Page 26 - Windhoek Graduation (20 May)(SESSION 2)(PhDs, Masters)

Executive Dean: Prof Judith Hall
Faculty of Health Sciences & Veterinary Medicine
SCHOOL OF NURSING AND PUBLIC HEALTH
Associate Dean: Prof Louise Pretorius

DOCTOR OF PHILOSOPHY IN PUBLIC HEALTH

CANDIDATE: ENDJALA Tuwilika

CURRICULUM VITAE

Tuwilika Endjala was born in Oshana region, Namibia. She obtained her
undergraduate nursing qualification from the University of Namibia, a Master’s
degree in Public Health from the University of the Western Cape and a Master’s
degree in Development Studies from the University of the Free State. She has
worked as a registered nurse both in the private and government sector. In addition, she worked as a Chief
Health Programme Officer in MoHSS. She later joined the University of Namibia in 2014 as a Lecturer at the School
of Nursing in Windhoek. She is currently a Senior Lecturer and serves as the Head of Community and Mental
Health Nursing Department.

CANDIDATE’S DISSERTATION

AN EMPLOYEE ASSISTANCE PROGRAMME TO SUPPORT MIDWIVES AFFECTED BY MATERNAL DEATHS AND STILLBIRTHS
IN THE KHOMAS REGION, NAMIBIA

This study was carried out under the supervision of Prof. Hans Justus Amukugo and Dr Emma Maano Nghitanwa,
both from the University of Namibia

Globally, the Employee Assistance Programme (EAP) has become a vital workplace programme that assists
employees in managing personal and work-related problems. Thus, this study targeted the Khomas region, as
the region that recorded the highest maternal deaths (MDs) and Stillbirths (SBs) in Namibia. The study aimed at
developing an EAP that supports midwives affected by maternal deaths and stillbirths.

This pragmatic worldview study was based on a mixed method approach that included a convergent parallel
design, in which the qualitative part used a descriptive, exploratory and contextual design while the quantitative
part used a cross-sectional design. Individual interviews, focus group discussions and structured questionnaires
were the tools used for data collection. The research employed the principles of qualitative and quantitative
data analysis.

The study showed that as a result of maternal deaths and Fresh Stillbirths (FSB), midwives experienced challenges
such as physical, social, psychological and environmental effects as results of high exposure to MD and FSB
coupled with inadequate professional and environmental support. Midwives were also found to be inadequately
prepared to deal with such incidences in the work place. Moreover, midwives were challenged with death
distress such as anxiety, obsession and depression. The coping mechanisms used by midwives in the absence of
an EAP included emotional and problem focused coping such as self-blame, religion, self-destruction, positive
reframing, and acceptance. The findings informed the development of the EAP, which encompasses four
implementation strategies guided by the theoretical and conceptual frameworks.

This study has made significant contributions to the body of knowledge as the situational analysis led to identifying
the midwives’ challenges in terms of MD and FSB in the Khomas Region. A conceptual framework was developed,
which formed the foundation for the study. An Employee Assistance Programme and implementation strategies
were developed to support midwives that have been affected by the witnessing of MD and SB.

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