Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.

Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension.

Although quality postnatal care (PNC) is a known significant intervention for curbing maternal and newborn morbidity and mortality, it is underutilized in most developing countries including Rwanda. Thus, it is crucial to identify factors that facilitate or occlude receipt of adequate PNC. This study aimed at assessing the prevalence of adequate PNC content and the associated factors in Rwanda.We used weighted data from the Rwanda Demographic and Health Survey (RDHS) of 2020, comprising of 4456 women aged 15-49 years, who were selected using multistage sampling. Adequate PNC was considered if a woman had received all of the five components; having the cord examined, temperature of the baby measured, counselling on newborn danger signs, counselling on breastfeeding and having an observed breastfeeding session. We, then, conducted multivariable logistic regression to explore the associated factors, using SPSS version 25.Out of the 4456 women, 1974 (44.3, 95% confidence interval (CI): 43.0-45.9) had received all the PNC components. Having no radio exposure (adjusted odds ratio (AOR) =1.41, 95% CI: 1.18-1.68), visited by a fieldworker (AOR = 1.35, 95% CI: 1.16-1.57), no big problem with distance to a health facility (AOR = 1.50, 95% CI:1.24-1.81), and residing in the Southern region (AOR = 1.75, 95% CI: 1.42-2.15) were associated with higher odds of adequate PNC compared to their respective counterparts. However, having no exposure to newspapers/magazines (AOR = 0.74, 95% CI: 0.61-0.89), parity of less than 2 (AOR = 0.67, 95% CI: 0.51-0.86), being a working mother (AOR = 0.73, 95% CI: 0.62-0.85), no big problem with permission to seek healthcare (AOR = 0.54, 95% CI: 0.36-0.82), antenatal care (ANC) frequency of less than 4 times (AOR = 0.79, 95% CI: 0.62-0.85), inadequate ANC quality (AOR = 0.56, 95% CI: 0.46-0.68), and getting ANC in a public facility (AOR = 0.57, 95% CI: 0.38-0.85) were associated with lower odds of adequate PNC.Less than half of the mothers in Rwanda had received adequate PNC, and this was associated with various factors. The results, thus, suggested context-specific evidence for consideration when rethinking policies to improve adequate PNC, including a need for intensified PNC education and counselling during ANC visits, continued medical education and training of PNC providers, and strengthening of maternal leave policies for working mothers. 

/pdf/prevalence-of-adequate-postnatal-care-and-associated-factors-95ewv2bz.pdf

Prevalence of adequate postnatal care and associated factors in Rwanda: evidence from the Rwanda demographic health survey 2020

Background
Infections contribute to 30% of the 2.5 million neonatal deaths that occur globally every year. A newly cut umbilical cord can be a pathway for bacteria to enter the vulnerable neonate and cause neonatal sepsis. Most infections are preventable with evidenced-based cord care.
Objective
To assess postnatal mothers’ knowledge and practice of umbilical cord care in the Kibungo Hospital catchment area in Rwanda.
 Methodology
A descriptive cross-sectional study design and purposive sampling strategy was used to recruit 224 postnatal mothers. Data were collected using a structured questionnaire. Descriptive and inferential statistics were used to analyze data.
 
Results
A third of mothers (33%) had adequate knowledge, and a half (54%) had good umbilical cord care practice. The majority (70%) reported dry cord care practice, though many applied substances including Vaseline (23%) and Movit ointment (15%). There was a negative correlation between knowledge of cord care and substance applied to cord (R2=0.224, p=0.001), and days applied (R2=0.167, p=0.012).
 Conclusion
The study population had low cord care knowledge. Health care providers need to educate mothers on the practice of allowing the cord to dry naturally, and discourage the use of harmful substances that delay cord separation and increase risk of sepsis and subsequent neonatal mortality.
Rwanda J Med Health Sci 2020;3(2):167-180

/pdf/umbilical-cord-care-among-postnatal-mothers-in-kibungo-2nueo2xquv.pdf

Umbilical Cord Care Among Postnatal Mothers in Kibungo Hospital Catchment Area, Rwanda

Background Ghana had significant reductions in neonatal mortality during the Millennium Development Goal (MDG) era. Few studies have attempted to identify the interventions, programs and policies that contributed to this progress. To understand the underlying factors which contributed to the reduction in neonatal mortality and to inform strategies to reach the Sustainable Development Goal (SDG) target to end preventable neonatal deaths, we conducted a mixed-methods study in the Northern, Upper West, and Volta Regions of Ghana. Methods The quantitative component consisted of an analysis of trends in coverage of key neonatal health interventions using subnational data from the Ghana Demographic and Health Surveys (DHS) and the Multiple Indicator Cluster Surveys (MICS). The Lives Saved Tool (LiST) was used to assess the contribution of various neonatal health interventions which resulted in reductions in neonatal mortality. Qualitative in-depth interviews (N=38) were conducted with government health officials, health workers, staff from non-government organizations, and community leaders, including traditional birth attendants and local chiefs from the Northern Region of Ghana. Findings Multiple interventions and contextual factors contributed to declines in the neonatal mortality rate (NMR) in all three regions. The Volta and Upper West Regions improved labor and delivery management practices which accounted for approximately one-third of the decline in NMR. The Northern Region had a substantial decline in NMR; the greatest proportion of the decline was attributed to control and management of infections in newborns (sepsis and pneumonia). Qualitative interviews suggest that improvements in neonatal survival were achieved through the prioritization of neonatal health at community-based health planning (CHPS) compounds and the development of a national-level strategic plan, coupled with neonatal health-related training for health workers. The establishment of neonatal intensive care units and strong partnership with local leaders and women’s groups to increase facility births and promote clean birth practices were also considered important. Conclusions The strategies that supported the reductions span from national-level policy intervention to facility-based quality improvement, to community level engagement. These strategies can be continued, strengthened, and scaled to improve neonatal survival in the SDG era. 

Factors contributing to neonatal mortality reduction in three regions in Ghana: a mixed-methods study using the Lives Saved (LiST) modelling tool

Background
Neonatal mortality is a worldwide concern, especially in sub-Sahara Africa. Millions of newborn deaths could be prevented with quality care at birth.
Objective
To identify immediate newborn care provided by birth attendants and associated outcomes in the delivery room of a district hospital in Kabgayi, Rwanda.
Methods
This study used a descriptive cross-sectional design and convenience sampling strategy. The sample of 171 newborns and birth attendants were observed in the delivery room using a standardized checklist during April and May 2019. Descriptive statistics were used to analyze data.
Results
The majority (65.5%) of newborns were female, and at term (93.6%). The majority had mouth and nose cleared (60%), dried thoroughly (75.4%), wet cloth removed (57.3%), delayed umbilical cord clamping (67.3%), and immediate skin-to-skin contact (67.3%). Limited interventions included APGAR evaluation (28%) and breastfeeding within the first hour (36.6%). The majority of 135(78.9%) were stable, and none died.
Conclusion
The majority of the study population was stable, though all newborns did not benefit from standard immediate newborn care. To reduce neonatal mortality and morbidity in Rwanda, we need to redouble efforts to strengthen the quality of immediate newborn care. Future research is needed to identify effective training to improve newborn outcomes at birth.
Rwanda J Med Health Sci 2020;3(2):238-249

/pdf/immediate-newborn-care-and-associated-outcomes-in-the-4ubxhg08xe.pdf

Immediate Newborn Care and Associated Outcomes in the Delivery Room: An Observational Study in Rwanda

Background and Objective: The Newborn Survival Case study in Rwanda provides an analysis of the newborn health and survival situation in the country It reviews evidence-based interventions and coverage levels already implemented in the country; identifies key issues and bottlenecks in service delivery and uptake of services by community/beneficiaries, and provides key recommendations aimed at faster reduction in newborn mortality rateMethods: This study utilized mixed method research including qualitative and quantitative analyses of various maternal and newborn health programs implemented in the country This included interviewing key stakeholders at each level, field visits and also interviewing beneficiaries for assessment of uptake of services Monitoring systems such as Health Management Information Systems (HMIS), maternal and newborn death audits were reviewed and data analyzed to aid these analysesResults: Policies, protocols, various guidelines and tools for monitoring are already in place however, implementation of these remains a challenge eg infection control practices to reduce deaths due to sepsis Although existing staff are quite knowledgeable and are highly motivated, however, shortage of health personnel especially doctors in an issue New facilities are being operationalized eg at Gisenyi, however, the existing facilities needs expansionConclusion and Global Health Implications: It is essential to implement high impact evidence based interventions but coverage levels need to be significantly high in order to achieve higher reduction in newborn mortality rate Equity approach should be considered in planning so that the services are better implemented and the poor and needy can get the benefits of public health programsKey words: Bottleneck Analysis • Lives Saved Tool • Rwanda • Maternal and Newborn Health • Neonatal MortalityCopyright © 2017 Khurmi et al Published by Global Health and Education Projects, Inc This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 40

https://www.mchandaids.org/index.php/IJMA/article/download/214/pdf

Newborn Survival Case Study in Rwanda - Bottleneck Analysis and Projections in Key Maternal and Child Mortality Rates Using Lives Saved Tool (LiST).

Background Considered a "best buy" intervention to cope with the obesity burden, a tax on sugar-sweetened beverage (SSB) has been adopted in more than 40 countries. In Vietnam, a tax on SSBs has been proposed several times (most recently in 2017). This study aimed to estimate the health impacts of different SSB tax plans currently under discussion to provide an evidence base to inform decision-making about a SSB tax policy in Vietnam. Method Five tax scenarios were modelled, representing three levels of price increase: 5%, 11% and 19-20%. Scenarios of the highest price increase were assessed across three different tax designs: ad valorem, volume-based specific tax & sugar based specific tax. In each case we modelled SSB consumption in each tax scenario; how this reduction in consumption translates to a reduction in total energy intake and how this relationship in turn translates to an average change in body weight and obesity status among adults by applying the calorie-to weight conversion factor. Changes in diabetes type 2 diabetes burden were then calculated based on the change in average body mass index of the modelled cohort. A Monte Carlo simulation approach was applied on the conversion factor of weight change and diabetes risk reduction for the sensitivity analysis. Results While the impact of a 5% price increase arising from a tax was relatively small, increasing SSBs price up to 20% appeared likely to impact substantially on national overweight and obesity rates. The greatest reduction in rates was observed for the population who were categorised as being overweight and obesity grade 1. The decline in overweight and obesity prevalence rates was slightly higher for women than men. Differences were evident across the three tax designs considered with a specific tax based on sugar density achieving greatest effects .

/pdf/estimating-the-health-impacts-of-sugar-sweetened-beverage-2vt4x6d1.pdf

Estimating the health impacts of sugar-sweetened beverage tax for informing policy decisions about the obesity burden in Vietnam

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Maharajan Muthu

Author Tools

Chat about Author

Papers

Newborn Survival Case Study in Rwanda - Bottleneck Analysis and Projections in Key Maternal and Child Mortality Rates Using Lives Saved Tool (LiST).

Estimating the health impacts of sugar-sweetened beverage tax for informing policy decisions about the obesity burden in Vietnam