Nurses’ Perceptions of Infertility Care in the Public Health Sector in Namibia
Bibliographic record
Abstract
BACKGROUND: Infertility affects an estimated 186 million people globally, with about 12% of couples of reproductive age being affected. In sub-Saharan Africa, the prevalence of infertility ranges between 9% and 30%, and individuals often experience stigma, gendered blame, and psychosocial distress. The role of nurses in infertility care support is paramount to improve patients’ experiences during treatment. In Namibia, research is limited, particularly on nurses’ perceptions of infertility care and patient experiences. METHODS: A qualitative exploratory and descriptive study was conducted between March and August 2024 at four referral hospitals: Intermediate Hospital Katutura, Windhoek Central Hospital, Intermediate Hospital Rundu, and Intermediate Hospital Oshakati. Eleven nurses were purposively sampled from the gynaecology departments. A semi-structured interview guide was used for the interviews. Data were analysed thematically using Braun and Clarke’s six-step framework, guided by the health belief model. Trustworthiness was ensured through Lincoln and Guba’s criteria. RESULTS: Five themes and twelve subthemes emerged: inadequate fertility care in the public sector, characterised by limited diagnostic and treatment options and financial barriers. Limited nursing roles and insufficient knowledge in psychosocial support. Patient experiences are marked by sadness, denial, and stigma, with women disproportionately blamed while men are often denied responsibility. Cultural and gender expectations that reinforced stigma and discouraged psychological support. Desired infertility care improvements, including the introduction of In Vitro fertilisation in the state facilities, community education, adoption options, training for nurses, and dedicated infertility clinics. CONCLUSION: Infertility care in Namibia remains inadequate, with important gaps in service provision and psychosocial support. Nurses emphasised the need for comprehensive infertility care in the public sector, strengthening nursing roles through training and the integration of patient-centred approaches to address stigma, gendered blame and emotional distress.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.006 | 0.003 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".