Ounongo Repository

Ounongo means “knowledge” in the Oshiwambo and Otjiherero languages.

The Ounongo Repository (OR) is the institutional repository of Namibia University of Science and Technology.

The OR is administered by the Library, with technical assistance from DTBS, and its aim is to collect, organize, manage, store, preserve, publish and make accessible worldwide, the knowledge assets or intellectual output of the University's researchers, staff and post-graduate students.

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Recent Submissions

An early detection model for anxiety, depression, and suicidal ideation among undergraduate students at public universities in Namibia
(Namibia University of Science and Technology, 2026-04) Siseho, Kristine Ndeuyamunye
Background: Mental health challenges among university students are an increasing global public health concern, with anxiety, depression, and suicidal ideation significantly affecting students’ well-being, academic performance, and daily functioning. Persistent anxiety and depression are associated with increased morbidity, while suicidal ideation remains an important indicator of severe psychological distress and risk of suicide. In Namibia, among the undergraduates, these mental health conditions are further intensified by academic pressure, financial hardship, social adjustment difficulties, childhood adversities, and cultural barriers that discourage open discussion of emotional distress. Despite the growing burden of student mental health problems, there is limited context-specific evidence on their prevalence, predictors, students’ coping mechanisms, and the practices of mental health service providers in the early identification and support of affected students in Namibian public universities. This study, therefore, sought to investigate anxiety, depression, and suicidal ideation among undergraduate students in Namibian public universities and to develop a contextual understanding of coping practices and early identification support systems. Method: The study employed a convergent parallel mixed-methods cross-sectional design across four phases. Phase I comprised three sub-objectives. Sub-objective one, which employed a quantitative research approach, with 578 samples drawn from 41,861 undergraduate participants at the Namibia University of Science and Technology (NUST) and the University of Namibia (UNAM), the only two public universities in Namibia. Participants were recruited from across four regions: Khomas, Ohangwena, //Karas, and Omusati. Data were collected using a self-administered questionnaire comprising the Beck Anxiety Inventory, Patient Health Questionnaire-9, and Columbia Suicide Severity Rating Scale. Quantitative data were analysed using SPSS version 30 through descriptive statistics, Pearson’s correlation coefficients, bivariate regression, and hierarchical multiple regression. Sub-Objective two employed an exploratory qualitative approach using semi-structured interviews to examine the coping mechanisms of 13 purposively sampled undergraduate students. Sub-Objective three explored the practices of 11 mental healthcare service providers in early detection and support of students experiencing anxiety, depression, and suicidal ideation in Namibia. Qualitative data were analysed using Braun and Clarke’s six-step thematic analysis framework, supported by ATLAS.ti version 8. Phase II of this study was to conceptualise the findings that informed Phase III, which involved developing, describing, and ii evaluating the model. The integration of findings informed the development of a context-specific model for early detection, grounded in the Health Belief Model, Interprofessional Shared Decision-Making model, and Chinn and Kramer’s theory-generating approach. Phase IV developed the guidelines for operationalising the model. Results: The quantitative findings revealed a high prevalence of mental health challenges among students, with 50.7% reporting moderate to severe anxiety, 73.2% meeting the criteria for depression, and 9.1% reporting an active suicidal plan. The qualitative findings generated key themes related to institutional gaps, peer-led early detection, stigma and cultural resistance, academic collaboration, informal support networks, and socio-economic vulnerabilities. Mental health service providers reported that their efforts to identify and support students were constrained by stigma, staff shortages, inadequate mental health facilities, and limited engagement of academic staff in mental health activities. Students described a range of coping strategies, including problem-focused efforts to manage stress, seeking peer and informal support, and avoidance behaviours, with emotional distress often linked to academic stressors, difficult childhood experiences, and cultural barriers to disclosure and help-seeking. Implications: The study contributes to knowledge by providing an evidence-based, integrated model to enhance early identification and intervention for student mental health challenges. It further offers practical recommendations to strengthen institutional mental health systems, promote interdisciplinary collaboration, and improve student well-being in higher education settings. The findings informed the development of a contextually relevant Early Detection Model to strengthen coordinated screening, early identification, referral pathways, and collaborative mental health support within university settings. The study contributes important empirical evidence to the limited literature on student mental health in Namibia and provides a foundation for strengthening institutional policies, multidisciplinary collaboration, and culturally responsive interventions aimed at improving student wellbeing and preventing mental health crises, including suicide, in higher education contexts. Conclusion: The study suggests that future researchers in the field of mental health focus on mixed-methods and longitudinal designs to produce evidence that guides mental health policy, practice, and curriculum development. Additionally, public universities should shift iii from reactive to proactive interventions that identify, support, and empower students, helping them succeed amid academic pressures and socio-economic challenges.
A standardized framework for integrating indigenous knowledge of traditional birth attendants into the formal health system to enhance reproductive health outcomes in northern Namibia
(Namibia University of Science and Technology, 2026-04) Haikera, Hertha Kasiku
Background: Traditional birth attendants play an important role in reproductive health in many communities in Africa. However, there is lack of evidence to support the adoption of traditional knowledge in reproductive health to support collaboration with formal health systems. This study sought to develop a standardised framework for integrating indigenous knowledge of traditional birth attendants into the formal health system to enhance reproductive health outcomes in selected regions of Northern Namibia. Method: Underpinned on the Constructivism philosophical paradigm, Health Belief Model (HBM) and the Donabedian SPO Model; this study employed a scoping review (Phase I) and the exploratory and descriptive qualitative (EDQ) phenomenological design (Phase II). Phase I: 11 articles were reviewed to map evidence of existing frameworks integrating TBAs into modern healthcare. The Preferred Reporting Items for Systematic reviews and Meta-analysis for Scoping Review (PRISMA- ScR) statement to describe the process and qualitative content analysis using an inductive approach for scoping reviews were applied. Phase II: Participants comprised 14 TBAs, 22 healthcare professionals (HCPs) and 15 women of childbearing age who were recruited through purposive sampling and sample size was determined by data saturation. Data collection were through face-to-face interviews and focus group interviews with TBAs and women of childbearing age. Semi-structured interviews through individual technology-mediated online interviews were provided for HCPs. Findings were analysed using latent content analysis which included data preparation, familiarisation, coding, and analysis of coded data to identify patterns and themes. Phase I Findings: The scoping review found that integrative frameworks are developed in response to the need aimed at improving maternal and newborn care rendered by TBAs as the need to empower community-based maternity care facilitated by TBAs is underscored. Out of the 11 articles reviewed, only four (4) articles comprised of frameworks. Despite the recommendations to integrate the two systems, there is a lack of collaborative frameworks in many countries, and a lack of implementation where they exist. Phase II Findings: Five themes emerged: indigenous knowledge, preconception care, antepartum, intrapartum and postpartum roles. Some of the TBAs perform minor surgery-related procedures similar to haemorrhoidectomy in their homes, which can cause sepsis and bleeding. Majority of HCPs perceive TBAs as relevant while supporting that training and regulating the TBAs can facilitate their integration in reproductive health promotion programmes. Some HCPs disagreed, expressing concern for harmful practices associated with the care rendered by TBAs. The women of childbearing age prefer TBAs due their availability in remote areas and cost-efficient services. However, some indicated that they have no interest in TBAs services. The scoping review conducted in Phase I, and the study findings in Phase II guided the iii development of the standardised collaboration framework (Phase III) and the training manual for TBAs in Phase (IV). Conclusion: TBAs are indigenously skilled practitioners who fill the gap between their communities and the formal health system. Recommendations to integrate TBAs into formal healthcare systems have been put forward by a multitude of researchers, but stagnation towards implementation is evident due to the unavailability of collaborative frameworks. Although the recommendation is that all women should be attended to by skilled healthcare professionals at healthcare facilities; poverty, socio-economic factors and cultural beliefs cause women to seek care from TBAs. The developed framework and training manual can guide integration, and empower TBAs with evidence-based knowledge to ensure optimum reproductive healthcare in their communities.
A community-based model for cervical cancer prevention in Ohangwena and Kavango west regions, Namibia.
(Namibia University of Science and Technology, 2026-04) Elizabeth Kaleinasho Ndakukamo
Background Cervical cancer remains one of the leading causes of cancer related morbidity and mortality among women in Namibia, particularly in rural settings where access to preventive and screening services is limited. Despite national efforts through the Ministry of Health and Social Services to implement the Cervical Cancer Prevention and Control Policy in 2018, service uptake remains low due to social, behavioural, and systemic constraints. This study sought to develop a community-based prevention model for cervical cancer management that integrates community empowerment, health system responsiveness, as well as policy support to strengthen cervical cancer prevention in the Ohangwena and Kavango West regions of Namibia. Methods The study adopted an inductive theory-generating design. Moreover, it was implemented in three sequential phases, adopting a multi-method approach. Phase I entailed a quantitative cross-sectional survey that assessed community members’ knowledge, attitudes, as well as practices regarding cervical cancer prevention. Phase II and III employed an exploratory design to explore women’s health-seeking behaviour that influences the uptake of prevention services, moreover, to examine health system constraints in cervical cancer prevention. Furthermore, data was collected through structured questionnaires, focus group discussions and in-depth interviews, and analysed employing SPSS v29 and ATLAS.ti v23. Findings across the three phases were synthesised to generate key concepts, relationships, and propositions that informed the development of the community-based prevention model for cervical cancer management. Results The study revealed substantial gaps in knowledge and preventive practices of rural communities despite generally positive attitudes toward cervical cancer screening. More importantly, misconceptions, fear of positive results, as well as limited male involvement were prominent impediments to health-seeking behaviour. Furthermore, system-level constraints, including inadequate infrastructure, stock-outs of screening supplies, limited trained personnel, and weak referral systems, further impeded programme effectiveness. However, strong community leadership structures, peer support networks, as well as increasing awareness of women’s health rights emerged as critical facilitators of change. The integration of these findings led to the conceptualisation of a six-component model grounded in policy and financing, research, decentralized governance, equitable and integrated care, capacity building, resilience, and supply chain management, all linked by facilitators such as people-centred care, community empowerment, partnership, and advocacy. Conclusion: This study concludes that achieving a cervical-cancer-free Namibia requires coordinated initiatives that merge community engagement with systemic reform. Moreover, while policy frameworks exist, their translation into context-specific and community-driven interventions remains limited. More importantly, the proposed community-based prevention model provides a practical and adaptable framework for guiding programme design, implementation, as well as evaluation of cervical cancer prevention initiatives in rural Namibia. It emphasises empowerment, inclusivity, and sustainability, offering policymakers and practitioners an avenue to enhance early detection, improve service utilisation, and ultimately reduce cervical cancer growth.
Community-based model for improving well-being and care of older persons in Namibia
(Namibia university of science and technology, 2026-04) Haufiku-Weyulu, Mouyelele Tuyeimo
Introduction/background: Population ageing is accelerating globally and in Namibia, where formal family support structures are increasingly under strain. Strengthened community-based care services (CBCS) are, therefore, essential for sustaining the health and social well-being of older persons. However, in this regard, empirical evidence from low- and middle-income countries (LMICs) remains fragmented and limited, hindering policy and service development. This study addressed these gaps through a programme of work culminating in the Namibia Community-Based Model for Improving the Well-Being and Care of Older Persons, which incorporates individual, social, health-system and structural determinants. This study was achieved through five objectives: it mapped existing CBCS approaches, examined older persons’ awareness and attitudes towards old-age homes; assessed the readiness of old age homes; profiled the prevailing health status and social living conditions of Namibian older persons aged 60 years and above; and developed the model for improving the well-being and care of Namibian older persons. Methodology: A multi-method approach was utilised. For Objective 1, a scoping review was conducted in accordance with the 2022 Joanna Briggs Institute Manual for Evidence Synthesis. The review employed Rayyan for screening, de-duplication, and reporting, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. For Objective 2, a mixed-methods, cross-sectional survey was conducted among community and old age home residents (≥60 years) across three regions. Quantitative analyses were performed using the Statistical Package for the Social Sciences, Version 30 (SPSS v30), (α = 0.05), whereas qualitative interviews with key informants were manually analysed thematically. Objective 3 entailed a structured checklist assessment of six old-age homes in the Khomas and Hardap regions (four private and two public); none were found in the Ohangwena region. The facilities were evaluated to compare the bed capacity, staffing, infrastructure, emergency readiness, and accessibility. For Objective 4, the results were informed by the cross-sectional survey administered to 304 older persons in communities and old-age homes. Correlation analyses and binary logistic regression were employed to examine the relationships between health outcomes and sociodemographic, regional, and service utilisation variables (α = 0.05). Insights from all four objectives informed the fifth objective, which was to develop a community-based model for Namibia to improve the well-being and care of older persons. Results: Objective 1 (scoping review). Twenty-two articles met the inclusion criteria. LMICs face systemic constraints in establishing comprehensive and sustainable frameworks for older-age support, including inadequate pensions, a scarcity of trained geriatric providers, and reliance on informal caregiving, all amidst the context of under-resourced primary care and residential services. Households with older members require additional income to sustain living standards comparable to those of households without older persons. The review emphasises the importance of CBCS, aligning with aspirations for ageing in place. Objective 2 (awareness and attitudes). Preferences indicated a marginal overall difference between remaining in the community and moving to old-age homes, with statistically significant associations between living arrangements, educational attainment, and the number of dependents to preferences for living places (P < 0.001). Qualitative data highlighted pension misuse, transportation barriers to vii healthcare, and caregiver burdens. The study notably integrates quantitative and qualitative perspectives in Namibia, highlighting the viewpoints of caregivers and community leaders and demonstrating the need for targeted awareness, caregiver training, and the expansion of affordable, well-equipped old age homes for older persons. Objective 3 (old age homes capacity and preparedness). The correlation between the bed capacity and occupancy displayed a near-perfect linear relationship (R²≈0.98; ŷ=−4.29+1.06x), indicating operation at or near full capacity, with some residences experiencing over-capacity. Private facilities consistently outperformed public ones in terms of staff, age-friendly amenities, service infrastructure, and emergency preparedness, although they were more expensive. The improvement requirements ranged significantly: public old age homes required extreme renovations/service gap remediation, whilst private homes needed either routine maintenance or medium-priority upgrades. Objective 4 (health status and social living conditions). Among 304 older persons, the predominant diagnoses were musculoskeletal disorders (179; 58.9%) and hypertension (176; 57.9%); about 60% of older persons relied heavily on daily medication. Numerous older persons reported positive residential satisfaction, comfort and safety; nevertheless, loneliness/isolation, financial hardship, and transport difficulties were common. Logistic regression revealed lower odds of current illness and perceived loss of independence among residents of old-age homes compared to their community counterparts (p < 0.05), after accounting for covariates. Objective 5 (Model synthesis). The Namibia Community-Based Model was developed. According to the panel validation results, the model achieved ≥80% agreement across all five Chin and Kramer criteria for model validation (clarity, simplicity, generality, accessibility, and importance), thereby demonstrating high agreement and acceptable validity. It positions older persons within interlocking concepts: individual/biological and health factors, social and community environments, health and care services and institutional/structural enablers. It prioritises caregiver support and professionalisation, as well as decentralised, regulated, and equitably paid long-term care, integrated chronic disease management and screening, and multi-sector collaboration across various sectors. Implementation can be done in phases/stages rather than strictly sequentially, with continuous monitoring and refinement. Conclusion: This study demonstrates that Namibia’s rapidly ageing population faces simultaneous challenges, including multimorbidity and medication dependence, limited household resources, inconsistent service capacity, and significant disparities in quality and accessibility between public and private old-age homes, as well as social barriers such as loneliness and restricted access to transportation. Although older persons often prefer to remain in their preferred home or community setting, this preference varies depending on several factors, including education, family obligations, and the availability of support. Strengthening community-based approaches and services through public awareness, caregiver training and support, enhancing geriatric competencies, providing accessible and age-friendly services, integrating chronic care, and ensuring equitable financing and regulation of residential alternatives are both urgent and feasible. The proposed model offers a practical, evidence-based framework to inform policy and practice, thereby enhancing the dignity, autonomy, and quality of life for older Namibians.
A doctrinal analysis on enforcement mechanisms and compliance challenges in African continental free trade area: Transport services regulatory framework
(Research in Business & Social Science, 2026) Nweke, Ogochukwu Chidiebere; Iipumbu, Vistorina; Petrus, Helvi Ndilimeke; Mabuku, Kennedy K
The purpose of this study was to evaluate the enforcement mechanisms and compliance challenges in Africa’s Continental Trade Regime. This study employed the qualitative doctrinal and policy research design to explore the issue of the enforcement of transport services regulatory matters within the context of the African Continental Free Trade Area (AfCFTA). The study adopted a doctrinal analysis of the AfCFTA instruments with a combination of thematic policy reviews; hence, it relied exclusively on secondary qualitative data obtained from authoritative legal and institutional sources. Primary data sources and materials comprise the AfCFTA Agreement, Protocol on Trade in Services, the Dispute Settlement Protocol, and relevant annexes that govern regulatory cooperation, market access, and nontariff barriers. The data collection procedure involved a systematic desk review and thematic analysis for qualitative studies to analyse the data. The review shows four main enforcement mechanisms of the regulatory framework of transport services under the AfCFTA. These include legal obligations and notification requirements, institutional oversight by AfCFTA bodies, peer review and political accountability, and dispute settlement mechanisms are some of the most outstanding aspects of the AfCFTA Agreement. Factors including regulation fragmentation, the absence of enforcement powers, non-transparency, and restrictive market access conditions, insufficient professional standards in commonality, insecurity, and transport barriers challenges the effectiveness of enforcement mechanisms. The authors conclude that the design of the AfCFTA alone is not adequate in facilitating the opening of the transport service. The study therefore provides pragmatic measures to strengthen the institutional capacity, harmonise the regulations, and monitor compliance better. These reforms can influence the reduction of trade costs, the improvement of supply chain reliability, and the attainment of the AfCFTA's broader aim of economic integration across the continent.