Vol 14 Issue 1 April 2026-September 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: Rwanda's Community-Based Health Insurance (CBHI/Mutuelle de Santé), managed by the Rwanda Social Security Board (RSSB), stands as Africa's most successful community health insurance model, achieving over 86.6% national coverage. Despite this remarkable enrollment achievement, a gap between enrollment and active utilization at the point of inpatient care has been observed. This study aimed to determine the factors associated with CBHI utilization and its role in promoting equity among adult inpatients at Rwanda Military Referral and Teaching Hospital (RMRTH) in Kigali City.

Methods: A descriptive, cross-sectional mixed-methods study was conducted among 422 adult inpatients at RMRTH using structured questionnaires, key informant interviews, and focus group discussions. Sampling combined census, purposive, and prospective approaches. Descriptive statistics, chi-square tests, and multivariate logistic regression were used for quantitative analysis. Qualitative data were analyzed thematically using NVivo. Ethical approval was obtained from Mount Kigali University and RMRTH Institutional Review Board.

Results: The overall CBHI enrollment rate was 71.6% (n=302), with 64.2% of enrolled respondents actively using CBHI for current hospitalization. Non-enrollment was primarily attributed to premium unaffordability (43.3%), limited awareness (23.3%), and system distrust (15.0%). In multivariate logistic regression, satisfaction with CBHI services (aOR=6.84, 95% CI: 3.14–14.89, p<0.001), trust in CBHI coverage (aOR=5.24, 95% CI: 2.86–9.58, p<0.001), complete knowledge of covered services (aOR=3.82, 95% CI: 1.78–8.20, p<0.001), and perceived premium affordability (aOR=3.46, 95% CI: 1.88–6.36, p<0.001) were the strongest independent predictors of utilization. Gender (male AOR=2.14), education level, proximity to health facility, and absence of prior service denial also showed significant independent associations. Qualitative data from key informant interviews and focus group discussions, revealed that drug availability gaps, misalignment between premium collection schedules and beneficiaries' income cycles, and concerns about care quality standardization collectively shape CBHI engagement at the point of inpatient care.

Conclusion: CBHI, as administered by RSSB, provides critical financial protection for inpatients and demonstrates significant equity-promoting potential. Optimizing utilization requires targeted action in health literacy strengthening, flexible premium collection mechanisms, quality assurance at health facilities, gender-responsive programming, and administrative simplification. These findings offer an evidence base to guide Rwanda's continued progress toward universal health coverage.

Keywords: Community-Based Health Insurance; CBHI; Mutuelle de Santé; health equity; inpatients; Rwanda; RSSB; health insurance utilization; universal health coverage.

Title: Factors associated with community-based health insurance utilization and its role in promoting equity among hospital inpatients in Kigali city, Rwanda

Author: Christine Nyirantezimana, Emile Sebera, Maurice Silari

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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

Page No: 451-463

Research Publish Journals

Website: www.researchpublish.com

Published Date: 06-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

Research Publish Journals

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

Research Publish Journals

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

Research Publish Journals

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

Abstract: Background: Breast cancer is the most common malignancy in women worldwide, and the spine is the most frequent site of skeletal metastasis, occurring in up to 70% of patients with metastatic disease. The clinical presentation is often insidious — patients may present first to a neurosurgeon with axial back pain, radiculopathy, or frank myelopathy, without any prior breast cancer diagnosis. This bidirectional clinical reality necessitates a structured collaborative framework between the breast oncosurgeon and neurosurgeon.

Objective: This review defines the complementary and interdependent roles of the breast oncosurgeon and neurosurgeon in the detection, evaluation, surgical planning, and postoperative management of breast cancer spinal metastases. We propose an evidence-based collaborative surgical framework applicable in multidisciplinary oncology settings.

Methods: A narrative review of peer-reviewed literature published between 2000 and 2024 was conducted using PubMed, Scopus, and Web of Science databases. Search terms included "breast cancer spinal metastases," "neurosurgery breast oncology collaboration," "separation surgery," "NOMS framework," "SINS score," and "multidisciplinary spine oncology." Fifty-five relevant articles were identified and synthesized.

Results: Breast cancer spinal metastases exhibit molecularly driven heterogeneity. The Spinal Instability Neoplastic Score (SINS) and the Neurological-Oncological-Mechanical-Systemic (NOMS) framework provide evidence-based surgical thresholds. Surgical indications encompass epidural spinal cord compression, spinal instability, radioresistant disease, intractable pain, and diagnostic uncertainty. A collaborative surgical framework — incorporating structured referral criteria, multidisciplinary tumor board (MDT) protocols, systemic therapy integration, and radiation sequencing — improves time-to-surgery and neurological outcomes.

Conclusion: Breast cancer reaches beyond the breast. An integrated, protocol-driven collaboration between the breast oncosurgeon and neurosurgeon optimizes patient outcomes across all phases of metastatic spinal disease. Standardized referral pathways, shared MDT platforms, and surgical sequencing algorithms are essential to this collaboration.

Keywords: Breast cancer; spinal metastases;  collaborative framework ; multidisciplinary team; NOMS; SINS; epidural spinal cord compression.

Title: From Primary to Spine: A Collaborative Surgical Framework for Breast Cancer with Spinal Metastases

Author: Dr. Richa Rani, Dr. Saurabh Patel

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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

Page No: 360-371

Research Publish Journals

Website: www.researchpublish.com

Published Date: 27-June-2026

Abstract: Background: Non-prescribed antibiotic use is a major global public health concern because of its role in driving antimicrobial resistance (AMR), treatment failure, and escalating healthcare costs. This study aimed to determine the prevalence of non-prescribed antibiotic dispensing, assess KAP among community pharmacy staff, and identify associated public health risks in Kigali, Rwanda.

Methods: A cross-sectional study was conducted among 207 community pharmacy staff across Gasabo, Nyarugenge, and Kicukiro districts. Data were collected using a structured and validated questionnaire. Descriptive statistics, Chi-square tests, and multivariate logistic regression were applied; statistical significance was set at p < 0.05.

Results: A total of 38.6% of respondents reported dispensing antibiotics without a prescription. Azithromycin (23.53%), amoxicillin (19.20%), ciprofloxacin (18.89%), and doxycycline (17.34%) were the most frequently dispensed antibiotics without prescriptions. Knowledge was predominantly moderate (87.0%), attitudes were mostly moderate (72.5%), and practice levels were moderate in 78.7% of participants. Practice level was the strongest and only statistically significant predictor of non-prescribed dispensing: staff with moderate practices were 78.5% less likely (aOR = 0.215; 95% CI: 0.092-0.503; p < 0.001), and those with high practice levels were 96.3% less likely (aOR = 0.037; 95% CI: 0.004-0.330; p = 0.003) to dispense without prescriptions compared to staff with low practice levels.

Conclusions: Non-prescribed antibiotic dispensing remains prevalent in Kigali, driven by patient pressure, economic incentives, and regulatory gaps. Practice adherence is the strongest modifiable determinant. Strengthening regulatory enforcement, continuous professional training, and targeted public health education are urgently recommended.

Keywords: non-prescribed antibiotics, antibiotic dispensing, community pharmacy, antimicrobial resistance, knowledge, attitudes and practices, Rwanda.

Title: Determinants of Utilizing Non-Prescribed Antibiotics among Patients with Bacterial Diseases Visiting Community Pharmacies in Kigali, Rwanda

Author: Ishimwe Thierry Patrick, Emile Sebera, Jean Damascene Dusabimana, Emile Twagirumukiza, Donatien Mbonyintwari, Amanuel Kidane Andegiorgish

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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

Page No: 351-359

Research Publish Journals

Website: www.researchpublish.com

Published Date: 27-June-2026

Abstract: Globally, an unwanted adolescent pregnancy is one of the biggest concerns. Annually, around 12 million adolescents between the ages of 15 and 19 experience pregnancy, with 75% residing in sub-Saharan Africa. In Rwanda, unwanted adolescent pregnancy is recognized as a critical public health setback requiring coordinated efforts across multiple sectors. Despite previous successes in reducing teen pregnancies in Rwanda, progress has recently stalled. No studies have been published to elucidate level of unwanted teenager pregnancy in Gasabo district or Kibagabaga Level II Teaching hospital. It was this reasons that let to study prevalence of unwanted teenager pregnancy in Gasabo district and lastly evaluate knowledge, attitude and practice (KAP) among teenagers attending Kibagabaga Level II Teaching Hospital, Rwanda. The study employed both quantitative and qualitative approaches through interviews and surveys. The design was descriptive, cross-sectional, and retrospective, covering data from the last five years. A sample of 341 teenage girls was selected using purposive and retrospective sampling techniques, and data were analyzed in SPSS version 25 using descriptive and inferential statistics. The results indicated that the period prevalence rate of teenage pregnancy among teenagers was 9.18% (31) with associated significant protective values of RR (0.01, 0.91) and p-value of 0,023. Knowledge of the negative attitudes and practices toward contraception significantly increased vulnerability. 94 (30.3%) of the respondents identified condoms as the method they were most familiar with. However, awareness of long-acting reversible contraceptives (LARCs) such as implants (4.1%) and emergency contraceptive pills (6.3%) was notably low. Attitudinal and practice assessments revealed similarly concerning trends where 58.1% (198) believed a girl should not suggest condom use to her boyfriend, and only 10.6% (36) reported using them consistently, while 60.7% (207) used them occasionally, and 28% (98) never used condoms. The study concluded that comprehensive SRH education, accessible youth-friendly services, and engagement of religious and cultural leaders are critical. Recommendations included establishing a youth-dedicated room (Icyumba cy’urubyiruko) at Kibagabaga Hospital served by trained SRH providers, expanding school and community outreach programs, integrating SRH into all education levels, and strengthening parent-adolescent communication on sexuality.

Keywords:  Prevalence, teenage pregnancy, health information, knowledge, attitude, practice, Kibagabaga, Rwanda.

Title: PREVALENCE OF UNWANTED TEENAGE PREGNANCY AMONG TEENAGERS ATTENDING KIBAGABAGA LEVEL II TEACHING HOSPITAL, RWANDA

Author: Mick Ndayishimiye, Maurice B. Silali

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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

Page No: 336-350

Research Publish Journals

Website: www.researchpublish.com

Published Date: 27-June-2026

Abstract: Exclusive breastfeeding (EBF) during the first six months of life is a proven, cost-effective strategy for improving child survival and health outcomes. Although Rwanda reports high national EBF rates, limited evidence exists on whether mothers receive, understand, and apply EBF-related health information. This study aimed to determine the prevalence of EBF health information uptake and describe information sources, accessibility, and perceived quality among mothers of infants younger than six months attending Kirehe District Hospital. A descriptive cross-sectional study was conducted between November and December 2025. Quantitative data were collected from 315 breastfeeding mothers using structured questionnaires, while qualitative data were obtained through five focus group discussions involving 53 mothers and 15 key informant interviews with healthcare providers. Descriptive statistics were analyzed using SPSS version 26. Findings showed that 90.1% of mothers had taken up EBF health information, while 83.5% reported receiving information from at least one source. Health facilities were the main source (73.0%), followed by media (18.0%), community health workers (5.3%), and family or friends (3.7%). Only 43.5% of mothers received EBF counseling at every antenatal care visit, whereas 40.5% received it occasionally and 16.0% rarely. Despite these gaps, 95.1% considered the information adequate. The study concludes that EBF information uptake in Kirehe District is high, but counseling remains inconsistent and largely dependent on health facilities. Strengthening counseling during antenatal care and expanding communication channels could improve access to breastfeeding information, support feeding decisions, and sustain breastfeeding practices as demand grows.

Keywords: exclusive breastfeeding; health information uptake; antenatal care; sources of information; Rwanda.

Title: Prevalence of Health Information Uptake on Exclusive Breastfeeding among Mothers of Infants below Six Months in Rural Rwanda

Author: Febronie Muhorakeye, Maurice Silali

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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

Page No: 329-335

Research Publish Journals

Website: www.researchpublish.com

Published Date: 26-June-2026

Abstract: Physical activity (PA) is essential for maintaining good health. Globally, there is growing evidence suggesting decline in PA. Physical inactivity is a major risk factor for non-communicable disease. Despite the role of healthcare workers (HCWs) in health promotion, they are on risk of insufficient physical activity due to their occupational demand. Information regarding PA among health care workers in Rwanda is limited creating a gap in knowledge critical for promoting their health and optimizing their ability to deliver healthcare services. Knowing the level of physical activity can help healthcare workers to plan for PA programs. This study was guided by 2 specific objectives including to assess the level of physical activity among healthcare workers and to determine the associated factors to physical activity. A quantitative cross-sectional study design was employed. A total of 254 participants were recruited using a systematic sampling technique. A Standardized international physical activity questionnaire short form (IPAQ-SF) was utilized to collect data, analyzed using SPSS 28.0. Both descriptive analysis including frequency and percentage as well as inferential analysis using chi-square test (p <0.05) was done. Bivariate and multivariate analysis was computed. The data was presented in frequency tables and figures. Among the 254 HCWs participated in this study composed of nurses 153 (60.2%), Allied health professionals 60 (23.6%) and Medical doctors 41(16.1%).  The findings revealed that most of HCWs 164(64.5%) had low level of PA followed by 67 (26, 4%) with moderate level and 23(9.1%) had high PA levels. Therefore only 90(35.5%) had adequate PA. There was significant associations between variables including age (χ²₌11.14, P=0.011, 95%CI: 1.01–1.09), gender (χ²₌6.51, P=0.011, 95% CI: 1.21–3.59), occupational status (χ²₌9.36, P=0.09, 95% CI: 0.92–1.68), and availability of PA policy (χ²₌6.52, P=0.011, 95% CI: 1.29–5.86) however none of the factors was found significant after adjusting with confounding factors. The study concluded that physical inactivity were prominent among healthcare workers at King Faisal Hospital Rwanda based on the WHO guideline and there were no single factors that can predict PA. Intensifying action that promote different types of PA among healthcare workers at King Faisal hospital is recommended.

Keywords: Physical Activity, Levels, Health Care Workers, King Faisal Hospital, Rwanda.

Title: Assessment of Physical Activity Levels and Its Associated Factors among Health Care Workers at King Faisal Hospital, Rwanda

Author: Kambali Alexis, Dr Amanuel Kidane Andegiorgish

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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

Page No: 318-328

Research Publish Journals

Website: www.researchpublish.com

Published Date: 26-June-2026

Abstract: Community-Based Health Insurance (CBHI) has become one of the most important health financing reforms for improving healthcare access in low- and middle-income countries. Rwanda’s Community-Based Health Insurance scheme, locally known as Mutuelles de Santé, has contributed significantly to the achievement of universal health coverage and improved healthcare utilization. However, the empirical data on how CBHI affects maternal health services utilization and maternal and neonatal outcomes is still limited. This study assessed the influence of CBHI on maternal healthcare services utilization and maternal and neonatal outcomes at Kibungo Level Two Teaching Hospital in Rwanda. The study used quantitative method design. A retrospective cohort approach was employed involving 375 well completed maternity records from 2023 to 2025 that were purposively selected. Data were entered into Microsoft excel, coded and cleaned, analyzed using SPSS version 26 through descriptive statistics, chi-square tests, and logistic regression analysis. Findings showed that 91.2% of women were enrolled in CBHI, while 16.3% possessed supplementary insurance schemes such as RAMA, MMI, Sanlam, and Old Mutual. Women enrolled in CBHI demonstrated significantly higher utilization of antenatal care 84.2% compared to 39.4% for uninsured, skilled birth attendance 96.8 vs 72.7%, and postnatal care services 88.6% vs 45.5% of uninsured women. Maternal complications and neonatal admissions were significantly lower among insured women. Logistic regression analysis indicated that insured women were 8.20 times more likely to experience favorable maternal and neonatal outcomes than uninsured women (OR = 8.20, p < 0.001), where insured women 93.3% had no maternal complications compared to 69.7% of uninsured, and neonates with ≥7 Apgar score 95.0% vs 70%. The study concludes that CBHI significantly influence maternal healthcare utilization and improves maternal and neonatal outcomes in Rwanda.

Keywords: Community-Based Health Insurance, maternal healthcare, maternal outcomes, neonatal outcomes, Rwanda.

Title: Community-Based Health Insurance as a Determinant of Maternal Health Outcomes: Evidence from a Retrospective Cohort Study in Rwanda

Author: Pierre NDAYIZEYE, Dr. Eugenia Nkechi Irechukwu

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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

Page No: 300-317

Research Publish Journals

Website: www.researchpublish.com

Published Date: 26 -June-2026

Abstract: Background: Adolescent pregnancy imposes a disproportionate burden on maternal and child health (MCH) outcomes globally, with over 21 million adolescent girls giving birth annually in developing regions. In Rwanda, only 45% of pregnant adolescent girls complete the recommended four antenatal care (ANC) visits, compared to 70% of adult women. Despite national efforts to expand MCH services, the factors limiting accessibility and utilization of MCH nutrition services specifically among pregnant adolescents at facility level in Kigali remain inadequately characterized. This study aimed to determine the prevalence and determinants of MCH nutrition service utilization among pregnant adolescent girls attending Remera Health Centre, Gasabo District, Kigali.

Methods: A cross-sectional mixed-methods study was conducted. The total population of 80 pregnant adolescents aged 10–19 years attending Remera Health Centre during the study period was enrolled via census sampling. Data were collected using structured questionnaires and in-depth interviews with health facility leaders. Descriptive statistics, chi-square/Fisher’s exact tests, and multivariable binary logistic regression identified independent predictors of ANC attendance. Qualitative data were analyzed thematically.

Results: Among 80 pregnant adolescent girls, 82.5% (n=66) reported attending ANC visits at Remera Health Centre; 27.5% always attended and 5.0% rarely attended. Of 21 candidate sociodemographic, geographic, sociocultural, and knowledge/attitude/practice (KAP) variables tested, only two were significantly associated with ANC attendance at the bivariate level: understanding the benefits of ANC check-ups (χ²=6.78, p=0.034) and awareness of community child health services (χ²=8.71, p=0.013). Neither association reflected a simple knowledge gradient; in both cases, attendance was similarly high among adolescents who answered “yes” (85.9% and 87.7%) or “no” (81.8% and 81.2%), but markedly lower among the small subgroup who answered “I don’t know” (40.0% and 42.9%). In a multivariable logistic regression model recoding each variable as certain (yes/no) versus uncertain (“don’t know”), uncertainty about ANC check-up benefits (aOR=0.08, 95% CI 0.01–0.54, p=0.010) and uncertainty about community child health services (aOR=0.09, 95% CI 0.02–0.47, p=0.004) were independently associated with markedly lower odds of ANC attendance (Nagelkerke R²=0.25). Comprehensive prenatal nutrition counselling was received by 63.8% and adequate breastfeeding support by 60.0% of participants. Stigma related to adolescent pregnancy was reported by 70.0% of participants, and qualitative interviews with facility leaders identified stigma, transportation costs, nutritional knowledge gaps, and inadequate adolescent-specific programming as barriers, providing contextual insight that complements the quantitative results.

Conclusion: Among pregnant adolescents attending Remera Health Centre, ANC attendance was high overall and was not significantly explained by the sociodemographic, geographic, or sociocultural factors commonly reported elsewhere in the sub-Saharan African literature, likely reflecting this facility’s urban location and the relative homogeneity of a single-site census sample. The clearest signal to emerge was that adolescents who responded with uncertainty rather than a confident “yes” or “no” to basic MCH knowledge questions had substantially lower odds of ANC attendance, suggesting that indecision or disengagement from health information may be a more useful marker of risk than knowledge level itself. Given the small sample and limited number of non-attendance events, these findings should be treated as exploratory and hypothesis-generating. Qualitative interviews nonetheless point to stigma, transportation costs, and gaps in adolescent-specific counselling as persistent, modifiable barriers worth addressing through targeted, adolescent-friendly service delivery, even where they did not reach statistical significance in this sample.

Keywords: adolescent pregnancy; antenatal care; maternal and child health nutrition; health literacy; knowledge uncertainty; stigma; Rwanda; Kigali; mixed methods.

Title: Factors influencing accessibility and utilization of maternal child health nutrition services among pregnant teenager girls visiting Remera Health Centre, Kicukiro District

Author: Larissa Mukire, Emile Sebera, Donatien Mbonyintwari, Emile Twagirumukiza, Jean Damascene Dusabimana, Maurice Silari

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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

Page No: 286-299

Research Publish Journals

Website: www.researchpublish.com

Published Date: 24-June-2026