Operational challenges and collaborative solutions in radiology image interpretation: perspectives from imaging departments in a low-resource setting.

INTRODUCTION: Medical imaging's critical role in diagnosis requires prompt and precise image interpretation. Numerous radiology departments, especially in low-resourced settings, encounter challenges such as a shortage of radiologists in their operational setup. This study explored the perceptions of radiographers and radiologists from low-resourced departments in a single country regarding operational challenges and potential solutions in image interpretation. METHODS: A qualitative approach was utilised, involving heads of departments, senior radiographers, and radiologists with a minimum of 5 years of experience, from three major state referral hospitals. Face-to-face, semi-structured interviews were conducted in November 2022, using an interview guide that included questions on the challenges encountered during image interpretation and the proposed solutions. Data analysis was conducted using Atlas.ti version 9.0, following the four-step content analysis method. All participants willingly provided consent to participate in the study. RESULTS: Ten participants, comprising two radiologists and eight radiographers participated in the study. The research identified three main themes: image interpretation pathways, image interpretation operational challenges and proposed solutions for image interpretation. In addition, a total of 10 subthemes were generated from the three main themes. CONCLUSION: The study revealed critical challenges and the need to explore the formal inclusion of radiographers in image interpretation, as a way to improve efficiency. However, a comprehensive assessment of the image interpretation system, encompassing radiographers' knowledge and competence, is recommended for context-specific, empirical-based modifications to enhance service provision.

Justification of radiological procedures: Radiographers' experiences at two public hospitals.

BACKGROUND: Justification is a process conducted by the radiographer in consultation with the radiologist to evaluate radiological procedures ordered by doctors. The main purpose for justifying all radiologic procedures is to assess the benefits and risks of a requested radiographic procedure and determine whether exposure will continue. Furthermore, justification helps to prevent unnecessary radiation exposure and reduce the chances of harmful effects of ionizing radiation. OBJECTIVES: The study aimed to explore the experiences of radiographers regarding the justification of radiological procedures at two public hospitals in Namibia METHODS: This study made use of a qualitative, exploratory design. A total number of 13 purposefully selected radiographers from radiology departments in two tertiary public - hospitals in Namibia were interviewed using a semi-structured interview guide and audio recorder. All interviews were conducted face-to-face until data saturation was achieved. Data were analysed using Atlas.ti Windows (version 9.0 using Tesch's 8-step method of qualitative data analysis to generate themes and subthemes. FINDINGS: The participants experienced an enhancement of patient care through enhanced radiation protection and optimised patient care. They also experienced defunct communication systems through deficient communication between radiographers and referrers, professional role conflict and incomplete referrals. CONCLUSION: The study revealed that the justification of radiological procedures was linked to both negative and positive experiences. Enhanced patient-centred care was a positive experience related to the radiographers' job responsibilities. The defunct communication support system was a negative experience as it related to the limited availability and utilisation of communication systems that are meant to enhance and support justification by radiographers. The study recommends an in-depth study to quantify unjustified procedures in these two hospital departments. Continuous professional development focusing on justification and referral protocols must be conducted jointly between radiographers and referrers to create awareness and a platform for shared decision-making models.

Knowledge, attitude, and practices of infection prevention and control among radiographers in a resource constraint setting in Namibia.

Background: Radiographers' role as healthcare workers places them at constant risk for hospital-acquired infections. Practical, evidence-based methods are necessary to reduce the transmission of pathogens to and from patients and healthcare workers. Objective: The main objectives of this study were to determine knowledge, attitude, and practice levels regarding infection prevention and control (IPC) strategies among radiographers in Windhoek and Oshakati, and measure their relationships with other variables. Method: A quantitative descriptive design was employed. To assess the knowledge, attitude, and practice levels among radiographers, a self-administered questionnaire was used. Twenty-seven radiographers took part in the study, producing a 68% response rate. Results: The study revealed that the majority of the radiographers showed an appropriate level of overall knowledge and attitude toward infection prevention and control. However, the majority of their practice levels were poor. Pearson rank correlation test revealed that the radiographers' knowledge was significantly associated with attitudes (P= 0.004; r=0.53) and practices (P=0.03; r=- 0.41) with a moderate positive and negative correlation, respectively. Conclusions: In conclusion, the study revealed that radiographers are knowledgeable about IPC strategies, and have good attitudes toward them. However, their practice was poor and inconsistent with the level of knowledge demonstrated. Therefore, it is recommended that healthcare service managers establish efficient and rigorous means of monitoring adherence to IPC strategies and improving practices to reduce incidences of health-acquired infections among radiographers, especially in the age of a pandemic.

Preparedness to assume professional roles: experiences of recently qualified radiographers: A qualitative study.

INTRODUCTION: Recently qualified health workers including radiographers struggle with workplace integration. Similarly, in our local context, undocumented complaints were received from the various heads of departments and radiologists regarding recently qualified radiographers' ability to fully assume their professional roles. In light of the complaints, this study sought to explore and describe the lived experiences of recently qualified radiographers from one local University on their readiness to assume their professional roles. METHODS: A qualitative, descriptive research design with a phenomenological approach was used to conduct the study. Ten (10) diagnostic radiographers who graduated between 2018 and 2020 from the local university were sampled using the snowball sampling technique. Telephonic interviews were conducted using a semi-structured interview guide. Data were analysed using Tesch's open coding method. RESULTS: The findings of this study have shown a combination of positive and negative experiences by recently qualified radiographers. The positive experiences (satisfactory work engagement) emanate from increased confidence and creativity, responsibility consciousness and teamwork. Negative experiences (reality shock and professional role conflict) emanated from excessive workload, patient care impediments, the burden of student supervision and lack of professional trust. CONCLUSION: Though the recently qualified radiographers from our local University experienced some contextual challenges upon assuming their professional roles, they appeared well-prepared for their clinical roles. Standardised induction and mentorship programmes should be implemented to facilitate the transition process from student to qualified radiographer.

Maternal factors associated with immediate low Apgar score in newborn babies at an intermediate hospital in Northern Namibia.

Background: All newborn infants are required to undergo the Apgar score/assessment immediately after birth and again at five minutes. This vital examination is performed to determine how well the infant is adjusting to the birthing process and the outside environment. Some newborns may have a normal Apgar score, while others may have a low score. The purpose of this study was to identify factors associated with low Apgar scores among newborns at an intermediate hospital in Northern Namibia. Objective: To identify maternal factors associated with an immediate low Apgar score in newborns at an intermediate hospital in Northern Namibia and to examine the association between maternal factors and an immediate low Apgar score. Quantitative, retrospective, descriptive research methodology was employed. A document review checklist was utilized to collect data at Onandjokwe Intermediate Hospital between August 2020 and October 2020. Results: Gravidity (p0.021), parity (p0.029), haemoglobin after the first ante-natal care visit (p0.011), ante-partum haemorrhage (APH) (p0.004), membrane status (p0.000), duration of labour (p0.000), type of delivery (p0.000), and caesarean section type and indication (p0.000) were found to be associated with an immediate low Apgar score. Conclusions: The study identified maternal factors that influence an infant's initial low Apgar score. Strengthen maternal health education regarding gravidity and parity, diet, and recognizing danger signs during pregnancy. In addition, strict monitoring of patients with a partograph, cardiotocography, accurate record keeping, and prompt referral of patients with risk factors is strongly advised.

Barriers to, and facilitators of, the adoption of a sugar sweetened beverage tax to prevent non-communicable diseases in Namibia: a policy landscape analysis.

Background: Nutrition-related non-communicable diseases contribute to approximately half of the premature deaths in Namibia. Westernisation and urbanisation of communities have resulted in changing dietary patterns that see people eating more refined and high sugar content foods that are a risk for nutrition-related non-communicable diseases. Sugar-sweetened beverage taxation has been found to influence consumer purchasing behaviour and to raise revenue for health-promoting activity in other low- and middle-income countries.Objectives: To analyse Namibia's non-communicable diseases prevention policy landscape and assess the readiness of the Government to adopt sugar-sweetened beverage taxation policies for public health.Methods: Government policy documents relating to nutrition-related non-communicable diseases were analysed, utilising predetermined variables based on policy theory. Thirteen key informant interviews were conducted with stakeholders from Government, non-governmental organisations and academic institutions. Data sets were analysed utilising Kingdon's analytical theory for agenda setting.Results: Nutrition-related non-communicable diseases are an increasing problem that requires immediate action. Diet and lifestyle are recognised as major contributors to non-communicable diseases. The Government has adopted a multisectoral approach to the control and prevention of non-communicable diseases in Namibia. A sugar-sweetened beverage tax is envisaged in policy, but there is no progress towards its enactment. At the highest level of Government, the Ministry of Finance has ruled out immediate action towards sugar-sweetened beverage taxation. There is little publicly available information about the Namibian beverages industry, but it is closely tied to the South African drinking industry and is influenced by policy action in that country.Conclusion: The Government of Namibia has taken positive steps and the policy environment is friendly towards an SSB tax. The proximity of trade and the competitive nature of the Namibian drinks industry with South Africa suggest that a regional perspective to advocacy would be of value.

The legal feasibility of adopting a sugar-sweetened beverage tax in seven sub-Saharan African countries.

Background: A number of countries have adopted sugar-sweetened beverage taxes to prevent non-communicable diseases but there is variance in the structures and rates of the taxes. As interventions, sugar-sweetened beverage taxes could be cost-effective but must be compliant with existing legal and taxation systems.Objectives: To assess the legal feasibility of introducing or strengthening taxation laws related to sugar-sweetened beverages, for prevention of non-communicable diseases in seven countries: Botswana, Kenya, Namibia, Rwanda, Tanzania, Uganda and Zambia.Methods: We assessed the legal feasibility of adopting four types of sugar-sweetened beverage tax formulations in each of the seven countries, using the novel FELIP framework. We conducted a desk-based review of the legal system related to sugar-sweetened beverage taxation and assessed the barriers to, and facilitators and legal feasibility of, introducing each of the selected formulations by considering the existing laws, laws related to impacted sectors, legal infrastructure, and processes involved in adopting laws.Results: Six countries had legal mandates to prevent non-communicable diseases and protect the health of citizens. As of 2019, all countries had excise tax legislation. Five countries levied excise taxes on all soft drinks, but most did not exclusively target sugar-sweetened beverages, and taxation rates were well below the World Health Organization's recommended 20%. In Uganda and Kenya, agricultural or HIV-related levies offered alternative mechanisms to disincentivise consumption of sugar-sweetened beverages without the introduction of new taxes. Nutrition-labelling laws in all countries made it feasible to adopt taxes linked to the sugar content of beverages, but there were lacunas in existing infrastructure for more sophisticated taxation structures.Conclusion: Sugar-sweetened beverage taxes are legally feasible in all seven countries Existing laws provide a means to implement taxes as a public health intervention.