College of Medicine and Health Sciences

Early outcomes and associated factors in neonates with extremely low birth weight at selected Referral Hospitals in Kigali, Rwanda

2023-01-24T15:23:10Z

Early outcomes and associated factors in neonates with extremely low birth weight at selected Referral Hospitals in Kigali, Rwanda BANKUNDIYE, Mechtilde Background: The prematurity, is the leading cause of childhood death and a global health challenge. Globally, 15 million babies are born prematurely every year. Purpose: To assess the early outcomes and associated factors of ELBW neonates at selected referral hospitals in Kigali/ Rwanda. Methods: A retrospective and descriptive cross-sectional design with quantitative approach was used. The study population included 108 ELBW neonates admitted in three referral hospitals in Kigali during the year 2020. A checklist was utilized to gather data and the statistical packages for STATA-12 was computed to analyze collected data. Analysis was descriptive statistics and Inferential statistics like, Chi-square test. Significance level of <.05 was considered as statistically significant. Findings: Findings from the present study showed that the proportion of ELBW neonate was 2.08%. Survivor and death of ELBW neonate were related to gestational age, birth weight and APGAR score. Death was found to be at 47.2% of all ELLBW neonates within 20 days, while 52.8% survived within 28 days. Surviving days were minimum 10 and 28 maximum). The minimum birth weight was 500grs and 1000grs for maximum with average of 881.32grs. The most mothers associated factors was malaria (10.1%), preeclampsia (38.8%) and, alcohol consumable (33.3%). The most major morbidity was infection (70.3%) and RDS (69.4%). Surviving was associated with receiving CPAP and being on ventilator machine (p<0.05). Conclusion: The present study findings revealed that ELBW proportion was high, survival rate was low, death rate was high and there were high morbidities in ELBW neonates. The more birth weight was low the less chance of surviving was. Also, advanced gestational age, receiving CPAP, being treated under ventilator machine were associated with survivor chance within 28 days. Recommendation: There should be innovative strategies in place such as availability of ventilator machine in all District and referral hospitals and conducting many researches on ELBW neonates’ outcomes and related factors would help to reduce morbidity and mortality in ELBW neonates. Master's Dissertation

Mothers’ perceptions of partners’ involvement in Kangaroo Care in Neonatology Unit in Rwanda

2023-01-18T12:40:33Z

Mothers’ perceptions of partners’ involvement in Kangaroo Care in Neonatology Unit in Rwanda ABAGIRIMANA, Verene Introduction: An evidence-based strategy for lowering mortality and morbidity in preterm and low-birth-weight newborns is known as kangaroo mother care (KMC). Kangaroo care is usually initiated in the neonatology unit or neonatal intensive care unit (NICU) when a stable newborn is placed in the prone position on the mother‟s chest for skin-to-skin contact. Recent studies have also demonstrated the advantages of giving the mother's partner the chance to participate in kangaroo care (KC) of the newborn; however, little is known about how Rwandan mothers see their partners' participation. Aim: This study explored the mothers‟ perceptions on value and barriers of their partners‟ involvement in Kangaroo Care of the newborn. Methods: The moms' perspectives on having a newborn in the neonatology unit and KMC were investigated using a descriptive qualitative design. The setting was the neonatology unit at Kibungo Referral Hospital in Rwanda with a catchment area of 15 health centers and 310,955 inhabitants. The mothers' perception of the value and obstacles related to their partners' participation in KC were evaluated using an exploratory qualitative approach method. All parents (mothers) who had a preterm/LBW newborn hospitalized during the data collecting period made up the study population. Purposive sampling was used to access mothers who had newborns in the neonatology unit during the study period and choose study participants from among them. The sample was continued to increase in size until no new information about KC is provided by the participants, a situation called data saturation. To collect information from participants and allow them to share their thoughts and views about the KC while achieving the goals of the study, an interview guide was used. The data analysis was performed using NVivo 12 qualitative content analysis software, which included reading the data, entering and coding the data in NVivo, then formulating themes and subthemes. The themes were divided into value and barriers to KC in the neonatology unit. Results: Thirteen participants (mothers) were interviewed. The mothers expressed their perceptions of the value of their partners‟ contribution to KC and myriad barriers that prevent KC involvement. Although their partners were less likely to be personally involved in KC and the mothers were considered as being crucial to delivering KMC, the participants highlighted many barriers that impede their partners from participating in KC practice: The barriers include Lack of time and other obligations; Cultural beliefs, religion and Stigma attached to fathers‟ providing newborn care including KC; Lack of opportunity to KC practice due to facility environment, Fathers‟ low awareness of KC, and other Family members‟ contribution in KC. Discussion: The partners (fathers) were challenged by a range of barriers to practice KC with their newborns. The mothers voiced that partners were less likely to be directly involved in KC but they play an indirectly important role in KMC, especially when their preterm and low-birth weight newborns are hospitalized. Master's Dissertation

Parents’ satisfaction with health care services in Neonatal Care Unit of two selected hospitals in Rwanda

2023-01-18T11:33:04Z

Parents’ satisfaction with health care services in Neonatal Care Unit of two selected hospitals in Rwanda MUKESHIMANA, Eugenie Introduction: A neonatal care unit is a place where sick and premature neonates are admitted and receive specialized care. Infants are unable to communicate their wants, experiences, demands, opinions, or satisfaction; therefore, parents play this role for their young children.Parental satisfaction in neonatal care units (NCUs) is a crucial indicator of the quality services provided to the neonates and helps to enhance healthcare delivery. Aim: To assess the parents’ satisfaction with the care provided to their neonate in the neonatal care unit (NCU) at two selected district hospitals in Rwanda. Method: To answer the research questions, a descriptive cross-sectional design was used and a random sampling method was applied to select two district hospitals of Kigali city (Muhima District Hospital and Kibagabaga District Hospital) as a study setting. The study population was all parents (mother or father) having their infants hospitalized in NCU at the period of study andparticipants signed consent voluntary. A sample of 261 parents was retrieved from the target population by using convenience non-probability sampling strategy method. Instrument was the neonatal satisfaction survey. With a 95% confidence interval (CI) and P-value under 0.05, descriptive statistics like frequencies, means, medians, and standard deviations as well as inferential statistics like ordered logistic regression were used. Results: The findings revealed that among 261 study participants, more than a half 171(66%) were satisfied with health care services in neonatal care unit. More than three quarter of respondents197 (75.5%), reported that they were strongly disagree on the care received by same group of doctors/nurses for themselves and their neonates. The nurses’ consideration and care for the neonate, the nurses’ and doctors’ interest in hearing the opinions of parents as next of kin, the nurses’ understanding and respect of parents are an important care and treatment that showed a positive strong relationship with level of satisfaction. Conclusion: To improve parents’ satisfaction in NCU service emphasis should made on the nurses’ care and treatment as they spend much time with the parents. Therefore continuous training about the parents centered care in NCU should be considered by institution administrators. Master's Dissertation

Determinants of HIV infection among adolescent girls and young women age 15-25 years: analysis of Rwanda demographic heaalth survey 2014-2015

2020-05-20T09:06:47Z

Determinants of HIV infection among adolescent girls and young women age 15-25 years: analysis of Rwanda demographic heaalth survey 2014-2015 Kayitesi, Florence Background: In Rwanda, the prevalence of Human Immunodeficiency Virus (HIV) is 3% over ten years in Adolescent Girls and Young Women (AGYW) it is most significant, impacting their ability to achieve and accomplish future plans. The Government of Rwanda, through the Ministry of Health, has initiated a number of measures to address HIV infection among AGYW. Still, the rate of HIV infection in this population remains high. This study analyzes factors of HIV infection among AGYW aged 15-24 years old. Methods: Descriptive statistics were summarized, and subsequently bivariate logistic regression was computed to determine associations between health risk behaviors and HIV among AGYW using the Rwanda Demographic Health Survey from 2014-15. From the bivariate analysis, odd ratios were determined (unadjusted and adjusted odd ratios) with 95% confidence interval. Adjusted odd ratios, using backward selection method, was used to find actual association with a p. value < 0.005. Results: A total of 737 AGYW aged 15-24 years old that completed the national survey questionnaires and interview made up the sample size for this study. Among them 4.2% (n=31) tested HIV positive. The results demonstrate that HIV infection was negatively significantly associated with AGYW having secondary school students [OR=0.14, 95% CI: 0.31-0.59, p=0.008] and residents of rural area [OR=0.33, 95% CI: 0.14-0.75, p=0.009]. The findings reveal that having 2 or more sexual partners is positively and significantly associated with HIV infection [OR=7.43, 95% CI: 1.79-30.86, p= 0.006]. Conclusion: These results recommend designing combined preventive interventions targeting AGYW focusing on socioeconomic needs of this fragile group. Moreover, there is need to improve the access and promote education and special follow-up for those who are in school in order to reduce the vulnerability of AGYW to HIV infection. An education package should include knowledge; attitudes and skills specifically aimed at HIV prevention, promoting behaviors such us condom use. Master's Dissertation