Background
In 2018, Rwanda launched a 5-year hepatitis C virus (HCV) elimination plan as per the World Health Organization global targets to eliminate HCV by 2030. To improve awareness of HCV status, strategies are needed to ensure easy access to HCV testing by as-yet unreached populations. HCV-self-testing, an innovative strategy, could further increase HCV testing uptake. This assessment explores perceptions around HCV self-testing among members of the public and healthcare workers in Rwanda.
Methods
A qualitative study was undertaken in Masaka District Hospital, comprising individual interviews, group interviews and participatory action research (PAR) activities. Purposive and snowball sampling methods guided the selection of informants. Informed consent was obtained from all participants. A thematic analysis approach was used to analyse the findings.
Results
The participants comprised 36 members of the public and 36 healthcare workers. Informants appreciated HCV self-testing as an innovative means of increasing access to HCV testing, as well as an opportunity to test privately and subsequently autonomously decide whether to seek further HCV care. Informants further highlighted the need to make HCV self-testing services free of charge at the nearest health facility. Disadvantages identified included the lack of pre/post-test counselling, as well as the potential psychosocial harm which may result from the use of HCV self-testing.
Conclusion
HCV self-testing is perceived to be an acceptable method to increase HCV testing in Rwanda. Further research is needed to assess the impact of HCV self-testing on HCV cascade of care outcomes.
BackgroundPoor countries carry 90% of the global burden of disease, with access to only 10% of globally available health research funding and technical capacity. Fragile south–south collaborations hinder effective use of limited resources, career opportunities and funding to retain the insufficiently available quality scientists. The Rwanda Health System established a clinical research network involving academia, non-governmental organisations and private sector to accelerate generation of talented scientists, create enabling environment and incentives to retain scientists by establishing a local funding model.MethodsBased on a baseline assessment, potential clinical trial units were mapped and developed through adoption of a Clinical trial management training model from European Universities. The Rwandan law on Public Private Partnership was leveraged to attract and engage local and international private players in a win-win approach. So far, countries such as Kenya and Sweden were engaged in the roadmap.ResultsFrom 2014 to date, a total of 285 scientists are trained on various clinical research components: Good Clinical Practice (28%), Research Grant writing (14%), systematic review and meta-analysis (9%) and scientific communication (8.7%). Ten Clinical Research Units and one centre for evidence-based healthcare were established. So far 13 health investigator-initiated projects in malaria, metabolic disorders and maternal health were funded through the local funding model. A process to empower six malaria sentinel sites into fully functioning clinical research sites is underway.ConclusionThe creation of strong networks of excellence forclinical research among southern academic, research institutions and pharmaceutical and non-pharmaceutical industry is a promising strategic approach to promote sustainable clinical research capacity. The government vision is that beyond national boundaries, resource sharing and involvement of private players are key factors to mitigate the high burden of disease, nationally and regionally.
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