Description of a quality improvement training programme for health professionals in the ministry of health and social services in Namibia


  • Julia Paul Nangombe 1Quality Assurances and Quality Improvement. Office of Vice President, Veterans Affairs, Republic of Namibia
  • Hans Justus Amukugo University of Namibia





Description, Quality Improvement, Training Programme, Health Professionals.


The aim of this paper is to describe the quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia. The Practice Oriented Theory of Dickoff (1968) was used as practical guidelines to develop the conceptual framework. This framework was employed during the research and the educational programme development process. During the research process, the agent was the researcher; recipients (Managers/leadership and health professionals); the context (MoHSS head office and healthcare facilities); dynamics (findings for objective one and two); Procedure (research process) and terminus (foundations for development of educational programme).

 For the educational programme developing process, agent (quality specialist), recipients (health professional), context (health facilities), procedure (training programme for health professionals), dynamics, (challenges hampering successful implementation of the programme) and the terminus (knowledge, skills and abilities acquired through the training programme). During the development of the quality improvement training programme, two main theories were adapted. The most prominent one was a model by Meyer and Van Niekerk (2008), which was adapted to guide the process of developing the training programme. Kolb’s experiential learning theory was used to explain the learning process and styles of developing knowledge through experiences.

The content of the training programme was derived from five main themes, 17 sub-themes and the conceptual framework based on the situation analysis about challenges faced by the health care facilities. The five themes were lack of implementation of policies and guidelines; inadequate resources; lack of interpersonal relationships; inadequate understanding of quality assurance and quality improvement; and inadequate research to provide evidence-based information during treatment and patient care.

The educational programme consisted of the purpose / aim, objectives, structure / design, facilitation process, implementation process, and evaluation of the programme.

Author Biography

Hans Justus Amukugo, University of Namibia

Dr Hans Justus Amukugo holds a PhD in Nursing Science from the University of Namibia.  He is specializing in Nursing science, education and health service management. Currently he is a lecturer, member of Unam postgraduate committee, supervisor for master and PhD students teach research methodology, co- coordinator of undergraduate and postgraduate research activities at the School of nursing and Public health. His research interests are qualitative research, model, and theory and programme development in health perspectives. E – Mail address:


[1] Ministry of Health and Social Services (2013). National Quality Management Policy. Windhoek. Namibia.

[2] Ministry of Health and Social Services (2013). Report of the Presidential Commission of Inquiry: Ministry of Health and Social Services, January 31, 2013. Windhoek.

[3] Ministry of Health and Social Services (2014). Final Report. Assessment of the National Quality Management System Used to Monitor and Improve Quality Health Service Provision in Hospitals and Health Centres in Namibia. Windhoek.

[4] World Health Organisation (2000). Design and implementation of health information systems. (Theo Lippeveld, Rainer Sauerborn, Claude Bodart, Eds.). Geneva. Retrieved June 5, 2015 from

[5] World Health Organisation (2000). Issues in health services delivery. Improving Provide Skills. Strategies for assisting health workers to modify and improve skill: Developing quality health care – a process of change. Discussion paper No.1. Retrieved August 20, 2014 from

[6] World Health Organisation (2006). HMN, Framework and standards for the development of country health information systems. The need for strong health information systems. (accessed, Oct. 9, 2014).

[7] World Health Organisation (2006). Improving health worker performance: in search of promising practices. Retrieved, June 12, 2013 from

[8] Whittaker, S., Lynam, F. P, Burns, D. & Doyle, V. Introducing quality assurance to health service delivery - some approaches from South Africa, Ghana and Kenya. International journal for Quality in Health Care, 1998; Vol.10 (3). pp. 263-267. Country reports. Retrieved June 14, 2015 from

[9] McLaughlin, C. P. & Kaluzny, A. D. (2006). Continuous Quality Improvement in Health Care. Theory, Implementations and Applications. (3rd ed.). Jones and Bartlett Publishers. United States of America.

[10] Meyer, J. A., Carroll, S.S., Kutyla, T., Stepnick, L. S., & Rybowski, L. S. (2004). Hospital quality: ingredients for success— overview and lessons learned.

[11] Berwick, D. (1989). Continuous Improvement as an Ideal in Health Care. New England Journal of Medicine; Vol.320 (1): pp. 53–56.

[12] Murray, C. J., & Frenk, J. (2000). A Framework for Assessing the Performance of Health Systems. Bulletin of the World Health Organization. Vol. 78 (6): pp. 717–31.

[13] Meyer, S. & Van Niekerk, S. (2008). Nurse educator in practice. Cape Town. Juta & Co Ltd.

[14] Tuch, R. (2007). An Introductory Guide to National Qualification Framework. Concept and Practice Issues for Policy Makers. International Labour Organisation (ILO). Switzerland. Retrieve December 4, 2014 from

[15] Offei, A., Sagoe, K., Owusu Acheaw, E., Doyle, V., & Haran, D. (2010). Health Care Quality Assurance Manual for a Regional-Led, Institutional -based Quality Assurance Programme. . Eastern Regional Health

[16] Harris, M. J. (2011). Evaluating Public and Community Health Programs. (1st Edition). JohnWiley & Sons. United States of America.

[17] Langer, A. M. (2002). Reflecting on practice: Using learning journals in higher education and continuing education. Teaching in Higher Education, Vol. 7(3), 337-351.

[18] Thorpe, K. (2004). Reflective learning journals: From concept to practice. Reflective practice, Vol. 5(3), 327-343.

[19] Bergström, P. (2010). Process Based Assessment for Professional Learning in HigherEducation: Perspectives on the Student-Teacher Relationship. May 2010, Vol. 1(2). Retrieved February 12, 2013 from

[20] Dover, K. H. (2004). Break the ice in classrooms and meetings. Icebreakers. Retrieved September 8, 2015 from

[21] Kelly, M. (2004). Warming up the classroom climate. The Ice Breaker. Retrieved September 8 2014 from

[22] Smith, P. and Ragan, T. (1999). Instructional design (2nd ed.). New York: John Wiley & Sons, Inc.

[23] Ziv, A., Wolpe, P., Small, S., & Glick, S. (2003). Simulation-based medical education: An ethical imperative. Academic Medicine, 78(8), 783-788.

[24] Begg, M., Ellaway, R., Dewhurst, D. & Macleod, H. (2007). Transforming Professional Healthcare Narratives into Structured Game-Informed-Learning Activities. Innovate: Journal of Online Education, 3(6).

[25] Galloway, S. J., (2009). Simulation Techniques to Bridge the Gap Between. Novice and Competent Healthcare Professionals. OJIN: The Online Journal of Issues in Nursing. Vol. 14(2). May 31, 2009.

[26] Doerr, H. & Murray, W. (2008). How to build a successful simulation strategy: The simulation learning pyramid. In R. Kyle & W. Murray (Eds.), Clinical Simulation: Operations, Engineering and Management (Chapt. 80). New York: Elsevier, Inc.

[27] Beaubien, J., & Baker, D. (2004b). The use of simulation for training teamwork skills in health. Vol.13 (i51–i56). Retrieved May 23, 2014 from http//

[28] Doerr, H. & Murray, W. (2008). How to build a successful simulation strategy: The simulation learning pyramid. In R. Kyle & W. Murray (Eds.), Clinical Simulation: Operations, Engineering and Management (Chapt. 80). New York: Elsevier, Inc.

[29] Oxford Pocket Dictionary of Current English (2009). Oxford University Press. Retrieved 8 September 2015 from

[30] Harlen, W., Gipps, C., Broadfoot, P. & Nuttall, D. (1994). Assessment and the improvement of education. Chapter 34 in Moon, B. & Mayes, A.S. Teaching and Learning in the Secondary School. London: Routledge / the Open University.

[31] Heritage, M. (2007). Formative assessment: What do teachers need to know and do? Phi Delta Kappan. Vol. 89(2), pp. 140–145.

View Full Article: