AbstractBackground. Rheumatic heart disease (RHD) remains a public health problem predominantly among women of reproductive age in low- to middle-income settings. Women living with RHD have various experiences pertaining to physical, psychological and reproductive health, before and after surgery.Objectives. To explore and describe the post-surgical experiences of women living with RHD in Namibia.Method. The study used a qualitative approach, using an explorative descriptive study to collect data from women living with RHD with in-depth interviews, followed by thematic analysis of the data. The final sample size was five participants.Results. Key themes that emerged were related to positive experiences in terms of surgical outcome; stigma, family and social relationships, and reproductive health. The findings indicated that the women had a broad range of experiences both at home and at work, and in their reproductive relationships.Conclusion. It is recommended that community RHD education programmes be enhanced to raise awareness and educate the communities in order to curb stigma and discrimination against women living with RHD. Programmes to support women with family planning and good maternal and child health are also recommended. The study findings have potential significance with regard to clinical practices involved in caring for women living with RHD, and efforts to improve their life experiences.
Karthikeyan G, Guilherme L. Acute rheumatic fever. Lancet 2018;392(10142):161-174. https://doi. org/10.1016/S0140-6736(18)30999-1
Marijon E, Mirabel M, Celermajer DS, Jouven X. Rheumatic heart disease. Lancet 2012;379(9819):953-964.
Coffey PM, Ralph AP, Krause VL. The role of social determinants of health in the risk and prevention of group A streptococcal infection, acute rheumatic fever and rheumatic heart disease: A systematic review. PLoS Negl Trop Dis 2018;12(6):e0006577. https://doi.org/10.1371/journal.pntd.0006577
Dougherty S, Beaton A, Nascimento BR, Zühlke LJ, Khorsandi M, Wilson N. Prevention and control of rheumatic heart disease: Overcoming core challenges in resource-poor environments. Ann Pediatr Cardiol 2018;11(1):68-78. https://doi.org/10.4103/apc.APC_135_17
Shimanda PP, Söderberg S, Iipinge SN, Neliwa EM, Shidhika FF, Norström F. Rheumatic heart disease prevalence in Namibia: A retrospective review of surveillance registers. BMC Cardiovasc Disord 2022;22(1):266. https://doi.org/10.1186/s12872-022-02699-2
Forcillo J, Watkins DA, Brooks A, et al. Making cardiac surgery feasible in African countries: Experience from Namibia, Uganda, and Zambia. J Thorac Cardiovasc Surg 2019;158(5):1384-1393. https://doi. org/10.1016/j.jtcvs.2019.01.054
Jonkman LJ, Gwanyanya MP, Kakololo MN, Verbeeck RK, Singu BS. Assessment of anticoagulation management in outpatients attending a warfarin clinic in Windhoek, Namibia. Drugs Ther Perspect 2019;35(7):341-346. https://doi.org/10.1007/s40267-019-00630-y
Liaw J, Walker B, Hall L, Gorton S, White AV, Heal C. Rheumatic heart disease in pregnancy and neonatal outcomes: A systematic review and meta-analysis. PLoS ONE 2021;16(6):e0253581. https://doi. org/10.1371/journal.pone.0253581
Zühlke L, Karthikeyan G, Engel ME, et al. Clinical outcomes in 3343 children and adults with rheumatic heart disease from 14 low- and middle-income countries. Circulation 2016;134(19):1456-1466. https://doi. org/10.1161/CIRCULATIONAHA.116.024769
Chang AY, Nabbaale J, Nalubwama H, et al. Motivations of women in Uganda living with rheumatic heart disease: A mixed methods study of experiences in stigma, childbearing, anticoagulation, and contraception. PLoS ONE 2018;13(3):e0194030. https://doi.org/10.1371/journal.pone.0194030
Tye SK, Kandavello G, Wan Ahmadul Badwi SA, Abdul Majid HS. Challenges for adolescents with congenital heart defects/chronic rheumatic heart disease and what they need: Perspectives from patients, parents and health care providers at the Institut Jantung Negara (National Heart Institute), Malaysia. Front Psychol 2021;11:481176. https://doi.org/10.3389/fpsyg.2020.481176
Neergaard MA, Olesen F, Andersen RS, Sondergaard J. Qualitative description – the poor cousin of health research? BMC Med Res Methodol 2009;9:52. https://doi.org/10.1186/1471-2288-9-52
Sandelowski M. Whatever happened to qualitative description? Res Nurs Health 2000;23(4):334-340.
Campbell MM, Matshabane OP, Mqulwana S, et al. Evaluating community engagement strategies to manage stigma in two African genomics studies involving people living with schizophrenia or rheumatic heart disease.
Glob Health Epidemiol Genom 2021;2021:9926495. https://doi.org/10.1155/2021/9926495
Khanna R, Chandra D, Yadav S, et al. Maternal and fetal outcomes in pregnant females with rheumatic heart
disease. Indian Heart J 2021;73(2):185-189. https://doi.org/10.1016/j.ihj.2021.01.012
Voleti S, Okello E, Murali M, et al. The personal and clinical impact of screen-detected maternal rheumatic heart disease in Uganda: A prospective follow up study. BMC Pregnancy Childbirth 2020;20(1):611. https://
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