Page 26 - SESSION 1 (Graduation e-BOOK)(3 October 2023)

School of Nursing and Public Health
FACULTY OF HEALTH SCIENCES &
VETERINARY MEDICINE

DOCTOR OF PHILOSOPHY
IN PUBLIC HEALTH

CANDIDATE: ZAUANA Katjiuanjo

CANDIDATE’S DISSERTATION
ANALYSIS OF FACTORS CONTRIBUTING TO NON-
ADHERENCE TO HIGHLY ACTIVE ANTIRETROVIRAL
THERAPY IN SELECTED FACILITIES IN NAMIBIA: A
DEVELOPMENT OF ADHERENCE IMPROVEMENT
PROGRAMME FOR HEALTH PROFESSIONALS.
The doctoral study was conducted and completed under the
supervision of Prof. Hans Justus Amukugo of the University of Namibia
as a Main - Supervisor and Prof Timothy Rennie of the University of Bath
as a Co-Supervisor.

The study assessed the level of adherence rates and the factors
contributing to non-adherence to antiretroviral therapy (ART)
in four Primary Health Care Clinics Oshikoto and Kavango West
Regions. Adherence plays an essential role in decreasing the viral
load and boosting immunity, while non-adherence may result in
the development of drug-resistant strains of HIV. The study revealed
sub-optimal adherence rates in Highly Active Antiretroviral therapy
(HAART) participants using two measures. Overall adherence levels
were 76 % with Adult AIDS Clinical Trial Group (AACTG) and 36 % with
Morisky Medication adherence Scale (MMAS-8). The barriers and
challenges that influence adherence to ART ranges from patient
related challenges because of socio-demographic, psycho-social
and socio-economic influences, treatment-related challenges, and
health-system-related challenges.

An adherence improvement programme was developed with input
from relevant stakeholders from four clinics in Onandjokwe, Tsumeb,
Sauyemwa and Rundu to support health professionals in addressing
ART adherence barriers and challenges. It will also be piloted in other
health facilities in Namibia.

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