KEY MESSAGES   Empowerment (women, youth, communities) Inclusion (age + gender) Prevention/Early Detection 
PROGRAM RECOMMENDATIONS   Partner with Rwandan medical students to improve program delivery Communicate monthly with local leaders Partner with Community Health Center 
FUTURE INTERVENTIONS   Partner with Rwandan medical students to improve program delivery Communicate monthly with local leaders Partner with Community Health Centerhttps://jdc.jefferson.edu/cwicposters/1026/thumbnail.jp

Zhang, Emily

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KEY MESSAGES   Empowerment (women, youth, communities) Inclusion (age + gender) Prevention/Early Detection 
PROGRAM RECOMMENDATIONS   Partner with Rwandan medical students to improve program delivery Communicate monthly with local leaders Partner with Community Health Center 
FUTURE INTERVENTIONS   Partner with Rwandan medical students to improve program delivery Communicate monthly with local leaders Partner with Community Health Centerhttp://jdc.jefferson.edu/cwicposters/1026/thumbnail.jp

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Sexual and Reproductive Health in Rwanda

Jefferson Digital Commons

Thomas Jefferson UniversityJefferson Digital CommonsCWIC Posters Jefferson College of Population Health11-30-2016Sexual and Reproductive Health in RwandaEmily ZhangThomas Jefferson University, emily.zhang@jefferson.eduFollow this and additional works at: http://jdc.jefferson.edu/cwicpostersPart of the International Public Health CommonsLet us know how access to this document benefits youThis Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of ThomasJefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarlypublications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers andinterested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion inCWIC Posters by an authorized administrator of the Jefferson Digital Commons. For more information, please contact:JeffersonDigitalCommons@jefferson.edu.Recommended CitationZhang, Emily, "Sexual and Reproductive Health in Rwanda" (2016). CWIC Posters. 26.http://jdc.jefferson.edu/cwicposters/26BACKGROUND                                         STATISTICS •  Fertility rate: 4.6 per woman (2010) •  Teen pregnancies: 4.7% (2012) •  Mortality:  •  Maternal- 340/100,000 (2011)  •  Infant- 50/1,000 (2013)   •  Contraceptive Use (15-49 y/0 women): 31% (2011) •  Syphilis prevalence: 0.9% (2016)            RWANDA INITIATIVES •  Decentralization •  Improved Monitoring •  Increased providers/integration •  Solidarity approach RESULTS                                             METHODS PROGRAM INTERVENTION DISCUSSION Sexual and Reproductive Health in Rwanda Emily Zhang Sidney Kimmel Medical College, Philadelphia, PA, USA References Family Planning curriculum + STI Introduction: Adapted from FEMpower Women’s Empowerment Health Education Program (University of Delaware) STIs and Hepatitis curriculum: Adapted from CDC, UpToDate, and WHO Binagwaho, A., Farmer, P. E., Nsanzimana, S., Karema, C., Gasana, M., Ngirabega, J. D., … & Drobac, P. C. (2014). Rwanda 20 years on: investing in life. The Lancet Public Health, 384, 371-375. doi: 10.1016/S0140-6736(14)60574-2 Farmer, P. E., Nutt, C. T., Wagner, C. M., Sakabaraga, C., Nuthulaganti, T., Weigel, J. L., … & Drobac, P. C. (2013). Reduced premature mortality in Rwanda: lessons from success. Boston Medical Journal, 346-352. doi: 10.1136/bmj.f65 Ministry of Health (2011). Rwanda health sector strategic plan 2012-2018. Retrieved from www.moh.gov.rw/fileadmin/templates/Docs/HSSP_III_FINAL_VERSION.pdf Ministry of Health (2013). National guidelines for prevention and management of HIV, STIs, & Other Blood Borne Infections. Retrieved from  www.aidsfree.usaid.gov/sites/default/files/hts_policy_rwanda.pdf Ministry of Health Rwanda, PMNCH, WHO, World Bank, AHPSR, & participants in the Rwanda multistakeholder policy review (2014). Success factors for women’s and children’s health: Rwanda. Retrieved from www.who.int/pmnch/successfactors/en/ Muhoza, D. N., Rutayisire, P. C., & Umubyeyi, A. (2016). Measuring the success of family planning initiatives in Rwanda: a multivariate decomposition analysis. American Journal of Population Research, 1-17. doi: 10.1007/s12546-016-9177-9   Mutagoma, M., Remera, E., Sebuhoro, D., Kanters, S., Riedel, D. J., & Nsanzimana, S. (2016). The prevalence of syphilis infections and its associated factors in the general population of Rwanda: a national household-based survey. Journal of Sexually Transmitted Diseases, 2016, 1-8. doi: 10.1155/2016/4980417 National Institute of Statistics of Rwanda (NISR) [Rwanda], Ministry of Health (MOH [Rwanda], & ICF International (2015). Rwanda demographic and health survey 2014-2015: key indicators. Retrieved from www.dhsprogram.com/pubs/pdf/FR316/FR316.pdf Solo, J. (2008). Family planning in Rwanda- how a taboo topic became priority number one. Retrieved from www.intrahealth.org/page/family-planning-in-rwanda-how-a-taboo-topic-became-priority-number-one Venkatraman, C. M., Camacho, A. V., & Michaud, P. A. (2013). WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. Journal of Adolescent Health, 52, 517-522. doi: 10.1016/j.jadohealth.2013.03.002 Westoff, C. F. (2013). The recent fertility transition in Rwanda. Population and Development Review, 38(1), 169-178. doi: 10.1111/j.1728-4457.2013.00558.x KEY DETERMINANTS INTERVENTIONS EVALUATION •  Pre-test and Post-test [Two sample two-tailed paired t-test (α=0.05)] •  Evaluation Survey (Likert Scale) + Behavior Change Goals •  Evaluation Workshop Akarambi RuliEvaluation	  Score	  (Likert	  Scale)8.2/10 10.0/10Family	  PlanningAkarambi RuliEvaluation	  Score	  (Likert	  Scale)8.8/10 9.0/10STIsAkarambi RuliEvaluation	  Score	  (Likert	  Scale)7.7/10 8.2/10Hepatitis23 25 55 23 0 10 20 30 40 50 60 Akarambi (n=4; p=0.03) Ruli (n=4; p=0.8) TEST SCORE (%) Family Planning Pre-test  Post-test  9 27 48 77 0 10 20 30 40 50 60 70 80 90 Akarambi (n=6; p=0.003)  Ruli (n=4; p=0.002) TEST SCORE (%) STIs Pre-test  Post-test  0 0 44 50 0 10 20 30 40 50 60 Akarambi (n=4; p=0.02)  Ruli (n=5; p=0.004) TEST SCORE (%) Hepatitis Pre-test  Post-test  •  RELATIONSHIP: Limited parent-teen support  •  COMMUNITY : Technology + Limited resources/evaluation •  SOCIETAL : Cultural pressure (children; contraception)  •  NATIONAL: •  Late policy making (1981) •  Instability (1994 Genocide) •  Limited services/integration KEY MESSAGES •  Empowerment (women, youth, communities) •  Inclusion (age + gender) •  Prevention/Early Detection •  Expand programs for 10-14 y/o children + parents •  Recruit more husbands/partners •  Increase workforce development, coordination, & research FUTURE INTERVENTIONS •  Partner with Rwandan medical students to improve program delivery •  Communicate monthly with local leaders  •  Partner with Community Health Center    PROGRAM RECOMMENDATIONS •  Key Messages •  Risk factors, Transmission, Prevention, Symptoms, Treatment •  Family Planning- Birth spacing + Better health •  Interventions •  Expanded young-adult services •  National gender policies •  Increased partnerships + male/religious leader recruitment INFRASTRUCTURE  	   TOPIC	   	   FAMILY PLANNING	   STIs	   HEPATITIS 	  SUBTOPICS	  •  Life Planning	  •  Father Involvement	  •  Female Empowerment	  •  Healthy Relationships	  •  Contraception	  •  Birth Spacing	  •  Preventing Unplanned Pregnancies	  •  Chlamydia 	  •  Genital Herpes 	  •  Syphilis 	  •  Gonorrhea	  •  Hepatitis A	  •  Hepatitis B	  •  Hepatitis C	  •  Hepatitis D	  •  Hepatitis E	  ACTIVITIES	  •  Reflection/review questions	  •  Videos	  •  3-D models	  •  Cycle bracelets	  •  Reflection questions	  •  Mini-Jeopardy	  •  Simulation game	  Mini-Jeopardy	  Family	  Planning-­‐	  Future	  Goals	  	  Teach	  +	  apply	  life	  planning	  Con1nue	  promo1ng	  contracep1on	  Help	  change	  villagers'	  behaviors	  Hepa55s	  -­‐	  Future	  Goals	  Start	  teaching	  about	  Hepa11s	  (preven1on	  +	  symptoms)	  Advise	  people	  to	  get	  tested	  STIs	  -­‐	  Future	  Goals	  Promote	  abs1nence	  +	  condom	  use	  Encourage	  community	  health	  center	  visits	  Teach	  about	  dangers	  of	  STIs	  

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Sexual and Reproductive Health in Rwanda

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