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A comparison of spinal anaesthesia with and without transversus abdominis plane block in patients undergoing elective caesarean section at Windhoek Hospital Complex
No full textA thesis in partial fulfilment for the requirements for the Degree of Master of Medicine (Anesthesiology, Critical care and Pain management)Background: Pain is a known outcome complication of surgery in the post-operative
period, especially after Caesarean section. Lack of pain relief postoperatively also poses
great risks for patients’ health. The combination of Transversus Abdominis Plane
(TAP) block with spinal anaesthesia is emerging as a superior approach for managing
postoperative pain, particularly in abdominal surgeries. While spinal anaesthesia
provides effective lower body analgesia, it can result in inadequate pain control and
side effects like hypotension. TAP block enhances pain relief without the adverse
effects associated with spinal anaesthesia. Overall, the integration of TAP block with
spinal anaesthesia offers significant advantages in pain management strategies.
Aim: The main objective of this study was to compare the benefit of adding transversus
abdominis plane (TAP) block to spinal anaesthesia versus spinal anaesthesia alone in
patients undergoing elective Caesarean section.
Setting and Design: This was a randomised single-blinded control study conducted
over a period of six months in the maternity theatres of Windhoek Central Hospital and
Intermediate Hospital, Katutura.
Methods and Materials: The effect size on pain scores was determined to be the
magnitude of the difference between groups, according to a study by Cohen et al. A
medium effect size of 0.5, an alpha error of 0.05, and a power of 80% were used to
calculate the number of patients required in each group. The result was 64 patients per
group. Assuming an average attrition rate of 11% quoted in a similar study, this
suggested that 72 patients were required per group so that in total, the study sample size
constituted 144 patients. Patients planned for elective caesarean section were randomly
allocated to two groups, A and B. Group A received spinal anaesthesia only with 0.5%
heavy bupivacaine 9 mg (1.8 ml) and fentanyl 15 mcg. Group B received spinal
anaesthesia and TAP block using 40 ml plain bupivacaine 0.25%. (with the same drug
doses as in Group A). The analgesic efficacy spinal anaesthesia alone and spinal
anaesthesia combined with TAP block was compared over various time intervals (2, 4,
6, 12, and 24 hours postoperatively) both at rest and movement.
Statistical Analysis: Numbers with percentages were used to represent nominal
variables, while continuous variables were summarized in terms of mean ± SD or
median and interquartile range, as appropriate. A statistician examined the distribution
of the data before
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using the Student's T-test to compare the results from the study groups. When
appropriate, the Z score for a two-population proportion was applied. Statistical
significance was defined as a P-value of less than 0.05.
Results: At both rest and movement, spinal anaesthesia alone consistently showed
higher pain scores compared to TAP block across all time intervals. Statistically
significant differences were observed with p value of (p= <0.001), except for the 2-hour
mark at rest where no significant difference of between the two groups was observed
(p=0.97).
Conclusion: This study highlights the effectiveness of TAP block as an adjunct to
spinal anaesthesia in managing postoperative pain following Caesarean section.
Patients who received both spinal anaesthesia and TAP block reported higher levels of
satisfaction with their pain relief, compared to those who received spinal anaesthesia
alone. These findings underscore the potential benefit of incorporating TAP block into
multimodal analgesic approaches to enhance postoperative pain management and
patient satisfactio
Comparing tree functional traits and species diversity along an increasing rainfall gradient in northern Namibia
No full textA thesis submitted in partial fulfilment of the requirements for the Degree of Master of Science in Wildlife Management and EcotourismChanges in precipitation patterns have the ability to affect the composition and the
variety of species within a plant community by altering their functional traits.
However, there has been a tendency to underestimate the importance of functional
diversity. This is particularly common in Namibia, despite a clear, gradient in
precipitation and where forecasts have predicted changes in precipitation regimes in
the future. This study examined how tree species diversity and functional traits
changed along an increasing rainfall gradient in northern Namibia. It employed a
quantitative approach with systematic sampling at 13 points along an approximately
1200 km transect. Tree species diversity fluctuated along the gradient and average
annual rainfall did not appear to have a significant effect, yet species diversity was
highest at sites with high rainfall. There was no statistical difference in the species
diversity among sites, but the estimated beta diversity was high. Plant functional
diversity indices and plant functional traits varied along the gradient. All three
functional diversity indices revealed weak relationships with species diversity. Among
the three functional diversity indices, only functional richness was significantly
affected by annual average rainfall. While the current study presents some contrasting
results, it remains relevant by providing an understanding of the dynamics between
plant species diversity and functional diversity. The results of the current study support
the conclusion that plant species diversity and plant functional diversity are both vital
components of ecosystem functioning, and that future research should incorporate a
wider array of functional traits and use more comprehensive data collection methods
that can build on the findings to further elucidate these complex interaction
Evaluation of the performance, quality, and effectiveness of environmental impact assessment in Namibia
No full textA dissertation submitted in fulfilment of the requirements for the degree of Doctor of Philosophy in Agriculture (Environment and natural resource management)Environmental Impact Assessment (EIA) has become an important environmental
management tool used in planning and decision-making since the 1970s. However, its
effectiveness has come under scrutiny in developing countries, where systems are often
copied from developed countries with minimal consideration of the contextual factors in
the country of implementation. Environmental protection was enshrined in the Namibian
Constitution in 1990, and EIA was formally introduced through the Environmental
Management Act (2007) and the EIA Regulations (2012). Namibia's EIA system has now
been in place for over a decade; however, little research has been undertaken to review
the functioning of this system. This study aims to assess and evaluate the status,
performance, quality, and effectiveness of Namibia's EIA system and the extent to which
it is achieving the set goals of environmental protection and sustainable development.
Data was collected through literature review and document analysis, alongside surveys
and interviews. Quantitative data was analysed using descriptive statistics and qualitative
data using thematic analysis. The study reveals that Namibia has a functional EIA system
grounded in a good legal basis, a regulated EIA process and sound institutional
arrangements. EIA in Namibia has proven to be beneficial and has had a preventive effect
on some proposed developments. However, the study highlights several implementation
weaknesses including limited and inadequate scoping, public participation, monitoring,
and implementation of the EMP. Other areas that are lacking include a lack of guidelines
on public participation, strategic assessment, and enforcement. Based on actors’
perceptions, the EIA process is inadequate, only partially satisfies good governance
principles, with poor ranks on transparency and accountability. The EIA process also
partially contributes to good environmental decisions, learning, and sustainability. The
case studies analysis revealed notable gaps including deficiencies in addressing
cumulative impacts and poor review and decision making. These weaknesses and gaps
present an opportunity to improve the system. With timely improvements and targeted
legislation reform, EIA can effectively facilitate good environmental decisions and
sustainable development in Namibia. For improvement, the Government needs to
demonstrate political will and support by mobilizing national and international funding
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required for EIA system implementation, monitoring, and decentralising EIA services to
regional and traditional authorities. Such interventions can facilitate acceptance of EIA,
environmental literacy, and the emergence of EIA champions in communitie
The implication of translanguaging on the linguistic competencies of deaf students
No full textThis current study has bridged the existing research gap through this
current systematic review of the implication of translanguaging on the
linguistic competencies of deaf studentsThe language competencies of the deaf students are key to various academic
discourses that are associated with the learning outcome of deaf students and
social interaction between deaf individuals and non-deaf members of society.
Methods to assist the deaf in building appreciable language capacities have been
encouraged in various studies. Hence, translanguaging has been found as a concept
that could influence the linguistic repertoire of deaf students but there is a dearth
of systematic review studies on the influence of translanguaging in deaf education,
this study therefore provided evidence on the implication of translanguaging
in the education of deaf students. Ten bibliographic databases were identified
and comprehensively searched for academic papers on translanguaging in deaf
education. Thirteen published articles were carefully selected for in-depth content
analysis from 5,937 academic papers. The findings revealed that there is a scarcity
of studies on translanguaging in deaf education in Sub-Saharan Africa. This study
showed that translanguaging serves as an inclusive fulcrum in deaf education.
Furthermore, findings showed that translanguaging can be delivered through a
multi-modal approach and such approach can significantly improve the language
capabilities of deaf students. Implications were advised for research, policies, and
practices of translanguaging in deaf educatio
Herding behaviour dynamics in the Namibian securities exchange
No full textA dissertation submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy in EconomicsThe main purpose of this research was to analyse herding behaviour dynamics in the
Namibian Securities Exchange (NSX) for the period 1
st January 2003 to 30th June 2023
using weekly and monthly data series. The time-varying transition probability Markov
two-Regime Switching model (MRSM) was used to estimate the equations which is able
to capture time-varying phenomenon of herding behaviour. This study employed the
cross-sectional absolute standard deviation (CSAD) proposed by Chang, Cheng and
Khorana (2000) as the proxy for herding behaviour. The first paper examined the
existence of herding behaviour in the NSX as a whole. The static results revealed absence
of herding behaviour for the period under review. However, herding behaviour was
detected in high volatile regimes after utilising the MRSM which is in line with theory
and other previous studies. Thus, management of firms listed on the NSX should improve
the flow of information and transparency in terms of disclosure of published financial
statements inorder to induce investors’ confidence and reduce herding behaviour.
The second paper examined the existence of sectoral herding behaviour in the NSX. The
results of the MRSM revealed evidence of herding behaviour for the Industrial and
Resource sectors, especially during high volatility regimes. In this regard, it is better to
come up with a larger investment portfolio in order to reach the same diversification goal
in more volatile state. The third paper examines the influence of variations in South
African interest rates and exchange rates on herding behaviour in the NSX. The MRSM
produces mixed results regarding the influence of interest rates and exchange rate
variations on herding behaviour in the NSX. Herding behaviour is found when all equity
stocks are considered, as well as for the sectors save for the Services sector. Results of
the changes in interest rates as proxied by the Johannesburg Interbank Average Rate
(JIBAR) 3 month yield rate reveal positive (negative) effect on herding behaviour. The
exchange rate as proxied by the United States Dollar (USD) to South African Rand (ZAR)
is also found to have both positive and negative effect on herding behaviour in the NSX.
Furthermore, extreme changes in ZAR appreciation and depreciation also amplified and
reduced herding behaviour in the NSX. Thus, coordination and synergy of monetary
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policies between the Republic of Namibia and Republic of South African (RSA) should
be strengthened, since changes in interest rates and exchange rates in South Africa
influence herding behaviour in the NS
An investigation of the impact of fiscal policy on economic growth in Namibia
No full textA thesis submitted in partial fulfilment of the requirements for the Degree of Master of Science in EconomicsThis study analyzed the impact of fiscal policy on economic growth in Namibia, using
annual time series data from 1990 to 2022. The study employed the Autoregressive
Distributed Lag (ARDL) estimation technique to examine the long-run relationship
between fiscal policy variables and economic growth, along with the Granger causality
Wald test to investigate the direction of causality between government expenditure and
economic growth. The economic variables analyzed included real gross domestic product
(RGDP), government expenditure (GE), budget deficit (BD), trade openness (TOPEN),
and inflation (INF). The empirical findings revealed a significant positive impact of
government expenditure on economic growth in both the short and long run. While trade
openness had a positive long-run impact, it also showed a negative short-run effect on
economic growth. The budget deficit exhibited an insignificant negative long-run impact
on growth, and inflation was not found to be a strong determinant. Furthermore, the study
found no causal relationship between government expenditure and economic growth,
indicating the absence of Granger causality in either direction. Based on these findings, it
is recommended that the government focuses on enhancing the effectiveness of the
Medium-Term Fiscal Consolidation Strategy, which was initiated in 2017 by the Ministry
of Finance and Public Enterprises to address fiscal imbalances and rising public debt,
aiming to reduce the budget deficit, stabilize debt levels, and promote sustainable
economic growt
Examining the intersections between emotional intelligence and leadership practices in higher education institutions to improve institutional success
No full textThe purpose of this paper is to look into how emotional intelligence (EI) and leadership practices help to improve higher education
institutions’ success. The paper explored ways in which emotional intelligence can promote resilience and long-term success in
educational settings by looking at how leaders with high EI contribute to institutional success. Furthermore, the paper emphasized how
EI can be used to develop long-term leadership strategies that promote the welfare of faculty, students, and the higher education
community at large. A crucial aspect of leadership practice is EI, which is the capacity of leaders to recognize how their behavior and
feelings impact those around them within the institutions. This study’s results show that emotional intelligence is a crucial and highly
relevant prerequisite for academic leadership practice in higher education institutions.
Furthermore, the study determined that the emotional intelligence qualities most relevant to academic leadership were those linked to
empathy, motivating and directing others, and appropriately handling oneself. Emotional intelligence becomes apparent as a crucial
leadership competency, highlighting how crucial it is for leaders to comprehend and control both their own and others’ emotions. Finally,
there is a constant emphasis on the symbiotic relationship between leadership and a positive school culture, emphasizing the roles that
leaders play in creating cooperative, trustworthy, and ever-improving learning environments. The researcher reviewed the existing
literature based on the research questions. This study employs a systematic review approach by reviewing existing qualitative articles on
intersections between emotional intelligence and leadership practices in higher education institutions to improve institutional success.
Findings were obtained from the reviewed articles by forming themes to make a thorough analysis and draw conclusion
Examining clinical librarians’ support for evidence-based medicine at teaching hospitals: A case study of Namibia
No full textThis study aims to identify and analyze the obstacles encountered in the absence and advantages stemming from the presence of clinical librarians within the framework of applying EBM in clinical departments at a prominent University of Namibia (UNAM) teaching hospital in northern NamibiaThis study highlights the value of evidence-based medicine (EBM) in resource-limited healthcare systems and the role of clinical librarians in promoting EBM at the University of Namibia Teaching Hospitals. By employing qualitative research techniques alongside a convenience sampling method, we can effectively gather insights and perspectives that enrich our understanding of the subject matter. The study examined the contributions of clinical librarians through literature searches, study evaluations, and training for medical practitioners. Despite challenges like limited funding, interviews with 19 participants emphasized their impact on patient care. The study recommends integrating librarians into clinical rounds, offering specialized literature search services, and developing tailored information packages to support timely decision-making. Showcasing Namibia’s successes and challenges, this paper provides a model for strengthening EBM in developing countries to enhance healthcare deliver
Factors associated with stillbirth and assessment of maternal health awareness among residents of northern Ghana
No full textA dissertation submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy in Public HealthGlobally, 14 stillbirths per 1,000 births occur annually. Most of these deaths occur in
Asia and sub-Saharan Africa. Ghana’s stillbirth rate ranges from 13 – 20 per 1,000
births. The northern zone is as high as 20 per 1,000 births. The Early Newborn Action
Plan aims at 12 per 1,000 births. This study sought to assess risk factors associated
with stillbirth and assess maternal health awareness in northern zone of Ghana to
develop a policy brief to inform strategies in reducing stillbirths. The study employed
a convergent mixed method of qualitative and quantitative approach (Case-Control
study, survey and grounded theory) among residents in the northern part of Ghana
from November 2021 – May 2023. Muti-stage sampling was used to select participants
for the survey, population proportionate to size was used for the case control, In-depth
interviews was based saturation and focus group discussions were based on availability
of respondents. Data was collected using a semi-structured questionnaire and
interview guide through focused group discussions, in-depth interviews, and records
review. Descriptive and analytic statistics were performed using Stata 16. Multivariate
logistic regression was used to calculate adjusted odds ratios (aOR) and 95%
confidence intervals (95%CI) for stillbirth. Qualitative data was analysed using the
thematic content analysis approach with Nvivo version 10. Risk factors for stillbirth
included being unmarried (aOR=9.78, 95%CI:16.48-57.98), family history of
stillbirth (aOR=2.63, 95%CI: 1.67-4.12), no patograph use (aOR=2.14,95%CI:1.45-
3.16), partner’s tobacco use (aOR=2.19,95%CI:1.16-4.16), Rhesus negative
(aOR=1.75,95%CI:1.12-2.73), sickle cell trait (aOR=2.29,95%CI:1.27-4.10), foetal
malpresentation (aOR=2.67,95%CI:1.33-5.35), eclampsia (aOR = 9.00,95%CI:2.91-
27.87) and premature rupture of membranes (aOR=2.64, 95%CI:1.17-5.95). Attending
>4 antenatal care visits (aOR=0.53, 95%CI:0.30-0.93) was protective. Overall,
22.89%(276/1206) of the women studied had good knowledge of maternal health,
47.60%(574/1206) of them had good attitude, and 89.55%(1080/1206) had good
practices towards maternal healthcare. Community members practiced both orthodox
and traditional remedies, perceived some stillbirths are caused by evil spirits.
Healthcare workers perceived their responsibilities included routine prenatal, antenatal
and postnatal care, with many facilities reporting incapacity of handling severe
maternal health conditions. In conclusion, risk factors for stillbirth in Northern Ghana
include being unmarried, family history of stillbirth, not using patograph, tobacco use,
rhesus negative, sickle cell trait, premature rupture of membrane, foetal
malpresentation and eclampsia. Knowledge and attitude on maternal health was poor
but practice was high. Maternal healthcare was influence by traditional beliefs with
mainly husbands having the right to decision making on maternal health seeking
behaviour. Healthcare workers incapacity of handling severe maternal health
conditions was identified. A policy brief has been developed to guide interventions by
Ghana Health Service with recommendations on improving healthcare capacity,
improving collaboration with traditional healers and empowering women to take up
their role before and during pregnanc
Adoption and utilisation of workplace e-learning practices in selected Namibian public sector organisations
No full textA dissertation submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy in Education (Adult Education)Recent times are witnessing a substantial increase in the adoption and utilisation of e learning for education. Furthermore, there is a growing trend of this tool effectively
used to facilitate learning and growth inside public sector organisations globally. In
this particular study the main aim was to explore the acceptance and use of e-learning
practices in a selection of organisations in the public sector of Namibia. The
aforementioned objective was achieved by the acquisition of a comprehensive
understanding of the contextual setting in which the research was conducted, as well
as a thorough analysis of factors that facilitate e-learning. The study adopted an
explanatory sequential mixed method approach comprising of quantitative research
(questionnaires) and qualitative research (interviews). The literature review revealed
gaps, theories and provided guidance on the formulation of the hypotheses and the
development of the instruments. Subsequent to the administration of the questionnaires
the follow up interviews were conducted. The framework of the study was based on
the model; Unified Theory of Acceptance and Use of Technology (UTAUT). The
model is aimed at elucidating adoption and utilisation of e-learning practices,
specifically focusing on their implementation. The sample size of 162 individuals,
consisting of managers and employees, was carefully chosen to ensure representation
across various public sector specialties and professional ranks.
Overall, the findings of the study suggest that individuals employed in the public sector
had positive view on e-learning use. The limited availability of resources directly
contributed to diminished levels of motivation, resulting in unfavourable view towards
the practice. It was found further that the literature review, questionnaires and
interviews converged since there were not much difference obtained; the methods were
rather complementary to one another. The results indicated that e-learning use in
Namibia necessitates a comprehensive and structured model. This study therefore
recommends a model that requires the meticulous development of factors to foster a
culture of e-learning use. It further recommends the development and implementation
of curricula as necessary for adoption and utilisation. The aforementioned
recommendations demand the incorporation of organisational factors within a wider
framework, encompassing guidelines and initiatives formulated by public sector
entities for the collective advantage of the Namibian public sector in its entirety.
The primary recommendation derived from this study is the conversion of Namibia
Institute of Public Administration and Management (NIPAM) into the Namibia Public
Service College, aiming to fulfil the public sector's overall educational needs. Based
on an extensive investigation into the public sector organisations in Namibia and a
thorough study of relevant literature, a proposed model has been established. The
model referred to as the Adoption and Utilisation of Workplace e-learning in the Public
Sector Organisations (AUWEPSO) is being proposed. The model exhibits the capacity
to serve as a framework for the effective adoption and utilisation of workplace e learning practices in organisations within the Namibian public sector and other
institutions with similar contextual characteristic