Vol 14 Issue 1 April 2026-September 2026

Abstract: Sierra Leone has expanded community-based primary healthcare (PHC), yet persistent workforce, service-delivery, financing, infrastructure, information-system, and equity constraints continue to affect service capacity and sustainability. This study examined these conditions and developed evidence-informed strategies for strengthening community health and PHC. A scoping review guided by PRISMA-ScR identified peer-reviewed and authoritative grey literature, with 18 studies and reports retained from 65 initially identified records. Evidence was mapped to the six World Health Organization Health System Building Blocks, with equity, community engagement, and resilience incorporated as cross-cutting dimensions, and subsequently analyzed using SWOT and TOWS frameworks. The analysis identified established Community Health Worker and Community Health Officer structures, community-based service platforms, PHC policy commitment, epidemic-response experience, and emerging digital-health capacity as important strengths. Major constraints included workforce shortages and maldistribution, limited workforce absorption and retention, inadequate service readiness, fragmented information systems, financing limitations, and inequitable access. Opportunities included digital integration, geospatial workforce planning, workforce development, integrated epidemic preparedness, and strategic partnerships, while epidemics, health-worker migration, financing pressures, supply-chain disruptions, and environmental risks represented significant threats. TOWS analysis consolidated these findings into six strategic priorities: a sustainable and equitably distributed workforce; strengthened PHC readiness and essential services; integrated digital health and information systems; epidemic-ready and resilient PHC; sustainable financing and coordinated governance; and equity-centered, community-responsive healthcare delivery. The findings demonstrate that sustainable community health improvement in Sierra Leone requires strengthening and integrating existing capacities rather than developing parallel systems and provide an evidence-informed pathway from health-system assessment to strategic planning and implementation.

Keywords: Sierra Leone; community health; primary healthcare; health-system strengthening; SWOT; TOWS; resilience; universal health coverage.

Title: Strategies for Strengthening Community Health in Sierra Leone: A SWOT–TOWS Matrix Approach

Author: Dr. David Bull

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 527-548

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Website: www.researchpublish.com

Published Date: 17-August-2026

Abstract: Introduction Treatment failure among youth aged 10–24 years receiving antiretroviral therapy (ART) remains a critical challenge to achieving the UNAIDS 95-95-95 targets in sub-Saharan Africa. In Rwanda, where HIV prevalence is approximately 3.0% nationally, adolescents and young adults face disproportionate adherence barriers and poorer treatment outcomes relative to older adults. Evidence on the magnitude and determinants of ART failure in this age group from decentralized Rwandan facilities is limited. This study aimed to quantify the prevalence and identify socio-demographic and clinical determinants of treatment failure among youth on ART at Rwamagana Level Two Teaching Hospital. Methods We conducted a retrospective cross-sectional study using secondary data extracted from 385 medical records of youth aged 10–24 years enrolled in HIV care and on ART for at least 12 months at Rwamagana Level Two Teaching Hospital, Rwanda (March–June 2024). Treatment failure was defined according to WHO 2023 criteria and classified as virological (viral load ≥1,000 copies/mL on two consecutive measurements following enhanced adherence counselling), immunological, or clinical failure. Socio-demographic and clinical variables were extracted using a structured data abstraction form. Data were analyzed using SPSS v26.0; descriptive statistics, chi-square tests, and multivariable logistic regression were performed. This study adheres to STROBE reporting guidelines. Results : Of 385 youth (53.8% female; median age group 20–24 years), 97 (25.2%) experienced treatment failure. Virological failure predominated (62.9%), followed by immunological (23.7%) and clinical (13.4%) failure. In the multivariable model, older youth aged 20–24 years had more than double the odds of treatment failure compared with those aged 10–14 years (AOR = 2.1; 95% CI: 1.2–3.8; p = 0.009). Female sex (AOR = 1.6; 95% CI: 1.0–2.6; p = 0.047), advanced WHO clinical stage III–IV (AOR = 3.8; 95% CI: 2.1–6.9; p < 0.001), presence of opportunistic infections (AOR = 2.2; 95% CI: 1.3–3.9; p = 0.004), and ART duration exceeding five years (AOR = 2.4; 95% CI: 1.3–4.1; p = 0.002) were independently associated with treatment failure. Conclusions: One in four youth on ART at Rwamagana Level Two Teaching Hospital experienced treatment failure, predominantly virological. Clinical disease burden, older adolescent age, female sex, and long ART duration are key risk factors. Targeted interventions including intensified viral load monitoring, gender-responsive adherence support, and early initiation of ART are urgently required. These findings inform national strategies for adolescent and youth-friendly HIV services in Rwanda and comparable settings.

Keywords: HIV; antiretroviral therapy; treatment failure; virological failure; adolescents; youth; Rwanda; sub-Saharan Africa.

Title: TREATMENT FAILURE AMONG YOUTH AGED 10-24 YEARS ON ANTIRETROVIRAL THERAPY ATA LEVEL TWO TEACHING HOSPITAL IN RWANDA

Author: Mbonigaba Youssouf, Japheths Ogendi, Monica Mochama

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 519-526

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Website: www.researchpublish.com

Published Date: 04-August-2026

Abstract: Background: Food has been used widely in parts of the world as a healing modality in naturopathic practice for more than a century. A core naturopathic principle is explained by the fact that our food choices influence our health and capacity to recover from diseases or conditions. Recent scientific research in nutrition, plant-based bioactive compounds, and the human physiology department has provided increasing evidence to support the therapeutic value of food in maintaining good health and reducing the risk of diseases.

Objective: The aim of this review is to synthesize the current evidence on the therapeutic use of foods in naturopathic practice, including the mechanisms of the action of the key dietary bioactive compounds, their role in chronic disease management, and their integration within contemporary integrative medicine frameworks.

Methods: A narrative literature review was conducted using the peer-reviewed articles from the PubMed, Scopus, and CINAHL databases (2000-2024). Studies that explore the dietary interventions in the field of naturopathic medicine, phytochemical mechanisms, gut microbiome modulation, and chronic disease outcomes were included in this study.

Results: There's evidence that the anti-inflammatory foods, fermented foods, adaptogenic herbs, and diets that are high in phytonutrients can be therapeutically effective for many chronic conditions like type 2 diabetes, cardiovascular disease, inflammatory bowel disease, autoimmune disorders, and neuropsychiatric conditions. Major mechanisms that are included are the modulation of the gut-brain-immune axis, epigenetic regulation, reduction of oxidative stress, and optimization of the microbiome.

Conclusion: The approach of the title food-as-medicine is scientifically-based, patient-centered, and cost-effective. Its inclusion in mainstream health care as part of integrative medicine holds great promise for the prevention and management of various chronic diseases. Nutrigenomic principles will be the next frontier of personalized nutrition.

Keywords: naturopathy; food as medicine; phytochemicals; gut microbiome; integrative medicine; chronic disease; anti-inflammatory diet; nutrigenomics.

Title: Therapeutic Role of Food as Medicine in Naturopathy: A Comprehensive Review

Author: Dr Keerthana .K, Dr. V. Deepa, Dr. M. Sivamani, Dr. Ishwariya, Dr. Vasunthara. M, M. Panchayathu Raja

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 512-518

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Website: www.researchpublish.com

Published Date: 04-August-2026

Abstract: This research study assessed knowledge, attitudes, and practices (KAP) regarding handwashing among mothers of children under five attending health centers in Gasabo District in 2026, Rwanda. Although handwashing is a simple and effective measure for preventing diarrhea and respiratory infections, gaps in proper handwashing practices remain. Using a cross-sectional design and systematic sampling, 385 mothers participated through structured face-to-face interviews. Results showed that 81.2% had good knowledge and 77.7% held positive attitudes toward handwashing, while 76.4% demonstrated adequate handwashing practices. Mothers with higher education were significantly more likely to practice proper handwashing, whereas those aged 25–39 years, those without household handwashing facilities, and those with negative attitudes were less likely to demonstrate adequate practices. Despite generally good knowledge and positive attitudes, important barriers to optimal handwashing behavior persisted. The study concludes that strengthening hygiene education, improving household access to handwashing facilities, and promoting positive behavioral change are essential to enhance handwashing practices and reduce preventable childhood infections in Gasabo District, Rwanda.

Keywords: Handwashing, Knowledge, Attitude, Practice, Under-five Children, Rwanda.

Title: Knowledge, Attitudes, and Practices of Handwashing among Mothers with Children Under Five Years of Age in Gasabo District in 2026, Rwanda

Author: Gasharazi Assiya, Dr. Habtu Micheal

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 497-511

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Website: www.researchpublish.com

Published Date: 31-July-2026

Abstract: Allergic rhinitis (AR) is a common allergic disease that affects so many people around the world. The main symptoms include sneezing, runny nose, and nasal itching, which may affect our daily activities and quality of life. Even though conventional treatments can reduce symptoms; some patients are still facing these symptoms. Traditional Chinese Medicine (TCM) has been used for many years as another option for treating allergic rhinitis. This review focuses on the effectiveness of TCM methods, including acupuncture, Sanfu acupoint herbal patching, auricular acupuncture, and Chinese herbal medicine. Several studies reported that these treatments could help reduce nasal symptoms and improve the quality of life of patients with allergic rhinitis. In addition, TCM was reported to be safe with few side effects. However, more studies with larger groups of patients are needed to confirm their effectiveness. This review provides an overview of the current evidence on the use of TCM for allergic rhinitis.

Keywords: Allergic rhinitis, Traditional Chinese Medicine, Acupuncture, Chinese herbal medicine.

Title: Efficacy of Traditional Chinese Medicine for the Management of Allergic Rhinitis

Author: Tiyada Yooyen

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 492-496

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Website: www.researchpublish.com

Published Date: 30-July-2026

Abstract: Aim: - To determine the prevalence of high-risk human papillomavirus infection and to describe the pattern of HR-HPV genotypes among women attending for cervical cancer screening in Karnataka, India by using a PCR based assay. The main etiologic factor of cervical cancer is persistent infection with high-risk human papillomavirus. HPV-16 and HPV-18 are the most prevalent genotypes responsible for cervical cancer globally, the distribution of HR-HPV genotypes is geographically heterogeneous. Methods: - This study was conducted at Greenarray Genomics Research and Solutions Pvt. Ltd., on cervical samples received from multiple hospitals in Karnataka, India between 2020-2026. A total of 500 clinician-collected cervical samples were screened for HR-HPV using a validated PCR-based assay. Furthermore, the genotype distribution of the positive samples was analysed. Results: Of the 500 women screened, 16 were positive for HR-HPV with the overall prevalence of 3.2%. The most detected genotype was HPV-16 (5 cases), followed by HPV-66 (4 cases). HPV-18 and HPV-33 were each found in 2 cases and HPV-31 and HPV-58 were each found in 1 case and 1 case of co-infection with HPV 16,66. Conclusions: The prevalence of HR-HPV infection in the screened population had HPV-16 as the predominant genotype followed by HPV-66. These results underscore the need for continuous regional surveillance of HR-HPV genotype distribution and support the rationale for the inclusion of extended HPV genotyping in cervical cancer screening and prevention programs. Larger multicentric studies with cytological, histopathological and longitudinal clinical follow up are warranted to better understand the epidemiology and clinical significance of HR-HPV genotypes in Indian population.

Keywords: Human papillomavirus (HPV), International Agency for Research on Cancer (IARC), Polymerase Chain Reaction (PCR), HPV 16, HPV 18, HPV 66.

Title: Region-Specific HR-HPV Prevalence and Genotype Distribution in Karnataka, India: A Multicentre Study

Author: Sarjan Shah, Hema Divakar, Arti Krishnamurthy, Shailaja Talwade, Savithri A, Bharathi Rajshekhar, Jagruti Karande, Shruti Jawale, Preeti Arora

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 489-491

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Website: www.researchpublish.com

Published Date: 17-July-2026

Abstract: Malaria remains a major public health challenge, particularly in sub-Saharan Africa, where it continues to contribute substantially to morbidity and mortality. Long-lasting insecticidal nets (LLINs) are among the most effective malaria prevention interventions; however, their utilization remains suboptimal in many high-risk settings. This study assessed the factors influencing the utilization of LLINs for malaria prevention among households in Gasabo District, Rwanda. A quantitative cross-sectional research design was employed, and data were collected using a structured questionnaire administered to 342 households selected from rural and peri-urban sectors. Data were analyzed using STATA 17.0 through descriptive statistics, binary logistic regression, and multivariable logistic regression to determine factors associated with LLIN utilization. The study was guided by the Health Belief Model (HBM) and the Social Ecological Model (SEM) to examine the influence of individual, household, and community-level factors on LLIN adoption and utilization. The findings revealed that the prevalence of LLIN utilization among households in Gasabo District was 55.8%. Awareness of LLINs was significantly associated with increased utilization (AOR = 3.5, 95% CI: 1.08–11.34, p = 0.037). Similarly, respondents who correctly identified mosquito bites as the mode of malaria transmission were significantly more likely to use LLINs appropriately (AOR = 2.7, 95% CI: 1.19–6.13, p < 0.001). Conversely, sleeping on foam mattresses (AOR = 0.62, 95% CI: 0.39–0.98, p = 0.040) and residing in houses with concrete walls (AOR = 0.61, 95% CI: 0.38–0.98, p = 0.035) were negatively associated with LLIN utilization. The findings indicate that although LLIN ownership is widespread, utilization remains inadequate and is influenced by both behavioral and structural factors. Strengthening community awareness, improving malaria education, and implementing context-specific interventions that address household environmental conditions could enhance LLIN utilization and contribute to reducing the malaria burden in Rwanda.

Keywords: Utilization, Insecticidal Nets, Malaria Prevention, Households, Gasabo District.

Title: Factors Contributing to the Utilization of Long-Lasting Insecticidal Nets in Malaria Prevention among Households in Gasabo District, Rwanda

Author: Agnes Nganyira, Dr Maurice B. Silali, Dr. Habimana Amos

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 476-488

Research Publish Journals

Website: www.researchpublish.com

Published Date: 13-July-2026

Abstract: Background: Antiretroviral therapy (ART) adherence is the cornerstone of effective HIV management; suboptimal adherence undermines viral suppression, increases transmission risk, and accelerates disease progression. Rwanda reports a 3% adult HIV prevalence, yet determinants of non-adherence at facility level, particularly in western district hospitals, remain insufficiently characterized. This study determined the prevalence and multidimensional determinants of antiretroviral drug (ARD) non-adherence among people living with HIV (PLHIV) at Kirinda District Hospital, Karongi District, Rwanda.

Methods: A cross-sectional analytical mixed-methods study was conducted among 196 adult PLHIV on ART for at least six months at Kirinda District Hospital. Participants were selected through a finite-population-adjusted sample size (Fisher formula). Data were collected via structured questionnaires and five focus group discussions (n=42). Quantitative analysis used IBM SPSS v28; bivariate chi-square and multivariate logistic regression (95% CI; p<0.05) identified independent predictors of non-adherence. Qualitative data were analyzed thematically using NVivo.

Results: The overall non-adherence prevalence was 23.0% (n=45). Among non-adherent participants, 72.4% reported missing doses at least weekly; principal self-reported barriers were HIV-related stigma (16.3%), fear of status disclosure (13.3%), and drug side effects (12.8%). Knowledge gaps were prominent: 27.6% were unaware of ARV effectiveness and 41.3% did not know the risks of non-adherence. Social support was inadequate, with 51.6% uncomfortable discussing HIV status with family. Multivariate analysis identified six independent predictors of non-adherence: widowhood (aOR=2.82, 95% CI: 1.39–12.88, p=0.043), no formal education (aOR=2.61, 95% CI: 2.37–17.24, p=0.002), less than one year on ART (aOR=0.42, 95% CI: 0.05–1.68, p=0.024), experiencing drug side effects (aOR=2.56, 95% CI: 2.30–19.86, p=0.012), lacking knowledge of non-adherence consequences (aOR=2.12, 95% CI: 1.50–8.56, p=0.012), and absence of reminder tools (aOR=1.92, 95% CI: 2.92–20.67, p=0.041). Qualitative findings corroborated these determinants, revealing four major thematic domains: biomedical challenges and side-effect burden, structural and stigma-related barriers, sociocultural dynamics, and treatment literacy gaps.

Conclusion: Non-adherence at Kirinda District Hospital is driven by intersecting biomedical, structural, sociocultural, and knowledge-related determinants. Effective responses require multilevel, patient-centered interventions including enhanced side-effect management, targeted psychosocial support for widowed PLHIV, culturally adapted treatment literacy programmes, universal reminder-tool provision, and strengthened community stigma-reduction initiatives.

Keywords: antiretroviral therapy; ART adherence; non-adherence; PLHIV; HIV; Rwanda; stigma; treatment literacy; mixed methods; district hospital.

Title: Prevalence of non-adherence to antiretroviral therapy among people living with HIV and mitigation used to control in Kirinda District Hospital

Author: Donatien Mbonyintwari, Emile Sebera, Leonisse Uwajeneza, Jerome Mfitumukiza, Larissa Mukire, Jean Damascene Dusabimana, Daniel Ukwishatse, Thierry Patrick Ishimwe, Denyse Umuhoza, Maurice Silari

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 464-475

Research Publish Journals

Website: www.researchpublish.com

Published Date: 09-July-2026

Abstract: Background: Misoprostol and tranexamic acid have been shown to reduce intra-operative haemorrhage during abdominal myomectomy, however, the side effect profiles remain understudied.

Aim: To determine whether misoprostol compared with tranexamic acid has less side effect profile when used to reduce bleeding during abdominal myomectomy in a tertiary hospital and two private specialist hospitals in Enugu. Materials and Methods: This was a non-randomized comparative prospective interventional study. A total of 52 consenting participants were recruited from women booked for abdominal myomectomy at the study centers over 7 months. They were consecutively selected by matching into group I (vaginal misoprostol 400 µg) and II (intravenous tranexamic acid 1g) one hour and 15 minutes before surgery respectively. Intraoperatively, all participants had a tourniquet application. The side effect profile, intraoperative blood loss and postoperative haematocrits were compared between the two groups. Descriptive and inferential analyses were carried out using IBM SPSS Version 26.0. A P‑ value of < 0.05 was considered statistically significant. All 26 participants (100%) completed the study according to the protocol in groups I and II, respectively. Socio-demographic characteristics were not significantly different in both groups. The side effect profile were nausea and vomiting seen each in 2(7.7%) participants in the tranexamic acid group while shivering and abdominal cramps were seen in 7(26.9%) and 3(11.5%) respectively in participants in the misoprostol group and these were tolerable in both groups. The mean intra-operative blood loss in Group I compared to Group II was not statistically difference (825 ± 471.7 ml vs 840 ± 514 ml, p = 0.918). There was also no significant difference in the mean pre and post-operative haematocrit of participants in group I and group II (5.2 ± 2.7 vs 6.2 ± 3.4, p = 0.245).

Conclusion: Among the women receiving tourniquet during open abdominal myomectomy in Enugu, the additional use of vaginal misoprostol 400 µg versus intravenous 1g tranexamic acid had comparable tolerable side effects as well as comparable effectiveness in reducing intraoperative haemorrhage.

Keywords: Misoprostol and tranexamic acid, tertiary hospital, abdominal myomectomy.

Title: Comparison of Side Effect Profile of Misoprostol Versus Tranexamic Acid Both used in Adjunction with Tourniquet in Reducing Blood Loss during Abdominal Myomectomy in Enugu: A non-randomized Prospective Multi-Centre Interventional Study

Author: Chika Thompson Ugwuanyi

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 440-450

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Website: www.researchpublish.com

Published Date: 05-July-2026

Abstract: Background: New-onset seizures in adults are an important neurological presentation and may be the first manifestation of an underlying structural, infective, metabolic, traumatic, neoplastic, or idiopathic disorder. Identification of the clinical profile and etiology is essential for early diagnosis, appropriate treatment, and prevention of recurrence.

Aim: To study the clinical profile, investigational findings, and etiological distribution of new-onset seizures in adults presenting to a tertiary care hospital.

Materials and Methods: This cross-sectional observational study was conducted among 64 adult patients presenting with new-onset seizures to the OPD, emergency department, Neuro Medicine, and Department of General Medicine at People’s College of Medical Sciences & Research Centre, Bhopal. Patients aged more than 18 years with new-onset seizures were included, while patients with previous history of seizures, pregnant women, patients aged less than 18 years, and those already taking anti-epileptic drugs were excluded. All enrolled patients underwent detailed clinical evaluation, neurological examination, biochemical investigations, neuroimaging by CT/MRI brain, and EEG. Data were analyzed using SPSS, and associations were assessed using Chi-square test or Fisher’s Exact Test. A p-value <0.05 was considered statistically significant.

Results: Among 64 patients, the maximum number belonged to the 36–55 years age group, 24 (37.5%), followed by 18–35 years, 22 (34.5%). Males were predominant, 41 (64.1%). Focal to bilateral GTCS was the most common seizure type, seen in 22 patients (34.4%), followed by focal seizure and GTCS in 21 patients each (32.8%). Stroke was the most common etiology, 17 (26.6%), followed by CNS infection and metabolic causes, 14 (21.9%) each. Brain MRI/CT was normal in 20 patients (31.3%), while ischemic infarct was the commonest abnormal finding, 12 (18.8%). EEG showed focal epileptiform discharges in 23 patients (35.9%). Abnormal sodium levels were seen in 23 patients (35.9%) and abnormal calcium levels in 14 patients (21.9%). MRI/CT findings showed a significant association with seizure etiology (p<0.001).

Conclusion: New-onset seizures in adults were more common among middle-aged males. Stroke, CNS infection, and metabolic abnormalities were the major etiologies. Neuroimaging, EEG, and biochemical evaluation are essential for early etiological diagnosis and appropriate management.

Keywords: New-onset seizures; Adults; Stroke; EEG; Neuroimaging.

Title: Clinical profile of new onset seizures in adults in a tertiary care hospital

Author: Dr Oaj Tuteja, Dr Rahul Jain, Dr Atul Patel

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 432-439

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Website: www.researchpublish.com

Published Date: 02-July-2026

Abstract: Background: School-based deworming has become a cornerstone of Rwanda's strategy against soil-transmitted helminth infections, yet measurable program coverage does not always translate into actual medication ingestion by children. Caregivers are central to this gap, since their understanding, beliefs, and day-to-day decisions ultimately determine whether a child swallows the tablet offered at school. This study explored caregivers' perceptions and lived experiences of deworming medication utilization among school-going children in Rusizi District, Rwanda. Methods: A descriptive qualitative design was used. Thirty caregivers of school-going children aged 7 to 18 years were purposively selected from communities in Rusizi District where school-based deworming campaigns had recently taken place. Data were collected through semi-structured, in-depth interviews and key informant interviews with teachers and community health workers, conducted in Kinyarwanda, audio-recorded with consent, and later transcribed and translated into English. Data collection continued until no new ideas emerged from successive interviews. Transcripts were analyzed using reflexive thematic analysis. Results: Six interconnected themes were identified: knowledge and awareness of deworming, perceived benefits of deworming, fear of side effects and misconceptions, trust in schools and community health workers, school attendance and access challenges, and the influence of previous experiences on future participation. Caregivers generally regarded deworming as beneficial for their children's appetite, growth, and classroom concentration, and placed considerable trust in schools and health workers as program implementers. At the same time, fear of side effects, lingering misconceptions about repeated dosing, and absenteeism on campaign days were recurring obstacles shaping whether children ultimately received and swallowed the medication. Conclusion: Caregivers' decisions about deworming participation are shaped by an interplay of knowledge, trust, fear, and prior experience rather than by any single factor in isolation. Strengthening pre-campaign communication, openly addressing side-effect concerns, and building structured catch-up mechanisms for absent children would help translate caregivers' generally favorable attitudes into more complete and consistent utilization.

Keywords: deworming; caregivers; qualitative study; school-going children; soil-transmitted helminths; Rwanda; thematic analysis.

Title: School-Based Deworming Medication Utilization among School-Going Children in Rural Rwanda: Caregivers' Perceptions and Experiences: A Qualitative Study

Author: Mutijima Olive, Peterson Kariuki

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 421-431

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Website: www.researchpublish.com

Published Date: 01-July-2026

Abstract: Background: Timely maternal and neonatal healthcare, including early antenatal care (ANC), skilled birth attendance, and postnatal care (PNC), reduces preventable pregnancy and postpartum complications. Although Rwanda has made national progress, delays in accessing these services persist in rural communities. This study determined the prevalence of timely maternal and neonatal healthcare uptake and identified sociodemographic and health service factors associated with service use among women of reproductive age in Ruli Sector, Gakenke District.

Methods: An analytical cross-sectional survey was conducted among 370 women aged 15–49 years selected through stratified random sampling between September and December 2025. Data were analyzed using descriptive statistics, chi-square tests, bivariate logistic regression, and multivariate logis   tic regression in STATA version 17.

Results: Most participants were aged 25–34 years (38.6%), while 58.7% had primary education or below. All respondents were enrolled in community-based health insurance. Early ANC attendance was reported by 63.2%, skilled birth attendance by 99.7%, and PNC attendance by 96.5%. Timely service uptake was independently associated with secondary education, tertiary education, living within 60 minutes of a health facility, CHW pregnancy follow-up, CHW home visits, and being married.

Conclusion: Timely maternal and neonatal healthcare uptake in Ruli Sector is influenced by educational attainment, geographic access, and CHW engagement. Strengthening community health worker outreach, improving transport access, and expanding women's educational opportunities could further improve timely care-seeking in similar rural settings. Keywords: Antenatal care; postnatal care; skilled birth attendance; timely uptake; community health workers; Rwanda; maternal health.

Keywords: Antenatal care; postnatal care; skilled birth attendance; timely uptake; community health workers; Rwanda; maternal health.

Title: Timely Uptake of Maternal and Neonatal Healthcare Services among Reproductive-Age Women in Rural Rwanda

Author: Claude FUNGAROHO, Fissehe Berehe

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 412-420

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Website: www.researchpublish.com

Published Date: 30-June-2026

Abstract: Background: Waste management refuse handlers are routinely exposed to pathogens responsible for hepatitis, tuberculosis, and gastrointestinal infections, and non-pharmaceutical safety devices (gloves, masks, protective clothing) are a primary barrier against this exposure. Evidence from Ghana, South Africa, and elsewhere in sub-Saharan Africa indicates that availability of such devices does not reliably translate into consistent use, and comparable data from Rwanda, particularly at district level, are limited [1,4,5,6]. This study assessed the uptake of non-pharmaceutical safety devices among waste management refuse handlers in Kicukiro District, Rwanda, and the factors associated with that uptake.

Methods: A concurrent mixed-methods cross-sectional study was conducted among refuse handlers employed by a waste management company operating in Kicukiro District. From a workforce of 892 staff, a sample of 276 was determined using the sample-size formula popularized by Slovin and mathematically equivalent to Yamane's approach for an unknown population variance, with a 5% margin of error, and selected by stratified random sampling. Structured questionnaires were administered to the 276 refuse handlers, and semi-structured key-informant interviews were conducted with 10 waste-management company leaders. Quantitative data were analyzed descriptively and using chi-square tests and multivariable binary logistic regression in SPSS version 28.0; qualitative data were analyzed thematically.

Results: Overall, 64.0% (177/276) of refuse handlers reported using non-pharmaceutical safety devices, with gloves (65.2%) and masks (54.3%) most commonly used; only 44.2% reported consistent use across all tasks. In multivariable logistic regression, independent positive predictors of uptake were participation in awareness/training programmes (adjusted odds ratio [AOR] 5.42, 95% confidence interval [CI] 2.90–10.14, p<0.001), acceptance of modern safety practices (AOR 6.88, 95% CI 3.54–13.36, p<0.001), permanent employment relative to casual work (AOR 3.85, 95% CI 2.10–7.05, p<0.001), and university-level education relative to secondary education (AOR 1.89, 95% CI 1.05–3.95, p=0.033). Female sex (AOR 0.45, 95% CI 0.25–0.78, p=0.004), age 46 years or older (AOR 0.40, 95% CI 0.19–0.81, p=0.012), and no formal education (AOR 0.48, 95% CI 0.24–0.97, p=0.041) were independently associated with lower uptake. Qualitative findings identified traditional beliefs, peer influence, fatalistic religious attitudes, and discomfort as recurring barriers to consistent use, even where awareness of safety devices' importance was high.

Conclusion: Uptake of non-pharmaceutical safety devices among refuse handlers among the study participants is suboptimal and inconsistent, shaped by a combination of structural employment conditions, training exposure, and socio-cultural beliefs. Training participation and acceptance of modern safety practices were the strongest modifiable predictors identified, but persistent associations with gender, age, education, and employment status indicate that behaviour-change interventions alone are unlikely to be sufficient without complementary policy and employment-formalization measures.

Keywords: personal protective equipment; occupational health; waste management; refuse handlers; Rwanda; disease prevention; mixed-methods.

Title: Uptake of non-pharmaceutical safety devices among waste management refuse handlers in Kicukiro District to prevent and control disease

Author: Denise Umuhoza, Emile Sebera, Donatien Mbonyintwari, Emile Twagirumukiza, Maurice Silari

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 398-411

Research Publish Journals

Website: www.researchpublish.com

Published Date: 30-June-2026

Abstract: Surgical conditions constitute a major global health burden, accounting for nearly 30% of the global disease burden, while more than 5 billion people lack access to safe and affordable surgical care. This study assessed the magnitude and factors associated with delays in accessing elective surgical care among adult postoperative patients at Centre Hospitalier Universitaire de Kigali (CHUK), Rwanda. A quantitative cross-sectional design was employed among 385 postoperative patients selected through stratified proportional random sampling from General Surgery, Urology, Neurosurgery, and Orthopedic wards. Data were analyzed using SPSS version 28. Descriptive statistics summarized patient characteristics and delay patterns, while multiple regression analysis identified factors associated with delays. Statistical significance was determined at a 95% confidence interval and p-value <0.05. Among participants, 58.4% were male, 61.6% were aged 41 years and above, 57.9% belonged to Ubudehe category 2, 40.3% resided in Kigali City, and 90.6% were covered by MUSA insurance. General Surgery represented the largest specialty group (32.9%). Delay 1 (seeking care) was most commonly greater than 120 days, Delay 2 (reaching healthcare facilities) was generally 30 days or less, while Delay 3 (receiving surgical treatment) was predominantly between 31 and 120 days. For Delay 1, older age was significantly associated with longer delays in seeking care, with participants aged ≥41 years experiencing increased delays compared with younger individuals (β=1.41, p<0.001). Unemployment (β=0.66, p=0.033) and lack of marital support (β=0.40, p=0.036) were also associated with prolonged delays. For Delay 2, access-related barriers were the primary determinants. Compared with financial barriers, distance, transport, and other reasons were associated with shorter delays (β=−1.45, p<0.001; β=−0.86, p=0.041; β=−1.41, p<0.001, respectively), while multiple barriers showed a borderline increase (β=0.30, p=0.066). Reporting other reasons for not seeking treatment was associated with longer delays than poor recognition of illness severity (β=0.43, p=0.007), whereas private or ambulance transport reduced delays compared with public transport (β=−0.61, p<0.001). Delay 3 was mainly driven by long waiting lists (34.1%) and limited operating theatre capacity (32.9%). Overall, delays were influenced by socioeconomic vulnerability, access barriers, and health system constraints, underscoring the need for targeted interventions to improve timely surgical care.

Keywords: Elective Surgery, Factors, Adult, Postoperative, Patients, CHUK, Rwanda.

Title: Delayed Elective Surgery and Factors Associated Among Adult Postoperative in Patients at Centre Hospitaliere Universitaire De Kigali, Rwanda

Author: Uwayesu Roda, Dr. Fisseha Berehe

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 385-397

Research Publish Journals

Website: www.researchpublish.com

Published Date: 30-June-2026

Abstract: Malaria remains a major cause of morbidity and mortality among children under five years in Sub-Saharan Africa, including Rwanda. Despite nationwide interventions such as long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), utilization of malaria preventive measures remains inadequate in some high-burden areas. Rusizi District, characterized by wetlands and irrigated agriculture, continues to experience persistent malaria transmission. Understanding factors influencing caregivers’ utilization of malaria preventive measures is essential for designing context-specific interventions to reduce malaria incidence and improve child health outcomes. This study assessed factors influencing the utilization of malaria preventive measures among caregivers of children under five years in Rusizi District, Rwanda, in 2025. Specifically, it examined the level of utilization, socio-demographic determinants, caregivers’ knowledge of malaria prevention, and environmental and household factors associated with preventive practices. A cross-sectional descriptive study design was employed among caregivers of children under five years who had resided in Rusizi District for at least six months. A multistage sampling technique was used to select 384 participants from selected sectors and villages. Data were collected using structured interviewer-administered questionnaires and analyzed using SPSS version 25. Descriptive statistics summarized utilization and knowledge levels, while bivariate and multivariate logistic regression analyses identified factors associated with utilization. Statistical significance was determined at p < .05. Findings were presented using tables and graphs. High utilization of malaria preventive measures was reported in 24.7% of households. Ownership of at least one mosquito net was 99%, while 97.7% of children under five reportedly slept under mosquito nets regularly. Chi-square analysis showed significant associations between utilization and caregivers’ age, marital status, education level, occupation, household size, presence of stagnant water nearby, house wall type, screened windows or doors, and participation in community health education sessions. Multivariate logistic regression revealed that education level, occupation, household size, and environmental factors were independent predictors of high utilization (p < .05). The model explained 44.6% of the variance in utilization (Nagelkerke R² = .446). Although mosquito net ownership is nearly universal, effective utilization of malaria preventive measures remains low. Strengthening caregiver education, environmental management, and community health education is necessary to enhance malaria prevention among households with children under five years in Rusizi District.

Keywords: Malaria, Preventive Measures, Caregivers, Children, Under Five Years, Rusizi District, Rwanda.

Title: Factors Influencing the Utilization of Malaria Preventive Measures among Caregivers of Children Under Five Years in Rusizi District, Rwanda, 2025

Author: Juvenal NISHIMWE, Dr. HABIMANA Amos, Dr. Clemence NISHIMWE

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 372-384

Research Publish Journals

Website: www.researchpublish.com

Published Date: 30-June-2026