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    Trauma care and referral patterns in Rwanda: Implications for trauma system development
    (Canadian journal of surgery, 2015-11-09) Ntakiyiruta, Georges., etal
    Background: Trauma remains a leading cause of death worldwide. The development of trauma systems in low-resource settings may be of benefit. The objective of this study was to describe operative procedures performed for trauma at a tertiary care facility in Kigali, Rwanda, and to evaluate geographical variations and referral patterns of trauma care. Methods: We retrospectively reviewed all prospectively collected operative cases performed at the largest referral hospital in Rwanda, the Centre Hospitalier Universitaire de Kigali (CHUK), between June 1 and Dec. 1, 2011, for injury-related diagnoses. We used the Pearson χ² and Fisher exact tests to compare cases arising from within Kigali to those transferred from other provinces. Geospatial analyses were also performed to further elucidate transfer patterns. Results: Over the 6-month study period, 2758 surgical interventions were performed at the CHUK. Of these, 653 (23.7%) were for trauma. Most patients resided outside of Kigali city, with 337 (58.0%) patients transferred from other provinces and 244 (42.0%) from within Kigali. Most trauma procedures were orthopedic (489 [84.2%]), although general surgery procedures represented a higher proportion of trauma surgeries in patients from other provinces than in patients from within Kigali (28 of 337 [8.3%] v. 10 of 244 [4.1%]). Conclusion: To our knowledge, this is the first study to highlight geographical variations in access to trauma care in a low-income country and the first description of trauma procedures at a referral centre in Rwanda. Future efforts should focus on maturing prehospital and interfacility transport systems, strengthening district hospitals and further supporting referral institutions.
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    An approach for setting evidence-based and stakeholder-informed research priorities in low- and middle-income countries
    (Bull World Health Organ, 2016) Rehfuess, Eva A.; Solange, Durão; Kyamanywa, Patrick; Meerpohl, Joerg J.; Taryn, Young; Anke, Rohwer
    To derive evidence-based and stakeholder-informed research priorities for implementation in African settings, the international research consortium Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) developed and applied a pragmatic approach. First, an online survey and face-to-face consultation between CEBHA+ partners and policy-makers generated priority research areas. Second, evidence maps for these priority research areas identified gaps and related priority research questions. Finally, study protocols were developed for inclusion within a grant proposal. Policy and practice representatives were involved throughout the process. Tuberculosis, diabetes, hypertension and road traffic injuries were selected as priority research areas. Evidence maps covered screening and models of care for diabetes and hypertension, population-level prevention of diabetes and hypertension and their risk factors, and prevention and management of road traffic injuries. Analysis of these maps yielded three priority research questions on hypertension and diabetes and one on road traffic injuries. The four resulting study protocols employ a broad range of primary and secondary research methods; a fifth promotes an integrated methodological approach across all research activities. The CEBHA+ approach, in particular evidence mapping, helped to formulate research questions and study protocols that would be owned by African partners, fill gaps in the evidence base, address policy and practice needs and be feasible given the existing research infrastructure and expertise. The consortium believes that the continuous involvement of decision-makers throughout the research process is an important means of ensuring that studies are relevant to the African context and that findings are rapidly implemented.
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    Legal Requirements and Mob Justice in Kabale Municipality, Western Uganda
    (Asian Journal of Business and Management, 2016-02) Byabashaija, Deusdedit1; Mbyemeire, Patrick; Manyange, Nyasimi Michael; Nakimuli, Amina; Nyambane, Ongabi David; Nyabuga, Douglas Omwenga; Manyange, Ochako Emanuel; Niwagaba, Patience Eliza
    This article investigated the relationship between legal requirements and Mob justice in Kabale Municipality. Using descriptive research design, a structured questionnaire and an interview guidewere used to garner data which was used to answer the research question on how legal requirements influences the practice of mob justice in Kabale Municipality in Western Uganda. Data was analyzed using descriptive statistics such as frequencies, percentages, tables and Bar graphs. Data for the correlation between the research variables was analyzed using Pearson product moment correlation coefficient index.Legal requirements in the due process of the law had a positive linear relationship with the practice of mob justice inKabaleMunicipality. The researcher recommends that there is need to re-enforce both intrinsically and extrinsically the investigative body of the police so that prosecution may produce sufficient evidence to bring to book the criminals thus reducing crime incidence in the area. This action may restore confidence in the judiciary and thus reduce cases related to the occurrences of mob justice. Government should revitalize and augment the salaries of the officers of the courts of judicature so that corruption may be on the wane and we have a free and fair judgement of all mankind. There is need to continue respecting the Constitution of the republic of Uganda (1995) which states that all persons have a right to life, to be heard and to be protected from inhuman treatment irrespective of race, tribe, or religious beliefs.
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    “Togetherness in Difference”: Perceived Personal Discrimination and Acculturation Preferences among Internal Migrants in a Poor Urban Community in Accra
    (Journal of Asian and African Studies, 2018) Tutu, Raymond Asare; Boateng, John; Ameyaw, Edmund Essah; Busingye, Janice Desire
    This paper assesses the relative effects of acculturation preferences (assimilation, separation, integration, and marginalization) on migrants’ perception of acceptability in James Town, a traditional urban neighborhood in Accra, Ghana. There is a paucity of academic work on the relationship between migrants’ acculturation inclinations and their assessment of the hosts’ attitude towards them in Ghana. Cognizant of the fluidity of acculturation strategies, the study focuses on individual inclinations towards acculturation. To examine migrants’ perception of acceptability by the host, we use perceived personal discrimination. We utilize results from a semistructured questionnaire administered to 301 migrant individuals from different migrant households in James Town. Our findings suggest that migrants with assimilation preferences are less likely to have a higher rating on the extent to which they are discriminated against by the host population. Such an exploratory study is pertinent to understanding relationships (conflicts or “togetherness in difference”) in poor multi-ethnic settings.
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    Acceptance of Electronic Health Record for Improving Quality of Health Service Delivery: Case Study of Aminu Kano Teaching Hospital, Nigeria.
    (Kampala International University, 2017) Shehu, Ibrahim; Kinene Nsereko, Amaal; Shamsudeen A., Sanni
    This study investigated acceptance of EHRs for Improving Quality of Health Service Delivery at Aminu Kano Teaching Hospital, which is the largest teaching hospital in Northern Nigeria. Findings indicated that study participants accept and use EHRs in order to enhance their job performance and believed that the system is very useful in their work. EHRs improves Service Quality and most of the antecedents of technology adoption (Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions) are significantly correlated (p<.01, p<.05) with Quality of EHRs, but fall short with Employee Satisfaction.Acceptance of EHRs has brought tremendous changes to the healthcare service and there is need to upgrade the functionality of the EHRs for sustainability.