Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda

Document Type: Original Article

Authors

1 Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

2 Office of the Vice-Chancellor, University of Rwanda, Kigali, Rwanda

3 Rwanda Human Resources for Health Program Team, Ministry of Health, Kigali, Rwanda

4 Office of the Dean, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

5 Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, MA, USA

6 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA

7 Center for Health Equity, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA

8 Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA

9 Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

10 Office of the Principal, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

11 Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University - Western Campus, Ishaka, Uganda

12 School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

13 Office of the Dean and Department of Oral and Maxillofacial Surgery, Oral Pathology and Oral Medicine, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

14 School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

15 Department of Anesthesiology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

16 Department of Ear, Nose, and Throat, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

17 Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

18 School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia

19 Department of General Medicine, Calvary Mater Hospital, Newcastle, NSW, Australia

20 Department of Neurosurgery, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

21 Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA

22 Department of Orthopedic Surgery, Rwanda Military Hospital, Kigali, Rwanda

23 Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

24 Department of Pediatrics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

25 Department of Mental Health, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

26 Department of Radiology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

27 Department of Surgery, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

28 Yale School of Medicine, New Haven, CT, USA

29 Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY, USA

30 Department of Pediatrics, BronxCare Health System, Bronx, NY, USA

31 Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA

32 Division of Hospital Medicine, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, USA

33 Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

34 Global Health Leadership Institute, Yale School of Public Health, New Haven, CT, USA

35 Department of Preventive and Community Dentistry, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

36 University of Global Health Equity, Kigali, Rwanda

37 Clinton Health Access Initiative, Boston, MA, USA

38 Clinton Health Access Initiative, Kigali, Rwanda

39 Office of Global and Community Health, Harvard School of Dental Medicine, Boston, MA, USA

40 Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA

41 Department of General Pediatrics, Boston Children’s Hospital, Boston, MA, USA

42 Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA

43 Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA

44 Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA

45 sidHARTe Program, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, NY, USA

46 Department of Emergency Medicine, Columbia University College of Physicians and Surgeons, New York City, NY, USA

47 Department of Anesthesiology, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA

48 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

49 Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA

50 Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA

51 Duke Hubert-Yeargan Center for Global Health, Durham, NC, USA

52 Department of Medicine, Duke University School of Medicine, Durham, NC, USA

53 Duke Global Health Institute, Durham, NC, USA

54 Duke University Medical Center, Durham, NC, USA

55 Duke University School of Nursing, Durham, NC, USA

56 Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, New York City, NY, USA

57 Obstetrics & Gynecology and Women’s Health, Montefiore Medical Center, New York City, NY, USA

58 Division of Nursing, Howard University College of Nursing and Allied Health Sciences, Washington, DC, USA

59 University of Connecticut School of Nursing, Storrs, CT, USA

60 New York University Rory Meyers College of Nursing, New York City, NY, USA

61 University of Illinois at Chicago College of Nursing, Chicago, IL, USA

62 Columbia University School of Nursing, New York City, NY, USA

63 Department of Family & Community Health, University of Maryland School of Nursing, Baltimore, MD, USA

64 Global Education and Mentorship, Office of Global Health, University of Maryland School of Nursing, Baltimore, MD, USA

65 Department of Oncology & Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA

66 Office of Global Health, University of Maryland School of Nursing, Baltimore, MD, USA

67 Partnerships, Professional Education, and Practice, University of Maryland School of Nursing, Baltimore, MD, USA

68 Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA

69 Department of Anesthesiology Perioperative and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA

70 Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA

71 Center for Global Health, American Society for Clinical Pathology, Chicago, IL, USA

72 Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA

73 Department of Psychiatry, Boston Children’s Hospital, Boston, MA, USA

74 Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA

75 Global Health and Research Programs, Biomedical Research Institute, Brigham and Women’s Hospital, Boston MA, USA

76 Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA

77 Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA

78 Office of the Vice-Chancellor, University of Global Health Equity, Kigali, Rwanda

Abstract

Background
The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda.

 
Methods
The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors.

 
Results
In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions.

 
Conclusion
The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals.

Highlights

Commentaries Published on this Paper

  • Disease Control Priorities Third Edition: Time to Put a Theory of Change Into Practice; Comment on “Disease Control Priorities Third Edition Is Published: A Theory of Change Is Needed for Translating Evidence to Health Policy”

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  • The Future of Disease Control Priorities; Comment on “Disease Control Priorities Third Edition Is Published: A Theory of Change Is Needed for Translating Evidence to Health Policy”

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  • On the Path to UHC – Global Evidence Must Go Local to Be Useful; Comment on “Disease Control Priorities Third Edition Is Published: A Theory of Change Is Needed for Translating Evidence to Health Policy”

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  • Reflections on Norheim (2018), Disease Control Priorities Third Edition Is Published; Comment on “Disease Control Priorities Third Edition Is Published: A Theory of Change Is Needed for Translating Evidence to Health Policy”

            Abstract | PDF

 

 Authors' Response to the Commentaries

  • The Human Resources for Health Program in Rwanda: A Response to Recent Commentaries

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References

  1. Farmer PE, Nutt CT, Wagner CM, et al. Reduced premature mortality in Rwanda: Lessons from success. BMJ. 2013;346:f65.
  2. World Health Organization. World Health Report 2006: Working Together for Health. Geneva, Switzerland: World Health Organization; 2006.
  3. Binagwaho A, Kyamanywa P, Farmer PE, et al. The Human Resources for Health Program in Rwanda—A new partnership. N Engl J Med. 2013;369:2054-2059. doi:10.1056/NEJMsr1302176
  4. Jamison DT, Summers LH, Alleyne G, et al. Global health 2035:a world converging within a generation. Lancet. 2013;382(9908):1898-1955. doi:10.1016/S0140-6736(13)62105-4
  5. Gupta V, Kerry VB, Goosby E, Yates R. Politics and universal health coverage—The Post-2015 Global Health Agenda. N Engl J Med. 2015;373(13):1189-1192. doi:10.1056/NEJMp1508807
  6. Jones A. Envisioning a global health partnership movement. Global Health. 2016;12:1. doi:10.1186/s12992-015-0138-4.
  7. Kruk ME, Yamey G, Angell SY, et al. Transforming global health by improving the science of scale-up. PLoS Biol. 2016;14(3):e1002360. doi:10.1371/journal.pbio.1002360
  8. Adams LV, Wagner CM, Nutt CT, Binagwaho A. The future of global health education: training for equity in global health. BMC Med Educ. 2016;16(1):296. doi:10.1186/s12909-016-0820-0
  9. Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet 2010;376(9756):1923-1958. doi:10.1016/S0140-6736(10)61854-5
  10. Farmer PE, Rhatigan JJ. Embracing medical education’s global mission. Acad Med. 2016. doi:10.1097/ACM.0000000000001433
  11. Collins FS, Glass RI, Whitescarver J, Wakefield M, Goosby EP. Developing health workforce capacity in Africa. Science. 2010;330:1324-1325. doi:10.1126/science.1199930
  12. Olapade-Olaopa EO, Baird S, Kiguli-Malwadde E, Kolars JC. Growing partnerships: Leveraging the power of collaboration through the Medical Education Partnership Initiative. Acad Med. 2014;89(8 Suppl):S19-S23. doi:10.1097/ACM.0000000000000345
  13. Mullan F, Kerry VB. The global health service partnership: Teaching for the world. Acad Med. 2014;89:1146-1148. doi:10.1097/ACM.0000000000000283
  14. Cancedda C, Farmer PE, Kerry V, et al. Maximizing the impact of training initiatives for health professionals in low-income countries: Frameworks, challenges, and best practices. PLoS Med. 2015;12:e1001840. doi:10.1371/journal.pmed.1001840
  15. United Nations. Transforming our world: the 2030 agenda for sustainable development. New York, NY: United Nations; 2015:5.
  16. Cancedda C, Riviello R, Wilson K, et al. Building capacity abroad while strengthening global health programs at home: Participation of seven Harvard-affiliated academic institutions in a health professional training initiative in Rwanda. Acad Med. 2017;92 (5):649-658. doi:10.1097/ACM.0000000000001638
  17. Global Strategy for Human Resources for Health: Agenda 2030. Geneva: World Health Organization; 2014.
  18. Transformative Education for Health Professionals website. http://whoeducationguidelines.org.  Accessed April 20, 2018.
  19. Five-Year Action Plan for Health Employment and Inclusive Economic Growth. International Labor Organization, Organization for Economic Cooperation and Development. World Health Organization; 2017.
  20. Chan DM, Wong R, Runnels S, Muhizi E, McClain CD. Factors influencing the choice of anesthesia as a career by undergraduates of the University of Rwanda. Anesth Analg 2016;123:481-487. doi:10.1213/ANE.0000000000001433
  21. Martin RF, Rangira C, d’Arc Uwambazimana J, Desai SP. The history and evolution of anesthetic care in Rwanda. J Anesth Hist 2017;3(1):5-11. doi:10.1016/j.janh.2016.12.004
  22. Mugeni C, Levine AC, Munyaneza RM, et al. Nationwide implementation of integrated community case management of childhood illness in Rwanda. Glob Health Sci Pract 2014 Aug 5;2(3):328-341. doi:10.9745/GHSP-D-14-00080
  23. Mbanjumucyo G, DeVos E, Pulfrey S, Epino HM. State of emergency medicine in Rwanda 2015: An innovative trainee and trainer model. Int J Emerg Med. 2015;8:20. doi:10.1186/s12245-015-0067-2
  24. Mbanjumucyo G, Cattermole GN. Emergency care conference in the land of a thousand hills. Afr J Emerg Med 2016;6(4):168-169. doi:10.1016/j.afjem.2016.11.002
  25. Mbanjumucyo G, George N, Kearney A, et al. Epidemiology of injuries and outcomes among trauma patients receiving prehospital care at a tertiary teaching hospital in Kigali, Rwanda. Afr J Emerg Med. 2016;6(4):195-197. doi:10.1016/j.afjem.2016.10.001
  26. Kwan GF, Bukhman AK, Miller AC, et al. A simplified echocardiographic strategy for heart failure diagnosis and management within an integrated noncommunicable disease clinic at district hospital level for sub-Saharan Africa. JACC Heart Fail. 2013;1(3):230-236. doi:10.1016/j.jchf.2013.03.006
  27. Binagwaho A, Muhimpundu MA, Bukhman G;NCD Synergies Group. 80 under 40 by 2020:An equity agenda for NCDs and injuries. Lancet. 2014;383:3-4. doi:10.1016/S0140-6736(13)62423-X
  28. Buregeya E, Fowler RA, Talmor DS, Twagirumugabe T, Kiviri W, Riviello ED. Acute respiratory distress syndrome in the global context. Glob Heart. 2014;9:289-295. doi:10.1016/j.gheart.2014.08.003
  29. Bukhman G, Bavuma C, Gishoma C, et al. Endemic diabetes in the world’s poorest people. Lancet Diabetes Endocrinol 2015;3:402-403. doi:10.1016/S2213-8587(15)00138-2
  30. Walker T, Dusabejambo V, Ho JJ, Karigire C, Richards B, Sofair A. An international collaboration for the training of medical chief residents in Rwanda. Ann Glob Health 2017;83(2):339-346. doi:10.1016/j.aogh.2016.12.006
  31. Krebs E, Gerardo CJ, Park LP et al. Mortality associated characteristics of traumatic brain injury patients at the University Teaching Hospital of Kigali, Rwanda. World Neurosurg. 2017;102:571–582. doi:10.1016/j.wneu.2017.03.001
  32. Riviello ED, Sugira V, Twagirumugabe T. Sepsis research and the poorest of the poor. Lancet Infect Dis. 2015;15:501-503. doi:10.1016/S1473-3099(15)70148-9
  33. Musabende M, Mukabatsinda C, Riviello ED, Ogbuagu O. Concurrent cryptococcal meningitis and disseminated tuberculosis occurring in an immunocompetent male. BMJ Case Rep 2016;2016. pii:bcr2015213380. doi:10.1136/bcr-2015-213380
  34. Riviello ED, Kiviri W, Fowler RA, et al. Predicting mortality in low-income country ICUs:The Rwanda Mortality Probability Model (R-MPM). PLoS One 2016;11(5):e0155858. doi:10.1371/journal.pone.0155858
  35. Nkurunziza A, Dusabejambo V, Everhart K, Bensen S, Walker T. Validation of the Kinyarwanda-version Short-Form Leeds Dyspepsia Questionnaire and Short-Form Nepean Dyspepsia Index to assess dyspepsia prevalence and quality-of-life impact in Rwanda. BMJ Open. 2016;6(6):e011018. doi:10.1136/bmjopen-2015-011018
  36. Riviello ED, Kiviri W, Twagirumugabe T, et al. Hospital incidence and outcomes of the acute respiratory distress syndrome using the Kigali Modification of the Berlin Definition. Am J Respir Crit Care Med. 2016;193:52-59. doi:10.1164/rccm.201503-0584OC
  37. Sutherland T, Musafiri S, Twagirumugabe T, Talmor D, Riviello ED. Oxygen as an essential medicine: Under- and over-treatment of hypoxemia in low- and high-income nations. Crit Care Med. 2016;44(10):e1015-e1016. doi:10.1097/CCM.0000000000001912
  38. Riviello ED, Buregeya E, Twagirumugabe T. Diagnosing acute respiratory distress syndrome in resource limited settings: the Kigali modification of the Berlin definition. Curr Opin Crit Care. 2017;23(1):18-23. doi:10.1097/MCC.0000000000000372
  39. Puri R, Rulisa S, Joharifard S, Wilkinson J, Kyamanywa P, Thielman N. Knowledge, attitudes, and practices in safe motherhood care among obstetric providers in Bugesera, Rwanda. Int J Gynaecol Obstet. 2012;116(2):124-127. doi:10.1016/j.ijgo.2011.09.025
  40. Joharifard S, Rulisa S, Niyonkuru F, et al. Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda. BMC Public Health. 2012;12:1049. doi:10.1186/1471-2458-12-1049
  41. Homaifar N, Mwesigye D, Tchwenko S, et al. Emergency obstetrics knowledge and practical skills retention among medical students in Rwanda following a short training course. Int J Gynaecol Obstet. 2013;120(2):195-199. doi:10.1016/j.ijgo.2012.07.031
  42. Rulisa S, Umuziranenge I, Small M, van Roosmalen J. Maternal near miss and mortality in a tertiary care hospital in Rwanda. BMC Pregnancy Childbirth. 2015;15:177. doi:10.1186/s12884-015-0619-8
  43. Leow JJ, Riviello R, Rulisa S. Access to safe obstetric surgical care in low-income countries. World J Surg. 2016;40(9):2289-2290. doi:10.1007/s00268-016-3638-3
  44. Nathan LM, Patauli D, Nsabimana D, Bernstein PS, Rulisa S, Goffman D. Retention of skills 2 years after completion of a postpartum hemorrhage simulation training program in rural Rwanda. Int J Gynaecol Obstet 2016;134(3):350-353. doi:10.1016/j.ijgo.2016.01.021
  45. Rwabizi D, Rulisa S, Aidan F, Small M. Maternal near miss and mortality due to postpartum infection:A cross-sectional analysis from Rwanda. BMC Pregnancy Childbirth 2016;16(1):177. doi:10.1186/s12884-016-0951-7
  46. Rwabizi D, Rulisa S, Matabele-Bazzett L, Small M. EP25.10: The “Honeycomb sign”: prevalence of gestational trophoblastic disease in the largest tertiary centre in Rwanda. Ultrasound Obstet Gynecol. 2016;48(Suppl 1):374. doi:10.1002/uog.17141
  47. Halfon J, Small M, Rulisa S. EP19.04: Use of ultrasound in diagnosis and management of post-Caesarean section peritonitis at a referral hospital in Rwanda. Ultrasound Obstet Gynecol. 2016;48(Suppl 1):349. doi:10.1002/uog.17062
  48. Ntirushwa D, Rulisa S, Muhorakeye F, Bazzett-Matabele L, Rurangwa T. Small M. Gastric rupture in pregnancy: case series from a tertiary institution in Rwanda and review of the literature. AJP Rep. 2016;6(4):e436-e441. doi:10.1055/s-0036-1597619
  49. Kalisa R, Rulisa S, van den Akker T, van Roosmalen J. Maternal near miss and quality of care in a rural Rwandan hospital. BMC Pregnancy Childbirth. 2016;16(1):324. doi:10.1186/s12884-016-1119-1
  50. Henwood PC, Mackenzie DC, Rempell JS, Douglass E, et al. Intensive point-of-care ultrasound training with long-term follow-up in a cohort of Rwandan physicians. Trop Med Int Health 2016 Dec;21(12):1531-1538. doi:10.1111/tmi.12780
  51. Friedman-Klabanoff D, Ball A, Rutare S, McCall N, Blackall DP. Three Rwandan children with massive splenomegaly and Epstein-Barr virus-associated lymphoproliferative disorders: Case presentations and the literature review. J Pediatr Hematol Oncol 2016;38(5):e158-e161. doi:10.1097/MPH.0000000000000561
  52. Nyirasafari R, Corden MH, Charlie Karambizi A, et al. Predictors of mortality in a paediatric intensive care unit in Kigali, Rwanda. Paediatr Int Child Health. 2017;37(2):109-115. doi:10.1080/20469047.2016.1250031
  53. Niyirimanzi T, Rogo T. Fever of unknown origin in family due to Salmonella typhi. Rwanda Medical Journal. 2016;73(4):12-15.
  54. Rogo T, Habimana R, Chow B, McCulloh R. High incidence of bacteria resistant to W.H.O. recommended empiric antibiotics for neonatal sepsis at a tertiary level neonatology unit in Rwanda. Rwanda Medical Journal. 2016;73(2):10-14.
  55. Karemera G, Tanya R, Odiit A. Acute kidney injury: its mortality rate in septic and critically ill children at Kigali University Teaching Hospital. Afr J Paed Nephrol. 2016;3:56-64.
  56. Rosman DA, Nshizirungu J, Rudakemwa E, Moshi C, Tuyisenge JD. Imaging in the Land of 1000 Hills: Rwanda Radiology Country Report. J Glob Radiol. 2015;1(1):5. doi:10.7191/jgr.2015.1004
  57. Mody GN, Nduaguba A, Ntirenganya F, Riviello R. Characteristics and presentation of patients with breast cancer in Rwanda. Am J Surg. 2013;205(4):409-413. doi:10.1016/j.amjsurg.2013.01.002
  58. Ntirenganya F, Petroze RT, Kamara TB, et al. Prevalence of breast masses and barriers to care:results from a population-based survey in Rwanda and Sierra Leone. J Surg Oncol. 2014;110(8):903-906. doi:10.1002/jso.23726
  59. Petroze RT, Byiringiro JC, Ntakiyiruta G, et al. Can focused trauma education initiatives reduce mortality or improve resource utilization in a low-resource setting? World J Surg. 2015;39(4):926-933. doi:10.1007/s00268-014-2899-y
  60. Rickard JL, Ntakiyiruta G, Chu KM. Identifying gaps in the surgical training curriculum in Rwanda through evaluation of operative activity at a teaching hospital. J Surg Educ. 2015;72(4):e73–81. doi:10.1016/j.jsurg.2015.01.013
  61. Linden AF, Maine R, Hedt-Gauthier BL, et al. Epidemiology of untreated non-obstetric surgical disease in Burera District, Rwanda: A cross-sectional survey. Lancet. 2015;385(suppl 2):S9. doi:10.1016/S0140-6736(15)60804-2
  62. Kim WC, Byiringiro JC, Ntakiyiruta G, et al. Vital statistics: estimating injury mortality in Kigali, Rwanda. World J Surg. 2016;40(1):6-13. doi:10.1007/s00268-015-3258-3
  63. Patel A, Krebs E, Andrade L, Rulisa S, Vissoci JR, Staton CA. The epidemiology of road traffic injury hotspots in Kigali, Rwanda from police data. BMC Public Health. 2016;16:697. doi:10.1186/s12889-016-3359-4
  64. Nkurunziza T, Toma G, Odhiambo J, et al. Referral patterns and predictors of referral delays for patients with traumatic injuries in rural Rwanda. Surgery. 2016;160(6):1636-1644. doi:10.1016/j.surg.2016.08.006
  65. Ndayizeye L, Ngarambe C, Smart B, Riviello R, Majyambere JP, Rickard J. Peritonitis in Rwanda: Epidemiology and risk factors for morbidity and mortality. Surgery. 2016;160(6):1645-1656. doi:10.1016/j.surg.2016.08.036
  66. Enumah S, Scott JW, Maine R, et al. Rwanda’s model prehospital emergency care service:A two-year review of patient demographics and injury patterns in Kigali. Prehosp Disaster Med. 2016;31(6):614-620. doi:10.1017/S1049023X16000807
  67. Kim WC, Byiringiro JC, Ntakiyiruta G, et al. Vital statistics: Estimating injury mortality in Kigali, Rwanda. World J Surg. 2016;40:6-13. doi:10.1007/s00268-015-3258-3
  68. Rickard JL, Ntakiyiruta G, Chu KM. Associations with perioperative mortality rate at a major referral hospital in Rwanda. World J Surg. 2016;40:784790. doi:10.1007/s00268-015-3308-x
  69. Kearney AS, Kabeja LM, George N, et al. Development of a trauma and emergency database in Kigali, Rwanda. Afr J Emerg Med. 2016;6(4):185-190. doi:10.1016/j.afjem.2016.10.002
  70. Aluisio AR, Umuhire OF, Mbanjumucyo G, et al. Epidemiologic characteristics of pediatric trauma patients receiving prehospital care in Kigali, Rwanda. Pediatr Emerg Care. 2017. doi:10.1097/PEC.0000000000001045.
  71. Gitembagara A, Relf MV, Pyburn R. Optimizing Nursing and Midwifery Practice in Rwanda. Rwanda Journal. 2015;2(2):26-30. doi:10.4314/rj.v2i2.4F
  72. Hardtman P, Dufatanye E, Maribori C. Global Collaboration in Nursing and Midwifery: Talking it out. Rwanda Journal. 2015;2(2):36-40. doi:10.4314/rj.v2i2.6F
  73. Moen M, Ndateba I, Collins A, Iyamuremye JD. Evidence Based Practice: Valuable and Successful Examples from Nursing and Midwifery in Rwanda. Rwanda Journal. 2015;2(2):62-68. doi:10.4314/rj.v2i2.11F
  74. Leshabari S, Chalo-Nabirye R, Mukamana D, Mill J. Looking forward to the East African Countries’ Collaboration in Nursing and Midwifery Education, Practice and Legislation. Rwanda Journal. 2015;2(2):69-73. doi:10.4314/rj.v2i2.12F
  75. Nkurunziza A., Nyirazigama A, Soule, I. Cultural humility in nursing practice. Rwanda J Med Health Sci. 2015;2(2):89. doi:10.1016/j.apnr.2013.06.008
  76. Moreland P, Soule I, Vanhook L, Baxter L, McKinley-Yoder C. Relf, MJ. Duke University School of Nursing’s impact on nursing and midwifery education in Rwanda. Rwanda J Med Health Sci. 2015;2(2):91. doi:10.4314/rj.v2i2.29F
  77. Mukamana D, Karonkano GR, Rosa W. Advancing Perioperative Nursing in Rwanda Through Global Partnerships and Collaboration. AORN J. 2016;104(6):583-587. doi:10.1016/j.aorn.2016.10.006
  78. Harerimana A, Mtshali NG, Ewing H, et al. E-learning in nursing education in Rwanda: Benefits and challenges. An exploration of participants’ perceptives. IOSR J Nurs and Health Sc. 2016;5(3):64-92. doi:10.9790/1959-0502036492
  79. Seymour B, Muhumuza I, Mumena C, Isyagi M, Barrow J, Meeks V. Including oral health training in a health system strengthening program in Rwanda. Glob Health Action. 2013;6:1-6. doi:10.3402/gha.v6i0.20109.
  80. Benzian H, Greenspan JS, Barrow J, et al. A competency matrix for global oral health. J Dent Educ. 2015;79(4):353-361.
  81. Harerimana JM, Nyirazinyoye L, Ahoranayezu JB, et al. Effect of shortened Integrated Management of Childhood Illness training on classification and treatment of under-five children seeking care in Rwanda. Risk Manag Healthc Policy. 2014;7:99-104. doi:10.2147/RMHP.S56520
  82. Ndagijimana A, Mugenzi P, Thomson DR, Hedt-Gauthier B, Condo JU, Ngoga E. PrePex male circumcision: Follow-up and outcomes during the first two years of implementation at the Rwanda Military Hospital. PloS One. 2015;10(9):e0138287. doi:10.1371/journal.pone.0138287.
  83. Rubanzana W, Ntaganira J, Freeman MD, Hedt-Gauthier BL. Risk factors for homicide victimization in post-genocide Rwanda: a population-based case-control study. BMC Public Health. 2015;15:809. doi:10.1186/s12889-015-2145-z
  84. Kiregu J, Murindahabi NK, Tumusiime D, Thomson DR, Hedt-Gauthier BL, Ahayo A. Socioeconomics and Major Disabilities: Characteristics of Working-Age Adults in Rwanda. PLoS One. 2016;11(4):e0153741. doi:10.1371/journal.pone.0153741
  85. Mukabutera A, Thomson DR, Hedt-Gauthier BL, Basinga P, Nyirazinyoye L, Murray M. Risk factors associated with underweight status in children under five: an analysis of the 2010 Rwanda Demographic Health Survey (RDHS). BMC Nutrition. 2016;2:40. doi:10.1186/s40795-016-0078-2.
  86. Rwabufigiri B, Mukamurigo J, Thomson DR, Hedt-Gauthier BL, Semasaka JPS. Factors associated with postnatal care utilisation in Rwanda: A secondary analysis of 2010 Demographic and Health Survey. BMC Pregnancy Childbirth. 2016;16:122. doi:10.1186/s12884-016-0913-0.
  87. Harerimana JM, Nyirazinyoye L, Thomson DR, Ntaganira J. Social, economic and environmental risk factors for acute lower respiratory infections among children under five years of age in Rwanda. Arch Public Health. 2016;74:19. doi:10.1186/s13690-016-0132-1.
  88. Ndenga E, Uwizeye G, Thomson DR, et al. Assessing the twinning model in the Rwandan Human Resources for Health Program:Goal setting, satisfaction and perceived skill transfer. Global Health. 2016;12:4. doi:10.1186/s12992-016-0141-4
  89. Bradley E, Mantopoulos J, Linnander E, Kagwiza J. Health management education and professional development in low-income settings. On the Horizon. 2016:24(4);313-315.
  90. Rex W, Ntagungira EK. Master in hospital and healthcare management program in Rwanda. On the Horizon. 2016:24(4);316-318. doi:10.1108/OTH-07-2016-0034
  91. Nyiratuza A, Wong R, Adomako E, et al. A quality improvement project to improve the accuracy in reporting hospital acquired infections in post cesarean section patients in a district hospital in Rwanda. On the Horizon. 2016;24(4);319-326. doi:10.1108/OTH-07-2016-0035
  92. Byukusenge JB, Adomako E, Lukas S, et al. Implementing a labor monitoring guideline and midwives responsibilities to increase the completion rate of partograph in Muhima Hospital, Rwanda. On the Horizon. 2016;24(4):335-340. doi:10.1108/OTH-07-2016-0036
  93. Gafirimbi N, Wong R, Adomako E, Kagwiza J. Lessons learned in establishing a quality improvement project to reduce hospital acquired infections in the neonatology ward at a referral hospital in Rwanda. On the Horizon. 2016;24(4):341-348. doi:10.1108/OTH-07-2016-0037
  94. Umulisa S, Musabyimana A, Wong R, Adomako E, Budd A, Ntakirutimana T. Improvement of hand hygiene compliance among health professional staff of Neonatology Department in Nyamata Hospital. On the Horizon. 2016;24(4):349-356. doi:10.1108/OTH-07-2016-0038
  95. Nibamureke A, Ntagungira EK, E Adomako, Pawelzik V, Wong R. Reducing post-cesarean wound infection at Muhororo Hospital by increasing hand hygiene practice. On the Horizon. 2016;24(4):357-62. doi:10.1108/OTH-07-2016-0039
  96. Mukakarake MG, Ndagijimana A, Adomako E, et al. Quality improvement project to increase compliance of administration of corticosteroids and aminophylline in neonatal department of Mibilizi District Hospital. On the Horizon. 2016:24(4);363-368. doi:10.1108/OTH-07-2016-0041
  97. Bahufite A, Ndagijimana A, Adomako E, et al. Implementing wound dressing protocol to reduce post cesarean section surgical site infections in Mibilizi District Hospital, Rwanda. On the Horizon. 2016;24(4):369-376. doi:10.1108/OTH-07-2016-0042
  98. Lukas S, Hogan U, Muhirwa V. Establishment of a hospital-acquired infection surveillance system in a teaching hospital in Rwanda. Int J Infect Control. 2016;12(3). doi:10.3396/ijic.v12i3.16200
  99. Nsengiyumva JP, Wong R, Adomako E. A quality improvement project to reduce intravenous catheter related infections in the neonatology unit of Kibogora hospital in Rwanda. J Hosp Adm. 2016;5(5):60-65. doi:10.5430/jha.v5n5p60
  100. Ibyimana C, Wong R, Adomako E, Lukas S, Birungi S, Munyanshongore S. Establishing a tracking system in human resources department to improve the completeness of personnel files at a district hospital in Rwanda. J Hosp Adm. 2016;5(5):66-71. doi:10.5430/jha.v5n5p66
  101. Shoman H, Karafillakis E, Rawaf S. The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review. Global Health. 2017;13(1):1. doi:10.1186/s12992-016-0224-2
International Journal of Health Policy and Management

Volume 7, Issue 11
November 2018
Pages 1024-1039

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