Prevalence and risk factors of anxiety and depression among non-communicable diseases clinic attendees in rural Rwanda: a cross-sectional study.

Objectives: This study aimed to estimate the prevalence of depression and anxiety and associated risk factors among non-communicable diseases (NCD) clinic attendees in rural Rwanda.

Design: Cross-sectional.

Setting: 44 health centres in three rural districts in Rwanda.

Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort study.

Introduction: The paucity of data on perioperative outcomes in low- and middle-income countries complicates the design and implementation of targeted interventions to improve the delivery of safe, affordable, accessible and timely surgical and anaesthesia care services. We assessed perioperative outcomes of patients undergoing surgical care at three Rwandan rural hospitals-Butaro District Hospital, Kirehe District Hospital and Rwinkwavu District Hospital-supported by Partners In Health/Inshuti Mu Buzima-an international non-governmental organisation.

Methods: We conducted a 6-month prospective observational cohort study at the three district hospitals.

Factors associated with recovery from stunting at 24 months of age among infants and young children enrolled in the Pediatric Development Clinic (PDC): A retrospective cohort study in rural Rwanda.

Introduction: Stunting (low height/length-for-age) in early life is associated with poor long-term health and developmental outcomes. Nutrition interventions provided during the first 1,000 days of life can result in improved catch-up growth and development outcomes. We assessed factors associated with stunting recovery at 24 months of age among infants and young Children enrolled in Pediatric Development Clinics (PDC) who were stunted at 11 months of age.

Impact of COVID-19 on access to cancer care in Rwanda: a retrospective time-series study using electronic medical records data.

Introduction: The COVID-19 pandemic has caused disruptions in access to routine healthcare services worldwide, with a particularly high impact on chronic care patients and low and middle-income countries. In this study, we used routinely collected electronic medical records data to assess the impact of the COVID-19 pandemic on access to cancer care at the Butaro Cancer Center of Excellence (BCCOE) in rural Rwanda.

Methods: We conducted a retrospective time-series study among all Rwandan patients who received cancer care at the BCCOE between 1 January 2016 and 31 July 2021.

Food insecurity and level of depression among patients with chronic diseases, and associated factors during the COVID-19 lockdown: a cross-sectional study in rural Rwanda.

Objectives: We aimed to describe access to food and symptoms of depression among patients with chronic diseases or their caregivers, and assess associated factors during the COVID-19 lockdown in rural Rwanda.

Design: A cross-sectional study.

Setting And Participants: A stratified random sampling technique was used to recruit 220 patients enrolled in the HIV, non-communicable diseases, mental health, paediatric development clinic and oncology programmes in three rural districts of Rwanda.

Promotion of early and exclusive breastfeeding in neonatal care units in rural Rwanda: a pre- and post-intervention study.

Background: Early initiation of breastfeeding after birth and exclusive breastfeeding for the first six months improves child survival, nutrition and health outcomes. However, only 42% of newborns worldwide are breastfed within the first hour of life. Small and sick newborns are at greater risk of not receiving breastmilk and often require additional support for feeding.

Evaluating the delivery of Problem Management Plus in primary care settings in rural Rwanda: a study protocol using a pragmatic randomised hybrid type 1 effectiveness-implementation design.

Introduction: Evidence-based low-intensity psychological interventions such as Problem Management Plus (PM+) have the potential to expand treatment access for depression and anxiety, yet these interventions are not yet effectively implemented in rural, public health systems in resource-limited settings. In 2017, Partners In Health adapted PM+ for delivery by primary care nurses in rural Rwanda and began integrating PM+ into health centres in collaboration with the Rwandan Ministry of Health, using established implementation strategies for mental health integration into primary care (Mentoring and Enhanced Supervision at Health Centers for Mental Health (MESH MH)). A gap in the evidence regarding whether low-intensity psychological interventions can be successfully integrated into real-world primary care settings and improve outcomes for common mental disorders remains.

Safety and effectiveness of a non-electric infant warmer for hypothermia in Rwanda: A cluster-randomized stepped-wedge trial.

Background: Neonatal hypothermia is a common source of morbidity and mortality in low resource settings. We developed the Dream Warmer, a low cost, re-usable non-electric infant warmer to prevent and treat hypothermia.

Methods: We conducted a cluster-randomized stepped-wedge trial.

Evaluation of an mHealth tool to improve nutritional assessment among infants under 6 months in paediatric development clinics in rural Rwanda: Quasi-experimental study.

Infants born preterm, low birthweight or with other perinatal complications require frequent and accurate growth monitoring for optimal nutrition and growth. We implemented an mHealth tool to improve growth monitoring and nutritional status assessment of high risk infants. We conducted a pre-post quasi-experimental study with a concurrent control group among infants enrolled in paediatric development clinics in two rural Rwandan districts.

Barriers and coping mechanisms to accessing healthcare during the COVID-19 lockdown: a cross-sectional survey among patients with chronic diseases in rural Rwanda.

Background: Large scale physical distancing measures and movement restrictions imposed to contain COVID-19, often referred to as 'lockdowns', abruptly and ubiquitously restricted access to routine healthcare services. This study describes reported barriers and coping mechanisms to accessing healthcare among chronic care patients during the nationwide COVID-19 lockdown in Rwanda.

Methods: This cross-sectional study was conducted among chronic care patients enrolled in pediatric development, HIV/AIDS, non-communicable diseases, mental health, and oncology programs at 3 rural Rwandan districts.

Father involvement in the care of children born small and sick in Rwanda: Association with children's nutrition and development.

Background: Little is known about father's involvement in the care of children born with perinatal risk factors. This study aimed to understand father's involvement in the care of children born preterm, low birth weight (LBW) and/or with hypoxic ischemic encephalopathy (HIE) in rural Rwanda and assess child and home environment factors associated with father involvement.

Methods: A cross-sectional study of children born preterm, LBW or with HIE who were discharged from Kirehe District Hospital neonatal unit from May 2015 to April 2016 and those enrolled in a neonatal unit follow-up programme from May 2016 to November 2017.

Quality improvement strategies to improve inpatient management of small and sick newborns across All Babies Count supported hospitals in rural Rwanda.

Background: Neonatal mortality contributes to nearly half of child deaths globally and the majority of these deaths are preventable. Poor quality of care is a major driver of neonatal mortality in low- and middle-income countries. The All Babies Count (ABC) intervention was designed to reduce neonatal mortality through provision of equipment and supplies, training, mentorship, and data-driven quality improvement (QI) with peer-to-peer learning through learning collaborative sessions (LCS).

Decentralized, primary-care delivered epilepsy services in Burera District, Rwanda: Service use, feasibility, and treatment.

Background: Integrating epilepsy care into primary care settings could reduce the global burden of illness attributable to epilepsy. Since 2012, the Rwandan Ministry of Health and the international nonprofit Partners In Health have collaboratively used a multi-faceted implementation program- MESH MH-to integrate and scale-up care for epilepsy and mental disorders within rural primary care settings in Burera district, Rwanda. We here describe demographics, service use and treatment patterns for patients with epilepsy seeking care at MESH-MH supported primary care health centers.

Assessing factors associated with poor maternal mental health among mothers of children born small and sick at 24-47 months in rural Rwanda.

Background: Global investments in neonatal survival have resulted in a growing number of children with morbidities surviving and requiring ongoing care. Little is known about the caregivers of these children in low- and middle-income countries, including maternal mental health which can further negatively impact child health and development outcomes. We aimed to assess the prevalence and factors associated with poor maternal mental health in mothers of children born preterm, low birthweight (LBW), and with hypoxic ischemic encephalopathy (HIE) at 24-47 months of age in rural Rwanda.

High Burden of Undernutrition among At-Risk Children in Neonatal Follow-Up Clinic in Rwanda.

Background: Sufficient knowledge of the disproportionate burden of undernutrition among vulnerable children is required for accelerating undernutrition reduction in low-income countries.

Objectives: We aimed to assess the prevalence of stunting, underweight and wasting and associated factors among high-risk children born preterm, with low birth weight or other birth and neurodevelopmental injuries, who received nutritional support and clinical care follow-up in a Pediatric Development Clinic (PDC) in rural Rwanda.

Methods: This cross-sectional study included all children from rural areas enrolled in PDC between April 2014-September 2017 aged 6-59 months at their last visit during this period.

Health management information system (HMIS) data verification: A case study in four districts in Rwanda.

Introduction: Reliable Health Management and Information System (HMIS) data can be used with minimal cost to identify areas for improvement and to measure impact of healthcare delivery. However, variable HMIS data quality in low- and middle-income countries limits its value in monitoring, evaluation and research. We aimed to review the quality of Rwandan HMIS data for maternal and newborn health (MNH) based on consistency of HMIS reports with facility source documents.

Nutritional evaluation and growth of infants in a Rwandan neonatal follow-up clinic.

Children born preterm, low birth weight (LBW) or with other perinatal risk factors are at high-risk of malnutrition. Regular growth monitoring and early intervention are essential to promote optimal feeding and growth; however, monitoring growth in preterm infants can be complex. This study evaluated growth monitoring of infants under 6 months enrolled in Paediatric Development Clinics (PDCs) in rural Rwanda.

Performance of a Nonelectric Infant Warmer in Rwandan Health Centers.

. Neonatal hypothermia remains a challenge in resource-limited settings. .

Risk factors for stunting among children under five years: a cross-sectional population-based study in Rwanda using the 2015 Demographic and Health Survey.

Background: Child growth stunting remains a challenge in sub-Saharan Africa, where 34% of children under 5 years are stunted, and causing detrimental impact at individual and societal levels. Identifying risk factors to stunting is key to developing proper interventions. This study aimed at identifying risk factors of stunting in Rwanda.

Using Electronic Medical Record Data to Improve HIV Patient Monitoring, Clinical Decision-Making, and Quality Improvement: Lessons from Rwanda.

In developing countries, clinical guidelines and patient follow-up are primarily paper-based. We describe the use of Electronic Medical Record data for evidence-based clinical decisions and improved HIV patients monitoring in rural Rwanda.