Prevalence and factors associated with fertility desire among HIV-positive women in Rwanda in the context of improved life expectancy.

BACKGROUND: The knowledge of the key factors associated with fertility desire among people living with HIV/AIDS is crucial for the efficient planning of maternal and child health care programs. Fertility desire has generally increased among women of reproductive age in Rwanda. However, its level and determinants among women living with HIV/AIDS (WLHA) are currently not well known in the context of Rwanda. The present study aimed to fill in this knowledge gap. METHODS: Data were extracted from the 2015 Rwanda demographic and health survey (RDHS) for 243 HIV-positive women of reproductive age. Univariate and multivariable logistic regression analyses were conducted in order to identify the most influential factors. RESULTS: The prevalence of desire to have another child in HIV-positive women was found to be as high as 40.7%. Multivariable logistic regression analyses showed that the woman's age of 35-49 years (AOR = 0.051, 95% CI: 0.013-0.204), woman's parity of 3 children or above (AOR = 0.177, 95% CI: 0.037-0.837), being employed (AOR = 0.298, 95% CI: 0.113-0.782) and currently using contraceptives (AOR = 0.146; 95% CI: 0.057-0.375) were significantly associated with low odds of fertility desire among HIV- positive women in Rwanda. Women younger than 25 years, with no living child, or who were unemployed or who were not using any contraceptive were significantly associated with greater odds of desire to have another child than did other HIV- positive women. A woman whose partner's desire for children is different  from hers was associated with about four times higher odds (AOR = 3.752; 95% CI: 1.203-11.702) of desire for more children than women who desire the same as their partners. CONCLUSION: Fertility desire in WLHA is currently high in Rwanda. It is significantly influenced by demographic and socioeconomic factors. The Rwanda's health care system should be prepared to intensify the required services for the prevention of the vertical transmission of HIV, the delivery of maternal and child health care services, and the support to WLHA in planning their fertility. Interventions should target low-parity young women, with a particular focus on meeting their contraceptive needs.

Factors associated with research productivity in higher education institutions in Africa: a systematic review.

Background: There are low levels of research productivity among Higher Education Institutions (HEIs) in Africa, a situation that is likely to compromise the development agenda of the continent if not addressed. We conducted a systematic literature review to synthesize evidence of the factors associated with research productivity in HEIs in Africa and the researchers' motives for research. Methods: We identified 838 publications related to research productivity in HEIs in Africa from various databases, from which we included 28 papers for review. The inclusion criteria were that (i) the paper's primary focus was on factors associated with research productivity, and motivations of doing research among faculty members in Africa; (ii) the setting was the HEIs in Africa; (iii) the type of publication was peer-reviewed papers and book chapters based on primary or secondary data analysis; and (iv) the language was English or French. Essays, opinions, blogs, editorials, reviews, and commentaries were excluded. Results: Most of the studies operationalized research productivity as either journal publications or conference proceedings. Both institutional and individual factors are associated with the level of research productivity in HEIs in Africa. Institutional factors include the availability of research funding, level of institutional networking, and the degree of research collaborations, while individual factors include personal motivation, academic qualifications, and research self-efficacy. Conclusions: Deliberate efforts in HEIs in Africa that addressed both individual and institutional barriers to research productivity are promising. This study recommends that the leadership of HEIs in Africa prioritizes the funding of research to enable researchers to contribute to the development agenda of the continent. Moreover, HEIs should build institutional support to research through the provision of research enabling environment, policies and incentives; strengthening of researchers' capabilities through relevant training courses, mentorship and coaching; and embracing networking and collaboration opportunities.

Prevalence of teenage pregnancy and the associated contextual correlates in Rwanda.

The rate of teenage pregnancy remains unacceptably high in most developing countries. In Rwanda, studies show a rapid increase over the past two decades despite the political achievements of women's empowerment, and efforts to curtail child sexual abuse. Unfortunately, the current knowledge of the household determinants of teenage pregnancies in Rwanda is limited, as recent studies have focused on providing numbers with little analysis of proximate causal factors or focused on the individual determinants. The study uses secondary data from the recent Rwanda Demographic and Health Survey (RDHS: 2014-2015) to analyse household factors associated with teenage pregnancies in Rwanda. In addition to descriptive analysis, we ran logistic regression models to determine the level of association between teenage pregnancy and household socioeconomic characteristics. Results indicate that marital status and age of household head, household size, number of bedrooms given the size of the household, and the educational level of the household-head are significantly associated with teenage pregnancy (p < 0.01). Teen girls from small households are more likely to get pregnant than those from large families, while financial, social and educational empowerment of parents, and harmonious household contexts contribute to lessening the cases of teenage pregnancy. It indicates that social and economic support to teen girls which include parental supervision, guidance, and financial care are essential aspects to consider in order to reduce teenage pregnancy rates. The study suggests that in addition to efforts directed to teens themselves, strategies for reducing teen pregnancies should focus on a range of household-level contexts that form two broad categories: empowering parents and maintaining parents' harmonious decisions on teen girls.

CARTA fellows' scientific contribution to the African public and population Health Research agenda (2011 to 2018).

BACKGROUND: Since its inception in 2009, the Consortium for Advanced Research Training in Africa (CARTA) program has focused on strengthening the capacity of nine African universities and four research centres to produce skilled researchers and scholars able to improve public and population health on the continent. This study describes the alignment between CARTA-supported doctoral topics and publications with the priorities articulated by the African public and population health research agenda. METHODS: We reviewed the output from CARTA PhD fellows between 2011 and 2018 to establish the volume and scope of the publications, and the degree to which the research focus coincided with the SDGs, World Bank, and African Development Bank research priority areas. We identified nine key priority areas into which the topics were classified. RESULTS: In total, 140 CARTA fellows published 806 articles in peer-reviewed journals over the 8 years up to 2018. All the publications considered in this paper had authors affiliated with African universities, 90% of the publications had an African university first author and 41% of the papers have CARTA fellows as the first author. The publications are available in over 6300 online versions and have been cited in over 5500 other publications. About 69% of the published papers addressed the nine African public and population health research agenda and SDG priority areas. Infectious diseases topped the list of publications (26.8%), followed by the health system and policy research (17.6%), maternal and child health (14.7%), sexual and reproductive health (14.3%). CONCLUSIONS: Investments by CARTA in supporting doctoral studies provides fellows with sufficient training and skills to publish their research in fields of public and population health. The number of publications is understandably uneven across Africa's public and population priority areas. Even while low in number, fellows are publishing in areas such as non-communicable disease, health financing, neglected tropical diseases and environmental health. Violence and injury is perhaps underrepresented. There is need to keep developing research capacity in partner institutions with low research output by training more PhDs in such institutions and by facilitating enabling environments for research.

Increasing collaborative research output between early-career health researchers in Africa: lessons from the CARTA fellowship program.

In 2008 nine African Universities and four African research institutions, in partnership with non-African institutions started the Consortium for Advanced Research Training in Africa (CARTA) to strengthen doctoral training and research capacity on health in Africa. This study describes particular aspects of the CARTA program that promotes collaboration between the PhD fellows in the program, and determines the patterns of collaborative publications that resulted from the intervention. We reviewed program monitoring and evaluation documents and conducted a bibliometric analysis of 806 peer-reviewed publications by CARTA fellows published between 2011 and 2018. Results indicate that recruiting multidisciplinary fellows from various institutions, encouraging registration of doctoral-level fellows outside home institutions, and organizing joint research seminars stimulated collaborative research on health-related topics. Fellows collaborated among themselves and with non-CARTA researchers. Fellows co-authored 75 papers (10%) between themselves, of which 53 (71%) and 42 (56%) included fellows of different cohorts and different disciplines respectively, and 19 (25%) involved fellows of different institutions. CARTA graduates continued to publish with each other after graduating - 11% of the collaborative publications occurred post-graduation - indicating that the collaborative approach was maintained after exiting from the program. However, not all fellows contributed to publishing collaborative papers. The study recommends concerted effort towards enhancing collaborative publications among the CARTA fellows, both doctoral and post-doctoral, which can include holding research exchange forums and collaborative grant-writing workshops.

Sharing perspectives and experiences of doctoral fellows in the first cohort of Consortium for Advanced Research Training in Africa: 2011-2014.

BACKGROUND: Resolution of public health problems in Africa remains a challenge because of insufficient skilled human resource capacity. The Consortium for Advanced Research Training in Africa (CARTA) was established to enhance capacity in multi-disciplinary health research that will make a positive impact on population health in Africa. OBJECTIVE: The first cohort of the CARTA program describes their perspectives and experiences during the 4 years of fellowship and puts forward suggestions for future progress and direction of research in Africa. CONCLUSIONS: The model of training as shown by the CARTA program is an effective model of research capacity building in African academic institutions. An expansion of the program is therefore warranted to reach out to more African academics in search of advanced research training.

Prevalence and correlates for diarrhoea in the mountainous informal settlements of Huye town, Rwanda.

Dwellers of urban informal settlements in developing countries are consistently reported to be victims of high diarrhoea prevalence. Studies have frequently reported the association between high diarrhoea prevalence and other factors, such as poor living conditions, inadequate hygiene, and sanitation in these settings. However, little is known about the dynamics of diarrhoea prevalence in mountainous urban informal settlements similar to the Rwandan context. This study was conducted in the Matyazo cell of Huye town to review the prevalence and correlates of diarrhoea. A survey of 214 households and transect walks in the neighbourhoods were conducted during the rainy and dry seasons. Logistic regression was used to analyse the survey data while the thematic analysis technique was used to analyse qualitative data. Results indicated a substantial reduction of diarrhoea prevalence from the rainy to the dry season. It was also found that the prevalence was unequally distributed in the neighbourhoods according to household location. After controlling for other household characteristics and sanitation conditions of around homes, the study indicated that households established at 1800 metres or more above sea level were protected against diarrhoea during both rainy seasons (Adjusted Odds Ratio_ AOR: .42, 95% Confidence Interval_ CI: .13-.81) and dry seasons (AOR: .58, CI: .12-.90) while households found further from the road were likely to suffer from diarrhoea during rainy seasons (AOR: 3.32, CI: 1.47-7.48) as well as in dry seasons (AOR: 1.60, CI: 1.26-4.10). Poor sanitation within and around homes was also found to be associated with the increase of diarrhoea in either season. However, the evidence was not sufficient enough to confirm a significant association between diarrhoea prevalence and other household characteristics. We believe this is due to the strength of environmental factors in mountainous settings.