UNAM Gā-aisib Repository (University of Namibia)
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The effect of pharmacist-provided discharge counselling on medication knowledge and adherence among patients with cardiovascular diseases at Windhoek central hospital, Namibia
No full textA thesis submitted in partial fulfillment of the requirements for the Degree of Master of Pharmacy (Clinical Pharmacy)Cardiovascular diseases (CVDs) are the leading cause of death globally and are a major contributor to reduced quality of life(1) . According to the World Health Organization (WHO), an estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke. Over three quarters of CVD deaths take place in low- and middle-income countries. Sub-Saharan Africa is ravaged by a growing burden of CVDs (2). Hypertension (HTN) is one of the most important modifiable risk factors for cardiovascular disease. HTN, as well as, heart failure (HF) are common causes of premature morbidity and mortality. They account for about 7.5 million deaths worldwide every year, with 82% occurring in low- and middle-income countries (3). HTN is defined as persistently elevated arterial blood pressure with a systolic blood pressure more than 140 mmHg and diastolic blood pressure more than 90 mmHg (3). HTN is known as the “silent killer”, as uncontrolled HTN is often asymptomatic. Left untreated, HTN can lead to myocardial infarction, left ventricular hypertrophy, congestive HF, aneurysm, stroke, chronic kidney disease (HTN nephropathy), and HTN retinopathy (4). HF is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body’s needs for blood and oxygen (4). Both HTN and HF require lifelong use of medications to prolong life, prevent complications, and reduce hospitalizations (3). Health care workers should accompany lifelong therapy with counselling, education, and adherence support. As medication experts, pharmacist are best placed to provide this support. 2 Counselling can be valuable at any point of the patient care journey but the current study focuses on the discharge stage. During inpatient hospital stay, a patient’s medications are administered by nurses and adherence is usually maintained. However, upon discharge, the patient (or a family member) must take responsibility for medication adherence in order to achieve and maintain their health status. The safety and efficacy of medication therapy depends on the correct information being shared with and understood by patients about their medication and patient understanding of that information (5). Therefore, the pharmacist undertaking discharge counselling should possess adequate knowledge and should be an effective communicator, making use of verbal and non-verbal communication skills (5). During medication counselling patients are provided with advice and information on their medicines. Patient counselling may be verbal or written, performed on an individual basis or in groups, and provided directly to the patient or caregiver (6). One of the pharmacist’s responsibilities is to optimize the patient's medication therapy by promoting adherence through good medication counseling. Pharmacists are ideally placed to provide useful medication counselling to patients at the time of discharge due to their extensive knowledge of medications (7). Providing tailored educational counselling and adequate information about medications, such as medication indications and clear instructions on medication use, improves adherence and increases patient confidence, self-efficacy and understanding on how to take their medications (8). Previous studies suggest that direct pharmacist interaction with patients through medication reconciliation, discharge counselling, and post discharge phone calls decreases the number of adverse drug events (ADEs) and plays a positive role in transitional care (9). For example, a study done by Fernandez and colleagues on the effect of pharmacist interventions on antidepressant medication adherence in 3 outpatients concluded that patients who received a pharmacist intervention were over 60% more likely to adhere to their medication than those who did not (OR=1.6, [95% Cl 1.2 to 2.2]) (10). Furthermore, some studies(11,12) have demonstrated the benefits of interventions provided by pharmacists in improving adherence and other patient outcomes. In addition to improved adherence, pharmacists can play an important role in the prevention of readmissions by counselling patients and providing relevant medication information. A study by Jackevicius et al., showed that after acute myocardial infarction, nearly 24% of patients did not fill their medications within seven days of discharge, and one third of patients decided to stop at least one medication in the first month (13). The relationship between medication knowledge and medication adherence is complicated. Some studies suggest that improved medication knowledge improves adherence (14), although, other reports show that counselling has little or no effect on adherence (15). Providing counselling to in-patients is one of the important tasks of hospital pharmacists. This study evaluated the impact of pharmacist-provided discharge counselling on patients’ medication knowledge and adherence
Eutrophication assessment in the Kavango river system from Rundu to Divundu, Namibia
No full textA mini thesis submitted in partial fulfilment of the requirements for the Degree of Master of Science (Biodiversity Management)Eutrophication is one of the most serious problems facing freshwater ecosystems globally. Nutrient enrichment of these freshwater ecosystems results in excessive plant and algal growth that have negative effects on biodiversity and water quality. The present study was conducted at six selected sites from Rundu to Divundu along the Kavango River namely; Rundu, Mashare, Shitemo Irrigation schemes, Quito, Shadikongoro Irrigation systems and Divundu. The overall objective of the study was to assess the level of eutrophication of the Kavango river downstream from Rundu to Divundu in Namibia by assessing concentration levels of Total Nitrogen, Total phosphate and Ortho-phosphate in the water. Water samples were collected in 50 ml plastic bottles from the main flow along the Kavango river gradient. Each site was sampled upstream (Before the site) and downstream (After the site) from Rundu to Divundu. Water samples were collected 3-5 cm below the surface following United States Environmental Protection Agency standards. Sampled water was analysed for Total Nitrogen (N), Total Phosphate (P), Ortho-phosphate using Inductively coupled plasma-atomic emission spectrometry (ICP-AES). Dissolved oxygen was also measured 3-5 cm below the water surface. Simple Linear Regression was used to test the effect of distance on the concentration levels of Total Nitrogen, Total Phosphates and Ortho-phosphate. The Wilcoxon Signed Rank test was used to compare nutrient concentration levels, flow rates and dissolved oxygen before and after sites. To test for compliance with acceptable standards International Water Quality Guidelines (IWQES) and South African Water Quality Guidelines for Aquatic Ecosystems (SAWQG), one Sample Wilcoxon Signed Rank test was used for non-parametric data and one -sample t test was used for parametric data.
There was no significant relationship between concentrations of Total Nitrogen and Total phosphate concentration in the Kavango river and the distance downstream from Rundu to Divundu. However, there was a significant relationship between the concentration of Ortho-phosphate (mg/l) and distance along the Kavango River (p= 0.028; R 2 =0.42971). Furthermore, there was no significant difference in concentrations of Total nitrogen, Total phosphate and Ortho-phosphate. The study also revealed no significant difference in flow rate and dissolved oxygen before and after the sampled sites. Total Nitrogen concentration in the River was significantly lower (p = 0.001) than the allowable general standards limit of 0.3mg/l set by US EPA (2000), and lower than the allowable concentration limit of 2.5mg/l as set by South African Water Quality Guidelines for Aquatic Ecosystems, Department of Water Affairs and Forestry (1996) value (p = 0.001). Although the observed Total phosphate in the Kavango River were significantly higher (p = 0.000) than the allowable general standards Total phosphate concentration limits of (0.1mg/l) set by US EPA (2000), the same Total phosphate concentrations were significantly lower (p = 0.001) than the allowable concentration limit of 2.5mg/l as set by South African Water Quality Guidelines for Aquatic Ecosystems, Department of Water Affairs and Forestry (1996). Total Phosphate concentrations of the Kavango River are below the acceptable regional limit, but do not comply with the standards set by the USEPA. However, the concentration of Ortho-phosphate in the Kavango River was significantly lower (p = 0.002) than both the allowable concentration limit (0.1 mg/l) as set by South African Water Quality Guidelines for Aquatic Ecosystems, Department of Water Affairs and Forestry (1996) and the allowable standard set by US EPA (2000). This study highlights the need to continually assess the nutrient concentration levels in the Kavango River to ensure that the nutrient loads are within the set regional and international guidelines, especially in this age where human population as well as the number of irrigation schemes in the area continue to increase
Investigating the effect of perceived training and development on employee performance: Moderating role of motivation
No full textA mini thesis submitted in partial fulfilment of the requirements for the Degree of Master of Business Administration (Public Sector Management)This study investigates the effect of perceived training and development on employee performance: moderating role of motivation at the City of Windhoek (CoW) in Namibia.The primary objective of this research was to investigate the effect of perceived training and development on employee performance. The specific objectives of the study were to determine the effect of perceived training and development on employee performance at the CoW, to determine the effect of perceived training and development on employee motivation at the CoW, to determine the impact of motivation on employee performance at the CoW and to test the moderating effect of motivation on the relationship between perceived training and development and employee performance at the CoW. Descriptive
research design was adopted and case study done on chosen organisation. Conveniencesampling technique was used and a total of 762 staff members were chosen from a total population of 2547 staff members. Structured questionnaires were used to gather data from CoW employees. The study revealed that, generally, employees at the City of Windhoek expressed no clear pattern of how they perceive the training and development programmes. Thus, two recommendations are made, firstly, it is recommended that the management at the City of Windhoek undertake a systematic review of the training and development policy, secondly, it is recommended that the City of Windhoek undertakes a comprehensive review of the training and development curriculum
Assessing the impact of floods on food security in the Zambezi region: A case study of the Ikaba area
No full textA mini thesis submitted in partial fulfilment of the requirements for the Degree of Master of Arts (Security and Strategic Studies)The present empirical study was conducted in the Ikaba area of Kabbe South Constituency (KSC) of the Zambezi Region, an area with a long and known history of persistent floods annually. Studies on flood and food security relations primarily focus on four dimensions of food security and have hardly received any attention from researchers, which is the reason that motivated this study. This study was aimed at assessing the impact of floods on food security by reviewing the lived experiences of those affected by flood in the Ikaba area of KSC. The
present study used semi-structured interviews to collect data from a sample of 14 households that consisted of 9 to 23 people and 4 key informants in the Zambezi region who occupy keystrategic positions.
A qualitative research approach was used, supported by the phenomenological research design. Data was analysed using thematic analysis to make sense of the participants’ accounts of the impact of the floods on food security. The study’s findings reveal that crop damages have been a recurring and uncontrolled phenomenon in the Ikaba area due to prevalent floods causing premature harvest, consequently affecting food availability. Besides, it has been found that accessing markets during flood time for all kinds of food is an unrealised endeavour, mainly
due to a lack of proper road infrastructure in the area. In the end, food accessibility has become one of the food security dimensions that have been affected.
The study further discovered that insufficient nutritious food has become a recurring trend within the Ikaba community regarding food utilisation. In addition, food utilisation was found to be affected by poor health status caused by contaminated food and water which comes with high health risks due to the floods. While food supply chain disruption affects food stability, the study also concluded that lack of food retailers and failure to access Agri-loans due to a lack of collateral by community members in the area affects food stability. The study concludes
that the Ikaba area inhabitants suffer from acute food insecurity. Not all people in the area have both physical and economic access to readily accessible, sufficient and suitable food to meet their dietary needs for a productive and healthy life.
In conclusion, the present study recommends the construction of permanent road infrastructure in the KSC to link the residents of Ikaba to the outside world, especially to markets. Also, the construction of a diversion canal, planting of early maturing varieties, improved access to affordable loans have been noted in the study as prospective coping strategies that may ameliorate the impact of floods on food security
Phytochemical analysis and acetylcholinesterase inhibition activity of medicinal plants used in the traditional treatment of mental disorders in Kavango east region of Namibia
No full textA mini-thesis submitted in partial fulfilment of the requirements for the Degree of Master of Science (Chemistry)In Namibia, various plants are used in the treatment of various illnesses in traditional healing systems, however the majority of these plants have not been characterised in terms of chemical constituents, and therefore, their safety and efficacy are unknown. The present study focused on the phytochemical analysis and evaluation of the acetylcholinesterase (AChE) inhibition activity of the extracts of five medicinal plants (Laggera decurrens, Ficus glumosa, Psendolachnostylis maprounifolia, Ochna pulchra and Ozoroa longipes) used in the traditional treatment of mental disorders in Kavango east region. Extracts were prepared from the powdered roots and leaves of the plants using dichloromethane/methanol (50/50, %v/v) and ethanol. Extracts were screened for the presence of alkaloids, saponins, diterpenes and flavonoids using standard methods. Saponins, diterpenes and flavonoids were found to be present in all the extracts, except for the leaves of O. longipes, while no alkaloids were detected in any of the plant extracts. Diterpenes appeared to be the most abundant phytochemicals for most of the samples. Leaf extracts exhibited varying levels of AChE inhibition activity. The L. decurrens proved to be the most potent plant species with percentage inhibition ranging from 74–101% for the dichloromethane/methanol (DCM/MeOH) extract and 93–106% for the ethanol extract. The highest inhibition percentages were observed at concentrations of 200 and 100 µg/mL for the DCM/MeOH and ethanol extracts respectively. Compounds were be tentatively assigned to chemical classes based on their ultraviolet absorption spectra. Future studies should employ spectroscopic techniques such as mass spectroscopy (MS) and nuclear magnetic resonance (NMR) spectroscopy to identify the chemical compounds present in these extract
Physical science teachers’ pedagogical knowledge and practices of inquiry method at three selected senior secondary school level, Khomas education region
No full textA thesis submitted in partial fulfillment of the requirements for the Degree of Master of Education (Science Education)The main purpose of this study was to investigate the Physical Science teachers’
pedagogical knowledge and practices of inquiry method at three selected senior
secondary school level in the Khomas education region, Namibia. This study
employed a qualitative, exploratory research design to explore the pedagogical
knowledge and practice of Physical Science teachers regarding inquiry method. The targeted population for this study was 104 Physical Science teachers in 34 senior secondary schools in the Khomas education region.
Extreme case sampling method was used to select one secondary school among the top ten performing schools and two secondary schools that were at the bottom of the rank in the Khomas education region for the NSSCO Physical Science results of the year 2018. Purposive sampling was used to select two Physical Science teachers at each school on the basis that they have taught Physical Science for more than three years.
Among the three participated schools, only one teacher from the second bottom
performed school and two teachers from each of the other two schools agreed to take part in the study. Hence, the total sample of this study consisted of five (5)
participants. Three research instruments were used namely: a questionnaire,
observation checklists, and structured interviews/ schedule. After the collection of data and coding, qualitative thematic analysis method was employed to analyse and interpret the data.
The findings from this study revealed that all the participants used the inquiry method when teaching Physical Science, of which four (4) of the participants had received training on how to use the inquiry method during their teachers’ training at the university or college. However, only one participant was not trained to use the inquiry method. The findings from this study also revealed that Physical Science teachers needed further training on the inquiry method of teaching. The participants suggested that continuous professional development should focus on how to use inquiry method in large classes and with learners of different abilities. This study recommended that the Ministry of Education, Arts and Culture together with the National Institute for Educational Development (NIED) should provide workshop trainings to Physical Science teachers on the use of the inquiry method. Further research should also be conducted to investigate the impact of the inquiry method to learners’ academic achievement in Physical Science
Eviction of families from Nkarapamwe black township houses in Rundu, north-east Namibia, 1970
No full textAn interest in a history of colonial eviction of families from Nkarapamwe Black Township houses of Rundu in north-east Namibia, along the Kavango River boundary with Angola in 1970, was inspired by the need to contribute to histories of colonial evictions in Namibia and Southern Africa generally. This paper is originally based on a chapter in a Master’sthesis by Likuwa in 2005 detailing Rundu removals.1Inter alia, as an urban space in north eastern Namibia, Rundu has relatively a recent history. Although the first assistant native commissioner Mr. RenéDickman (aka Kayuruor Shongola) was posted to Kavango at Nkurenkuru in 1922, it was only on 16 September 1936 that an Assistant Natives Affairs Commissioner Harold Eedes (aka Nakare) opened office doors at Rundu where he operated until 1946after which he was replaced by. Mr. Morris (1946-1954). It was however during the tenure of Mr. DaveMaree (1958-January 1970) as a Bantu Affairs Commissionerthat Kavango people in Rundu were first relocated from the riverside villages into Nkarapamwe Bantu Township by 1968.2By 1970, at the times of the Nkarapamwe evictions, Mr. Van Niekerk served as theBantu Affairs Commissionerfor barely a year(February-December 1970). The history of Rundu as an administrative town is thus situated in colonial development and security schemes, such as contract labour supply, Odendaal Commission Plan and the so-called counter-terrorism or surveillance concerns necessitated the removal or evictions of people in Rundu.3Colonial evictions were extensive during the Apartheid period in both South Africa and Namibia and, in the case of South Africa, such history is widely documented.4Uma Mesthrie, for example, focused on the experiences of forced removals by Coloured and Indian residents from Sea-point and she placed the eviction in the broader context of evolving policy, legislation and institutional structures for imple-menting forced resettlement of communities in the name of the Apartheid ideology.5In South Africa, as in Namibia, the eviction of ‘squatters’ from land during apartheid both involved the use of legal procedures and institutions to protect property interests, however, in the period following the abolition of apartheid, this logic was not abandoned and seemingly, liberty was acquired at the price of economic subjugation.6Racial discriminatory laws such as the Groups Areas Act of 1950 and other laws such the Squatters Act were identified as the reasons for the various evictions in the urban areas of South Africa and Namibia during the colonial and apartheid period.7However, these reasons were most often a time disguised by the colonial authorities who instead justified the evictions of the local African residents. 1Kletus Likuwa, “Nkarapamwe, new beginning and endings”, in:idem, Rundu, Kavango: a case study of forced relocations in Namibia, 1954 to 1972, unpul. MA thesis, Cape Town, UWC, 2005:52-72.2Kletus Muhena Likuwa, “Colonial relocations in Northern Namibia: from the Riverside village to Nkarapamwe Black Township in Rundu”,European Scientific Journal, Special edition, 2014: 605-615.3Shampapi Shiremo, Vamama’sHistory and Heritage: ‘Forgotten’ History of Namibia, Windhoek, Meinert, 2020: 1-34.4Alan Baldwin, “Mass removals and separate development”, Journal of Southern African Studies, 1 (2), 1975: 215-227.5Uma Duphelia Mesthrie, “The tramway road removals, 1959-61”, Kronos, 15 (21), 1994: 61-78.6Andries Jacobus Van Der Walt,“Rendition/eviction, apost-apartheid reflection” Law and Critique, 15(3), 2004:321-344.7Cosmos Desmond, The Discarded People: An Account of African Resettlement in South Africa, Harmondsworth, Penguin, 197
Examining the effects of understaffing on employee performance at the forensic pathology division, Namibia police force
No full textA thesis submitted in partial fulfilment of the requirements for the Degree of Master of Business Administration (Management Strategy)The study sought to examine the effects of understaffing on employee performance at the Forensic Pathology Division of the Namibia Police Force. The main objectives of the study were to find out the effects understaffing has on employee performance, the factors that lead to understaffing and the effects of staff shortage on employee workload at the Forensic Pathology Department. The study employed both quantitative and qualitative research approaches in which the questionnaires and interviews were the main data collection instruments. One hundred and three questionnaires were administered in the Police Department in Oshakati. Probability sampling and non-probability sampling methods were employed to select the participants from the sample frame. The data was analysed using SPSS which assist in data presentation. Content analysis method was used to gain better understanding of qualitative data from interviews. The study revealed that excessive workload, lack of incentives at the mortuary, poor working conditions and lack of understanding on the essence of working at the mortuary as well as lack of opportunities for growth and advancement were amongst the key reasons why staff shunned the Forensic Pathology Division leading to understaffing. The study further concluded that understaffing had an effect on employee performance in terms of
the hectic working environment which increased staff dissatisfaction and decreased staff morale leading to poor performance. It was also concluded that understaffing leads to work overload that leads to further abandonment of other tasks resulting in poor performance. The study recommended that the Forensic Pathology Division should find ways of improving remuneration and compensation schemes for employees in an endeavour to minimise labour turnover. The Division should recognise excellent work and institute various motivation and retention strategies which make staff fulfilled while attracting new members to join the division
Examining strategy implementation at the Namibian ports authority
No full textA thesis submitted in partial fulfilment of the requirements for the degree of master in business administration management strategyThis study aimed at examining strategy implementation at NamPort for the year 2014 to
2019. This study adopted a mixed -methods approach. The study limits itself to NamPort
employees covering a population of 120 participants. A pilot study was done to make
strides on validity and reliability. Literature from different analysts was consulted to guide
strategy implementation and get managers’ valuable suggestions on their industry. The
closed ended questions response of the management staff were analysed with the aid of
ATLAS.ti. Qualitative data analysis were presented in tables. Stratified random sampling
was utilized to choose the sample sizes for the study. This study was limited to NamPort’s
employees and the Board of Directors. The data collection procedure for this study
required participants whom in one way or the other formed part of the strategy formulation
and/or implementation that NamPort embraced for the period 2014-19. The challenges to
the strategic implementation process were noted to be ageing of equipment, staff members'
discontent and poor corporate culture. Findings from the study revealed that the strategy
implementation at NamPort for the year 2014 to 2019 was influenced by the organisational
culture and the legal requirements. The research recommends that NamPort creates a
communication plan to address challenges experienced during the strategy
implementation proces
Evaluation of the implementation of the national policy for school health in Namibia
No full textA dissertation submitted in fulfilment of the requirement for the Degree of Doctor of Philosophy in Public Health at The University of South AfricaBackground: A school health policy is intended to improve learners’ quality of life; however, three challenges are faced in the policy implementation: i) low coverage of health assessments; (ii) poor and inequitable nurse-to-school ratios; and (iii) the lack of data collection. Purpose: The purpose of this study was to evaluate the implementation of the national policy for school health in Namibia with the view of proposing a framework to strengthen the national school health policy (NSHP). Setting and population: The study was conducted in three regions of Namibia. The population from which the study’s sample was derived comprised school principals, primary healthcare supervisors and NSHP national and regional managers in the Khomas, Oshana and Kavango regions of Namibia. Methods: A sequential, exploratory mixed-methods design was used for this study to evaluate the NSHP’s implementation across management levels, schools and health facilities in the country. A purposive sampling method was used to select participants for interviews and focus group discussions in the qualitative strand. Non-probability convenience sampling was used to select respondents for the quantitative strand’s structured questionnaires. Quantitative data from completed structured questionnaires (n=300) were analysed using SPSS. Thematic analysis was used to derive themes and subthemes from the qualitative data. Results: Qualitative findings indicated a lack of skilled staff, training, equipment and recordkeeping as factors contributing to non-compliances with the NSHP’s implementation. These findings were further described statistically by the quantitative results. The quantitative results indicated a correlation between job position and work experience in the policy’s implementation. This was revealed by the study findings that managers at the national level (n=66; 100%), had sufficient knowledge and better attitudes towards the NSHP. Also, employees with more than 10 years of experience (n=114; 60.3%) had good knowledge of the policy (variation). The findings indicated poor implementation of NSHP interventions, thus assuming low compliance with Namibia’s NSHP. The results show that eighty-one (n=81; 71.1%) and (n=63; 52.5%) schoolteachers from urban and rural schools indicated negative attitudes toward school health policy implementation, respectively. The results indicate that nurses who conducted health programmes at the time were completely uninformed of the NSHP (n=102; 68%), had not implemented NSHP or had never even seen the policy document. Development of conceptual framework: The qualitative and quantitative results and literature review contributed to the formulation of an NSHP implementation conceptual framework in Namibia. The framework consists of monitoring and evaluation strategies to enhance the school health policy’s implementation. Conclusion: The study reflected a gap between policy knowledge, attitudes and implementation of the NSHP. Insufficient documentation of interventions led to poor reporting in the database system. Based on the findings, a framework was formulated to improve implementation and compliance with the NSH