Opportunities to Improve Primary-Level Otolaryngology Care: A Survey of Rwandan General Practitioners.

Authors

Kamala Pullakhandam, Christian Kabongo, Mahbuba Tusty, Sarah Nuss, Gabrielle Cahill, Nina Patel, John Bukuru, Hirwa Nteyumwete, Aristote Hakizimana, Aimee Kamaliza, David A Shaye, Charles Nkurunziza, Eric Uwizeyimana, Ornella Masimbi, Mary Jue Xu, Gratien Tuyishimire

Published in

OTO open. Volume 10. Issue 4. Pages e70303. Epub Oct 17, 2026.

Abstract

In Rwanda, 30 OHNS clinicians serve the country's population of 14 million. With low subspecialist density, primary care providers (PCPs) become the first line of otolaryngologic triage and care. However, it is unclear if Rwandan PCPs are equipped to bridge OHNS care gaps.
Cross-sectional qualitative survey-based study.
Rwandan PCPs were surveyed, and responses were collected between November 2024 and May.
Surveys were co-developed with Rwandan OHNS clinicians and evaluated the diagnostic and management confidence of common head and neck conditions. Responses were analyzed with descriptive statistics.
Forty-four PCPs completed the survey. PCPs most frequently encountered sinonasal, pediatric, and ear/hearing diseases (mean of 10.5, 9.7, and 6.7 presentations/week, respectively). However, confidence in sinonasal skills was low (mean confidence score of 2.9 out of 5). Diagnostic and management confidence scores were stable across disease categories. Eighty-eight percent of PCPs identified limited training/knowledge as barriers to patient care. Ninety-seven percent of PCPs agreed that further emphasis on otolaryngology training is needed during medical school.
This study highlights training gaps and systemic barriers affecting the Rwandan primary care workforce. Targeted hands-on training is needed to improve PCPs' skills. Furthermore, evaluation of PCP recognition and management confidence did not reveal specific areas of deficit, indicating that training topics should be comprehensive and diverse. Finally, limited training/knowledge/skills was a common barrier to care, highlighting the importance of PCP-focused continuing medical education. This survey framework could be utilized in other LMIC settings to identify areas of reduced confidence in otolaryngology provision.

PMID:
42893152
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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