Browsing by Author "Thielman, Nathan"

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    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.
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    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.