Little is available in scholarly literature about how HIV-positive prisoners, especially in low-income countries, access antiretroviral therapy (ART) medication. We interviewed 18 prisoners at a large prison in Namibia to identify barriers to medication adherence. The lead nurse researcher was a long-standing clinic employee at the prison, which afforded her access to the population. We identified six significant barriers to adherence, including (1) the desire for privacy and anonymity in a setting where HIV is strongly stigmatized; (2) the lack of simple supports for adherence, such as availability of clocks; (3) insufficient access to food to support the toll on the body of ingesting taxing ART medications; (4) commodification of ART medication; (5) the brutality and despair in the prison setting, generally leading to discouragement and a lack of motivation to strive for optimum health; and (6) the lack of understanding about HIV, how it is transmitted, and how it is best managed. Because most prisoners eventually transition back to communitysettings when their sentences are served, investments in prison health represent important investments in public health.

Introduction:The main objective for this study was to investigate the quality of Sexually Transmitted Infections (STI) treatment and control by the private sector in Namibia.Method:This was a cross-sectional study employing quantitative methodology using different methods of data collection. A self-administered questionnaire exploring General Practitioners (GPs) perceptions of factors that influence the way they manage Sexually Transmitted Infections (STI) which was then concluded with the face to face interviews and the checklist that was used while doing observations in the consulting roomsResults:A total of 50 private general practitioners in the area of Windhoek were interviewed, 48 self-administered questionnaires plus all checklists were received back from the private general practitioners.None of the private general practitioners interviewed had specific training in the syndromic management of the STIs. The 86% of all patients were seen by these private general practitioners on a medical aid, while 14 % pay cash for service provided.With regard to Urethral Discharge, an average of 56.5% of GPs could treat urethral discharge correctly as per the Namibian syndromic approach guidelines. None of the GPs could demonstrate the correct treatment of genital ulcer (whether they received medical aid or not) as recommended in the syndromic approach guidelines in Namibia (GRN, 1999; 2000). Only 28% of the GPs could demonstrate the correct treatment of Pelvic Inflammatory Disease (PID) as per the syndromic management of the STIs. For patients without medical aid the drugs prescribed and their dosages for PID are correct but the frequencies are not in line with the guidelines as for patients with medical aid.Discussion:In general, patients presenting with STIs to the GPs in private practices are not given quality of care because not all private general practitioners have time to do investigations, counseling, give condoms and to notify the partners of those with urethral discharge, genital ulcers and PID looking for treatment.

The primary objective of this study was to explore the perceptions of the community and other stakeholders regarding the delivery and quality of sexually transmitted infection (STI) treatment and care provided by private general practitioners (PGPs) in Windhoek, Namibia.The study provided a situational and contextual analysis employing qualitative methodologies using different methods of data collection. The methodology used included (1) a review of available country policy documents on STI management and surveillance, as well as the policy with regard to private primary care providers, (2) eight in-depth interviews conducted with key informants and (3)three focus-group discussions held with community members attending PGP practices in Windhoek.The perceptions of the care received from PGPs differed from one person to the next. It emerged that some participants had good experiences and some had negative experiences of the care given.The participants believed that going to a PGP for treatment is a matter of affordability that goes hand in hand with the expectations of receiving care, whilst maintaining confidentiality. The study established that there is no real difference between the care provided to patients with medical aid or those without medical aid.It is recommended that interactions between the public and private sector at various levels be initiated to ensure that curable STIs are appropriately managed and that national guidelines for STI management are adhered to. Health workers should also be sensitised about their approach towards patients. It is further recommended that awareness creation amongst PGPs with regard to the public health importance of STIs needs to be raised to encourage them to participate in the STI-control programme.OpsommingDie hoofdoel van die studie was om ondersoek in te stel na die persepsies van die gemeenskap en ander belanghebbendes oor die lewering en kwaliteit van die behandeling en sorg ten opsigte van seksueel oordraagbare infeksies (SOIs) deur privaat algemene praktisyns in Windhoek.Die studie het ’n situasionele en kontekstuele analise behels, waarin gebruik gemaak is van kwalitatiewe metodologieë en verskillende metodes van data-insameling. Die metodologie het ingesluit (1) die bestudering van beskikbare nasionale beleidsdokumente oor die behandeling en monitering van SOIs sowel as die beleid op privaat primêresorgvoorsieners, (2) agt diepteonderhoude met sleutelinformante en (3) drie fokusgroepgesprekke met lede van die gemeenskap wat die praktyke van privaat algemene praktisyns in Windhoek besoek.Die persepsies van die sorg wat van algemene praktisyns ontvang is, verskil van deelnemer tot deelnemer. Dit het aan die lig gekom dat sommige deelnemers die gelewerde sorg positief ervaar het terwyl ander dit negatief ervaar het. Die deelnemers het geglo dat om ’n algemene praktisyn vir behandeling te besoek ’n kwessie van bekostigbaarheid is wat gepaard gaan met ’n verwagting van sorglewering terwyl vertroulikheid behou word. Die studie het bevind dat daar geen verskil is in die sorg wat gelewer word aan pasiënte met ’n mediese fonds teenoor dié daarsonder nie.Daar word aanbeveel dat interaksie op verskillende vlakke tussen die openbare en privaat sektor aangemoedig moet word om te verseker dat behandelbare SOIs voldoende bestuur word en dat die nasionale riglyne ten opsigte daarvan nagekom word. Gesondheidswerkers behoort gesensitiseer te word ten opsigte van hul benadering tot hul kliënte. Daar word verder aanbeveel dat die bewusmaking van die openbaregesondheidsbelang van SOIs onder privaat praktisyns opgeskerp moet word sodat hulle aan die SOI-beheerprogram sal deelneem.

The nursing profession is characterised by the fact that a significant amount of time is spent on competency-related activities. The assessment of clinical competence is therefore an important issue in nursing education and the utilisation of objective structured clinical evaluation for that purpose was considered to be very important in this study. The objective of this research was to explore and describe the perceptions of first- and third-year student nurses with regard to the objective structured clinical evaluation assessment approach. A quantitative, cross-sectional, analytical research design was used. The instrument was a questionnaire (ordinal). This questionnaire focused on the perceptions of student nurses with regard to the objective structured clinical evaluation approach in particular, and with regard to aspects such as reality, execution, time allocation and student and assessor variables. The findings indicated that, as an assessment tool, the objective structured clinical evaluation approach was perceived as not being totally realistic, especially by the more senior nursing students (third-year) as compared with the first-year nursing students. Varying degrees of stress were experienced by the nursing students in their first and third years but, in general, the overall perception appeared to be that the approach was well organised and that the respective students would be able to perform equally well in the clinical field. It may be concluded that the majority of students appreciate the format of the objective structured clinical evaluation approach. However, the study further highlighted the fact that more extensive training of students on time management and the relief of emotional stress is necessary during the implementation of this approach.

Background The current COVID-19 pandemic is affecting all aspects of society worldwide. To combat the pandemic, measures such as face mask–wearing, hand-washing and -sanitizing, movement restrictions, and social distancing have been introduced. These measures have significantly disrupted education, particularly health professions education, which depends on student-patient contact for the development of clinical competence. The wide-ranging consequences of the pandemic are immense, and health professions education institutions in sub-Saharan Africa have not been spared. Objective This paper describes a protocol for assessing the preparedness of selected health professions education institutions in sub-Saharan Africa for remote teaching and learning during the COVID-19 pandemic. Methods A mixed-methods design with a case study approach will be used. The awareness, desire, knowledge, ability, and reinforcement model of change was selected as the conceptual framework to guide the study. Eight higher education institutions in 6 sub-Saharan countries have participated in this study. Data will be collected through electronic surveys from among whole populations of academic staff, students, and administrators in undergraduate medicine and nursing programs. Qualitative and quantitative data from each institution will be analyzed as a case study, which will yield an inventory of similar cases grouped for comparison. Quantitative data will be analyzed for each institution and then compared to determine associations among variables and differences among programs, institutions, or countries. Results Our findings will provide information to higher education institutions, particularly those offering health professions education programs, in Africa regarding the preparedness for remote teaching and learning to influence efforts related to web-based teaching and learning, which is envisaged to become the new normal in the future. Conclusions This study has not received any funding, and any costs involved were borne by individual consortium members at the various institutions. Ethics approval from the institutional review board was obtained at various times across the participating sites, which were free to commence data collection as soon as approval was obtained. Data collection was scheduled to begin on October 1, 2020, and end on February 28, 2021. As of this submission, data collection has been completed, and a total of 1099 participants have been enrolled. Data analysis has not yet commenced. International Registered Report Identifier (IRRID) DERR1-10.2196/28905