BackgroundVasectomy is the only permanent method of male contraception. It is safer, cheaper, and easier to provide than female sterilisation. Men typically take a vocal role as decision-makers in Africa, yet it is women who take family planning (FP) action. Objective To assess the knowledge and attitude of men toward vasectomy as a method of FP in the Eastern Province of Rwanda. Methods A cross-sectional design, and systematic sampling of every other household was used in a selected area. The sample size was 390 men and a valid questionnaire was used to collect data. Data analysis included descriptive and inferential statistics. ResultsSociodemographic characteristics affecting vasectomy included education (p < 0.001), religion (p < 0.001), and the number of sexual partners (p = 0.018). Knowledge scores ranged from 58.4% to 82.6%. Many participants agreed that men should take part in FP (78.7%), and use vasectomy as an FP method (77.2%). ConclusionMen scored over 50% on vasectomy knowledge items, though many erroneously believed misconceptions. Misinformation is a barrier to vasectomy uptake, and greater awareness of vasectomy knowledge is needed to change attitudes and increase acceptance. Rwandan families and communities could greatly benefit from men's active role in family planning.

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BackgroundPostnatal depression is a significant public health issue that demands attention, and recent evidence indicates that rates are relatively high in low-income countries such as Rwanda. However, lack of social support is recognized as a potential risk factor for postnatal depressive symptoms. This study sought to explore the influence of poor maternal social support on postnatal depressive symptoms in a sample of women in Rwanda.MethodA prospective cohort research design was conducted with women recruited from four different health centers in Rwanda's Southern Province. A sample of 396 pregnant women accessing antenatal care services was recruited at the baseline from their late second term or later, then followed up after giving birth. The dropout rate was 21.46%; thus, the data of 311 women were analyzed. The outcome variable was the presence of depressive symptoms (Edinburgh Postnatal Depression Scale (EPDS) (≥12 cut-off score), while predictor variables included maternal social support measured using a modified Maternal Social Support Scale (MSSS), perceived health status, socio-demographic information (marital status, wealth class, age, education, occupation), negative life events, gestational and obstetric information (parity, pregnancy intention, age at birth, children given birth, and mode of delivery). Univariate and multivariate analyses were performed.ResultsFrom a sample of 311 participants, over a quarter (20.9%) had elevated postnatal depressive symptoms (EPDS ≥ 12 scores). Elevated scores were predicted by poor perceived health status; respondents reporting neither poor nor good (AOR = 0.28, CI = 0.11; 0.72, p = 0.007) or good health (AOR = 0.14, CI = 0.05; 0.37, p = 0.001) were less likely to be affected. Poor maternal social support was also linked with postnatal depressive symptoms; poor partner support (AOR = 4.22; CI = 1.44; 12.34; p = 0.009) was associated with high risk, while good friend support (AOR = 0.47, CI = 0.23; 0.98, p = 0.04) was a significant protector. Additionally, violence or negative life events were also independent predictors of postnatal depressive symptoms (AOR: 2.94, CI: 1.37–6.29, p = 0.005).ConclusionPostnatal depressive symptoms were found to affect one in five Rwandan women. However, good maternal social support can be a strong protector. Early interventions targeting mothers in the postnatal period and strengthened social support networks for women at risk should be developed.

BackgroundHemodialysis is the most standard method of Renal Replacement Therapy (RRT) used in Rwanda. Nephrology nursing is a new speciality, and little is known about the nurses' work performance while caring for patients under going hemodialysis. Objective To explore factors influencing nurse's work performance in the care of hemodialysis patients in four nephrology units in Rwanda. Methods A qualitative descriptive design used a purposive sampling strategy to recruit 12 registered nurses working on the hemodialysis unit. Data were collected through interviews using a semistructured guide. Data analysis used a thematic approach with six phases. ResultsTwo themes and eight subthemes were revealed. Facilitating factors to increase work performance included the nurses' education and speciality training, good working environment, good interpersonal relationships among staff, and effective management and leadership. Barriers included, self-perceived knowledge and skills insufficiencies, moral distress, logistical concerns, and poor working conditions. ConclusionThe findings revealed specific facilitating factors and barriers to nurses' work performance. Nurses at these study sites, in conjunction with faculty in the Master's Nephrology Track at the University of Rwanda, could become change agents and begin to increase facilitating factors and decrease barriers. Continual improvement in facilitating factors is needed to keep nurses performing well.Rwanda J Med Health Sci 2019;2(2):178-184.