BackgroundPreoperative anxiety is a common occurrence in patients awaiting surgery. Preoperative anxiety adversely affects anaesthesia and surgical process and increases the risk of postoperative complications. Level of anxiety in patients awaiting surgical procedures in Rwanda is not well known or documented. Objective To assess preoperative anxiety and associated factors of patients awaiting surgery at a teaching hospital in Kigali. Methods A cross-sectional study design was adopted. A convenience sampling method was used to recruit 151 adult patients, and the instrument entitled "Pre-operative Intrusive Thoughts Inventory (PITI)" anxiety scale was used to assess anxiety. Descriptive and inferential statistics were used to analyse data. ResultsNearly three quarters (72.8%) of participants had a high level of clinically significant preoperative anxiety. Patients awaiting orthopaedic surgery were 10 times more likely to have clinically significant pre-operative anxiety (OR 10.22; 95%; CI 1.144 -91.304; P= 0.037), whereas participants with impending Cesarean (OR: 0.03; 95% CI-0.002-0.568; P=0.018), and older participants had decreased pre-operative anxiety levels (OR: 0.22; 95% CI 0.075 -0.650; P=0.006). ConclusionPatients awaiting surgery had clinically significant pre-operative anxiety level (72.8%) associated with age, medical diagnosis and type of surgical intervention. A preoperative intervention incorporating individual characteristics is needed to reduce preoperative anxiety.

BackgroundChronic Kidney Disease (CKD) is a global public health burden. Most people miss the early subtle signs that can develop at any age. CKD has severe complications, including End-stage Renal Disease. ObjectiveTo assess the knowledge level of CKD risk factors and preventive practices among university students in Rwanda. Methods A cross-sectional study design was used from April to May 2017. A stratified random sampling technique was used to recruit 260 university students. A 36-item questionnaire was selfadministered. Data were analyzed using descriptive and inferential statistics. ResultsThe mean age was 29 years and over half were female (53.4%). A great number (44%) had a low knowledge level of CKD and its risk factors, a third (34%) had moderate, and only (22%) had a high knowledge level of CKD risk factors. The majority (50.4%) had low level of preventive practices, nearly half (45%) had moderate and only (4.6%) had high level of preventive practice. Conclusion CKD knowledge and preventive practices in this study population were low. Knowledge gained and desire for healthy preventive practices may have been a benefit of the study. CKD educational programs should be further developed to prevent this significant problem affecting the Rwandese community.Rwanda J Med Health Sci 2019;2(2): 185-193.

BackgroundCervical cancer is a global public health threat for women. Rwanda Ministry of Health recommends screening as preventive strategy. However, the screening remains low in Rwanda.ObjectiveTo determine the uptake level of cervical cancer screening and associated factors among Rwandan women.MethodsA quantitative analytical cross-sectional study design was used. We recruited 178 participants using convenience sampling from an estimated 320 women who attended outpatient department in the previous month. The sample size was calculated using the Yamane’s formula. We used chi-square test, t-test and multiple logistic regression analysis to analyse data.ResultsA total of 178 (100%) participants completed the survey. Forty-one (23%) participants had undertaken cervical cancer screening. Knowledge (OR: 1.26,95% CI:1.069-1.485, p=.006) and income were predictors of cervical cancer screening uptake. Participants earning RWF ≥ 63,751 were more likely to uptake cervical cancer screening (OR:11.141, 95% CI:3.136-39.571, p< .001) compared to those earning less than RWF 25,500 monthly.ConclusionCervical cancer screening uptake among study population was low. Participants with more knowledge and high-income were more likely to uptake cervical cancer screening. Improving women’s knowledge and socioeconomic situation would improve the uptake of cervical cancer screening.Rwanda J Med Health Sci 2021;4(3):387-397

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The traditional teaching approach has been criticised for not equipping health professionals with the necessary knowledge and skills to work in rural, remote and under-resourced communities. [1,2] The conventional approach focuses on hospital-based, curative-focused teaching, which relies on sophisticated technology. Furthermore, upon graduation, many nurses are reluctant to work in rural, underprivileged areas, where resources are scant and the focus is on healthcare and prevention. [2] This instructional approach hinders the equal distribution of health professionals in South Africa (SA) and therefore the quality of services provided to its citizens. This, in turn, impedes the promotion of primary healthcare (PHC). The World Health Organization (WHO) defines PHC as 'essential healthcare based on practical scientifically sound and socially sound acceptable method and technology, universally accessible to all in the community through their full participation; at an affordable cost, and geared toward self-reliance and self-determination'. [3] PHC is therefore an approach to healthcare that promotes the attainment by all people of a level of health that will permit them to live socially and economically productive lives. Healthcare is essential, practical, socially and scientifically sound (evidence based), ethical, accessible, equitable, affordable, and accountable to the community. Furthermore, PHC is more than primary medical or curative care or a package of low-cost medical interventions for the poor and marginalised. To address these challenges, the WHO, International Council of Nurses (ICN) and South African Nursing Council (SANC) recommended the implementation of a community-based education (CBE) programme as part of the teaching curriculum in the training of nurses. [2,4-6] CBE refers to learning activities that take place in a particular setting, i.e. the community setting. [7] Students are allocated to different communities (urban, peri-urban and rural or semi-rural) to undertake activities relevant to community health needs and that address community health-related needs. CBE may contribute to solve the inequity in service delivery by producing healthcare professionals who are willing and able to work in underserved areas, particularly rural communities. [8,9] CBE also offers opportunities for students to learn in situations similar to those in which they might work later in their professional lives. It may equip students with transferable core competencies that they would not learn otherwise, such as leadership skills, the ability to work in teams, and the capability to interact with the community. The South African Department of Education (DoE) and the Council on Higher Education (CHE) endorse the implementation of CBE as a responsive educational method. [10] Furthermore, the Department of Health (DoH) (SA), in the 1997 White Paper on the Transformation of the Health System, highlighted that in order to align nursing education with PHC the curriculum should be based on community needs and linked to PHC...