Background: The burden of diarrheal diseases among children is by far more in low and middle-income countries where it is the second leading cause of deaths in children under 5 years. In Rwanda, it is a third leading cause of childhood morbidity and mortality where it counts 15% of deaths.

Background: The cost of hypertension healthcare services is increasing worldwide due to increase of its prevalence estimated to 40% in adults globally and high prevalence 46% is in Sub-Saharan African. The purpose of this study is to provide information of the cost of hypertension health care services in monetary values on one hand and to determine the cost of health care services of each stage of hypertension at district hospital in rural Rwanda. The study benefits the care givers of hypertension care to understand the socioeconomic status of the patients and plan their management. Methods: Retrospective study of 68 patients followed-up in the NCD clinic from January to December, 2013. The data have been collected using patients' files included demographic information, numbers of visits, diagnostic tests and medications. The Ministry of Health tariff, the information from the charts and Excel cost analysis was done to discover the average cost per patient and requirement of good care at each stage of hypertension. Results: Of the 68 patients analyzed, 74% were female and 26% were male. Their socioeconomic status was generally very low; most of the patients had zero formal education 37% and 34% patients had only a primary education level; 53% patients were famers owned small pieces of lands which are not considerably productive and 18% patients were unemployed. The cost of providing hypertension healthcare services estimated in monetary values was 53,656,736 Rwf excluding the maintenance cost in financial year 2013. The driving cost of hypertension care delivery was the expenditure on medicines, which were estimated at 9,343,956 Rwf per year. The capital cost was 52% and the recurrent cost was 65% of the total cost of hypertension care. The average costs of hypertension care per patient for each stage per year were 25,431 Rwf for stage one, 45,812 Rwf for stage two and 82,778 Rwf for stage three. Conclusion and implications for translation: The overall control of hypertension with insurance coverage is good at Rwinkwavu District Hospital. Hypertension health care services can be effectively implemented in every district hospital in Rwanda through the NCD program. The cost of providing hypertension health care services information are critically missing in the region, more studies are needed on cost of NCDs health care services and their countries' economy impact as the prevalence increasing rapidly.

This study investigated the healthcare provider’s knowledge and attitudes towards induced abortion in Rwanda. A total of 152 healthcare providers from six public hospitals in Kigali city participated in this study. Questionnaires were used to record data on demographics, level of knowledge and attitudes towards abortion law then be cleaned, coded and entered into Excel sheet. Then all data were exported into SPSS version 22 for final cleaning and analysis. The study findings revealed that 54.6% were female, 56.0% were single, and 73% participants said that they attended formal training on abortion care. The study findings revealed that 23.70% healthcare providers had poor knowledge towards legal abortion law, and 57.20% had positive attitude with regards to induced abortion law. The findings revealed that religion and formal training on abortion care were among the factors which were strongly influencing attitudes of health care providers towards induced abortion where protestants were unlikely to have positive attitude with regards to induced abortion (AOR=0.277; 95% CI=0.027-0.377; P=<0.001) compared to participants belonged to catholic religion and participants who were not trained were unlikely to have positive attitude with regards to induced abortion (AOR=0.696; 95% CI=0.056-0.721; P=0.048) compared to trained respondents. It concludes that marital status, category of caregiver, religion, formal training on abortion and level of knowledge were the main risk factors of level of attitude towards induced abortion. More training about induced abortion are highly needed among health care providers to increase related knowledge as well as to eliminate negative attitude towards induced abortion.

Background or Objectives: Quality and safety of health care service delivery remain a challenge worldwide due to unsafe care, inappropriate practices, adverse events and medication errors that result in harm, disability and death of patients. This study examines the status of quality and safety management of health care service delivery in public hospitals in Rwanda. Methods: The study was a descriptive cross-sectional study. Overall population of interest comprised of 564 hospital managers from 47 hospitals. An online email-based questionnaire was used for data collection. Statistical analysis included bivariate, multivariable, and logistic regression analyses with significance at p<0.05. Data were analyzed using Statistical Package for social Sciences (SPSS) Software v.21. Results: The study sample population was 235 managers (5 persons from each hospital). Of the 235 responses received, 72.3% were from male managers and 27.7% were from female managers. The prevalence of adverse events among public hospitals in Rwanda is 0.007% (p=0.02, 95% CI: 0.017-0.023) with risk of incidents of 0.073%. In all, 98.7% of public hospitals reported incidents, and only 39.3% of them have regularly reported all types of incidents. The most common incidents were adverse drug event (25.3%), loss to follow-up/referrals (25%), and surgical site infection (20%). Rwanda has 0.043 (IQR: 0.032-0.060) doctors per 1,000 population. The country also has 0.25 (IQR: 0.18-0.33) nurses per 1,000 population. The 76.5% of respondents reported that variation of consultation time is between 10-15 minutes (p=0.003, 95% CI: 0.002-0.004) which is associated with 0.12% risk of incidents. The public hospitals have on average 44.25 ± 13.46 SD consultations per clinician per day. More than a half of respondents 54.3% (p=0.033, 95%CI: 0.029- 0.036) reported that 10-20% of treatment given to patients were not needed and are significantly associated with high risk of incidents. The public hospitals score Level 1(documentation) (p=0.016, 95%CI: 0.014-0.019) for quality health care services delivery and, over half score Level 2(implementation). They also score Level 1(documentation) (p: 0.209, 95%CI: 0.201-0.216) for safe health care, and approximately half of them score Level 2(implementation). Conclusion and Implications for Translation: The quality and safety of health care services should be a priority for health care professionals and healthcare systems. The culture of blame and punishment is a challenge across hospitals. Reassuring adverse events reporting and learning from errors need to be emphasized and prioritized in public hospitals. Key words: • Quality and Safety Management • Health Care Service Delivery • Rwanda • Quality and Safety Score levels   Copyright © 2019 Ndagijimana et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.