Background: Infertility is a public health concern affecting many individuals globally. It is defined as the inability to achieve a pregnancy after 12 months or more of uninterrupted and unprotected sexual intercourse and affects both males and females. Primary infertility occurs when conception has never been achieved, while secondary infertility occurs after at least one previous pregnancy has been achieved. Objectives: This study analysed the prevalence and predictors of infertility in Namibia. The research was conducted at four selected public hospitals categorised as central, regional and district. Method: A retrospective and analytical study reviewed 577 hospital records of patients diagnosed with infertility. A structured checklist was developed to extract relevant data, analysed using SPSS version 30 to determine the prevalence and identify predictors of male and female infertility from 2021 to 2023. Ethical approval and permission to access hospital records were obtained from the Namibian Ministry of Health and Social Services and participating hospitals. Results: Of the 577 patient records, secondary infertility was more prevalent (53.6%) than primary infertility (46.4%). Women constituted 79% of cases, with infertility mainly attributed to hormonal imbalances, tubal, uterine factors and ovulation disorders, while male infertility was largely linked to sperm anomalies. One-way analysis of variance indicated significant differences across age, sex, marital status, infertility type, lifestyle and reproductive history (p < 0.05). Multiple regression identified the number of children, sex, age, group, marital status, lifestyle and medication use as significant predictors. Decision tree analysis confirmed parity as the strongest classifier. Conclusion: Secondary infertility was more prevalent, especially among women, with notable variation across sociodemographic and clinical factors. Contribution: The findings contribute to the literature on infertility predictors and prevalence in Namibia. This evidence will be used to structure strategies to support individuals affected by infertility.
BACKGROUND:In higher education, the student-lecturer evaluation (SLE) system is a critical mechanism for enhancing teaching quality and fostering student-centred learning. Despite its importance, limited research exists in Namibia on students' perceptions and experiences of this evaluation process, particularly regarding its effectiveness in improving teaching and learning outcomes. OBJECTIVES:The study aimed to explore and describe nursing students' perceptions and experiences regarding the SLE system at the Rundu Campus of the University of Namibia (UNAM). METHOD:A qualitative, explorative, descriptive and contextual design was employed. Fifteen students were purposively selected to participate in the study. Data were collected through semi-structured interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data and identify emerging themes and sub-themes. RESULTS:Three main themes and nine subthemes were identified from the data analysis. This study explored nursing students' perceptions and experiences regarding the use of SLE as a strategy for improving teaching and learning at the UNAM. Participants highlighted both the benefits and challenges of SLE, including its potential to improve teaching quality, as well as barriers such as lack of feedback, fear of reprisal, poor communication, late notifications and limited transparency. CONCLUSION:The study concluded that while SLEs have significant potential to improve teaching and learning, their effectiveness is constrained by administrative, logistical and communication challenges. Addressing these barriers and implementing students' recommendations can enhance the credibility, accessibility and impact of evaluation systems.Contribution: The findings provide valuable insights for universities to develop ongoing strategies and targeted interventions to improve the implementation of SLEs, foster accountability and promote continuous enhancement of teaching and learning quality.
Background: Globally, adolescents experience peer pressure, drug and substance abuse and unemployment. In addition, other adolescents are living with chronic conditions such as type 1 diabetes mellitus (T1DM), which seems to have a negative impact on the quality of life they experience daily. Objectives: The study aimed to explore and describe the lived experiences of adolescents with T1DM. Method: This study employed a descriptive phenomenological approach. Unstructured individual interviews were conducted with 12 adolescents. The data were analysed using Giorgi’s data analysis steps. Results: Revealed shared struggles among adolescents living with T1DM. Their narratives illuminated the psychological, physical and social challenges they faced. Conclusion: This study unveiled the experiences of adolescents living with T1DM. The findings can help develop a more holistic clinical approach to managing adolescents with this condition, thereby enhancing their quality of life. Contribution: The study offered significant insights into the lives of adolescents living with T1DM and promotes awareness of their daily struggles, which gives healthcare organisations insight into what may be implemented to facilitate a supportive clinical environment that enhances the quality of life of adolescents living with type one diabetes mellitus.
Background: Access to dignified healthcare services is regarded as a human right; however, individuals identified as LGBTQI+ persons still appear to be humiliated and uncared for when accessing primary healthcare facilities. Objectives: This study explored and described the experiences of the LGBTQI+ persons when accessing primary healthcare facilities. Method: A qualitative interpretative phenomenological analysis was employed. Unstructured individual interviews were conducted with 16 self-identified LGBTQI+ persons from five districts and analysed using inductive thematic analysis. Results: Three themes were identified: (1) social injustice, (2) professional nurses’ unpreparedness for inclusive care and (3) experiences of affirmative care. Each theme encompassed relevant sub-themes. Conclusion: The results revealed a lack of humanity and uncaring healthcare services that LGBTQI+ individuals received when accessing primary healthcare facilities in Gauteng, South Africa. Contribution: These findings advocate for inclusive, respectful, dignified and sensitive healthcare services.
BACKGROUND:Although the Expanded Programme on Immunisation in South Africa has received considerable funding for universal access, immunisation rates remain low. It is important to understand the perceptions of caregivers to develop interventions that can improve immunisation adherence. OBJECTIVES:To examine the perceptions of caregivers in relation to immunisation adherence in the selected Western Cape districts, and to examine the important barriers and facilitators that affect the immunisation process in urban primary healthcare. METHOD:A qualitative research method was employed to gain a clear understanding of the phenomenon. The semi-structured interview technique was employed using an interview guide focused on the perceptions of caregivers regarding immunisation adherence. The participants were selected through purposive and convenience sampling. The qualitative thematic analysis technique was employed to identify themes based on the framework proposed by Braune and Clark, as discussed in the data analysis and management section of this article. RESULTS:Six themes emerged that affect immunisation compliance: barriers to accessibility, communication, efficiency of the healthcare system, knowledge and attitudes of caregivers, socioeconomic factors, and the role of cultural and religious beliefs. CONCLUSION:The conclusion of the study was that caregivers showed high levels of commitment to childhood immunisation, but were hindered in their efforts by systemic, socioeconomic and cultural factors.Contribution: The contribution of the study is that it offers evidence that can be used to develop strategies to improve immunisation compliance.
Background: Culturally sensitive nursing care is vital in paediatric settings, where children’s health experiences and responses to care are influenced by their cultural beliefs, family practices and developmental needs. Objectives: This study aimed to develop, describe and evaluate a model to guide professional nurses in providing culturally sensitive care for hospitalised children. Method: A theory-generative, qualitative, exploratory, descriptive and contextual design was employed. The model was created through four systematic steps: concept analysis, formulation of relationship statements, model construction and expert evaluation. Results: The resulting model helps professional nurses to recognise and clarify their own values, incorporate institutional cultural guidelines and utilise relevant resources to facilitate culturally sensitive care. Conclusion: At the core of the model is the active involvement of mothers or primary caregivers throughout the child’s hospitalisation, ensuring holistic, culturally responsive and developmentally appropriate care. Contribution: The model provides a practical framework to improve cultural competence and enhance paediatric nursing care across diverse clinical settings.
Background: Transitioning from academic study to professional practice is a critical and often challenging phase for newly graduated nurses. Providing structured support during this period is essential for fostering confidence, competence and professional growth. Objectives: This study aimed to explore the experiences of new nurse graduates from a university in the Western Cape following their participation in a WhatsApp peer support group designed to facilitate their transition to practice. Method: A qualitative, exploratory descriptive design was used. A 12-week WhatsApp-based intervention was implemented, with weekly discussions on predetermined topics related to professional development. Twelve participants took part in in-depth interviews after the intervention – four through an open call and eight through individual invitations – until data saturation was reached. Data were collected using an interview guide and were analysed thematically. Results: Four major themes emerged: (1) information sharing empowered participants and enhanced professional development; (2) a supportive community of practice was formed; (3) the online presence of moderators fostered engagement; and (4) participants experienced personal growth through skill development and relevant discussions. Conclusion: The study demonstrated that a structured online peer support intervention can effectively promote empowerment, professional confidence and collaboration among newly graduated nurses. Contribution: This research contributes to the growing body of evidence on the use of digital platforms – specifically WhatsApp – for facilitating professional transitions and continuous learning. It provides practical insights for designing supportive, technology-enhanced learning environments in nursing education and practice.
Background: Emergency nursing is complex, fast-paced, often unpredictable and focuses on the management of acute medical conditions or injured patients of all ages. It involves rapid assessment, prioritisation, timely interventions, resuscitation and stabilisation of the patient to reduce morbidity and mortality. This requires nurses to gain specific emergency care knowledge and skills. Objectives: The study investigated the experiences of student nurses in a Bachelor of Nursing programme regarding their theoretical and clinical preparation and readiness for placement in emergency units. Method: Qualitative, exploratory-descriptive methods were used. Thirty-four student nurses from a university in the Western Cape were purposively selected and participated in focus group discussions. Inductive thematic analysis was used. Results: Four themes and twelve categories were generated. The findings indicated that student nurses were inadequately prepared both theoretically and clinically for practice in emergency units. Several factors contributed to the planning and implementation challenges, leading to students’ lack of preparedness. Conclusion: Despite changes in the requirements of the South African Nursing Council for clinical placement of undergraduate students in emergency units, work integrated learning in these units would benefit graduate nurses intending to further their studies in critical and emergency care nursing. However, learning outcomes are required to ensure that student nurses have access to specific emergency care knowledge and clinical skills. Contribution: Highlights student nurses’ need for orientation, clinical supervision and debriefing sessions by competent critical and emergency care nurses, and professional counselling when needed.
BACKGROUND:Patient satisfaction is a key indicator of healthcare quality. Several studies conducted revealed that there is patient dissatisfaction globally, in the sub-Saharan region and nationally. However, factors influencing patients' satisfaction during healthcare delivery remain unknown. OBJECTIVES:The study aimed to examine the factors that influence patients' satisfaction during healthcare delivery at a selected district hospital. METHOD:A quantitative descriptive design was used. The questionnaire was developed using the Donabedian model for quality care to measure patient satisfaction. The tool was piloted before use. Questionnaires were distributed to 320 respondents who were randomly selected. The response rate was 100%. Data were analysed using statistical software, SAS 9.2, with descriptive statistics and the Chi-square tests. RESULTS:Key issues that made patients dissatisfied with healthcare facilities were poor communication, inpatient disagreement (19% as compared to 6% outpatient, p = 0.0018), long waiting time (76% of inpatients as compared to 24% of outpatient respondents, p 0.001), unclean environment (26% inpatient and 35% outpatient), dirty linen, unsafe water for drinking, and poor infrastructure. CONCLUSION:It is evident that many issues contribute to patient dissatisfaction in healthcare facilities, highlighting the need for improvement. Satisfied patients are more likely to return, while dissatisfied ones may neglect treatment, spread negative feedback, or pursue legal action. Such dissatisfaction can also discourage others from seeking care. Therefore, healthcare providers must regularly assess their services, identify areas for improvement, and implement changes to maintain patient satisfaction. Furthermore, recommendations were made on how to improve the healthcare facilities. Implementing the recommended strategies can greatly enhance quality care and patient satisfaction.Contribution: The findings will contribute to the development of quality improvement strategies and monitoring systems.
Background: Nurse educators are instrumental in preparing the next generation of nurses. However, the changing landscape of nursing education is making it difficult for them to exemplify and advocate for work-life balance (WLB). Nursing education institutions face challenges with limited resources and increasing student numbers, making educators crucial for maintaining high educational standards. Despite this, there has been limited research on how educators manage the overlapping pressures of their careers and personal lives. Objectives: This study explored the experiences of nurse educators regarding WLB at a nursing education institution in Gauteng province, South Africa. Method: A qualitative, exploratory, descriptive and contextual design was employed. Purposive sampling was used to select 16 nurse educators across four campuses. Data collection involved face-to-face individual semi-structured interviews, and data analysis followed a qualitative thematic approach. Results: This research revealed two themes: Heavy workload and responsibilities, and Blurred boundaries between work and personal life. The spillover of work demands into personal time, particularly those driven by student expectations, emerged as a significant challenge to achieving a balanced work-life dynamic. Conclusion: Addressing the challenges faced by nurse educators in achieving WLB requires more than individual resilience. There is a need for comprehensive support systems and strategic interventions to help nurse educators manage their responsibilities effectively and achieve a healthier balance between work and life. Contribution: This study could assist larger efforts to create supportive and sustainable work environments for nurse educators, which would benefit the educators and further the development of the nursing profession
BACKGROUND:Over one-third of maternal deaths, nearly half of stillbirths, and a quarter of neonatal deaths are attributed to complications during labour and childbirth. Currently, the Labour Care Guide (LCG) is the only tool that promotes the implementation of the World Health Organization's recommendations on intrapartum care, ensuring a positive childbirth experience. Previous studies examining midwives' experiences in utilising the LCG did not include Namibia, hence this study. OBJECTIVES:This study aimed to explore and describe midwives' experiences and perceptions of using the LCG at a training hospital in Namibia. METHOD:An exploratory descriptive qualitative design was employed to collect data from 10 midwives between May 2023 and July 2023. The interviews were audio-recorded, transcribed, and analysed using inductive reflective thematic analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research reporting guideline. RESULTS:The study identified three themes: LCG optimisation challenges, perceived usefulness of LCG and suggestions for improvement. While midwives expressed overall satisfaction with the new components of the LCG, some midwives perceived a shortcoming with regard to monitoring and managing labour progress in mothers who consumed traditional oxytocin known as Sivatu as being at risk for uterine rupture, foetal distress, or even death. The lack of resources and cultural norms on labour companionship poses LCG implementation challenges. CONCLUSION:This study found that while some midwives embraced the use of the LCG for monitoring labour and identifying abnormalities and complications, others perceived a limitation pertaining to monitoring women using traditional oxytocin.Contribution: The study thus recommends exploring alternative methods and strategies for safe labour monitoring and management.
BACKGROUND:The effectiveness of primary and special healthcare systems depends on the patient referral system. In Namibia, most patients that require specialised care are referred to a referral hospital in Windhoek because of inadequate facilities, equipment and health workers in most of the regions. OBJECTIVES:This study aimed to investigate the experiences of orthopaedic patients referred from regional hospitals to Katutura Intermediate Hospital in Namibia. The study was conducted at the Katutura Intermediate Hospital in Namibia. METHOD:A qualitative approach with descriptive-exploratory design was utilised. The target population comprised of 50 patients referred to the orthopaedic department from the regions to Katutura Intermediate Hospital in Namibia, and purposive sampling was used to sample participants. Data were collected among 28 participants till there was no more new information emerging. Data were collected through semi-structured interviews and analysed using thematic analysis. RESULTS:The study found that patients had varied experiences related to healthcare provision, with positive and negative experiences reported. Most patients were satisfied with the quality of healthcare services provided, while some indicated negative experiences. Areas for improvement in the referral transportation experience were identified, with a need for better vehicles and improved communication. CONCLUSION:The study reveals positive and negative experiences among participants, but most participants have positive experiences in service deliveries during hospital referrals.Contribution: The study contributed to the literature by revealing the experiences of patients referred that might assist the management to develop strategies to address the challenges identified for quality healthcare.
BACKGROUND:Implementing HIV policy involves translating policy goals into practical action. In the Western Cape, South Africa, the lack of clear guidelines has challenged the consistent implementation of HIV policies at primary healthcare (PHC) facilities. OBJECTIVES:This study aimed to explore HIV managers' experiences regarding the challenges of HIV policy implementation at PHC facilities within the Northern Tygerberg sub-district, Cape Metropole, Western Cape. METHOD:An exploratory, descriptive, qualitative design was employed. Purposive sampling was applied to select HIV managers (n = 10) with experience in policy implementation. Data were collected through semi-structured interviews and analysed using thematic analysis. RESULTS:Four themes emerged from the study, reflecting the challenges experienced by HIV managers during the implementation of HIV policies at PHC facilities, including human resource challenges, staff knowledge and attitudes, system readiness, and training. CONCLUSION:Effective implementation of HIV policy remains essential to the national HIV response. While significant targets have been achieved, ongoing systemic challenges continue to hinder optimal policy execution and the delivery of services.Contribution: The study highlights the critical need for stronger human resource systems, improved training platforms, and enhanced facility infrastructure to ensure effective HIV policy implementation and better health outcomes for individuals living with HIV.
BACKGROUND:The World Health Organization (WHO) recognises interprofessional learning as an effective component of transformative medical education. Health discipline students represent the core disciplines that form the primary collaborative healthcare team in clinical settings. However, the implementation of interprofessional learning within health disciplines in Namibia remains unassessed. OBJECTIVES:To assess and describe the readiness for interprofessional learning among undergraduate health discipline students at three campuses of the University of Namibia. METHOD:A quantitative descriptive online survey was conducted to recruit 236 health discipline students through purposive sampling. To allow enough time for data collection, data were collected between May and August 2023, using the validated readiness for Interprofessional Learning Scale. RESULTS:The mean teamwork and collaboration were high at 4.22 ± 1.02, roles and responsibilities had a high score for interprofessional learning readiness at 1.93 ± 0.25, while the professional identity readiness domain was low at 1.40 ± 0.27. Professional identity showed a strong positive correlation with course of study (rho = 0.722; p = 0.010). Teamwork and collaboration (R2 = 0.838; p 0.001) and roles and responsibilities (R2 = 0.208; p 0.001) emerged as the most robust predictors of readiness, accounting for 20% and 83.8% of the variance in readiness. CONCLUSION:Using the framework for interprofessional education, the study assessed student readiness and determined that both teamwork and collaboration and roles and responsibilities were the major statistically significant predictors of interprofessional readiness.Contribution: This study identified predictors of interprofessional collaboration among health discipline students in Namibia.
Background: Loss to follow-up and treatment defaulting in HIV care led to hospitalisations for advanced complications, undermining retention strategies. Breaches of confidentiality compel patients into transferring clinics to conceal their HIV status. The shift from traditional nurse–patient relationships to team-based care, while improving comprehensive services, complicates confidentiality maintenance and can increase risks of unintended disclosures, eroding trust. Observations across ten community health centres with nurse-led HIV and AIDS services in the OR Tambo district revealed high rates of antiretroviral therapy (ART) defaulting. The absence of a formal confidentiality training framework leads to inconsistent practices and nonadherence to confidentiality guidelines. Objectives: This study aimed to develop a contextually relevant conceptual framework guiding the design and implementation of a boundary-based confidentiality training programme for HIV care providers. Method: Empirical data were collected by semistructured interviews with nurses across ten centres and analysed thematically Dickoff’s six factors, comprising agent, recipient, context, procedure, dynamics and terminus, was used to guide the conceptual framework and ensure relevance and feasibility. Results: Four themes and twelve sub-themes formed the basis for the framework’s six components. These components provide a systematic approach to addressing training elements aligned with programme goals. Conclusion: The developed framework offers a structured foundation for tailored confidentiality training, guided by Dickoff’s model. This approach aims to improve confidentiality adherence, foster patient trust and promote treatment retention among HIV clients. Contribution: The framework bridges research, practice and education by providing an evidence-based, practically applicable and educationally effective approach to confidentiality training, ultimately improving knowledge and understanding of HIV care.
Background: An estimated one in seven adolescents globally experiences a mental disorder, and parents, as primary caregivers, play an essential role in caring for their adolescent with a mental disorder. Consequently, parents face many challenges and require support from psychiatric nurses. Objectives: To describe and evaluate the development of a model for psychiatric nurses to facilitate support for parents who are caring for an adolescent with a mental disorder. Method: A theory-generative, qualitative, exploratory, descriptive and contextual study design was used to develop the model. The central concept of the model was derived from a previous study. The process entailed identifying the central concept and other essential criteria, classifying the central concepts and describing the relationships between them. Results: The central concept was identified as ‘facilitation of support’ for parents who are caring for an adolescent with a mental disorder. The identified and defined central concepts were placed into interrelated statements. The model to facilitate support for parents who are caring for an adolescent with a mental disorder was developed, described and evaluated. The model has not been implemented. Conclusion: The model provides facilitation of support for parents who are caring for an adolescent with a mental disorder. Additionally, the model empowers psychiatric nurses with the skills to facilitate support for parents. Contribution: The model contributes to the facilitation of support for parents who are caring for an adolescent with a mental disorder. This model will also contribute to the empowerment of psychiatric nurses.
Background: HIV and AIDS continues to be a critical public health challenge, with sub-Saharan Africa shouldering the heaviest burden. Progress towards disease management has been implemented over the years, and antiretroviral therapy (ART) has been the most significant milestone. The World Health Organization recommended dolutegravir as the second line of treatment for the disease. A dolutegravir-based regimen has been appreciated for its great benefits. While its effectiveness is apparent, reports of side effects have raised concerns about adherence, posing a challenge to long-term treatment success. Objectives: This study explored the perceptions of people living with HIV (PLHIV) in Limpopo province regarding the use of dolutegravir-based regimens. Method: A qualitative, explorative-descriptive design was followed. Twenty individual semi-structured interviews were conducted. Purposive sampling and sample size were determined when data saturation was reached. Thematic analysis was used. Results: Four major themes emerged: high acceptance of dolutegravir, limited knowledge of treatment details, the burden of managing long-term ART and barriers to adherence, including concerns about side effects. Conclusion: While dolutegravir was generally well accepted, there were notable deficiencies in understanding treatment, underscoring the importance of improving patient education to ensure enhanced adherence to treatment. This study provides critical insights into the lived experiences of PLHIV using dolutegravir, offering valuable direction for future interventions aimed at improving adherence and optimising treatment outcomes in HIV care. Contribution: The study provides context-specific insights into how PLHIV perceive and experience dolutegravir-based regimens. By uncovering both the drivers of acceptance and the hidden barriers to adherence, it offers actionable evidence to guide patient-centred ART counselling, inform policy decisions and strengthen HIV treatment programmes to achieve sustained viral suppression in similar settings.
Background: In 2021, there were about 263 million cases of malaria reported around the world and 579 reported deaths globally. There were extreme cases of malaria worldwide, regionally, provincially, and in the Vhembe District. Despite current efforts and several advancements to control vectors and prevent bites to minimise its burden, malaria remains a serious health issue. Objectives: The objective of the study was to explore the experiences of people diagnosed with malaria regarding signs and symptoms at Mhinga Village in the Vhembe District, Limpopo province, South Africa. Method: A qualitative method, with an exploratory, descriptive and contextual design was used to get an in-depth understanding of the phenomenon. Data were collected using semi-structured interviews with an interview guide focused on the experiences of people who were diagnosed with malaria regarding signs and symptoms at Mhinga Village in the Vhembe District, Limpopo. Participants were purposively selected. Qualitative thematic analysis was conducted using codes. Results: Two subthemes emerged: experiences with signs and symptoms and circumstances prompting immediate consultation. Different signs and symptoms were experienced based on the systems. Conclusion: The study concluded that the participants had experienced symptoms of malaria according to systems and certain circumstances were present that drove participants to consult immediately. Contribution: This study increased awareness of malaria prevention strategies, which may lower malaria transmission. Unique contributions include protecting Limpopo province’s Department of Health from admittance cuts. Malaria morbidity, death and treatment costs may decrease. Policymakers may encourage the community to continue malaria prevention methods, including mosquito avoidance and antimalarial use, which have been shown to work.
Background: Patient safety incidents are a major concern in healthcare delivery, impacting patient care and health outcomes. Understanding the factors contributing to patient safety incidents is important for developing targeted strategies. Identifying these factors will enable healthcare organisations to formulate effective approaches to prevent and mitigate incidents. Objectives: This study aimed to assess the contributing factors to patient safety incidents at the three selected public hospitals in Gauteng province, South Africa. The research was conducted at the three selected public hospitals in Gauteng province, South Africa, categorised as central, regional and district. Method: A descriptive quantitative approach was utilised. Five hundred questionnaires were administered to nursing staff and quality assurance managers. A stratified sampling strategy was employed. The data were analysed using the Statistical Package for Social Sciences (SPSS) Version 26.0. Results: Work or environment (92.72%), organisational or service (91.00%), staff (87.40%) and patient (90.97%) factors were identified as the contributing factors to patient safety incidents. Conclusion: The overall impression of these results is that multiple factors contribute to patient safety incidents, with varying levels of perceived impact. The findings of the study imply the need for policy development, provision of adequate staffing, consumables and equipment, staff training on developed policies and procedures, and embarking on continuous quality improvement initiatives. Contribution: This study contributes to the understanding of factors contributing to patient safety incidents within the public hospitals and furnishes healthcare leaders with focused areas for improvement.
