Distribution of hepatitis B virus infection in Namibia

Background. Namibia regards hepatitis B virus (HBV) infection as a public health problem and introduced hepatitis B vaccinations for infants during 2009. However, information on HBV infection in the country remains limited, and effective public health interventions may be compromised in the absence of adequate evidence-based data. Available data from the World Health Organization (WHO) estimate that 15 - 60% of the normal population in many African countries may be positive for one or more of the HBV serological markers.Objective. To investigate the distribution of HBV infection in Namibia, using available laboratory data for 2013.Methods. A cross-sectional descriptive study was conducted using pre-existing electronic laboratory data on HBV infection. The data were retrieved from the central Namibia Institute of Pathology laboratory in Windhoek during January - December 2013. Tests were done on the following three main groups: (i) pregnant women during routine antenatal care (ANC) visits; (ii) patients with HIV/AIDS during antiretroviral therapy clinic visits; and (iii) any other individual suspected of having HBV infection.Results. Of a total of 77 238 hepatitis B surface antigen test results retrieved countrywide, 9 087 (11.8%) were positive. Of the positive results, 246/9 087 (2.7%) were in children aged 0 - 14 years, with the sexes equally affected. HBV infections increased markedly, particularly among females, in the age group 15 - 39 years, reaching a peak in the age group 30 - 34 years. Routine screening of pregnant women for HBV during ANC visits was found to be systematically conducted in only two regions, Ohangwena and Khomas.Conclusions. This study showed high proportions of positive results in pregnant women, patients with HIV/AIDS and individuals suspected of having HBV infection. The Ministry of Health and Social Services and stakeholders may wish to consider improving the routine and surveillance reporting systems for viral hepatitis and uptake of screening for pregnant women in all regions, and expanding HBV screening to other population groups. Population-based or similar studies are therefore required to determine the HBV prevalence and risk factors. This will assist Namibia in developing appropriate national viral hepatitis strategies as per WHO recommendations

Quality-of-Life Experiences From the Perspective of Patients Receiving Haemodialysis for Chronic Renal Failure

This study describes the experiences of patients receiving haemodialysis for chronic renal failure at the only dialysis centre in Windhoek; Namibia. A qualitative; explorative and descriptive design was used. Data were collected by means of in-depth interviews and analysed using Tesch's process. Four themes emerged from the data; relating to (1) financial constraints; (2) loss of independence and spontaneous activities; (3) strain on relationships and (4) feelings of significant physiological changes and weakness. Based on the results; recommendations were submitted for psychosocial support and the establishment of support groups

Foreign Nursing Students: Their Profile and Perceptions Ofnursing Care in Namibia

A survey was conducted using open and close-ended questions to determine how visiting nursing students in Namibia could be assisted during their visits (cultural encounters). Many students decide to complete their clinical exposure in a foreign country; either for personal reasons or in order to meet the course requirements for transcultural nursing. Since 1998; Namibia has received a number of these students. In discussion and from passing remarks from the students themselves; the question has arisen as to how an optimum placement for each student might be achieved. Aspects of the Campina-Bacote model and The Process of Cultural Competence in the Delivery of Health Care Services were used to answer this question. It was decided to gather both biographical (profile) information and information on perceptions of nursing care in Namibia from such foreign nursing students. The biographical (profile) information collected indicates a prevalence of certain shared biographical characteristics among international students. Such students tend to be adventurous; caring and sensitive to human rights issues. This finding correlates with the constructs of cultural desire and cultural awareness as described in the model of Campina-Bacote. Based on this finding; specific recommendations were made for clinical allocations. From the data gathered from the open-ended questions; three themes emerged: firstly; nursing in Namibia has identifiable characteristics; secondly; there is a paternalistic and one-sided communication style among nursing caregivers in Namibia; and finally; nursing care delivery in this country is often characterised by a detached attitude. It was concluded that these themes correlated with a cultural awareness and cultural knowledge among the nursing students. The discovery of these themes was useful for making recommendations for clinical guidelines to help these students adapt; as well as for providing a foundation and substantiation for clinical placement

Exposure to Domestic Violence during Pregnancy : Perceptions and Coping Mechanisms of a Vulnerable Group

The purpose of this study was to explore and describe the perceptions of maternity clients' relating to domestic violence. A quantitative; exploratory and descriptive design was utilised. The population consisted of maternity patients admitted to a referral hospital in Windhoek; Namibia. The findings indicate that some perceptions reflect biographical differences such as education; age and economic status. In some instances; perceptions of maternity clients were in line with findings published in existing literature that reported socio-economic circumstances and familial obligations which forced women to endure abuse. It was recommended that these differences in perceptions be taken into account during the counselling of maternity clients or while health education is being given

Trans-Cultural Nursing : Exploring the Experiences of International Students Visiting Namibia

"In a rapidly changing world; where people from diverse cultures move about more readily; nurses may find themselves faced with patients and clients with a totally different world perspective and health belief system. Because this aspect has long been recognised by nurse educators; many educational institutions; in a proactive fashion; have incorporated trans-cultural nursing content in their nursing curricula. As possible options for students to gain clinical exposure in caring for a culturally diverse population; educational visits by student nurses to foreign countries have been increasingly accepted and credited. Namibia is amongst the countries that are visited by foreign nursing students; who are usually well-prepared with regard to what is required during their clinical exposure; as their educational institutions provide them with instructions and objectives. However; they are not as well-prepared in respect of ""acclimatising"" to the country per se and the world view of Namibians. In fact; it appears that there is a huge gap between their expectations and reality. Consequently; it becomes necessary to provide them with basic guidelines to bridge this discrepancy and to make their visit more meaningful. A qualitative; explorative; descriptive and contextual study was conducted to determine the nature of their experiences. Data were collected over a period of four years by means of narratives that were written by students who had spent at least 12 weeks within the Namibian health care services as visiting nurses. Three themes emerged; namely (1) experiences relating to recognition of differences in care delivery; (2) experiences relating to feelings of culture shock; and (3) appreciation for experiencing a cultural encounter. Based on these themes; guidelines were constructed. These guidelines addressed aspects such as the health structure of the country; health belief systems; legal aspects; and the philosophy of nursing care in Namibia."

The Contribution of the Clinical Nurse Instructor to the Development of Critical Thinking Skills of the Student Nurse in Namibia

A quantitative; non-experimental and exploratory study was undertaken to determine the contribution by the clinical nurse instructor to develop critical thinking skills of student nurses in Namibia. The study was conducted at the training hospitals of Namibia; namely Windhoek; Oshakati and Onandjokwe State hospitals. Clinical nurse instructors from all disciplines were included in the study; as well as student nurses in their second; third and fourth year of undergraduate nursing study. The findings of the study revealed that; although the clinical instructors in the training hospitals of Namibia are aware of their responsibility; they do not focus on the development of critical thinking of student nurses in Namibia. A need for in-service programmes to emphasise the development of critical thinking skills of both clinical nurse instructors and student nurses was identified