Quality improvement and quality assurance in healthcare settings depend to a great degree on interpersonal relationships that enable effective communication and understanding between individuals. Poor interpersonal relationships between health professionals, patients or groups are considered detrimental to the achievement and sharing of common goals. This paper explored the experiences of managers and health professionals regarding the quality of health care delivery at the Ministry of Health and Social Services (MoHSS) in Namibia, using interviews and focus group discussions. The findings indicated negative attitudes by health professionals towards patients; poor communication among health professionals; lack of motivation and team work as well as resistance to change. It was concluded that most of the problems at MoHSS health care facilities are due to the lack of strong interpersonal relationships, either between patients and health professionals or between health professionals and management. The researchers recommend future research to document the views and experiences of private health providers and patients.

This article describe the process followed by the researcher in the development of the conceptual framework for a quality improvement training programme for health professionals in the Ministry of Health and Social Services in Namibia. The conceptual framework of this study was based on the Practice Orientated Theory of Dickoff (1968) that assisted with explaining the concepts used in developing the quality improvement training programme for health professionals at the health facilities. Dickoff' s (1968) practice orientated theory consists of the agent, recipients, context, procedure, dynamics, and the terminus. In this study, the agent was a quality specialist, the recipients were health professionals, the context was the health facilities, the dynamics were challenges that health professionals were experiencing; the procedure was the training programme, while the terminus was knowledgeable and skillful health professionals in quality health care delivery.

This article focuses on the paradigmatic perspective facilitate the development of a quality improvement training programme for health professionals in the ministry of health and social services in Namibia. The study of this nature requires a paradigmatic perspective; this is a collection of logically linked concepts and propositions that provide a theoretical perspective or orientation that tends to guide the research approach to a specific. Assumptions are useful in directing research decisions during the research process. The study adopted a constructivism and interpretivism approach, since it involved understand the current situation of quality health care/service delivery at health care facilities, and explore and describe the of the health professionals; experiences at the health care facilities. The study was based on the specific information that was accepted as true, as obtained from those lived the experiences of challenges and constraints of providing quality health care at the health care facilities. The paradigm perspectives in this study include Meta -theoretical assumption which consisted ontological, epistemological, axiological, methodological and rhetorical assumptions. Theoretical basis of the study includes Dickoff (1968), Practice Oriented Theory; Programme development by Meyer and Van Niekerk; Kolb's Theory of experiential learning; Demining's model of quality improvement, Quality improvement policy of the Ministry of Health and Social Services (MoHSS) and Centre for Diseases control (CDC) framework for programme education.

The paper describes the steps followed in the development of a quality improvement training programme for health professionals. This was echoed by the facts that the health professionals are facing in their quest for quality health care delivery. In Namibia, most health care facilities have not been yielding good results in response to patients' health care needs. Health care dynamics are complex and inundated with several factors; among others new methods, speed of improving medical science and technology, as well as increasing demands of the clients to address emerging and re-emerging diseases. In order to achieved that the five phases of programme development by Meyer and Van Niekerk (2008) were modified to facilitate the programme development. Quality improvement training for health professionals. Those five phases were situational analysis; conceptual framework; developing of the training programme; development of the guidelines for the implementation; and Evaluation of training programme.

This paper is focuses on the description of the guidelines for implantation of a quality improvement training programme for health professionals. The formulation of the guidelines also borrowed the CDC (2001) steps and UNFPA phases of developing the guidelines for successful implementation of the training programme at the health care facilities in the MoHSS. The facilitator(s) and implementers of the training programme are advised to first understand the background and the development process of the training programme for successful implementation. These guidelines have been developed to assist quality manager(s) and facilitator(s) with the implementation of the quality improvement training programme for health professionals at the health care facilities (MoHSS). The guidelines enhance consistency in steps and methods to be followed during the implementation of the programme. The guidelines were derived from the conceptual framework that was developed during the exploratory and situation analysis of quality health care delivery at the health care facilities. Two prominent theories were adapted in developing these guidelines. Firstly, Deming's PDSA model of quality improvement and secondly, Kolb's experiential learning theory. These theories were used to understand the teaching and learning styles. The guidelines outlined the process, activities, and elements required to implement the such programme.