Implementation and evaluation of a Project ECHO telementoring program for the Namibian HIV workforce.

BACKGROUND: The Namibian Ministry of Health and Social Services (MoHSS) piloted the first HIV Project ECHO (Extension for Community Health Outcomes) in Africa at 10 clinical sites between 2015 and 2016. Goals of Project ECHO implementation included strengthening clinical capacity, improving professional satisfaction, and reducing isolation while addressing HIV service challenges during decentralization of antiretroviral therapy. METHODS: MoHSS conducted a mixed-methods evaluation to assess the pilot. Methods included pre/post program assessments of healthcare worker knowledge, self-efficacy, and professional satisfaction; assessment of continuing professional development (CPD) credit acquisition; and focus group discussions and in-depth interviews. Analysis compared the differences between pre/post scores descriptively. Qualitative transcripts were analyzed to extract themes and representative quotes. RESULTS: Knowledge of clinical HIV improved 17.8% overall (95% confidence interval 12.2-23.5%) and 22.3% (95% confidence interval 13.2-31.5%) for nurses. Professional satisfaction increased 30 percentage points. Most participants experienced reduced professional isolation (66%) and improved CPD credit access (57%). Qualitative findings reinforced quantitative results. Following the pilot, the Namibia MoHSS Project ECHO expanded to over 40 clinical sites by May 2019 serving more than 140 000 people living with HIV. CONCLUSIONS: Similar to other Project ECHO evaluation results in the United States of America, Namibia's Project ECHO led to the development of ongoing virtual communities of practice. The evaluation demonstrated the ability of the Namibia HIV Project ECHO to improve healthcare worker knowledge and satisfaction and decrease professional isolation

Prevalence of intimate partner violence and associated factors amongst women attending antenatal care at Outapi primary health care facility, Namibia: a descriptive survey

Thesis (MFamMed)--Stellenbosch University, 2017.ENGLISH SUMMARY : Background: Intimate partner violence (IPV) violence is an important public health problem with negative long term effects on the mother’s health and the unborn baby. In one Namibian study performed in the capital city over one third (36%) of ever-partnered women reported physical or sexual violence from an intimate partner. No study had been conducted to determine the prevalence of IPV amongst pregnant women in a primary care setting in Namibia. Aim and objectives: This study aimed to determine the prevalence of IPV amongst women attending antenatal care at Outapi primary health care clinic, Namibia. The objectives of the study were to measure the prevalence of IPV amongst pregnant women, to assess the relationship between the different types of IPV and to evaluate the presence of known risk factors for IPV. Methods: A descriptive survey conducted at Outapi clinic in Namibia. Data was collected using a validated questionnaire from 386 consecutive participants in the antenatal clinic. Results: The mean age of the participants was 27.5 years (SD 6.8) and 335(86.8%) of the women were unmarried, 215(55.7%) with only primary school education and 237(61.4%) in their third trimester. Overall 41(10.6%) had HIV and 44(11.4%) were teenage pregnancies. The reported lifetime prevalence of IPV was 10.1%, the 12-month prevalence was 27(7.0%) and the prevalence during pregnancy was 23(6.0%). Emotional abuse was the commonest type of abuse in 27(7.0%) although the commonest specific abusive behaviour was refusing to provide money to run the house or look after the children when there was money for other things in 19(4.9%). Increased age was associated with an increase in occurrence of IPV. Conclusion: Presence of IPV in this setting is comparable to Uganda and Malawi but much less than prevalence in neighbouring countries. Nevertheless, the prevalence is sufficient to warrant the development of guidelines to recognize, assess and assist women affected by IPV.AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar

Prevalence of intimate partner violence and associated factors amongst women attending antenatal care at Outapi clinic, Namibia: A descriptive survey

Background: Intimate partner violence (IPV) is a significant and largely hidden public health problem for all women and, during pregnancy, can have significant effects on the health of both mother and the unborn baby. Previous Namibian studies suggest rates of IPV as high as 36%, although few studies have been conducted in primary care. Aim: To determine the prevalence of IPV amongst women attending antenatal care. Setting: Outapi primary care clinic, Namibia. Methods: A descriptive survey administering a validated questionnaire to 386 consecutive participants. Results: The mean age of the participants was 27.5 years (standard deviation = 6.8), 335 (86.8%) were unmarried, 215 (55.7%) had only primary school education and 237 (61.4%) were in their third trimester. Overall, 51 participants (13.2%) had HIV and 44 (11.4%) had teenage pregnancies. The reported lifetime prevalence of IPV was 39 (10.1%), the 12-month prevalence was 35 (9.1%) and the prevalence during pregnancy was 31 (8.0%). Emotional abuse was the commonest type of abuse in 27 (7.0%). The commonest specific abusive behaviour was refusing to provide money to run the house or look after the children whilst the partner spent money on his priorities (4.9%). Increased maternal age was associated with an increase in the occurrence of IPV. Conclusion: The reported lifetime prevalence of IPV was 10.1%, with emotional abuse being the commonest type of abuse. Increased age was associated with an increase in reported IPV. IPV is significant enough to warrant that healthcare providers develop guidelines to assist women affected by IPV in Namibia

Prevalence of intimate partner violence and associated factors amongst women attending antenatal care at Outapi clinic, Namibia : a descriptive survey

CITATION: Bikinesi, L.T., Mash, R. & Joyner, K. 2017. Prevalence of intimate partner violence and associated factors amongst women attending antenatal care at Outapi clinic, Namibia: A descriptive survey. African Journal of Primary Health care & Family Medicine, 9(1): a1512, doi:10.4102/phcfm.v9i1.1512.The original publication is available at https://phcfm.org/index.php/phcfmBackground: Intimate partner violence (IPV) is a significant and largely hidden public health problem for all women and, during pregnancy, can have significant effects on the health of both mother and the unborn baby. Previous Namibian studies suggest rates of IPV as high as 36%, although few studies have been conducted in primary care. Aim: To determine the prevalence of IPV amongst women attending antenatal care. Setting: Outapi primary care clinic, Namibia. Methods: A descriptive survey administering a validated questionnaire to 386 consecutive participants. Results: The mean age of the participants was 27.5 years (standard deviation = 6.8), 335 (86.8%) were unmarried, 215 (55.7%) had only primary school education and 237 (61.4%) were in their third trimester. Overall, 51 participants (13.2%) had HIV and 44 (11.4%) had teenage pregnancies. The reported lifetime prevalence of IPV was 39 (10.1%), the 12-month prevalence was 35 (9.1%) and the prevalence during pregnancy was 31 (8.0%). Emotional abuse was the commonest type of abuse in 27 (7.0%). The commonest specific abusive behaviour was refusing to provide money to run the house or look after the children whilst the partner spent money on his priorities (4.9%). Increased maternal age was associated with an increase in the occurrence of IPV. Conclusion: The reported lifetime prevalence of IPV was 10.1%, with emotional abuse being the commonest type of abuse. Increased age was associated with an increase in reported IPV. IPV is significant enough to warrant that healthcare providers develop guidelines to assist women affected by IPV in Namibia.publishers versio