BackgroundThe care of high-risk neonates in intensive care units is a relatively new field in resource-limited countries. Consequently, pain management of neonates has not been included or considered as part of neonatal care. Neonatal pain is more difficult to assess than adult pain, as they are unable to self-report. Nurses and midwives caring for neonates have a professional responsibility to recognise and manage neonatal pain. ObjectivesTo assess the knowledge, attitude, and practice of nurses and midwives providing neonatal pain management at two hospitals in Kigali. Methodology A descriptive cross-sectional design was used. Data were collected from a convenience sample of 66 nurses and midwives providing neonatal care. Data analysis was achieved through descriptive and inferential statistics. ResultsThe majority (74.2%) demonstrated a low level of knowledge of neonatal pain and its management. Over half (51.5%) had a positive attitude toward neonatal pain management, though over three quarters (84.8%) reported a low level of integrating pain management into practice. ConclusionsThere is a knowledge deficit among the nurses and midwives providing neonatal pain management. A gap lies between their attitude and practice. More educational opportunities are needed to better assess and manage pain in the neonatal patient.Rwanda J Med Health Sci 2019;2(2):138-146.

Background Neonatal jaundice is one of the most common reasons for hospital admission in the neonatal unit, and it is associated with significant morbidity and mortality. Objective To assess risk factors associated with neonatal jaundice among newborns at a District Hospital in Rwanda.  Methods A quantitative approach has been used with a retrospective cross-sectional design. Two hundred and ten files were used as sample size. Stratified proportional sampling was used for the years 2016-2018 to select files. Data was collected using a structured questionnaire. Descriptive statistics and inferential statistics were used for the data analysis.   Results The study findings showed that nearly half (44.3%) of 210 newborns were diagnosed with neonatal jaundice. The majority (87.2%) was term, and male gender (60.5%). Nearly a third (29.5%) were Low Birth Weight. Significant risk factors for neonatal jaundice were birth weight (p=0.015), gestational age of the newborn (p=0.002), neonatal gender (p=0.004), method of delivery (p=.000), blood group incompatibility (p=0.001); infections (p =0.000), cesarean section (p= 0.000) and prematurity (p=0.017).  Conclusion There was a high prevalence of neonatal jaundice. Neonatal jaundice risk factors were predominantly demographic, maternal and neonatal. Hence there is need to formulate tailored interventions that mitigate neonatal jaundice. Rwanda J Med Health Sci 2020;3(2):204-213.

Background Low birth weight (LBW) is a major public health problem worldwide that is linked to childhood morbidity and mortality. Newborns considered ‘Very LBW’ have a high risk of disease and death during infancy. Maternal socioeconomic status, medical factors, and lifestyle are linked to LBW, but these factors remain unknown in Rwanda is unknown. Objective To describe the factors associated with LBW among newborns at a selected referral hospital in Rwanda. Methods A prospective, cross-sectional design study was used to assess 108 mothers who delivered a low birth weight newborn. Results Mothers had a mean age of 30.6 years, 79.6% married, 23.1% primary educated, 50.6% unemployed, and 61.9% lived in a rural area. The majority of LBW (63%) were in the first category of LBW (2500-1500g), and over a quarter (25.9%) with Very LBW (VLBW). Mothers were 89.7% multigravida, and 88.8% had a previous unsuccessful pregnancy, 81.3% premature birth, 97.9% LBW. Over half, 59.8% had hypertension during pregnancy. Lifestyle included 45.5% doing strenuous work, and 50.9% heavy lifting during pregnancy. The level of education (p=0.009), spouse employment (p=0.017), having previous premature baby (p=0.025), previous history of miscarriage (p=0.028), presence of hypertension (p=0.020) and antenatal care visits (p=0.025) the trimester of miscarriage were significantly associated to type of low birth weight. Conclusion Demographic, pregnancy history and lifestyle factors remain a concern to mothers and neonates born with low birth weight. Educational awareness campaigns among mothers with the factors above are crucial to reduce morbidity and mortality related to low birth weight. Rwanda J Med Health Sci 2020;3(2):214-224

Background Globally, 2.5 million neonates die each year from hypothermia. The World Health Organization (WHO) considers neonatal hypothermia as a decrease of axillary temperature in infants below 36.5° Celsius. New mothers, or the nearest caregivers, should be aware that hypothermia is a newborn danger sign, in order to apply best practices regarding neonatal hypothermia prevention to reduce subsequent mortality. Objective To assess mothers’ knowledge and practice of neonatal hypothermia at a selected provincial hospital in Rwanda. Methods A cross-sectional study design and convenience sampling method were used to select 161 mothers with living babies. Data were collected using a structured questionnaire. Descriptive and inferential statistics were used to analyze data. Results About 97% of mothers had inadequate knowledge, and the majority (83%) had inadequate neonatal hypothermia practices. Predictor variables for knowledge were ANC attendance (OR=1.884, 95% CI=1.675-2.565, p=0.042) and secondary educational level (OR=1.787, 95% CI=1.521-2.187, p=0.032). Practice was significantly associated with educational level (OR=1.787, 95% CI=1.521-2.187, p=0.032).   Conclusion There is a need to increase a mother's evidence-based practice of neonatal hypothermia. This condition unchecked leads to high-risk life-threatening complications. Prevention should emphasize on observed gaps to decrease deaths related to neonatal hypothermia. Rwanda J Med Health Sci 2020;3(2):152-166