achieved against a backdrop of scarce human resources thus
various options have been explored such as task-shifting to increase access to safe
VMMC. Since the introduction of male circumcision task-shifting in the Khomas region, little is known about the perceived perceptions of nurses regarding male circumcision
task-shifting. Therefore, the purpose of this study was to explore and describe the
perceived perceptions of registered nurses on task-shifting of male circumcision in
public health facilities in the Khomas Region of Namibia. A qualitative, explorative, descriptive and contextual design was conducted, using individual in-depth interviews to
gather data from 14 registered nurses in Katutura Health Centre, of the Khomas region. Data analysis was done using Tesch’s method. The results showed that registered nurses
have good and positive perceived perceptions of task-shifting of male circumcision. The
study revealed that through task-shifting, nurses are now equipped with special skills, and knowledge that was not part of their scope of practice initially. The study also
revealed that because of male circumcision task-shifting, there is limited backlog for
patients in need of circumcision services. Recommendations based on this study’s
findings include: that the Ministry of Health should provide continuous training and
refresher training for the nurses so they gain more skills and knowledge and improve
where they can, for continuous provision of exceptional services to the clients
Assessment of knowledge, attitudes and practices on infertility among adults visiting the gynaecology and urology clinics at Intermediate Katutura Hospital and Windhoek Central Hospital, Namibia
(University of Namibia, 2024) Namene, Maria; Uushona, S. I.
Infertility is one of the global burdens, an under-observed but significant health
problem affecting one in four couples in developing countries. A total number of 48
million couples are affected by infertility globally and a total number of 186 million
individuals globally. In Namibia, about 15% of couples struggle with infertility.
Although causes of infertility are equally shared among male and female factors each
accounting for 30%, infertility is highly stigmatised, and women are usually blamed
for it. The study aims to assess knowledge, attitudes, and practices on infertility among
adults visiting the Gynaecology and Urology clinics at Intermediate Hospital Katutura
and Windhoek Central Hospital in Windhoek, Namibia. A convergent parallel mixed
method approach was used in this study. A total number of 118 respondents were
recruited to fill in the questionnaire and 18 interviews held. The study was conducted
on respondents aged 21 to 79 years, including both males and females. Participants
had varying levels of education, ranging from no formal education to tertiary
education, and different employment statuses, including employed, self-employed,
and unemployed. Additionally, respondents came from diverse tribal backgrounds.
The study discovered that the knowledge on infertility is limited, 37.1% do not identify
infertility as a disease and 75.2% believe contraceptives causes infertility. Participants
believe witchcraft and curses causes infertility. Seeking medical services is listed as
the initial option when struggling with infertility. Adoption and in vitro fertilisation
(IVF) are acceptable options when struggling with infertility. Knowledge on infertility
is limited among respondents, the misconception about contraceptives is widespread.
An average practice on infertility is noted and the act of assigning blame for infertility
is widespread in various communities. Raising awareness on infertility is
recommended to increase infertility knowledge, reduce stigma, and create awareness.
Dedicated fertility clinics in state hospitals are required to offer specialised services to
individuals struggling with infertility. Research recruiting individuals dealing with
infertility is encouraged, in order to understand their experiences better. The
misconceptions of contraceptive usage leading to infertility need to be tackled through
the health campaigns
The lived experiences of resilience among Namibian children in middle childhood who have been exposed to parental divorce
(University of Namibia, 2024) van Schalkwyk, Janine; Gentz, S.
Divorce remains a primary contributor to family instability within Africa, hence,
increasing amounts of children are exposed to the impacts thereof. Given that the
family unit has been identified as central to the development and healthy adjustment
of children, the mere presence of its breakdown constitutes as a risk to the Namibian
youth. However, research shows that not all children react uniformly to the impact of
parental divorce and are able to thrive. Therefore, this study aimed to understand how
some children are capable of resilience amidst the risks associated with the exposure
to parental divorce. Consequently, this study focused primarily on identifying and
understanding positive factors that nurture the capacity for resilience, among children
aged 9-12 years, post parental divorce. A non-experimental, mixed-methods approach
with a multiple case-study design was employed to acquire comprehensive information
on the lived experiences of 24 children within middle childhood. Purposeful sampling
were used to ensure the assembly of relevant data required for this study. The Children
and Youth Resilience Measurement scale was administered to all 24 participants in
order to test each participant for resiliency. To eliminate some of the challenges
associated with gathering qualitative data from younger children, QMethodology, with
visual material, was utilised and administered to all 24 participants. The data of 12
participants were used for analysis who measured high on resiliency during the CYRM
scale administration. For data analysis, the PQ Method 2.35 software program, was
used to conduct by-person factor analysis. Four factors emerged from the analysis
process as statistically significant in fostering resilience, namely Quality Parent-Child
Relationships, Healthy School Attachment, Strong Community Attachment as well as
Effective Parent Conflict Resolution and Relationships. These results highlighted the
multisystemic nature of resilience, emphasising the importance of individual, familial
and environmental/community protective factors when considering resources which
nurture resilience within children exposed to parental divorce. Therefore, it becomes
critical for support to extend beyond the perimeters of the nuclear family and include
efforts to nurture stable relationships with extended family members, peer groups, the
school system and the wider community. Furthermore, among some methodological
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recommendations for future studies include exploring the complex dynamic and
resultant impact of siblings and stepparents on children’s capacity for resilience
Integrating traditional health care practice into primary health care services: From the perceptions of nurses and medical officers in Windhoek District, Khomas region
(University of Namibia, 2024) Shilyomunhu, Hesekiel Tuutaleni; Shumba, T. W.
This research explored the perceptions of nurses and medical officers in Windhoek
District, Khomas Region, on the relevance of integrating traditional health care practice
into primary health care services. The study aimed to understand the role of traditional
health care practice on the healthcare system and the potential advantages and
disadvantages associated with its integration.
Methods: The population of this study consisted of nurses and medical officers stationed
in Primary Health Care Facilities in Windhoek District, Khomas Region. A total of thirty eight (38) participants comprised of; twenty-nine (29) nurses and nine (9) Medical
Officers took part in this study, who were selected using purposive heterogeneous
sampling method. An ethnographic research design was used to collect data through
interviews and focus group discussions. Data analysis was guided by the direct content
analysis framework from Roger’s Diffusion of Innovation (DOI) theory on adoption
processes for a new innovation, namely: compatibility, relative advantage, trial ability,
observability, and complexity. These criteria were applied to the adoption of traditional
health care services as a new/innovative idea for incorporation into the modern health care
system (PHC services).
Results: The findings from this study revealed the importance of embracing and
respecting traditional healthcare practices and professionalizing them. Integration,
collaboration, and regulation were seen as essential elements for enhancing healthcare
services and meeting the diverse healthcare needs of the population. Additionally, the
findings emphasized the need for regulatory frameworks to ensure the safety and
effectiveness of traditional healthcare services and echoed the significance of
interdisciplinary dialogue and cooperation.
Conclusion: It is recommended that policymakers and healthcare authorities consider
developing clear regulatory frameworks, create comprehensive, holistic regulatory
guidelines, and standards for the integration of traditional health practices into the primary
healthcare system, with a special focus on patient safety, efficacy, cultural sensitivity, and
the preservation of Namibia’s diverse ethnic traditional knowledge and healing practices
The association between disclosure and adherence to Antiretroviral Therapy among adolescents living with HIV in Windhoek, Khomas region, Namibia
(University of Namibia, 2024) Manvwali, Martha Kachana; Alfeus, Anna
The study was conducted in Windhoek, Khomas region, Namibia, focusing on adolescents
living with HIV aged 10-19 who had been receiving antiretroviral therapy (ART) care for at
least six months between 2010 and 2021. It also included healthcare workers who had worked
in the ART department for at least six months during the data collection period. The primary
objective was to assess the association between disclosure (the process of revealing one's
HIV-positive status) and adherence to ART among adolescents living with HIV. A mixed method approach with an explanatory sequential design was employed. The quantitative
component used an unmatched case-control design with a 1:1 ratio, while the qualitative
component utilized an exploratory design to complement the quantitative analysis. The study
participants included 20 healthcare workers and 37 adolescents living with HIV who were on
ART care. Findings revealed that among adolescents with good adherence (≥90%), 76% had
been fully disclosed about their HIV-positive status, while 20% were partially disclosed. In
contrast, among adolescents with poor adherence (<90%), 92% had not been disclosed about
their HIV-positive status. Some adolescents who were fully disclosed learned about their
status accidentally. Caregivers of the adolescents and healthcare workers were the key
informants in disclosure and adherence aspect. The study recommends strengthening
disclosure programs through enhanced efforts by the Ministry of Health and Social Services.
This includes training healthcare providers involved in the disclosure process, educating
parents/caregivers or guardians about the disclosure process and the skills required to conduct
it at home, ensuring equitable distribution of disclosure tools and equipment among health
facilities, and implementing standardized disclosure processes through Standard Operating
Procedures (SOPs) and guidelines consistently across all health facilities nationwide. Future
research should explore factors that enable adolescents to accept their HIV-positive status
with reduced distress and examine their experiences during and after disclosure sessions,
including their psychosocial support needs. In summary, this study aimed to understand the
relationship between disclosure and adherence to ART among adolescents living with HIV in
Namibia and provided recommendations to improve the disclosure process and support for
these adolescents
An analysis of the challenges hampering the successful implementation of gender based violence policies: A case study of the Kavango East region of Namibia
(University of Namibia, 2024) Likando, Johanna M.; Lwendo, Sitali Brian
This study was aimed at analysing the challenges hampering the successful
implementation of Gender-Based Violence (GBV) policies in Namibia using the
Kavango East Region as the unit of analysis. The study employed a descriptive and case
study research design. A semi-structured questionnaire and an interview guide were used
as data collection instruments. Thirty-five (35) respondents were purposively and
conveniently selected from key stakeholders (regional councillors, traditional leaders,
and Church leaders, civil society, government ministries). The empirical data collected
from respondents was analysed qualitatively using thematic and content analysis to
complement documentary analysis of secondary data. The thematic presentation and
discussion of the results was guided by the study research questions. The findings of
study revealed that it was imperative to review the existing policies on GBV to
accommodate emerging issues if radical change in reducing GBV is expected. The
findings of the study further revealed that key stakeholders such as civil society
organisations, traditional leaders, church leaders and community members were not fully
engaged and involved in the design of appropriate measures that would ensure effective
and efficient implementation of policies aimed at reducing GBV. Given the gap between
GBV policy and practice, the study advanced key recommendations that hinge on,
capacity building for various key stakeholders, adopting technology in reporting of GBV
cases, developing strategies to enhance coordination, monitoring and evaluation of the
policy implementation, creation of effective engagement platforms for communities,
traditional and church leaders on GBV matters, and robust revision of the existing GBV
policies and Action Plans
Evaluating public participation in the integrated development planning process of Groot Aub Namibia
(University of Namibia, 2024) Mwiya, Kabuku T.
This study was aimed at evaluating public participation in the Integrated Development
Planning Process at Groot Aub in Namibia. The qualitative research method was
adopted in carrying out the study. A sample size of 30 people was selected from the
population of the study. The study used Stratified sampling to select (15) residents of
Groot Aub, (5) small business owners and (6) Constituency Committee members.
Whereas, Purposive sampling technique was used to select (1) Groot Aub traditional
leader, (2) CoW staff members from the Public Participation and Economic
Development department, (1) Windhoek Rural Councillor. Purposive sampling was
deliberately used because the researcher believed that the people selected purposefully
would provide insight that is valuable to the research topic. A tape recorder was used for
interviews with the City of Windhoek personnel, focus group discussions were used with
other participants of the study, then the researcher analysed data in a narrative way.
Constituency committee members who participated in this study indicated that they had
attended the constituency committee induction workshop, also they attended training
courses that were related to their roles and responsibility. The study revealed that the
traditional leader in Groot Aub is capacitated through attending Council meetings
referred to as local municipality and constituency committee meetings as this is where
information needed is received. Moreover, the CoW should create a training unit for its
staff that deals with the IDP with the aim of training them continuously in order to
ensure the effective and efficient implementation of all the programmes and projects in
the IDP process sufficient funds to the IDP section in order to spearhead local economic
activities in the Municipality. Findings from group discussion indicate that further
studies should consider analysing the perceptions and attitudes of the stakeholders
towards the effectiveness and efficiency of the local authorities‟ IDP Processes
Development and characterization of sintered porous bioactive glass scaffolds for medical application
(University of Namibia, 2024) Angula, Linus Tshiimi; Johnson, Oluwagbenga T.
There is an ongoing effort to innovate engineering materials that are used in medical
applications to support, enhance, or replace damaged tissue or perform a biological function.
This study focuses on researching bioactive glass scaffolds resembling natural trabecular
bone tissues that are widely used in medical applications. The research investigates the
relationship between processing parameters and the resulting microstructures of borosilicate,
borophosphate, and phosphate bioactive glass scaffolds. The study developed glass ceramics
using traditional melt-quench methods; silicate composition S53B50 was processed at 1200
°C, while the P40B10 and Sr phosphate glasses were heated to 1100 °C. The sintering ability
of the three types of glasses with a NaCl sacrificial pore-generating agent was achieved via
spark plasma sintering technology at a rapid heat rate of 100 °C/min and temperatures
ranging from 490- to 610- °C. The research work employed analytical techniques of
thermogravimetric analysis (TGA), particle size analysis (PSD), X-ray diffraction (XRD),
Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM) to
gather data and characteristic results. It was observed that producing the glass ceramics by
fritting the melts produced more desirable amorphous microstructures with less than 50%
crystallization over casting and annealing. Also, the S53B50 scaffolds had the highest
strength at 1.7 MPa and Sr glass had the most deformation at 1.62 mm. The findings are
attributed to the partially crystallized microstructures, with indexes varying between 47 %
and 58 %. Sintering increased scaffold density, compressive strength, and crystallinity while
decreasing the porosity in this way demonstrating an ability to control scaffold properties
for different applications through the sintering process. This research study contributes to
the improvement of bioactive glass scaffolds and their potential applications in the clinical
sciences of drug delivery systems
Anticoagulation control in a standard of care versus a pharmacist-managed warfarin monitoring service at Windhoek Central Hospital, Namibia
(University of Namibia, 2024) Thikukutu, Moses Mukwipure; Verbeeck, Roger
Introduction: Warfarin remains the drug of choice for treating thromboembolic
diseases in Namibia. A historical control study reported a patient’s mean time in the
therapeutic range (TTR) at the Warfarin Outpatient Clinic of Windhoek Central
Hospital (WCH) to be suboptimal (29.4%). Interventions to improve anticoagulation
control were instituted and they involved a pharmacist-directed warfarin therapy. The
main objective was to improve anticoagulation control in the intervention group and
compare it to the historical control group.
Methods: A prospective cohort design was used. Adult patients who attended the
warfarin clinic on Wednesdays and gave consent were exposed to the intervention
study. The main outcome measure was the TTR computed using the Rosendaal
method. Binary logistic regression was used to identify factors associated with poor
anticoagulation control. A between groups comparison of anticoagulation control was
based on the paired and unpaired patient cases. A p value < 0.05 was considered
statistically significant. Results: A total of 330 patients were part of the present study
(control (215) and intervention (115)). The majority (63.4%) of the patients in the
intervention group were females. The mean (± SD) age was 45 ± 17 years. The top
three prevalent clinical indications for warfarin in the intervention study were deep
vein thrombosis (49.6%), mitral valve replacement (13.9%), and pulmonary embolism
(13%). Only the baseline INR (OR 0.34 [95%CI: 0.13-0.86]) and warfarin dosage
adherence (OR 0.17 [95%CI: 0.04-0.84]) were significant predictors of good
anticoagulation control in the intervention group. The Mann-Whitney U test showed
an 18% (p<0.050) improvement in the median %TTR when the unpaired cases
between the groups were compared. The paired t-test showed a 10% (p=0.220)
improvement in the mean %TTR when the paired patient cases between the groups
were compared. Conclusion: Interventions involving a pharmacist-directed warfarin
therapy were associated with improved anticoagulation control at the WCH warfarin
clinic. Baseline INR and warfarin dosage adherence were statistically significant
predictors of good anticoagulation control