UNAM Gā-aisib Repository (University of Namibia)
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A model for health professionals to facilitate a wellness program in the state health facilities of Oshikoto region, Namibia
No full textA dissertation submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy (Public Health)The purpose of this study was to develop a model for health professionals to facilitate a wellness program in the state health facilities of Oshikoto Region in Namibia. A significant number of health professionals experience psychosocial, physical and personal challenges in the workplace, which has necessitated the development of this proposed model. However, the development of the model required concepts that are derived from empirical data. To achieve that, the study design involved a convergent mixed method approach which required both quantitative and qualitative methods of data collection and analysis. The study was conducted in four phases. Phase 1 involved identification and analysis of concepts focusing on: (1) assessing the state health facilities in terms of the facilitation of wellness programs, using a checklist, (n=3) which were purposely selected; (2) describing knowledge, practices and experiences of health professionals with regard to the facilitation of a wellness programs, using self-administered questionnaires, nurses (n=147) who were randomly selected through stratified sampling; doctors (n=17) who were conveniently sampled and (3) exploring and describing perceptions of health professional managers regarding facilitation of wellness programs, using in-depth interviews, (n=6) which were purposely selected and all- inclusively sampled. The findings revealed that health professionals are faced with organizational challenges such as unavailability of wellness policies, unavailability of wellness program and lack of consultation for staff recruitment; resource challenges such as staff shortage, inadequate facilities and equipment; psychosocial challenges such as insufficient support from management, stress, scope of practice issues and workload; and personal challenges such as inadequate knowledge on wellness program, illnesses and lack of self-care in the work environment that hinder the facilitation of wellness programs. Using the WHO Framework and model (2010), psychosocial, physical and personal environment concepts were identified as the main central concepts and as a guiding tool to develop this model. These concepts form the basis of model development. The WHO framework and model (2010) guided the identification and analysis of concepts; and the Practice Oriented theory of Dickoff, James and Wiedenbach (1968) was used to describe the identified concepts. Phase 2 involved the construction of the relationships statement. To achieve this, the Practice Oriented theory of Dickoff et al. (1968), WHO framework and model (2010); and Fayol’s Management theory (1920) were adopted to guide the construction of the relationships statements v that formed the basis for the development of a model. Phase 3 involved the description and evaluation of the model. A model for health professionals to facilitate wellness programs was described according to Chinn and Kramer’s descriptive components in terms of its purpose, structure (assumptions, definitions of concepts, relation statements and nature) and process. Three phases of the model were identified, namely: needs assessment, managing and maintaining a conducive environment and outcome. The model was evaluated using Fawcett’s six criteria (significance, internal consistency, parsimony, testability, empirical adequacy, and pragmatic adequacy) of evaluating nursing theories. Phase 4 involved the development of guidelines for operationalization of the model, based on the needs identified from the study findings, to guide the Ministry of Health and Social Services (MoHSS), health professionals and all stakeholders in the facilitation of wellness programs. Guidelines were developed to direct the effective implementation of the model that would facilitate the wellness program in the state health facilities. Based on the study findings, recommendations were made to the policymakers, regulatory body, MoHSS and management respectively, to develop a comprehensive and inclusive wellness policy to institute a wellness program in the state health facilities; revise the scope of practice for nurses; establish a wellness directorate at the national level; advocate for and facilitate psychosocial, physical and personal support to enable health professionals cope with challenges in their work environment. Future research is recommended on implementation and evaluation of the effectiveness of the model and guidelines that has been developed
Analysing the effects of debt financing on fiscal sustainability of the City of Windhoek
No full textA thesis submitted in partial fulfilment of the requirements for the Degree of Master of Business Administration (Management Strategy)Municipalities' capacity to stay financially viable will determine their long term viability. Well-managed municipalities provide evident positive outcomes that are critical to guaranteeing the continued provision and maintenance of high-quality, affordable services for all residents in their jurisdiction.
Municipalities that rely heavily on transfers and grants from the federal government are unlikely to run up huge debts. As a result, they are exposed to financial and sustainability hazards. However, the mounting debt levels reported in the Municipality of Windhoek financials is a source of concern since it may eventually reach unsustainable levels. This study's main objective was to investigate the impact of debt financing on the City of Windhoek's fiscal sustainability. Accordingly, the study explored the factors that influence fiscal sustainability in Windhoek in order to understand the underlying causes of the Windhoek Municipality's rising debt burden.
The study adopted a quantitative explanatory research design that used secondary
data from financial audit reports for the period 2008 to 2019. The data was then computed into indicators based on literature and transformed into logarithmic ratios using Principal Component Analysis (PCA) and Dendrograms. The study then used temporal causal modelling and ARDL model estimation to establish the nature of relationships between fiscal sustainability and debt burden indicators within the context of financial independence. The study found evidence of both long-term and short-term relationships between fiscal sustainability, debt burden, and financial
independence. However, the long-term relationships were not statistically
significant. The study concludes that fiscal sustainability in the City of
Windhoek is dependent on expenditure coverage ratios, debt burdens related
to non-statutory funds, budget deficits, and employee benefit liabilities. The
study recommends that the municipality must focus on diversifying their
revenue streams and revise their long-term investment strategy
Assessment of death notification and registration process: Case study of Rundu district in Kavango east region, Namibia
No full textA mini-thesis submitted in partial fulfilment of requirements for the Degree of Master of Applied Field EpidemiologyMortality information is most directly valuable in the health sector. They help to identify high mortality areas and high-risk groups in the population. They are necessary to determines health services and the mostly needed relevant interventions that are likely to have great impact. Vital registration systems provide an ongoing record of demographic events, such as births and deaths. It is requirement of the country’s law to register all deaths with the Ministry of Home Affairs, Immigration, Safety and Security (MHAISS). The same ministry is the custodian of the National Population Register. The National Population Register contains records of births and deaths. Citizens are to report deaths, which took place outside health facilities to the police at local Forensic Pathology Units. The study used a Case Study methodology whereby Key-Informant Interview mapped out the business processes of death notification and registration in Rundu District. The study reviewed randomly selected notified death cases and assessed them for completeness and usefulness using the ICD-10 criteria. The quality of the data was determined using the Vital Statistic Performance Index (VSPI). The quality of the data determined four data quality attributes namely: completeness, accuracy, consistency and timeliness. The quantitative results shows that the number of registered deaths rose dramatically after the introduction of electronic death notification (e-death notification). Contrary, incompleteness in death reporting and registration systems resulted due to a variety of reasons. Among others includes poor access to serviceable facilities and lack of information on how and where to notify and register deaths. Since the year 2018, district hospitals and the department of Civil Registration (CR) offices were responsible to capture timely records on the electronic National Population Register (e-NPR). The Ministry of Health and Social Services (MoHSS) aggregate information on deaths that occurred at public health facilities. Such records do not include deaths occurred at private hospitals, households, violent and accidental deaths. There is a need to improve the coordinated system in terms of data quality in order to enhance credibility and validity of conclusions drawn from them. An improved law is required to facilitate the creation of a complete and accurate electronic National Population Register (eNPR). The evaluation of the data quality is integral in providing end users with credible understanding from the analysis of notified death in order to improve the CR system
An analysis of financial development and economic growth nexus evidence from the South African Development Community
No full textA thesis submitted in fulfilment of the requirements for the degree of Master of Science (Economics)While there is vast evidence on finance-growth literature, the lack of consensus in the literature calls for continuous, renewed and more robust evidence. This study extends the empirical analysis of finance-growth nexus, by examining the possible non-linear relationship that could exist for the SADC region. The study analysed the impact of financial development on economic growth using annual panel dataset for 16 SADC countries from the period 1995 to 2019. The study used three proxies for financial development, namely, broad money, domestic credit to private sector, and domestic credit to private sector by banks. The study employed the system generalized method of moments (SYGMM) to address panel estimation problems, such as the presence of unobserved country specific effects, common time effects and potential endogeneity. The study found that liquid liabilities and domestic credit to the private sector have a negative and significant relationship with economic growth. The study found no non-linear relationship between financial development and economic growth when domestic credit to the private sector and liquid liabilities are considered. However, the results suggest an inverse U-shaped relationship between domestic credit to the private sector and economic growth. The results show a uni-directional causality between economic growth and financial development, confirming the demand-following hypothesis in the SADC region. For SADC to support growth through financial development, there is need to promote reforms that will address factors hindering the potentials of financial development in stimulating growth. This includes adopting appropriate policies that improve innovative financial infrastructure and promoting sound regulatory frameworks. In addition, it is recommended that pro-growth policies be strengthened so that growth subsequently pulls with it financial development
The effects of drought on household food consumption: A case of Okahauyulu and Eeshoke villages in Engela constituency, Ohangwena region, Namibia
No full textA thesis submitted in partial fulfilment of the requirements for the Degree of Master of Arts (Development studies)The increasing of drought instances in Namibia has had a devastating effect on people’s livelihood, particularly in the arid and semi-arid parts of the country. Faced with an increasing frequency of droughts, the local communities of Okahauyulu and Eeshoke Villages are constantly at risk of food insecurity, which exacerbates their food consumption during the times of drought due to their dependence on rain-fed agriculture. The study investigated the effects of drought on household food consumption, using a case study of Okahauyulu and Eeshoke Villages in Engela Constituency of the Ohangwena Region. The study was guided by the following objectives: to investigate and compare the household food consumption patterns during drought and non-drought periods; to explore the challenges that households faced in coping with the food shortages in the past drought; and to examine the coping mechanisms/strategies employed in instances of food shortages during the drought periods. A mixed methods approach, drawing on both qualitative and quantitative research methods was employed, which exposed the study to a rich data set. To meet the quantitative dimension, a total of 86 households were selected through stratified sampling and 14 participants purposefully sampled as key informants for the focus group discussion to meet qualitative objectives. The study exposed that during normal periods, households have adequate food to consume and they sell surplus food to cater for other household necessities. It is also emerged that, during trying times, households lack enough food and as such, they deviate from normal consumption patterns and resort to skipping meals. Moreover, the findings revealed that the main coping mechanisms employed included reducing the quantities of meals served, destocking livestock, seasonal migration by men to the ohambo (cattle post), salaried casual labour, basket weaving and extraction of Marula oil by females, reliance on the government drought relief food, and support from family, friends and community network ties. However, the study found that the coping strategies employed were not adequate to curtail the effects of drought on households’ food consumption in the study area. Thus, evidence suggests the need for the government to install water tanks at every household so as to harvest water during the rainy season, excavate earth dams which can be lined with trampolines, provision of diversified drought resistant seeds, conservation agriculture, and capacity building of households through subsided education
An assessment of social protection and the living conditions of the elderly: A study of Omatunda village, Ohangwena region
No full textA research submitted in partial fulfillment of the requirements for the Degree of Master of Arts (Development Studies)In Africa, ageing is a phenomenon that is just beginning to reveal its shape. Most
governments, including the Government of the Republic of Namibia, acknowledge the increasing number of older persons. Social protection interventions usually include measures to provide adequate housing and nutrition, ensure access to education, health and promote social inclusion and political stability. The lack of access to social protection constitutes a major obstacle to the socio-economic development and wellbeing of the elderly.
This was a mixed method descriptive design: a study of Omatunda village, Ohangwena Region of Namibia. The primary objective of the study was to determine
the extent to which the Namibian social protection scheme affords to bring a decent
living for the rural elderly people in Omatunda village. Purposive sampling was used
to select a sample from the population of elderly people above the age of 60 and living in Omatunda village rural Namibia.
The results show that about 76% of the respondents were female, while 24% were
male. The majority of the respondents 47.6% were between the ages of 70 – 79 years.
The majority of the respondents 52.4% were married and 23.8% were a widow.
Furthermore, 14.3% were never married, while 9.5% were divorced. About 100% of
the elderly people interviewed were receiving Government grant (pension) every
month as their main source of income, however, only 43% were satisfied with the
amount they are receiving, they perceived the social assistance grant as enabling them to provide the necessities of life and to pay their grandchildren’s school fees. However,about 57% of the elderly were displeased with the grant, which means 48% were neutral and 9.5% were unsatisfied at all. The study revealed that the respondents do use pension funds for a lot of their basic needs, however, noted that all the needs are not covered. Furthermore, the study revealed that there is a public health facility in the area where elderly people are receiving medical care free of charge, only 57% were satisfied with the health service to them, 43% were not satisfied due to long waiting time in the queue as well as the frequently stock out of essential medicines.
Although the study revealed that the general health condition of the majority of the
respondents is reported to be good, this does not mean that they are unrestricted from challenges. Like many other people, elderly people are faced with numerous
challenges which are both social and economic. The study concluded that the old-age pension fund is regarded as a most vital source of income for many households and it is used to improve the living condition of the elderly
An investigation of the relationship between public infrastructure investments and fiscal sustainability in Namibia
No full textA thesis submitted in partial fulfilment of the requirements for the Degree of Master of Science (Development Finance)The study investigates the relationship between public infrastructure investment and fiscal sustainability in Namibia. The study aimed to determine whether there is a link between public infrastructure investment and fiscal sustainability indicators, such as the budget deficit, public debt, and growth. The study uses indicators of fiscal sustainability to highlight the ability of the Namibian public sector to meet its financial obligations, as well as determine the direction of causality and establish if they have any long-run relationship with public infrastructure investment. The study employs a combination of three dynamic estimation models for robust estimates of co-integration regression derived from empirical evidence for 25 years from 1994 to 2019. There is evidence of a causal relationship between public infrastructure investment and fiscal sustainability indicators (Budget Balance, Public Debt, and Growth). In addition, the study found that public infrastructure investment (PII) had a significant unidirectional positive long-run relationship with GDP growth and budget balance, while total public debt had a bidirectional negative relationship with PII in the long run. The study revealed a short-run unidirectional positive relationship between public infrastructure and total public debt, as well as a negative short-run relationship with budget balance. The research confirmed the existence of causal linkages and established their magnitudes and directions. Thus, it advises that modelling thresholds be concentrated on assisting decision-making for development finance planning and resource mobilisation sustainably
Social media classifications for impactful marketing
No full textSocial media usage and applications are on the upsurge. Marketers must synchronize advertising content, consumer profile and social media applications for impactful advertising. Nevertheless, social media applications proportionally grew in numbers and types giving both marketers and consumers endless options and creating confusion in choice. This study used factor analysis to classify social media into three classifications marketers can use to target consumers during social media marketing campaigns. The study suggested novel practical marketing stratagems for social media marketing practitioners. This study pursued a positivist research philosophy. In particular, an empirical research methodological approach was adopted for this study. The reliability of the scales in the research instrument was tested using the Cronbach alpha coefficient. Systematic random sampling was employed to reach a sample of 355 consumers. A self-administered questionnaire was used to collect data. Structural Equation Modelling (SEM) was used to perform regression analysis in validating the research model. Findings revealed three types of social media exist, formal, informal and entertainment social media. Formal social media being the main social media is influenced by entertainment social media and informal social media. In addition, informal social media platforms are WhatsApp, Twitter Instagram, Facebook, and others. While entertainment social media platforms are YouTube and Snapchat. Future research can focus on social media products for marketing as well as focused social media on age marketing. Future studies can determine the relationships between age versus focused social media usage and product versus focused social media correlations
Exploring the adoption of social media marketing among Namibia Stock Exchange listed companies
No full textThis study focused on examining and understanding the factors that influence the adoption of social media marketing among Namibia Stock Exchanged Listed Companies. The paper undertook an exploratory research design and a qualitative research approach to collect data from a target population of 38 companies of
Namibia Stock Exchanged Listed Companies through interviews via zoom meetings, telephonic conversation and emails. It was discovered that companies understand what is social media marketing and its potential with regards
to brand image, customer awareness and ease of customer and prospect reach. As per participants interviews, factors such as brand awareness, customer care, customer´s feedback, competitive advantage, financial return in the form of growth in sales, where some of the benefits that social media marketing has brought to their business so that for some companies a social media marketing manager is being taken into consideration as a permanent position. On the other hand, irrespective of what some companies might know about social media marketing, its usage is not part of their marketing strategic objectives. The fear to go through the hurdles of employing new technologies, organisational influences (top management), the competitive environment in which companies operate have a strong influence on the adoption of social media marketing
Development of strategies for registered nurses to facilitate services rendered by community health workers in Hardap, Kavango east and Khomas regions, Namibia
No full textA dissertation submitted in fulfillment of the requirements for the Degree of Doctor in Nursing ScienceWith the adoption of the community health worker programme, the primary health care directorate of the ministry of health aimed at delivering family and community-centred promotive, preventive, rehabilitative and basic curative services to all citizens of Namibia. The programme’s services focused on preventive and promotive infant and under-five-year-olds’ health care, maternal and neonatal health care, adolescent and youth-friendly health services, human immunodeficiency virus and acquired immunodeficiency syndrome and tuberculosis prevention, social welfare and disability prevention. However, no functional unit with its own ideal structure for monitoring and facilitation of community health workers’ services was established. The latter resulted in the programme experiencing challenges with the planning of facilitation strategies that would enhance the programme’s effects.
The overall purpose of the study was to investigate the effectiveness and functionality of facilitation (mentoring, supervision, monitoring, evaluation and training) by the registered nurses to the community health workers deployed by the ministry in the Hardap, Kavango East and Khomas regions of Namibia. It was also to develop strategies for registered nurses to facilitate services rendered by CHWs based on Standard Operating Procedures Guidelines of primary health care. This study was conducted in a quantitative and qualitative nature, thus a mixed methods approach in five phases. Phase1 being a situational analysis, phase 2 conceptual framework development, phase 3 strategy development and phases 4 and 5 comprising testing the implementability and preliminary evaluation of the developed strategies in the Khomas region. The study was conducted within a pragmatist
paradigm, which employed the quantitative research approach, exploratory, descriptive, and non experimental designs. At the same time, it was interpretive, employing a qualitative phenomenological, exploratory, contextual and descriptive research approach to understand recipients’ experiences.
Four groups of respondents (138 community health workers for the quantitative design, three primary health care supervisors, 10 registered nurses and 64 community health workers for the qualitative design) were used to learn their responses and experiences. Structured questionnaires were completed
for the quantitative part, while eight focus group discussions were performed with community health workers. Unstructured in-depth interviews were conducted with registered nurses and primary health care supervisors until data saturation.
The main challenges that were identified from the situational analysis include, inadequate and infrequent facilitation of community health workers’ services, negative perceptions on facilitation of community health workers’ services and insufficient communication among implementers.
Furthermore, the findings indicated lack of feedback and training, lack of supportive supervision, monitoring and evaluation and poor management of the community health worker programme.
The findings shaped the basis for the conceptualisation in phase 2. Key findings from the mixed methods research were linked to the practice-oriented theory of Dickoff, James and Wiedenbach (as cited in Chinn & Kramer, 2015). The practice-oriented theory consists of concepts such as agent (the researcher), the recipient (registered nurse who will primarily be introduced to the developed strategies
and community health workers who will benefit from registered nurse knowledge on strategies) as well as the context (health facilities where the developed strategies are to be used and communities where community health workers are deployed and where facilitation will take place). In this study, dynamics refer to the challenges that registered nurses experience in facilitating services rendered by community health workers. Procedure refers to the process followed by the agent in the development of strategies for effective implementation of the community health worker programme. The terminus refers to facilitators and supervisors who utilise the developed strategies to facilitate the services rendered by community health workers, ensure the community health worker programme is managed appropriately and functioning optimally, and that community health workers are receiving in-service training and are satisfied with the facilitation of their services. Phase 3 dealt with the development of the strategies for facilitators of the community health workers. The researcher used the findings from the situational
analysis (phase 1) and the survey list of Dickoff et al. (as cited in Chinn & Kramer, 2015) as the reasoning map. The Standard Operating Procedure Guidelines of the ministry of health (Ministry of Health and Social Services, 2014) supplemented the information of the five strategies.
Phase 4 aimed at determining implementability of developed strategies in the Khomas region, as there were limitations to determining implementability in the Hardap and Kavango East regions. This was done to authenticate and ensure accessibility of developed strategies. The researcher made use of
national and international professionals who were experts in the field of community health workers.
During phase 5, a preliminary evaluation of the strategies was done in accordance with the criteria proposed by Chinn and Kramer (2011), namely clarity, simplicity, generality, accessibility and importance. The researcher achieved this by conducting a two-day discussion workshop during which
attendees gave their comments and inputs. The study recommends that districts construct a supervision structure and deploy a knowledgeable enrolled nurse to provide frequent, supportive supervision to community health workers. Furthermore, the researcher recommends compulsory attachment of community health workers to outreach teams. Another recommendation proposed is the strengthening of advocacy within the community