المؤلفون: Claire Bahati, Amina Nyiranteziryayo, Josias Izabayo, Pauline Atete, Vincent Sezibera, Leon Mutesa

المصدر: BMC Pediatrics, Vol 24, Iss 1, Pp 1-9 (2024)

مصطلحات موضوعية: Intimate partner violence, Mental health outcomes, Offspring, Rwanda, Pediatrics, RJ1-570

الوصف: Abstract Background Children who witness parental intimate partner violence (IPV) are more likely to develop mental health issues compared to those who do not witness such violence. Objective The main objective of this study is to assess the association between parental intimate partner violence and child mental health outcomes. Methodology This cross-sectional study involved 548 participants divided into two groups: parents (N = 304) and offspring (N = 244). The participants were recruited from Mageragere Sector in the City of Kigali (urban), as well as Mbazi and Ruhashya sectors in Huye District (rural). To assess the difference about mental difficulties reported by the offspring, a Mann-Whitney U test was employed to compare the responses of parents and their children on mental health outcomes. Additionally, multiple linear regression analysis was conducted to explore the association between parental intimate partner violence (IPV) and the mental health outcomes of their offspring. Results The results highlighted significant levels of mental and emotional challenges in children, as reported by both parents and the children themselves. Depression and youth conduct problems were more prevalent among the children compared to their parents, whereas anxiety and irritability were more commonly reported by parents than by their children. Intimate partner violence showed to be a predictor of irritability and anxiety symptoms in offspring. In terms of irritability, depression, and youth conduct problems they were identified as predictors of anxiety symptoms. Particularly, anxiety and irritability were revealed to predict youth conduct problems. Conclusion The study indicates that parental intimate partner violence (IPV) has an impact on the mental well-being of their offspring. Furthermore, it was observed that there is not only a correlation between IPV and poor mental health outcomes, but also a connection between different mental conditions, implying that children exposed to IPV are more prone to experiencing a range of mental issues. As a result, intervention programs should place emphasis on addressing the mental disorders of both parents and children.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2431Test

الوصول الحر: https://doaj.org/article/b2929bb3bc404f1d9313fca7308130e8Test

المؤلفون: Yvonne Kayiteshonga, Vincent Sezibera, Lambert Mugabo, Jean Damascène Iyamuremye

المصدر: BMC Public Health, Vol 22, Iss 1, Pp 1-13 (2022)

مصطلحات موضوعية: Rwanda, Mental health, Genocide survivors, Healthcare knowledge, Mental health service utilization, Mental illness, Public aspects of medicine, RA1-1270

الوصف: Abstract Background In order to respond to the dearth of mental health data in Rwanda where large-scale prevalence studies were not existing, Rwanda Mental Health Survey was conducted to measure the prevalence of mental disorders, associated co-morbidities and knowledge and utilization of mental health services nationwide within Rwanda. Methods This cross-sectional study was conducted between July and August 2018, among the general population, including survivors of the 1994 Genocide against the Tutsi. Participants (14–65 years) completed the Mini-International Neuropsychiatric Interview (Version 7.0.2), sociodemographic and epilepsy-related questionnaires. General population participants were selected first by random sampling of 240 clusters, followed by systematic sampling of 30 households per cluster. Genocide survivors within each cluster were identified using the 2007–2008 Genocide Survivors Census. Results Of 19,110 general survey participants, most were female (n = 11,233; 58.8%). Mental disorders were more prevalent among women (23.2%) than men (16.6%) (p

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2458Test

الوصول الحر: https://doaj.org/article/fae25c0bbda74bee93737a3808f29f0dTest

المؤلفون: Chris Desmond, Kathryn G Watt, Sarah K G Jensen, Erik Simmons, Shauna M Murray, Jordan Farrar, Matias Placencio-Castro, Vincent Sezibera, Laura B Rawlings, Briana Wilson, Theresa S Betancourt

المصدر: PLOS Global Public Health, Vol 3, Iss 10, p e0002473 (2023)

مصطلحات موضوعية: Public aspects of medicine, RA1-1270

الوصف: Early childhood development (ECD) programmes are heralded as a way to improve children's health and educational outcomes. However, few studies in developing countries calculate the effectiveness of quality early childhood interventions. This study estimates the cost and cost-effectiveness of the Sugira Muryango (SM) trial, a home-visiting intervention to improve ECD outcomes through positive parent-child relationships. Cost-effectiveness analysis of ECD interventions is challenging given their potential to have multiple benefits. We propose a cost-effectiveness method using a single outcome, in this case the improvement in cognitive development per home-visit session, as an indication of efficiency comparable across similar interventions. The trial intervention cost US$456 per family. This cost will likely fall below US$200 if the intervention is scaled through government systems. The cost-effectiveness analysis suggests that while SM generated a relatively small impact on markers of early development, it did so efficiently. The observed improvements in cognitive development per home-visit are similar to other home-visiting interventions of longer duration. SM by focusing on the family had benefits beyond ECD, including reductions in violence against children and intermate partner violence, further analysis is needed to include these returns in the economic evaluation.

وصف الملف: electronic resource

العلاقة: https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002473&type=printableTest; https://doaj.org/toc/2767-3375Test

الوصول الحر: https://doaj.org/article/121d0a0b90664f65ae77afdd91d5588dTest

المؤلفون: Claire Bahati, Josias Izabayo, Japhet Niyonsenga, Vincent Sezibera, Léon Mutesa

المصدر: BMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-11 (2021)

مصطلحات موضوعية: Intimate partner violence, Antenatal care, Pregnant women, Reproductive health, Rwanda, Gynecology and obstetrics, RG1-991

الوصف: Abstract Background Although compelling evidence shows that exposure to intimate partner violence (IPV) during pregnancy is detrimental to both physical and mental health of the victims and their fetuses, studies on negative impact of IPV on antenatal care (ANC) services utilization are scarce. Methods The aim of the current study was to determine the impact of IPV exposure on ANC services utilization indicators such as (i) initiation of care within the first 3 months of pregnancy, (ii) receipt of at least four ANC visits and (iii) receipt of care from skilled providers among reproductive age women in Rwanda. This study used the data from the 2014–15 Rwanda Demographic and Health Survey. Multiple logistic regression was used to estimate the effects of physical and sexual IPV on the ANC services utilization indicators. Results Among married women living with their partners with at least one child aged 5 years or under (N = 5116), 17% of them reported physical violence, 22.8% reported psychological violence and 9.2% reported sexual violence. We found that there was a significant negative relationship between physical IPV and both early ANC and sufficient ANC. Women who had experienced physical violence by their partners during the preceding 12 months were less likely to receive more than four ANC visits, (O.R = 0.61, CI = 0.417–0.908) and they were less likely to attend the first ANC visits within the first 3 months (O.R = 0.656, CI = 0.445–0.967). Conclusion In this study, the prevalence of IPV still remains high and there is evidence that it does have significant impact on ANC. Therefore, the results provide support for continued efforts to reduce intimate partner violence, through the improvement of screening for IPV during ANC visits.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2393Test

الوصول الحر: https://doaj.org/article/fbbbfe267e1b4c32a0bee266abe443ffTest

المؤلفون: Theresa S. Betancourt, Sarah K. G. Jensen, Dale A. Barnhart, Robert T. Brennan, Shauna M. Murray, Aisha K. Yousafzai, Jordan Farrar, Kalisa Godfroid, Stephanie M. Bazubagira, Laura B. Rawlings, Briana Wilson, Vincent Sezibera, Alex Kamurase

المصدر: BMC Public Health, Vol 20, Iss 1, Pp 1-11 (2020)

مصطلحات موضوعية: Home-visiting, Early childhood development (ECD), Violence, Social protection, Father engagement, Poverty, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Sugira Muryango is a father-engaged early child development and violence-prevention home-visiting programme delivered by trained lay workers. This cluster-randomised trial evaluates whether families living in extreme poverty (Ubudehe 1, the poorest category in the Government of Rwanda’s wealth ranking) who receive Sugira Muryango in combination with a government-provided social protection programme demonstrate greater responsive, positive caregiving, nutrition, care seeking, hygiene, and father involvement compared with control families receiving usual care (UC). Methods Using detailed maps, we grouped closely spaced villages into 284 geographic clusters stratified by the type of social protection programmes operating in the village clusters; 198 clusters met all enrolment criteria. Sugira Muryango was delivered to n = 541 families in 100 treatment clusters with children aged 6–36 months living in extreme poverty. We assessed changes in outcomes in intervention and n = 508 UC control families using structured surveys and observation. Analyses were intent to treat using mixed models to accommodate clustering. Results Families receiving Sugira Muryango improved on core outcomes of parent-child relationships assessed using the Home Observation for Measurement of the Environment (Cohen’s d = 0.87, 95% CI: 0.74, 0.99) and the Observation of Mother-Child Interaction (Cohen’s d = 0.29, 95% CI: 0.17, 0.41). We also saw reductions in harsh discipline on items from the UNICEF MICS (OR = 0.30: 95% CI: 0.19, 0.47) and in violent victimisation of female caregivers by their partners (OR = 0.49, 95% CI: 0.24, 1.00) compared with UC. Moreover, children in families receiving SM had a 0.45 higher increase in food groups consumed in the past 24 h (Cohen’s d = 0.35, 95% CI: 0.22, 0.47), increased care seeking for diarrhoea (OR = 4.43, 95% CI: 1.95, 10.10) and fever (OR = 3.28, 95% CI: 1.82, 5.89), and improved hygiene behaviours such as proper treatment of water (OR = 3.39, 95% CI: 2.16, 5.30) compared with UC. Finally, Sugira Muryango was associated with decreased caregiver depression and anxiety (OR = 0.58, 95% CI: 0.38, 0.88). Conclusions Sugira Muryango led to improvements in caregiver behaviours linked to child development and health as well as reductions in violence. Trial registration ClinicalTrials.gov number NCT02510313 .

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s12889-020-08693-7Test; https://doaj.org/toc/1471-2458Test

الوصول الحر: https://doaj.org/article/82f53c6a9f8e42d7b649bf35762802dbTest

المؤلفون: Celestin Mutuyimana, Vincent Sezibera, Epaphrodite Nsabimana, Lambert Mugabo, Cindi Cassady, Clarisse Musanabaganwa, Yvonne Kayiteshonga

المصدر: BMC Psychology, Vol 7, Iss 1, Pp 1-7 (2019)

مصطلحات موضوعية: PTSD, Prevalence, Survivors, In country non-targeted, Old returnees, Offspring, Psychology, BF1-990

الوصف: Abstract Background The 1994 Genocide against the Tutsi was a major traumatic event affecting nearly all Rwandans. Significant psychological sequels continue to occur in the population 25 years after, with a high prevalence of posttraumatic stress disorder (PTSD) found in women. Three groups are typically designated with regard to the Genocide against the Tutsi: those who were targeted and categorized as genocide “survivors,” those who were in the country during the genocide and were the “non-targeted” group, and those who were outside of the country, referred to as the “1959 returnees.” Each group experienced various traumatic events during and in the aftermath of the genocide. Offspring of the designated groups, currently exhibit symptoms of PTSD disregarding of being born in the years following the genocide. A number of studies have described the prevalence of PTSD in the general adult population. There is a lack of research comparing the prevalence of PTSD in women and their offspring among these three target groups, therefore, this study aimed to bridge the gap. Methods We conducted a comparative cross-sectional study with a sample of 432 mothers and 432 children in three categories: genocide survivors, in country non-targeted and 1959 returnees. Participant ages for children were between 14 to 22 years and for mothers, between the ages of 32 to 87 years. The UCLA-PTSD DSM-5, PTSD Check list-5 and Life events Checklist-5 were translated from English to Kinyarwanda and were used to assess exposure to trauma and the prevalence of PTSD symptoms in Rwandan mothers and their offspring. Results Key Results yield a PTSD rate of 18.8, 6.2, 5.2% within survivors, in country non-targeted, and returnees respectively with an average PTSD rate of 43.8% for parents, and 16.5% for offspring. Conclusion PTSD among the mothers’ groups and their offspring have been found, specifically in the offspring of genocide survivors. Considering these adolescents were not born at the time of the 1994 Genocide against the Tutsi, the results suggest future studies should explore the precipitating factors contributing to the PTSD symptoms within this specific group.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2050-7283Test

الوصول الحر: https://doaj.org/article/b30567bd27ad42dea0979cb63f55fc87Test

المؤلفون: Aisha Yousafzai, Theresa S Betancourt, Sarah KG Jensen, Matias Placencio-Castro, Shauna M Murray, Robert T Brennan, Simo Goshev, Jordan Farrar, Laura B Rawlings, Briana Wilson, Emmanuel Habyarimana, Vincent Sezibera

المصدر: BMJ Global Health, Vol 6, Iss 1 (2021)

مصطلحات موضوعية: Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216

الوصف: Introduction Families living in extreme poverty require interventions to support early-childhood development (ECD) due to broad risks. This longitudinal cluster randomised trial examines the effectiveness of Sugira Muryango (SM), a home-visiting intervention linked to Rwanda’s social protection system to promote ECD and reduce violence compared with usual care (UC).Methods Families with children aged 6–36 months were recruited in 284 geographical clusters across three districts. Cluster-level randomisation (allocated 1:1 SM:UC) was used to prevent diffusion. SM was hypothesised to improve child development, reduce violence and increase father engagement. Developmental outcomes were assessed using the Ages and Stages Questionnaire (ASQ-3) and the Malawi Development Assessment Tool (MDAT) and anthropometric assessments of growth. Violence was assessed using questions from UNICEF Multiple Indicators Cluster Survey (MICS) and Rwanda Demographic and Health Surveys (DHS). Father engagement was assessed using the Home Observation for Measurement of the Environment. Blinded enumerators conducted interviews and developmental assessments.Results A total of 541 SM families and 508 UC families were enrolled and included in the analyses. Study attrition (2.0% children; 9.6% caregivers) was addressed by hot deck imputation. Children in SM families improved more on gross motor (d=0.162, 95% CI 0.065 to 0.260), communication (d=0.081, 95% CI 0.005 to 0.156), problem solving (d=0.101, 95% CI 0.002 to 0.179) and personal-social development (d=0.096, 95% CI −0.015 to 0.177) on the ASQ-3. SM families showed increased father engagement (OR=1.592, 95% CI 1.069 to 2.368), decreased harsh discipline (incidence rate ratio, IRR=0.741, 95% CI 0.657 to 0.835) and intimate partner violence (IRR=0.616, 95% CI:0.458 to 0.828). There were no intervention-related improvements on MDAT or child growth.Conclusion Social protection programmes provide a means to deliver ECD intervention.Trial registration number NCT02510313.

وصف الملف: electronic resource

العلاقة: https://gh.bmj.com/content/6/1/e003508.fullTest; https://doaj.org/toc/2059-7908Test

الوصول الحر: https://doaj.org/article/3d3ed74cf02640efaf730d527afcfa68Test

المؤلفون: Celestin Mutuyimana, Cindi Cassady, Vincent Sezibera, Epaphrodite Nsabimana

المصدر: European Journal of Psychotraumatology, Vol 12, Iss 1 (2021)

مصطلحات موضوعية: depression, trauma exposure, prevalence, mothers, daughters, survivors, nontargeted, 1959 returnees, Psychiatry, RC435-571

الوصف: Background: In the past 26 years since the genocide against the Tutsi, mental illness continues to be the greatest challenges facing the Rwandan population. In the context of the 1994 genocide against Tutsi, there are three different survival status within Rwandan women. Those who were targeted by the genocide referred to as ‘survivors’, those who were in the country during the genocide but were not targeted referred to as ‘non-targeted’, and those who were outside the country referred to as ‘1959 returnees’. All these groups experienced the traumatic events differently. The literature shows that traumatic stress exposure is associated with depression. Objectives: To demonstrate differences in trauma exposure in a sample of mothers and daughters according to their genocide survival status. To examine differences in depression prevalence between these three groups of mothers and daughters as a function of their genocide survival status and place of residence. To examine the relationship between major depression, survival status, place of residence, and trauma exposure in sample of mothers and daughters, including the relationship between mothers’ depression and daughters’ depression. Methods: A sample of 309 dyads of mothers and daughters was recruited. Data were collected using the Mini International Neuropsychiatric Interview, Life Events Questionnaire and the Social Demographics Questionnaire. Data were analysed using descriptive statistics, chi-square test, logistic regression, and one-way ANOVA. Results: There is a significant difference in trauma exposure in three survival categories of mothers and daughters. A 23% of mothers and 18.4% of daughters met criteria for major depression, with urban participants twice as likely to meet criteria as participants from rural areas. Depression was associated with trauma exposure and place of residence in mothers’ and daughters’ samples. Maternal depression was associated with depression in daughters. Conclusions: Family support counselling services and research to identify factors of intergenerational depression are needed.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2000-8066Test

الوصول الحر: https://doaj.org/article/1e1893c648b84bed8aa0ee55e537cfe8Test

المؤلفون: Nyirandamutsa, Fortunée, Niyonsenga, Japhet, Lisette, Gaju Kethina, Izabayo, Josias, Kambibi, Emilienne, Munderere, Samuel, Sebuhoro, Célestin, Muhayisa, Assoumpta, Vincent, Sezibera

المساهمون: Khalid, Shazia

المصدر: PLOS ONE ; volume 19, issue 4, page e0302330 ; ISSN 1932-6203

الوصف: Background There is little known about the family and community maltreatment of the offspring born of the genocidal rape and the offspring’s self-perceptions and how they influence their recovery from mental health problems. This study aimed to examine how the mental health prognosis of these offspring could be influenced by the family or community perceptions and attitudes toward them and their self-perception and coping strategies. Methods Thirty-two semi-structured qualitative interviews were conducted on 16 dyads of mothers and their offspring who were selected from countrywide. The interviews were audio-recorded and transcribed verbatims that were analysed inductively using thematic analysis within the NVivo 12 software. Results Participants reported long-term psychological and psychosomatic consequences stemming from being born of genocidal rape. Notably, family and community maltreatment of the offspring and their self-perception exacerbated psychological distress and affected their capacity to recover. The majority of the offspring were using coping strategies such as sole collaboration with peers with the same history, efforts to hide their birth history, social Isolation (silence, untrusting, involvement in media etc), hardworking, reversed roles in the parental relationship, extreme involvement in praying, and harmful alcohol use. Conclusion Given the documented detrimental effects of individual, family and community attitudes and perceptions on psychological, and psychosomatic symptoms as well as the offspring coping strategies, culturally relevant mental health interventions are required to support the well-being and social reintegration of individuals born of genocidal rape while minimizing stigma and their maladaptive coping strategies.

الإتاحة: https://doi.org/10.1371/journal.pone.0302330Test

المؤلفون: Josias Izabayo, Claire Bahati, Japhet Niyonsenga, Yves Gashugi, Pascaline Munezero, Siméon Sebatukura Gitibwa, Peace Uwambaye, Vincent Sezibera

مصطلحات موضوعية: Intimate Partner Violence and Health Consequences, Health, Social Sciences, Global Maternal and Child Health Outcomes, Pediatrics, Perinatology and Child Health, Medicine, Health Sciences, Adolescent Sexual Health and Behavior Patterns, General Health Professions, Health Professions, Intimate Partner Violence, Domestic violence, Underweight, Socioeconomic status, Psychological intervention, Malnutrition, Reproductive health, Demography, FOS Sociology, Logistic regression, Environmental health, Poison control, Population, Injury prevention, Obesity, Overweight, Psychiatry, Pathology, Sociology, Internal medicine

الوصف: Background Despite significant socio-economic progress and a decade of interventions aimed at improving nutrition, malnutrition remains a significant problem among children under the age of five in Rwanda. While several studies have been conducted to identify important risk factors for malnutrition in Rwanda, none have specifically assessed the association between intimate partner violence (IPV) and child nutritional status. Therefore, this study aimed to examine the association between women's exposure to IPV and the nutritional status of their children in Rwanda. Methods The study analyzed secondary data from the Rwanda Demographic and Health Survey 2019–20 (RDHS 2019/20). Data was gathered on women's emotional, physical, and sexual IPV experiences, as well as demographic and socioeconomic characteristics. Furthermore, their children's birth outcomes were included as mediating factors. To determine the association between IPV exposure and child nutrition status, we used a series of binary logistic ... : نبذة مختصرة على الرغم من التقدم الاجتماعي والاقتصادي الكبير وعقد من التدخلات الرامية إلى تحسين التغذية، لا يزال سوء التغذية يمثل مشكلة كبيرة بين الأطفال دون سن الخامسة في رواندا. في حين أجريت العديد من الدراسات لتحديد عوامل الخطر المهمة لسوء التغذية في رواندا، لم تقيم أي منها على وجه التحديد العلاقة بين عنف الشريك الحميم والحالة التغذوية للأطفال. لذلك، تهدف هذه الدراسة إلى دراسة العلاقة بين تعرض المرأة لعنف الشريك الحميم والحالة التغذوية لأطفالها في رواندا. الأساليب قامت الدراسة بتحليل البيانات الثانوية من المسح الديموغرافي والصحي لرواندا 2019–20 (RDHS 2019/20). تم جمع البيانات حول تجارب عنف الشريك الحميم العاطفية والجسدية والجنسية للنساء، بالإضافة إلى الخصائص الديموغرافية والاجتماعية والاقتصادية. علاوة على ذلك، تم تضمين نتائج ولادة أطفالهم كعوامل وساطة. لتحديد العلاقة بين التعرض لعنف العشير وحالة تغذية الطفل، استخدمنا سلسلة من نماذج الانحدار اللوجستي الثنائية. تمت دراسة ما مجموعه 2965 طفلاً، تتراوح أعمارهم بين 6 و 59 شهرًا، ولدوا لنساء تتراوح أعمارهن بين 15 و 49 عامًا. النتائج وجدت هذه الدراسة أن ما يقرب من ...

العلاقة: https://dx.doi.org/10.60692/4xhc1-gtc32Test

الإتاحة: https://doi.org/10.60692/90amt-thd7810.60692/4xhc1-gtc32Test