Academic literature on the topic 'Primary health care – Rwanda'

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Journal articles on the topic "Primary health care – Rwanda"

1

Francois, U., J. P. Balinda, M. Hagenimana, R. Samuel, E. Arielle, and M. A. Muhimpundu. "Scaling Up of Cervical Cancer Screening at Primary Health Care Level in Rwanda." Journal of Global Oncology 4, Supplement 2 (2018): 54s. http://dx.doi.org/10.1200/jgo.18.78700.

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Background: Rwanda is a high cervical cancer-burden country, with an age standardized rate (ASR) of cervical cancer incidence of 41.8 cases per 100,000 people in 2012. In the same year, cervical cancer mortality lay at 26.2 deaths per 100,000 people. Aim: To address this burden, Rwanda initiated the vision inspection with acetic acid (VIA) screening-based strategy in 2013 in line with WHO recommendations for low- and middle-income countries. The target audience of the program was set for women between the ages of 30 and 49 and remains today. Here, we describe the implementation status of the program at the primary health care level; health centers and district hospitals in Rwanda. Methods: Integrating into Rwanda's existing health system, the program was purposefully rooted in health centers, with a pathway designed for women who screen positive to be referred to the district hospital for cryotherapy or LEEP, according to the lesions' size. Nurses, midwives and medical officers from health centers and district hospitals are trained through a 10-day curriculum (5 days for theory and 5 days for practice) before initiating the provision of services to clients in routine care. Monitoring of the program is conducted through both quarterly, on-site mentorship and screening indicators that are integrated into Rwanda's Health Management Information System (HMIS), through which facilities report on monthly basis. Results: Since its initiation in August 2013, Rwanda's cervical cancer screening program has been established in 21 of 38 (55%) district hospitals and 256 health centers in their catchment area. Training has been an integral component as well, with at least two nurses/midwives trained at implementing health centers and a medical officer with two nurses/midwives trained on cervical cancer screening and the treatment of precancerous lesions at district hospital. In addition, district hospitals have been equipped with cryotherapy, LEEP, and colposcopy machines. Over this program's implementation three-and-a-half-year course, 38,000 women have been screened for cervical cancer. Conclusion: Using a simple VIA-based strategy, Rwanda has been able to swiftly and effectively increase the number of health facilities implementing cervical cancer screening program. Though additional innovative implementation strategies are still needed to proportionally increase women's screening coverage, these initial steps hold great promise in Rwanda's ability to effectively implement a sustainable cervical cancer screening program.
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2

Lygidakis, Charilaos, Jean Paul Uwizihiwe, Per Kallestrup, Michela Bia, Jeanine Condo, and Claus Vögele. "Community- and mHealth-based integrated management of diabetes in primary healthcare in Rwanda (D²Rwanda): the protocol of a mixed-methods study including a cluster randomised controlled trial." BMJ Open 9, no. 7 (2019): e028427. http://dx.doi.org/10.1136/bmjopen-2018-028427.

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IntroductionIn Rwanda, diabetes mellitus prevalence is estimated between 3.1% and 4.3%. To address non-communicable diseases and the shortage of health workforce, the Rwandan Ministry of Health has introduced the home-based care practitioners (HBCPs) programme: laypeople provide longitudinal care to chronic patients after receiving a six-month training. Leveraging technological mobile solutions may also help improve health and healthcare. The D²Rwanda study aims at: (a) determining the efficacy of an integrated programme for the management of diabetes in Rwanda, which will provide monthly patient assessments by HBCPs, and an educational and self-management mHealth patient tool, and; (b) exploring qualitatively the ways the interventions will have been enacted, their challenges and effects, and changes in the patients’ health behaviours and HBCPs’ work satisfaction.Methods and analysisThis is a mixed-methods sequential explanatory study. First, there will be a one-year cluster randomised controlled trial including two interventions ((1) HBCPs’ programme; (2) HBCPs’ programme + mobile health application) and usual care (control). Currently, nine hospitals run the HBCPs’ programme. Under each hospital, administrative areas implementing the HBCPs’ programme will be randomised to receive intervention 1 or 2. Eligible patients from each area will receive the same intervention. Areas without the HBCPs’ programme will be assigned to the control group. The primary outcome will be changes in glycated haemoglobin. Secondary outcomes include medication adherence, mortality, complications, health-related quality of life, diabetes-related distress and health literacy. Second, at the end of the trial, focus group discussions will be conducted with patients and HBCPs. Financial support was received from the Karen Elise Jensens Fond, and the Universities of Aarhus and Luxembourg.Ethics and disseminationEthics approval was obtained from the Rwanda National Ethics Committee and the Ethics Review Panel of the University of Luxembourg. Findings will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberNCT03376607; Pre-results.
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Zraly, Maggie, Julia Rubin-Smith, and Theresa Betancourt. "Primary mental health care for survivors of collective sexual violence in Rwanda." Global Public Health 6, no. 3 (2011): 257–70. http://dx.doi.org/10.1080/17441692.2010.493165.

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4

Kamanzi, Moses. "Community Health Workers and The Promotion of Health Care Services in Gasabo District, Rwanda." Matters of Behaviour 9, no. 10 (2019): 1–5. http://dx.doi.org/10.26455/mob.v9i10.57.

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Health care is a primary need of human being. Life expectancy as an indicator of Human Development is below 40 years in most developing countries due to high Maternal Mortality Rate, HIV prevalence, Infant Mortality rate, Malaria prevalence and many other related diseases. This study examined the importance of Community Health Workers (CHWs) role in promoting Health Care services in Gasabo District of Rwanda. A simple random sampling method with the use of a self-administered questionnaire to get primary data was used as well as a literature review for secondary data. The target population was 1500 CHWs with a sample size of 183 CHWs. 55.6% of CHWs have a role of monitoring Malnutrition & growth for children under the age of 5years, 43.2% monitor women during their pregnancy period and diagnose and treat Malaria, Diarrhoea & Pneumonia for children under 5 years old. Other roles of CHWs include; providing health education (43% of CHWs), providing Family Planning services to women (24%), and sensitizing the community for HIV/AIDS testing (14.3%), psychosocial support (11%) and Vaccination (9.8%). The challenges faced by CHWs to accomplish their roles include; transportation facilitation (39.9%), limited time (32.8%), negative perception by communities (37.7%) and no monthly salary pay (38.8%). Although the work of CHWs in Rwanda is voluntary, however, the Ministry of Health should invest more in their work through the provision of transportation facilitation and motivational incentives CHWs.
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5

Nyirandagijimana, B., J. K. Edwards, E. Venables, et al. "Closing the gap: decentralising mental health care to primary care centres in one rural district of Rwanda." Public Health Action 7, no. 3 (2017): 231–36. http://dx.doi.org/10.5588/pha.16.0130.

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6

Price, Jessica E., Jennifer Asuka Leslie, Michael Welsh, and Agnès Binagwaho. "Integrating HIV clinical services into primary health care in Rwanda: a measure of quantitative effects." AIDS Care 21, no. 5 (2009): 608–14. http://dx.doi.org/10.1080/09540120802310957.

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7

Dhillon, Ranu S., Matthew H. Bonds, Max Fraden, Donald Ndahiro, and Josh Ruxin. "The impact of reducing financial barriers on utilisation of a primary health care facility in Rwanda." Global Public Health 7, no. 1 (2012): 71–86. http://dx.doi.org/10.1080/17441692.2011.593536.

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8

Ndayisaba, Aphrodis, Emmanuel Harerimana, Ryan Borg, et al. "A Clinical Mentorship and Quality Improvement Program to Support Health Center Nurses Manage Type 2 Diabetes in Rural Rwanda." Journal of Diabetes Research 2017 (December 3, 2017): 1–10. http://dx.doi.org/10.1155/2017/2657820.

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Introduction. The prevalence of diabetes mellitus is rapidly rising in SSA. Interventions are needed to support the decentralization of services to improve and expand access to care. We describe a clinical mentorship and quality improvement program that connected nurse mentors with nurse mentees to support the decentralization of type 2 diabetes care in rural Rwanda. Methods. This is a descriptive study. Routinely collected data from patients with type 2 diabetes cared for at rural health center NCD clinics between January 1, 2013 and December 31, 2015, were extracted from EMR system. Data collected as part of the clinical mentorship program were extracted from an electronic database. Summary statistics are reported. Results. The patient population reflects the rural settings, with low rates of traditional NCD risk factors: 5.6% of patients were current smokers, 11.0% were current consumers of alcohol, and 11.9% were obese. Of 263 observed nurse mentee-patient encounters, mentor and mentee agreed on diagnosis 94.4% of the time. Similarly, agreement levels were high for medication, laboratory exam, and follow-up plans, at 86.3%, 87.1%, and 92.4%, respectively. Conclusion. Nurses that receive mentorship can adhere to a type 2 diabetes treatment protocol in rural Rwanda primary health care settings.
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9

Ross, Jonathan, Gad Murenzi, Sarah Hill, et al. "Reducing time to differentiated service delivery for newly diagnosed people living with HIV in Kigali, Rwanda: study protocol for a pilot, unblinded, randomised controlled study." BMJ Open 11, no. 4 (2021): e047443. http://dx.doi.org/10.1136/bmjopen-2020-047443.

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IntroductionCurrent HIV guidelines recommend differentiated service delivery (DSD) models that allow for fewer health centre visits for clinically stable people living with HIV (PLHIV). Newly diagnosed PLHIV may require more intensive care early in their treatment course, yet frequent appointments can be burdensome to patients and health systems. Determining the optimal parameters for defining clinical stability and transitioning to less frequent appointments could decrease patient burden and health system costs. The objectives of this pilot study are to explore the feasibility and acceptability of (1) reducing the time to DSD from 12 to 6 months after antiretroviral therapy (ART) initiation,and (2) reducing the number of suppressed viral loads required to enter DSD from two to one.Methods and analysesThe present study is a pilot, unblinded trial taking place in three health facilities in Kigali, Rwanda. Current Rwandan guidelines require PLHIV to be on ART for ≥12 months with two consecutive suppressed viral loads in order to transition to less frequent appointments. We will randomise 90 participants to one of three arms: entry into DSD at 6 months after one suppressed viral load (n=30), entry into DSD at 6 months after two suppressed viral loads (n=30) or current standard of care (n=30). We will measure feasibility and acceptability of this intervention; clinical outcomes include viral suppression at 12 months (primary outcome) and appointment attendance (secondary outcome).Ethics and disseminationThis clinical trial was approved by the institutional review board of Albert Einstein College of Medicine and by the Rwanda National Ethics Committee. Findings will be disseminated through conferences and peer-reviewed publications, as well as meetings with stakeholders.Trial registration numberNCT04567693.
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10

Huerta Munoz, Ulises, and Carina Källestål. "Geographical accessibility and spatial coverage modeling of the primary health care network in the Western Province of Rwanda." International Journal of Health Geographics 11, no. 1 (2012): 40. http://dx.doi.org/10.1186/1476-072x-11-40.

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