Developing an intervention model for data quality management and health information use at community and district levels in Rwanda

Doctor of Philosophy in Nursing. University of KwaZulu-Natal, Howard College 2014.The purpose of this study was to develop an intervention model for health data quality management (DQM) and health information use at community and district levels in Rwanda and similar settings, based on a situation analysis of current practices and performance in Rwanda and existing evidence found in similar settings. This thesis is by publication and comprises three research papers based on the findings of three evaluation studies conducted, and reports on the study four which describes the model developed. Methods The study was initiated based on a systematic review of health DQM and best practices at community and district levels in low-and middle-income countries (LMIC). A retrospective design was used to evaluate the quality of clinical and community health data, and a survey of health information users was conducted. The mixed methods approach was adopted to collect quantitative and qualitative data, and the teamwork in “Group Model Building” (GMB) process through a workshop was used to develop the model.Findings Poor health DQM and health information use at community and District levels in Rwanda and other LMIC was found, particularly at the sources of data. Best practices were also found, but several issues hindering the quality of health data and utilization namely poor management of District Health Information System, lack of institutional support to all stakeholders involved in DQM, and lack of information culture. Variables that influenced the quality of health data and use included the training of the staff and community health workers (CHWs), regular formative supervision and monitoring and evaluation, involvement of all stakeholders, Data Quality Audit (DQA), feedback initiatives, understanding and perception of data usefulness, use of electronic and computerized systems, and proper leadership and coordination. Those variables were included in the model developed. Conclusion Based on the identified barriers to high quality data systems, an intervention model for health DQM and health information use at community and District levels in Rwanda was developed as the main achievement of this study

Exploration of factors that influence the utilisation of HIV/AIDS prevention mehtods among University of KwaZulu-Natal students residing in a selected campus.

Thesis (MN)-University of KwaZulu-Natal, Durban, 2009.In this study, the researcher is interested in the utilization of HIV/AIDS prevention methods among university students. The purpose of this study was to explore factors that influence the utilization of existing HIV/AIDS prevention methods amongst students at the University of KwaZulu-Natal residing in a selected campus. Four residences within the selected campus were randomly selected and participants were conveniently selected from each of sampled residences. There was a total of 335 respondents and 261 (78%) completed the manual questionnaires while 74 (22%) completed online questionnaires. The study used quantitative approach and was descriptive-exploratory in nature. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 15. The majority of respondents were young people with the mean age of 22.9 years. The sample comprised 278 (78%) undergraduate and 57 (17%) post graduate students. Study findings showed that the factors which influenced the utilization of HIV/AIDS prevention methods varied and that they were mainly influenced by the awareness of the existing university-based HIV/AIDS prevention strategies. It also emerged that the mostly utilized HIV prevention methods were VCT services and free condoms. Perceived susceptibility and the perceived threat of HIV/AIDS score was also found to be correlated with HIV Risk Index score. Furthermore, there was Correlation between perceived susceptibility and perceived threat of HIV/AIDS and self-efficacy on condoms and their utilization. However, there seemed to be no relationship between utilization of HIV/AIDS prevention methods and these variables. In conclusion, the findings of this study suggest that most of Health Beliefs Model (HBM) variables were not predictors of the utilization of HIV/AIDS prevention methods among students. Intervention aiming to improve the utilization of HIV/AIDS prevention methods among students at the UKZN should focus on removing identified barriers, promoting HIV/AIDS prevention services and providing correct knowledge on HIV for behavioral change

Uptake of Cervical Cancer Screening and Associated Factors Among Women Attending Outpatient Services in Rwamagana Hospital, Rwanda

BackgroundCervical cancer is a global public health threat for women. Rwanda Ministry of Health recommends screening as preventive strategy. However, the screening remains low in Rwanda.ObjectiveTo determine the uptake level of cervical cancer screening and associated factors among Rwandan women.MethodsA quantitative analytical cross-sectional study design was used. We recruited 178 participants using convenience sampling from an estimated 320 women who attended outpatient department in the previous month. The sample size was calculated using the Yamane’s formula. We used chi-square test, t-test and multiple logistic regression analysis to analyse data.ResultsA total of 178 (100%) participants completed the survey. Forty-one (23%) participants had undertaken cervical cancer screening. Knowledge (OR: 1.26,95% CI:1.069-1.485, p=.006) and income were predictors of cervical cancer screening uptake. Participants earning RWF ≥ 63,751 were more likely to uptake cervical cancer screening (OR:11.141, 95% CI:3.136-39.571, p< .001) compared to those earning less than RWF 25,500 monthly.ConclusionCervical cancer screening uptake among study population was low. Participants with more knowledge and high-income were more likely to uptake cervical cancer screening. Improving women’s knowledge and socioeconomic situation would improve the uptake of cervical cancer screening.Rwanda J Med Health Sci 2021;4(3):387-39

Knowledge, attitudes and barriers of nurses on benefits of the quality of patient record-keeping at selected public district hospitals in Burundi

The study examined the patient record-keeping knowledge, attitudes and barriers of nurses on benefits of the quality of patient record-keeping in two hospitals in Burundi. A quantitative descriptive survey design with a selfadministered questionnaire was used to collect data from 121 nurses at two public district hospitals. The results show 82.6% (n = 100) of nurses scored > 80% on the scale of knowledge indicating adequate knowledge; 17.4% (n = 21) of nurses scored < 80%, indicating insufficient knowledge. Regarding attitudes, 64% (n = 78) of nurses scored > 80% on the attitudes scale, while 36% (n = 43) scored < 80%, indicating negative attitudes. Barriers contributing to poor quality of patient record-keeping were lack of training on record-keeping (81.3%, n = 99), excessive work load, demotivation (81.3%, n = 99), lack of time (46, n = 38%), and poor support by administrative policies (55.4%, n = 67). The Chi-square test show statistically there was a significant association between years of experience and respondents’ knowledge on benefits of the quality of patient record-keeping (χ2 = 19.182, p = .000724). On the attitudes scale the Chi-square test shows that level of education was significantly associated with respondents’ attitudes on benefits of the quality of patient record-keeping (χ2 = 22.674, p = .001). The study demonstrated that although there was adequate knowledge and positive attitudes on benefits of the quality of patient record-keeping, there were barriers contributed to poor quality of patient record-keeping in the selected hospitals. Gender, and years of experience as well as level of education was significantly associated with nurse’s knowledge on benefits of the quality of patient record-keeping. Implications of the findings were discussed

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries - Study protocol

© 2018 Munar W et al. Background. For the last two decades there has been growing interest in governmental and global health stakeholders about the role that performance measurement and management systems can play for the production of high-quality and safely delivered primary care services. Despite recognition and interest, the gaps in evidence in this field of research and practice in low- and middle-income countries remain poorly characterized. This study will develop an evidence gap map in the area of performance management in primary care delivery systems in low- and middle-income countries. Methods. The evidence gap map will follow the methodology developed by 3Ie, the International Initiative for Impact Evaluation, to systematically map evidence and research gaps. The process starts with the development of the scope by creating an evidence-informed framework that helps identify the interventions and outcomes of relevance as well as help define inclusion and exclusion criteria. A search strategy is then developed to guide the systematic search of the literature, covering the following databases: Medline (Ovid), Embase (Ovid), CAB Global Health (Ovid), CINAHL (Ebsco), Cochrane Library, Scopus (Elsevier), and Econlit (Ovid). Sources of grey literature are also searched. Studies that meet the inclusion criteria are systematically coded, extracting data on intervention, outcome, measures, context, geography, equity, and study design. Systematic reviews are also critically appraised using an existing standard checklist. Impact evaluations are not appraised but will be coded according to study design. The process of map-building ends with the creation of an evidence gap map graphic that displays the available evidence according to the intervention and outcome framework of interest. Discussion. Implications arising from the evidence map will be discussed in a separate paper that will summarize findings and make recommendations for the development of a prioritized research agenda