Lawrence N Kazembe

University of Namibia | UNAM · Department of Statistics and Population Studies

Mpox, a zoonotic disease similar to smallpox, has garnered increasing attention due to its sporadic outbreaks across different regions. This study employs a comprehensive statistical approach, combining Poisson regression, Generalized Linear Mixed Models (GLMM), and Bayesian Hierarchical Models (BHM) to analyze the spread of Mpox. The analysis acco...

Universal access to childhood vaccination is important to child health and sustainable development. Here we identify, at a fine spatial scale, under-immunized children and zero-dose children. Using Chad, as an example, the most recent nationally representative household survey that included recommended vaccine antigens was assembled. Age-disaggrega...

In agricultural research, the precision of variable measurement is crucial as it forms the foundation for accurate estimations and informed decision-making. However, the presence of measurement errors in real-world data often leads to skewed estimates and flawed conclusions. This study addresses the common challenge of measurement error, focusing o...

High-quality vaccine-preventable disease (VPD) surveillance data are critical for timely outbreak detection and response. In 2019, the World Health Organization (WHO) African Regional Office (AFRO) began transitioning from Epi Info, a free, CDC-developed statistical software package with limited capability to integrate with other information system...

Climate change poses severe consequences, particularly in sub-Saharan Africa, where poverty rates may escalate by 2050 without significant climate and development action. The health impacts are diverse, encompassing communicable and non-communicable diseases. Mozambique, a climate-vulnerable nation, has experienced significant natural disasters in...

Background Malawi has one of the highest under-five mortality rates in Sub Sahara Africa. Understanding the factors that contribute to child mortality in Malawi is crucial for the development and implementation of effective interventions to reduce child mortality. The aim of this study is to use survival analysis in modeling time to death for under...

Universal access to childhood vaccination is important to child health and sustainable development. Here we identify, at a fine spatial scale, under-immunized children and zero-dose children. Using Chad, as an example, the most recent nationally representative household survey that included recommended vaccine antigens was assembled. Age-disaggrega...

The global onslaught of COVID-19 brought about unforeseen disruptions, significantly imprinting on sectors like essential goods, services, manufacturing, and education. African nations, characterized by their distinct socioeconomic tapestries, stood at an intriguing juncture-facing both systemic vulnerabilities and demonstrating admirable adaptabil...

Introduction Length of hospital stay (LOS), defined as the time from inpatient admission to discharge, death, referral, or abscondment, is one of the key indicators of quality in patient care. Reduced LOS lowers health care expenditure and minimizes the chance of in-hospital acquired infections. Conventional methods for estimating LOS such as the K...

Access and use of antenatal care (ANC) are among the identified interventions to reduce maternal and neonatal mortality. However, access and frequency of ANC visits are inter-related. Quantifying dependencies and shared determinants among inter-related variables are crucial to avoid erroneous conclusions and misinformed policy interventions. This s...

Food security measurement is of paramount importance as it guides governance, policy formulation and intervention projects targeting and monitoring and evaluation. The measurement of food insecurity has proven to be a difficult task owing to the multi-dimensionality of the construct and different measurements have been developed to measure differen...

Background In Malawi, malaria is responsible for 40% of hospital deaths. Prompt diagnosis and effective treatment within 24 h of fever onset is critical to prevent progression from uncomplicated to severe disease and to reduce transmission. Methods As part of the large evaluation of the malaria vaccine implementation programme (MVIP), this study a...

Climate change (CC) poses severe consequences, particularly in sub-Saharan Africa, where poverty rates may escalate by 2050 without significant climate and development action. The health impacts are diverse, encompassing communicable and non-communicable diseases. Mozambique, a climate-vulnerable nation, has experienced significant natural disaster...

Due to the heterogeneity among households across locations, predicting the impacts of stay-at-home mitigation and lockdown strategies for COVID-19 control is crucial. In this study, we quantitatively assessed the effects of the Namibia government’s lockdown control measures on food insecurity in urban informal settlements with a focus on Windhoek,...

Rapid urbanisation and food system transformation in Africa have been accompanied by growing food insecurity, reduced dietary diversity, and an epidemic of non-communicable disease. While the contribution of wild and indigenous foods (WIF) to the quality of rural household diets has been the subject of longstanding attention, research on their cons...

Literature on participation in the informal food sector in cities of the Global South is conventionally characterized by a survivalist or opportunistic perspective. The main difference is that opportunists, in contrast to survivalists, are motivated by entrepreneurial choice rather than necessity and see opportunities for economic and social advanc...

The urbanizing world population has seen increased food insecurity in urban spaces, a result of unsustainable food systems, growing inequalities and weak urban governance that lacks urban food strategies. To improve our knowledge of household strategies employed to survive in urban spaces, we conducted a household survey to examine the relationship...

A central feature of the transformation of urban food systems in cities of the Global South is the growing presence of supermarkets and their supply chains, often termed supermarketization or a supermarket revolution. A key issue in the African context is whether supermarkets are a threat to other sources of food including informal sector vendors....

In health care utilisation, multiple correlated data are common. Quantifying dependencies among interrelated variables is an important statistical problem, particularly to account for the nature of their association. Copula models permit a flexible approach to modelling dependence in interrelated outcome variables. However, their applications are c...

Background Recurrent clinical malaria episodes due to Plasmodium falciparum parasite infection are common in endemic regions. With each infection, acquired immunity develops, making subsequent disease episodes less likely. To capture the effect of acquired immunity to malaria, it may be necessary to model recurrent clinical disease episodes jointly...

This article aims to identify policy responses that would promote short term recovery from Covid-19 and long term inclusive growth in SSA countries. it proposes policy initiatives that would allow an employment-led economic recovery and hence support policy makers, specifically finance and labour ministries as well as aligning social partners to pr...

Fertility rate has been declining over the years in Namibia, and a number of studies have been conducted to investigate how socio-economic and physiological factors influenced fertility decline. This study was aimed at modelling the direct and indirect effects of socio-economic, socio-demographic and health attributes on fertility, as well as the p...

Air Namibia, like any other airline, faces challenges as it operates in the global economy. Extreme scrutiny and debate about Air Namibia's viability has highlighted some of the airline's major issues of strategic, operational inefficiency and inability to create customer value. The study's aim was to establish the impact of passenger loyalty on cu...

Stated preference experiments are become an increasingly popular survey methodology for investigating air traveler's choices. Analysis of this behaviour, which is an element of the demand prediction, helps for a better future planning and development of competing airlines. In this paper, emphasis is stressed on the stated preferences of passengers...

Excellence is an art won by training and habituation* - Aristotle The need for science, technology, engineering and mathematics (STEM) to spearhead development has increased steadily, while communication and dissemination fall behind. In a world continuously influenced by scientific development, STEM communication grows ever more important to enabl...

Background In preventive drug trials such as intermittent preventive treatment for malaria prevention during pregnancy (IPTp), where there is repeated treatment administration, recurrence of adverse events (AEs) is expected. Challenges in modelling the risk of the AEs include accounting for time-to-AE and within-patient-correlation, beyond the conv...

Background In drug trials, adverse events (AEs) burden can induce treatment non-adherence or discontinuation. The non-adherence and discontinuation induce selection bias, affecting drug safety interpretation. Nested case-control (NCC) study can efficiently quantify the impact of the AEs, although choice of sampling approach is challenging. We inves...

Childhood diarrhoea accounts for over 15% of all under-five deaths in Africa. The disease is exacerbated by social vulnerability. This study operationalizes social vulnerability by using three indicators: water poverty, sanitation and assets, to capture social disadvantage, which measures individual or community resources to prevent or mitigate hea...

In December 2019, the SARS-CoV-2 virus emerged in Wuhan, Hubei Province, China, and later spread rapidly to other parts of China and eventually across all countries around the world, including Namibia. Despite causing severe to fatal acute respiratory syndrome, there are no known cures for the SARS-CoV-2 virus, only preventive measures such as soci...

Background In drug trials, clinical adverse events (AEs), concomitant medication and laboratory safety outcomes are repeatedly collected to support drug safety evidence. Despite the potential correlation of these outcomes, they are typically analysed separately, potentially leading to misinformation and inefficient estimates due to partial assessme...

The Informal Food Sector in Oshakati, Namibia, by Lawrence N. Kazembe, Ndeyapo M. Nickanor, Tobias Shinyemba and Jonathan Crush – forms part of the network’s efforts to increase knowledge on urban food systems and household food insecurity in Africa’s cities. It presents the findings of AFSUN-FUEL’s survey of informal food vendors in Oshakati in no...

This report presents the results of the first comprehensive survey of the informal food sector in the Namibian capital of Windhoek. As such, it aims to shed light on the food system of the country’s largest urban centre. The informal food sector is critical to the food security of poor urban households in most rapidly growing towns and cities in th...

This issue of the Journal starts volume 3, an occasion to pause, give thanks, and reflect on the past year or so. Two major events in recent times have shed a true meaning to the saying "think globally, act locally". The Covid-19 pandemic and the Russia-Ukraine war underscored that we exist in a globalizing and “boundaryless” economy. There has bee...

This paper investigates the relationship between dietary patterns and non-communicable diseases (NCDs) in Windhoek based on data from a cross-sectional random sample of 863 households. We identify three major dietary patterns: starch–sugar–oil, fruits–vegetables, and meat–fish, which explain more than 43% of the variation in food consumption. High...

Background In drug trials, clinical adverse events (AEs), concomitant medication and laboratory safety outcomes are repeatedly collected to support drug safety evidence. Despite the potential correlation of these outcomes, they are typically analysed separately, potentially leading to misinformation and inefficient estimates due to partial assessme...

The increase in health research in sub-Saharan Africa (SSA) has led to a high demand for biostatisticians to develop study designs, contribute and apply statistical methods in data analyses. Initiatives exist to address the dearth in statistical capacity and lack of local biostatisticians in SSA health projects. The Sub-Saharan African Consortium f...

The increase in health research in sub-Saharan Africa (SSA) has generated large amounts of data and led to a high demand for biostatisticians to analyse these data locally and quickly. Donor-funded initiatives exist to address the dearth in statistical capacity, but few initiatives have been led by African institutions. The Sub-Saharan African Cons...

Africa is rapidly urbanising and urban food systems are being transformed. Some have argued that this transformation is driven by a supermarket revolution akin to that in North America, Europe and Latin America. Others suggest that the supermarket revolution model oversimplifies complex African realities and that urban food systems are experiencing...

There is growing recognition that removal of gender inequality and women empowerment are central to realizing development goals. Attainment of gender equality would further promote economic growth, reduce poverty, improve maternal and child health in related sustainable development goals. The Demographic and Health Survey (DHS) data provide an oppo...

Background: Drug safety assessments in clinical trials present unique analytical challenges. Some of these include adjusting for individual follow-up time, repeated measurements of multiple outcomes and missing data among others. Furthermore, pre-specifying appropriate analysis becomes difficult as some safety endpoints are unexpected. Although ex...

Background Drug safety assessments in clinical trials present unique analytical challenges. Some of these include adjusting for individual follow-up time, repeated measurements of multiple outcomes and missing data among others. Furthermore, pre-specifying appropriate analysis becomes difficult as some safety endpoints are unexpected. Although exis...

Background Drug safety assessments in clinical trials present unique analytical challenges. Some of these include adjusting for individual follow-up time, repeated measurements of multiple outcomes and missing data among others. Furthermore, pre-specifying appropriate analysis becomes difficult as some safety endpoints are unexpected. Although exis...

Background Drug safety assessments in clinical trials present unique analytical challenges. Some of these include adjusting for individual follow-up time, repeated measurements of multiple outcomes and missing data among others. Furthermore, pre-specifying appropriate analysis becomes difficult as some safety endpoints are unexpected. Although exis...

Namibia is experiencing an increase in its population living in urban areas due to rapid urbanisation, with the biggest growth rate experienced in Windhoek, where about 16% of the total population lives. With rapid population growth, Windhoek faces a number of challenges including the development of informal settlements, which manifest compromised...

Policy responses to the growth of the informal food sector in African cities vary from benign neglect to active destruction. The eradication of street food vending is the dominant mode of governance. Alternative approaches that recognize the inevitability of informality and the role of the sector in making food accessible to the urban poor have beg...

Background: Modelling risk of malaria in longitudinal studies is common, because individuals are at risk for repeated infections over time. Malaria infections result in acquired immunity to clinical malaria disease. Prospective cohorts are an ideal design to relate the historical exposure to infection and development of clinical malaria over time,...

In Malawi, the current approach to family planning using contraceptive methods is individualised, yet studies have shown that variability in contraceptive-use still remains after accounting for it at individual and household levels. Therefore, this study assessed variability at higher levels such as enumeration areas, districts and regions. Biasnes...

Much of the literature on urban food systems has focused on supermarket expansion and their ability to reach urban consumers. However, the current pace of urbanisation and rising urban poverty has been accompanied by a major upsurge in informality and a growing role for the informal food sector. One of the persistent arguments in the supermarkets l...

Background: In malaria endemic areas such as sub-Saharan Africa, repeated exposure to malaria results in acquired immunity to clinical disease but not infection. In prospective studies, time-to-clinical malaria and longitudinal parasite count trajectory are often analysed separately which may result in inefficient estimates since these two process...

There is some controversy on the applicability of the summand-based Household Food Security Assessment Score (HFIAS) and Household Dietary Diversity Score (HDDS) as measures of food insecurity in urban areas in the Global South. These measures were primarily designed for measurement in rural communities where food insecurity itself was first identi...

Informal settlements in rapidly-growing African cities are urban and peri-urban spaces with high rates of formal unemployment, poverty, poor health outcomes, limited service provision, and chronic food insecurity. Traditional concepts of food deserts developed to describe North American and European cities do not accurately capture the realities of...

Impact of Food Insecurity on Quality of Life in Windhoek Informal Settlements: A structural Equation Modelling Approach

Background Mumps are known to occur in Zambia, but outbreaks are rare. Here we report on a recent mumps outbreak, between January and September, 2015. Objective The study was to verify the existence and extent of mumps outbreak in Copperbelt province; to describe the epidemiological characteristics of the outbreak; to identify risk factors associa...

Background Making inferences about measles distribution patterns at small area level is vital for more focal targeted intervention. However, in statistical literature, the analysis of originally collected data on one resolution with the purpose to make inferences on a different level of spatial resolution is referred to as the misalignment problem....

R-codes used to fit Spatio-Temporal models. (TXT)

Data used in this study. (XLS)

The purpose of this evaluation study was to determine the extent to which the teacher educators in the Faculty of Education at the University of Namibia implemented the national Information and Communication Technology (ICT) Policy for Education. This study employed both the quantitative method in the form of questionnaires and the qualitative meth...

We provide first evidence regarding education-occupation mismatch among the youth in Namibia. We investigated and compared the incidence of over-education, under-education and relative wages to education (as a measure of rate of return to education) across regional locations, and between male and female. Key individual determinants of over-educatio...

The surprisingly high rate of supermarket patronage in low-income areas of Windhoek, Namibia's capital and largest city, is at odds with conventional wisdom that supermarkets in African cities are primarily patronized by middle and high-income residents and therefore target their neighbourhoods. What is happening in Namibia and other Southern Afric...

Background Urinary schistosomiasis has been a major public health problem in Zambia for many years. However, the disease profile may vary in different locale due to the changing ecosystem that contributes to the risk of acquiring the disease. The objective of this study was to quantify risk factors associated with the intensity of urinary schistoso...

Socio-economic disadvantage (SED) is an established risk factor or effect modifier of child health status. Motivated by concerns of addressing health inequalities and social justice, this paper examined the place-specific association of SED with child health in Namibia. We explored this aspect by generating two local indicators of SED: material and...

Introduction Quite often disease data are available in aggregated formats mostly to maintain confidentiality. This leads to a misalignment problem when the goal is to analyze risk at a different level of spatial resolution different from the original administrative level where data were available. Objective To estimate and map the risk of measles...

This paper examined care-seeking behaviour and its associated risk factors when a family member had diarrhoea. Data was obtained from a survey conducted in Chikwawa, a district in Southern Malawi. Chikwawa is faced with a number of environmental and socioeconomic problems and currently diarrhoea morbidity in the district is estimated at 24.4%, stat...

Early sexual debut is often associated with a number of social challenges. However, the hazard and risk factors of changing pattern of age at first sex have not been fully explained. This paper investigated the period-cohort effects by fitting flexible time-to-event models of sexual debut using retrospective cross-sectional data of the 2000 and 200...