Theogene Uwizeyimana

Health systems play a critical role in providing services that aim to improve, promote, restore, or maintain the health of communities. Unfortunately, health systems in low-income countries are fragile, having an adverse effect on the health of the population. Whereas international development aid remains crucial in strengthening health systems in low-income countries (LICs), COVID-19 has induced changes in the dynamics in the availability, provision and access to international development aid. These changes have aggravated the already weak health systems of LICs. Understanding the effects of the COVID-19 pandemic on the distribution of international development aid and how these effects impacted on the quality of the health systems in response to the outbreak is critical to improving the health of populations in LICs. This article discusses the impact of the challenges faced by LICs in the context of international development aid needed for the development of health systems.

AbstractThe COVID‐19 pandemic has caused significant disruption to global healthcare systems, including Rwanda's. Rwanda has taken measured actions in response to the pandemic using a multisectoral and one‐government approach. The introduction of the COVID‐19 vaccine boosted the hope of many people but has left debates on the measure of the population required to attain herd immunity. Herd immunity threshold (HIT) was introduced to track progress toward containing COVID‐19. HIT represents the number of people with long‐term immunity from COVID‐19. World Health Organization (WHO) established population vaccination targets for all countries worldwide, which included 40% coverage of the entire population by the end of 2021 and 70% by June 2022. In this paper, we discussed the efforts and progress that have been made so far toward achieving herd immunity in Rwanda.

Abstract Background To provide just equity in academic exchange, as well as to reduce prohibitive travel cost and address environmental concerns, the past paradigm of international student exchange has fundamentally shifted from one directional travel to mutually beneficial bidirectional remote communication between students all over the globe. Current analysis aims to quantify cultural competency and evaluate academic outcomes. Methods Sixty students half from the US and half from Rwanda grouped in teams of 4 engaged in a nine-month project-focused relationship. Cultural competency was evaluated prior to project initiation and six months after completion of the project. Student perspective of project development was analyzed weekly and final academic outcome was evaluated. Results Change in cultural competency was not significant; however, students did identify satisfaction in team interaction and academic outcomes were achieved. Conclusion A single remote exchange between students in two countries may not be transformative but it can provide cultural enrichment and successful academic project outcome and may serve to enhance cultural curiosity.

Background Presumptive treatment of malaria is often practiced in community pharmacies across sub-Saharan Africa (SSA).To address this issue, the World Health Organization (WHO) recommends that malaria Rapid Diagnostic Tests (m-RDTs) be used in these settings, as they are used in the public sector. However, their use remains unlicensed in the community pharmacies in Rwanda. This can lessen their availability and foster presumptive treatment. Therefore, this study investigated the availability of m-RDTs, knowledge of community pharmacists on the use of m-RDTs, and explored Pharmacists’ perceptions of the advantages and disadvantages of licensing the use of m-RDTs in community pharmacies. Methods This was a cross-sectional study among 200 licensed community pharmacists who were purposefully sampled nationwide from 11th February to 12th April 2022. Data was collected using an online data collection instrument composed of open-ended and closed-ended questions. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 25.0. The chi-square test was used to evaluate the association between the availability of m-RDTs and independent variables of interest. Content analysis was used for qualitative data. Results Although 59% were consulted by clients requesting to purchase m-RDTs, only 27% of the participants had m-RDTs in stock, 66.5% had no training on the use of m-RDTs, and 18.5% were not at all familiar with using the m-RDTs. Most of the participants (91.5%) agreed that licensing the use of m-RDTs in community pharmacies could promote the rational use of antimalarials. The chi-square test indicated that being requested to sell m-RDTs (x2 = 6.95, p = 0.008), being requested to perform m-RDTs (x2 = 5.39, p  = 0.02),familiarity using m-RDTs (x2 = 17.24, p = 0.002), availability of a nurse in the Pharmacy (x2 = 11.68, p < 0.001), and location of the pharmacy (x2 = 9.13, p = 0.048) were all significantly associated with the availability of m-RDTs in the pharmacy. Conclusions The availability of m-RDTs remains low in community pharmacies in Rwanda, and less training is provided to community pharmacists regarding the use of m-RDTs. Nevertheless, community pharmacists had positive perceptions of the advantages of licensing the use of m-RDTs. Thus, licensing the use of m-RDTs is believed to be the first step toward promoting the rational use of antimalarial medicines in Rwanda.

Purpose: Instructional technology integration at the institutional level can be fraught with a lack of preparedness (25.6%) and understanding (39.1%) (Kihoza et al., 2016; Lacruz, 2018). To mediate these issues a sound instructional technology integration approach is critical to the success of educational programs. The Substitution, Augmentation, Modification, Redefinition (SAMR) model (Lacruz, 2018) was designed to aid educator’s measuring the level of technology integration in their class and to offer suggestions for the lack thereof. For technology integration to be successful overtime, faculty and student satisfaction must remain high. The purpose of this study is to implement an instructional technology approach based on the SAMR model and assess faculty and student satisfaction with this model. Methodology: This study was a mixed methods cross-sectional study that evaluated Prep Phase courses for the level of SAMR model use. Findings: Results showed that courses with a high level of technology integration at the Modification and Redefinition levels also had high levels of student satisfaction. What is distinctive in this study is that the implementation was tracked from beginning to end, with student and faculty satisfaction being assessed. Unique Contribution to Theory, Practice and Policy: The study recommends that a looser version of the SAMR Model may be used so that faculty training focuses more on engaging technologies and less on a broad model. Faculty training time can be limited so finding ways to maximize that time would certainly be beneficial.

Neurenteric cysts (NEC) are rare congenital abnormalities of the spine that usually happen when there is an abnormal connection between the primitive endoderm and ectoderm. This happens when the proper separation of the endoderm and notochord is prevented by the persistence of the ordinarily transitory neurenteric canal, and this connection leads to the presence of mucus-secreting epithelium reminiscent of the gastrointestinal tract. The clinical presentation of NEC can be subtle and is dependent on the cyst’s location on the spine. Diagnostic imaging and histopathology are performed in addition to a detailed history taking and physical examination for the proper diagnosis of this condition. In this chapter, we gathered and described NEC from pathogenesis to clinical presentation, diagnosis to clinical management, and prognosis and clinical outcome.

Community pharmacies (CPs) represent a crucial source of primary care for the Nigerian population. Pharmacists in this setting provide essential primary care services to the public and, when required, facilitate care transitions or referrals for patients to higher levels of care. Given their accessibility and expanding roles in patient care, pharmacists are considered pivotal to meeting the transition of care (TOC) goals, that is, continuity, quality, and safety, especially at the community level. However, CPs in Nigeria face significant systemic and human-factor barriers that impede their TOC performance, especially with their exclusion from the national care referral framework. Removing these barriers is essential to avoid the health consequences of a breakdown in the TOC system for the patients receiving care at the CPs. This paper discusses the barriers to effective TOC performance of the CPs in Nigeria and offers recommendations to address the deficiencies to improve patient care delivery using an inclusive and collaborative referral model.

Background The National Older Person’s Policy of 2021 in Rwanda highlights the need for social protection of older populations. However, there is a lack of local knowledge regarding the priorities and challenges to healthy aging faced by older people and their caregivers. Objectives This study aimed to identify and compare the needs and priorities of older people and other stakeholders involved in caring for them in rural and urban areas of Rwanda. Methods The study was conducted in two locations, Kigali (urban) and Burera district (rural). Each site hosted two separate one-day workshops with older people (≥60 years) and stakeholders (all ages). Discussions were held in plenary and roundtable-groups to generate a list of the top 4 prioritized responses on areas of importance, priorities/enablers to be addressed, and obstacles to living a healthy and active life for older people. The research team identified similarities between stakeholder and older people’s responses in each area and a socio-ecological model was used to categorize findings. Results There were substantial differences in responses between rural and urban areas and between older people and stakeholders. For each question posed, in each rural or urban area, there was only agreement between stakeholders and older people for a maximum of one response. Whereas, when comparing responses from the same participant groups in urban or rural settings, there was a maximum agreement of two responses, with two questions having no agreement in responses at all. Responses across all discussion-areas were mostly categorized within the Societal level, with Individual, Relationship, and Environment featuring less frequently. Conclusion This study highlights the need for contextually curated interventions to address the concerns of older adults and their caregivers in rural and urban settings. An inclusive and multidimensional approach is needed to conquer the barriers that impede healthy aging, with input from various stakeholders.

Africa faces a significant burden of infectious diseases, including Malaria and HIV/AIDS, along with an increasing prevalence of non-infectious diseases such as diabetes and cancer. This dual health challenge is amplified by socioeconomic difficulties, restricted access to healthcare, and lifestyle changes, thus present unique scientific needs. Effectively addressing these issues requires a skilled scientific workforce adept in comprehensive healthcare strategies. This analysis explores the critical landscape of health research in Africa, emphasizing the unique opportunity presented by the continent’s youthful population, projected to reach almost 1 billion by 2050. The youth’s innovative potential and fresh perspectives offer a chance to overcome development barriers in health research. Nevertheless, challenges such as under-resourced education, limited research training, inadequate mentorship, and funding difficulties persist. This paper urgently calls upon African leaders, international partners, and stakeholders to prioritize health research, mobilize funding, forge strategic partnerships, and empower the youth as essential steps to capitalize on the continent’s dynamic youth for breakthrough health outcomes. Such investments are vital not just for health but for the overall economic, social, and strategic growth of the continent. Through shared responsibility and a united effort, the potential of African youth can be harnessed, leading to transformative research, improved health outcomes, and a prosperous future. This perspective represents the collective voice of passionate young researchers and advocates across Africa, calling for a new era of health research on the continent.

Oxygen is an essential medication used across all levels of healthcare for conditions such as surgery, trauma, heart failure, asthma, pneumonia, and maternal and child care. Despite its critical importance and inclusion on the World Health Organization’s list of essential medicines, many low- and middle-income countries (LMICs) face significant challenges in providing adequate oxygen supplies. These challenges are exacerbated by the COVID-19 pandemic, which has drastically increased global oxygen demand. This paper examines the current challenges and advancements in the oxygen supply chain within LMICs, focusing on availability, infrastructure, and usage. It highlights the innovative solutions being implemented to improve oxygen access and offers strategic recommendations for enhancing oxygen delivery and maintenance in resource-limited settings.