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. Interviews were conducted when the children were ages 24–47 months in the child's home. Primary caregivers reported on father involvement in parenting, home environment, child disability, and child development outcomes. Children's nutritional status were directly measured. Only children whose fathers were living in the home were included in the sample. Bivariate analyses were conducted using Fisher's exact test and Wilcoxon Rank Sum test. Results A total of 236 children aged 24–47 months were included in this study, 66.4% were born preterm or LBW with a mean age of 33.3 months. 73.5% of children were at risk of disability and 77.7% had potential delay in overall child development. 15.5% of fathers reported engaging in four or more activities with their child in the last 3 days. Factors associated with father involvement included smaller household size (p = 0.004), mother engaged in decision‐making (p = 0.027), being on‐track in developmental milestones for problem solving (p = 0.042) and mother's involvement in learning activities (p = 0.043); the number of activities a father engaged in was significantly associated with the child's overall development (p = 0.032). Conclusion We found that father involvement in activities to support learning was low amongst children born preterm/LBW and/or with HIE. Programme interventions should encourage fathers to engage with their children given the benefits for children's development.
Background Traditional medicine is commonly used in low- and middle-income countries (LMICs). Little is known about the use of traditional medicine among women undergoing cesarean section (c-section) and the association to surgical site infections (SSIs) in LMICs. In this study, we describe peripartum use of traditional medicines and the risk of SSIs among women delivering via c-section in rural Rwanda.Methods This prospective cohort study enrolled women who underwent c-section at Kirehe District Hospital in rural Rwanda between September 2019 and February 2020. We collected self-reported data regarding traditional medicine use before and during pregnancy and after discharge up to postoperative day (POD) 11. On POD 11 (+/- 3 days), the women returned to the hospital for a study follow-up visit. We used Fisher’s exact test to assess the relationship between sociodemographic characteristics and traditional medicine use, and logistic regression to determine the association between traditional medicine use and SSI development while controlling for confounders. Results Of the 841 women enrolled in this study, 45 (5.4%) reported using traditional medicine to get pregnant. Nearly 39% used traditional medicine during pregnancy; the majority (96.9%) for a pregnancy-related reason. Only four women (0.5%) reported traditional medicine use between c-section and the POD 11 study visit. Of the 775 women who responded at all time-points, 341 (44.0%) reported using traditional medicine at some point during pregnancy or c-section recovery. No demographic characteristics were significantly associated with traditional medicine use (p>0.05), except for smoking (p=0.048) and alcohol consumption (p=0.010). Both traditional medicine use during pregnancy (p=0.04, aOR=2.0, 95% CI: 1.05, 3.85) and at any time point (p=0.04, aOR=2.0, 95% CI: 1.04, 3.83) were associated with development of SSI.Conclusions Traditional medicine use among c-section patients was high in the peripartum period, particularly during pregnancy, and was significantly associated with SSI. Knowing patterns of traditional medicine use during the peripartum period can help providers collaborate with traditional healers and give appropriate, culturally-sensitive pregnancy and postoperative care and counseling to patients.
Chi-squared analysis with an expected 100% completion per item was calculated. An anonymous survey for staff members was constructed using the measurement instrument validated for innovation determinants with 5-point Likert scale responses. Free answers about the observed purpose of the SBP and perceived barriers to its completion were documented.RESULTS: Within 24-months, 556 operations were performed with >90% completion rate of 15/22 items, and only 7/22 items exhibiting completion rates <90%. However, chi-squared analysis suggested that statistically significant incompletion of the SBP existed (c2 ¼ 36.56, p ¼ 0.0189). Fourteen staff members participated in the surveys; many reported time (36%), education of the surgical team (29%), form issues (14%), and communication (14%) as barriers to completion. CONCLUSION:This study successfully evaluated the use of a novel pre-verification checklist in a MSU in a low-resource setting. The main barrier for compliance was time and volume of cases. The results of our study will direct the adoption of future changes to the SBP that will facilitate consistent use and improved quality of surgical care delivered.
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