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Item Exploring factors associated with abortion in Walvis Bay community in Erongo region, Namibia(University of Namibia, 2023) Shaker, Amir EskanderWalvis Bay is one of Namibia’s districts, which recently recorded a significant increase in the number of threatened abortion cases. For the period 2009 to 2015, Walvis Bay town recorded an average 2000 abortion cases per year which accounts for 4 to 6 cases per day for women aged between 15-28 years old (Erongo Health Directorate’s Annual Report: 2014). Ninety-eight percent of the diagnostic abortion (Threatened Abortion) conducted at Walvis Bay hospital, were treated with dilatation and curettage in order to safely complete the abortion process whilst remaining 2% was treated for other pregnancy disorders. The increase in abortions and increase of maternal death due to bleeding is a big concern in the harbour town. Thus, the increase in teenage abortion is becoming a public health concern that needs to be addressed. The study purpose of the study was to explore factors associated with abortion in Walvis Bay community. It was essential for a study to be conducted in order to investigate the factors leading women to engage in unsafe abortions, and find an amicable solution to help them access maternal health services, and help policy makers to find solutions to address the abortion problem in the region. A qualitative, phenomenological approach was applied. The researcher conducted in depth interviews with key informants including community members, health care workers and teenagers who had abortion. Population for the study was Walvis Bay community of which key informants were made up of patients (abortion victims), Social workers, doctors, nurses, community and religious leaders, secondary school teachers and police officers working at women and child protection welfare. A non- ii probability purposive sampling was used to recruit the participants and a total of eight participants were recruited and participated in the study. The study findings revealed that there are several factors that contribute to abortion such as burden to look after the baby while the mother is still at school, humiliation by peers, fathers do not want the responsibility of pregnancies, some ladies have affairs with married men, and some have multiple partners. These are some of the factors that make young women to go for illegal abortion. Therefore, the researcher recommended that health education programme should be strengthened to improve awareness, the use of family planning, support system and creation of adoption centresItem The experiences of health care workers on prescribing PrEP to adolescent girls and young women at public health centers in Windhoek, Khomas region, Namibia(University of Namibia, 2023) Shipena, KristineOral pre-exposure prophylaxis (PrEP) is the usage of antiretroviral medications by HIV uninfected persons to prevent HIV. It has the potential to significantly reduce HIV acquisition among adolescent girls and young women (AGYW) aged 15–24 who have not yet been exposed to HIV. The purpose of this study was to explore health care workers’ experiences on prescribing Pre-exposure prophylaxis to adolescent girls and young woman at high risk of HIV in Windhoek. The objectives of the study were to explore health care workers’ experiences to prescribing PrEP to adolescent girls and young woman at high risk of HIV infections and to explore health care workers views on PrEP delivery services among AGYW at public health centers. A qualitative, phenomenology design was conducted at public health centers in Windhoek, Khomas region to explore health care workers’ experiences to prescribing PrEP to adolescent girls and young woman at high risk of HIV infections and explore their views on PrEP service delivery among AGYW. Population of the study were nurses that are PrEP prescribers and health centers contain of 58 nurses. Convenience sampling method was used to recruit nurses into the study. A semi-structured interview guide was used as a data collection instrument. Data were analyzed using thematic content analysis. Majority of HCWs indicated that they promoted PrEP uptake among AGYW and were willing and comfortable with prescribing Prep to AGYW. Few HCWs were not comfortable prescribing PrEP to AGYW citing that it promotes the reduction in condom use. The study highlighted a need to sensitize PrEP and sexual reproductive health for AGYW in all departments within the health centers. PrEP introduction among AGYW requires more than solely training HCWs on the clinical aspects of prescribing PrEP. It involves addressing HCWs’ biases and preference regarding sexual health services to AGYW and preparing the health facilities organization for the introduction of PrEP among AGYW. Furthermore, health care workers need to conduct community health education to AGYW for them to develop a culture of voluntarily visiting the health facility and request PrEP when the need arise. Most importantly there is a need for health care workers to educate the community on PrEP to reduce stigma based on PrEP initiation in the societyItem Factors associated with road traffic accidents among young drivers in Khomas region, Namibia(University of Namibia, 2023) Shaduka, EmmaAs per the current statistics, road traffic accidents (RTAs) are among the leading causes of deaths and disabilities among young people worldwide. The deaths and injuries attributed by the RTAs are a major public health crisis faced by Namibia, just as in many countries all over world. There is a need to investigate the risk factors contributing to RTAs in Namibia, therefore, this study was conducted with a purpose of determining the factors associated with RTAs among young drivers in Khomas region, Namibia. The study utilised a mixed methods convergent-parallel design to collect data from the National Road Safety Council (NRSC) of Namibia, as well from the traffic law enforcement officers in Khomas region. The relationship between independent variables and dependent variables was analysed using multiple logistic regression analysis based on p-value <0.05, while interviews were analysed using inductive thematic analysis. The quantitative data revealed that a total 21 574 RTAs were recorded in Khomas region between 2017 and 2019, with male young drivers being responsible for the majority (83%) of the RTAs in the region. Most (17.2%) of the recorded RTAs occurred on Fridays. The least (5.7%) RTAs were recorded in the month of December. The study found a strong association between days of the week and no injury (p=0.000), and between visibility of the road due to different weather conditions and RTAs (p=0.000). Risky driving behaviours among young drivers such as driving under the influence of alcohol, speeding, and driving whilst using mobile devices are some of the risk factors revealed by the qualitative data contributing to the high rates of RTAs among young drivers in Khomas region. The study recommends “road safety awareness” as a key measure to reducing the rates of RTAs in Khomas regionItem Experiences of Okahandja park informal settlement residents with the COVID-19 preventative measures in Khomas region(University of Namibia, 2023) Shiweva, LibertinaAbout seventy percent (70%) of Namibia's population comprises of people who live in circumstances that provide limited protection against the Coronavirus disease (COVID 19). One of Windhoek's informal communities, Okahandja Park lacks access to potable water, proper sanitation, and basic housing. It is also overcrowded. This study's goal was to discover and characterise how Okahandja Park informal settlement residents experienced the COVID-19 prevention guidelines. The study used the Theory of Reasoned Action (TRA) method and was qualitative. The study’s sample comprised of twenty-seven residents from Okahandja Park who were older than eighteen years. The data gathered was collected with high ethical standards in line with the University of Namibia’s (UNAM) ethical clearance standards. Data was collected using four focus group discussions, in-depth face-to-face interviews as research techniques. The Theory of Tesch, which produces themes and subthemes, was used to analyse the data. The investigation found that the Okahandja Park informal settlement residents were required to wear face masks at all times. The local stores and clinic were overcrowded due to the long lines that resulted from a limited number of people being permitted to enter facilities at a given time. Due to COVID 19, many citizens lost their employment since their employers could no longer afford to pay their monthly salaries. During COVID-19, participants struggled to live due to a lack of food and had to resort to a few coping techniques. Most of the inhabitants lacked sufficient cosmetics to maintain their hygiene practices at home. The study concluded that the WHO preventive measures during the lock down had both an adverse and favourable influence on the Okahandja Park informal settlement residents. The study recommends that public health measures for a pandemic like COVID-19 should be put in place, such that the Office of the President in Namibia and significant NGOs provide food distribution packages to vulnerable populations. In order to improve the informal settlers' abilities and knowledge to run their enterprises successfully, the Namibian Ministry of Industrialisation, Trade, and SMEs Development should offer them training and workshops on SMEs developmentItem Factors influencing antibiotic prescribing choice among private general practitioners in Windhoek(University of Namibia, 2023) Phillips, HileniBackground: Inappropriate prescribing of antibiotics by physicians has been implicated as the driving force behind antibiotic resistance posing a major threat to public health. This study aimed to determine the factors influencing antibiotic prescribing among private general practitioners in Windhoek. Method: A quantitative, descriptive cross-sectional research design method was used. A total of 71 private general practitioners in Windhoek completed the questionnaire. Data were collected from May to June 2022 and analysed using SPSS version 26 software. Findings: The patient-doctor relationship was found to influence antibiotic prescribing majorly. While 68% of the participants indicated fear of the patient developing a severe infection. The Namibian standard treatment guidelines and advice from medical representatives were also found to affect prescribing behaviour. Lastly, a positive correlation (p< 0.05) was found between participants being pressured to prescribe antibiotics and their location of practice, fear of losing patients due to lack of antibiotic prescription, and the number of patients seen per day. Conclusion: This study uncovered correlations between the factors and the demographic characteristics of the participants. These results indicate that antibiotic stewardship programs and interventions may have to be tailored to accommodate specific groups such as the age of physicians, location of practice, and the number of patients seen per dayItem Experiences of Okahandja park informal settlement residents with the covid-19 preventative measures in Khomas region(University of Namibia, 2023) Shiweva, LibertinaAbout seventy percent (70%) of Namibia's population comprises of people who live in circumstances that provide limited protection against the Coronavirus disease (COVID 19). One of Windhoek's informal communities, Okahandja Park lacks access to potable water, proper sanitation, and basic housing. It is also overcrowded. This study's goal was to discover and characterise how Okahandja Park informal settlement residents experienced the COVID-19 prevention guidelines. The study used the Theory of Reasoned Action (TRA) method and was qualitative. The study’s sample comprised of twenty-seven residents from Okahandja Park who were older than eighteen years. The data gathered was collected with high ethical standards in line with the University of Namibia’s (UNAM) ethical clearance standards. Data was collected using four focus group discussions, in-depth face-to-face interviews as research techniques. The Theory of Tesch, which produces themes and subthemes, was used to analyse the data. The investigation found that the Okahandja Park informal settlement residents were required to wear face masks at all times. The local stores and clinic were overcrowded due to the long lines that resulted from a limited number of people being permitted to enter facilities at a given time. Due to COVID-19, many citizens lost their employment since their employers could no longer afford to pay their monthly salaries. During COVID-19, participants struggled to live due to a lack of food and had to resort to a few coping techniques. Most of the inhabitants lacked sufficient cosmetics to maintain their hygiene practices at home. The study concluded that the WHO preventive measures during the lock down had both an adverse and favourable influence on the Okahandja Park informal settlement residents. The study recommends that public health measures for a pandemic like COVID-19 should be put in place, such that the Office of the President in Namibia and significant NGOs provide food distribution packages to vulnerable populations. In order to improve the informal settlers' abilities and knowledge to run their enterprises successfully, the Namibian Ministry of Industrialisation, Trade, and SMEs Development should offer them training and workshops on SMEs developmentItem Factors influencing the retention of clients receiving HIV Pre-exposure Prophylaxis in Engela district, Namibia.(University of Namibia, 2023) Kosmas, KristianaHuman Immunodeficiency Virus (HIV) is one of the epidemics that has affected the world for years now. Namibia remains one of the countries burdened and overstrained by the HIV epidemic. Oral Pre-Exposure Prophylaxis (PrEP) is now included as an additional option for people at substantial risk of HIV infection in the context of a combination HIV prevention package in Namibia. However, the retention rate in PrEP care remains low. This study, therefore, aimed to determine the factors influencing the retention rate of clients receiving PrEP in Engela district, Namibia. The objectives of the study were to determine the retention rate of clients in PrEP care three months after initiation, to identify socio-demographic factors that affected retention in care of clients on PrEP, to describe structural factors affecting retention in care of clients in PrEP, and to determine factors and strategies to improve retention of clients on PrEP in the Engela district, Namibia. A quantitative cross-sectional design was used for this study. Two hundred and fifty participants for the study were selected using a proportional stratified random sampling method. A self-administered questionnaire was used to collect the data. SPSS version 28 was used to analyse the data. Statistical tests used included Chi-square tests and logistic regression. The findings from this study showed that the participants’ retention rate in PrEP care was 35.6%. Chi-square tests showed associations between retention in PrEP care and sex, relationship status, education, and employment status (p55 years. Males were statistically significantly less likely to be retained in PrEP care compared to females. Divorced participants and participants in a relationship were statistically significantly less likely to be retained in PrEP care compared to single participants. The unemployed participants were statistically significantly less likely to be retained in PrEP care compared to the employed. More than three-fifths of the participants agreed or strongly agreed that distance to the healthcare facilities, lack of friendly staff at the healthcare facilities, shortage of staff at the healthcare facilities, and having a supportive partner would strongly influence their retention in PrEP care. In conclusion, it was therefore recommended that PrEP education be offered to patients and the public at healthcare facilities and other public places, PrEP services are ii decentralised, operating hours of healthcare facilities be expanded, healthcare facilities are adequately staffed, and PrEP drugs’ availability is improved.Item Demographic and socio-economic factors influencing medical care-seeking behaviour among people who experienced mental health issues in Namibia(University of Namibia, 2023) Tjimuine, KuaraThe current study originated from the effort to establish if the demographic and socio-economic factors influence the medical-care seeking behaviours of people who experienced mental health issues in Namibia. The study identifies geographically diverse populations in Namibia through the secondary data collected from the 2013 Namibia Demographic and Health Survey (NDHS) to gain information regarding overall influences on medical-care seeking behaviours. The study employed a quantitative approach, and cross-sectional, analytical design. Thereafter, descriptive and inferential statistics, lineal regression and Chi-square were used to determine the demographic factors and socio-econmic factors influences on medical-care seeking behaviours of respondents with mental health problems. The study established an association between the medical care-seeking behaviour of respondents with mental illnesses and demographic factors such as age, gender, place of residence, and their regions. This association includes the socio-economic factors such as wealth and education. Women were found to develop mental challenges than their men counterparts, yet are likely to seek medical care than their men equivalents. Other results showed that mental-health illness were more common among women than their men counterparts and they are more likely to seek medical care compared with men. Although the age group from 15-44 is more susceptible to encounter mental health challenges, they are more likely to seek medical care than those in the age group from 45 and above. Rural resopndents are more likely to seek medical care compared to urban dwellers. It is important to study whether these influences are changing over time, and ii whether help seeking for mild and common disorders versus severe mental illness is becoming easier or harder as a result of the overall combination of influences.Item Health care seeking behaviour of caregivers for children under five years towards diarrhoea in Havana – Windhoek, Namibia(University of Namibia, 2023) Kashile, JoolokeniPoor sanitation, lack of access to clean water supply and inadequate personal hygiene are responsible for 90 % of diarrheal disease occurrences worldwide. This study identified the health care seeking behaviours of caregivers toward diarrhoeal disease among children under-five years in the Havana informal settlement in Windhoek Namibia. The research methodology utilized a mixed method approach, with explanatory sequential design. The study recruited 147 participants using systematic random sampling for the quantitative data and 8 participants using purposive sampling for the qualitative data. Data was collected using a structured questionnaire for quantitative data and in-depth interviews for qualitative data. SPSS version 25.0 was used to analyse the quantitative data and thematic analysis was used to analyse the qualitative data. Quantitative findings revealed that 44.9 % of the children had diarrhoea in three months before the study and 46.94 % of those caregivers sought medical care. The study found that there is no significant association between health seeking behaviour and Caregiver’s s Marital Status (p=0.474), Caregiver’s Age (p= 0.478), Employment Status (p=0.95), Health Insurance Status (p=0.209) and Household Monthly Income Range (p=0.307).Qualitative data revealed that “the caregivers perceive diarrhoea a disease that is easy to treat and that they do not seek medical care because the disease disappears on its own without the need for medical care”. The study recommends that the Ministry of Health and Social Services should increase awareness about diarrhoea in Informal settlement.Item The determinants and effects of alcohol use among women in Oshikoto region, Namibia(University of Namibia, 2022) Netope, Rebekka NangulaAlcohol use is one of the major public health concerns in the world. The aim of this study was to investigate the determinants and effects of alcohol use among women in Oshikoto Region. The study objectives were: to assess the determinants of alcohol use among women in Oshikoto region; to describe the effects of alcohol use among women in Oshikoto region and to assess the relationship between sociodemographic characteristics and determinants of alcohol use among women in Oshikoto region. The study adopted a quantitative research approach with analytical, cross-sectional design. Ethical clearance was obtained from the relevant authorities prior to the study. The study population were all women aged 18-49 years residing in the selected constituencies who were receiving their daily medical consultations at Onandjokwe Intermediate Hospital and Omuthiya State Hospital during the study. Informed consent was obtained from all participants prior to data collection. The data was collected from one hundred and twenty-one (121) participants who were selected through the purposive sampling. An interviewer-led questionnaire with close-ended questions was used on the voluntary participants to collect the data. The data was analysed by means of Statistical Package for the Social Sciences (SPSS) version 26. A chi square statistical test was used to determine the association between variables with the alternative of Fisher exact test. Log-binomial regression reporting risk ratio was applied to assess the association between determinants of alcohol use and risky use of alcohol. The median age of the participants was 33 years. The majority 84 (69.4) of participants lived in rural areas, while 49 (40.5) were single and 75 (62%) had children. The findings indicated that 64 (52.89%) of the respondents use alcohol sometimes in order to cope with their problems. About 56 (46.28%) of the respondents use alcohol when they feel anxious, making them relaxed and forget their challenges. In the univariable log-binomial regression analysis, family history of alcohol use (p value 0.019), peer pressure (p value 0.004), and spending most time iii at cuca shops (p value 0.000) were all significantly associated with an increased risk of harmful use of alcohol. In contrast age (p value 0.329), residence (p value 0. 437), being employed (p value 0.565), education (p value 0.199), and being unemployed (p value 0.777) were not significantly associated with harmful use of alcohol. The study recommends that the Ministry of Health and Social Services (MoHSS), needs to develop guidelines on preventative measures and awareness programs on alcohol use.Item Assessing the perceptions of clients and nurses regarding integration of the primary health care services, okuryangava and Wanahenda clinics Windhoek, Namibia(University of Namibia, 2022) Paulus, BerthaThe successful implementation of the Integrated of Primary Health Care (PHC) services is major challenge for health systems internationally. This research study aimed to explore the perception of clients and nurses regarding integration of primary health care services between the two clinics (Okuryagava and Wanaheda clinics). The study objectives were to assess the perceptions of clients regarding integration of PHC services; To assess the perceptions of nurses regarding integration of PHC Services; and suggest possible recommendations that can be adopted to improve integration of PHC Services based on the perceptions of Clients and Nurses. The research was conducted using qualitative research methodology. The study used an interview guide to collect data through in-depth interviews. A total of 20 participants who include both nurses and clients were purposively sampled. Data is presented using the thematic approach while content analysis was used to analyse data. Research results show that integration of PHC services has improved relationship between nurses and clients, integration of PHC services is convenient, integration of PHC services enhances competence and PHC makes nurses assessment of clients made easier. On the other hand, integration of PHC services has led to the mixing of services that do not go along, it prolongs time a client is served, integration of PHC services does not resonate with the structure as well as the resources of the clinics and stigmatises clients. On the basis of the findings, it is recommended that there is need for resources, consultation rooms and instruments to be addressed so as improve the integration of PHC services at the clinics. If more infrastructure could be provided it would ease the problems that the nurses are currently facing. The study recommends that there is need to restructure the processes of the PHC provision at the clinics as the current ones seem to be out of sync with the available resources. The study suggests that immediate actions towards patient-centred care are necessary in order to operationally integrate all provided services and existing functions of the PHC system at the clinics. Participants were also of the view that health policymakers should adopt an evidence-based action plan that ensures and safeguards patient-centeredness, comprehensiveness, sound coordination, and continuity of services at the clinics.