Pre-eclampsia is a multi-organ system disorder that occurs after the 20th week of gestation in pregnancy and is characterized by hypertension and proteinuria with or with out oedema. It is a major cause of morbidity and mortality for the woman and her child. Based on surveillance data, pre-eclampsia is one of the leading causes of maternal mortality in Namibia. However, there is no depth study done in Namibia that looks at the extent of confirmed pre-eclampia and its contribution to maternal and perinatal morbidity and mortality. There is also no standard management protocol currently recommended in Namibia. The aim of this study was to evaluate the outcomes and quality of care given to pre-eclamptic patients treated in Windhoek Central and Katutura referral hospitals in Namibia within the period of January 2003 to December 2004.

Pre-eclampsia is a multi-organ system disorder that occurs after the 20th week of gestation in pregnancy and is characterized by hypertension and proteinuria with or with out oedema. It is a major cause of morbidity and mortality for the woman and her child. Based on surveillance data, pre-eclampsia is one of the leading causes of maternal mortality in Namibia. However, there is no depth study done in Namibia that looks at the extent of confirmed pre-eclampia and its contribution to maternal and perinatal morbidity and mortality. There is also no standard management protocol currently recommended in Namibia. The aim of this study was to evaluate the outcomes and quality of care given to pre-eclamptic patients treated in Windhoek Central and Katutura referral hospitals in Namibia within the period of January 2003 to December 2004.

Thesis submitted in fulfillment of the requirements for the M Tech: Nursing in the Faculty of Health and Wellness Sciences at the Cape Peninsula University of Technology, Bellville Campus 2014 / Recent reports suggest that there has been an alarming increase in the pregnancy rate of young adults especially in the Outjo district, the northwestern part of Namibia. No formal studies have been conducted recently to get a better understanding of this phenomenon, which is of great concern to all social and healthcare stakeholders. According to the annual report of the Outjo hospital 2009/2010, 36% of the pregnancies reported at the hospital were youth still at school (Namibian 2011). Negative health outcomes of early pregnancy and sexually transmitted infections (STIs), including HIV/AIDS (Human immunodeficiency virus infection / Acquired immunodeficiency syndrome), threaten the health of these young adults who will become the mature adults and parents of the future. This study aimed to assess factors that hinder young adults both male and female from utilizing contraceptives in Outjo district in the north-western part of the Republic of Namibia. Some of the objectives of this study were to explore the personal factors that influence the decision to use contraceptives among young adult of the Outjo district; examine socio-economic factors that influence young adult’ decision to use contraceptives, and determine pregnancy rate amongst female young adults in the Outjo district. In order to achieve the objectives of the study, a quantitative descriptive survey method and retrospective analysis of the records was used. The study population was young adults 18 to 24 years of age. A semi-structured validated questionnaire was utilized to collect data. Data was analyzed by using SPSS 19 software to generate frequency, percentage, mean and standard deviation. The findings can contribute and play a significant role in developing new strategies by all stakeholders including the Ministry of Health and Education, to approach non adherence of contraceptive use amongst the young adult population in an innovative ways, and ultimately stem the tide against the high rate of youth pregnancies in the Outjo district. Keywords: Adherence, contraceptives, young adults, youth, teenage pregnancy Namibia, Outjo district, quantitative descriptive survey

Master of Public Health - MPH / Pre-eclampsia is a multi-organ system disorder that occurs after the 20th week of gestation in pregnancy and is characterized by hypertension and proteinuria with or with out oedema. It is a major cause of morbidity and mortality for the woman and her child. Based on surveillance data, pre-eclampsia is one of the leading causes of maternal mortality in Namibia. However, there is no depth study done in Namibia that looks at the extent of confirmed pre-eclampia and its contribution to maternal and perinatal morbidity and mortality. There is also no standard management protocol currently recommended in Namibia. The aim of this study was to evaluate the outcomes and quality of care given to pre-eclamptic patients treated in Windhoek Central and Katutura referral hospitals in Namibia within the period of January 2003 to December 2004. / South Africa

Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Republic of Namibia situated at the South West of Africa near Atlantic Ocean is a country in Sub-Saharan Africa region. It was divided into fourteen political administrative regions during the delimitation committee of 2013. Namibia has a population of 3 million according to the census report of 2011 (Census report 2011). The prevalence rate of HIV in Zambezi Region is higher than in other thirteen regions of Namibia. Zambezi Region is geographically located between the four SADC countries such as Zambia, Angola, Botswana and Zimbabwe. Trans–Caprivi high way is believed to contribute to the high prevalence rate of 37.7 % according to the sentinel survey report of pregnant women of 2012.The traditional beliefs and customs are affecting HIV/AIDS programmes that are implemented in the region by stakeholders and the Ministry of Health and Social Services. Namibia as a country since 1992 to 2014 has conducted sentinel surveys among pregnant women and National testing days from 2008 to find out how to address HIV and AIDS epidemic in the country. Zambezi Region according to the sentinel survey reports has the highest HIV prevalence rate among pregnant women than the other thirteen regions. The reasons that are causing the high prevalence rate of HIV in this part of the country are not yet know to the citizens. The researcher in this research has used the qualitative approach method, to investigate the perceptions of community members regarding reasons of higher HIV prevalence rate in Zambezi Region. Sampling was conducted using purposive sampling in all six constituencies of the region in which 30 participants of 15 females and 15 males were interviewed. The semi - structured interview qualitative method was used to collect data from respondents. This study is the eye opener as the reasons that are contributing to the high HIV prevalence rate in Zambezi Region have been discovered. / AFRIKAANSE OPSOMMING: Nie beskikbaar

The study aimed to investigate the educationally-related challenges faced by teenage mothers in coming back to school in two senior schools in the Kavango Education Region. This small-scale study focused on the challenges that influence or affect the academic progress and development of these learners. The study looked at how teenage pregnancy is perceived as a social problem in many countries as well as in Namibia and examined its impact on the educational aspirations of the young mothers. Namibia has a policy in place to cater for the continued education of learners returning to school after the birth of their babies. This policy was analysed and its implementation in the selected schools formed part of the study, The findings revealed that the educational challenges faced by these young women range from social exclusion to the need to manage the dual responsibilities of motherhood and study. The way in which the learners who participated in this study are viewed by their peers and their teachers was found to be influenced by the cultural connotations ascribed to women as soon as they become mothers, a factor that adds to the challenges these learners face when returning to schools. Cultural connotations which perceived a mother as an adult in the society was attached to the change of the behaviours and attitudes of school young mothers. The findings also showed that while these learners tended to be withdrawn in class and were generally unable to participate in extra-mural activities, they none the less were able to compete with their peers in terms of their academic performance. The study revealed that there is no shared understanding of the policy among the participants and that it is not effectively implemented in the schools, nor is it uniformly applied.

Thesis (MEd)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The exclusion of girls who fall pregnant while attending school has long been a contentious issue in the literature as it normally ends their schooling. Namibian school-going girls who become pregnant while attending school are no longer excluded from continuing with their education, as new policies in education prevent such exclusion. This qualitative research explores teachers’ experiences of and support practices for school-going teenage mothers in Namibian secondary schools, given this policy context of inclusion. The study was framed within Bronfenbrenners’ bio-ecological system theory focusing on teachers’ interactions with teenage mothers. Eight participants were selected purposively from two secondary schools in the Oshikoto region, Namibia, provided that they were secondary-school teachers and had taught teenage mothers in the past three years. Data were collected in the form of semi-structured focus groups, follow-up individual interviews and field notes. Each focus group was represented by four teachers from the same school, two males and two females. Qualitative content analysis was used as a method of data analysis. The themes that emerged included the following: teachers’ responses to the inclusion of teenage mothers in schools, unpacking teachers’ perceptions on the policy of inclusion of teenage mothers, and support practices. The results revealed that there was a lack of resources and teachers’ felt burdened, not only in the classroom but generally in the school. Teachers, nevertheless, did have empathy for mothers as learners. They also felt both satisfied and dissatisfied, often blaming the inclusion policy for their difficulties in managing classroom dilemmas when teenage mothers were present. They displayed conditional caring and raised concerns about gender and care, as well as expressing a need for comprehensive information. The key finding was that teachers made a distinction between pregnant and parenting learners when thinking of support. The physical appearance of a pregnant learner played a role. Therefore teachers cared for a pregnant learner because they feared that something might happen to the pregnant learner while in their care in the classroom. This resulted in teachers seemingly providing “strategic caring” based on the condition of the pregnant learner. From the findings, it is recommended that pre-service and in-service training of teachers should pay attention to the practise of inclusion of teenage mothers in schools. / AFRIKAANSE OPSOMMING: Die uitsluiting van meisies wat tydens hul skoolloopbaan swanger word, is lank reeds in die literatuur ʼn netelige saak aangesien dit gewoonlik die einde van hul skoolloopbaan beteken. Namibiese skoolmeisies wat swanger word terwyl hulle nog skool bywoon, word nie meer verbied om hul skoolloopbaan voort te sit nie aangesien nuwe onderwysbeleide sodanige uitsluiting voorkom. Hierdie kwalitatiewe navorsing ondersoek onderwysers se ervaring van en die ondersteuningspraktyke vir skoolgaande tienermoeders in sekondêre skole in Namibië gesien uit die hoek van ʼn beleid van inklusie. Die studie val binne die raamwerk van Bronfenbrenner se bio-ekologiese sistemiese teorie en fokus op onderwysers se interaksie met tienermoeders. Agt deelnemers is deur middel van doelgerigte steekproefneming uit twee sekondêre skole in die Oshikoto-gebied in Namibië gekies met die voorbehoud dat hulle aan ʼn sekondêre skool onderwys gegee het en in die voorafgaande drie jaar tienermoeders onderrig het. Data oor onderwysers se ervarings is versamel deur middel van semi-gestruktureerde fokusgroepe, opgevolg deur individuele onderhoude en veldnotas. Elke fokusgroep is verteenwoordig deur vier onderwysers van dieselfde skool waarvan twee manlik en twee vroulik was. Kwalitatiewe inhoudsanalise is gebruik as metode om data te analiseer. Die temas wat te voorskyn gekom het, sluit in: onderwysers se reaksie ten opsigte van die insluiting van tienermoeders in skole, hul opvattings oor die beleid van inklusiwiteit van tienermoeders asook ondersteuningspraktyke. Die resultate het openbaar dat daar ʼn tekort aan hulpmiddels was, dat onderwysers gevoel het dat ʼn las op hulle geplaas is, nie net in die klaskamer nie, maar ook in die algemene skoolopset en ook dat onderwysers empatie getoon het teenoor leerders wat moeders was. Hulle het terselfdertyd tevrede en ontevrede gevoel en het dikwels die inklusiwiteitsbeleid blameer vir die probleme wat hulle ondervind het om dilemmas in die klaskamer te hanteer waar tienermoeders teenwoordig was. Hulle het voorwaardelike sorg aan die dag gelê, besorgdheid oor geslag en versorging uitgespreek en het ʼn behoefte aan omvattende inligting gehad. Die belangrikste bevinding was dat onderwyses ʼn onderskeid getref het tussen swanger leerders en leerders wat reeds ouers was wanneer ondersteuning ter sprake gekom het. Die fisieke voorkoms van ʼn swanger leerder het ʼn invloed gehad. Daarom het bevindings veronderstel dat onderwysers besorgd was oor ʼn swanger leerder wat in hul klaskamer was omdat hulle bang was dat iets met die swanger leerder kon gebeur terwyl sy in hul sorg in die klaskamer was. Dit het tot gevolg gehad dat onderwysers selfgerigte of strategiese sorg verleen het op grond van die toestand van die leerder. Na aanleiding van die bevindings word aanbeveel dat voordiens- en indiensopleiding van onderwysers aandag moet skenk aan die praktyk van inklusiwiteit van tienermoeders in skole.

Thesis (MTech (Biomedical Sciences))--Cape Peninsula University of Technology, 2015. / BACKGROUND AND OBJECTIVES: Group B Streptococci (GBS) can asymptomatically colonise the vagina and rectum of women. Studies have shown that this bacterium is the leading cause of septicemia, meningitis and pneumonia in neonates. In Namibia no known studies have investigated GBS colonisation and the antibiotic resistance profile of GBS isolates in pregnant women. This study accessed the GBS colonisation rate amongst the pregnant women who attended the Windhoek Central Hospital Antenatal Clinic (Khomas region), in Namibia for a period of 13 months. Furthermore, using the VITEK 2 system, the GBS isolates were tested against the following antimicrobial substances; benzylpenicillin, ampicillin, clindamycin, erythromycin, tetracycline, vancomycin, cefotaxime, ceftriaxone, linezolid and trimethoprim/sulfamethoxazole. Penicillin G is the drug of choice in the majority of studies, and seems to be the most effective drug for intrapartum antibiotic prophylaxis (IAP). All the GBS isolates found in this study were also analysed for the presence of selected genes known to be associated with resistance to key antibiotics using specific primers within a polymerase chain reaction (PCR).

Condom use is promoted as an effective method for prevention and contraception for people who practice or are at risk of practicing high-risk sexual behaviors. According to the UNAIDS (2009) report, condoms are the only resource available to prevent the sexual spread of the HI-Virus; and with regard to family planning, the same report proposes that condoms expand the choices, have no medical side effects, and thus provide dual protection against pregnancy and disease. However, in Africa as elsewhere in the world, condom use has been fiercely debated. The debates on the accessibility, availability and distribution of condoms in schools are not new nor are they uncontested. In Namibia, the HIV and AIDS policy in education does not explain how, when and by whom condoms should be made available to learners. This leaves it to schools to decide on how (and whether) to make condoms available to learners. As a result, individual school‘s choices not only vary, but are mediated by different factors that are not always in the best interest of learners who, as the foregoing discussion suggests, continue to participate in behaviour that, amongst other things, puts them at risk of HIV infection and falling pregnant. Relying on Foucault‘s theory of discourses, this study investigated the dominant discourses that shape learner, teacher, parent religious and traditional leader and traditional healer perspectives, responses, and experiences with regard to the accessibility, availability, and distribution of condoms in school. The study was conducted in nine schools in Kavango Region in Namibia using a mixed methods approach. The study used triangulation in the data collection process through the use of questionnaires where 792 learners participated in this component, and focus group discussions and individual interviews targeting four groups namely, learners, teachers, parents and religious leaders, traditional leaders and traditional healers. The quantitative data were analyzed using the Statistical Packages for Social Sciences (SPSS), and findings from the focus group discussions and individual interviews were analyzed identifying themes and patterns and then organizing them into coherent categories with sub-categories. The study revealed that the majority of adult participants opposed the idea of making condoms available in schools; advocating abstinence instead. This was despite evidence on the prevalence of sexual activity amongst youth in the community. Reasons had to do with various competing and hierarchized discourses operating to shape participant beliefs, perspectives, and responses in a highly regulated and surveilled social and cultural context. Put differently, the dominant discourses invoked a particular sexual subject; authorized and legitimated who invoked such a subject; who was and was not allowed to speak on sexual matters; as well as how sexual matters were brought into the public space of schools. Such authorization and legitimation regulated the discursive space in which discussions on sexual health, safe sex, and resources such as condoms were permitted; with negative consequences for the sexual well-being of youth in Kavango Region. The study also highlighted the tension between freedom, choice, and rights, showing how complex in fact is decision to make condoms available in school. On the one hand, teenagers positioned themselves as capable subjects who had the right to exercise choice over their sexual lives. Requesting parent consent was thus viewed as a violation of this right to choose. Such a position displayed authority and agency by learners that was pitted against views amongst adults in this study that positioned youth as having no agency. In their view, youth (a) were still children and thus innocent and pure, (b) ought to abstain, and (c) were difficult to control given the modern context. Adults believed that early sexual involvement by learners did not result from lack of vigilance and control on their part, but rather from exposure to modern social mores. The study concluded that (a) schools remain difficult spaces not only for mediating discussions of sex and sexuality, but also for providing resources to mitigate sexual risk amongst leaners, (b) in highly regulated societies, dominant religious discourses are produced and reproduced in and through existing institutions such as family, church, and schools; highlighting how these serve to normalize beliefs and perspectives, (c) the dominant discourses shaping communities in which schools find themselves remain inconsistent with school discourses that are shaped by modernist conceptions of childhood and youth, and (b) adult choices to sanction and obstruct schools from making condoms available (and in the case of teachers, not accessible and distributable) put the very children at risk that they propose to be protecting.

Text in English / Teenage pregnancy is a growing social concern in Namibia. In 2013, 19% of teenagers fell pregnant (MoHSS, 2014). Implications are enormous including economic, social and health issues. Attachment between parents and children is important in child development and enduring through life. The study aims to examine whether attachment styles of single parents increase the risk of teenage pregnancy in their daughters. The research used a quantitative method with a sample of 100 teenage girls in Windhoek, Namibia, completing the IPPA and Questionnaire to measure attachment and biographical data. Results analysis in this study suggests that teenagers from two-parents families are more likely to be securely attached (65%) and less likely to get pregnant as teenagers. On the other hand teenagers from single parent families are more likely to be insecurely attached (44%) and are more likely to get pregnant as teenagers. Thus, the attachment style predicted teenage pregnancy, particularly in single parent families where insecure attachment was more prominent. Recommendations for future research and for the government and other stake holders were provided. / Psychology / M.A. (Psychology)