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Iita, Hermine Amutenya, Kaarina N. 2025-11-12T09:11:26Z 2025-11-12T09:11:26Z 2024 http://hdl.handle.net/11070/4183 A Dissertation submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy in Public Health Background: The Namibian Public Service (NPS) makes no provision to profile the health statuses of its employees/public servants, despite being a legislative requirement. As a result, government will not be able to, for instance, predict work incapacities due to ill-health absence which is a major measurement of performance/productivity. Worldwide, governments have instituted different approaches, within/outside the Occupational Health and Safety continuum, to profile employees ‘health/ill health to inform promotion of health in workplaces. Aim: This study sought to develop a conceptual framework and an implementation guide to enable the profiling of Namibians public servants’ health statuses entrenched in the principle of the Health in All policies (HiAP) approach. Methods: A multi-phased pragmatic study was conducted. Phase 1 employed an explorative descriptive convergent parallel mixed method design using document reviews, a Focus Group Discussion, a Discourse Analysis, a Cross sectional and a Knowledge, Attitude and Practice (KAP) surveys. Max Weber Qualitative Data Analysis and the Statistical Package for Social Sciences enabled analysis of data, respectively, herein synthesised by means of triangulation. Findings: Documents reviewed revealed the existence of public servants’ health information sources such as the employees’ health recruitment questionnaires, sick leave systems and medical aid, appropriate for profiling. Key Informant’s perspective that the HiAP framework was appropriate to facilitate profiling of public servants’ health statutes was further echoed by result of the Discourse Analysis. The cross-sectional survey, conducted among 346 public servants’ participants established that 83.3% of the survey participants self-reported ‘a good’ health status. The remainder 16.7% self-reported ‘a poor’ health status citing the prevalence of Hypertension (27%), Musculoskeletal disorders (30.6%), Stress (55%), Physical in-activeness (38%) and a High Body Mass Index (BMI) (27%). A Chi-square logistic regression test, pegged to a p-value of less than 5% and using: 1. Good health = self-reported score for Excellent/Very Good/Good; 2. ii Poor health = Fair/Poor/Very Poor: reveals significant statistical associations to poor health in relation to Hypertension (p-value=0.001), Mental conditions (p-value=0.009) and access to electricity (p-value=0.045). No significant statistical association was observed with elevated blood sugar (p-value=0.258≤5%), BMI and income. The KAP study, conducted among 51 Wellness Officers, reported very low HiAP knowledge citing a lack of information and henceforth no application of the HiAP approach, overall. Phase II focussed on the design, and development of the above-mentioned framework using results emanating from Phase I; enlisting elements of the World Health Organization’s (WHO) HiAP Analytical framework alongside elements of the Systems and Practice Oriented Theories, namely: [input (procedures, agent, recipient and dynamics); output (terminus); synergies (agent, recipient, procedures and dynamics) and feedback (context, inputs, outputs, terminus)]. Five purposely selected subject experts who validated the suitability of the developed conceptual frame recommended amongst others aligning it to the legislative provisions of the Public Health and Environmental Act. Phase III enlisted the WHO’s Handbook on developing guidelines and the Public Service Staff Rule format to inform the design of an implementation guide. Conclusions: The study encapsulates evidence that proofs the gap identified as well devised approach to fill the gap: a conceptual framework to profile Namibian public servants’ health statuses embedded in the HiAP principles. Evidence of poor HiAP knowledge could implicate successful implementation. Henceforth a recommendation that the NPS adopts the designed conceptual framework, the introductory and ensued implementation guide using a policy brief, attached hereto, to ensure compliance with the law en University of Namibia Health in all policies approach Conceptual framework Public servants Health statuses Namibian public service Namibia University of Namibia A health in all policies (HIAP) conceptual framework to facilitate the profiling of public servants’ health statuses in the Namibian public service Thesisopen.access