UNAM Gā-aisib Repository

The UNAM Gā-aisib Repository serves as a central platform to preserve and showcase the university's scholarly output.

Gā-aisib, a term from the local Khoekhoegowab language meaning “wisdom".
 

Recent Submissions

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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
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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
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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
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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 5 recommendations for future studies include exploring the complex dynamic and resultant impact of siblings and stepparents on children’s capacity for resilience
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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
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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
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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
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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
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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
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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