A5078504341- Global Maternal and Child Health
- Child Nutrition and Water Access
- Healthcare Systems and Reforms
- HIV/AIDS Research and Interventions
- Tuberculosis Research and Epidemiology
- Global Health and Surgery
- Pneumocystis jirovecii pneumonia detection and treatment
- Health Systems, Economic Evaluations, Quality of Life
- Diagnosis and treatment of tuberculosis
- Adolescent Sexual and Reproductive Health
- Infectious Diseases and Tuberculosis
- Health and Conflict Studies
- Global Public Health Policies and Epidemiology
- HIV Research and Treatment
- Global Cancer Incidence and Screening
- Food Security and Health in Diverse Populations
- HIV/AIDS drug development and treatment
- Poverty, Education, and Child Welfare
- Primary Care and Health Outcomes
- Linguistics, Language Diversity, and Identity
- Economic and Financial Impacts of Cancer
- Pneumonia and Respiratory Infections
- Healthcare Policy and Management
- HIV, Drug Use, Sexual Risk
- Global Health Workforce Issues
University of Oxford
2019
Partners In Health
2009-2018
Harvard Global Health Institute
2012-2018
Brigham and Women's Hospital
2009-2018
Harvard University
2012-2018
University of Global Health Equity
2016-2018
Ministry of Health
2014-2016
Rwanda Biomedical Center
2012-2016
Dana-Farber Brigham Cancer Center
2016
Boston University
2015
Rwanda's approach to delivering healthcare in a setting of post-conflict poverty offers lessons for other poor countries, say Paul Farmer and colleagues In the immediate aftermath 1994 genocide, which claimed up million lives left two homeless, Rwanda was among poorest countries world.1 Health education systems, already weak limited reach before conflict, lay ruins; less than 5% population had access clean water; banking system collapsed; almost no taxes were collected. Epidemics infectious...
Nationally, health in Rwanda has been improving since 2000, with considerable improvement 2005. Despite improvements, rural areas continue to lag behind urban sectors regard key outcomes. Partners In Health (PIH) supporting the Ministry of (MOH) two districts Since 2009, MOH and PIH have spearheaded a systems strengthening (HSS) intervention these as part Population Implementation Training (PHIT) Partnership. The partnership is guided by belief that HSS interventions should be comprehensive,...
Access to antiretroviral therapy (ART) has rapidly expanded; as of the end 2010, an estimated 6.6 million people are receiving ART in low-income and middle-income countries. Few reports have focused on experiences rural health centers or use community workers. We report clinical programatic outcomes at 24 months for a cohort patients enrolled community-based program southeastern Rwanda under collaboration between Partners In Health Rwandan Ministry Health.A retrospective medical record...
Community health workers (CHWs) can play important roles in primary care delivery, particularly settings of workforce shortages. However, little is known about CHWs’ perceptions barriers and motivations, as well those the beneficiaries CHWs. In Rwanda, which faces a significant gap human resources for health, Ministry Health expanded its community programme beginning 2007, eventually placing 4 trained CHWs every village country by 2009. The aim this study was to assess capacity factors...
<h3>Objective</h3> Integrated Management of Childhood Illness (IMCI) is the leading clinical protocol designed to decrease under-five mortality globally. However, impact threatened by gaps in IMCI quality care (QOC). In 2010, Partners Health and Rwanda Ministry implemented a nurse mentorship intervention Mentoring Enhanced Supervision at Centres (MESH) two rural districts. This study measures change QOC following addition MESH didactic training. <h3>Design</h3> Prepost after 12 months...
OBJECTIVES. The goals were to describe the management of multidrug-resistant tuberculosis among children, examine tolerability second-line antituberculosis agents and report outcomes children treated for in poor urban communities Lima, Peru, a city with high prevalence. METHODS. A retrospective analysis data 38 &lt;15 years age tuberculosis, either documented drug sensitivity testing child's isolate or suspected on basis presence clinical symptoms child household contact was performed....
Multidrug-resistant tuberculosis (MDR-TB) disproportionately affects young adults, including women of childbearing age; however, treatment MDR-TB during pregnancy is still controversial. This study looks at the and outcomes in a cohort who were treated for period 10 years.A retrospective case was performed using standardized data collection form from 3 ranked sources patient records. All 38 participants with individualized regimens that included second-line TB medications. We examined...
Cancer services are inaccessible in many low-income countries, and few published examples describe oncology programs within the public sector. In 2011, Rwanda Ministry of Health (RMOH) established Butaro Center Excellence (BCCOE) to expand cancer nationally. hopes informing care delivery similar settings, we program-level experience implementing BCCOE, patient characteristics, challenges encountered.Butaro was founded on diverse partnerships that emphasize capacity building. Services...
Global disparities in the distribution, specialization, diversity, and competency of health workforce are striking. Countries with fewer professionals have poorer outcomes compared countries that more. Despite major gains indicators, Rwanda still suffers from a severe shortage professionals.This article describes partnership launched 2005 by Rwanda's Ministry Health U.S. nongovernmental organization Partners In Harvard Medical School Brigham Women's Hospital. The has expanded to include...
Although Rwanda's health system underwent major reforms and improvements after the 1994 Genocide, population in southeast lagged behind other areas. In 2005, Partners Health Rwandan Ministry of began a strengthening intervention this region. We evaluate potential impacts on maternal child indicators.Combining results from 2005 2010 Demographic Surveys with those supplemental survey, we compared changes output indicators outcomes between as reported by women living area pooled all rural areas...
We determined the prevalence of depression in HIV-infected adults on antiretroviral therapy rural Rwanda and measured association with non-adherence. In all, 292 patients for ≥6 months were included. Adherence was self-reported by four-day recall, two- seven-day treatment interruptions, CASE Index, which is a composite score accounting difficulty taking medications time, average number days per week dose missed, most recent missed dose. A total 84% 87% participants reported good adherence...
Rwanda has dramatically reduced child mortality, but the causes and sociodemographic drivers for mortality are poorly understood.We conducted a matched case-control study of all children who died before 5 years age in eastern between 1st March 2013 28th February 2014 to identify risk factors death. We identified deaths at facility level via community health worker reporting system. used verbal social autopsy interview caregivers deceased controls by area age. InterVA4 determine probable...
Treatment of gestational multidrug-resistant tuberculosis (MDR-TB) is controversial. We describe follow-up 6 children exposed to second-line antituberculous agents in utero. Each child (average age, 3.7 years) underwent comprehensive clinical evaluation. One had MDR-TB diagnosed. There was no evidence significant late-presentation toxicity among the children. The results suggest that aggressive management may benefit both mother and child.
As resource-limited health systems evolve to address complex diseases, attention must be returned basic primary care delivery. Limited data exists detailing the quality of general adult and adolescent delivered at front-line facilities in these regions. Here we describe baseline for adults adolescents rural Rwanda. Patients aged 13 older presenting eight center outpatient departments one district southeastern Rwanda between February March 2011 were included. Routine nurse-delivered was...
OBJECTIVE: We examined factors associated with in-hospital death among children tuberculosis (TB). hypothesized that a negative response to tuberculin skin testing (TST) would predict decreased survival. METHODS: This retrospective cohort comprised 2392 ages 0 14 years hospitalized TB at Peruvian referral hospital over the 25-year study period. Detailed chart abstraction captured clinical history including contacts, physical examination findings, diagnostic data, treatment regimen, and...
Background Rwanda's National PMTCT program aims to achieve elimination of new HIV infections in children by 2015. In November 2010, Rwanda adopted the WHO 2010 ARV guidelines for recommending Option B (HAART) all HIV-positive pregnant women extended throughout breastfeeding and discontinued (short course-HAART) only those not eligible life treatment. The current study assess cost-effectiveness this policy choice. Methods Based on a cohort HIV-infected Rwanda, we modelled six regimens: dual...
Abstract Objective Determining interventions to address food insecurity and poverty, as well setting targets be achieved in a specific time period have been persistent challenge for development practitioners decision makers. The present study aimed assess the changes access consumption at household level after one-year implementation of an integrated security intervention three rural districts Rwanda. Design A before-and-after comparing Household Food Insecurity Access Scale (HFIAS) scores...