It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide.

Background The World Health Organization (WHO) guidelines recommend practicing KMC (Kangaroo Mother Care) continuously for weeks after discharge of preterm newborns. However, little is known about KMC practices in the community in Rwanda and other African countries.Therefore, this study sought to assess KMC practices in Southern Rwanda, primarily after hospitalization and identify barriers to KMC in the community. Methods A cross-sectional study was performed with data collected through a survey among 124 caregivers of preterm infants and Community Health Workers. The Statistical Package for the Social Sciences SPSS version 22 was used to analyze the data. Results Among all caregivers interviewed, 86.7% confirmed that they practiced KMC, both in the hospital (KABUTARE District Hospital) as well as after discharge, but there is a large variation in practice time and place. KMC is practiced more during daytime. Working in the fields and lack of support to the caregivers are reported most frequently as barriers to practice KMC in the community. Conclusion KMC-practice is still sub-optimal in Rwanda. Special attention should be directed towards KMCpractice at night and towards the reported obstacles of practicing KMC in the community, e.g. working in the field, lack of support and equipment, difficulties to sleep and health problems.

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IntroductionThere is lack of information on economic cost of violent related injuries in Uganda. The study estimates both direct and indirect costs incurred as a result of interpersonal and self directed violent injuries.MethodsData were collected from four hospitals and two health centres (September 2008 to November 2009) using a standardised form while medico-legal data were collected from Government chemist and Police surgeon. Estimating cost parameters were derived from a WHO Manual. Statistical analyses were done using Stata 10.ResultsIntentional injuries accounted for 20.7% of all injuries. Self-inflicted accounted for 30.3%, while interpersonal 69.7%. Violent injuries were frequent in homes; with causes: stabbing (31.1%) and poisoning (8.5%). Proportion of intentional injuries in homes was significantly higher than of unintentional injuries, 46.9% versus 23.7% (p<0.001). Direct total costs for self-directed injuries were $16 971 while per self-directed injury was $132.6. Indirect total costs for self-directed injuries were $506 443, while per self-directed injury was $3957. Direct medical costs for interpersonal injuries were $44 469, while $155 per interpersonal injury. Indirect costs for interpersonal injuries were $1 519 329, while $5312 per interpersonal injury. Direct costs due to violent injuries accounted for 0.04% of GDP while indirect costs accounted for 5.14% of GDP.Discussion and ConclusionEconomic cost of violent injuries in Uganda is substantive and could be saved for more pressing priorities if a preventive strategy is implemented.