In 2001, a program of distance learning was started within Kigali Institute of Education in collaboration with the Rwanda's Ministry of Education. It is an in-service training program that aims to upgrade in-service secondary school teachers and alleviate the shortage of teachers both in terms of quality and number. This program runs parallel to a pre-service program, also conducted within the Kigali Institute. Academic staff members working in the pre-service program are involved in this distance learning program. After three years, a descriptive qualitative case study was conducted to determine the experiences of academic staff involved in the distance learning program. Purposive and theoretical sampling was used for participants' identification and inclusion. Individual unstructured interview and focus group discussion was used to gather the data. A qualitative software analysis called NVivo 2, developed by Qualitative Solutions and Research (QSR) International in 2002, was used to compile and analyse the data. Results of the study revealed that faculty members involved in both in-service and pre-service programs face challenges associated with heavy workload. Moreover, the pre-service program is typically prioritized at the expense of the distance learning in-service program. Academic relationships between faculty members and tutors also need to be reinforced. Serving as the critical link between the distance learning in-service program and pre-service departments and faculties, this research also shows that course coordinators play a pivotal role in the smooth operation of the distance learning program.
Aim and objectives This review analysed the implementation and integration into healthcare systems of maternal and newborn healthcare interventions in Africa that include community health workers to reduce maternal and newborn deaths. Background Most neonatal deaths (99%) occur in low‐ and middle‐income countries, with approximately half happening at home. In resource‐constrained settings, community‐based maternal and newborn care is regarded as a sound programme for improving newborn survival. Health workers can play an important role in supporting families to adopt sound health practices, encourage delivery in healthcare facilities and ensure timeous referral. Maternal and newborn mortality is a major public health problem, particularly in sub‐Saharan Africa, where the Millennium Development Goals 4, 5 and 6 were not achieved at the end of 2015. Methods The review includes quantitative, qualitative and mixed‐method studies, with a data‐based convergent synthesis design being used, and the results grouped into categories and trends. The review took into account the participants, interventions, context and outcome frameworks (PICO), and followed the adapted PRISMA format for reporting systematic reviews of the qualitative and quantitative evidence guide checklist. Results The results from the 17 included studies focused on three themes: antenatal, delivery and postnatal care interventions as a continuum. The main components of the interventions were inadequate, highlighting the need for improved planning before each stage of implementation. A conceptual framework of planning and implementation was elaborated to improve maternal and newborn health. Conclusion The systematic review highlight the importance of thoroughly planning before any programme implementation, and ensuring that measures are in place to enable continuity of services. Relevant to the clinical practice Conceptual framework of planning and implementation of maternal and newborn healthcare interventions by maternal community health workers.
In developing countries, intravenous (IV) catheter related infections (CRI) rate is generally high. Neonates are more susceptible to develop CRI. We examined the impact of a quality improvement project on IV CRI rates in the neonatal intensive care unit (NICU) of a district hospital in Rwanda. A pre-and post-intervention study was conducted from 2014 to 2016 to evaluate the IV CRI rate and nurses' IV management technique. A written test was administered to evaluate their knowledge on the matter. The intervention had three components: First implementing an IV management policy. Secondly, training staff on the policy and finally, managers provided support and supervision during the change. We measured five indicators: (1) the IV CRI rate; (2) the percentage of nurses who tested ≥ 80% on IV management knowledge; (3) the percentage of IV devices changed following the World Health Organization (WHO) guideline; (4) IV management technique; and (5) the hospital length of stay (LOS). The IV CRI rate reduced from 32.1% to 14.5% (p < .001). The hospital LOS reduced from 15.31 to 7.43 days (p < .001). The compliance of changing IV following WHO guideline increased from 0% to 99% (p < .001); proper IV management technique use increased from 43% to 96% (p < .001); the mean rank of staff on IV management knowledge score significantly increased from 3.5 to 9.5 (p = .004). This project demonstrates that a quality improvement project can help address the IV CRI at very low cost in a resource-challenged setting.
The human development sector has been influenced largely by the integration of ICT in education and different sectors. This study explored the employees' perceptions on the influence of ICT as catalyst for pedagogical changes in order to create a smart manpower requirement for 21st century. The study was qualitative in its nature. Thirtysix respondents participated in this study. Data were collected through interview conducted to explore different views related to how ICT influences the pedagogical changes to generate a smart human capital for the development of countries. Results revealed ICT as a transformational tool that influences the attainment of new skills required by students, teachers and other different employees in other working sectors. Employees' perceptions towards the role of ICT in changing pedagogical activities in order to create a smart manpower requirement for this century were positive. The study also proposed different recommendations which would be considered in order to solve all identified barriers.
Several studies have reported dramatic increase of the prevalence of diabetes mellitus in Africa, and barriers to early detection and treatment, which are cost-effective strategies to prevent and control diabetes mellitus and combat its morbidity and premature mortality. The paper aimed to review the literature on the prevalence of diabetes mellitus and determinants of early detection in Africa. MeSH terms in the PUBMED Medline, LISTA (EBSCO), Cochrane, and Google Scholar in order to identify recent literature published from the year 2012 to 2017. Seven articles were reviewed, and high increase of the prevalence of diabetes mellitus in Africa was found. Evidences of cost-effectiveness with early detection and treatment were found; however, early detection is hindered by several factors that need to be addressed. In addition, the paucity of articles on early detection of diabetes mellitus and community-based prevention and control programs was observed. There is an increasing prevalence of diabetes mellitus in Africa, and there is paucity of evidences on the determinants of early detection and treatment program. Operational studies and community-based interventions aiming to community sensation and screening for diabetes mellitus are highly recommended.
Several studies have reported high prevalence of hypertension in Africa, but little is known on awareness and determinants of preventive measures uptake. The purpose of the review was to identify and review the studies which reported at the same time on the prevalence of hypertension and awareness among the participants in sub-Saharan Africa, and to recommend needed research studies and interventions to prevent and control hypertension increase. High prevalence of hypertension was found across sub-Saharan African countries. The increasing hypertension rate moved from 19.7% in 1990 to 30.8% in 2010, with very high increase in some sub-regions up to 77%. A low awareness was found, less than 50% and in some place less than 10%. Also a high rate of hypertensive patients who were not on treatment was found. There is a very increasing prevalence of hypertension and unawareness in sub-Saharan Africa. There is also a high rate of hypertensive patients who are not on treatment. Studies and interventions aiming at understanding determinants of hypertension screening and treatment uptake are much recommended.
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