Reducing barriers to use maternal health care is one of the critical components to improving maternal health. Rwanda is among the countries that have made tremendous efforts to reduce maternal mortality. However, the current maternal mortality ratio is still high which calls for further efforts to be considered. This study used a qualitative approach to understand mothers' perceptions and experiences of using maternal health care in Rwanda. Using in-depth interviews and focus group discussions, data were collected in the Western and Eastern provinces of the country where forty-five women participated in the study from June to August 2014. This paper highlights perceptions of these participants regarding issues that contribute to suboptimal use of maternal health-care services. The geographical, financial, and social-cultural barriers that emerged in this study highlight the need to understand mothers' experiences and perceptions when using maternal health care as Rwanda and other countries strive to reduce negative maternal health outcomes.

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Background: Blended learning (BL) is defined as the combination of both traditional face-to-face learning and synchronous or asynchronous e-learning approaches. The aim of this scoping review was to explore the literature to obtain a broad understanding of the use of BLin nursing and midwifery education in general, in Sub-Saharan Africa (SSA), and in particular Rwanda.Methods: The literature published between 2010 and 2019 were reviewed from six electronic databases using keywords including blended learning, nursing education, midwifery education, higher education, SSA, and Rwanda. Arksey and O'Malley's framework was used in this review.Results: The initial search identified 1,283 records. Eleven articles were selected for this review after the application of predetermined inclusion criteria. Almost all reviewed articles indicated that the integration of BLmethods improved the quality of nursing and midwifery education in general, and in SSAcountries including Rwanda.Conclusions: Initial research in this area highlights that moving from traditional classroom-delivered programs to the BLapproach is feasible and can promote the quality of nursing and midwifery standards of education. This scoping review highlights a paucity of research on BL in nursing and midwifery education, particularly in SSAcountries. Keywords: Blended learning, nursing and midwifery education, SSA, Rwanda

BackgroundAlthough blended learning (BL) is being adopted in public and private higher learning institutions (HLIs) in Rwanda, little is known about students’ use of BL in their learning activities. This article describes a qualitative descriptive study of students’ perceptions and experiences of BL in Rwanda’s post-secondary nursing and midwifery programs in public and private HLIs.MethodsThirty-three nursing and midwifery students from all public and private HLIs in Rwanda exposed to BL were invited to participate in three online focus group discussions (FGDs) conducted using a developed FGD guide with open-ended questions. Inductive content analysis was used to analyze the transcripts.ResultsThree main themes emerged from the data analysis:(1) BL perceived as a new and effective teaching and learning approach, (2) Contextual challenges to the BL method, and (3) Recommendations to improve the BL method. From students’ experiences, the benefits included but were not limited to the flexibility of the approach, time, and cost-saving. However, several challenges were identified, including technological issues such as lack of ICT skills and poor internet connectivity.ConclusionThis study provides insights into the usefulness of BL in HLIs and offers recommendations on how BL teaching and learning can be improved to strengthen nursing and midwifery pre-service education quality.Rwanda J Med Health Sci 2022;5(2):203-215

Languagethe words we usecan play a key role in enabling or limiting transformation of inequalities in the field of global health. At the same time, given the interdisciplinary, intersectoral, and international nature of much global health work, intended meanings, commitments, and underlying values for words used cannot be taken for granted. This commentary sets out to clarify, and in this manner render available for further discussion and debate, the phrase 'critical and ethical global engagement' (CEGE). It derives from discussions between scholars and partners in research, education, and healthcare practice based at one Canadian and two Rwanda institutions. Initially, our aim was to conceptualise the term 'critical and ethical global engagement' in order to guide our own practices. As the complexity of the values, commitments, and considerations underlying our use of this phrase emerged, however, we realised these discussions merited being captured and shared, to facilitate further exploration and exchange on this phrase.