Knowledge, attitudes and practices of primary healthcare nurses on motor development in children aged 0-24 months in Khomas region, Namibia.

Abstract

Primary healthcare (PHC) nurses play a critical role in monitoring motor development which is a vital aspect of overall child growth and an important indicator for detecting developmental impairments. Early identification of atypical motor patterns facilitates timely intervention, reducing the long-term effects of childhood disabilities. This study therefore aimed to assess the knowledge, attitudes and practices (KAP) of Namibian PHC nurses on motor development monitoring to support early detection and align local practices with international standards of care. In total, forty-five (45) PHC nurses participated in this mixed-methods study. The research followed an exploratory sequential design, commencing with a qualitative phase in which ten (10) in-depth interviews were conducted with chief nurses at each facility using a structured interview guide. Findings from the qualitative phase informed the development of the quantitative instrument. Thirty-five (35) PHC nurses responded to the questionnaire developed for the quantitative data collection phase. PHC nurses completed a structured questionnaire to further explore and quantify the identified themes. This process provided information on the structure and routine operations of the facility and further provided an overview of the existing opportunities to develop knowledge, observed attitudes and current practices employed within the facility. Quantitative results indicated moderate knowledge levels (mean score 58.1%) and highly positive attitudes toward developmental monitoring (mean 8.66/10). Although most participants (88.6%) routinely assessed motor milestones during immunisation visits, only 54.3% were familiar with validated screening tools, suggesting inconsistencies in practice quality. No significant relationships were observed between knowledge, attitudes, and practices (Spearman correlation). Similarly, qualitative findings echoed the same trends as quantitative results, revealing a potentially strong professional commitment but highlighting barriers such as inadequate training, lack of standardised tools and inconsistent referral systems. The study concluded that PHC nurses in Namibia display positive attitudes and moderate knowledge of motor development monitoring, yet limited use of standardised tools and inconsistent practices hinder effective implementation. Strengthening developmental surveillance requires targeted in-service training, adoption of vi standardised assessment protocols and improved referral systems to enhance early identification and intervention for developmental delays.