Building a health-promoting schools conceptual framework model as a strategy to address barriers to learning and to promote healthy development of school-aged children

Philosophiae Doctor - PhDAfter suffering almost total collapse. Rwanda has made impressive post-genocide progress. Many children of school going age are now attending school, but regrettably, only half complete primary school. High numbers of orphans, disabled children and a growing number of children from child-headed households still suffer the consequences of the poverty inherited from the past. Health problems include HIV/Aids, STIs, malaria, tuberculosis, enteric diseases, mental health problems, hunger and malnutrition. Use of drugs and substance abuse, unwanted pregnancies, lack of support services, unavailability of teaching and learning materials, inflexible curricula and poor teaching methodologies also contribute to learning breakdown. It is against this background that this thesis was conducted to investigate the development of a health-promoting schools model to provide an appropriate strategy to address barriers to learning and to promote healthy development of school children in Rwanda. Two research questions were the focus of this research, first, how does a health-promoting schools model provide an appropriate strategy to address barriers to learning and to promote healthy development of school-aged children in Rwanda and second, what are the participants’ views on and understanding of the model and its potential use in their schools? A mixed methods research design that employed both qualitative and quantitative approaches was used. The study followed sequential implementation: Phase 1 was concerned with the identification of the components for the model. It was a case study of four schools, two rural schools and two urban schools in Kigali City. The sample included 60 teachers, pupils, principals and parents from schools and nine key informants who were policymakers from the Ministries of Education and Health and Social Welfare, line institutions and the UNICEF. Data collection strategies included focus group discussions, semi-structured, in-depth individual interviews, a transect walk and observations. Data analysis was through content analysis. Eight themes emerged out of the data: school leadership and management; school health policies; pupil wellbeing; school partnership with parents, families and local communities; school health services; factors affecting teaching and learning for all children; teacher wellbeing; and a healthy physical school environment. These themes became the components that informed the development of a health-promoting schools model. In Phase 2, the degree of understanding of this proposed model and its components were investigated in each school community

Epidemiology of and risk factors for falls among the community-dwelling elderly people in selected districts of Umutara Province, Republic of Rwanda

Magister Scientiae (Physiotherapy) - MSc(Physio)Falls among elderly people have been identified as a significant and serious medical problem confronting a growing number of older people. Falls have been found to be a leading cause of disability, distress, admission to supervised care and death among older persons that pose a serious problem to public health. The purpose of this study was to determine the prevalence of and risk factors for falls in the community-dwelling elderly persons in the Umutara province of Rwanda.South Afric

Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda

Abstract Background: The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda. Methods: The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors. Results: In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions. Conclusion: The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals