Page 23 - UNAM Virtual Graduation e-Book (April2021)

FACULTY OF HEALTH SCIENCES
SCHOOL OF PUBLIC HEALTH

DOCTOR OF PHILOSOPHY IN PUBLIC HEALTH

CANDIDATE: MAHALIE Roswitha

CURRICULUM VITAE

Roswitha Mahalie grew up in a small settlement called Bergsig, 170km outside
Khorixas, in the Kunene region. She matriculated from Cornelius Goreseb High
School in the same region. Her qualifications include a Postgraduate Diploma
in Monitoring Evaluation and Research, Stellenbosch University, (2008); Master
in Public Health, University of Limpopo, (2004); Bachelor Degree in Nursing (Advanced Practice), University of
Namibia, (2001) Postgraduate Diploma in Nursing Science (Operating Room), University of Namibia, (2003);
Comprehensive Diploma in Nursing Science, University of Namibia, (1996). Her professional career includes
working as a registered nurse at the Ministry of Health and Social Services; Managing, Monitoring and Evaluation
at the Namibian Global Fund Programme, Pact Namibia and Intrahealth International. She is currently working
as a Health Information Systems Management Lecturer at the Namibia University of Science and Technology in
Windhoek. Her research interest focus is based on surveillance of cardiovascular diseases; integration of public
health and health informatics using machine learning approaches; as well as health information management.

CANDIDATE’S DISSERTATION

A NOVEL SURVEILLANCE FRAMEWORK FOR TRACKING AND PREDICTING HEALTH OUTCOMES OF CARDIOVASCULAR
DISEASES RISK FACTORS AMONG PEOPLE LIVING WITH HIV INITIATED ON ART IN KHOMAS REGION, NAMIBIA

The doctoral study was undertaken and completed under the supervision of Dr. Penehafo Angula (University of
Namibia) as Main-Supervisor, and Prof. Honoré Kabwebwe Mitonga (University of Namibia) and Prof. Olanrewaju
Oladimedji University of Namibia) as Co-Supervisors.

Cardiovascular diseases (CVDs) and the prevalence of traditional risk factors are some of the increasing chronic
comorbidities for People Living with HIV (PLHIV), thus, leading to poor cardiovascular outcomes. Previous studies
have demonstrated that screening for and treatment of intervenable CVDs risk factors could sustain the benefits
achieved with Antiretroviral (ART). Crucially, health systems are not adequately prepared to respond to the
growing CVDs burden in Namibia, by particularly identifying risk factors when clients are screened, enrolled,
or initiated into long-term ART care at health facilities. Despite efforts to ensure integration of CVDs data
management into existing ART platforms, incomplete disease surveillance and record-keeping remain prominent
drawbacks for health data managers. Therefore, the study’s purpose was to develop a surveillance framework to
enhance the tracking and prediction of health outcomes of cardiovascular disease risks among PLHIV initiated
on ART at health facilities in the Khomas region. The study adopted a mixed-methods exploratory sequential
design which was conducted in four phases. The qualitative findings revealed fragmented data management
practices for CVDs preventative care. Furthermore, quantitatively the study suggested that high blood pressure,
obesity, tobacco smoking, and alcohol use are greatly prevalent, particularly among males. Schwartz and
Kim’s hybrid model of concept development was used to identify and analyse main concepts pertaining to
enabling environment, sound data management practices, and evidence-based health outcomes. Guided by
the outcome of the study findings and Arthur Samuel’s seminal work on the machine learning model of 1959, a
surveillance framework was thereafter developed to enhance the tracking and prediction of cardiovascular risks
among PLHIV initiated on ART in the Khomas region. Guidelines to operationalise the framework was developed
based on the core element such as identifying CVDs risk factors, monitoring calculated risks, and measuring
health outcomes. Systems that provide accurate information on CVDs risks, early screening with subsequent
interventions for PLHIV initiated on ART, is recommended by this study.

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