Browsing by Author "Joharifard, Shahrzad"

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Emergency Obstetrics Knowledge and Practical Skills Retention Among Medical Students in Rwanda Following a Short Training Course
(WILEY , 111 RIVER ST, HOBOKEN, USA, NJ, 07030-5774, 2013) Homaifar, Nazaneen; Mwesigye, David; Tchwenko, Samuel; Worjoloh, Ayaba; Joharifard, Shahrzad; Kyamanywa, Patrick; Wilkinson, Jeff; Rulisa, Stephen; Thielman, Nathan M
Objective:To describe rates of improved knowledge following a structured 2-day emergency obstetrics trainingcourse.Methods:Quantitative assessments to evaluate emergency obstetrics knowledge and practical skillswere administered before, immediately after, and 3–9 months following the training course for 65final-yearmedical students at the National University of Rwanda. A survey was administered during thefinal assessment.Results:In total, 52 (80.0%) students demonstrated knowledge improvement after training. Fifty-seven (87.7%)students improved or maintained their scores from the post-training written test to thefinal assessment,and 32 (49.2%) retained practical skills. Twenty-one (32.3%) of the class demonstrated competency in bothwritten and practical skills. According to multivariable logistic regression analysis, female gender was associatedwith overall competency (P=0.01), and use of the internet for academic purposes more than 3–5 timesper week tended toward competency (P=0.11).Conclusion:A 2-day emergency obstetrics training courseincreased knowledge among medical students. Because educational policies are tailored to address highrates of maternal mortality in resource-poor settings, workshops dedicated to emergency obstetrics shouldbe promoted.
Estimating Operative Disease Prevalence in a Low-income Country: Results of a Nationwide Population Survey in Rwanda
(MOSBY-ELSEVIER , 360 PARK AVENUE SOUTH, NEW YORK, USA, NY, 10010-1710, 2013) Petroze, Robin T; Groen, Reinou S; Niyonkuru, Francine; Mallory, Melissa; Ntaganda, Edmond; Joharifard, Shahrzad; Guterbock, Thomas M; Kushner, Adam L; Kyamanywa, Patrick; Calland, J Forrest
Background. Operative disease is estimated to contribute to 11% of the global burden of disease, but no studies have correlated this figure to operative burden at the community level. We describe a survey tool that evaluates population-based prevalence of operative conditions and its first full-country implementation in Rwanda. Methods. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool is a cross-sectional, cluster-based population survey designed to measure conditions that may necessitate an operative consultation or intervention. Household surveys in Rwanda were conducted in October 2011 in 52 clusters nationwide. Data were population-weighted and analyzed with the use of descriptive statistics. Results. A total of 1626 households (3175 individuals) were sampled with a 99% response rate. 41.2% (95% confidence interval [95 CI%] 38.8–43.6%) of the population has had at least one operative condition during their lifetime, 14.8% (95% CI 13.3–16.5%) had an operative condition during the previous 12 months, and 6.4% (95% CI 5.6–7.3%) of the population were determined to have a current operative condition. A total of 55.3% of the current operative need was found in female respondents and 40.3% in children younger than 15 years of age. A total of 32.9% of household deaths in the previous year may have been related to operative conditions, and 55.0% of responding households lacked funds for transport to the nearest hospital providing general practitioner operative services. Conclusion. The SOSAS survey tool provides important insight into the burden of operative disease in the community. Our results show a high need for operative care, which has important implications for the global operative community as well as for local health system strengthening in Rwanda. (Surgery 2012)
Knowledge, Attitudes, and Practices in Safe Motherhood Care Among Obstetric Providers in Bugesera, Rwanda
(Wiley, 2012) Puri, Ruchi; Rulisa, Stephen; Joharifard, Shahrzad; Wilkinson, Jeffrey; Kyamanywa, Patrick; Thielman, Nathan
Objective To determine the knowledge, attitudes, and practices of obstetric care providers (OCPs) in Bugesera District, Rwanda, crucial to the delivery of safe motherhood services. Methods A quantitative descriptive survey in Kinyarwanda targeting all OCPs in the district was implemented in November 2010 to determine demographic characteristics, safe motherhood knowledge, obstetric practices, and attitudes toward additional training. Results The study captured 87% of OCPs, of whom 137 of 168 (82%) were A2 level nurses. Most expressed a need to improve their knowledge (60.6%) and skills confidence (72.2%) in safe motherhood. The mean percentage of correct answers of 50 questions assessing overall knowledge was 46.4%; sections on normal labor (39.3% correct) and obstetric complications (37.1% correct) were the weakest. Fundal pressure during vaginal delivery was practiced by 60.8%, and only 15.9% of providers practiced active management of the third stage of labor for all deliveries. Providers supported additional training, and 89.3% expressed willingness to participate in a 2-day workshop even if it were their day off. Conclusion The study has identified a need to improve safe motherhood knowledge and practices of OCPs in the Bugesera District of Rwanda. OCPs support additional training as an intervention to reduce maternal mortality.