Perspectives of pregnant women on the utilisation of a maternity waiting home near Onandjokwe Lutheran Hospital in Oshikoto Region, Namibia.

BACKGROUND:  Despite the efforts of Namibia's Ministry of Health and Social Services to build maternity waiting homes (MWHs), few pregnant women make use of them. Long distances among the general population in Namibia limit the utilisation of MWHs. Little research has investigated what factors are limiting the use of these facilities despite the urgent need for them. The aim of this study thus was to explore and describe the perspectives of pregnant women on the utilisation of the MWHs near Onandjokwe Lutheran Hospital in Oshikoto Region. METHODS:  A qualitative, exploratory, descriptive and contextual design was employed. The accessible population in this study comprised 18 participants who were selected for the study using a purposive sampling technique. RESULTS:  Participants reported numerous barriers to visiting MWHs in Namibia, including an inadequate number of rooms, theft, food scarcity and the effects of poverty on the living conditions of the MWH users. Enablers visiting MWHs included the safe delivery of babies by skilled staff, reduced transport costs, access to timely management of labour complications and affordable accommodation. CONCLUSION:  The study revealed that a number of barriers must be overcome before the desired number of women take advantage of MWHs. Multiple factors act as constraints to their use, including inadequate number of rooms, theft, food scarcity and the long distance between patients' homes and MWH services.Contribution: The study's findings can be used to develop targeted interventions and strategies that can be used by MWH providers to address the identified barriers.

Experiences of nursing students during their mental health clinical training at a general hospital in Namibia.

BACKGROUND:  Clinical training is important because it constitutes more than half of the formal courses in nursing education. Accordingly, it is important for institutions of higher learning to continually explore the experiences of nursing students during their clinical placement. These experiences can be used to promote a positive clinical learning environment for students. However, the experiences of nursing students during their mental health clinical training in Namibia have not been extensively researched. OBJECTIVES:  The aim of this study was to explore and describe the experiences of nursing students during their mental health clinical training at a general hospital in Namibia. METHOD:  A qualitative, exploratory, descriptive and contextual research design was followed as the basis for conducting the study. A sample of 15 nursing students was conveniently selected from the target population of 73 nursing students. This sample size was determined by the saturation of data as reflected in repeating themes. RESULTS:  The following three themes emerged: collating theory and mental health practice experiences, facing challenges in clinical placements, and recommendations to ensure effective learning about mental health. CONCLUSION:  The use of a general hospital for clinical placements within an undergraduate nurse training course led to some concerns regarding the relevance and appropriateness of such experience within a nursing programme.Contribution: The findings have important implications for the training of undergraduate nursing students in general hospitals. It can be utilised to develop strategies to improve positive clinical practice placement and develop clinical skills for undergraduate nursing students in general hospitals.

A qualitative descriptive enquiry of nursing students' experiences of utilising a portfolio as an assessment tool in nursing and midwifery education.

BACKGROUND: The use of a portfolio as an assessment tool in nursing and midwifery education is still a relatively new phenomenon. Institutions of higher education should therefore continuously explore the experiences of nursing students in the use of a portfolio in clinical nursing education. In Namibia little research exists on the perspectives of nursing students on the use of a portfolio as an assessment tool. PURPOSE: The purpose of the study was to explore nursing students' experiences with portfolio as an assessment tool in nursing and midwifery education. METHOD: The study used the qualitative approach, with an explorative, descriptive, and contextual design. Fifteen (15) undergraduate nursing students participated in this study, using a snowball sampling technique. Data was collected through semi-structured interviews. Data was analysed using thematic analysis for recurring themes. RESULTS: The following four themes emerged: understanding of a portfolio, positive experiences, negative experiences, and effective portfolio utilisation. CONCLUSION: The results revealed nursing students' positive and negative experiences, with suggestions for improvement. The findings may help identify strengths and weaknesses in portfolio usage for assessment purposes in nursing and midwifery education. This study recommended well-articulated plans and actions from students, clinical instructors, lecturers, faculty management teams, and the nurses in practice facilities, to address the challenges identified.

Assessment of Preparedness for Remote Teaching and Learning to Transform Health Professions Education in Sub-Saharan Africa in Response to the COVID-19 Pandemic: Protocol for a Mixed Methods Study With a Case Study Approach.

BACKGROUND: The current COVID-19 pandemic is affecting all aspects of society worldwide. To combat the pandemic, measures such as face mask-wearing, hand-washing and -sanitizing, movement restrictions, and social distancing have been introduced. These measures have significantly disrupted education, particularly health professions education, which depends on student-patient contact for the development of clinical competence. The wide-ranging consequences of the pandemic are immense, and health professions education institutions in sub-Saharan Africa have not been spared. OBJECTIVE: This paper describes a protocol for assessing the preparedness of selected health professions education institutions in sub-Saharan Africa for remote teaching and learning during the COVID-19 pandemic. METHODS: A mixed-methods design with a case study approach will be used. The awareness, desire, knowledge, ability, and reinforcement model of change was selected as the conceptual framework to guide the study. Eight higher education institutions in 6 sub-Saharan countries have participated in this study. Data will be collected through electronic surveys from among whole populations of academic staff, students, and administrators in undergraduate medicine and nursing programs. Qualitative and quantitative data from each institution will be analyzed as a case study, which will yield an inventory of similar cases grouped for comparison. Quantitative data will be analyzed for each institution and then compared to determine associations among variables and differences among programs, institutions, or countries. RESULTS: Our findings will provide information to higher education institutions, particularly those offering health professions education programs, in Africa regarding the preparedness for remote teaching and learning to influence efforts related to web-based teaching and learning, which is envisaged to become the new normal in the future. CONCLUSIONS: This study has not received any funding, and any costs involved were borne by individual consortium members at the various institutions. Ethics approval from the institutional review board was obtained at various times across the participating sites, which were free to commence data collection as soon as approval was obtained. Data collection was scheduled to begin on October 1, 2020, and end on February 28, 2021. As of this submission, data collection has been completed, and a total of 1099 participants have been enrolled. Data analysis has not yet commenced. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/28905.

Namibian prisoners describe barriers to HIV antiretroviral therapy adherence.

Little is available in scholarly literature about how HIV-positive prisoners, especially in low-income countries, access antiretroviral therapy (ART) medication. We interviewed 18 prisoners at a large prison in Namibia to identify barriers to medication adherence. The lead nurse researcher was a long-standing clinic employee at the prison, which afforded her access to the population. We identified six significant barriers to adherence, including (1) the desire for privacy and anonymity in a setting where HIV is strongly stigmatized; (2) the lack of simple supports for adherence, such as availability of clocks; (3) insufficient access to food to support the toll on the body of ingesting taxing ART medications; (4) commodification of ART medication; (5) the brutality and despair in the prison setting, generally leading to discouragement and a lack of motivation to strive for optimum health; and (6) the lack of understanding about HIV, how it is transmitted, and how it is best managed. Because most prisoners eventually transition back to communitysettings when their sentences are served, investments in prison health represent important investments in public health.

The delivery and quality of sexually transmitted infections treatment by private general practitioners in Windhoek Namibia.

INTRODUCTION: The main objective for this study was to investigate the quality of Sexually Transmitted Infections (STI) treatment and control by the private sector in Namibia. METHOD: This was a cross-sectional study employing quantitative methodology using different methods of data collection. A self-administered questionnaire exploring General Practitioners (GPs) perceptions of factors that influence the way they manage Sexually Transmitted Infections (STI) which was then concluded with the face to face interviews and the checklist that was used while doing observations in the consulting rooms. RESULTS: A total of 50 private general practitioners in the area of Windhoek were interviewed, 48 self-administered questionnaires plus all checklists were received back from the private general practitioners. None of the private general practitioners interviewed had specific training in the syndromic management of the STIs. The 86% of all patients were seen by these private general practitioners on a medical aid, while 14 % pay cash for service provided. With regard to Urethral Discharge, an average of 56.5% of GPs could treat urethral discharge correctly as per the Namibian syndromic approach guidelines. None of the GPs could demonstrate the correct treatment of genital ulcer (whether they received medical aid or not) as recommended in the syndromic approach guidelines in Namibia (GRN, 1999; 2000). Only 28% of the GPs could demonstrate the correct treatment of Pelvic Inflammatory Disease (PID) as per the syndromic management of the STIs. For patients without medical aid the drugs prescribed and their dosages for PID are correct but the frequencies are not in line with the guidelines as for patients with medical aid. DISCUSSION: In general, patients presenting with STIs to the GPs in private practices are not given quality of care because not all private general practitioners have time to do investigations, counseling, give condoms and to notify the partners of those with urethral discharge, genital ulcers and PID looking for treatment.