Theme 9 and 10

• Namibia is an upper middle-income country (World Bank), with a population of 3million. Females' make-up 51.2%, males' make-up 48.8%. The average life expectancy for Namibians is 65.8 years; 63.1 for males and 68.3 for females (NSA, 2023).
• Khomas region remains the most populous region in Namibia (with a population of 494,729 people). Ohangwena region closely follows as the second most populous region (with a population count of 337,729 people) (NSA, 2023).
• Major cause of morbidity and premature death in Namibia


  • Deaths due to communicable diseases specifically HIV/AIDS
  • The Zambezi Region has the highest HIV/AIDS prevalence in the country (World Health Report, 2021)
  • HIV/AIDS related illnesses have been the leading cause of death in Namibia since 1996 up to today
  • More male HIV deaths than female
• Non-communicable diseases (NCDs) in Namibia


  • Cardiovascular diseases, stroke, Diabetes Mellitus and Cancers are emerging as threats to the health system that is already burdened by infectious diseases, namely HIV/AIDS, TB and malaria
• Most common NCDs in Namibia


  • Cardio-vascular Diseases (CVD) e.g. Hypertension, Stroke, Congestive Cardiac Failure (CCF) and other cardio myopathies
  • Diabetes Mellitus (Type 2 Diabetes is increasingly occurring among young children)
  • Cancers (cervical, prostate and breast cancers)
  • Chronic Respiratory Diseases, e.g. Asthma, Chronic Obstructive Pulmonary Diseases (COPD)
  • Violence and Injuries including Road Traffic Accidents (RTAs) or Motor Vehicle Accidents (MVA)
  • Mental health problems
  • Oral- and dental diseases and conditions
• Most diagnosed cancers in Namibia


  • breast cancer, Kaposi Sarcoma, cervical, prostate and lip/oral cavity cancers
• Intentional injuries in Namibia


  • domestic or interpersonal violence
  • Self-harm (suicide)
• Unintentional injuries in Namibia


  • road or motor vehicle accidents (especially males between age 20-29)
  • poison
  • fires
  • falls
• Risk factors for communicable and NCDs in Namibia


  • the use of tobacco products (both active and passive smokers; more common among males than females)
  • excessive alcohol intake (widespread in Namibia, especially among the youth; Increases likelihood of engaging in unsafe sexual behaviour)
  • lack of physical exercise (more males than females are physically active)
  • unhealthy diets (The consumption of fruits and vegetables is below the recommended standard)
• Most popular drugs of choice in Namibia


  • Cannabis
  • Mandrax tablets
  • Cocaine powder
  • Crack cocaine
  • Crystal meth
• Ways drugs can kill users and non-users in Namibia

  • Overdose
  • Suicide
  • Motor vehicle injuries
  • Unsafe sexual practices (increasing risk for HIV/AIDS infections)
  • Homicide
  • Birth defects
• Sexual behaviour in Namibia can lead to HIV/AIDS infections and unwanted pregnancy (contribute to unsafe abortions practices, abandoned or neglected children)
• Statistics from the MoHSS, from 2018 to 2021, teenage pregnancies in Namibia stood at 56 300
• Challenges related to medical and medication errors in Namibia


  • Stocking up on some medications and not others
  • Lack of healthcare equipment's/tools
  • Different drugs that may have similar names
  • Lack of the health system to identify fatalities caused by medical errors hampers efforts to prevent such deaths
  • For fear of malpractice claims
  • Unsure of how many deaths are autopsied for cause of death and for identifying medical errors
• Examples of medical and medication errors in Namibia


  • Giving a patient two drugs that interact dangerously
  • Prescribing wrong medication
  • Removing someone's womb without their consent
  • Mistaking the small intestine for the umbilical cord
  • Misdiagnosis and therefore incorrect treatment
  • Premature discharge of patient
  • Surgical device left inside a patient during surgery
  • Surgery gone wrong, often leaving the patient scarred for life
  • Unnecessary operations
• Between 1 April 2017 to 31 March 2019, 119 cases of medical negligence have been reported by the HPCNA
• Major causes of premature death in Namibia vs Africa and the World

  • Namibia: HIV/AIDS, Cardiovascular diseases, Ill-defined (cause of death unknown/under investigation)

  Africa: Lower respiratory infections (pneumonia, bronchitis), Neonatal diseases, TB, Diarrhoeal diseases, Cerebrovascular diseases (strokes), Nephritis and Nephrosis (kidney diseases), Motor Vehicle Accidents (MVA), Digestive diseases

  World: Lower respiratory infections, HIV/AIDS, Diarrhoeal diseases, Coronary heart disease, Malaria, TB, Stroke, Maternal, MVAs, Coronary heart disease, Stroke, Pulmonary disease, Lower respiratory infections, Alzheimer's, Lung cancers, Diabetes, MVAs, Diarrhoeal diseases, TB
• Social stress


  Can lead to illness regardless of individual health behaviours and healthy lifestyle choices
• Three major meanings of stress


  • Stress refers to situations that makes individuals feel anxious and out of balance

  2. Stress refers to the emotions that result from exposure to such situations

  3. Stress refers to the bodily changes that occur in response to these situations and emotions
• Acute stress


  Such as the death of a loved one
• Chronic stress


  Such as long-term social isolation/loneliness/low self-esteem/financial difficulties/poverty
• Stress is often cumulative (resulting from acute and chronic stresses that an individual has experienced). Cumulative stress is a strong predictor of ill-health.
• Fight-or-flight syndrome


  The physical stress response that helps our bodies produce additional energy and oxygen and hence respond more quickly and effectively to threats
• Prolonged stress can encourage individuals to adopt unhealthy behaviours.
• Chronic stress (especially poverty) diminishes individual's abilities to ward-off infections, depression and other health problems.
• Social networks


  The webs of social relationships that link people to each other, whether friends, peers, classmates, relatives, acquaintances, co-workers, etc.
• How social networks affect health

  • Offer individuals access to social support, assistance with assignments, financial assistance

  Provide health-related information that can help individuals remain or become healthy

  Expose individuals to specific social norms
• Disadvantaged individuals are less able to avoid stress or recover from illness.
• Patient adherence


  The extent to which a patient correctly follows medical advice
• Health communication


  The study and practice of communicating promotional health information, such as in public health campaigns, health education, and between doctor and patient
• Reasons why individuals consult for health care


  • Differences in symptom perception

  Differences in symptom explanation

  Differences in symptom evaluation
• Differences in symptom perception

  People perceive the seriousness of their symptoms according to the severity, familiarity, and duration/frequency of the symptoms
• Differences in symptom explanation


  People make sense of their symptoms and explain them within the context of their lives, using their own knowledge and experience as well as that of family and friends
• Differences in symptom evaluation


  People weigh the relative costs and benefits of consulting, and may decide against it due to other priorities, waiting to see if symptoms cease, or concerns about what the healthcare provider will think
• Delays in healthcare consultations may seriously affect a patient's risk of disease progression and the development of health-related complications.
• Iceberg figure


  Demonstrates how healthcare providers do not see or treat illnesses that occurs in a specific community, and only see and treat symptoms of a disease (the 'tip of the iceberg')
• A larger percentage of individuals may experience health challenges that would respond to medical treatment but may show no symptoms, take the symptoms lightly, self-medicate, or seek alternative treatments.
• Mismatch


  Between what patients and healthcare practitioners perceive as appropriate reason for consulting
• Some HPs experience feelings of frustration and anger


  To what they may perceive to be inappropriate or trivial consultations
• Both experiences (HP frustration/anger and patient consultations)


  Influence subsequent consultations, adherence to treatment and health-seeking behaviour