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Introduction: Insufficient knowledge of intravenous fluid therapy is a significant challenge contributing to morbidity and mortality in hospitalized patients. Nurses play a critical role in evaluating patients' fluid and electrolyte balance as well as in restoring fluid levels. Various studies have indicated a deficiency in nurses' knowledge of intravenous therapy, yet this remains understudied in many settings, including Namibia., Objectives: To assess nurses' knowledge of intravenous fluid therapy and to describe the variables associated with knowledge of intravenous fluid therapy at a teaching hospital in Namibia., Methods: A cross-sectional online survey involving 164 nurses who were recruited using total population sampling. Data were collected between September and November 2021, using a self-administered 14-item validated tool (α = 0.8). Data analysis was conducted using SPSSv28.0 software., Results: The majority of nurses (84%) in this study exhibited an insufficient level of knowledge regarding intravenous therapy, with only a minority (16%) demonstrating a moderately adequate understanding of intravenous fluid therapy. A significant positive correlation was found between educational qualification and knowledge of intravenous therapy ( r  = 0.21; p  = .01)., Conclusion: The study's results indicate a worrying trajectory in nurses' knowledge of intravenous therapy. These findings underscore the need for hospitals to establish comprehensive training programs for nurses to guarantee the provision of secure and efficient intravenous therapy. Additional research is needed to investigate how educational qualifications impact patient outcomes related to intravenous therapy., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Introduction: Ensuring strong student engagement in both traditional and virtual learning settings was essential for achieving positive educational results during the COVID-19 pandemic. However, fostering student engagement in both the traditional (face-to-face) and virtual learning environments has been accompanied by distinct challenges. There has been a lack of research specifically addressing the issue of nursing students' engagement within a blended learning setting in Namibia., Aim: To explore and describe nursing students' learning engagement experiences at a university campus in Namibia during the COVID-19 pandemic., Methods: A qualitative, descriptive, phenomenological study was employed to collect data from 10 purposively selected nursing students at a university campus in Namibia. Data from in-depth, face-to-face, individual interviews were collected using a semistructured interview guide. Data were analyzed using Colaizzi's seven-step method., Results: The findings of the study describe students' learning engagement experiences under four distinct themes: (a) conditions and contexts of engagement; (b) student acts of engagement: positionality of teacher- and student-facilitated engagement; (c) consequences of engagement in a blended learning environment; and (d) student engagement dispositions: students' initiatives., Conclusion: The research findings revealed that despite mental health challenges, both teacher-facilitated and student-facilitated engagement were necessary for positive learning engagement in the blended learning environment. Student-facilitated engagement was significantly responsible for enabling students to maintain focus, adhere to guidelines, and adapt to the blended learning environment. These findings are useful in understanding the challenges faced by students during the COVID-19 pandemic. The findings thus provide valuable data for future studies seeking to address challenges associated with the blended learning environment., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Pyrethroid-based indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) have been employed as key vector control measures against malaria in Namibia. However, pyrethroid resistance in Anopheles mosquitoes may compromise the efficacy of these interventions. To address this challenge, the World Health Organization (WHO) recommends the use of piperonyl butoxide (PBO) LLINs in areas where pyrethroid resistance is confirmed to be mediated by mixed function oxidase (MFO)., Methods: This study assessed the susceptibility of Anopheles gambiae sensu lato (s.l.) mosquitoes to WHO tube bioassays with 4% DDT and 0.05% deltamethrin insecticides. Additionally, the study explored the effect of piperonyl butoxide (PBO) synergist by sequentially exposing mosquitoes to deltamethrin (0.05%) alone, PBO (4%) + deltamethrin (0.05%), and PBO alone. The Anopheles mosquitoes were further identified morphologically and molecularly., Results: The findings revealed that An. gambiae sensu stricto (s.s.) (62%) was more prevalent than Anopheles arabiensis (38%). The WHO tube bioassays confirmed resistance to deltamethrin 0.05% in the Oshikoto, Kunene, and Kavango West regions, with mortality rates of 79, 86, and 67%, respectively. In contrast, An. arabiensis displayed resistance to deltamethrin 0.05% in Oshikoto (82% mortality) and reduced susceptibility in Kavango West (96% mortality). Notably, there was reduced susceptibility to DDT 4% in both An. gambiae s.s. and An. arabiensis from the Kavango West region. Subsequently, a subsample from PBO synergist assays in 2020 demonstrated a high proportion of An. arabiensis in Oshana (84.4%) and Oshikoto (73.6%), and 0.42% of Anopheles quadriannulatus in Oshana. Non-amplifiers were also present (15.2% in Oshana; 26.4% in Oshikoto). Deltamethrin resistance with less than 95% mortality, was consistently observed in An. gambiae s.l. populations across all sites in both 2020 and 2021. Following pre-exposure to the PBO synergist, susceptibility to deltamethrin was fully restored with 100.0% mortality at all sites in 2020 and 2021., Conclusions: Pyrethroid resistance has been identified in An. gambiae s.s. and An. arabiensis in the Kavango West, Kunene, and Oshikoto regions, indicating potential challenges for pyrethroid-based IRS and LLINs. Consequently, the data highlights the promise of pyrethroid-PBO LLINs in addressing resistance issues in the region., (© 2024. The Author(s).)

Aim: The aim of the study was to explore nurses' barriers to the pressure ulcer risk assessment scales implementation., Design: A qualitative descriptive phenomenological study., Methods: The research participants comprised of 10 nurses at various medical and surgical departments in a teaching hospital northeast of Namibia. Data were collected between August and September 2022 through in-depth, semi-structured face-to-face individual interviews and analysed using Colaizzi's 7-step method., Results: The interviews with nurses, led to two major themes being discovered: (1) factors hindering the effective prevention of pressure ulcers; (2) suggestions for improvements in the utilization of risk assessment scales. The participants noted that they had inadequate knowledge of the formal risk assessment scales; there were inadequate resources and insufficient staff; there were no policies or guidelines regarding the management of pressure ulcers, all of which influenced their utilization of pressure risk assessment scales. Education and training, the provision of equipment, the hiring of new staff and the formulation of policies/guidelines would thus improve the nurses' utilization of the scales., Conclusion: The findings of this study have uncovered three primary factors that have a detrimental impact on the utilization of risk assessment scales by nurses, that is their lack knowledge on pressure ulcer risk assessment scales; a shortage of staff and equipment; and an absence of policies/guidelines. The findings from this study provide valuable implications for guiding quality improvement initiatives aimed at enhancing the standard of care in Namibia and other resource-limited settings., (© 2024 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: The study aimed to explore and describe the barriers affecting Registered Nurses in undertaking clinical teaching in clinical settings. The exploration was based on the experiences of Registered Nurses at a selected teaching hospital in Namibia. The researcher intended to identify strategies that could be used to mitigate the negative effects of barriers to effective clinical teaching., Design: A qualitative explorative, descriptive and contextual research design was used., Methods: Purposive sampling was used to select 16 participants. Data were collected through in-depth, semi-structured interviews, which were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis., Results: Clinical teaching is negatively affected by several barriers that hamper clinical teaching and nursing students' learning outcomes. Seven main themes were identified: (1) participants' understanding of clinical teaching; (2) organizational barriers; (3) patient barriers; (4) Registered Nurse barriers; (5) student barriers; (6) training institution barriers; and (7) strategies to mitigate barriers to clinical teaching., Conclusion: The findings revealed that several barriers negatively affect clinical nursing education and hamper the clinical teaching and learning of nursing students., Patient or Public Contribution: This study may assist in the development of targeted interventions that address the barriers that hinder clinical teaching at teaching hospitals. Additionally, this study could assist in improving the health care that is provided by nursing students to patients. The findings may assist with improved quality by reducing nursing students' theory-practice gap and by promoting collaboration between Registered Nurses and nurse educators in clinical settings., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Background: Nurses play a key role in cases of cardiopulmonary arrest by promptly attending to and initiating cardiopulmonary resuscitation. Effective cardiopulmonary resuscitation thus requires nurses to possess appropriate attitudes, competencies, and adherence to the best nursing practice. Cardiac arrests are a prevalent cause of fatalities, being responsible for approximately 30% of deaths worldwide. Despite this statistic, however, research in this specific field is lacking in Namibia., Objective: The objective of this research was to examine registered nurses' knowledge, attitudes toward, and practice with regard to cardiopulmonary resuscitation at a selected teaching hospital in Namibia., Methods: A cross-sectional survey design using a self-administered questionnaire was utilized to purposively recruit 158 registered nurses from the inpatient and outpatient departments of a teaching hospital in Namibia. Descriptive and chi-square tests were performed using SPSSv26., Results: The results of the study indicate that a significant percentage of nurses have limited knowledge (14.7 ± 1.50), negative attitudes (36.2 ± 4.8), and poor practice (11.16 ± 1.18) when it comes to cardiopulmonary resuscitation. Their poor knowledge is strongly associated with poor practice (χ 2  = 9.162, P  = .002). The study further revealed a significant correlation between the departments in which the nurses worked and their practice of cardiopulmonary resuscitation, suggesting that the work environment is a crucial factor in determining a nurse's approach to emergency care., Conclusion: The findings of study indicate that the cardiopulmonary resuscitation practice in the selected hospital is unsafe due to the registered nurses' poor knowledge and negative attitudes. It is strongly recommended that hospital managers and policy-makers take steps to formulate guidelines that mandate regular cardiopulmonary resuscitation training at predetermined times., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Aim: To examine the correlations between self-regulation, learning flow, academic stress and learning engagement as predicting variables for academic achievement in a blended learning environment in Namibia., Design: Cross-sectional survey., Methods: Data were collected from 166 randomly selected undergraduate nursing students through an online survey between January and February 2023, and were analysed using IBM SPSS AMOS version 28.0. The data were explored through factor, parallel and confirmatory factor analyses. The relationship between the study factors and the total score of the scale was analysed using the Pearson correlation coefficient., Results: The results indicate that the two factors identified in the factor analysis are consistent with the theoretical proposition in this research. Factor 1 comprises items C1 to C24, which pertain to self-regulation (SR), while factor 2 consists of items D1 to D9, which relate to learning flow (LR). The findings demonstrate that self-regulation significantly predicts both flow and stress, as well as learning engagement. Additionally, there is a significant relationship between stress and self-regulated learning, as well as between stress and learning flow (r = 0.23-0.26; p= < .05). However, none of the study constructs were found to predict academic achievement., Conclusion: Although self-regulation significantly predicted flow, stress and learning engagement, a non-significant association exists between all the study constructs and academic achievement. The results of this study have significant implications for improving the development of a positive learning environment that fosters active student engagement. Future studies should investigate correlation by conducting large-scale studies., Impact: This study makes a valuable contribution to the current body of literature concerning academic achievement within the context of undergraduate nursing education. The insignificant relationship between the study variables and academic achievement indicate that these elements are not of considerable significance in enhancing educational achievements in blended learning surroundings in Namibia., Patient or Public Contribution: One hundred and sixty-six undergraduate nursing students participated in the survey. The data collected were analysed and interpreted by a skilled statistician., Competing Interests: The authors declare that they have no known competing financial interests or personal interest appeared to influence the work reported in this paper., (© 2023 The Authors.)

Aim: The aim of this study was to investigate nursing students' experiences of communication in a multilingual and multicultural clinical environment., Background: Effective communication in a healthcare setting plays a crucial role in patient care. Yet, since universities, globally, have experienced an increase in the enrolment of both local and international students in various degree programmes, student populations have become increasingly multilingual and multicultural. This study was conducted in a multilingual country where many languages are not spoken by all citizens, which results in nursing students experiencing varied outcomes., Design: A qualitative, explorative, descriptive research design was used., Methods: Sixteen nursing students enrolled in either the Bachelor of Nursing Science (Clinical, Honours) or the Diploma in Nursing Science. Data were collected by means of in-depth, semi-structured interviews with a sample of 16 nursing students who were selected through convenience sampling. Data were analysed using thematic analysis., Results: The study revealed four themes: aspects that complicate communication; interesting aspects about communication; the need for communication assistance; and the need for policy intervention, which is key to addressing challenges in multilingual clinical environments., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Background: Caesarean section rates are increasing worldwide in both developed and developing countries becoming an issue of grave concern., Objective: The aim of the study was to determine the factors associated with caesarean sections performed on pregnant women admitted to a private academic hospital in Ongwediva, Oshana region, Namibia., Materials and Methods: A retrospective data approach was conducted on 200 patients' files using a self-administered checklist at a private academic hospital. A total of 200 records of mothers who underwent caesarean sections were systematically reviewed from January 2020 to December 2020 at a private academic hospital in Ongwediva, Namibia. A pretested structured checklist was used to record the data., Results: The study revealed that 95.5% of women who had caesarean sections (C-section) were performed. A previous C-section was the most frequent indication, while 0.5% were performed due to patient requests. The p-value for the chi-square statistic was smaller than the standard alpha value (P<0.05), i.e. , there is a relationship between the demographic characteristics and factors associated with caesarean sections, as well as between socioeconomic factors and factors associated with caesarean sections., Conclusions: This study shows that 95.5% of C-sections are done as a necessity with clear indications, while only 0.5% are done due to patient requests. This study's findings can be used to develop strategies and targeted interventions geared towards reducing the increasing rates of cesarean section considering maternal age, the number of indications of primary cesarean delivery, and following standard operating procedures that might improve the quality of prenatal and delivery care., Competing Interests: Conflict of interest: the authors declare no potential conflict of interest., (Copyright © 2023, the Author(s).)

Background: An estimated 159 million children under five are affected by malnutrition, with an additional 101 million children under five being underweight in sub-Saharan Africa. In Namibia, 24% of children under age 5 are stunted and 8% are severely stunted. The Kavango region has the highest rate of stunting (38.8%) in the country., Objective: The purpose of the study was to determine and describe the nutritional knowledge and practices of mothers with malnourished children regarding feeding at Rundu Intermediate Hospital, Kavango East Region, Namibia., Materials and Methods: A quantitative cross-sectional research design was used. A convenience sampling technique was used to select 199 mothers with malnourished children who were admitted to the pediatric ward. Data were collected via self-administered questionnaires with closed-ended questions., Results: 51.8% of the mothers had correct nutritional knowledge regarding breastfeeding for six months before giving other food, and 74.4% believed that newborns should be initiated to breastfeeding within an hour after birth, while the same number breastfed their babies on demand. Furthermore, 35.6% of the participants followed appropriate practices regarding feeding., Conclusions: Most mothers (51.8%) had appropriate nutritional knowledge. However, only a minority (35.6%) of the mothers had the appropriate practices regarding feeding their children. Hence, there was a knowledge/practice mismatch regarding the significance of exclusive breastfeeding during the first six months, and generally the vitality of breast milk to the child. These findings may be used to develop strategies and target interventions to create awareness among mothers regarding effective breastfeeding practices., (Copyright © 2023, the Author(s).)

Introduction: The global consequences of the COVID-19 pandemic cannot be overstated. Vaccinations are one of the leading strategies to protect against the virus, and it is likely that students' understanding and desire to be vaccinated can be major factors in helping contain the pandemic. Nonetheless, no studies looked into the vaccine attitude, knowledge and willingness in Namibia., Objectives: To assess and describe the association between knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines in the school of education, nursing and economics and management science at the university campus in Namibia., Methods: The study employed a cross-sectional descriptive study from 200 undergraduate university students using a convenience sampling. Data analysis was done using SPSSv28 and descriptive statistics were used to depict trends in data while a Pearson's correlation determined the relationship between the study variables., Results: The data showed that 54.2% (1.54  ±  0.49) of the participants had adequate knowledge concerning the vaccine, while 57.1% and 58.6% had a negative outlook and were unwilling to get vaccinated. A moderate positive correlation was observed between attitudes and willingness to take COVID-19 vaccines ( r   =  .546, P   =<.001), while a negative relation existed between knowledge and attitudes ( r   =  -.017, P   =>.001)., Conclusions: This study has provided valuable insight into the knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines. Despite more than half of the participants having appropriate knowledge, they had an unfavourable outlook toward COVID-19 vaccination. It is recommended that further studies focus on how factors such as incentives, religion and cultural values affect their desires to be vaccinated., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Aim: Vaccinations remain one of the most effective measures to prevent and control the spread of COVID-19, while also reducing hospitalizations and deaths, yet many are unwilling to be vaccinated. This study explores the barriers and facilitators affecting the uptake of COVID-19 vaccines among frontline nurses., Design: A qualitative, explorative, descriptive, and contextual research strategy was employed., Methods: A sample of 15 nurses were selected via purposeful sampling to the point of data saturation. The participants were nurses at the COVID-19 vaccinations Centre in Rundu, Namibia. Data were collected using semistructured interviews and analyzed thematically., Results: Three themes and 11 subthemes were identified, namely: (a) barriers, (b) facilitators, and (c) measures to increase the COVID-19 vaccine uptake. Barriers included living in deep rural areas, unavailability of vaccines, and misinformation, whereas scared of death, availability of COVID-19 vaccines, and family influence and peer pressure emerged as facilitators to the uptake of COVID-19 vaccines. Adoption of vaccination passport as a requirement to work premises and as an international travel requirement were the measures proposed to increase the COVID-19 vaccine uptake., Conclusion: The study found several facilitators and barriers to COVID-19 vaccine uptake among frontline nurses. The identified barriers cover the individual, health system, and social factors hindering the COVID-19 vaccine uptake among frontline nurses. Whereas fear of COVID-19 deaths, family influence, and availability of vaccines were found to promote COVID-19 uptake. This study recommends targeted interventions to improve the uptake of COVID-19 vaccines., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

In 2016, almost 31 million births in low- and middle-income countries occurred without a qualified birth attendant. 90% were in South Asia and sub-Saharan Africa. In sub-Saharan Africa, where Namibia is located, 50% of births are unattended. This study aimed at identifying factors contributing to home births in Rundu District, Kavango East Region. This study was quantitative cross-sectional. Postnatal moms who gave birth at home completed a self-administered questionnaire with closedended questions. 27.2% of respondents were 33 to 38. Most responders (83.3%) were unmarried and 38.6% were "other" religious. Participants were mostly unemployed (79.8%). 49.1% of respondents were uneducated. 8.8% of employed people were in the public sector, 6.1% in private, and 1.8% self-employed. Most (93.9%) visited antenatal clinics once (25.4%), twice (20.2%), or three times (40%) before delivery. 81% picked where to deliver on their own, and 71% had previously delivered at home. No one explained this behavior. The majority of women in this study had given delivery at home. Education, religion, and delivery location were correlated. These findings inform the community and government about the present trend of home births, which may harm mother and newborn outcomes., (©Copyright: the Author(s).)

Although varicella-zoster virus (VZV) is preventable and curable, the disease remains a public health problem in Namibia. Access to vaccination in the country remains a challenge for many citizens including students. No previous study has been conducted to assess awareness on the prevention and control of VZV in Namibia. The overall purpose of the study was to investigate the awareness of hostel students on prevention and control measures for VZV in Namibia. The objective of the study was to assess and describe the awareness of hostel students on the prevention and control measures for VZV in Namibia. A quantitative descriptive study using an online questionnaire was used. Simple random sampling was used to select 165 respondents. Descriptive statistics and a non-parametric Kruskal Wallis test were performed to test the mean differences between variables and the significance of the data. A great proportion of the respondents, 70.7% (n=118), were aware that VZV is caused by a virus (0.71±0.45) while 76% (n=127) (0.76±0.42) were aware that VZV can be vaccinated against. The study found a strong association between aetiology (p=0.03), available information (p=0.00), mode of transmission (p=0.02), and knowledge on contagious diseases (p=0.03). The results were inconclusive as to whether the level of awareness is high or low, owing to the differences in scores for each variable. The study recommends that a mobile clinic be established on campus to offer health education information., Competing Interests: Conflict of interest: The authors declare no conflict of interest., (©Copyright: the Author(s).)

Background: In sub-Saharan Africa, over 1,000 newborns are infected with HIV every day, despite available medical interventions. Mother-to-child transmission (MTCT) remains one of the primary sources of HIV infection in children and without interventions 40% of babies born from HIV-positive mothers would be infected with the virus. It is estimated that 300 000 children become infected with HIV worldwide, whilst 1.5 million children die when their mothers opt for other choices instead of breastfeeding., Objective: The purpose of the study was to assess and describe the knowledge, attitudes and practices of HIV-positive mothers regarding the benefits of exclusive breastfeeding at Rundu Intermediate Hospital, Kavango East Region in Namibia., Method: The study was a descriptive cross-sectional survey that used convenience sampling, as the researcher sought to use subjects available during the time of study to select 79 HIV positive mothers., Results: Participants in this study (94%; n=51) had good knowledge of the benefit of exclusive breastfeeding and that the benefits of breastfeeding outweigh the risk of HIV transmission from mother to child. The results confirmed that (77.2%; n=42) of the mothers opted to take ART with the babies until they stop breastfeeding., Conclusion: HIV positive mothers had good knowledge, attitudes and practices regarding the benefits of exclusive breastfeeding. A significant number of mothers were, however, not sure about breastfeeding exclusively for 6 months as they would stop if offered free formula milk for the baby. Support by the fathers and others in the community is vital., (© 2021 Ashipala DO et al.)