Background: Non-communicable diseases are on the rise across sub-Saharan Africa. The region has become a targeted growth market for sugar-sweetened beverages, which are associated with weight gain, cardiovascular diseases and diabetes. Objective: To identify politico-economic factors relevant to nutrition-related fiscal policies, and to draw lessons regarding strategies to strengthen sugar-sweetened beverages taxation in the region and globally. Methods: We collected documentary data on policy content, stakeholders and corporate political activity from seven countries in east and southern Africa augmented by qualitative interviews in Botswana, Namibia, Kenya and Zambia, and stakeholder consultations in Rwanda, Tanzania and Uganda. Data were analysed using a political economy framework, focusing on ideas, institutions, interests and power, and a 'bricolage' approach was employed to identify strategies for future action. Results: Non-communicable diseases were recognised as a priority in all countries. Kenya, Zambia, Rwanda, Tanzania and Uganda had taxes on non-alcoholic beverages, which varied in rate and tax base, but appeared to be motivated by revenue rather than health concerns. Botswana and Namibia indicated intention to adopt sugar-sweetened beverage taxes. Healthoriented sugar-sweetened beverage taxation faced challenges from entrenched economic policy paradigms for industry-led economic growth and was actively opposed by sugarsweetened beverage-related industries. Strategies identified to support stronger sugar-sweetened beverage taxation included shifting the economic discourse to strengthen health considerations, developing positive public opinion, forging links with the agriculture sector for shared benefit, and leadership by a central government agency. Conclusions: There are opportunities for more strategic public health engagement with the economic sector to foster strong nutrition-related fiscal policy for non-communicable disease prevention in the region.

This paper reports on the design of a study to examine the policy landscape relevant to sugar-sweetened beverage taxation in seven sub-Saharan African countries. The study responds to the need for strong policy to address the rising burden of non-communicable diseases in the region. Sugar-sweetened beverage taxation has been widely recommended as a key component of a comprehensive policy approach to NCD prevention. However, it has proved a contentious policy intervention, with industry strongly opposing the introduction of such taxes. The aim was to identify opportunities to strengthen sugar-sweetened beverage taxation-related policy for the prevention of nutrition-related NCDs in a subset of Eastern and Southern African countries: Kenya, Tanzania, Botswana, Rwanda, Namibia, Zambia, Uganda. The study was conducted as a collaboration by researchers from nine institutions; including the seven study countries, South Africa, and Australia. The research protocol was collaboratively developed, drawing on theories of the policy process to examine the existing availability of evidence, policy context, and stakeholder interests and influence. This paper describes the development of a method for a policy landscape analysis to strengthen policies relevant to NCD prevention, and specifically sugar-sweetened beverage taxation. This takes the form of a prospective policy analysis, based on systematic documentary analysis supplemented by consultations with policy actors, that is feasible in low-resource settings. Data were collected from policy documents, government and industry reports, survey documentation, webpages, and academic literature. Consultations were conducted to verify the completeness of the policy-relevant data collection. We analysed the frames and beliefs regarding the policy ‘problems’, the existing policy context and understandings of sugar-sweetened beverage taxation as a potential policy intervention, and the political context across relevant sectors, including industry interests and influence in the policy process. This study design will provide insights to inform public health action to support sugar-sweetened beverage taxation in the region.

Background : A number of countries have adopted sugar-sweetened beverage taxes to prevent non-communicable diseases but there is variance in the structures and rates of the taxes. As interventions, sugar-sweetened beverage taxes could be cost-effective but must be compliant with existing legal and taxation systems. Objectives : To assess the legal feasibility of introducing or strengthening taxation laws related to sugar-sweetened beverages, for prevention of non-communicable diseases in seven countries: Botswana, Kenya, Namibia, Rwanda, Tanzania, Uganda and Zambia. Methods : We assessed the legal feasibility of adopting four types of sugar-sweetened beverage tax formulations in each of the seven countries, using the novel FELIP framework. We conducted a desk-based review of the legal system related to sugar-sweetened beverage taxation and assessed the barriers to, and facilitators and legal feasibility of, introducing each of the selected formulations by considering the existing laws, laws related to impacted sectors, legal infrastructure, and processes involved in adopting laws. Results : Six countries had legal mandates to prevent non-communicable diseases and protect the health of citizens. As of 2019, all countries had excise tax legislation. Five countries levied excise taxes on all soft drinks, but most did not exclusively target sugar-sweetened beverages, and taxation rates were well below the World Health Organization’s recommended 20%. In Uganda and Kenya, agricultural or HIV-related levies offered alternative mechanisms to disincentivise consumption of sugar-sweetened beverages without the introduction of new taxes. Nutrition-labelling laws in all countries made it feasible to adopt taxes linked to the sugar content of beverages, but there were lacunas in existing infrastructure for more sophisticated taxation structures. Conclusion : Sugar-sweetened beverage taxes are legally feasible in all seven countries Existing laws provide a means to implement taxes as a public health intervention.

AimsThe present study outlines the perceptions of participants on male involvement in reproductive health (RH) from a management perspective. Background Namibia is one of the African countries affected by cultural and socioeconomic influences that have persuaded gender roles in a way that hinders male-partner involvement in RH. Method A qualitative, exploratory, descriptive design was followed. The target population included all male and female partners attending a health facility and all nurse managers (registered nurses in charge) that provided RH services in the health facility in a northern region in Namibia. Individual interviews were conducted until data saturation occurred. ResultsThe results indicate that the management principles, policy and legislation, as well as resources to facilitate male involvement in RH, were indicated as barriers for nurse managers to facilitate male involvement. Conclusion Male involvement in RH care is needed for an interpersonal and interactive partnership. Implications for Nurse Managers Recommendations are made to establish a partnership within the current health care framework in which reproductive health is provided. IntroductionPreviously, Jamison et al. (2006) as well as Abu-Raddad et al. (2010) have indicated that the majority of people in Africa have a limited knowledge of sexuality and reproductive health (RH), although statistics show that 250 000 mothers and 3 million babies die in Africa annually from complications that are related to sexuality and RH. The current health framework for reproductive health care (RHC) in public health care facilities in Namibia is designed to meet the needs of ante-or prenatal women. However, this framework lacks a focus on including male partners (PANOS/NRCS/ SAFAIDS 2003).The World Health Organization (WHO) regards RH as a basic human right of men and women, because it enables them to be well informed and to have access to safe, effective, affordable and acceptable methods of family planning of their own choice; allowing women to go through a safe pregnancy and childbirth and providing couples with the best chances of having healthy infants (WHO 2006). RH care is defined by the World Health Organization (WHO) (2006) as: 'A constellation of methods, techniques and services that 2 contribute to reproductive health and the well-being of the individual and the family by preventing and solving reproductive health problems'. It also includes sexual health and the purpose of enhancement of life and personal relations, counselling and care related to reproduction and sexuality transmitted diseases

The purpose of the study sought to assess and evaluate the contents and records of the emergency trolley in the maternity section of the state hospitals in Windhoek, Namibia. A quantitative and descriptive research design was used for the study to investigate emergency equipment, essential drugs and emergency trolleys. A convenient sample of 10 emergency trolleys in the Windhoek Central Hospital (Hospital A) and Katutura Intermediate Hospital (Hospital B) in Windhoek, Namibia were used. Data was collected using a checklist adapted and edited from the EMSSA. Data were analysed using Microsoft excel 2013. Essential paediatric equipment including bag valve mask devices, Magill's forceps, oxygen masks were absent in many of the units and wards. Data described that checking of defibrillators, monitors and suction devices still remained a major problem in the units/wards that were fortunate enough to have the aforementioned equipment. A conclusion was that generally the units/wards performed well during the assessments and evaluations. There were still units without emergency trolleys, trolleys that were poorly assessed, and those that were obstructed and registered nurses that had a negative perception to the audit of the emergency trolley. Specialized units such as NICU and Hi-Care Hospital A and Prem Unit Hospital B performed very well in their assessments. Development of policy with regards to assessing, restocking and maintenance of emergency supplies can be used to guide the nurses on what to do. Resuscitation morbidity and mortality meetings in order to identify issues and outcomes surround resuscitation incidences within the unit or ward.

Background: Anaemia remains a public health concern, and the its prevalence varies between countries as well as between age, sex and levels of poverty. This study aims at examining the association between socio-demographic factors and anaemia among children aged 6–59 months in Namibia. Methods: Data was extracted from the 2013 Namibian Demographic Health Survey. The association between anaemia and other factors was examined with logistic regression. Results are reported in odds ratio (OR), with 95% confidence intervals (CI). Results: In total, 1,383 children aged 6–59 months had complete data and included in the analyses. Our study shows that there is a statistically significantly increased risk of anaemia among children from poorer households compared with the richest quintile. Also, there was a statistically significance supporting anaemia being more common among boys than girls. There was also a statistically significant negative effect related to age. Discussion: Our study shows that young children, boys and children in poorer households have an increased risk of anaemia. Considering the adverse impact of anaemia on child development, policies must prioritise factors exacerbating anaemia risk.

Background: Nutrition-related non-communicable diseases contribute to approximately half of the premature deaths in Namibia. Westernisation and urbanisation of communities have resulted in changing dietary patterns that see people eating more refined and high sugar content foods that are a risk for nutrition-related non-communicable diseases. Sugarsweetened beverage taxation has been found to influence consumer purchasing behaviour and to raise revenue for health-promoting activity in other low-and middle-income countries. Objectives: To analyse Namibia's non-communicable diseases prevention policy landscape and assess the readiness of the Government to adopt sugar-sweetened beverage taxation policies for public health. Methods: Government policy documents relating to nutrition-related non-communicable diseases were analysed, utilising predetermined variables based on policy theory. Thirteen key informant interviews were conducted with stakeholders from Government, nongovernmental organisations and academic institutions. Data sets were analysed utilising Kingdon's analytical theory for agenda setting. Results: Nutrition-related non-communicable diseases are an increasing problem that requires immediate action. Diet and lifestyle are recognised as major contributors to noncommunicable diseases. The Government has adopted a multisectoral approach to the control and prevention of non-communicable diseases in Namibia. A sugar-sweetened beverage tax is envisaged in policy, but there is no progress towards its enactment. At the highest level of Government, the Ministry of Finance has ruled out immediate action towards sugar-sweetened beverage taxation. There is little publicly available information about the Namibian beverages industry, but it is closely tied to the South African drinking industry and is influenced by policy action in that country. Conclusion:The Government of Namibia has taken positive steps and the policy environment is friendly towards an SSB tax. The proximity of trade and the competitive nature of the Namibian drinks industry with South Africa suggest that a regional perspective to advocacy would be of value.

Background : Credible data and indicators are necessary for country-specific evidence to support the design, implementation, monitoring and evaluation of sugar-sweetened beverage (SSB) taxation. Objective : A cross-country analysis was undertaken in seven Sub-Saharan African countries to describe the potential role of available data in strengthening SSB taxation. The objectives were to: document currently available data sources; report on public access; discuss strengths and limitations for use in monitoring SSB taxation; describe policy maker's data needs, and propose improvements in data collection. Methods : The study used a mixed-methods approach involving a secondary data analysis of publicly available documents, and a qualitative exploration of the data needs of policy makers’ using primary data. Findings were synthesised and assessed for data strengths and weaknesses, including usability and availability. SSB taxation-related data availability was critically assessed with respect to adequacy in strengthening taxation policy on SSBs. Results : Findings showed a paucity of SSB taxation-related data in all seven countries. National survey data are inadequate regarding the intake of SSBs and household expenditure on SSBs. Fiscal data from SSB tax revenue, value added tax from SSB sales, corporate income tax from SSB companies and SSB custom duty revenues, are lacking. Accurate information on the soft drink industry is not easily accessed. Conclusion : Timely, easily understood, concise, and locally relevant evidence is needed in order to inform policy development on SSBs. The relevant data are drawn from multiple sectors. Cross- sector collaboration is therefore needed. Indicators for SSBs should be developed and included in current data collection tools to ensure monitoring and evaluation for SSB taxation.