Understanding the culture of care: An ethnographic study of how healthcare workers in a mental health centre negotiate care in Windhoek, Namibia

Abstract

This study was aimed at exploring the culture of care that healthcare workers at a Namibian Mental Health Centre have cultivated, their lived experiences and how they use their agency to deliver the service of care. a qualitative research approach to conduct the study. Convenience sampling was used to select a sample of healthcare workers at this Mental Health Centre, based on availability and presence at the Mental Health Centre. Data was collected through the use of participant observations and semi-structured interviews. The findings showed that the Mental Health Centre at Windhoek Central Hospital functions like a 'total institution', however, it is under-equipped, understaffed and lacking the capacity to accommodate all patients. Furthermore, it was established that healthcare workers at the centre have cultivated for themselves a culture of care that is centered on patients feeling and looking better than when they were admitted. Care that involves allowing patients to express themselves in their most comfortable language to make the treatment process smoother was the order of the day. A weekly routine at the centre was found to help both the healthcare workers and the hospital run smoothly. The study also found that the healthcare workers were significantly desensitized to the violence in the workplace that they considered it to be a part of the package of working in a Mental Health Centre. These healthcare workers used their agency to care for both inpatients and outpatients, improvising is second nature for them. This study highlights how agency plays an important role in the provision of care as well as recommends government intervention especially through financial and human capital support to help lead to more effective care at this facility.