ABSTRACT
Mobile technology has become the leading utility in the social and well-being of people especially in low-resource settings. The use of mobile applications in healthcare promise to improve care and treatment. This study explored the user experience of muzima mobile application among community health workers in Rwanda. We used three data collection methods: observation, Key informant interviews and focus group discussions. We analysed data using thematic content analysis. We found that users were able to complete tasks in the app although some less experienced and older participants struggled to complete the tasks. Users felt that the application helped them to screen and manage patients with diabetes and hypertension in the community which reduced frequent visits to the health centers. Users felt that the application needs improvements in the workflow to facilitate the ease of use. They suggested to digitse other health programs implemented by community health workers. To improve the use and ensure wider implementation, there is a need to consider users' needs and concerns as discussed in this paper.
Subject(s)
Community Health Workers , Diabetes Mellitus , Hypertension , Mobile Applications , Rwanda , Humans , Hypertension/diagnosis , Mass Screening , Adult , Female , Male , Middle Aged , TelemedicineABSTRACT
The management of NCDs require a secure and continuous collection and use of patient data to improve care and treatment. The OpenMRS NCDs module was developed and piloted in three districts to ascertain the possibility of using it in early detection and management of Hypertension and Diabetes in Rwanda. This paper explored the user experience NCDs module of OpenMRS, an open sources EMR used in health centers of Rwanda. We used two methods to explore the user experience of the system among the nurses: Key informant interviews and observations. We analysed the data using thematic content analysis and drawn upon the views and expectations of the users to experience effective use of the system. We collected the data using the developed and piloted tools. In this study we interviewed 10 nurses and observed how they complete tasks in the system. In general, the nurses found that the system was useful because it simplified patient care and reporting. Some barriers related to the use of the system were slowness of the system, and turnover of trained users. We concluded that during the first 12 months of the pilot of the OpenMRS in 5 hospitals located in three districts, nurses were able to use the system with limited and manageable challenges. However, some challenges related to system design and navigations should be addressed before wider implementation.
Subject(s)
Diabetes Mellitus , Electronic Health Records , Hypertension , Rwanda , Diabetes Mellitus/therapy , Hypertension/nursing , Humans , Attitude of Health Personnel , Qualitative Research , Attitude to ComputersABSTRACT
ABSTRACT: In Rwanda, women have higher incidence of HIV and intimate partner violence (IPV). This study aimed to estimate the prevalence of IPV among women living with HIV (WWH) in Rwanda and measure the difference in psychological outcomes, demographic data, and HIV-related outcomes using a cross-sectional, descriptive, observational design. A convenience sample of 162 Rwandan WWH were purposefully recruited to participate. The study collected demographic data and data about IPV, depression, HIV-related stigma, coping, self-esteem, and hope. The prevalence of any form of IPV in the sample was 27% with psychological IPV being the most prevalent. Demographic data had no statistical significance with the prevalence of IPV. WWH who experienced IPV had higher HIV stigma, lower coping self-efficacy, lower self-esteem, and less hope and worse HIV psychological outcomes. Further studies are needed to look into the correlation between the two and interventions addressing IPV prevention.
Subject(s)
Adaptation, Psychological , Depression , HIV Infections , Intimate Partner Violence , Self Concept , Social Stigma , Humans , Female , Cross-Sectional Studies , Rwanda/epidemiology , Intimate Partner Violence/psychology , Intimate Partner Violence/statistics & numerical data , HIV Infections/psychology , HIV Infections/epidemiology , Adult , Prevalence , Middle Aged , Depression/epidemiology , Depression/psychology , Surveys and Questionnaires , Young Adult , Hope , Self Efficacy , Sexual Partners/psychologyABSTRACT
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.
Subject(s)
Nurses, Pediatric , Sustainable Development , Child , Humans , Adolescent , RwandaABSTRACT
Visual impairment and blindness affect an estimated 2.2 billion people worldwide. Accessible low-cost diagnostic tools and interprofessional education and collaborative practice are part of ongoing strategies to improve eye care services. This study evaluated the impact of an interprofessional Arclight workshop on undergraduate healthcare students' clinical identification skills related to eye health, and self-reported confidence in ophthalmic skills. Undergraduate students from clinical medical officer, ophthalmic clinical officer, Bachelors and Diploma nursing, and medical programs at the University of Rwanda participated in a pilot interprofessional eye health workshop. The Arclight device, a low-cost ophthalmoscope and simulation eyes were used to enable students to practice ophthalmic skills and thereafter equip them. Clinical identification skills related to common eye conditions, and self-reported confidence in ophthalmic skills were assessed pre and post workshop. Overall, students' ability to identify common eye conditions, and self-reported confidence in relation to all skills statistically improved post workshop, with some differences between professional groups in relation to eye health skills. This IPE experience used the Arclight package as a vehicle for IPE, enabling healthcare students to share and acquire new skills and confidence in relation to recognizing common eye conditions and assessing eye health.
Subject(s)
Students, Health Occupations , Students, Medical , Humans , Interprofessional Relations , Health Personnel , CurriculumABSTRACT
BACKGROUND: Stigma is an underlying cause of health inequities, and a major barrier to HIV prevention, care, and treatment. Experiences of HIV stigma have been shown to reduce engagement in care across the HIV care continuum, from testing and diagnosis to long-term retention in care and anti-retroviral therapy adherence. In Rwanda, approximately 130,000 women are living with HIV, representing a prevalence rate (3.7%) which is substantially higher than Rwandan men (2.2%). Both the national Rwanda and City of Kigali HIV and AIDS strategic plans identify stigma as a key concern for reducing the burden of HIV. OBJECTIVES: The first objective of this study was to understand the sources of HIV-related stigma among women living with HIV in Rwanda. The second objective was to understand the cultural, linguistic, and contextual context of HIV-related stigma and the intersection of HIV-related stigma to the HIV care continuum (engagement in care, medication/treatment adherence) among women with HIV in Rwanda. DESIGN: This study used a cross-sectional, qualitative design. SETTING AND PARTICIPANTS: Three-three women from urban and rural settings in Rwanda were recruited from public HIV treatment and care centers to participate in this study. METHOD: Focus groups discussions, guided by a structured interview guide, were used to collect qualitative data. Framework analysis was used to analyze the data, which was collected during July 2018. RESULTS: The participants in this study highlighted that Rwandan women with HIV experience all forms of stigma - enacted, anticipated, perceived, and internalized - associated with HIV as well as structural stigma. Further, three major themes - dehumanizing language, importance of motherhood in the context of HIV, and overcoming HIV stigma - emerged from the data. CONCLUSION: The results of this study are among the few to give voice and perspective to the stigma experiences of Rwandan women with HIV. The women with HIV participating in this study shed light on the pervasive and culturally constructed effects of stigma that continue to exist. Further, the findings from this study highlighted the significant intersection of the role dehumanizing language experienced by Rwandan women with HIV. Additionally, the intersectional identities of being a woman with HIV and a mother and their relationship to societal and cultural norms and expectations must be considered concurrently. Finally, the beneficial effects of support groups was identified as key in helping Rwandan women with HIV to accept self.
Subject(s)
HIV Infections , Language , Cross-Sectional Studies , Female , Focus Groups , HIV Infections/drug therapy , Humans , Male , Rwanda/epidemiologyABSTRACT
Background To continue delivering the courses despite school closure during the covid-19 pandemic, the University of Rwanda abruptly shifted its teaching from traditional physical to online teaching. This was the compulsory medium of teaching during the lockdown period. This sudden change did not allow for adequate preparation for students. Objectives To assess the preparation of learners to use the e-learning platform, and to explore the factors that enabled or inhibited learners' use of the e-learning platform. Method This was a cross-sectional quantitative research design study done between June and July 2020. An online questionnaire was sent to all students registered in the College of Medicine and Health Sciences for the academic year 2019-2020. Results A total of 446 students completed the questionnaire. Students reported not being adequately oriented and unprepared to effectively use e-learning. Students were motivated to use e-learning when the learning objectives were clear, interactive, with engaging materials. Inadequate e-learning infrastructure, limited access to internet connectivity and inadequate devices were identified as the strongest barriers of using e-learning. Conclusion The covid-19 pandemic has brought a transformational opportunity to embrace a blended learning approach. To sustain such a transformation, proper and timely planning and strategies need to be invested.
Subject(s)
Humans , Male , Female , Students, Medical , Education, Distance , Physical Distancing , COVID-19 , PandemicsABSTRACT
Background Towards the beginning of 2020, the COVID-19 pandemic spread worldwide and caused many schools to close. Many educational institutions transitioned from traditional face-to-face or blended to a total e-learning approach. The University of Rwanda rapidly shifted from a blended teaching and learning approach to a total e-learning approach. Thus,this study assessed the faculty preparedness and the factors influencing the use of e-learningplatforms at the College of Medicine and Health Sciences. Methods The study used a cross-sectional design. A web self-administered questionnaire was used to collect data from 450 CMHS faculty from June to July 2020, with a response rate of 34.4% (n=155). SPSS was used to describe nominal variables with frequencies and percentages. Similarly, continuous variables were analyzed by calculating median and interquartile ranges. The Chi-Square and Man-Whitney tests were also computed using SPSS. Results The majority of participants (93.7%) started using the e-learning approach, and 92.4% attended e-learning training. The top motivator for e-learning use was a personal interest in technology use (93.3%) and the leading barrier to using e-learning was the concern about access to students (77.1%). Conclusion This study found that faculty preparedness was significantly associated with e-learning use. The leading motivator and barriers were a personal interest in technology use and concern about access to students, respectively.
Subject(s)
Pandemics , COVID-19ABSTRACT
Preventable and treatable visual impairment affects more than 1 billion people worldwide. Rwanda has an estimated visual impairment prevalence of 3.7% amongst the 12 million inhabitants. Around one third of this demand could be addressed through a more integrated and collaborative approach, particularly in primary eye care services. Healthcare students, therefore, need to be prepared for collaborative practice in eye health through interprofessional learning. Interprofessional workshops were piloted with ophthalmic clinical officer, medical clinical officer, nursing and medical students from the University of Rwanda. The aim was to promote collaborative practice by teaching students how to assess and recognize common eye conditions using the Arclight; a low cost, solar powered, portable ophthalmoscope designed for use in low resource settings. Students reported that the workshop content was relevant to all professional groups. They valued the opportunity to learn interprofessionally, share their knowledge and perspectives, and acquire new knowledge and skills together. This pilot helped to identify the most relevant skills and knowledge for future interprofessional eye health training. It enabled the facilitators to reflect on how best to maintain a balance between a quality interprofessional experience and the more specific eye health related learning objectives.