Understanding life satisfaction among the original inhabitants in the suburbanized areas at the outskirts of a major city: a qualitative study.

PURPOSE: Suburbanization has become a major characteristic of urban development in sub-Saharan Africa, and shifting from agricultural-based areas modus vivendi to urban lifestyles affects subjective wellbeing of the original settlers. While there is lack of evidence in the literature of wellbeing in these areas, this study examines life satisfaction of these populations by means of individuals' own appreciation and evaluation of quality of life. METHODS: The study uses interpretionist and reflexive approaches, and analyses 76 interviews conducted through snowball sampling in two major suburbanized areas. Thematic analysis was used to analyse the data. RESULTS: Generally, the findings show that respondents are satisfied with material living conditions due to improvement of availability of economic opportunities, roads and other transport services, social and community support. However, income inequality and urban poverty result in the inability to afford modern and high-quality urban living conditions, which creates feelings of vulnerability while limiting social relationships. CONCLUSIONS: There is a need to strenghten existing frameworks to fully respond to urban life requirements that relate to transport, education, hygiene, and sanitation services. It is also important to develop support systems that mitigate issues of gender discrimination, human rights, household decision-making, fashion, and cultural norms.

Correction: Experiences of doctoral students enrolled in a research fellowship program to support doctoral training in Africa (2014 to 2018): The Consortium for Advanced Research Training in Africa odyssey.

[This corrects the article DOI: 10.1371/journal.pone.0252863.].

Child stunting and associated risk factors in selected food-insecure areas in Rwanda: an analytical cross-sectional study.

Introduction: stunting rates among the under-five children are generally high in Rwanda. They are unexpectedly lower than the national average stunting rate in some districts where poverty rates are the highest in the country. This study aimed to ascertain the key factors that protect children from stunting in these poorest areas, where stunting rates are lower than expected. Methods: we analysed cross-sectional data from 2019/2020 Rwanda Demographic and Health Survey (RDHS) for 477 under-five children from Karongi, Rulindo, Nyanza, and Gisagara districts. Univariate and bivariate statistical analyses were used to find out the factors to retain for multivariable analysis. We obtained the key risk factors of child stunting through a multivariable binary logistic regression analysis. Results: the child stunting rate in the study districts was 30 percent, which is three percent lower than the national average rate. Child stunting was negatively associated with a birth weight of at least 2.5 kg (AOR = 0.393, 95% CI: 0.180 - 0.856), a high household economic status (AOR = 0.506, 95%CI: 0.273 - 0.937), urban residence (AOR = 0.467; 95% CI: 0.222 - 0.984), and health insurance coverage (AOR = 0.418; 95% CI: 0.228 -0.767). Children aged one year and above, as well as female-headed households, were associated with at least three times and two times greater odds of child stunting than children aged below 12 months and those from male-headed households respectively. Conclusion: the nutritional performance of children in the study districts is substantially driven by the high uptake of health insurance, which fosters increased access to healthcare services. To address child-stunting gaps in low-income areas in Rwanda, child nutrition programs should improve the utilization of healthcare services, and leverage the potential high effect of nutrition education, especially during pregnancy and lactation.

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.

Experiences of doctoral students enrolled in a research fellowship program to support doctoral training in Africa (2014 to 2018): The Consortium for Advanced Research Training in Africa odyssey.

BACKGROUND: The Consortium for Advanced Research Training in Africa (CARTA) aims to transform higher education in Africa. One of its main thrusts is supporting promising university faculty (fellows) to obtain high quality doctoral training. CARTA offers fellows robust support which includes funding of their attendance at Joint Advanced Seminars (JASes) throughout the doctoral training period. An evaluation is critical in improving program outcomes. In this study; we, CARTA fellows who attended the fourth JAS in 2018, appraised the CARTA program from our perspective, specifically focusing on the organization of the program and its influence on the fellows' individual and institutional development. METHODS: Exploratory Qualitative Study Design was used and data was obtained from three focus group discussions among the fellows in March 2018. The data were analyzed using thematic approach within the framework of good practice elements in doctoral training-Formal Research Training, Activities Driven by Doctoral Candidates, Career Development as well as Concepts and Structures. RESULTS: In all, 21 fellows from six African countries participated and all had been in the CARTA program for at least three years. The fellowship has increased fellows research skills and expanded our research capacities. This tremendously improved the quality of our doctoral research and it was also evident in our research outputs, including the number of peer-reviewed publications. The CARTA experience inculcated a multidisciplinary approach to our research and enabled significant improvement in our organizational, teaching, and leadership skills. All these were achieved through the well-organized structures of CARTA and these have transformed us to change agents who are already taking on research and administrative responsibilities in our various home institutions. Unfortunately, during the long break between the second and the third JAS, there was a gap in communication between CARTA and her fellows, which resulted in some transient loss of focus by a few fellows. CONCLUSION: The CARTA model which builds the research capacity of doctoral fellows through robust support, including intermittent strategic Joint Advanced Seminars has had effective and transformative impacts on our doctoral odyssey. However, there is a need to maintain the momentum through continuous communication between CARTA and the fellows all through this journey.

Involvement in decision-making processes and retention of health workers: findings from a cross-sectional study in the Rwandan Public District Hospitals.

INTRODUCTION: The contribution of the health workforce for better health care service provision is undoubtedly of great merit to any health system. However, the public district hospitals in Rwanda have been faced with the challenges of retaining the health personnel. This study looks into the management approach to address this challenge by investigating into the effect of employee involvement in the hospital decision-making processes on the retention of professional health workers. METHODS: A cross-sectional design with quantitative approach was used. With a population of 469 health workers from 3 hospitals, a sample of 252 respondents was considered. Data collection was done by use of survey questionnaire. For data analysis, we used descriptive statistics to report perceived levels of involvement of health workers and intents to stay, and multiple logistic regression at 95% of confidence intervals to assess the effect of health workers? involvement in the hospital decision-making processes on the retention. RESULTS: The findings revealed that health workers who perceived a high level of involvement in the hospital decision-making processes through the determination of teams for quality improvement in the health care service delivery were more likely to stay in the hospital (OR=100.111; P=0.001; CI=5.984-16.747) than those who perceived this function as low. It was also found that while an average level of involvement of health workers in the establishment of systems for suggestion in the hospital was associated with 6 odds of staying (OR=6.005; P=0.010; CI=1.529-23.571), health workers who perceived a high level of involvement were nearly 11 times more likely to stay (OR=10.952; P=0.001; CI=7.730-15.519) than their counterparts with low levels of perceptions. CONCLUSION: Although there are positive associations between involvement of health workers in the hospitals decision-making processes and the intentions to stay, the existing level of staff involvement may have a negative effect on retention capacity in the public district hospitals.

Involvement in decision-making processes and retention of health workers: findings from a cross-sectional study in the Rwandan Public District Hospitals

Introduction: the contribution of the health workforce for better health care service provision is undoubtedly of great merit to any health system. However, the public district hospitals in Rwanda have been faced with the challenges of retaining the health personnel. This study looks into the management approach to address this challenge by investigating into the effect of employee involvement in the hospital decision-making processes on the retention of professional health workers.Methods: a cross-sectional design with quantitative approach was used. With a population of 469 health workers from 3 hospitals, a sample of 252 respondents was considered. Data collection was done by use of survey questionnaire. For data analysis, we used descriptive statistics to report perceived levels of involvement of health workers and intents to stay, and multiple logistic regression at 95% of confidence intervals to assess the effect of health workers? involvement in the hospital decision-making processes on the retention.Results: the findings revealed that health workers who perceived a high level of involvement in the hospital decision-making processes through the determination of teams for quality improvement in the health care service delivery were more likely to stay in the hospital (OR=100.111; P=0.001; CI=5.984-16.747) than those who perceived this function as low. It was also found that while an average level of involvement of health workers in the establishment of systems for suggestion in the hospital was associated with 6 odds of staying (OR=6.005; P=0.010; CI=1.529-23.571), health workers who perceived a high level of involvement were nearly 11 times more likely to stay (OR=10.952; P=0.001; CI=7.730-15.519) than their counterparts with low levels of perceptions.Conclusion: although there are positive associations between involvement of health workers in the hospitals decision-making processes and the intentions to stay, the existing level of staff involvement may have a negative effect on retention capacity in the public district hospitals

Involvement in decision-making processes and retention of health workers: findings from a cross-sectional study in the Rwandan Public District Hospitals

Introduction: the contribution of the health workforce for better health care service provision is undoubtedly of great merit to any health system. However, the public district hospitals in Rwanda have been faced with the challenges of retaining the health personnel. This study looks into the management approach to address this challenge by investigating into the effect of employee involvement in the hospital decision-making processes on the retention of professional health workers.Methods: a cross-sectional design with quantitative approach was used. With a population of 469 health workers from 3 hospitals, a sample of 252 respondents was considered. Data collection was done by use of survey questionnaire. For data analysis, we used descriptive statistics to report perceived levels of involvement of health workers and intents to stay, and multiple logistic regression at 95% of confidence intervals to assess the effect of health workers? involvement in the hospital decision-making processes on the retention.Results: the findings revealed that health workers who perceived a high level of involvement in the hospital decision-making processes through the determination of teams for quality improvement in the health care service delivery were more likely to stay in the hospital (OR=100.111; P=0.001; CI=5.984-16.747) than those who perceived this function as low. It was also found that while an average level of involvement of health workers in the establishment of systems for suggestion in the hospital was associated with 6 odds of staying (OR=6.005; P=0.010; CI=1.529-23.571), health workers who perceived a high level of involvement were nearly 11 times more likely to stay (OR=10.952; P=0.001; CI=7.730-15.519) than their counterparts with low levels of perceptions.Conclusion: although there are positive associations between involvement of health workers in the hospitals decision-making processes and the intentions to stay, the existing level of staff involvement may have a negative effect on retention capacity in the public district hospitals