Met and unmet palliative care needs of people living with HIV/AIDS in Rwanda

The rising number of people living with HIV/AIDS (PLWHA) worldwide has made health care professionals and policy makers search for accessible health care that will meet the needs of people who are suffering from the disease and enhance their quality of life (QoL).This study investigated met and unmet palliative care needs of PLWHA in selected areas in Rwanda.The study sample included 306 participants: PLWHA, health care professionals and coordinators of HIV/AIDS units. Quantitative and qualitative methodologies were used.The data were analysed separately and then triangulated. In the findings, over 50% of PLWHA had symptoms related to HIV/AIDS most of the time, with the most common symptom being pain. Participation in activities of daily living was significantly associated with the health status of PLWHA (

Lokale participatie in het bos- en natuurbeheer in de gemeente Ede

Resultaten van een onderzoek onder de inwoners van Ede naar de behoefte aan participatie in het bosbeheer en naar de frequentie van bosbezoek, en een vergelijking met de participatiegedachten die leven bij enkele grote bos- en natuurbeheerders in de gemeente Ede. Op grond van het bosbezoek in relatie tot de participatiebehoeften zijn vier verschillende participatiegroepen onderscheiden , die niet alleen verschillen in sociaal-economisch opzicht maar ook in hun visie op de gewenste toekomst van het landelijk gebied (natuur- en landschapsontwikkeling, biologisch-organische plattelandsontwikkeling of economische ontwikkeling). De ideeën van de boseigenaren over participatie gaan minder ver (consultatie) dan de wensen van de gebruikers (meebeslissen

Enhancing the education of paediatric nurses: A positive step towards achieving sustainable development goals

Aim: The aim of this discursive paper was to describe and expound on how paediatric nurses will be able to address the needs of children and adolescents through the lens of selected Sustainable Development Goals (SDGs) in Rwanda. Design: A discursive analysis of SDGs relating to the roles of paediatric nurses in the context of Rwanda. Methods: A discursive method using SDGs as a guiding framework is used in this paper. We drew on our own experiences and supported them with the available literature. Results: A collection of contextually relevant examples of how paediatric nurses will be able to address the needs of children and adolescents through the lens of selected SDGs in Rwanda was discussed. The selected SDGs expounded on were: no poverty, good health and well-being, quality of education, decent work and economic growth, reduced inequalities, and partnerships for the goals. Conclusions: There is no doubt that the paediatric nurses in Rwanda play undeniable key roles in attaining SDGs and their targets. Thus, there is a need to train more paediatric nurses with the support of the interdisciplinary partners. Collaboratively, this is possible in the bid to ensure equitable and accessible care to the current and future generations. Public contribution: This discursive paper is intended to inform the different stakeholders in nursing practice, research, education and policy to support and invest in the advanced education of paediatric nurses for attainment of the SDGs

Why HIV Positive Patients on Antiretroviral Treatment and/or Cotrimoxazole Prophylaxis Use Traditional Medicine: Perceptions of Health Workers, Traditional Healers and Patients: A Study in Two Provinces of South Africa

The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART). The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART), using an exploratory qualitative design in two provinces of South Africa: an urban township health facility in the Western Cape, and a rural district hospital in KwaZulu-Natal (KZN) with antennal HIV rate of 32% and 28%’respectively. In-depth interviews were conducted with 14 participants: six HIV patients on ART and using Traditional Medicine(TM), two doctors, two nurses and four traditional healers. Two focus group discussions - one at each site - were held with community health workers who work with HIV-positive patients (Western Cape [5] and in KZN [4]). Patient said to have used Traditional Healing Practices (THP) before they were diagnosed with HIV, and some who have been diagnosed with HIV continue using TM in conjunction with ART and/or Cotrimoxazole prophylaxis. Patients preferred not to disclose THP to health professionals because of lack of support and understanding. Patients utilize THP because of family expectations, privacy and confidentiality, especially when they have not disclosed their HIV status. Healthcare professionals had strong negative opinions about THP, especially for HIV-positive patients. Traditional healers supported the patient’s rationale for THP use. This study revealed a need to better understand factors involved in patients’ choosing to use THP concurrently with ART

Prevalence of hepatitis B and C infection in persons living with HIV enrolled in care in Rwanda

BACKGROUND: Hepatitis B (HBV) and C (HCV) are important causes of morbidity and mortality in people living with human immunodeficiency virus (HIV). The burden of these co-infections in sub-Saharan Africa is still unclear. We estimated the prevalence of the hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCVAb) among HIV-infected individuals in Rwanda and identified factors associated with infection. METHODS: Between January 2016 and June 2016, we performed systematic screening for HBsAg and HCVAb among HIV-positive individuals enrolled at public and private HIV facilities across Rwanda. Results were analyzed to determine marker prevalence and variability by demographic factors. RESULTS: Overall, among 117,258 individuals tested, the prevalence of HBsAg and HCVAb was 4.3% (95% confidence interval [CI] (4.2-4.4) and 4.6% (95% CI 4.5-4.7) respectively; 182 (0.2%) HIV+ individuals were co-infected with HBsAg and HCVAb. Prevalence was higher in males (HBsAg, 5.4% [5.1-5.6] vs. 3.7% [3.5-3.8]; HCVAb, 5.0% [4.8-5.2] vs. 4.4% [4.3-4.6]) and increased with age; HCVAb prevalence was significantly higher in people aged ≥65 years (17.8% [16.4-19.2]). Prevalence varied geographically. CONCLUSION: HBV and HCV co-infections are common among HIV-infected individuals in Rwanda. It is important that viral hepatitis prevention and treatment activities are scaled-up to control further transmission and reduce the burden in this population. Particular efforts should be made to conduct targeted screening of males and the older population. Further assessment is required to determine rates of HBV and HCV chronicity among HIV-infected individuals and identify effective strategies to link individuals to care and treatment

Adherence to isoniazid preventive therapy among child contacts in Rwanda: A mixed-methods study

The World Health Organization recommends isoniazid preventive therapy (IPT) for six months for child contacts without tuberculosis (TB), who are exposed to an adult with active TB. The effectiveness of IPT depends on 80% or greater adherence to medication. In the current study, we assessed IPT adherence and explored barriers to and facilitators of adherence among eligible child contacts in Kigali, Rwanda.A mixed method study design was used to prospectively assess adherence to IPT among eligible child contacts and its associated factors through a quantitative, observational cohort study, and to explore barriers to and facilitators of adherence to IPT through a descriptive qualitative study

Lived experience of healthcare professionals providing safe abortion in Rwanda

BACKGROUND: Various countries have ratified the law declaring that safe abortion is a fundamental women’s right. Rwanda has expanded legal grounds for abortion in Law n° 68/2018 of 30/08/2018, determining offenses and penalties in general. This study aimed to gain an in- depth understanding of how physicians, midwives and nurses perceive safe abortion service provision and their experience of providing the service in Rwanda. METHODS: A qualitative, descriptive phenomenological method with transcendental theory devised by Husserl Edmund was used to guide this study. A non-random purposive sampling recruited twenty-three informants, and a semi-structured interview guide was used to collect data. The data analysis used NVivo pro 12 software to categorize and code ideas, while the eight steps of transcendental descriptive phenomenology were used to generate the final themes. RESULTS: Four themes with ten sub-themes were generated: (1) personal feelings and beliefs (humiliation and stigma, guilty and wonder); (2) resilient mechanisms (Clients’ protection, institutional support, appreciation of the law); (3) training and (4) informants’ recommendations (integrated service, community awareness, psychological support, follow-up). CONCLUSION: Healthcare providers’ willingness to provide safe abortion services depend on the individual’s beliefs about abortion. Professionalism and resilient mechanisms are key to sustaining the safe abortion service provision in addition to the law determining offenses and penalties in general in Rwanda