Browsing by Author "Ntirenganya, Faustin"

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Building trauma and EMS systems capacity in Rwanda: lessons and recommendations
(Ubiquity Press Ltd , Unit 3.22, East London Works, 65-75 Whitechapel Road, London, England, E1 1du, 2021) Jayaraman, Sudha; Ntirenganya, Faustin; Nkeshimana, Menelas; Rosenberg, Ashley; Dushime, Theophile; Kabagema, Ignace; Uwitonze, Jean Marie; Uwitonize, Eric; Nyinawankusi, Jeanne d'Arc; Riviello, Robert; Bagahirwa, Irene; Williams, Kenneth L; Krebs, Elizabeth; Maine, Rebecca; Banguti, Paulin; Rulisa, Stephen; Kyamanywa, Patrick; Byiringiro, Jean Claude
Background: Surgical capacity building has gained substantial momentum. However, care at the hospital level depends on improved access to emergency services. There is no established model for facilitating trauma and EMS system capacity in LMIC settings. This manuscript describes our model for multi-disciplinary collaboration to advance trauma and EMS capacity in Rwanda, along with our lessons and recommendations. Methods: After high-level meetings at the Ministry of Health in Rwanda (MOH), in 2016, a capacity building plan focusing on improved clinical services, quality improvement/ research and leadership capacity across prehospital and emergency settings. The main themes for the collaborative model included for empowerment of staff, improving clinical service delivery, and investing in systems and infrastructure. Funding was sought and incorporated into the Sector Wide Approaches to Planning process at the Ministry of Health of Rwanda. Findings: A shared mental model was created through a fully funded immersion program for Rwandese leaders from emergency medicine, nursing, prehospital care, and injury policy. Prehospital care delivery was standardized within Kigali through a train-thetrainers program with four new context-appropriate short courses in trauma, medical, obstetric/neonatal, and pediatric emergencies and expanded across the country to reach >600 staff at district and provincial hospitals. Forty-two protocols and checklists were implemented to standardize prehospital care across specialties. The WHO Trauma Registry was instituted across four major referral centers in the country capturing over 5,000 injured patients. Long-term research capacity development included Masters’ Degree support for 11 staff. Conclusions and Recommendations: This collaboration was highly productive in empowering staff and leadership, standardizing clinical service delivery in EMS, and investing in systems and infrastructure. This can be a useful model for trauma and EMS system capacity development in other LMICs.
Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda
(Kerman Univ Medical Sciences , Jahad Blvd, Kerman, Iran, 7619813159, 2018) Cancedda, Corrado; Cotton, Phil; Shema, Joseph; Rulisa, Stephen; Riviello, Robert; Adams, Lisa V; Farmer, Paul E; Kagwiza, Jeanne N; Kyamanywa, Patrick; Mukamana, Donatilla; Mumena, Chrispinus; Tumusiime, David K; Mukashyaka, Lydie; Ndenga, Esperance; Twagirumugabe, Theogene; Mukara, Kaitesi B; Dusabejambo, Vincent; Walker, Timothy D; Nkusi, Emmy; Bazzett-Matabele, Lisa; Butera, Alex; Rugwizangoga, Belson; Kabayiza, Jean Claude; Kanyandekwe, Simon; Kalisa, Louise; Ntirenganya, Faustin; Dixson, Jeffrey; Rogo, Tanya; McCall, Natalie; Corden, Mark; Wong, Rex; Mukeshimana, Madeleine; Gatarayiha, Agnes; Ntagungira, Egide Kayonga; Yaman, Attila; Musabeyezu, Juliet; Sliney, Anne; Nuthulaganti, Tej; Kernan, Meredith; Okwi, Peter; Rhatigan, Joseph; Barrow, Jane; Wilson, Kim; Levine, Adam C; Reece, Rebecca; Koster, Michael; Moresky, Rachel T; O’flaherty, Jennifer E; Palumbo, Paul E; Ginwalla, Rashna; Binanay, Cynthia A; Thielman, Nathan; Relf, Michael; Wright, Rodney; Hill, Mary; Chyun, Deborah; Klar, Robin T; McCreary, Linda L; Hughes, Tonda L; Moen, Marik; Meeks, Valli; Barrows, Beth; Durieux, Marcel E; McClain, Craig D; Bunts, Amy; Calland, Forrest J; Hedt-Gauthier, Bethany; Milner, Danny; Raviola, Giusappe; Smith, Stacy E; Tuteja, Meenu; Magriples, Urania; Rastegar, Asghar; Arnold, Linda; Magaziner, Ira; Binagwaho, Agnes
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.
Prevalence of Breast Masses and Barriers to Care: Results From a Population‐based Survey in Rwanda and Sierra Leone
(Wiley , 111 River St, Hoboken, Usa, Nj, 07030-5774, 2014) Ntirenganya, Faustin; Petroze, Robin T; Kamara, Thaim B; Groen, Reinou S; Kushner, Adam L; Kyamanywa, Patrick; Calland, J Forrest; Kingham, T Peter
Background and Objectives:Breast cancer incidence may be increasing in low‐and middle‐income countries (LMIC). This study estimates theprevalence of breast masses in Rwanda (RW) and Sierra Leone (SL) and identifies barriers to care for women with breast masses. only.Methods:Data were collected from households in RW and SL using Surgeons Overseas Assessment of Surgical Need (SOSAS), a cross‐sectional,randomized, cluster‐based population survey designed to identify surgical conditions. Data regarding breast masses and barriers to care in womenwith breast masses were analyzed.Results:3,469 households (1,626 RW; 1,843 SL) were surveyed and 6,820 persons (3,175 RW; 3,645 SL) interviewed. Breast mass prevalence was3.3% (SL) and 4.6% (RW). Overall, 93.8% of masses were in women, with 49.1% (SL) and 86.1% (RW) in women>30 years. 73.7% (SL) and92.4% (RW) of women reported no disability; this was their primary reason for not seeking medical attention. Overall, 36.8% of women who reportedmasses consulted traditional healers only.Conclusions:For women in RW and SL, minimal education, poverty, and reliance on traditional healers are barriers to medical care for breastmasses. Public health programs to increase awareness and decrease barriers are necessary to lower breast cancer mortality rates in low‐and middle‐income countries (LMIC).