Pediatric emergency care capacity in a low-resource setting: An assessment of district hospitals in Rwanda

Science.gov (United States)

Shoveller, Jean; Tuyisenge, Lisine; Kenyon, Cynthia; Cechetto, David F.; Lynd, Larry D.

2017-01-01

Background Health system strengthening is crucial to improving infant and child health outcomes in low-resource countries. While the knowledge related to improving newborn and child survival has advanced remarkably over the past few decades, many healthcare systems in such settings remain unable to effectively deliver pediatric advance life support management. With the introduction of the Emergency Triage, Assessment and Treatment plus Admission care (ETAT+)–a locally adapted pediatric advanced life support management program–in Rwandan district hospitals, we undertook this study to assess the extent to which these hospitals are prepared to provide this pediatric advanced life support management. The results of the study will shed light on the resources and support that are currently available to implement ETAT+, which aims to improve care for severely ill infants and children. Methods A cross-sectional survey was undertaken in eight district hospitals across Rwanda focusing on the availability of physical and human resources, as well as hospital services organizations to provide emergency triage, assessment and treatment plus admission care for severely ill infants and children. Results Many of essential resources deemed necessary for the provision of emergency care for severely ill infants and children were readily available (e.g. drugs and laboratory services). However, only 4/8 hospitals had BVM for newborns; while nebulizer and MDI were not available in 2/8 hospitals. Only 3/8 hospitals had F-75 and ReSoMal. Moreover, there was no adequate triage system across any of the hospitals evaluated. Further, guidelines for neonatal resuscitation and management of malaria were available in 5/8 and in 7/8 hospitals, respectively; while those for child resuscitation and management of sepsis, pneumonia, dehydration and severe malnutrition were available in less than half of the hospitals evaluated. Conclusions Our assessment provides evidence to inform new strategies

Theater Sustainment Reserve for the Rwanda Defence Forces

Science.gov (United States)

2016-06-10

The East African magazine stated that the illegal armed group operating in the eastern DRC was moving into Burundi (Magical 2015). Rwanda’s...Gisenyi District Hospital in Rwanda.” National Center for Biotechnology Information. Accessed 31 March 2016. http://www.ncbi.nlm.nih.gov/books

Prevalence of Brucellosis among Women Presenting with Abortion/Stillbirth in Huye, Rwanda

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Nadine Rujeni

2014-01-01

Full Text Available The incidence of human brucellosis is not documented in Rwanda despite several reports on the disease in cattle. Because brucellosis has been associated with abortion, the aim of this study was to investigate the prevalence of positive serology in women presenting with abortion and/or stillbirth. The study was done in Huye District, in the Southern Province of Rwanda, and the patients were recruited from both the University Teaching Hospital of Butare (CHUB and Kabutare District Hospital. Serum samples were collected and the Rose Bengal plate test (RBPT was performed on each sample. A questionnaire was also used to investigate potential contacts with animals and/or consumption of raw milk. A total of 60 women were recruited and 15 (i.e., 25% were Brucella seropositive. The questionnaire showed that those with seropositivity either were in contact with domestic animals (cattle, goat, or sheep or were consuming raw cow’s milk. Human brucellosis appears to be of public health importance in Rwanda and more attention should be drawn on the disease. The current study provides a basis for larger studies to establish the incidence of human brucellosis in Rwanda. More mechanistic studies will also demonstrate the pathogenicity of Brucella in human placentas.

Geographical accessibility to healthcare and malnutrition in Rwanda.

Science.gov (United States)

Aoun, Nael; Matsuda, Hirotaka; Sekiyama, Makiko

2015-04-01

The prevalence of stunting in children less than five years of age is elevated in Rwanda. It is one of the main health challenges upon which the government is struggling to achieve progress. Health centers and district hospitals in Rwanda are expected to provide a package of health services including nutrition related activities, nutritional rehabilitation, education, and growth monitoring. They can hence play a potent role in alleviating malnutrition and stunting in Rwanda. This study tested whether travel time from household clusters to the nearest health center was significantly and negatively associated with the distribution of height-for-age z-scores of younger than five year old children in the eastern province of Rwanda. Data for 974 children was extracted from the Rwanda Demographic and Health Survey (DHS) database. However, since DHS does not contain any information on travel time to health centers, the latter was simulated using AccessMod 4.0, an extension to ArcGIS 9.3.1 that simulates health facilities' catchment areas and travel times to health facilities. Travel time was found to be negatively associated with height-for-age z-scores at the 5% level in a stepwise regression analysis that controlled for wealth index, mother's primary and secondary education, sex of the child, preceding birth interval, and birth order of the child. Field measurements are needed to validate travel time. If validated, results point to the importance of improved access to healthcare facilities as a potential pathway in reducing stunting in Rwanda. Copyright © 2015 Elsevier Ltd. All rights reserved.

Capacity building for oncology programmes in sub-Saharan Africa: the Rwanda experience.

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Stulac, Sara; Binagwaho, Agnes; Tapela, Neo M; Wagner, Claire M; Muhimpundu, Marie Aimee; Ngabo, Fidele; Nsanzimana, Sabin; Kayonde, Leonard; Bigirimana, Jean Bosco; Lessard, Adam J; Lehmann, Leslie; Shulman, Lawrence N; Nutt, Cameron T; Drobac, Peter; Mpunga, Tharcisse; Farmer, Paul E

2015-08-01

Despite an estimated 456,000 deaths caused by cancer in sub-Saharan Africa in 2012 and a cancer burden that is predicted to double by 2030, the region accounts for only 0·3% of worldwide medical expenditure for cancer. Challenges to cancer care in sub-Saharan Africa include a shortage of clinicians and training programmes, weak healthcare infrastructure, and inadequate supplies. Since 2011, Rwanda has developed a national cancer programme by designing comprehensive, integrated frameworks of care, building local human resource capacity through partnerships, and delivering equitable, rights-based care. In the 2 years since the inauguration of Rwanda's first cancer centre, more than 2500 patients have been enrolled, including patients from every district in Rwanda. Based on Rwanda's national cancer programme development, we suggest principles that could guide other nations in the development of similar cancer programmes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Inter-Pregnancy Intervals and Maternal Morbidity: New Evidence from Rwanda

NARCIS (Netherlands)

Habimana-Kabano, Ignace; Broekhuis, E.J.A.; Hooimeijer, P.

The effects of short and long pregnancy intervals on maternal morbidity have hardly been investigated. This research analyses these effects using logistic regression in two steps. First, data from the Rwanda Demographic and Health Survey 2010 are used to study delivery referrals to District

Bayesian mapping of HIV infection among women of reproductive age in Rwanda.

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François Niragire

Full Text Available HIV prevalence is rising and has been consistently higher among women in Rwanda whereas a decreasing national HIV prevalence rate in the adult population has stabilised since 2005. Factors explaining the increased vulnerability of women to HIV infection are not currently well understood. A statistical mapping at smaller geographic units and the identification of key HIV risk factors are crucial for pragmatic and more efficient interventions. The data used in this study were extracted from the 2010 Rwanda Demographic and Health Survey data for 6952 women. A full Bayesian geo-additive logistic regression model was fitted to data in order to assess the effect of key risk factors and map district-level spatial effects on the risk of HIV infection. The results showed that women who had STIs, concurrent sexual partners in the 12 months prior to the survey, a sex debut at earlier age than 19 years, were living in a woman-headed or high-economic status household were significantly associated with a higher risk of HIV infection. There was a protective effect of high HIV knowledge and perception. Women occupied in agriculture, and those residing in rural areas were also associated with lower risk of being infected. This study provides district-level maps of the variation of HIV infection among women of child-bearing age in Rwanda. The maps highlight areas where women are at a higher risk of infection; the aspect that proximate and distal factors alone could not uncover. There are distinctive geographic patterns, although statistically insignificant, of the risk of HIV infection suggesting potential effectiveness of district specific interventions. The results also suggest that changes in sexual behaviour can yield significant results in controlling HIV infection in Rwanda.

Bayesian mapping of HIV infection among women of reproductive age in Rwanda.

Science.gov (United States)

Niragire, François; Achia, Thomas N O; Lyambabaje, Alexandre; Ntaganira, Joseph

2015-01-01

HIV prevalence is rising and has been consistently higher among women in Rwanda whereas a decreasing national HIV prevalence rate in the adult population has stabilised since 2005. Factors explaining the increased vulnerability of women to HIV infection are not currently well understood. A statistical mapping at smaller geographic units and the identification of key HIV risk factors are crucial for pragmatic and more efficient interventions. The data used in this study were extracted from the 2010 Rwanda Demographic and Health Survey data for 6952 women. A full Bayesian geo-additive logistic regression model was fitted to data in order to assess the effect of key risk factors and map district-level spatial effects on the risk of HIV infection. The results showed that women who had STIs, concurrent sexual partners in the 12 months prior to the survey, a sex debut at earlier age than 19 years, were living in a woman-headed or high-economic status household were significantly associated with a higher risk of HIV infection. There was a protective effect of high HIV knowledge and perception. Women occupied in agriculture, and those residing in rural areas were also associated with lower risk of being infected. This study provides district-level maps of the variation of HIV infection among women of child-bearing age in Rwanda. The maps highlight areas where women are at a higher risk of infection; the aspect that proximate and distal factors alone could not uncover. There are distinctive geographic patterns, although statistically insignificant, of the risk of HIV infection suggesting potential effectiveness of district specific interventions. The results also suggest that changes in sexual behaviour can yield significant results in controlling HIV infection in Rwanda.

Risk of red blood cell alloimmunisation in Rwanda: Assessment of ...

African Journals Online (AJOL)

Background: Screening of alloantibodies in patients is not yet done in district hospitals of Rwanda. The practice is to transfuse ABO/D compatible blood following an immediate spin crossmatch (IS-XM) or indirect antiglobulin test crossmatch (IAT-XM). Objectives: To assess the risk of red blood cell (RBC) alloimmunisation ...

Prevalence and risk factors of malaria among children in southern highland Rwanda

NARCIS (Netherlands)

Gahutu, J.B.; Steininger, C.; Shyirambere, C.; Zeile, I.; Cwinya-Ay, N.; Danquah, I.; Larsen, C.H.; Eggelte, T.A.; Uwimana, A.; Karema, C.; Musemakweri, A.; Harms, G.; Mockenhaupt, F.P.

2011-01-01

Background: Increased control has produced remarkable reductions of malaria in some parts of sub-Saharan Africa, including Rwanda. In the southern highlands, near the district capital of Butare (altitude, 1,768 m), a combined community-and facility-based survey on Plasmodium infection was conducted

Prevalence and risk factors of malaria among children in southern highland Rwanda

NARCIS (Netherlands)

Gahutu, Jean-Bosco; Steininger, Christian; Shyirambere, Cyprien; Zeile, Irene; Cwinya-Ay, Neniling; Danquah, Ina; Larsen, Christoph H.; Eggelte, Teunis A.; Uwimana, Aline; Karema, Corine; Musemakweri, Andre; Harms, Gundel; Mockenhaupt, Frank P.

2011-01-01

Increased control has produced remarkable reductions of malaria in some parts of sub-Saharan Africa, including Rwanda. In the southern highlands, near the district capital of Butare (altitude, 1,768 m), a combined community-and facility-based survey on Plasmodium infection was conducted early in

Impact of implementing performance-based financing on childhood malnutrition in Rwanda.

Science.gov (United States)

Binagwaho, Agnes; Condo, Jeanine; Wagner, Claire; Ngabo, Fidele; Karema, Corine; Kanters, Steve; Forrest, Jamie I; Bizimana, Jean de Dieu

2014-11-04

Malnutrition remains a serious concern in Rwanda, particularly among children under-5 years. Performance-based financing (PBF), an innovative health systems financing strategy, has been implemented at the national level since 2008. This study aimed to assess the impact of PBF and other factors associated with the prevalence of three classifications of malnutrition (stunting, wasting and underweight) in children under-5 years in Rwanda. The study is a cross-sectional study comprising of 713 children under five years old from 557 households, whose anthropometric measurements (height, weight and age) had been obtained as part of the 2008 Rwanda General Health and HIV household survey. Z-scores for height-for-age, weight-for-age, weight-for-height, and body mass index-for-age were analyzed according to the World Health Organization 2006 Child Growth Standards. Random intercept logistic regression models were used to regress each anthropometric measure (WAZ, HAZ and WHZ) against child, maternal and household characteristics. Child participants ranged in age from 0 to 60 months, 20.2% of children were under 12 months and 5.1% were HIV positive. The prevalence of wasting was 8.8%; of stunting was 58.4%; and of underweight status was 20.7%. Maternal emotional and social wellbeing was protective of wasting in children under-5 years of age. Living in districts implementing PBF was protective of wasting (Adjusted Odds Ratio: 0.43; 95% confidence interval: 0.19-0.97). Living in a district with PBF was not found to be associated with either stunting or underweight status among children under-5. PBF may have a protective association with particular forms of malnutrition among children under-5 years in Rwanda. These findings warrant further investigation in relation to the impact of implementing innovative financing schemes on health outcomes.

African Journals Online: Rwanda

African Journals Online (AJOL)

... Panama, Papua New Guinea, Paraguay, Peru, Philippines, Poland, Portugal, Puerto Rico ... Rwanda Journal, Series C: Mathematical Sciences, Engineering and Technology ... Rwanda Journal, Series F: Medicine and Health Sciences ... The Rwanda Journal of Health Sciences, a publication of Kigali Health Institute, ...

Imaging in the Land of 1000 Hills: Rwanda Radiology Country Report

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David A. Rosman

2015-03-01

Full Text Available Rwanda is an equatorial country in central Africa (Figure 1, and part of the East African Community of Burundi, Kenya, Uganda and Tanzania. It is a small country, just over 10,000 square miles. Its population of nearly 12,000,000 makes it the most densely populated state in continental Africa. Rwanda’s capital, Kigali, is a mile-high city. Its elevation makes the climate much cooler and more comfortable than a typical equatorial climate. The average annual temperature is 20.5 degrees Celsius with a narrow range – April, the coldest month has an average temperature of 20 degrees, whereas August, the warmest month has an average temperature of 21.5 degrees. Economically, Rwanda functions as a subsistence agricultural country but has been actively striving to emerge as a middle-income country. Its primary exports are coffee and tea. In 1994, the majority Hutu population carried out mass genocide of the ethnic Tutsi minority In a coordinated slaughter committed by neighbors against each other, and with low-technology weapons like machetes, nearly 1,000,000 people were killed in 100 days (1. The country was devastated. Immediately post-genocide, Rwanda was one of the poorest countries in the world with nearly 70% of the population living below the poverty line (2. Until 1997, Rwanda had the lowest life expectancy of any country in the world (3. The physician work force was depleted due to the direct and indirect consequences of the Rwandan Genocide. Since this time there has been a steady economic recovery (4, along with remarkable medical recovery. Average life expectancy nationwide, only 27 years in the early 1990s, has now reached 63 years (3.Since the 2012 publication (5 highlighting its advances, radiology in Rwanda has benefitted from the capital infusion that has helped to propel the overall growth in the economic and health sectors. As of 2012, there are five national referral hospitals, 41 district hospitals, one military hospital and

15 CFR 746.8 - Rwanda.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Rwanda. 746.8 Section 746.8 Commerce... CONTROLS § 746.8 Rwanda. (a) Introduction. In addition to the controls on Rwanda reflected on the Country... 918 of May 17, 1994, an embargo applies to the sale or supply to Rwanda of arms and related matériel...

Validation of a community-based survey assessing non-obstetric surgical conditions in Burera District, Rwanda.

Science.gov (United States)

Linden, Allison F; Maine, Rebecca; Hedt-Gauthier, Bethany L; Kamanzi, Emmanual; Mody, Gita; Ntakiyiruta, Georges; Kansayisa, Grace; Ntaganda, Edmond; Niyonkuru, Francine; Mubiligi, Joel; Mpunga, Tharcisse; Meara, John G; Riviello, Robert

2015-04-27

Community-based surveillance methods to monitor epidemiological progress in surgery have not yet been employed for surgical capacity building. The aim of this study was to create and assess the validity of a questionnaire that collected data for untreated surgically correctable diseases throughout Burera District, northern Rwanda, to accurately plan for surgical services. A structured interview to assess for the presence or absence of ten index surgically treatable conditions (breast mass, cleft lip/palate, club foot, hernia or hydrocele [adult and paediatric]), hydrocephalus, hypospadias, injuries or wounds, neck mass, undescended testes, and vaginal fistula) was created. The interview was built based on previously validated questionnaires, forward and back translated into the local language and underwent focus group augmentation and pilot testing. In March and May, 2012, data collectors conducted the structured interviews with a household representative in 30 villages throughout Burera District, selected using a two-stage cluster sampling design. Rwandan physicians revisited the surveyed households to perform physical examinations on all household members, used as the gold standard to validate the structured interview. Ethical approval was obtained from Boston Children's Hospital (Boston, MA, USA) and the Rwandan National Ethics Committee (Kigali, Rwanda). Informed consent was obtained from all households. 2990 individuals were surveyed, a 97% response rate. 2094 (70%) individuals were available for physical examination. The calculated overall sensitivity of the structured interview tool was 44·5% (95% CI 38·9-50·2) and the specificity was 97·7% (96·9-98·3%; appendix). The positive predictive value was 70% (95% CI 60·5-73·5), whereas the negative predictive value was 91·3% (90·0-92·5). The conditions with the highest sensitivity and specificity, respectively, were hydrocephalus (100% and 100%), clubfoot (100% and 99·8%), injuries or wounds (54·7% and

Drivers Behind Adoption Of Cassava Brown Streak Disease Control Measures In Rwanda

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Nyirahorana

2017-11-01

Full Text Available Cassava Brown Streak Disease CBSD continues to spread and its effect on productivity remains at high level losses 50- 100 in Sub-Saharan Africa. However there is little knowledge about the drivers of adoption on CBSD control measures in Rwanda. Thus this study investigated the drivers to adopt CBSD control measures in Rwanda during 2015-2016 agricultural seasons. A total of 152 households were randomly sampled in Bugesera and Ruhango districts where cassava demonstration plots are established. A multi stage sampling techniques was used. A structured questionnaire was used to collect data from respondents. Logistic regression analysis was employed to estimate drivers behind adoption of CBSD control measures. The key factors that influenced adoption of CBSD control measures was farm size farmers experience access to credit period of plantation access to demonstration plot. In order to increase adoption of CBSD control measures policy makers and implementers in Rwanda should improve farmers social economic and Insistutional characteristics sensitize and mobilize farmers on the importance of adopting the CBSD control measures.

Cassava brown streak disease in Rwanda, the associated viruses and disease phenotypes.

Science.gov (United States)

Munganyinka, E; Ateka, E M; Kihurani, A W; Kanyange, M C; Tairo, F; Sseruwagi, P; Ndunguru, J

2018-02-01

Cassava brown streak disease (CBSD) was first observed on cassava ( Manihot esculenta ) in Rwanda in 2009. In 2014 eight major cassava-growing districts in the country were surveyed to determine the distribution and variability of symptom phenotypes associated with CBSD, and the genetic diversity of cassava brown streak viruses. Distribution of the CBSD symptom phenotypes and their combinations varied greatly between districts, cultivars and their associated viruses. The symptoms on leaf alone recorded the highest (32.2%) incidence, followed by roots (25.7%), leaf + stem (20.3%), leaf + root (10.4%), leaf + stem + root (5.2%), stem + root (3.7%), and stem (2.5%) symptoms. Analysis by RT-PCR showed that single infections of Ugandan cassava brown streak virus (UCBSV) were most common (74.2% of total infections) and associated with all the seven phenotypes studied. Single infections of Cassava brown streak virus (CBSV) were predominant (15.3% of total infections) in CBSD-affected plants showing symptoms on stems alone. Mixed infections (CBSV + UCBSV) comprised 10.5% of total infections and predominated in the combinations of leaf + stem + root phenotypes. Phylogenetic analysis and the estimates of evolutionary divergence, using partial sequences (210 nt) of the coat protein gene, revealed that in Rwanda there is one type of CBSV and an indication of diverse UCBSV. This study is the first to report the occurrence and distribution of both CBSV and UCBSV based on molecular techniques in Rwanda.

Prevalence of Untreated Surgical Conditions in Rural Rwanda: A Population-Based Cross-sectional Study in Burera District.

Science.gov (United States)

Maine, Rebecca G; Linden, Allison F; Riviello, Robert; Kamanzi, Emmanuel; Mody, Gita N; Ntakiyiruta, Georges; Kansayisa, Grace; Ntaganda, Edmond; Niyonkuru, Francine; Mubiligi, Joel M; Mpunga, Tharcisse; Meara, John G; Hedt-Gauthier, Bethany L

2017-12-20

In low- and middle-income countries, community-level surgical epidemiology is largely undefined. Accurate community-level surgical epidemiology is necessary for surgical health systems planning. To determine the prevalence of surgical conditions in Burera District, Northern Province, Rwanda. A cross-sectional study with a 2-stage cluster sample design (at village and household level) was carried out in Burera District in March and May 2012. A team of surgeons randomly sampled 30 villages with probability proportionate to village population size, then sampled 23 households within each village. All available household members were examined. The presence of 10 index surgical conditions (injuries/wounds, hernias/hydroceles, breast masses, neck masses, obstetric fistulas, undescended testes, hypospadias, hydrocephalus, cleft lip/palate, and clubfoot) was determined by physical examination. Prevalence was estimated overall and for each condition. Multivariable logistic regression was performed to identify factors associated with surgical conditions, accounting for the complex survey design. Of the 2165 examined individuals, 1215 (56.2%) were female. The prevalence of any surgical condition among all examined individuals was 12% (95% CI, 9.2-14.9%). Half of conditions were hernias/hydroceles (49.6%), and 44% were injuries/wounds. In multivariable analysis, children 5 years or younger had twice the odds of having a surgical condition compared with married individuals 21 to 35 years of age (reference group) (odds ratio [OR], 2.2; 95% CI, 1.26-4.04; P = .01). The oldest group, people older than 50 years, also had twice the odds of having a surgical condition compared with the reference group (married, aged >50 years: OR, 2.3; 95% CI, 1.28-4.23; P = .01; unmarried, aged >50 years: OR, 2.38; 95% CI, 1.02-5.52; P = .06). Unmarried individuals 21 to 35 years of age and unmarried individuals aged 36 to 50 years had higher odds of a surgical condition compared with the

Drivers of improved health sector performance in Rwanda: a qualitative view from within.

Science.gov (United States)

Sayinzoga, Felix; Bijlmakers, Leon

2016-04-08

Rwanda has achieved great improvements in several key health indicators, including maternal mortality and other health outcomes. This raises the question: what has made this possible, and what makes Rwanda so unique? We describe the results of a web-based survey among district health managers in Rwanda who gave their personal opinions on the factors that drive performance in the health sector, in particular those that determine maternal health service coverage and outcomes. The questionnaire covered the six health systems building blocks that make up the WHO framework for health systems analysis, and two additional clusters of factors that are not directly covered by the framework: community health and determinants beyond the health sector. Community health workers and health insurance come out as factors that are considered to have contributed most to Rwanda's remarkable achievements in the past decade. The results also indicate the importance of other health system features, such as managerial skills and the culture of continuous monitoring of key indicators. In addition, there are factors beyond the health sector per se, such as the widespread determination of people to increase performance and achieve targets. This determination appears multi-levelled and influenced by both intrinsic and extrinsic motivation. It is the comprehensiveness and combination of interventions that drive performance in Rwanda, rather than a single health systems strengthening intervention or a set of interventions that target a specific disease. There is need for policy makers and scholars to acknowledge the complexity of health systems, and the fact that they are dynamic and influenced by society's fabric, including the overall culture of performance management in the public sector. Rwanda's robust model is difficult to replicate and fast-tracking elsewhere in the world of some of the interventions that form part of its success will require a holistic approach.

Optimizing Nursing and Midwifery Practice in Rwanda ...

African Journals Online (AJOL)

Following the 1994 genocide in Rwanda, the number of nurses remaining in practice in Rwanda was critically low. Since that time the leaders of Rwanda have worked diligently to increase both the number of nurses in Rwanda and their level of education. They have also set goals for the number of healthcare workers that ...

Toward utilization of data for program management and evaluation: quality assessment of five years of health management information system data in Rwanda.

Science.gov (United States)

Nisingizwe, Marie Paul; Iyer, Hari S; Gashayija, Modeste; Hirschhorn, Lisa R; Amoroso, Cheryl; Wilson, Randy; Rubyutsa, Eric; Gaju, Eric; Basinga, Paulin; Muhire, Andrew; Binagwaho, Agnès; Hedt-Gauthier, Bethany

2014-01-01

Health data can be useful for effective service delivery, decision making, and evaluating existing programs in order to maintain high quality of healthcare. Studies have shown variability in data quality from national health management information systems (HMISs) in sub-Saharan Africa which threatens utility of these data as a tool to improve health systems. The purpose of this study is to assess the quality of Rwanda's HMIS data over a 5-year period. The World Health Organization (WHO) data quality report card framework was used to assess the quality of HMIS data captured from 2008 to 2012 and is a census of all 495 publicly funded health facilities in Rwanda. Factors assessed included completeness and internal consistency of 10 indicators selected based on WHO recommendations and priority areas for the Rwanda national health sector. Completeness was measured as percentage of non-missing reports. Consistency was measured as the absence of extreme outliers, internal consistency between related indicators, and consistency of indicators over time. These assessments were done at the district and national level. Nationally, the average monthly district reporting completeness rate was 98% across 10 key indicators from 2008 to 2012. Completeness of indicator data increased over time: 2008, 88%; 2009, 91%; 2010, 89%; 2011, 90%; and 2012, 95% (pservice output increased from 3% (2011) to 9% (2012). Eighty-three percent of districts reported ratios between related indicators (ANC/DTP1, DTP1/DTP3) consistent with HMIS national ratios. Conclusion and policy implications: Our findings suggest that HMIS data quality in Rwanda has been improving over time. We recommend maintaining these assessments to identify remaining gaps in data quality and that results are shared publicly to support increased use of HMIS data.

Health Information in Kinyarwanda (Rwanda)

Science.gov (United States)

... PDF Strong Family Relationships Can Prevent Alcohol and Drug Use Among Teens - Rwanda (Kinyarwanda) MP3 Karen Chemical Dependency Taskforce of Minnesota What Is Addiction? - English PDF What Is Addiction? - Rwanda (Kinyarwanda) PDF ...

Increasing Access to Prevention of Postpartum Hemorrhage Interventions for Births in Health Facilities and at Home in Four Districts of Rwanda.

Science.gov (United States)

Dao, Blami; Ngabo, Fidele; Zoungrana, Jeremie; Rawlins, Barbara; Mukarugwiro, Beata; Musoni, Pascal; Favero, Rachel; MacDowell, Juliet; Eugene, Kanyamanza

2015-12-01

To assess coverage, acceptability, and feasibility of a program to prevent postpartum hemorrhage (PPH) at community and facility levels, a study was conducted in 60 health facilities and their catchment areas in four districts in Rwanda. A total of 220 skilled birth attendants at these facilities were trained to provide active management of the third stage of labor and 1994 community health workers (ASMs) were trained to distribute misoprostol at home births. A total of 4,074 pregnant women were enrolled in the program (20.5% of estimated deliveries). Overall uterotonic coverage was 82.5%: 85% of women who delivered at a facility received a uterotonic to prevent PPH; 76% of women reached at home at the time of birth by an ASM ingested misoprostol--a 44.3% coverage rate. Administration of misoprostol at the time of birth for home births achieved moderate uterotonic coverage. Advancing the distribution of misoprostol through antenatal care services could further increase coverage.

Volksmoord in Rwanda: Missiologiese opmerkings

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J. J. Kritzinger

1996-08-01

Full Text Available Genocide in Rwanda: missiological notes The recent tragic events in Rwanda, a country generally regarded as �Christian�, put the accomplishments of the church in its mission under question. Why didn't the church and the millions of Christians make a difference? Or did they? An introspective missiological analysis is done. What are the things that Christians elsewhere can learn from Rwanda? Aspects which are discussed are: the gospel and ethnicity; the gospel and revival; the gospel and ethics; the gospel and culture; the gospel and politics; the gospel and socio-economic development; and the gospel and land.

Assessing the social vulnerability to malaria in Rwanda.

Science.gov (United States)

Bizimana, Jean-Pierre; Twarabamenye, Emmanuel; Kienberger, Stefan

2015-01-07

indicates which indicators need to be addressed and in which districts. The results from this study are salient for public health policy- and decision makers in malaria control in Rwanda and timely support the national integrated malaria initiative. Future research development should focus on spatial explicit vulnerability assessment by combining environmental and social drivers to achieve an integrated and complete assessment of vulnerability to malaria.

Workplace violence and gender discrimination in Rwanda's health workforce: Increasing safety and gender equality

Science.gov (United States)

2011-01-01

Background Workplace violence has been documented in all sectors, but female-dominated sectors such as health and social services are at particular risk. In 2007-2008, IntraHealth International assisted the Rwanda Ministries of Public Service and Labor and Health to study workplace violence in Rwanda's health sector. This article reexamines a set of study findings that directly relate to the influence of gender on workplace violence, synthesizes these findings with other research from Rwanda, and examines the subsequent impact of the study on Rwanda's policy environment. Methods Fifteen out of 30 districts were selected at random. Forty-four facilities at all levels were randomly selected in these districts. From these facilities, 297 health workers were selected at random, of whom 205 were women and 92 were men. Researchers used a utilization-focused approach and administered health worker survey, facility audits, key informant and health facility manager interviews and focus groups to collect data in 2007. After the study was disseminated in 2008, stakeholder recommendations were documented and three versions of the labor law were reviewed to assess study impact. Results Thirty-nine percent of health workers had experienced some form of workplace violence in year prior to the study. The study identified gender-related patterns of perpetration, victimization and reactions to violence. Negative stereotypes of women, discrimination based on pregnancy, maternity and family responsibilities and the 'glass ceiling' affected female health workers' experiences and career paths and contributed to a context of violence. Gender equality lowered the odds of health workers experiencing violence. Rwandan stakeholders used study results to formulate recommendations to address workplace violence gender discrimination through policy reform and programs. Conclusions Gender inequality influences workplace violence. Addressing gender discrimination and violence simultaneously should

Workplace violence and gender discrimination in Rwanda's health workforce: Increasing safety and gender equality

Directory of Open Access Journals (Sweden)

d'Arc Kanakuze Jeanne

2011-07-01

Full Text Available Abstract Background Workplace violence has been documented in all sectors, but female-dominated sectors such as health and social services are at particular risk. In 2007-2008, IntraHealth International assisted the Rwanda Ministries of Public Service and Labor and Health to study workplace violence in Rwanda's health sector. This article reexamines a set of study findings that directly relate to the influence of gender on workplace violence, synthesizes these findings with other research from Rwanda, and examines the subsequent impact of the study on Rwanda's policy environment. Methods Fifteen out of 30 districts were selected at random. Forty-four facilities at all levels were randomly selected in these districts. From these facilities, 297 health workers were selected at random, of whom 205 were women and 92 were men. Researchers used a utilization-focused approach and administered health worker survey, facility audits, key informant and health facility manager interviews and focus groups to collect data in 2007. After the study was disseminated in 2008, stakeholder recommendations were documented and three versions of the labor law were reviewed to assess study impact. Results Thirty-nine percent of health workers had experienced some form of workplace violence in year prior to the study. The study identified gender-related patterns of perpetration, victimization and reactions to violence. Negative stereotypes of women, discrimination based on pregnancy, maternity and family responsibilities and the 'glass ceiling' affected female health workers' experiences and career paths and contributed to a context of violence. Gender equality lowered the odds of health workers experiencing violence. Rwandan stakeholders used study results to formulate recommendations to address workplace violence gender discrimination through policy reform and programs. Conclusions Gender inequality influences workplace violence. Addressing gender discrimination and

Workplace violence and gender discrimination in Rwanda's health workforce: Increasing safety and gender equality.

Science.gov (United States)

Newman, Constance J; de Vries, Daniel H; d'Arc Kanakuze, Jeanne; Ngendahimana, Gerard

2011-07-19

Workplace violence has been documented in all sectors, but female-dominated sectors such as health and social services are at particular risk. In 2007-2008, IntraHealth International assisted the Rwanda Ministries of Public Service and Labor and Health to study workplace violence in Rwanda's health sector. This article reexamines a set of study findings that directly relate to the influence of gender on workplace violence, synthesizes these findings with other research from Rwanda, and examines the subsequent impact of the study on Rwanda's policy environment. Fifteen out of 30 districts were selected at random. Forty-four facilities at all levels were randomly selected in these districts. From these facilities, 297 health workers were selected at random, of whom 205 were women and 92 were men. Researchers used a utilization-focused approach and administered health worker survey, facility audits, key informant and health facility manager interviews and focus groups to collect data in 2007. After the study was disseminated in 2008, stakeholder recommendations were documented and three versions of the labor law were reviewed to assess study impact. Thirty-nine percent of health workers had experienced some form of workplace violence in year prior to the study. The study identified gender-related patterns of perpetration, victimization and reactions to violence. Negative stereotypes of women, discrimination based on pregnancy, maternity and family responsibilities and the 'glass ceiling' affected female health workers' experiences and career paths and contributed to a context of violence. Gender equality lowered the odds of health workers experiencing violence. Rwandan stakeholders used study results to formulate recommendations to address workplace violence gender discrimination through policy reform and programs. Gender inequality influences workplace violence. Addressing gender discrimination and violence simultaneously should be a priority in workplace violence

Translating continuing professional development education to nursing practice in Rwanda: Enhancing maternal and newborn health

Directory of Open Access Journals (Sweden)

Yvonne Kasine

Full Text Available Introduction: Approximately 99% of the three million neonatal deaths that occur annually are in developing countries. In Rwanda, neonatal asphyxia is the leading cause of neonatal mortality accounting for 38% of all neonatal deaths. The Helping Babies Breathe (HBB© course was initiated by the American Academy of Pediatrics (AAP in 2010 to reduce neonatal mortality in resource limited areas. Despite the provision of HBB© courses to practicing nurses in Rwanda, little is known about nurses’ experiences of applying the knowledge and skills acquired from those courses to practice. This study was conducted in 2014 in five district hospitals (Nyamata, Rwamagana, Gahini, Kiziguro, and Kibungo located in the Eastern Province of Rwanda. Purpose: Explore nurses’ experiences of translating continuing professional development (CPD education utilizing the HBB© course to nursing practice in Rwanda. Methods: Qualitative descriptive design. A purposive sample of 10 nurses participated in individual interviews. NVIVO computer software was used to manage qualitative data. Content analysis was used for generating categories from the data. Findings: Three categories emerged from the analysis: 1 application of competencies acquired from education sessions to practice, 2 benefits of CPD, and 3 facilitators and barriers to the application of competencies into practice. Qualitative interviews revealed that Nurses’ perceived confidence in performing newborn resuscitation improved after taking part in HBB© courses. Nonetheless, nurses voiced the existence of conditions in their work environment that hindered their ability to apply the acquired knowledge and skills including insufficient materials, shortages of nurses, and potential inadequate human resource allocation. Recommendations and conclusion: Regular offerings of newborn resuscitation CPD courses to health professionals in developing countries could increase their knowledge and skills, which could

Schistosomiasis and soil-transmitted helminthiasis in Rwanda: an update on their epidemiology and control.

Science.gov (United States)

Rujeni, Nadine; Morona, Domenica; Ruberanziza, Eugene; Mazigo, Humphrey D

2017-03-01

Even though Rwanda lies within a region that has a high prevalence of schistosomiasis and soil-transmitted helminth (STH) infections, epidemiological information regarding these infections in the country remains scarce. The present review attempts to compile the available data on schistosomiasis and STHs, from 1940 to 2014, to provide an insight on the epidemiological profile of these infections. This information will, in turn, support the design and implementation of sustainable control measures. The available records indicate that only Schistosoma mansoni and all the major species of STHs are endemic in Rwanda. In 2008, the national prevalence of S. mansoni was reported to be 2.7%, ranging from 0 to 69.5%, and that of STH infections was 65.8% (diagnosed using the Kato-Katz technique). The prevalence of these infections varies from one district to another, with schoolchildren remaining a highly affected group. The main control approach is mass drug administration using albendazole and praziquantel, mostly targeting school-aged children in school environments. In 2008, adult individuals living in areas with a prevalence of S. mansoni ≥30% were also included in the mass drug administration programme. However, despite Rwanda achieving an almost 100% coverage of this programme in 2008-2010, the transmission of S. mansoni and STHs continues to take place, as illustrated by the most recent surveys. If Rwanda is to achieve sustainable control and elimination of schistosomiasis and STHs, there is a need to revise the country's control strategy and adopt an integrated control approach that involves a combination of measures.

Rwanda. Dansk støtte er en god investering

DEFF Research Database (Denmark)

Larsen, Josefine Kühnel

2012-01-01

Danmark fortsætter militær støtte til Rwanda mens andre lande fryser bistand Rwandas regering har siden 2005 bidraget betydeligt til fredsbevarende operationer. Rwanda har gennem sit styrkebidrag til fredsbevarende operationer potentialet til at spille en væsentlig regional rolle pga. landets...... militære styrke og erfaring med forsoning, konfliktløsning og genopbygning efter krigen og folkemordet i 1994. Aktuelt bidrager Rwanda med 4,577 soldater til fredsbevarende missioner i FN-regi, hvilket betyder, at Rwanda er det land i verden, der leverer det sjette største militære styrkebidrag til FN...

Automated high resolution mapping of coffee in Rwanda using an expert Bayesian network

Science.gov (United States)

Mukashema, A.; Veldkamp, A.; Vrieling, A.

2014-12-01

African highland agro-ecosystems are dominated by small-scale agricultural fields that often contain a mix of annual and perennial crops. This makes such systems difficult to map by remote sensing. We developed an expert Bayesian network model to extract the small-scale coffee fields of Rwanda from very high resolution data. The model was subsequently applied to aerial orthophotos covering more than 99% of Rwanda and on one QuickBird image for the remaining part. The method consists of a stepwise adjustment of pixel probabilities, which incorporates expert knowledge on size of coffee trees and fields, and on their location. The initial naive Bayesian network, which is a spectral-based classification, yielded a coffee map with an overall accuracy of around 50%. This confirms that standard spectral variables alone cannot accurately identify coffee fields from high resolution images. The combination of spectral and ancillary data (DEM and a forest map) allowed mapping of coffee fields and associated uncertainties with an overall accuracy of 87%. Aggregated to district units, the mapped coffee areas demonstrated a high correlation with the coffee areas reported in the detailed national coffee census of 2009 (R2 = 0.92). Unlike the census data our map provides high spatial resolution of coffee area patterns of Rwanda. The proposed method has potential for mapping other perennial small scale cropping systems in the East African Highlands and elsewhere.

Mapping Rwanda public health research (1975-2014).

Science.gov (United States)

Poreau, Brice

2014-12-01

Since the genocide occurred in 1994, Rwanda has faced up to the challenge of rebuilding. Public health is a main field to understand this rebuilding. In this paper, the aim was to map the scientific research on public health in Rwanda after the genocide and to present the links between different financing systems. We used bibliographic analyses with Web of Science of papers published during the period 1975-2014. We performed analyses on journals, most cited articles, authors, publication years, organizations, funding companies, countries, and keywords. We obtained 86 articles between 1975 and 2014. Most articles were published after 2007. The main countries of research laboratories were the United States of America, Rwanda, England and Belgium and represented the main network collaboration. The relevant keywords were: HIV, woman, child, program, rural and violence. Public health research on Rwanda appeared 14 years after the genocide. A main field was emerging: the spread of HIV with mother-child transmission, and the policies to take this subject into account in rural zones. The network of institutions developing these studies was USA-Rwanda.

Rwanda Economic Update, No. 6 : Unearthing the Subsoil

OpenAIRE

World Bank Group

2014-01-01

The Rwanda economic update reports on and synthesizes recent economic developments and places them in a medium-term and global context. It analyzes the implications of these developments and policies for the outlook of Rwanda s economy. These reports attempt to make an analytical contribution to the implementation of Rwanda s national development strategy. Each edition of the report includ...

Gender Brief on ADRA (Adventist Development and Relief Organisation) in Rwanda

DEFF Research Database (Denmark)

Madsen, Diana Højlund

The Gender Brief is based on focus groups interviews in Rwanda on the gender perspectives of ADRA-Rwanda and gives recommendations for the organisation.......The Gender Brief is based on focus groups interviews in Rwanda on the gender perspectives of ADRA-Rwanda and gives recommendations for the organisation....

Participatory assessment of potato production constraints and trait preferences in potato cultivar development in Rwanda

Directory of Open Access Journals (Sweden)

Jean Baptiste Muhinyuza

2012-09-01

Full Text Available Potato (Solanum tuberosum L. is the major food and cash crop in the highland regions of Rwanda. However, farmers are not integrated into the potato breeding process. The objectives of this research were to identify farmers’ key potato production constraints and establish preferred traits in potato cultivar development in Rwanda. A participatory rural appraisal (PRA study was conducted through structured survey involving 144 households and 22 focus groups with 258 participants in Musanze, Gicumbi and Nyamagabe districts. The structured survey used a questionnaire administered to farmers to collect information on importance of potatoes and other main crops. While focus groups discussions used matrix scoring of key production constraints and pair-wise ranking of traits. Potato is the most important food and cash crop, followed by maize, beans and wheat. The dominant potato varieties are Kirundo, Cruza, Mabondo and Victoria. The most important potato production constraints are lack of access to credit, lack of high yielding cultivars, insufficient clean seeds and late blight disease. Variety Mabondo is the most tolerant to late blight, followed by Cruza, Kirundo, Kinigi and Rutuku in all the districts. High yield, disease tolerance and high dry matter content are the most important attributes preferred by farmers. Active farmer participation in early breeding stages is critical for a successful potato breeding programme.

A review of energy in Rwanda

Energy Technology Data Exchange (ETDEWEB)

Safari, Bonfils [Department of Physics, National University of Rwanda, P.O. Box 117, Huye District, South Province (Rwanda)

2010-01-15

During the last two decades, Rwanda has experienced an energy crisis mostly due to lack of investment in the energy sector. With the growing of the population and increasing industrialization in urban areas, energy provided by existing hydro and thermal power plants has been increasingly scarce with high energy costs, and energy instability. Furthermore, as wood fuel is the most important source of energy in Rwanda, the enduring dependence on it and fossil fuel consumption as well, will continue to impact on the process of environmental degradation. Rwanda is rich with abundant renewable energy resources such as methane gas in Lake Kivu, solar, biomass, geothermal; and wind energy resource is currently being explored. Recently, the Government has given priority to the extension of its national electrical grid through development of hydro power generation projects, and to rural energy through development of alternative energy projects for rural areas where access to national grid is still difficult. This paper presents a review of existing energy resources and energy applications in Rwanda. Recent developments on renewable energy are also presented. (author)

Correlates of intimate partner violence against women during a time of rapid social transition in Rwanda: analysis of the 2005 and 2010 demographic and health surveys.

Science.gov (United States)

Thomson, Dana R; Bah, Assiatou B; Rubanzana, Wilson G; Mutesa, Leon

2015-10-28

In Rwanda, women who self-reported in household surveys ever experiencing intimate partner violence (IPV) increased from 34 % in 2005 to 56 % in 2010. This coincided with a new constitution and majority-female elected parliament in 2003, and 2008 legislation protecting against gender-based violence. The increase in self-reported IPV may reflect improved social power for women, and/or disruptions to traditional gender roles that increased actual IPV. This is a cross-sectional study of IPV in 4338 couples interviewed in the 2005 and 2010 Rwanda Demographic and Health Surveys (RDHSs). Factors associated with physical or sexual IPV in the last 12 months were modeled using manual backward stepwise logistic regression. Analyses were conducted in Stata v13 adjusting for complex survey design. Risk factors for IPV in 2005 (p Rwanda's Isange One Stop Center project, with medical, legal, and psychosocial services for domestic violence victims, is currently scaling to all 44 district hospitals, and police station gender desks reduce barriers to legal reporting of IPV. Additional support to Abunzi mediators to hear IPV cases in communities, and involvement of men in grassroots efforts to redefine masculinity in Rwanda are suggested. Additional research is needed to understand why self-reported IPV has increased in Rwanda, and to evaluate effectiveness of IPV interventions.

Rwanda - eller hvor som helst

DEFF Research Database (Denmark)

Sonne, Charlotte Kærgaard; Weis, Rikke Lise

2010-01-01

Sundhedspersonalets rolle under konflikter er ofte et springende punkt, ikke mindst fordi intellektuelle og hermed også uddannet sundhedspersonale ikke sjældent er blandt ofrene i konflikten, som vi har set det med eksemplet i Rwanda.......Sundhedspersonalets rolle under konflikter er ofte et springende punkt, ikke mindst fordi intellektuelle og hermed også uddannet sundhedspersonale ikke sjældent er blandt ofrene i konflikten, som vi har set det med eksemplet i Rwanda....

Chinese external assistance to Rwanda | Byusa | Rwanda Journal

African Journals Online (AJOL)

Using a triangulation of methods such as quantitative data, interviews with key stakeholders, and existing literature; the study shows that China – Rwanda friendship and cooperation is both a source of investment, jobs creation, and technology transfer. China's assistance has helped to address some challenges in key ...

Rwanda: a country still in post war syndrome--twelve years later.

Science.gov (United States)

Brown, Geraldine

2006-01-01

Rwanda, a small country in Central Africa is still trying to survive and rebuild itself some 12 years after the initial deadly war between two ethnic rival groups, the Hutus and the Tutsis. Since my visit in October, 1994, with a handpicked health team (two senior nursing students, an internal medicine physician, social worker, and a nurse volunteer from the District of Columbia community) on a six week mission that was a collaborative effort between Howard University and the Washington, DC based organization, Africare, Inc., very little has happened to better the lives of the citizens. The task at-hand was to assist in the promotion and repairing of a near-fatal health care delivery system, that occurred just six months after the major attack in April. Rwanda experienced a war, noted as the most brutal in the memory of the country, that killed so many people and destroyed so much of the country and its resources. Since our mission, so much has been written and new concerns have surfaced such as "Hotel Rwanda", a million dollar plus movie that truthfully tells the story of how a real-life person actually saved some 1,200 countrymen in what is carefully termed a "genocide", and the book "Left to Tell", written by a female Tutsi survivor, Immaculee Ilibagiza tells the story of how she survived the genocide and discovered that "with God all things are possible." This present article has attempted to discuss the genocide and how it relates, bringing a connection from within the inner world to the outer world through my experience of "having been there and done that" as seen by the naked human eyes.

Nationwide implementation of integrated community case management of childhood illness in Rwanda

Science.gov (United States)

Mugeni, Catherine; Levine, Adam C; Munyaneza, Richard M; Mulindahabi, Epiphanie; Cockrell, Hannah C; Glavis-Bloom, Justin; Nutt, Cameron T; Wagner, Claire M; Gaju, Erick; Rukundo, Alphonse; Habimana, Jean Pierre; Karema, Corine; Ngabo, Fidele; Binagwaho, Agnes

2014-01-01

ABSTRACT Background: Between 2008 and 2011, Rwanda introduced integrated community case management (iCCM) of childhood illness nationwide. Community health workers in each of Rwanda's nearly 15,000 villages were trained in iCCM and equipped for empirical diagnosis and treatment of pneumonia, diarrhea, and malaria; for malnutrition surveillance; and for comprehensive reporting and referral services. Methods: We used data from the Rwanda health management information system (HMIS) to calculate monthly all-cause under-5 mortality rates, health facility use rates, and community-based treatment rates for childhood illness in each district. We then compared a 3-month baseline period prior to iCCM implementation with a seasonally matched comparison period 1 year after iCCM implementation. Finally, we compared the actual changes in all-cause child mortality and health facility use over this time period with the changes that would have been expected based on baseline trends in Rwanda. Results: The number of children receiving community-based treatment for diarrhea and pneumonia increased significantly in the 1-year period after iCCM implementation, from 0.83 cases/1,000 child-months to 3.80 cases/1,000 child-months (P = .01) and 0.25 cases/1,000 child-months to 5.28 cases/1,000 child-months (P<.001), respectively. On average, total under-5 mortality rates declined significantly by 38% (P<.001), and health facility use declined significantly by 15% (P = .006). These decreases were significantly greater than would have been expected based on baseline trends. Conclusions: This is the first study to demonstrate decreases in both child mortality and health facility use after implementing iCCM of childhood illness at a national level. While our study design does not allow for direct attribution of these changes to implementation of iCCM, these results are in line with those of prior studies conducted at the sub-national level in other low-income countries. PMID:25276592

Current status of cattle production system in Nyagatare District-Rwanda.

Science.gov (United States)

Mazimpaka, Eugene; Mbuza, Francis; Michael, Tukei; Gatari, Eugene N; Bukenya, E M; James, Okwee-Acai

2017-12-01

A study was conducted to characterize the cattle production systems in Nyagatare District, Eastern Province of Rwanda using pre-tested questionnaires, interviews with key informants as well as focus group discussions in a period of 2 months. The respondents were selected by multi-stage sampling at sector and cell levels. Based on the procedure of Krejcie and Morgan (Educational and Psychological Measurement 30:607-610, 1970) to determine the overall sample size, the result indicated that the majority (98.3%) of farms were privately owned by large families of five to seven members, and most farmers (53.9%) had only primary education. Most respondents (52.6%) were in the age bracket of 41-50 years and were mainly (48.3%) located within 3 km from trading centers. The farm size averaged 6.5 ± 0.8 ha and most farms (64.7%) were fenced except in Rukomo Sector (50%) where zero grazing prevailed. Natural pastures (savanna grass land) were the main feed resource; tethering (9%) and communal grazing had diminished. Napier grass was the main planted forage (93.2%), followed by Chloris guyana (3.1%) and Brachiara (1.2%). Leguminous forages were rarely (2.5%) reported. Vita-mineral and salt block supplements, hay, and crop residues were the predominant supplementary feed stuffs used except in Karangazi and Rwemiyaga Sectors where only vita-mineral block predominated. However, maize and rice brans were reported to be the main feed stuffs used in supplementary feeding of lactating cows. Most farmers (89.7%) reported shortage of water as most of the farmers trekked their cattle to the nearest valley dams (59.2%), rivers (21.1%), and a few 6% had water on farms. Indigenous cattle were predominant (67.03%) followed by cross-breeds (28.37%) and exotics (4.6%) while all farmers kept small ruminants. Natural breeding predominated (74.9%) and most farms (60.6%) had animal houses most of which were temporary (52.8%). The reported mean age at first calving (AFC) was highest (40.2�

Rwanda Economic Update, May 2013 : Maintaining Momentum with a Special Focus on Rwanda's Pathway Out of Poverty

OpenAIRE

World Bank

2013-01-01

The Rwanda economic update reports and synthesizes recent economic developments and places them in a medium term and global context. It analyzes the implications of these developments and policies for the outlook of Rwanda's economy. In this way, these reports contribute to the implementation of the Bank's Africa strategy. The economic update reports cover in each edition a special feature...

Measles seroprevalence, outbreaks, and vaccine coverage in Rwanda.

Science.gov (United States)

Seruyange, Eric; Gahutu, Jean-Bosco; Mambo Muvunyi, Claude; Uwimana, Zena G; Gatera, Maurice; Twagirumugabe, Theogene; Katare, Swaibu; Karenzi, Ben; Bergström, Tomas

2016-01-01

Measles outbreaks are reported after insufficient vaccine coverage, especially in countries recovering from natural disaster or conflict. We compared seroprevalence to measles in blood donors in Rwanda and Sweden and explored distribution of active cases of measles and vaccine coverage in Rwanda. 516 Rwandan and 215 Swedish blood donors were assayed for measles-specific immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA). Data on vaccine coverage and acute cases in Rwanda from 1980 to 2014 were collected, and IgM on serum samples and polymerase chain reaction (PCR) on nasopharyngeal (NPH) swabs from suspected measles cases during 2010-2011 were analysed. The seroprevalence of measles IgG was significantly higher in Swedish blood donors (92.6%; 95% CI: 89.1-96.1%) compared to Rwandan subjects (71.5%; 95% CI: 67.6-75.4%) and more pronounced Rwanda, with the exception of an outbreak in 1995 following the 1994 genocide. 76/544 serum samples were IgM positive and 21/31 NPH swabs were PCR positive for measles, determined by sequencing to be of genotype B3. Measles seroprevalence was lower in Rwandan blood donors compared to Swedish subjects. Despite this, the number of reported measles cases in Rwanda rapidly decreased during the study period, concomitant with increased vaccine coverage. Taken together, the circulation of measles was limited in Rwanda and vaccine coverage was favourable, but seroprevalence and IgG levels were low especially in younger age groups.

Prevalence and risk factors for cervical cancer and pre-cancerous lesions in Rwanda.

Science.gov (United States)

Makuza, Jean Damascène; Nsanzimana, Sabin; Muhimpundu, Marie Aimee; Pace, Lydia Eleanor; Ntaganira, Joseph; Riedel, David James

2015-01-01

Cervical cancer prevalence in Rwanda has not been well-described. Visual inspection with acetic acid or Lugol solution has been shown to be effective for cervical cancer screening in low resource settings. The aim of the study is to understand the prevalence and risk factors for cervical cancer and pre- cancerous lesions among Rwandan women between 30 and 50 old undergoing screening. This cross-sectional analytical study was done in 3 districts of Rwanda from October 2010 to June 2013. Women aged 30 to 50 years screened for cervical cancer by trained doctors, nurses and midwives. Prevalence of pre-cancerous and cancerous cervical lesions was determined. Bivariate and multivariate logistic regressions were used to assess risk factors associated with cervical cancer. The prevalence of pre-cancer and invasive cervical cancer was 5.9% (95% CI 4.5, 7.5) and 1.7% (95% CI 0.9, 2.5), respectively. Risk factors associated with cervical cancer in multivariate analysis included initiation of sexual activity at less than 20 years (OR=1.75; 95% CI=(1.01, 3.03); being unmarried (single, divorced and widowed) (OR=3.29; 95% CI=( 1.26, 8.60)); Older age of participants (OR= 0.52; 95% CI= (0.28, 0.97)), older age at the first pregnancy (OR=2.10; 95% CI=(1.20, 3.67) and higher number of children born (OR=0.42; 95%CI =(0.23, 0.76)) were protective. Cervical cancer continues to be a public health problem in Rwanda, but screening using VIA is practical and feasible even in rural settings.

Socioeconomics and Major Disabilities: Characteristics of Working-Age Adults in Rwanda.

Directory of Open Access Journals (Sweden)

Joshua Kiregu

Full Text Available Disability affects approximately 15% of the world's population, and has adverse socio-economic effects, especially for the poor. In Rwanda, there are a number of government compensation programs that support the poor, but not specifically persons with disability (PWDs. This study investigates the relationship between poverty and government compensation on disability among working-age adults in Rwanda.This was a secondary analysis of 35,114 adults aged 16 to 65 interviewed in the 2010/2011 Rwanda Household Wealth and Living Conditions survey, a national cross-sectional two-stage cluster survey, stratified by district. This study estimated self-reported major disability, and used chi-square tests to estimate associations (p<0.1 with income, government compensation, occupation type, participation in public works programs, and household poverty status. Non-collinear economic variables were included in a multivariate logistic regression, along with socio-demographic confounders that modified the relationship between any economic predictor and the outcome by 10% or more. All analyses adjusted for sampling weights, stratification, and clustering of households.Over 4% of working-age adults reported having a major disability and the most prevalent types of disability in order were physical, mental, and then sensory disability. In bivariate analysis, annual income, occupation type, and poverty status were associated with major disability (p<0.001 for all. Occupation type was dropped because it was collinear with income. Age, education, and urban/rural residence were confounders. In the multivariate analysis, adults in all income groups had about half the odds of disability compared to adults with no income (Rwf1-120,000 OR = 0.57; Rwf120,000-250,000 OR = 0.61; Rwf250,000-1,000,000 OR = 0.59; Rwf1,000,000+ OR = 0.66; p<0.05 for all, and non-poor adults had 0.77 the odds of disability compared to poor adults (p = 0.001.Given that personal income rather than

Asymptomatic only at first sight: malaria infection among schoolchildren in highland Rwanda.

Science.gov (United States)

Sifft, Kevin C; Geus, Dominik; Mukampunga, Caritas; Mugisha, Jean Claude; Habarugira, Felix; Fraundorfer, Kira; Bayingana, Claude; Ndoli, Jules; Umulisa, Irenee; Karema, Corine; von Samson-Himmelstjerna, George; Aebischer, Toni; Martus, Peter; Sendegeya, Augustin; Gahutu, Jean Bosco; Mockenhaupt, Frank P

2016-11-14

Plasmodium infection and malaria in school children are increasingly recognized as a relevant public health problem, but data on actual prevalence and health consequences are insufficient. The present study from highland southern Rwanda aimed at estimating infection prevalence among children attending school, at identifying associated factors and at assessing the clinical consequences of these infections. In a survey including 12 schools in the Huye district of Rwanda, 1089 children aged 6-10 years were clinically and anthropometrically examined, malaria parasites were diagnosed by microscopy and PCR, haemoglobin concentrations were measured, and socio-economic and behavioural parameters as well as medical histories were obtained. Upon examination, the vast majority of children was asymptomatic (fever 2.7%). Plasmodium infection was detected in 22.4% (Plasmodium falciparum, 18.8%); 41% of these were submicroscopic. Independent predictors of infection included low altitude, higher age, preceding antimalarial treatment, and absence of electricity or a bicycle in the household. Plasmodium infection was associated with anaemia (mean haemoglobin difference of -1.2 g/dL; 95% CI, -0.8 to -1.5 g/dL), fever, underweight, clinically assessed malnutrition and histories of fever, tiredness, weakness, poor appetite, abdominal pain, and vomiting. With the exception of underweight, these conditions were also increased at submicroscopic infection. Malaria infection is frequent among children attending school in southern highland Rwanda. Although seemingly asymptomatic in the vast majority of cases, infection is associated with a number of non-specific symptoms in the children´s histories, in addition to the impact on anaemia. This argues for improved malaria surveillance and control activities among school children.

Structured Spatial Modeling and Mapping of Domestic Violence Against Women of Reproductive Age in Rwanda.

Science.gov (United States)

Habyarimana, Faustin; Zewotir, Temesgen; Ramroop, Shaun

2018-03-01

The main objective of this study was to assess the risk factors and spatial correlates of domestic violence against women of reproductive age in Rwanda. A structured spatial approach was used to account for the nonlinear nature of some covariates and the spatial variability on domestic violence. The nonlinear effect was modeled through second-order random walk, and the structured spatial effect was modeled through Gaussian Markov Random Fields specified as an intrinsic conditional autoregressive model. The data from the Rwanda Demographic and Health Survey 2014/2015 were used as an application. The findings of this study revealed that the risk factors of domestic violence against women are the wealth quintile of the household, the size of the household, the husband or partner's age, the husband or partner's level of education, ownership of the house, polygamy, the alcohol consumption status of the husband or partner, the woman's perception of wife-beating attitude, and the use of contraceptive methods. The study also highlighted the significant spatial variation of domestic violence against women at district level.

Plausible role for CHW peer support groups in increasing care-seeking in an integrated community case management project in Rwanda: a mixed methods evaluation

Science.gov (United States)

Langston, Anne; Weiss, Jennifer; Landegger, Justine; Pullum, Thomas; Morrow, Melanie; Kabadege, Melene; Mugeni, Catherine; Sarriot, Eric

2014-01-01

ABSTRACT Background: The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. Methods: The 2005 and 2010 Demographic and Health Surveys were re-analyzed to evaluate how project and non-project districts differed in terms of care-seeking for fever, diarrhea, and acute respiratory infection symptoms and related indicators. We developed a logit regression model, controlling for the timing of the first CHW training, with the district included as a fixed categorical effect. We also analyzed qualitative data from the final evaluation to examine factors that may have contributed to improved outcomes. Results: While there was notable improvement in care-seeking across all districts, care-seeking from any provider for each of the 3 conditions, and for all 3 combined, increased significantly more in the project districts. CHWs contributed a larger percentage of consultations in project districts (27%) than in non-project districts (12%). Qualitative data suggested that the PSG model was a valuable sub-level of CHW organization associated with improved CHW performance, supervision, and social capital. Conclusions: The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of i

Rwanda Health and Education Information Network (OASIS-RHEIN ...

International Development Research Centre (IDRC) Digital Library (Canada)

Rwanda Health and Education Information Network (OASIS-RHEIN). Partners in Health (PIH), an international nongovernmental organization, has demonstrated the effectiveness of its open source electronic medical record system (OpenMRS) in eight clinics in Rwanda. As a result, the Ministry of Health has decided to roll ...

Expanding Integrated Pest Management Capacity: Rwanda Case Study

Science.gov (United States)

Baributsa, Dieudonne; Flores, Luis; Rukazambuga, Daniel; Wise, John C.

2014-01-01

Purpose: Rwanda is developing its agricultural capacity to meet the needs of national food security while addressing food demands and requirements of regional and international markets. The Rwanda Horticultural Export Standards Initiative was developed by the Ministry of Agriculture and Natural Resources in collaboration with Michigan State…

Prevalence and risk factors of malaria among children in southern highland Rwanda

Directory of Open Access Journals (Sweden)

Karema Corine

2011-05-01

Full Text Available Abstract Background Increased control has produced remarkable reductions of malaria in some parts of sub-Saharan Africa, including Rwanda. In the southern highlands, near the district capital of Butare (altitude, 1,768 m, a combined community-and facility-based survey on Plasmodium infection was conducted early in 2010. Methods A total of 749 children below five years of age were examined including 545 randomly selected from 24 villages, 103 attending the health centre in charge, and 101 at the referral district hospital. Clinical, parasitological, haematological, and socio-economic data were collected. Results Plasmodium falciparum infection (mean multiplicity, 2.08 was identified by microscopy and PCR in 11.7% and 16.7%, respectively; 5.5% of the children had malaria. PCR-based P. falciparum prevalence ranged between 0 and 38.5% in the villages, and was 21.4% in the health centre, and 14.9% in the hospital. Independent predictors of infection included increasing age, low mid-upper arm circumference, absence of several household assets, reported recent intake of artemether-lumefantrine, and chloroquine in plasma, measured by ELISA. Self-reported bed net use (58% reduced infection only in univariate analysis. In the communities, most infections were seemingly asymptomatic but anaemia was observed in 82% and 28% of children with and without parasitaemia, respectively, the effect increasing with parasite density, and significant also for submicroscopic infections. Conclusions Plasmodium falciparum infection in the highlands surrounding Butare, Rwanda, is seen in one out of six children under five years of age. The abundance of seemingly asymptomatic infections in the community forms a reservoir for transmission in this epidemic-prone area. Risk factors suggestive of low socio-economic status and insufficient effectiveness of self-reported bed net use refer to areas of improvable intervention.

Prevalence and risk factors of malaria among children in southern highland Rwanda.

Science.gov (United States)

Gahutu, Jean-Bosco; Steininger, Christian; Shyirambere, Cyprien; Zeile, Irene; Cwinya-Ay, Neniling; Danquah, Ina; Larsen, Christoph H; Eggelte, Teunis A; Uwimana, Aline; Karema, Corine; Musemakweri, Andre; Harms, Gundel; Mockenhaupt, Frank P

2011-05-18

Increased control has produced remarkable reductions of malaria in some parts of sub-Saharan Africa, including Rwanda. In the southern highlands, near the district capital of Butare (altitude, 1,768 m), a combined community-and facility-based survey on Plasmodium infection was conducted early in 2010. A total of 749 children below five years of age were examined including 545 randomly selected from 24 villages, 103 attending the health centre in charge, and 101 at the referral district hospital. Clinical, parasitological, haematological, and socio-economic data were collected. Plasmodium falciparum infection (mean multiplicity, 2.08) was identified by microscopy and PCR in 11.7% and 16.7%, respectively; 5.5% of the children had malaria. PCR-based P. falciparum prevalence ranged between 0 and 38.5% in the villages, and was 21.4% in the health centre, and 14.9% in the hospital. Independent predictors of infection included increasing age, low mid-upper arm circumference, absence of several household assets, reported recent intake of artemether-lumefantrine, and chloroquine in plasma, measured by ELISA. Self-reported bed net use (58%) reduced infection only in univariate analysis. In the communities, most infections were seemingly asymptomatic but anaemia was observed in 82% and 28% of children with and without parasitaemia, respectively, the effect increasing with parasite density, and significant also for submicroscopic infections. Plasmodium falciparum infection in the highlands surrounding Butare, Rwanda, is seen in one out of six children under five years of age. The abundance of seemingly asymptomatic infections in the community forms a reservoir for transmission in this epidemic-prone area. Risk factors suggestive of low socio-economic status and insufficient effectiveness of self-reported bed net use refer to areas of improvable intervention.

Prevalence of Hepatitis C Virus Infection and Its Risk Factors among Patients Attending Rwanda Military Hospital, Rwanda.

Science.gov (United States)

Umumararungu, Esperance; Ntaganda, Fabien; Kagira, John; Maina, Naomi

2017-01-01

In Rwanda, the prevalence of viral hepatitis (HCV) is poorly understood. The current study investigated the prevalence and risk factors of HCV infection in Rwanda. A total of 324 patients attending Rwanda Military Hospital were randomly selected and a questionnaire was administered to determine the risk factors. Blood was collected and screened for anti-HCV antibodies and seropositive samples were subjected to polymerase chain reaction method. Hematology abnormalities in the HCV infected patients were also investigated. Anti-HCV antibody and active HCV infection were found in 16.0% and 9.6% of total participants, respectively. Prevalence was highest (28.4%; 19/67) among participants above 55 years and least (2.4%; 3/123) among younger participants (18-35 years). There was a significant ( P = 0.031) relationship between place of residence and HCV infection with residents of Southern Province having significantly higher prevalence. The hematological abnormalities observed in the HCV infected patients included leukopenia (48.4%; 15/52), neutropenia (6.5%; 2/52), and thrombocytopenia (25.8%; 8/52). The HCV infection was significantly higher in the older population (>55 years) and exposure to injection from traditional practitioners was identified as a significant ( P = 0.036) risk factor of infection. Further studies to determine the factors causing the high prevalence of HCV in Rwanda are recommended.

Rwanda Mission System PRPMS

Data.gov (United States)

US Agency for International Development — The purpose of the MEMS Project is to assist the USG Rwanda Team to develop and implement a comprehensive performance management, monitoring, and reporting program....

IDRC in Rwanda

International Development Research Centre (IDRC) Digital Library (Canada)

to track individual patients' medical infor- mation and help improve healthcare delivery. The research team also trains local program- mers to ensure Rwanda's ... an inventory of policies that work best in promoting democracy, reducing poverty, and increasing governments' ability to ensure security and provide health care.

Rebuilding Rwanda: From Genocide to Prosperity through Education

Science.gov (United States)

Bridgeland, John; Wulsin, Stu; McNaught, Mary

2009-01-01

Rwanda is on the verge of a breakthrough. Having weathered one of the worst humanitarian crises imaginable just fifteen years ago, and with an impoverished countryside plagued by HIV/AIDS, hunger, and malaria, Rwanda seems an unlikely place for an economic renaissance. Yet the nation's commitment to good government and support for free market…

Landslide Hazard Mapping in Rwanda Using Logistic Regression

Science.gov (United States)

Piller, A.; Anderson, E.; Ballard, H.

2015-12-01

Landslides in the United States cause more than $1 billion in damages and 50 deaths per year (USGS 2014). Globally, figures are much more grave, yet monitoring, mapping and forecasting of these hazards are less than adequate. Seventy-five percent of the population of Rwanda earns a living from farming, mostly subsistence. Loss of farmland, housing, or life, to landslides is a very real hazard. Landslides in Rwanda have an impact at the economic, social, and environmental level. In a developing nation that faces challenges in tracking, cataloging, and predicting the numerous landslides that occur each year, satellite imagery and spatial analysis allow for remote study. We have focused on the development of a landslide inventory and a statistical methodology for assessing landslide hazards. Using logistic regression on approximately 30 test variables (i.e. slope, soil type, land cover, etc.) and a sample of over 200 landslides, we determine which variables are statistically most relevant to landslide occurrence in Rwanda. A preliminary predictive hazard map for Rwanda has been produced, using the variables selected from the logistic regression analysis.

Language Policy, Multilingual Education, and Power in Rwanda

Science.gov (United States)

Samuelson, Beth Lewis; Freedman, Sarah Warshauer

2010-01-01

The evolution of Rwanda's language policies since 1996 has played and continues to play a critical role in social reconstruction following war and genocide. Rwanda's new English language policy aims to drop French and install English as the only language of instruction. The policy-makers frame the change as a major factor in the success of social…

Traditional justice in the reconciliation between Rwanda and Burundi

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Antoni Castel

2009-10-01

Full Text Available This article reviews the use of traditional justice in two post-conflicts in the Great Lakes region: those of Rwanda and Burundi. In Rwanda, the government, led by the Rwanda Patriotic Front (FPR, has modernised and shaped for its own interests the gacaca, who are responsible for seeking justice for the victims of the 1994 genocide. In Burundi, the government has yet not deployed all the transitional justice mechanisms as envisaged in the Arusha agreement. The bushingantahe (the rehabilitation of whom is also envisaged in the agreement have not yet been incorporated into transitional justice.

Enabling Access to Medical and Health Education in Rwanda Using Mobile Technology: Needs Assessment for the Development of Mobile Medical Educator Apps.

Science.gov (United States)

Rusatira, Jean Christophe; Tomaszewski, Brian; Dusabejambo, Vincent; Ndayiragije, Vincent; Gonsalves, Snedden; Sawant, Aishwarya; Mumararungu, Angeline; Gasana, George; Amendezo, Etienne; Haake, Anne; Mutesa, Leon

2016-06-01

Lack of access to health and medical education resources for doctors in the developing world is a serious global health problem. In Rwanda, with a population of 11 million, there is only one medical school, hence a shortage in well-trained medical staff. The growth of interactive health technologies has played a role in the improvement of health care in developed countries and has offered alternative ways to offer continuous medical education while improving patient's care. However, low and middle-income countries (LMIC) like Rwanda have struggled to implement medical education technologies adapted to local settings in medical practice and continuing education. Developing a user-centered mobile computing approach for medical and health education programs has potential to bring continuous medical education to doctors in rural and urban areas of Rwanda and influence patient care outcomes. The aim of this study is to determine user requirements, currently available resources, and perspectives for potential medical education technologies in Rwanda. Information baseline and needs assessments data collection were conducted in all 44 district hospitals (DHs) throughout Rwanda. The research team collected qualitative data through interviews with 16 general practitioners working across Rwanda and 97 self-administered online questionnaires for rural areas. Data were collected and analyzed to address two key questions: (1) what are the currently available tools for the use of mobile-based technology for medical education in Rwanda, and (2) what are user's requirements for the creation of a mobile medical education technology in Rwanda? General practitioners from different hospitals highlighted that none of the available technologies avail local resources such as the Ministry of Health (MOH) clinical treatment guidelines. Considering the number of patients that doctors see in Rwanda, an average of 32 patients per day, there is need for a locally adapted mobile education app

Rwanda; Poverty Reduction Strategy Paper: Progress Report

OpenAIRE

International Monetary Fund

2011-01-01

Rwanda’s Economic Development and Poverty Reduction Strategy (EDPRS) covers the period 2008–12 and provides a medium-term framework for achieving the country’s long-term development aspirations as embodied in Rwanda Vision 2020, the seven-year Government of Rwanda (GoR) program, and the Millennium Development Goals. The economic cluster covers the macroeconomic and financial sector (energy, transport, information and communication technology (ICT) and Science, Technology and Innovation (STI),...

An interoperability architecture for the health information exchange in Rwanda

CSIR Research Space (South Africa)

Crichton, R

2012-08-01

Full Text Available Zulu-Natal and Council for Scientific and Industrial Research, Durban, South Africa 2 Jembi Health Systems, Cape Town and Durban, South Africa, 3 Medical Research Council, Cape Town, South Africa Abstract. Rwanda, one of the smallest and most densely populated... and the national rollout of an electronic medical record application[15]. The Rwanda Health Enterprise Architecture (RHEA) project, led by the Rwanda MoH and supported by a consortium of partners and donors has developed an architecture to contribute...

YOUTH EMPLOYMENTin Rwanda

International Development Research Centre (IDRC) Digital Library (Canada)

For more information, please refer to Laterite Ltd. (2015) Youth employment in Rwanda: A scoping paper, commissioned by IDRC and the MasterCard Foundation. 13.5% of Rwandans with a university degree are unemployed– 7 times the national unemployment rate. Among the economically inactive, more than 1 in 5 ...

Guidelines for biomass energy policy implementation in Rwanda

International Nuclear Information System (INIS)

Hategeka, A.; Karenzi, P.C.

1997-01-01

This chapter reports on the energy scene in Rwanda, and discusses the evolution of the energy development concept in the framework of national development policy, biomass and other energy sources, biomass supply and demand, and commercialised wood and biomass consumption. Prospects to stabilise the biomass cycle are examined, and the implementation of biomass energy policy in Rwanda is considered. (UK)

Iron beans in Rwanda: crop development and delivery experience ...

African Journals Online (AJOL)

HarvestPlus and its partners have successfully developed and delivered iron bean varieties to more than one million farming households in Rwanda, DRC, and Uganda to help combat the adverse health effects of iron deficiency widespread in these countries. Focusing primarily on Rwanda, this chapter summarizes the ...

Youth employment in Rwanda

International Development Research Centre (IDRC) Digital Library (Canada)

the Ministry of Public Service and Labour, the Ministry of. Education, the ... on the provision of vocational training through the Government of Rwanda's Tech- ... entrants to the labour market and provide higher quality jobs to those currently ...

Rwanda Journal ISSN 2305-2678 (Print); ISSN 2305- 5944 (Online ...

African Journals Online (AJOL)

Education

Rwanda Journal, Series B: Social Sciences, Volume 4 No 1, 2017 33. Rwanda Journal .... The print media, the political parties manifestos, the official reports ..... and of psychological alienation from taboos by which it was surrounded by the ...

Community-Level Responses to Disability and Education in Rwanda

Science.gov (United States)

Karangwa, Evariste; Miles, Susie; Lewis, Ingrid

2010-01-01

This article explores the meaning of community and perceptions of disability in Rwanda, as revealed through a community-based ethnographic study. This study took place in Rwanda in an educational policy context driven by international rhetoric about human rights, inclusion and the arguably unachievable Education for All targets. We argue that the…

Effect Of Biofortified Beans Adoption On Socio-Economic Welfare Of Farmers In Eastern Rwanda

Directory of Open Access Journals (Sweden)

Nsengiyumva

2017-10-01

Full Text Available Common bean has emerged to be an important staple food as well as cash crop for the majority of farmers in Rwanda. Productivity is a function of the usage of improved inputs like seeds fertilizers combined with farm management practices. Although biofertified beans have been introduced as improved varieties their adoption is disappointing. This study was initiated with the objective to assess the effect of adoption of biofortified beans on social economic welfare of farmers in Nyagatare district Eastern province of Rwanda. Stratified survey was used with 197 households heads selected by multi stage random sampling and cluster sampling. Qualitative and quantitative methods were then used for data collection. Propensity Score Match was performed to determine the effect of adoption on bean yield and income between adopters and non-adopters groups. The results showed that in four agriculture seasons considered 2016 A 2015 B 2015 A and 2014 B Average Total Effect ATE between the yield of adopters and non-adopters were 334.0625 499.3531 185.4956 and 241.575 respectively and were significantly different p 0.05. Application of propensity score matching on income between two groups of farmers overlapped due to backyard farmers. Biofertified beans proved potential for high production and income than local bean varieties.

The International Criminal Tribunal for Rwanda: A Distorting Mirror ...

African Journals Online (AJOL)

Angela

certainly at work in Rwanda, where an estimated one million people from a ... See Office of the Press Secretary, The White House, US Efforts to Promote Human .... Part 2 of the article provides a tour d'horizon of Rwanda's history, aimed at bringing ..... misleading and distorts the overall vision and dialectics necessary for the.

International Uranium Resources Evaluation Project (IUREP) orientation phase mission summary report: Rwanda

International Nuclear Information System (INIS)

1985-01-01

A report has recently been published which describes the findings of the International Uranium Resources Evaluation Project (IUREP) Mission to Rwanda. The IUREP Orientation Phase Mission to Rwanda estimates that the Speculative Resources of that country fall within the range of 500 to 5 000 tonnes of uranium. The majority of this potential is expected to be located in the Precambrian Ruzizian, especially in conjunction with tectonized pegmatoidal remobilizations of metamorphic sediments of western Rwanda. Other favourable geological environments include lamprophyric dikes and post tectonic granites of central Rwanda. The Mission recommends that over a period of five years approximately US$4.2 million be spent on exploration in Rwanda. The majority of this would be spent on airborne and ground geophysical surveys ($1.5 million) and exploration drilling ($1 million). Prospecting, trenching and tunneling and analytical work would require the remainder of the $4.2 million ($1.7 million). (author)

Schistosomiasis mansoni incidence data in Rwanda can improve prevalence assessments, by providing high-resolution hotspot and risk factors identification.

Science.gov (United States)

Nyandwi, E; Veldkamp, A; Amer, S; Karema, C; Umulisa, I

2017-10-25

Schistosomiasis mansoni constitutes a significant public health problem in Rwanda. The nationwide prevalence mapping conducted in 2007-2008 revealed that prevalence per district ranges from 0 to 69.5% among school children. In response, mass drug administration campaigns were initiated. However, a few years later some additional small-scale studies revealed the existence of areas of high transmission in districts formerly classified as low endemic suggesting the need for a more accurate methodology for identification of hotspots. This study investigated if confirmed cases of schistosomiasis recorded at health facility level can be used to, next to existing prevalence data, detect geographically more accurate hotspots of the disease and its associated risk factors. A GIS-based spatial and statistical analysis was carried out. Confirmed cases, recorded at primary health facilities level, were combined with demographic data to calculate incidence rates for each of 367 health facility service area. Empirical Bayesian smoothing was used to deal with rate instability. Incidence rates were compared with prevalence data to identify their level of agreement. Spatial autocorrelation of the incidence rates was analyzed using Moran's Index, to check if spatial clustering occurs. Finally, the spatial relationship between schistosomiasis distribution and potential risk factors was assessed using multiple regression. Incidence rates for 2007-2008 were highly correlated with prevalence values (R 2  = 0.79), indicating that in the case of Rwanda incidence data can be used as a proxy for prevalence data. We observed a focal distribution of schistosomiasis with a significant spatial autocorrelation (Moran's I > 0: 0,05-0.20 and p ≤ 0,05), indicating the occurrence of hotspots. Regarding risk factors, it was identified that the spatial pattern of schistosomiasis is significantly associated with wetland conditions and rice cultivation. In Rwanda the high density of health

What Justice for Rwanda? Gacaca versus Truth Commission?

OpenAIRE

Reuchamps, Min

2008-01-01

In post-genocide Rwanda, in addition to gacaca courts, a truth commission is needed in order to promote justice and foster reconciliation. In the context of transitional justice, retributive justice, which seeks justice and focuses on the perpetrators, appears to be inadequate to lead a society towards reconciliation. Therefore, some forms of restorative justice, which emphasize the healing of the whole society, seem necessary. In Rwanda, gacaca courts and a truth commission are complementary...

Bio-economic farm modelling to analyse agricultural land productivity in Rwanda

NARCIS (Netherlands)

Bidogeza, J.C.

2011-01-01

Keywords: Rwanda; farm household typology; sustainable technology adoption; multivariate analysis;
land degradation; food security; bioeconomic model; crop simulation models; organic fertiliser; inorganic fertiliser; policy incentives

In Rwanda, land degradation contributes to the

Fertility Decline in Rwanda : Is gender preference in the way?

NARCIS (Netherlands)

Habimana Kabano, I.; Broekhuis, A.; Hooimeijer, P.

2013-01-01

In 2007 Rwanda launched a campaign to promote 3 children families and a program of community based health services to improve reproductive health. This paper argues that mixed gender offspring is still an important insurance for old age in Rwanda and that to arrive at the desired gender composition

A Spatial Analysis of Poverty in Kigali, Rwanda using indicators of ...

African Journals Online (AJOL)

A Spatial Analysis of Poverty in Kigali, Rwanda using indicators of household ... conducted by the National Institute of Statistics of Rwanda in 2000-2001. ... The third region of low poverty incident has between 4-12% of its population poor.

Rwanda Journal ISSN 2305-2678 (Print); ISSN 2305- 5944 (Online ...

African Journals Online (AJOL)

Education

Rwanda Journal, Series B: Social Sciences, Volume 4 No 1, 2017 62. Rwanda Journal ... constitution of men is different from that of women and that men are unable to ... share the same biological disposition driving sexual behaviors, then all could be ... gender roles (Brannon 1985; Brannon & Juni 1984), negative attitudes ...

A study on sustainable energy for cement industries in Rwanda

NARCIS (Netherlands)

Kumaran, G.S.; Msinjili, N.S.; Schmidt, W.; Florea, M.V.A.; Nibasumba, P.

2012-01-01

Rwanda is a landlocked country in the East Africa. It is surrounded by Uganda, Tanzania, Congo and Burundi. Rwanda is a fast developing country and it spends most of its revenues to import fossil fuels from either through Mombasa Port in Kenya or Dar es Salaam port in Tanzania because the energy

Modelling homogeneous regions of social vulnerability to malaria in Rwanda.

Science.gov (United States)

Bizimana, Jean Pierre; Kienberger, Stefan; Hagenlocher, Michael; Twarabamenye, Emmanuel

2016-03-31

Despite the decline in malaria incidence due to intense interventions, potentials for malaria transmission persist in Rwanda. To eradicate malaria in Rwanda, strategies need to expand beyond approaches that focus solely on malaria epidemiology and also consider the socioeconomic, demographic and biological/disease-related factors that determine the vulnerability of potentially exposed populations. This paper analyses current levels of social vulnerability to malaria in Rwanda by integrating a set of weighted vulnerability indicators. The paper uses regionalisation techniques as a spatially explicit approach for delineating homogeneous regions of social vulnerability to malaria. This overcomes the limitations of administrative boundaries for modelling the trans-boundary social vulnerability to malaria. The utilised approach revealed high levels of social vulnerability to malaria in the highland areas of Rwanda, as well as in remote areas where populations are more susceptible. Susceptibility may be due to the populations' lacking the capacity to anticipate mosquito bites, or lacking resilience to cope with or recover from malaria infection. By highlighting the most influential indicators of social vulnerability to malaria, the applied approach indicates which vulnerability domains need to be addressed, and where appropriate interventions are most required. Interventions to improve the socioeconomic development in highly vulnerable areas could prove highly effective, and provide sustainable outcomes against malaria in Rwanda. This would ultimately increase the resilience of the population and their capacity to better anticipate, cope with, and recover from possible infection.

Governmental Accounting in Rwanda : a case study with focus on the financial statements

OpenAIRE

Mwanaidi, Mari Claire

2011-01-01

The purpose of this thesis is to analyse the consolidated financial statements of the government of Rwanda for the year ended 31 December 2008. Two types of accounting are discussed namely, money accounts and accrual (profit) accounts. The aim is to discuss which accounting model is used to prepare the financial statements of Rwanda. We found out that, the accrual accounts (fund accounting) are used in Rwanda to report the money effects of revenues and expenditures. Accordingly, we introduce ...

Rwanda Journal of Health Sciences

African Journals Online (AJOL)

The Rwanda Journal of Health Sciences, a publication of Kigali Health Institute, publishes original research, short communications, and review articles on current topics of special interest and relevance in various health related fields including public health, allied health sciences, nursing, environmental health, nutrition, ...

Prevalence of HIV among people with physical disabilities in Rwanda.

Science.gov (United States)

Munymana, J B; M'kumbuzi, V R P; Mapira, H T; Nzabanterura, I; Uwamariyai, I; Shema, E

2014-01-01

To determine the prevalence of HIV among persons with physical disabilities in Rwanda. Across-sectional HIV diagnostic study. A national referral rehabilitation centre in Rwanda. Persons aged 5 to 49 years with lower or upper limb impairments that were obtaining rehabilitation services at the centre. Blood samples were collected from the subjects who voluntarily accepted to participate in the study. Blood samples (4mls) were collected in vacutainer tubes and centrifuged to obtain serum which was analyzed using standard HIV rapid tests-determine HIV-1/2 Ab/Ag, SD-Bioline and UNI-Gold Recombigen HIV as a tie-breaker. The HIV status of participants--negative or positive. Descriptive statistics were computed to characterize the sample and proportions for the HIV test results. All one hundred and fifty-seven subjects, 59 (37.6%) male and 98 (62.4%) female, completed the study. The HIV prevalence obtained was 5.73%. All participants that tested positive were female and all tested positive for HIV-1. The prevalence obtained was higher than the population prevalence of 3.0% reported for Rwanda. Targeted HIV prevention is required for PWDs in Rwanda, with at least as much rigor as programs targeted towards the general population. Further, this should address the wide range of gender inequalities that make women particularly vulnerable to HIV. Further research needs to be conducted on a larger sample that draws participants from non-institutional settings and from other disability categories; as well as to study more specifically, the risk factors for HIV infection among PWDs in Rwanda.

tations at Rwanda Military Hospital (RMH)

African Journals Online (AJOL)

tary Hospital. ... in collaboration with clinical faculty, were present at all times. ... Based on the approval of both students and clinical instructors, we have ... structured learning environment during clinical rotations at Rwanda Military Hospital.

Rwanda Journal of Health Sciences: Submissions

African Journals Online (AJOL)

Rwanda Journal of Health Sciences: Submissions ... in various health related fields including public health, allied health sciences, nursing ... Following the abstract, about 3 to 10 key words that will provide indexing references should be listed.

Gender-sensitive Value Chain Intervention Improved Profit Efficiency among Orange-fleshed Sweetpotato Producers in Rwanda

Directory of Open Access Journals (Sweden)

Bocher Temesgen

2017-02-01

Full Text Available The Rwanda Super Foods project sought to develop a value chain for processed orange-fleshed sweetpotato products to respond to farmer concerns over lack of markets. This study used data collected from five districts in rural Rwanda under supper food project between August and September 2014. The study applied a stochastic profit frontier model to data collected from 846 households growing sweetpotato, among which 327 were value chain participants; 312 were “spillover” households that received planting material from participant households, and the remainder control households with no project links. Results showed that average level of profit efficiency in sweetpotato production systems is 55%; suggesting that an estimated 45% of profit is lost due to the combined effect of technical, allocative and scale inefficiency. The profit efficiency of participant households was 64% compared to 20% of the control households. Moreover, the profit efficiency of the female beneficiary, female spillover, and male beneficiary households was found to be 55%, 70%, and 90% against 17% for male control households, respectively. Findings suggest that an orange-fleshed sweetpotato based value chain intervention can enhance the profit efficiency of the poor and disadvantageous households, if designed with special attention to women’s needs. Thus, polices and programs aiming at improving the livelihood of smallholder should be designed targeting women and resource poor.

Universal health coverage in Rwanda: dream or reality.

Science.gov (United States)

Nyandekwe, Médard; Nzayirambaho, Manassé; Baptiste Kakoma, Jean

2014-01-01

Universal Health Coverage (UHC) has been a global concern for a long time and even more nowadays. While a number of publications are almost unanimous that Rwanda is not far from UHC, very few have focused on its financial sustainability and on its extreme external financial dependency. The objectives of this study are: (i) To assess Rwanda UHC based mainly on Community-Based Health Insurance (CBHI) from 2000 to 2012; (ii) to inform policy makers about observed gaps for a better way forward. A retrospective (2000-2012) SWOT analysis was applied to six metrics as key indicators of UHC achievement related to WHO definition, i.e. (i) health insurance and access to care, (ii) equity, (iii) package of services, (iv) rights-based approach, (v) quality of health care, (vi) financial-risk protection, and (vii) CBHI self-financing capacity (SFC) was added by the authors. The first metric with 96,15% of overall health insurance coverage and 1.07 visit per capita per year versus 1 visit recommended by WHO, the second with 24,8% indigent people subsidized versus 24,1% living in extreme poverty, the third, the fourth, and the fifth metrics excellently performing, the sixth with 10.80% versus ≤40% as limit acceptable of catastrophic health spending level and lastly the CBHI SFC i.e. proper cost recovery estimated at 82.55% in 2011/2012, Rwanda UHC achievements are objectively convincing. Rwanda UHC is not a dream but a reality if we consider all convincing results issued of the seven metrics.

Genocide, Nuptiality, and Fertility in Rwanda and Bosnia-Herzegovina

OpenAIRE

Staveteig, Sarah Elizabeth

2011-01-01

How does exposure to genocide affect nuptiality and fertility among the surviving population? Genocides in Rwanda and in Bosnia-Herzegovina in the early 1990s caused high levels of population displacement, trauma, and death, along with a dramatic decline in the standard of living. In Rwanda, genocide also reduced the sex ratio of the marriage-aged population, while in Bosnia, despite the high proportion of male casualties, the overall sex ratio of the marriage-age population did not decline s...

Maternal death audit in Rwanda 2009-2013: a nationwide facility-based retrospective cohort study.

Science.gov (United States)

Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

2016-01-22

Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Nationwide facility-based retrospective cohort study. All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. 987 audited cases of maternal death. Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other strategies, in particular confidential enquiries and near-miss audits, so as to

An investigation of construction accidents in Rwanda: Perspectives from Kigali

OpenAIRE

Cokeham, M; Tutesigensi, A

2013-01-01

The International Labour Organization suggests that measuring accident statistics is the first step in reducing accident numbers. However, many developing countries, especially in sub-Saharan Africa, including Rwanda, do not record accident statistics. In response to this, a questionnaire survey of 130 construction workers was undertaken in Kigali, the capital of the Republic of Rwanda, to raise awareness of construction accidents within the country. The survey generated information about 482...

Concluding Remarks | Ewing | Rwanda Journal

African Journals Online (AJOL)

Rwanda Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 2 (2015) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Concluding Remarks. Helen Ewing. Abstract. No Abstract. Full Text:.

Pathological findings of condemned bovine liver specimens and associated economic loss at Nyabugogo abattoir, Kigali, Rwanda.

Science.gov (United States)

Habarugira, Gervais; Mbasinga, Gloria; Mushonga, Borden; Chitura, Teedzai; Kandiwa, Erick; Ojok, Lonzy

2016-12-01

There are no published abattoir bovine hepatic lesion prevalence studies in cattle in Rwanda. This study estimated that 12.3% of the livers (n=4751) examined at Nyabugogo slaughterhouse in Kigali were condemned. Condemnation prejudiced the nation of 3492.00kg of meat with attendant economic losses of US$8932.40 during the study period. Risk factors for these lesions were also assessed. Male and female animals from 11 districts were used in this study. Hepatic lesions were higher in females (14.6%; n=1494) than in males (11.1%; n=3257). About 78.7% of the condemnations were due to fascioliasis, followed by abscesses (5.7%), hepatitis (5.3%), cirrhosis (4%) and other lesions (6.3%). Female animal livers showed more fascioliasis and abscesses (82.2% and 9.5%) than male animal livers (73.3% and 3.3%). The highest rate of condemnation was observed from Kayonza (40.2%; n=413) and the least was from Gakenke district (0.9%; n=1031). Cattle from the Eastern Province showed significantly (PRwanda. Copyright © 2016 Elsevier B.V. All rights reserved.

Prevalence of pregnancy-related complications and course of labour of surviving women who gave birth in selected health facilities in Rwanda: a health facility-based, cross-sectional study.

Science.gov (United States)

Semasaka Sengoma, Jean Paul; Krantz, Gunilla; Nzayirambaho, Manasse; Munyanshongore, Cyprien; Edvardsson, Kristina; Mogren, Ingrid

2017-07-09

This study estimated health facility-based prevalence for pre-eclampsia/eclampsia, postpartum haemorrhage and caesarean section (CS) due to prolonged labour/dystocia. The background characteristics of Rwandan pregnant women, the course of labour and the level of healthcare were investigated in relation to pregnancy and delivery outcomes. This is health facility-based study and data were collected in 2014-2015 through structured interviews and medical records (n=817) in Kigali and Northern Province, Rwanda. Frequencies and prevalence were used to describe participants' background factors, labour and delivery-related characteristics. Bivariable and multivariable logistic regression models were performed for different background factors and pregnancy/delivery outcomes. Pre-eclampsia/eclampsia, postpartum haemorrhage and CS due to prolonged labour/dystocia represented 1%, 2.7% and 5.4% of all participants, respectively. In total, 56.4% of the participants were transferred from facilities with low levels to those with higher levels of healthcare, and the majority were transferred from health centres to district hospitals, with CS as the main reason for transfer. Participants who arrived at the health facility with cervical dilation grade of ≤3 cm spent more hours in maternity ward than those who arrived with cervical dilatation grade of ≥4 cm. Risk factors for CS due to prolonged labour or dystocia were poor households, nulliparity and residence far from health facility. The estimated health facility-based prevalence of pregnancy-related complications was relatively low in this sample from Rwanda. CS was the main reason for the transfer of pregnant women from health centres to district hospitals. Upgrading the capacity of health centres in the management of pregnant women in Rwanda may improve maternal and fetal health. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

A survey of the praying mantises of Rwanda, including new records (Insecta, Mantodea).

Science.gov (United States)

Tedrow, Riley; Nathan, Kabanguka; Richard, Nasasira; Svenson, Gavin J

2015-10-01

We report the results of two surveys targeting praying mantises in four localities in Rwanda, specifically Akagera National Park, Nyungwe National Park, Volcanoes National Park, and the Arboretum de Ruhande at the National University of Rwanda. Using an assortment of collecting techniques, including metal halide light traps, sweep netting vegetation and general searching, we obtained 387 adult and 352 juvenile specimens, representing 41 species. A total of 28 novel species records for Rwanda are added to the 18 previously recorded species for the country, in addition to 20 novel species records for the broader region, including neighbouring Uganda and Burundi. This study provides high resolution images of the dorsal habitus of both sexes of representative species, both pinned and living. Species distribution records are presented and discussed. With a 155% increase in species recorded from Rwanda, this survey illustrates the need for further taxonomic work in the region.

Assessing the effects of air temperature and rainfall on malaria incidence: an epidemiological study across Rwanda and Uganda

Directory of Open Access Journals (Sweden)

Felipe J. Colón-González

2016-03-01

Full Text Available We investigate the short-term effects of air temperature, rainfall, and socioeconomic indicators on malaria incidence across Rwanda and Uganda from 2002 to 2011. Delayed and nonlinear effects of temperature and rainfall data are estimated using generalised additive mixed models with a distributed lag nonlinear specification. A time series cross-validation algorithm is implemented to select the best subset of socioeconomic predictors and to define the degree of smoothing of the weather variables. Our findings show that trends in malaria incidence agree well with variations in both temperature and rainfall in both countries, although factors other than climate seem to play an important role too. The estimated short-term effects of air temperature and precipitation are nonlinear, in agreement with previous research and the ecology of the disease. These effects are robust to the effects of temporal correlation. The effects of socioeconomic data are difficult to ascertain and require further evaluation with longer time series. Climate-informed models had lower error estimates compared to models with no climatic information in 77 and 60% of the districts in Rwanda and Uganda, respectively. Our results highlight the importance of using climatic information in the analysis of malaria surveillance data, and show potential for the development of climateinformed malaria early warning systems.

Making good citizens from bad life in post-genocide Rwanda

DEFF Research Database (Denmark)

Turner, Simon

2014-01-01

out of ‘bare life’, the Rwandan state is attempting to exorcise a concrete historical moment of violence, and the Hutu who enter the ingando are produced as what I term ‘bad life’. In this sense, the idea of a new beginning in Rwanda differs from universal claims to justice in the legalistic sense...... and is in stead specific, political and at times violent. It is a political project of casting a new Rwanda in a specific image....

Hepatitis C treatment outcomes using interferon- and ribavirin-based therapy in Kigali, Rwanda.

Science.gov (United States)

Riedel, David J; Taylor, Simone; Simango, Raulina; Kiromera, Athanase; Sebeza, Jackson; Baribwira, Cyprien; Musabeyezu, Emmanuel

2016-08-01

Hepatitis C virus (HCV) treatment data in sub-Saharan Africa are limited. This study was to determine HCV sustained virologic response(SVR) at 24 weeks in patients undergoing HCV therapy in Kigali, Rwanda. The paper presents data for all patients treated for HCV with ribavirin/interferon at King Faisal Hospital in Kigali, Rwanda, from 1 January 2007 to 31 December 2014. There were 69 evaluable patients. HCV genotype 4(61%, 42/69) predominated. 24-week SVR was 70%(26/37) by per-protocol and 32%(26/69) by intention-to-treat analysis. HCV treatment in Rwanda is feasible. SVR with interferon/ribavirin was acceptable in the per-protocol analysis. Transition to newer direct acting antivirals is urgently needed in Rwanda and sub-Saharan Africa more generally to improve treatment outcomes. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The assessment of water resources in ungauged catchments in Rwanda

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O.P. Abimbola

2017-10-01

New hydrological insights for the region: Results of this study show that climate, physiography and land cover strongly influence the hydrology of catchments in Rwanda. Using leave-one-out cross-validation, the log-transformed models were found to predict the flow parameters more suitably. These models can be used for estimating the flow parameters in ungauged catchments in Rwanda and the methodology can be applied in any other region, as long as sufficient and good quality streamflow data is available.

Everyday suffering outside prison walls: a legacy of community justice in post-genocide Rwanda

NARCIS (Netherlands)

Rutayisire, T.; Richters, A.

2014-01-01

Twenty years after the 1994 genocide, Rwanda shows all indications of moving quickly towards socio-economic prosperity. Rwanda's community justice system, Gacaca, was to complement this prosperity by establishing peace and stability through justice, reconciliation and healing. Evaluations of the

Combating gender based violence in Rwanda

Directory of Open Access Journals (Sweden)

Liberata Gahongayire

2012-09-01

Full Text Available Gender Based Violence (GBV exists in Rwanda as in many other African societies. Efforts are being made by Governments and NGOs to curb the menace and help its victims. This study examines these efforts with particular reference to the city of Kigali in Rwanda. The study reveals the prevalence and various strategies used by government and other organisations in combating the practice of GBV. According to the study effective response to the plight of GBV victims depends on the competence and expertise of various individuals and organisations involved in giving assistance to victims. The establishment of a one-stop assistance centre for GBV services in Kigali has successfully given much needed aid to victims. The study recommends that in order to eradicate GBV all the stakeholders should utilize available resources. Logistical, economic and socio-cultural constraints should be dealt with accordingly. Above all, the judiciary has a crucial role to play. An effective judicial system is needed to curb the practice.

Ubutabera : Facts and case files from the International Criminal Tribunal for Rwanda (ICTR)

NARCIS (Netherlands)

Bouwknegt, Thijs Bastiaan; van der Heijde, Hannah

2017-01-01

Twenty-two years ago, immediately after the genocide in Rwanda, the United Nations set up the International Criminal Tribunal for Rwanda (UN/ICTR). In December 2015, the Appeals Chamber rendered the tribunal’s last decision in the case of the ‘Butare 6’. Meanwhile, some ‘residual’ work has been

Investigations of foreign bodies in the fore-stomach of cattle at Ngoma Slaughterhouse, Rwanda.

Science.gov (United States)

Mushonga, Borden; Habarugira, Gervais; Musabyemungu, Aline; Udahemuka, Jean C; Jaja, Festus I; Pepe, Dunisani

2015-07-30

Ingestion of indigestible foreign bodies in cattle is a pathological condition of both economic and health importance. It is has mostly been reported in association with feed scarcity. The aim of this study was to investigate the occurrence and nature of indigestible foreign materials in abattoir fore-stomach specimens in Ngoma district, Rwanda. Each chamber was opened by incision, then given a thorough macroscopic examination by visual inspection and palpation for the presence of foreign materials. The results show that there is an overall occurrence of 17.4% foreign bodies in cattle. The highest occurrence (25.3%) was recorded in June (the driest month). Results further show that the majority of the foreign bodies were plastics (65.0%). More foreign bodies (29.5%) were found in older animals (5 years and above) than in younger and middle-aged animals (16.5 % and 6.0%, respectively). There was a higher prevalence of foreign bodies in female cattle (20.0%) than in males (15.7%). The presence of cassette tape, as observed in the study, has not been reported elsewhere. The high representation of plastics in animals (65.5%) in the light of a government plastic bag ban in supermarkets presents a major challenge to livestock production in Rwanda. What is disturbing is that it is not known if this problem is increasing or decreasing as there are no previous studies for comparison. However, the results will serve as a reference point for future studies to understand the true trend and true burden of plastic bags in livestock.

Investigations of foreign bodies in the fore-stomach of cattle at Ngoma Slaughterhouse, Rwanda

Directory of Open Access Journals (Sweden)

Borden Mushonga

2015-07-01

Full Text Available Ingestion of indigestible foreign bodies in cattle is a pathological condition of both economic and health importance. It is has mostly been reported in association with feed scarcity. The aim of this study was to investigate the occurrence and nature of indigestible foreign materials in abattoir fore-stomach specimens in Ngoma district, Rwanda. Each chamber was opened by incision, then given a thorough macroscopic examination by visual inspection and palpation for the presence of foreign materials. The results show that there is an overall occurrence of 17.4% foreign bodies in cattle. The highest occurrence (25.3% was recorded in June (the driest month. Results further show that the majority of the foreign bodies were plastics (65.0%. More foreign bodies (29.5% were found in older animals (5 years and above than in younger and middle-aged animals (16.5 % and 6.0%, respectively. There was a higher prevalence of foreign bodies in female cattle (20.0% than in males (15.7%. The presence of cassette tape, as observed in the study, has not been reported elsewhere. The high representation of plastics in animals (65.5% in the light of a government plastic bag ban in supermarkets presents a major challenge to livestock production in Rwanda. What is disturbing is that it is not known if this problem is increasing or decreasing as there are no previous studies for comparison. However, the results will serve as a reference point for future studies to understand the true trend and true burden of plastic bags in livestock.

Optimizing Nursing and Midwifery Practice in Rwanda

African Journals Online (AJOL)

of Rwanda have worked diligently to build human resources and infrastructure to provide health ser- vices to Rwandan .... tion of human resources in nursing and midwifery. To ensure that nurses and .... cisco, CA: Jossey-Bass. Government of ...

Rwanda kuningas igatseb kodumaale tagasi / Allan Espenberg

Index Scriptorium Estoniae

Espenberg, Allan

2007-01-01

Ameerika Ühendriikides Washingtonis elav Rwanda kuningas Kigeli V pole kodumaad külastanud 48 aastat. Riigi praegune president Paul Kagame sõnul võib pagenduses viibiv kuningas naasta kodumaale vaid tavakodanikuna ning mingit eristaatust talle ei anta

A health partnership to reduce neonatal mortality in four hospitals in Rwanda.

Science.gov (United States)

Ntigurirwa, Placide; Mellor, Kathy; Langer, Daniel; Evans, Mari; Robertson, Emily; Tuyisenge, Lisine; Groves, Alan; Lissauer, Tom

2017-06-01

A health partnership to improve hospital based neonatal care in Rwanda to reduce neonatal mortality was requested by the Rwandan Ministry of Health. Although many health system improvements have been made, there is a severe shortage of health professionals with neonatal training. Following a needs assessment, a health partnership grant for 2 years was obtained. A team of volunteer neonatologists and paediatricians, neonatal nurses, lactation consultants and technicians with experience in Rwanda or low-income countries was assembled. A neonatal training program was provided in four hospitals (the 2 University hospitals and 2 district hospitals), which focused on nutrition, provision of basic respiratory support with nasal CPAP (Continuous Positive Airway Pressure), enhanced record keeping, thermoregulation, vital signs monitoring and infection control. To identify if care delivery improved, audits of nutritional support, CPAP use and its complications, and documentation in newly developed neonatal medical records were conducted. Mortality data of neonatal admissions was obtained. Intensive neonatal training was provided on 27 short-term visits by 10 specialist health professionals. In addition, a paediatric doctor spent 3 months and two spent 6 months each providing training. A total of 472 training days was conducted in the neonatal units. For nutritional support, significant improvements were demonstrated in reduction in time to initiation of enteral feeds and to achieve full milk feeds, in reduction in maximum postnatal weight loss, but not in days for regaining birth weight. Respiratory support with bubble CPAP was applied to 365 infants in the first 18 months. There were no significant technical problems, but tissue damage, usually transient, to the nose and face was recorded in 13%. New medical records improved documentation by doctors, but nursing staff were reluctant to use them. Mortality for University teaching hospital admissions was reduced from 23

Pharmacovigilance of artemether-lumefantrine in pregnant women followed until delivery in Rwanda

OpenAIRE

Rulisa Stephen; Kaligirwa Nadine; Agaba Steven; Karema Corine; Mens Petra F; de Vries Peter J

2012-01-01

Abstract Background The World Health Organization presently recommends Artemisinin-based combination therapy (ACT) as first-line therapy for uncomplicated P. falciparum malaria. Many malaria-endemic countries, including Rwanda, have adopted these treatment guidelines. The Artemisinin derivative Artemether, in combination with lumefantrine, is currently used in Rwanda for malaria during the second and third trimesters of pregnancy. Safety data on the use of ACT in pregnancy are still limited t...

High seroprevalence of HBV and HCV infection in HIV-infected adults in Kigali, Rwanda

NARCIS (Netherlands)

Rusine, John; Ondoa, Pascale; Asiimwe-Kateera, Brenda; Boer, Kimberly R.; Uwimana, Jean Marie; Mukabayire, Odette; Zaaijer, Hans; Mugabekazi, Julie; Reiss, Peter; van de Wijgert, Janneke H.

2013-01-01

Data on prevalence and incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in Rwanda are scarce. HBV status was assessed at baseline and Month 12, and anti-HCV antibodies at baseline, in a prospective cohort study of HIV-infected patients in Kigali, Rwanda: 104 men and 114

Including oral health training in a health system strengthening program in Rwanda

Directory of Open Access Journals (Sweden)

Brittany Seymour

2013-03-01

Full Text Available Objective: Rwanda's Ministry of Health, with the Clinton Health Access Initiative, implemented the Human Resources for Health (HRH Program. The purpose of the program is to train and retain high-quality health care professionals to improve and sustain health in Rwanda. Design: In May 2011, an oral health team from Rwanda and the United States proposed that oral health be included in the HRH Program, due to its important links to health, in a recommendation to the Rwandan Ministry of Health. The proposal outlined a diagonal approach to curriculum design that supports the principles of global health through interconnected training for both treatment and collaborative prevention, rather than discipline-based fragmented training focused on isolated risk factors. It combined ‘vertical’ direct patient care training with ‘horizontal’ interdisciplinary training to address common underlying risk factors and associations for disease through primary care, program retention, and sustainability. Results: The proposal was accepted by the Ministry of Health and was approved for funding by the US Government and The Global Fund. Rwanda's first Bachelor of Dental Surgery program, which is in the planning phase, is being developed. Conclusions: Competencies, the training curriculum, insurance and payment schemes, licensure, and other challenges are currently being addressed. With the Ministry of Health supporting the dental HRH efforts and fully appreciating the importance of oral health, all are hopeful that these developments will ultimately lead to more robust oral health data collection, a well-trained and well-retained dental profession, and vastly improved oral health and overall health for the people of Rwanda in the decades to come.

Including oral health training in a health system strengthening program in Rwanda

Science.gov (United States)

Seymour, Brittany; Muhumuza, Ibra; Mumena, Chris; Isyagi, Moses; Barrow, Jane; Meeks, Valli

2013-01-01

Objective Rwanda's Ministry of Health, with the Clinton Health Access Initiative, implemented the Human Resources for Health (HRH) Program. The purpose of the program is to train and retain high-quality health care professionals to improve and sustain health in Rwanda. Design In May 2011, an oral health team from Rwanda and the United States proposed that oral health be included in the HRH Program, due to its important links to health, in a recommendation to the Rwandan Ministry of Health. The proposal outlined a diagonal approach to curriculum design that supports the principles of global health through interconnected training for both treatment and collaborative prevention, rather than discipline-based fragmented training focused on isolated risk factors. It combined ‘vertical’ direct patient care training with ‘horizontal’ interdisciplinary training to address common underlying risk factors and associations for disease through primary care, program retention, and sustainability. Results The proposal was accepted by the Ministry of Health and was approved for funding by the US Government and The Global Fund. Rwanda's first Bachelor of Dental Surgery program, which is in the planning phase, is being developed. Conclusions Competencies, the training curriculum, insurance and payment schemes, licensure, and other challenges are currently being addressed. With the Ministry of Health supporting the dental HRH efforts and fully appreciating the importance of oral health, all are hopeful that these developments will ultimately lead to more robust oral health data collection, a well-trained and well-retained dental profession, and vastly improved oral health and overall health for the people of Rwanda in the decades to come. PMID:23473054

Monitoring long-lasting insecticidal net (LLIN) durability to validate net serviceable life assumptions, in Rwanda

NARCIS (Netherlands)

Hakizimana, E.; Cyubahiro, B.; Rukundo, A.; Kabayiza, A.; Mutabazi, A.; Beach, R.; Patel, R.; Tongren, J.E.; Karema, C.

2014-01-01

Background To validate assumptions about the length of the distribution–replacement cycle for long-lasting insecticidal nets (LLINs) in Rwanda, the Malaria and other Parasitic Diseases Division, Rwanda Ministry of Health, used World Health Organization methods to independently confirm the three-year

Coffee farming and soil management in Rwanda

NARCIS (Netherlands)

Nzeyimana, I.; Hartemink, A.E.; Graaff, de J.

2013-01-01

Agriculture is the cornerstone of Rwanda's economy. The authors review how the sector has changed and specifically what soil management practices are now being implemented to enhance coffee production. Coffee covers around 2.3% of total cultivated arable land, and is grown mainly by smallholder

Maltreatment of Youth Heads of Households in Rwanda

African Journals Online (AJOL)

In Rwanda, the combined effects of the 1994 genocide and the spread of AIDS have resulted in large ... to maltreatment because of marginalization from the community. ..... why you find kids who become delinquents or commit suicide.

De nasleep van Somalië, Rwanda en Srebrenica: overeenkomsten en verschillen

Directory of Open Access Journals (Sweden)

Thijs Brocades Zaalberg

2010-01-01

Full Text Available Klep, Christ, Somalië, Rwanda, Srebrenica. De nasleep van drie ontspoorde vredesmissies (Dissertatie Utrecht 2008; Amsterdam: Boom, 2008, 385 blz., ISBN 978 90 8506 668 2The Aftermath of Somalia, Rwanda and Srebrenica: Parallels and DifferencesChrist Klep has written an impressive and highly accessible thesis on the aftermath of three unsuccessful peace operations. By using a bold comparative approach and an ambitious tone of enquiry he places the traumatic Dutch Srebrenica experience in the context of two broadly similar processes of finger-pointing and evading responsibility in Canada and Belgium following their respective interventions in Somalia and Rwanda. He thus exposes many fascinating parallels, yet the historian Klep pays little attention to the differences between his case studies. This is regrettable, as this would have strengthened rather than weakened his otherwise compelling argument. The Somali case in particular differs from ‘Srebrenica’ and ‘Rwanda’, since the murders perpetrated by Canadian soldiers – horrific as they may have been – and the subsequent cover-up in no way constituted a defining moment in the collapsing international mission as a whole. Unlike the genocides in Rwanda and Srebrenica the death of the two Somalis was the result of a purely national Canadian failure, which helps explain why the Somalia Inquiry could identify guilty compatriots far more decisively than, for example, the Netherlands Institute for War Documentation (NIOD in its Srebrenica report.

Peacebuilding through Language Mentorship in Rwanda's Primary ...

African Journals Online (AJOL)

Several studies have been conducted following a 2008 policy in Rwanda that made English language the medium of instruction from the fourth year of primary school. However, there is a considerable research gap between language policy changes, positive peace and peacebuilding generally. Thus, based on existing ...

Long-term mental health outcome in post-conflict settings: Similarities and differences between Kosovo and Rwanda.

Science.gov (United States)

Eytan, Ariel; Munyandamutsa, Naasson; Nkubamugisha, Paul Mahoro; Gex-Fabry, Marianne

2015-06-01

Few studies investigated the long-term mental health outcome in culturally different post-conflict settings. This study considers two surveys conducted in Kosovo 8 years after the Balkans war and in Rwanda 14 years after the genocide. All participants (n = 864 in Kosovo; n = 962 in Rwanda) were interviewed using the posttraumatic stress disorder (PTSD) and major depressive episode (MDE) sections of the Mini International Neuropsychiatric Interview (MINI) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Proportions of participants who met diagnostic criteria for either PTSD or MDE were 33.0% in Kosovo and 31.0% in Rwanda, with co-occurrence of both disorders in 17.8% of the Rwandan sample and 9.5% of the Kosovan sample. Among patients with PTSD, patterns of symptoms significantly differed in the two settings, with avoidance and inability to recall less frequent and sense of a foreshortened future and increased startle response more common in Rwanda. Significant differences were also observed in patients with MDE, with loss of energy and difficulties concentrating less frequent and suicidal ideation more common in Rwanda. Comorbid PTSD and MDE were associated with decreased SF-36 subjective mental and physical health scores in both settings, but significantly larger effects in Kosovo than in Rwanda. Culturally different civilian populations exposed to mass trauma may differ with respect to their long-term mental health outcome, including comorbidity, symptom profile and health perception. © The Author(s) 2014.

[Rwanda: population problems, development in question].

Science.gov (United States)

Tallon, F

1988-04-01

An international symposium was held in Kigali, Rwanda, in December 1987 on population and development policies. Rwanda's rate of population increase is 3.7%/year, apparently the 2nd highest in the world after Kenya, and it is one of the most densely populated countries of Africa. Development programs including population components have become ever more important since the Scientific Consultative Council on Sociodemographic Problems was created in 1974. The National Office of Population (ONAPO) arranged the symposium on population and development policies to sensitize the authorities even further to the problems of excessive growth and to the links between population and other economic development variables such as health, nutrition, education, the environment, and employment. The symposium focused on the evolution of population policies and their integration into development plans in Rwanda. Among its recommendations were that efforts to inform the population about family planning be increased and that the quality of family planning services be improved. Family life education should be integrated into the educational system at all levels. Pronatalist elements should be removed from Rwandan legislation, and legal protection for family planning should be assured. Coercive family planning measures were considered inopportune. Although the need for external aid in technical assistance and evaluation was expected to persist, it was recommended that greater national resources be assigned to population programs. In the area of agriculture and nutrition, it was recommended that measures be taken to stop the subdivision of farm plots, that nonagricultural employment be created, and that nonfarmers give up their lands. Farmers should be assisted with tools, agricultural inputs, and technical advice. Interregional exchanges of agricultural products should be encouraged, but consumption of local products should also be promoted. Agricultural production objectives should take

Measurements of Background and Polluted Air in Rural Regions of Rwanda

Science.gov (United States)

DeWitt, L.; Gasore, J.; Prinn, R. G.; Potter, K. E.

2015-12-01

Rwanda, a mountainous nation in Equatorial East Africa, is one of the least-urbanized nations in Africa. The majority of the population are subsistence farmers, and major sources of air pollution (e.g., particulates, greenhouse gases) in Rwanda include agricultural burning and cookstoves in rural areas, and older diesel vehicles and mototaxis in cities. Currently, initiatives to supply efficient cookstoves, development of cleaner-burning fuel from recycled agricultural waste, and new regulations on vehicle emissions and importation are underway. These initiatives seek to help Rwanda grow in the greenest way possible, to mitigate negative health and climate effects of development; however, little ambient data on air quality is available in different regions of Rwanda for a baseline study before and benefits study after these initiatives. The Rwanda Climate Observatory, located on the summit of Mt. Mugogo (-1.5833°, 29.5667°), a 2.5 km peak, has recently begun measurements of black carbon (BC) aerosol concentration and O3 and CO gas concentrations. BC measurements were performed with a 7-wavelength Magee Scientific aethalometer and the aethalometer model was used to calculate the influence of fossil fuel and biomass burning sources on BC concentrations. CO and O3 measurements were used in conjunction with BC aerosol data, and HYSPLIT back trajectories were also used to help discriminate between periods of heavy burning and periods of regional influence from traffic and general cookfire emissions. Since Mt. Mugogo is in a rural area, this station captures a snapshot of regional background pollution away from high anthropogenic influence. The nearby households and fields also allow case studies of household and crop burning during localized events and help quanitfy potential daily exposure to particulates and climate-forcing emissions in remote areas of this developing country. We will present time series of the BC, O3, CO and insolation measurements at Mt. Mugogo

Critical care nursing practice and education in Rwanda

African Journals Online (AJOL)

3 Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada ... relevant to the healthcare system and the disease profile of Rwanda, as well as the ... of education to obtain a high-school certificate and some basic nursing training.

Umuganda for improved health professions education in Rwanda ...

African Journals Online (AJOL)

Objective: This article describes several recent milestones in collaborative development of health professional education at the College of Medicine and Health Sciences, University of Rwanda, towards more socially accountable education. Methodology: Literature review and personal experiences from the authors were ...

Development aid and the diffusion of technology: Improved cookstoves in Kenya and Rwanda

International Nuclear Information System (INIS)

Tigabu, Aschalew; Berkhout, Frans; Beukering, Pieter van

2017-01-01

This paper analyses the role of official development assistance (ODA) in the evolution of Technological Innovation Systems (TISs) of improved cookstoves in Kenya and Rwanda. Functionally balanced TISs are central to the diffusion of new technologies and practices. We find that ODA has significantly influenced major innovation activities related to improved cookstoves in both Kenya and Rwanda over the last 30 years. However, donors’ funding has been focused mainly on the development and diffusion of technical knowledge. We find that this pattern of ODA support has not fostered balanced and effective Technology Innovation Systems, and that this has contributed to the failure to achieve widespread diffusion of improved cookstoves. We develop a quasi-evolutionary model for the long-term and systematic ODA support of innovation systems to build sustainable renewable energy TISs in developing countries. - Highlights: • We report the role of aid in the evolution of cookstove innovation systems in Kenya and Rwanda. • We show that aid was mainly focused on two functions over time, overlooking other functions • Aid has failed to foster the development of balanced innovation systems in the studied cases. • This is associated with low level of diffusion of improved cookstoves in Kenya and Rwanda. • A conceptual proposal for effective aid interventions is provided.

The Media and the Rwanda Genocide | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2007-01-20

Jan 20, 2007 ... The news media played a crucial role in the 1994 Rwanda genocide: ... This book is a startling record of the dangerous influence that the media ... Health and Social Care (DHSC)—are partnering on a new initiative, aimed at ...

Mapping Rwanda public health research(1975-2014)

African Journals Online (AJOL)

Objectives: In this paper, the aim was to map the scientific research on public health in Rwanda ... formed analyses on journals, most cited articles, authors, publication years, ... One of the major areas is public health. In fact, public health represented the needs ... In the advanced ... searches to get the main relevant topics.

A Short Twenty Years: Meeting the Challenges Facing Teachers Who Bring Rwanda into the Classroom

Science.gov (United States)

Gudgel, Mark

2013-01-01

As the twentieth anniversary of the 1994 genocide in Rwanda approaches, Mark Gudgel argues that we should face the challenges posed by teaching about Rwanda. Drawing on his experience as a history teacher in the US, his experience researching and supporting others' classrooms in the US and UK, his training in Holocaust education and his knowledge…

Rwanda endine president jäi vanglasse / Allan Espenberg

Index Scriptorium Estoniae

Espenberg, Allan

2006-01-01

Rwanda ekspresident Pasteur Bizimungu arreteeriti 2002. aastal, kui ta püüdis moodustada uut poliitilist parteid, mis uutele võimudele ei meeldinud. Ta mõisteti 2004. aasta juunis süüdi kolmes kuriteoepisoodis

Wages in Rwanda. WageIndicator survey 2012

NARCIS (Netherlands)

Besamusca, J.; Tijdens, K.; Ngeh Tingum, E.; Mbassana, M.E.

2013-01-01

This WageIndicator Data Report presents the results of the face-to-face WageIndicator survey in Rwanda, conducted between the 27th of October and the 3rd of December 2012. The survey aimed to measure in detail the wages earned by Rwandan workers. In total 2,074 persons were interviewed in towns in

Entrepreneurial motivation and small business growth in Rwanda

NARCIS (Netherlands)

Eijdenberg, E.L.; Masurel, E.; Paas, L.J.

2015-01-01

Purpose – The purpose of this study is to investigate the relationship between entrepreneurial motivation and small business growth in one of the poorest emerging countries: the African least developed country (LDC), Rwanda. Design/methodology/approach – On the basis of theoretical resources and a

Improving health outcomes through concurrent HIV program scale-up and health system development in Rwanda: 20 years of experience.

Science.gov (United States)

Nsanzimana, Sabin; Prabhu, Krishna; McDermott, Haley; Karita, Etienne; Forrest, Jamie I; Drobac, Peter; Farmer, Paul; Mills, Edward J; Binagwaho, Agnes

2015-09-09

The 1994 genocide against the Tutsi destroyed the health system in Rwanda. It is impressive that a small country like Rwanda has advanced its health system to the point of now offering near universal health insurance coverage. Through a series of strategic structural changes to its health system, catalyzed through international assistance, Rwanda has demonstrated a commitment towards improving patient and population health indicators. In particular, the rapid scale up of antiretroviral therapy (ART) has become a great success story for Rwanda. The country achieved universal coverage of ART at a CD4 cell count of 200 cells/mm(3) in 2007 and increased the threshold for initiation of ART to ≤350 cells/mm(3) in 2008. Further, 2013 guidelines raised the threshold for initiation to ≤500 cells/mm(3) and suggest immediate therapy for key affected populations. In 2015, guidelines recommend offering immediate treatment to all patients. By reviewing the history of HIV and the scale-up of treatment delivery in Rwanda since the genocide, this paper highlights some of the key innovations of the Government of Rwanda and demonstrates the ways in which the national response to the HIV epidemic has catalyzed the implementation of interventions that have helped strengthen the overall health system.

Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda

Science.gov (United States)

Lu, Chunling; Cook, Benjamin; Desmond, Chris

2017-01-01

Background Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Methods Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Findings Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. Conclusions These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities. PMID:29082015

Nursing and Midwifery Education in Rwanda: Telling our Story ...

African Journals Online (AJOL)

Nursing and Midwifery Education in Rwanda: Telling our Story. ... Journal Home > Vol 2, No 2 (2015) > ... The establishment of the Kigali Health Institute in1996 greatly advanced nursing and midwifery education with the awarding of an ...

The Rwanda Field Epidemiology and Laboratory Training Program ...

African Journals Online (AJOL)

The Rwanda Field Epidemiology and Laboratory Training Program (RFELTP) is a 2-year public health leadership development training program that provides applied epidemiology and public health laboratory training while the trainees provide public health service to the Ministry of Health. RFELTP is hosted at the National ...

"Education at Our School Is Not Free": The Hidden Costs of Fee-Free Schooling in Rwanda

Science.gov (United States)

Williams, Timothy P.; Abbott, Pamela; Mupenzi, Alfred

2015-01-01

As primary school enrolment rates in Rwanda near ubiquity, completion rates remain low and repetition rates remain high. This study investigates the impact of the "hidden costs" of schooling in the context of Rwanda's fee-free education policy. Using a social-science case study, focus groups and interviews were undertaken with 200…

Kigali and Phoenix: Historical Similarities between Pre-Genocide Rwanda and Arizona's Anti-Immigrant Wave

Science.gov (United States)

Dwyer, Eric

2018-01-01

Historical events in Arizona, including very recent ones, are eerily similar to those of Rwanda. In this article, stories of Arizona's political history are relayed while recalling those leading to Rwanda's genocide. The stories include references to key roles education policy has played in the oppression of students labeled Tutsi and students…

[Women, fertility, development: the case of Rwanda].

Science.gov (United States)

Kabagwira, A

1992-08-01

Rwanda's high fertility rate and very rapid population growth have a negative impact on the welfare of women. Traditionally, women in Rwanda won the respect of their in-laws by having many children, on whom they depended for social status, help in agricultural work, and support in old age. Women also played a very important role in agricultural production in addition to their daily household activities. Migration of men and young people to urban areas has left many women totally in charge of agricultural production and has further deprived them of their limited leisure time. Low income, legal obstacles, literacy, custom and other factors limit women's resulting from their inferior social and juridical status conditions their reproductive behavior despite the development of a family planning program dating to 1981. The low level of female education is an important factor; 33% of women vs. 61% of men are literate. 25% of Rwanda's budget is devoted to education, but population growth has impeded progress Illiteracy implies a lack of receptivity to new ideas, including family planning. A 1983 fertility study in Rwanda showed that marriage age increased with education, from 18.8 years for illiterate women to 19.5 for those within 3-5 years. The number of children declined with the educational attainment of the mother, as did infant mortality rates. Considering the physical labor that women carry out, their repeated pregnancies are a handicap to the promotion of their own and their family's health. The prevailing high fertility exacerbates nutritional problems; some 20% of infants weigh less that 2.5 kg at birth. Efforts have recently been made to recognize the contribution of women and to elevate their status, such as improving their access to education, raising the legal marriage to 21, and prohibiting polygamy. The National Office of Population was created in 1981 to study population problems and take action to resolve them. The national population policy adopted in

Structured Additive Quantile Regression for Assessing the Determinants of Childhood Anemia in Rwanda

Directory of Open Access Journals (Sweden)

Faustin Habyarimana

2017-06-01

Full Text Available Childhood anemia is among the most significant health problems faced by public health departments in developing countries. This study aims at assessing the determinants and possible spatial effects associated with childhood anemia in Rwanda. The 2014/2015 Rwanda Demographic and Health Survey (RDHS data was used. The analysis was done using the structured spatial additive quantile regression model. The findings of this study revealed that the child’s age; the duration of breastfeeding; gender of the child; the nutritional status of the child (whether underweight and/or wasting; whether the child had a fever; had a cough in the two weeks prior to the survey or not; whether the child received vitamin A supplementation in the six weeks before the survey or not; the household wealth index; literacy of the mother; mother’s anemia status; mother’s age at the birth are all significant factors associated with childhood anemia in Rwanda. Furthermore, significant structured spatial location effects on childhood anemia was found.

Structured Additive Quantile Regression for Assessing the Determinants of Childhood Anemia in Rwanda.

Science.gov (United States)

Habyarimana, Faustin; Zewotir, Temesgen; Ramroop, Shaun

2017-06-17

Childhood anemia is among the most significant health problems faced by public health departments in developing countries. This study aims at assessing the determinants and possible spatial effects associated with childhood anemia in Rwanda. The 2014/2015 Rwanda Demographic and Health Survey (RDHS) data was used. The analysis was done using the structured spatial additive quantile regression model. The findings of this study revealed that the child's age; the duration of breastfeeding; gender of the child; the nutritional status of the child (whether underweight and/or wasting); whether the child had a fever; had a cough in the two weeks prior to the survey or not; whether the child received vitamin A supplementation in the six weeks before the survey or not; the household wealth index; literacy of the mother; mother's anemia status; mother's age at the birth are all significant factors associated with childhood anemia in Rwanda. Furthermore, significant structured spatial location effects on childhood anemia was found.

Workplace violence and gender discrimination in Rwanda's health workforce: Increasing safety and gender equality

OpenAIRE

Newman, Constance J; de Vries, Daniel H; d'Arc Kanakuze, Jeanne; Ngendahimana, Gerard

2011-01-01

Abstract Background Workplace violence has been documented in all sectors, but female-dominated sectors such as health and social services are at particular risk. In 2007-2008, IntraHealth International assisted the Rwanda Ministries of Public Service and Labor and Health to study workplace violence in Rwanda's health sector. This article reexamines a set of study findings that directly relate to the influence of gender on workplace violence, synthesizes these findings with other research fro...

Monthly Wind Characteristics and Wind Energy in Rwanda

African Journals Online (AJOL)

user

Abstract. Evaluating wind power potential for a site is indispensable before making any decision for the installation of wind energy infrastructures and planning for relating projects. This paper presents a branch of a composite analysis whose objective was to investigate the potential of wind energy resource in Rwanda.

Preparing youth for productive employment in Rwanda | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2015-12-16

Dec 16, 2015 ... A scoping paper commissioned by Canada's International Development Research Centre and the MasterCard Foundation highlights research pathways that could help build a solid base of evidence for strategies to ensure Rwanda's youth — and economy — prosper. Read the brief, Preparing youth for ...

identification of banana varieties with resistance to nematodes in ...

African Journals Online (AJOL)

jen

Institut des Sciences Agronomiques du Rwanda (ISAR), ISAR-Kibungo, Ngoma district, Rwanda ... for sustainable nematode management. Previous studies ..... Technology Development and Transfer project. ... INIBAP, Montpellier, France.

Malaria has no effect on birth weight in Rwanda

NARCIS (Netherlands)

Rulisa, S.; Mens, P.F.; Karema, C.; Schallig, H.D.F.H.; Kaligirwa, N.; Vyankandondera, J.; de Vries, P.J.

2009-01-01

Background: Malaria has a negative effect on pregnancy outcome, causing low birth weight, premature birth and stillbirths, particularly in areas with high malaria transmission. In Rwanda, malaria transmission intensity ranges from high to nil, probably associated with variable altitudes. Overall,

Malaria has no effect on birth weight in Rwanda

NARCIS (Netherlands)

Rulisa, Stephen; Mens, Pètra F.; Karema, Corine; Schallig, Henk D. F. H.; Kaligirwa, Nadine; Vyankandondera, Joseph; de Vries, Peter J.

2009-01-01

Malaria has a negative effect on pregnancy outcome, causing low birth weight, premature birth and stillbirths, particularly in areas with high malaria transmission. In Rwanda, malaria transmission intensity ranges from high to nil, probably associated with variable altitudes. Overall, the incidence

Post-apartheid South Africa and Post-genocide Rwanda ...

African Journals Online (AJOL)

apartheid in South Africa and genocide in Rwanda. It specifi es the scope of their individual, collective and political memory and the ways through which that memory structures people's representations, determines social relations and infl uences political life. It shows that in both contexts, memory constitutes a major stake ...

Rwanda National Days Celebrations and Racist Propaganda (1962 ...

African Journals Online (AJOL)

This article addresses the link between Rwanda national days celebrations and a racist propaganda between 1962 and 1982. It states a problem to know whether the political messages on the national days celebrations conveyed a democratic message or a racist propaganda. First, it explores a theoretical theory related to ...

Prospects for Prosperity: Rwanda and the Entrepreneurial Society

Science.gov (United States)

Streeter, Ryan; McNaught, Mary

2008-01-01

Upon first examination, Rwanda does not seem an ideal place for business investment and development. It is a landlocked country, often described as the "land of a thousand hills," surrounded by neighbors at varying stages of socioeconomic progress and stagnation. Because of the underdeveloped transportation infrastructure and a lack of…

How Motherhood Triumphs Over Trauma Among Mothers With Children From Genocidal Rape in Rwanda

Directory of Open Access Journals (Sweden)

Odeth Kantengwa

2014-08-01

Full Text Available Rape is a common occurrence during genocide and the presence of children born as a result of rape poses a challenge to post-genocide recovery processes. This paper treats mothers of children born as a result of genocidal rape during the 1994 Genocide against the Tutsi as a separate category of survivors and explores the contribution of a positive embrace of motherhood in their recovery. It is based upon a study that included fourteen women from Kigali city, Karongi District in the Western Province and Huye District in the Southern Province. Qualitative analysis of individual interviews and focus groups provided a means to explore in-depth the perceptions of mothers and the value of motherhood. It was found that mothers of children of rape experienced challenges raising their children, especially in the early stages of parenting. Social stigma related to rape and children born of rape created challenges, as did the lack of psychosocial resources for the women, particularly when faced with disclosing paternity to the children. However, despite these and other difficulties, motherhood played a positive role for many women, often providing a reason to live again after the genocide. These findings show that positive experiences of motherhood can be key to the recovery of survivors of genocidal rape in Rwanda and points to future directions for research and health promotion among populations affected by conflict-related sexual violence.

Everyday partner violence in Rwanda: The contribution of ...

African Journals Online (AJOL)

opperwjj

to contribute to family conflict and intimate partner violence in Rwanda to this day. .... The social psychologist Martín-Baró (1989) introduced the term “psychosocial ... couples' lives and relationships, and the role that sociotherapy has played in .... which soon has a positive spin-off effect on their families and communities.

Everyday suffering outside prison walls: a legacy of community justice in post-genocide Rwanda.

Science.gov (United States)

Rutayisire, Théoneste; Richters, Annemiek

2014-11-01

Twenty years after the 1994 genocide, Rwanda shows all indications of moving quickly towards socio-economic prosperity. Rwanda's community justice system, Gacaca, was to complement this prosperity by establishing peace and stability through justice, reconciliation and healing. Evaluations of the Gacaca courts' achievements from 2002 to 2012 have had widely differing conclusions. This article adds to previous evaluations by drawing attention to specific forms of relatively neglected suffering (in literature and public space) that have emerged from the Gacaca courts or were amplified by these courts and jeopardize Gacaca's objectives. The ethnographic study that informs the article was conducted in southeastern Rwanda from September 2008-December 2012 among 19 ex-prisoners and 24 women with husbands in prison including their family members, friends and neighbors. Study findings suggest that large scale imprisonment of genocide suspects coupled with Gacaca court proceedings have tainted the suffering of ex-prisoners and women with imprisoned husbands in unique ways, which makes their plight unparalleled in other countries. We argue that the nature and scale of this suffering and the potentially detrimental impact on families and communities require humanitarian action. However, in Rwanda's post-genocide reality, the suffering of these two groups is overwhelmed by that of other vulnerable groups, such as genocide survivors and orphaned children; hence it is rarely acknowledged. Copyright © 2014 Elsevier Ltd. All rights reserved.

Building oral health research infrastructure: the first national oral health survey of Rwanda.

Science.gov (United States)

Morgan, John P; Isyagi, Moses; Ntaganira, Joseph; Gatarayiha, Agnes; Pagni, Sarah E; Roomian, Tamar C; Finkelman, Matthew; Steffensen, Jane E M; Barrow, Jane R; Mumena, Chrispinus H; Hackley, Donna M

2018-01-01

Oral health affects quality of life and is linked to overall health. Enhanced oral health research is needed in low- and middle-income countries to develop strategies that reduce the burden of oral disease, improve oral health and inform oral health workforce and infrastructure development decisions. To implement the first National Oral Health Survey of Rwanda to assess the oral disease burden and inform oral health promotion strategies. In this cross-sectional study, sample size and site selection were based on the World Health Organization (WHO) Oral Health Surveys Pathfinder stratified cluster methodologies. Randomly selected 15 sites included 2 in the capital city, 2 other urban centers and 11 rural locations representing all provinces and rural/urban population distribution. A minimum of 125 individuals from each of 5 age groups were included at each site. A Computer Assisted Personal Instrument (CAPI) was developed to administer the study instrument. Nearly two-thirds (64.9%) of the 2097 participants had caries experience and 54.3% had untreated caries. Among adults 20 years of age and older, 32.4% had substantial oral debris and 60.0% had calculus. A majority (70.6%) had never visited an oral health provider. Quality-of-life challenges due to oral diseases/conditions including pain, difficulty chewing, self-consciousness, and difficulty participating in usual activities was reported at 63.9%, 42.2% 36.2%, 35.4% respectively. The first National Oral Health Survey of Rwanda was a collaboration of the Ministry of Health of Rwanda, the University of Rwanda Schools of Dentistry and Public Health, the Rwanda Dental Surgeons and Dental (Therapists) Associations, and Tufts University and Harvard University Schools of Dental Medicine. The international effort contributed to building oral health research capacity and resulted in a national oral health database of oral disease burden. This information is essential for developing oral disease prevention and management

Urine testing to monitor the impact of HPV vaccination in Bhutan and Rwanda.

Science.gov (United States)

Franceschi, Silvia; Chantal Umulisa, M; Tshomo, Ugyen; Gheit, Tarik; Baussano, Iacopo; Tenet, Vanessa; Tshokey, Tshokey; Gatera, Maurice; Ngabo, Fidele; Van Damme, Pierre; Snijders, Peter J F; Tommasino, Massimo; Vorsters, Alex; Clifford, Gary M

2016-08-01

Bhutan (2010) and Rwanda (2011) were the first countries in Asia and Africa to introduce national, primarily school-based, human papillomavirus (HPV) vaccination programmes. These target 12 year-old girls and initially included catch-up campaigns (13-18 year-olds in Bhutan and ninth school grade in Rwanda). In 2013, to obtain the earliest indicators of vaccine effectiveness, we performed two school-based HPV urine surveys; 973 female students (median age: 19 years, 5th-95th percentile: 18-22) were recruited in Bhutan and 912 (19 years, 17-20) in Rwanda. Participants self-collected a first-void urine sample using a validated protocol. HPV prevalence was obtained using two PCR assays that differ in sensitivity and type spectrum, namely GP5+/GP6+ and E7-MPG. 92% students in Bhutan and 43% in Rwanda reported to have been vaccinated (median vaccination age = 16, 5th-95th: 14-18). HPV positivity in urine was significantly associated with sexual activity measures. In Rwanda, HPV6/11/16/18 prevalence was lower in vaccinated than in unvaccinated students (prevalence ratio, PR = 0.12, 95% confidence interval, CI: 0.03-0.51 by GP5+/GP6+, and 0.45, CI: 0.23-0.90 by E7-MPG). For E7-MPG, cross-protection against 10 high-risk types phylogenetically related to HPV16 or 18 was of borderline significance (PR = 0.68; 95% CI: 0.45-1.01). In Bhutan, HPV6/11/16/18 prevalence by GP5+/GP6+ was lower in vaccinated than in unvaccinated students but CIs were broad. In conclusion, our study supports the feasibility of urine surveys to monitor HPV vaccination and quantifies the effectiveness of the quadrivalent vaccine in women vaccinated after pre-adolescence. Future similar surveys should detect increases in vaccine effectiveness if vaccination of 12 year-olds continues. © 2016 UICC.

Analysis and modification of blue sapphires from Rwanda by ion beam techniques

International Nuclear Information System (INIS)

Bootkul, D.; Chaiwai, C.; Tippawan, U.; Wanthanachaisaeng, B.; Intarasiri, S.

2015-01-01

Highlights: • Ion beam analysis is an effective method for detecting trace elements. • Ion beam treatment is able to improve optical and color appearances of the blue sapphire from Rwanda. • These alternative methods can be extended to jewelry industry for large scale application. - Abstract: Blue sapphire is categorised in a corundum (Al_2O_3) group. The gems of this group are always amazed by their beauties and thus having high value. In this study, blue sapphires from Rwanda, recently came to Thai gemstone industry, are chosen for investigations. On one hand, we have applied Particle Induced X-ray Emission (PIXE), which is a highly sensitive and precise analytical technique that can be used to identify and quantify trace elements, for chemical analysis of the sapphires. Here we have found that the major element of blue sapphires from Rwanda is Al with trace elements such as Fe, Ti, Cr, Ga and Mg as are commonly found in normal blue sapphire. On the other hand, we have applied low and medium ion implantations for color improvement of the sapphire. It seems that a high amount of energy transferring during cascade collisions have altered the gems properties. We have clearly seen that the blue color of the sapphires have been intensified after nitrogen ion bombardment. In addition, the gems were also having more transparent and luster. The UV–Vis–NIR measurement detected the modification of their absorption properties, implying of the blue color increasing. Here the mechanism of these modifications is postulated and reported. In any point of view, the bombardment by using nitrogen ion beam is a promising technique for quality improvement of the blue sapphire from Rwanda.

Access to Paid Work and Women's Empowerment in Rwanda ...

African Journals Online (AJOL)

Abahuzamugambi" (AKM) situated in the rural area and OCIR Café located in Kigali the capital of Rwanda. The sample constitutes of 48 respondents – namely 8 widows, 8 married women and 8 young girls from each of both cases. In order to collect ...

Rwanda after the Genocide: Formal and Informal Institutions in Overcoming Development Traps

Directory of Open Access Journals (Sweden)

Ekaterina S. Glazova

2015-01-01

Full Text Available Permanent self-reproduction of crises or getting into so called development traps in underdeveloped countries constitutes one of the most significant world problems. An explanatory hypothesisis that antagonistic relationship between formal and informal institutions makes it impossible to overcome path dependence. The problem is illustrated by the case of Rwanda, which, despite the large-scale foreign aid in the 1960s-early 1990s, failed to resolve the growing socio-political contradictions that eventually led to the 1994 genocide. However, since the 2000s Rwanda has been demonstrating an upward trend especially in governance and control of corruption. In the author's view, success in the post-genocidal period was determined by two factors: first, by the institutional vacuum created by the collapse of competitive rules and practices of the President Habyarimana era; second, by the effective leadership shown by the ruling elite support of informal practices to overcome the crisis. Between the possible reform options the choice was made in favor of formalization of autochthonous practices, introduction of traditional or restored (filled with a new meaning institutions into the legal sphere, and creation of new rules. Rwanda is therefore an example of successful institutional transformation.

The acquisition of English as a second language in Rwanda ...

African Journals Online (AJOL)

The acquisition of English as a second language in Rwanda: Challenges and ... E Sibomana ... Building on the factors which are believed to affect second language (L2) acquisition and learning, this article explores constraints, challenges, ...

Die kerke in Rwanda: Skandes en uitdagings - en lesse vir Suid-Afrika 1

Directory of Open Access Journals (Sweden)

P. G.R. Meiring

2000-12-01

Full Text Available The churches in Rwanda: Disappointments and challenges -and lessons for South Africa. The author, one of a team of South Africans invited to Rwanda to advise the newly appointed Unity and Reconciliation Commission, gives an overview of the political developments that led to the bloody genocide (February-April 1994 during which more than a million Rwandans died at the hands of their compatriots. The role that the churches played during the crisis was a disappointment to many; the conduct of many of the clergy - who not only condoned what was happening but actively took part in the events - is nothing less than shameful in view of the Gospel. If the churches want to regain their integity, five challenges should be taken seriously: the churches should lead the country in a sincere confession of guilt; the churches should regain their prophetic witness in the country; they should contribute to leadership development and training; the churches shouldplay their part in ministering to the poor and needy, to the traumatized in Rwanda; and, lastly, the churches should act as servants of reconciliation.

The Challenging Road to Reconciliation in Rwanda: Societal Processes, Interventions and Their Evaluation

Directory of Open Access Journals (Sweden)

Ervin Staub

2014-10-01

Full Text Available This article briefly discusses some efforts that Rwanda has made to recover from the genocide, ranging from trying perpetrators to creating just social arrangements. It also discusses problematic policies and practices that may interfere with reconciliation. It then describes work the author and his associates have engaged in to promote healing and reconciliation in Rwanda. First, they conducted training/workshops to help people understand the influences that lead to genocide and other great violence, and avenues to prevention, healing and reconciliation. Following this they created educational radio programs for the same ends. The article describes a highly popular radio drama in Rwanda, which has been broadcast since 2004. Evaluation studies of both the effects of the trainings and of the radio drama have found positive effects that are highly relevant for reconciliation. These include more positive attitudes toward the other group, more empathy, more willingness to say what one believes, and more moderate respect for authority (presumably leading to less blind obedience. Anecdotal reports from the community also show the positive effects of the radio drama.

Mulching as a strategy to improve soil properties and reduce soil erodibility in coffee farming systems of Rwanda

NARCIS (Netherlands)

Nzeyimana, I.; Hartemink, A.E.; Ritsema, C.J.; Stroosnijder, L.; Huerta Lwanga, Esperanza; Geissen, V.

2017-01-01

In Rwanda, mulch is applied in coffee fields to control soil erosion. The objective of this paper is to quantify the effects of different types of mulch on soil properties and soil erodibility in coffee farming systems in three different agro-ecological zones of the highlands of Rwanda. The

Quality improvement practices to institutionalize supply chain best practices for iCCM: Evidence from Rwanda and Malawi.

Science.gov (United States)

Chandani, Yasmin; Duffy, Malia; Lamphere, Barbara; Noel, Megan; Heaton, Alexis; Andersson, Sarah

2017-11-01

Supply chain bottlenecks that prevent community health workers (CHWs) from accessing essential medicines significantly increase under-5 child mortality, particularly in poor and rural areas. Using implementation research, interventions aimed at improving supply chain practices and access to medicines were tested in Malawi and Rwanda. These interventions included simple demand-based resupply procedures, using mobile technology and traditional methods for communication, and multilevel, performance-driven quality improvement (QI) teams. Mixed-method evaluations were conducted at baseline (2010), midline (2013), and endline (2014). Baseline assessments identified common bottlenecks and established performance levels. Midline assessments identified which intervention package had the greatest impact. Endline surveys measured the progress of scale-up and institutionalization of each innovation. In both Rwanda and Malawi CHWs, health center staff, and district managers all cited many benefits of the establishment of resupply procedures and QI teams: such as providing structure and processes, a means to analyze and discuss problems and enhance collaboration between staff. Implementing simple, streamlined, demand-based resupply procedures formed the basis for informed and regular resupply, and increased the visibility of appropriate and timely community logistics data. QI teams played a critical role in reinforcing resupply procedures and routinely unlocking the bottlenecks that prevent the continuous flow of critical health products. While simple, streamlined, demand-based resupply procedures provide the basis for regular, functional, and efficient resupply of CHWs, the procedures alone are not sufficient to create consistent change in product availability. Supporting these procedures with multilevel QI teams reinforces the correct and consistent use of resupply procedures. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Fragmented lives: reconstructing rural livelihoods in post-genocide Rwanda

NARCIS (Netherlands)

Koster, M.

2008-01-01

During the genocide in Rwanda (1994) nearly a million Tutsi and moderate Hutu were killed and millions of people were displaced. Since 2002, social scientist Marian Koster has regularly visited the country for her PhD-research at Wageningen University. Her study centred on the strategies that

Building a National Simulation Program in Rwanda Through the Use ...

African Journals Online (AJOL)

KHI) and VVOB (the Flemish Interna- tional Corporation in Belgium). Through this partnership former KHI, currently College of Medicine and. Health Sciences of the University of Rwanda – ( UR-CMHS) was able to build an initial simulation ...

The acquisition of English as a second language in Rwanda ...

African Journals Online (AJOL)

Dr Karangwa

The use of English in daily communication in Rwanda is very limited and the proficiency in ... Pearson, 2013; Uwubuntu, 2013). .... as Noam Chomsky suggests, there is a period in the human development (Critical Period) when the brain is.

Nursing and Midwifery Education in Rwanda: Telling our Story

African Journals Online (AJOL)

1University of Rwanda College of Medicine and Health Sciences. 2Human ... This increased level of education for nursing and midwifery was supported by ... education appeared when nursing students were al- lowed to ... study model of innovative E-learning, thus allowing ... the production of qualified teachers. Raising ...

Some physico-chemical characteristics of ground water in Rwanda

African Journals Online (AJOL)

These results indicated different levels of pollution in groundwater of Rwanda. A detailed study looking at different plausible pollution sources should be conducted in order to validate the results and advice on environmental protection of this precious source of drinking water. Key words: groundwater, heavy metals, pollution ...

Making Abortion Safer in Rwanda: Operationalization of the Penal ...

African Journals Online (AJOL)

Penal code was revised in Rwanda in 2012 allowing legal termination of pregnancy resulting from rape, incest, forced marriage, or on medical grounds. An evaluation was conducted to assess women's access to abortion services as part of an ongoing program to operationalize the new exemptions for legal abortion.

Analysis and modification of blue sapphires from Rwanda by ion beam techniques

Energy Technology Data Exchange (ETDEWEB)

Bootkul, D., E-mail: mo_duangkhae@hotmail.com [Department of General Science - Gems & Jewelry, Faculty of Science, Srinakharinwirot University, Bangkok 10110 (Thailand); Chaiwai, C.; Tippawan, U. [Plasma and Beam Physics Research Facility, Department of Physics and Materials Science, Faculty of Science, Chiang Mai University, Chiang Mai 50200 (Thailand); Wanthanachaisaeng, B. [Gems Enhancement Research Unit, Faculty of Gems, Burapha University, Chanthaburi Campus, Chanthaburi 22170 (Thailand); Intarasiri, S., E-mail: saweat@gmail.com [Science and Technology Research Institute, Chiang Mai University, Chiang Mai 50200 (Thailand)

2015-12-15

Highlights: • Ion beam analysis is an effective method for detecting trace elements. • Ion beam treatment is able to improve optical and color appearances of the blue sapphire from Rwanda. • These alternative methods can be extended to jewelry industry for large scale application. - Abstract: Blue sapphire is categorised in a corundum (Al{sub 2}O{sub 3}) group. The gems of this group are always amazed by their beauties and thus having high value. In this study, blue sapphires from Rwanda, recently came to Thai gemstone industry, are chosen for investigations. On one hand, we have applied Particle Induced X-ray Emission (PIXE), which is a highly sensitive and precise analytical technique that can be used to identify and quantify trace elements, for chemical analysis of the sapphires. Here we have found that the major element of blue sapphires from Rwanda is Al with trace elements such as Fe, Ti, Cr, Ga and Mg as are commonly found in normal blue sapphire. On the other hand, we have applied low and medium ion implantations for color improvement of the sapphire. It seems that a high amount of energy transferring during cascade collisions have altered the gems properties. We have clearly seen that the blue color of the sapphires have been intensified after nitrogen ion bombardment. In addition, the gems were also having more transparent and luster. The UV–Vis–NIR measurement detected the modification of their absorption properties, implying of the blue color increasing. Here the mechanism of these modifications is postulated and reported. In any point of view, the bombardment by using nitrogen ion beam is a promising technique for quality improvement of the blue sapphire from Rwanda.

An interoperability architecture for the health information exchange in Rwanda

CSIR Research Space (South Africa)

Crichton, R

2012-08-01

Full Text Available Rwanda, one of the smallest and most densely populated countries in Africa, has made rapid and substantial progress towards designing and deploying a national health information system. One of the challenging aspects of the system is the design...

DOI: https://dx.doi.org/10.4314/rj.v2i1.1A Dear Rwanda Journal ...

African Journals Online (AJOL)

Corporate Edition

DOI: https://dx.doi.org/10.4314/rj.v2i1.1A. EDITORIAL. Dear Rwanda Journal Series A readers,. On behalf of the editorial board, I am pleased to have this volume number 2 of Rwanda Journal of. Arts and Humanities out! With contributions from scholars and lecturers in the field of arts and humanities and philosophy, this ...

Non-technical skills of anaesthesia providers in Rwanda: an ethnography.

Science.gov (United States)

Livingston, Patricia; Zolpys, Lauren; Mukwesi, Christian; Twagirumugabe, Theogene; Whynot, Sara; MacLeod, Anna

2014-01-01

Patient safety depends on excellent practice of anaesthetists' non-technical skills (ANTS). The ANTS framework has been validated in developed countries but there is no literature on the practice of ANTS in low-income countries. This study examines ANTS in this unexplored context. This qualitative ethnographic study used observations of Rwandan anaesthesia providers and in-depth interviews with both North American and Rwandan anaesthesia providers to understand practice of ANTS in Rwanda. Communication is central to the practice of ANTS. Cultural factors in Rwanda, such as lack of assertiveness and discomfort taking leadership, and the strains of working in a resource-limited environment hinder the unfettered and focused communication needed for excellent anaesthesia practice. Despite the challenges, anaesthesia providers are able to coordinate activities when good communication is actively encouraged. Future teaching interventions should address leadership and communication skills through encouraging both role definition and speaking up for patient safety.

Six years of inclusive education at the University of Rwanda-College ...

African Journals Online (AJOL)

USER

2013-04-01

Apr 1, 2013 ... The College of Education of the University of Rwanda developed and implemented the ... special educational assessment/placement tool” and “Profile, ... the learning environment and teaching strategies to ensure high quality ...

Some aspects of risks and natural hazards in the rainfall variability space of Rwanda.

Science.gov (United States)

Nduwayezu, Emmanuel; Derron, Marc-Henri; Jaboyedoff, Michel; Penna, Ivanna; Kanevski, Mikhaïl

2014-05-01

Rwanda is facing challenges related to its dispersed population and their density. Risk assessment for natural disasters is becoming important in order to reduce the extent and damages of natural disasters. Rwanda is a country with a diversity of landscapes. Its mountains and marshes have been considered as a water reserve, a forest and grazing reserve by the population (currently around 11 million). Due to geologic and climate conditions, the country is subject of different natural processes, in particular hydrological events (flooding and also landslides), but also earthquakes and volcanism, which the communities have to live with in the western part. In the last years, population expansion for land by clearing of forests and draining marshes, seems to be acting as an aggravating factor. Therefore, a risk assessment for rainfall related hazards requires a deep understanding of the precipitation patterns. Based on satellite image interpretation, historical reports of events, and the analysis of rainfalls variability mapping and probabilistic analyses of events, the aim of this case study is to produce an overview and a preliminary assessment of the hazards scenario in Rwanda.

Monthly Wind Characteristics and Wind Energy in Rwanda | Sarari ...

African Journals Online (AJOL)

Evaluating wind power potential for a site is indispensable before making any ... objective was to investigate the potential of wind energy resource in Rwanda. ... fit to the distribution of the measured wind data varies from a location to another. ... (14); Eritrea (1); Ethiopia (30); Ghana (27); Kenya (29); Lesotho (1); Libya (2) ...

Teaching History after Identity-Based Conflicts: The Rwanda Experience

Science.gov (United States)

Freedman, Sarah Warshauer; Weinstein, Harvey M.; Murphy, Karen; Longman, Timothy

2008-01-01

In response to the educational challenges countries face after violent conflict, the authors explored the links between larger political processes and decisions about teaching history. The authors focus on secondary schools in Rwanda, where they have been working on educational issues since 2001, and ask the questions: How can material for a…

Role of Conflict in shaping fertility preferences in Rwanda

NARCIS (Netherlands)

Rutayisire, P.-C.; Broekhuis, A.; Hooimeijer, P.

2013-01-01

Conflicts affect the social and economic conditions that could account for the stall in fertility decline in Sub-Saharan Africa. For Rwanda, the total fertility rate decreased very rapidly to 6.1 in the eighties but stalled at that level in the nineties. Part of the stall can be attributed to a lack

Purpose of Introduction as a Predictor of Invasiveness among Introduced Shrubs in Rwanda

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Jean Leonard Seburanga

2015-01-01

Full Text Available The introduced shrub flora in Rwanda was analyzed and the risk of invasion was assessed based on the species’ purposes of introduction. The results showed that more than half of invasive alien shrubs in Rwanda were introduced as ornamentals. They include Agave americana L., Bryophyllum proliferum Bowie ex Hook., Caesalpinia decapetala (Roth Alston, Lantana camara L., and Tithonia diversifolia (Hemsley A. Gray. However, these represented only 3.16% of the total number of introduced ornamental shrubs. At the time when the study was conducted, no introduced food crop had become invasive. Species introduced for purposes other than food or culinary use showed higher likelihood of becoming invasive.

The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

Science.gov (United States)

Ngabo, Fidele; Mvundura, Mercy; Gazley, Lauren; Gatera, Maurice; Rugambwa, Celse; Kayonga, Eugene; Tuyishime, Yvette; Niyibaho, Jeanne; Mwenda, Jason M; Donnen, Philippe; Lepage, Philippe; Binagwaho, Agnes; Atherly, Deborah

2016-01-01

Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction. This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$. Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction. Households often bear the largest share of the economic burden attributable to

Care-seeking patterns among families that experienced under-five child mortality in rural Rwanda.

Science.gov (United States)

Kagabo, Daniel M; Kirk, Catherine M; Bakundukize, Benjamin; Hedt-Gauthier, Bethany L; Gupta, Neil; Hirschhorn, Lisa R; Ingabire, Willy C; Rouleau, Dominique; Nkikabahizi, Fulgence; Mugeni, Catherine; Sayinzoga, Felix; Amoroso, Cheryl L

2018-01-01

Over half of under-five deaths occur in sub-Saharan Africa and appropriate, timely, quality care is critical for saving children's lives. This study describes the context surrounding children's deaths from the time the illness was first noticed, through the care-seeking patterns leading up to the child's death, and identifies factors associated with care-seeking for these children in rural Rwanda. Secondary analysis of a verbal and social autopsy study of caregivers who reported the death of a child between March 2013 to February 2014 that occurred after discharge from the child's birth facility in southern Kayonza and Kirehe districts in Rwanda. Bivariate analyses using Fisher's exact tests were conducted to identify child, caregiver, and household factors associated with care-seeking from the formal health system (i.e., community health worker or health facility). Factors significant at α = 0.10 significance level were considered for backwards stepwise multivariate logistic regression, stopping when remaining factors were significantly associated with care-seeking at α = 0.05 significance level. Among the 516 eligible deaths among children under-five, 22.7% (n = 117) did not seek care from the health system. For those who did, the most common first point of contact was community health workers (45.8%). In multivariate logistic regression, higher maternal education (OR = 3.36, 95% CI: 1.89, 5.98), having diarrhea (OR = 4.21, 95%CI: 1.95, 9.07) or fever (OR = 2.03, 95%CI: 1.11, 3.72), full household insurance coverage (3.48, 95%CI: 1.79, 6.76), and longer duration of illness (OR = 22.19, 95%CI: 8.88, 55.48) were significantly associated with formal care-seeking. Interventions such as community health workers and insurance promote access to care, however a gap remains as many children had no contact with the health system prior to death and those who sought formal care still died. Further efforts are needed to respond to urgent cases in communities and further

The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

Directory of Open Access Journals (Sweden)

Fidele Ngabo

Full Text Available Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction.This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$.Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction.Households often bear the largest share of the economic burden

Financial Literacy and Financial Behaviour: Experimental Evidence from Rural Rwanda

NARCIS (Netherlands)

Sayinzoga, Aussi; Bulte, E.H.; Lensink, Robert

We organise a field experiment with smallholder farmers in Rwanda to measure the impact of financial literacy training on financial knowledge and behaviour. The training increased financial literacy of participants, changed their savings and borrowing behaviour and had a positive effect on the new

Experience with a Massive Open Online Course in Rural Rwanda

Science.gov (United States)

Warugaba, Christine; Naughton, Brienna; Hedt-Gauthier, Bethany; Muhirwa, Ernest; Amoroso, Cheryl L.

2016-01-01

The growing utilization of massive open online courses (MOOCs) is opening opportunities for students worldwide, but the completion rate for MOOCs is low (Liyanagunawardena, Adams, & Williams, 2013). Partners In Health (PIH) implemented a "flipped" MOOC in Rwanda that incorporated in-class sessions to facilitate participant…

Developing human rights-based strategies to improve health among female sex workers in Rwanda.

Science.gov (United States)

Binagwaho, Agnès; Agbonyitor, Mawuena; Mwananawe, Aimable; Mugwaneza, Placidie; Irwin, Alec; Karema, Corine

2010-12-15

How governments should address sex work is a topic of current debate in Rwanda and other countries. Some constituencies propose harsher punishment of sex workers as the cornerstone of an improved policy. We argue that an adequate policy response to sex work in the Rwandan context must prioritize public health and reflect current knowledge of the social determinants of health. This does not imply intensified repression, but a comprehensive agenda of medical and social support to improve sex workers' access to health care, reduce their social isolation, and expand their economic options. Evidence from social epidemiology converges with rights-based arguments in this approach. Recent field interviews with current and former sex workers strengthen the case, while highlighting the need for further social scientific and epidemiological analysis of sex work in Rwanda. Rwanda has implemented some measures that reflect a rights-based perspective in addressing sex work. For example, recent policies seek to expand access to education for girls and support sex workers in the transition to alternative livelihoods. These policies reinforce the model of solidarity-based public health action for which Rwanda has been recognized. Whether such measures can maintain traction in the face of economic austerity and ideological resistance remains to be seen. Copyright © 2010 Binagwaho, Agbonyitor, Mwananawe, Mugwaneza, Irwin, and Karema. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

The Evolution of the Internet in Ethiopia and Rwanda: Towards a “Developmental” Model?

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Iginio Gagliardone

2016-08-01

Full Text Available The Internet in Africa has become an increasingly contested space, where competing ideas of development and society battle for hegemony. By comparing the evolution of the Internet in Ethiopia and Rwanda, we question whether policies and projects emerging from two of Africa’s fastest growing, but also most tightly controlled countries, can be understood as part of a relatively cohesive model of the ‘developmental’ Internet, which challenges mainstream conceptions. Our answer is a qualified yes. Ethiopia and Rwanda have shared an overarching strategy which places the state as the prime mover in the development of Internet policy and large-scale ICT projects. Rwanda, however, appears to have developed a more open model which can accommodate a greater variety of actors and opinions, and incorporate them within a relatively coherent vision that emanates from the centre. Ethiopia, in contrast, has developed a more closed model, where all powers rest firmly in the hands of a government that has refused (so far to entertain and engage with alternative ideas of the Internet. In the case of Rwanda, we argue, this approach reflects broader strategies adopted by the government in the economic domain but appears to counter the prevailing political approach of the government, allowing for a greater degree of freedom on the Internet as compared to traditional media. While in the case of Ethiopia, the opposite is true; Ethiopia’s Internet policies appear to run counter to prevailing economic policies but fit tightly with the government’s approach to politics and governance.

Environmental causes and impacts of the genocide in Rwanda ...

African Journals Online (AJOL)

The last decade of the 20th century was the most turbulent Rwanda has ever experienced in its history. The country was ravaged by civil war, ... Rwandan families were affected by and are still dealing with impacts such as death, disease, disability, poverty, loss of dignity and imprisonment. This paper uses a geographical ...

Small Hydropower Development in Rwanda: Trends, Opportunities and Challenges

Science.gov (United States)

Geoffrey, Gasore; Zimmerle, Daniel; Ntagwirumugara, Etienne

2018-04-01

The Rift Valley region of Sub-Saharan Africa represents a promising area for the development of small (facilities constructed after 2007 are connected to off-grid systems. The study provides an overview of the economic incentives for developing small hydropower systems in Rwanda and the potential contribution of that development to Rwanda’s electrification goals.

Lactic Acid Bacteria in Health and Disease | Ongol | Rwanda ...

African Journals Online (AJOL)

Rwanda Journal of Health Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 1, No 1 (2012) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected ...

Basic elements for breast screening programs for Rwanda

International Nuclear Information System (INIS)

Abenanye, Emmanuel

2015-02-01

Mammography refers to the X-ray examination of the human breast, and is considered the single most important diagnostic tool in the early detection of breast cancer, which is by far the most common cancer among women. There is good evidence from clinical trials, that mammographic screening can reduce the breast cancer mortality with about 30%. The side effects include a small and age related risk of carcinogenesis due to the exposure of the glandular tissues in the breast to ionizing radiation. As for all X-ray examinations, and of special importance when investigating large populations of asymptomatic women, the relationship between radiation risk and diagnostic accuracy in mammography must be optimized. The overall objective of this thesis was to investigate and improve methods for average glandular dose (AGD) and image quality evaluation in mammography and provide some practical guidance. To assess the behavioral factors influencing breast screening the best set up of the mammography unit as well as equipment construction and the skills of people operating the machines in terms of the radiation protection screening programs. There has been doubts about the efficiency of so called service screening, i.e. routine screening programs (Sjonell and Stahle, 1999), but there is evidence suggesting a reduction of breast cancer mortality similar to that observed in the randomised trials (Duffy et al. 2002). However no study has been carried out in Rwanda of this nature to see what are the basic breast screening elements and behavioral elements that influence it. Therefore, the factors that influence women's mammography screening behavior is an important issue to be uncovered, in order to facilitate the understanding of such a behavior. This report sets out to investigate the factors that influence participation in mammography screening in Rwanda. Such an investigation aims to raise the awareness of health care providers of the factors that influence Rwanda's women

A Case Study Optimizing Human Resources in Rwanda's First Dental School: Three Innovative Management Tools.

Science.gov (United States)

Hackley, Donna M; Mumena, Chrispinus H; Gatarayiha, Agnes; Cancedda, Corrado; Barrow, Jane R

2018-06-01

Harvard School of Dental Medicine, University of Maryland School of Dentistry, and the University of Rwanda (UR) are collaborating to create Rwanda's first School of Dentistry as part of the Human Resources for Health (HRH) Rwanda initiative that aims to strengthen the health care system of Rwanda. The HRH oral health team developed three management tools to measure progress in systems-strengthening efforts: 1) the road map is an operations plan for the entire dental school and facilitates delivery of the curriculum and management of human and material resources; 2) each HRH U.S. faculty member develops a work plan with targeted deliverables for his or her rotation, which is facilitated with biweekly flash reports that measure progress and keep the faculty member focused on his or her specific deliverables; and 3) the redesigned HRH twinning model, changed from twinning of an HRH faculty member with a single Rwandan faculty member to twinning with multiple Rwandan faculty members based on shared academic interests and goals, has improved efficiency, heightened engagement of the UR dental faculty, and increased the impact of HRH U.S. faculty members. These new tools enable the team to measure its progress toward the collaborative's goals and understand the successes and challenges in moving toward the planned targets. The tools have been valuable instruments in fostering discussion around priorities and deployment of resources as well as in developing strong relationships, enabling two-way exchange of knowledge, and promoting sustainability.

Global Gender Discourses in Education: Evidence from Post-Genocide Rwanda

Science.gov (United States)

Russell, Susan Garnett

2016-01-01

This paper investigates global gender policy discourses within the education realm in post-genocide Rwanda. Drawing on interview data from students in seven secondary schools and Unterhalter's gender framework (Unterhalter, Elaine. 2007. "Gender, Schooling and Global Social Justice." New York, NY: Routledge), I analyse the extent global…

Time domain astronomy with Swift and Fermi | Gehrels | Rwanda ...

African Journals Online (AJOL)

Rwanda Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 1, No 1 (2016) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your ...

Gender Inequality Prevents Abused Women from Seeking Care Despite Protection Given in Gender-Based Violence Legislation: A Qualitative Study from Rwanda.

Science.gov (United States)

Umubyeyi, Aline; Persson, Margareta; Mogren, Ingrid; Krantz, Gunilla

2016-01-01

Despite its burden on a person's life, Intimate Partner Violence (IPV) is known to be poorly recognised and managed in most countries and communities. This study aimed to explore health care professionals' experiences of the health care seeking processes of women exposed to intimate partner violence in Rwanda. Six focus group discussions were conducted in three district hospitals and three mental health units in Rwanda. A sample of 43 health care professionals with various professions and length of work experience, who regularly took care of patients subjected to IPV, was selected for focus group discussions. The analysis was performed using qualitative content analysis. The theme "Gendered norms and values defeat the violence legislation in women's health care seeking when women are abused" expressed the health care professionals' experiences of the double-faced situation which women exposed to IPV met in their help seeking process. Positive initiatives to protect women were identified, but the potential for abused women to seek help and support was reduced because of poverty, gender inequality with prevailing strong norms of male superiority, and the tendency to keep abuse as a private family matter. Legislative measures have been instituted to protect women from abuse. Still many Rwandan women do not benefit from these efforts. The role of the health care services needs to be reinforced as an important and available resource for help and support for abused women but further legislative changes are also needed. Initiatives to further improve gender equality, and institutionalised collaboration between different sectors in society would contribute to protecting women from IPV.

Gender Inequality Prevents Abused Women from Seeking Care Despite Protection Given in Gender-Based Violence Legislation: A Qualitative Study from Rwanda.

Directory of Open Access Journals (Sweden)

Aline Umubyeyi

Full Text Available Despite its burden on a person's life, Intimate Partner Violence (IPV is known to be poorly recognised and managed in most countries and communities. This study aimed to explore health care professionals' experiences of the health care seeking processes of women exposed to intimate partner violence in Rwanda.Six focus group discussions were conducted in three district hospitals and three mental health units in Rwanda. A sample of 43 health care professionals with various professions and length of work experience, who regularly took care of patients subjected to IPV, was selected for focus group discussions. The analysis was performed using qualitative content analysis.The theme "Gendered norms and values defeat the violence legislation in women's health care seeking when women are abused" expressed the health care professionals' experiences of the double-faced situation which women exposed to IPV met in their help seeking process. Positive initiatives to protect women were identified, but the potential for abused women to seek help and support was reduced because of poverty, gender inequality with prevailing strong norms of male superiority, and the tendency to keep abuse as a private family matter.Legislative measures have been instituted to protect women from abuse. Still many Rwandan women do not benefit from these efforts. The role of the health care services needs to be reinforced as an important and available resource for help and support for abused women but further legislative changes are also needed. Initiatives to further improve gender equality, and institutionalised collaboration between different sectors in society would contribute to protecting women from IPV.

Sharing scarcity : land access and social relations in Southeast Rwanda

NARCIS (Netherlands)

Leegwater, M.

2015-01-01

Land is a crucial yet scarce resource in Rwanda, where about 90% of the population is engaged in subsistence farming, and access to land is increasingly becoming a source of conflict. This study examines the effects of land-access and land-tenure policies on local community relations, including

Unity in diversity – the One UN, UNHCR and Rwanda

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Tim Maurer

2007-12-01

Full Text Available Rwanda is one of eight countries chosen to pilot the ‘One UN’concept. In an impoverished nation shaped by displacement,there are currently 16 UN agencies. The challenges of‘Delivering as One’ – and tackling inefficiency, fragmentationand inter-agency competition for resources – are daunting.

The needs of patient family members in the intensive care unit in Kigali Rwanda

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Petra Brysiewicz

2014-07-01

Full Text Available Background. The admission of a relative to an intensive care unit (ICU is a stressful experience for family members. There has been limited research addressing this issue in Kigali, Rwanda.Objective. To explore the needs of patient family members admitted into an ICU in Kigali, Rwanda.Methods. This study used a quantitative exploratory design focused on exploring the needs of patient family members in ICU at one hospital in Kigali, Rwanda. Family members (N=40 were recruited using the convenience sampling strategy. The Critical Care Family Needs Inventory was used to collect relevant data.Results. The participants identified various needs to be met for the family during the patient’s admission in ICU. The most important was the need for assurance, followed by the need for comfort, information, proximity and lastly support. Three additional needs specific to this sample group were also identified, related to resource constraints present in the hospital where the study was carried out.Conclusion. These results offer insight for nurses and other healthcare professionals as to what the important needs are that must be considered for the patient family members in ICUs within a resource-constrained environment.

‘Confession’ and ‘Forgiveness’ as a strategy for development in post-genocide Rwanda

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Anne Kubai

2016-11-01

Full Text Available The government of Rwanda has pursued reconciliation with great determination in the belief that it is the only moral alternative to post-genocide social challenges. In Rwanda, communities must be mobilised and reshaped for social, political and economic reconstruction. This creates a rather delicate situation. Among other strategies, the state has turned to the concepts of confession and forgiveness which have deep religious roots, and systematised them both at the individual and community or state level in order to bring about reconciliation, justice, social cohesion and ultimately economic development. In view of these strategies and challenges, some of the important questions are: Does forgiveness restore victims and empower them to heal their communities? What empirical evidence exists that religiously inspired justice and reconciliation processes after mass political violence make a difference? In what areas might the understanding of religious thought and activity towards transitional justice be deepened? These questions provide the backdrop against which I examine the case of post-genocide Rwanda in this article. A hermeneutic interpretative analysis is used to situate the phenomena of forgiveness, confession and social transformation within the specific context of post-conflict societies.

Extent of Cropland and Related Soil Erosion Risk in Rwanda

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Fidele Karamage

2016-06-01

Full Text Available Land conversion to cropland is one of the major causes of severe soil erosion in Africa. This study assesses the current cropland extent and the related soil erosion risk in Rwanda, a country that experienced the most rapid population growth and cropland expansion in Africa over the last decade. The land cover land use (LCLU map of Rwanda in 2015 was developed using Landsat-8 imagery. Based on the obtained LCLU map and the spatial datasets of precipitation, soil properties and elevation, the soil erosion rate of Rwanda was assessed at 30-m spatial resolution, using the Revised Universal Soil Loss Equation (RUSLE model. According to the results, the mean soil erosion rate was 250 t·ha−1·a−1 over the entire country, with a total soil loss rate of approximately 595 million tons per year. The mean soil erosion rate over cropland, which occupied 56% of the national land area, was estimated at 421 t·ha−1·a−1 and was responsible for about 95% of the national soil loss. About 24% of the croplands in Rwanda had a soil erosion rate larger than 300 t·ha−1·a−1, indicating their unsuitability for cultivation. With a mean soil erosion rate of 1642 t·ha−1·a−1, these unsuitable croplands were responsible for 90% of the national soil loss. Most of the unsuitable croplands are distributed in the Congo Nile Ridge, Volcanic Range mountain areas in the west and the Buberuka highlands in the north, regions characterized by steep slopes (>30% and strong rainfall. Soil conservation practices, such as the terracing cultivation method, are paramount to preserve the soil. According to our assessment, terracing alone could reduce the mean cropland soil erosion rate and the national soil loss by 79% and 75%, respectively. After terracing, only a small proportion of 7.6% of the current croplands would still be exposed to extreme soil erosion with a rate >300 t·ha−1·a−1. These irremediable cropland areas should be returned to mountain forest to

Kivuguto traditional fermented milk and the dairy industry in Rwanda. A review

Directory of Open Access Journals (Sweden)

Karenzi, E.

2013-01-01

Full Text Available Traditional methods of fermenting milk involve the use of indigenous microorganisms, leading to the production of a variety of tastes in fermented milk products. Kivuguto is a fermented milk product, which is popular in Rwanda. Kivuguto is produced by traditional spontaneous acidification of raw milk by a microflora present both on utensils and containers used for milk preservation and in the near environment of cattle. Thus, this method does not allow the shelf stability of the product. Faced to such a situation, modern dairies now produce fermented milk and other dairy products using exotic strains. The main objectives of this paper are firstly, to provide documentation on the traditional production of kivuguto, as well as its by-products, and secondly, to describe the current situation of the dairy industry in Rwanda.

Well-Being in Central Asia and the Caucasus | Abbott | Rwanda ...

African Journals Online (AJOL)

This paper deals with four countries that, like Rwanda, suffered economic and social collapse in the early 1990s. It develops a sociologically informed understanding of what influences the well-being of people living in Kazakhstan and Kyrgyzstan (Central Asian Republics) and Armenia and Georgia ( the Caucasus), four of ...

The Economic Burden Attributable to a Child’s Inpatient Admission for Diarrheal Disease in Rwanda

Science.gov (United States)

Ngabo, Fidele; Mvundura, Mercy; Gazley, Lauren; Gatera, Maurice; Rugambwa, Celse; Kayonga, Eugene; Tuyishime, Yvette; Niyibaho, Jeanne; Mwenda, Jason M.; Donnen, Philippe; Lepage, Philippe; Binagwaho, Agnes; Atherly, Deborah

2016-01-01

Background Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction. Methods This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child’s caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$. Results Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction. Conclusion Households often bear the largest share

Innovative private micro-hydro power development in Rwanda

International Nuclear Information System (INIS)

Pigaht, Maurice; Plas, Robert J. van der

2009-01-01

Under the 'Private Sector Participation in Micro-Hydro Development Project in Rwanda', four newly registered Rwandan companies are each constructing a micro-hydro electricity plant (100-500 kW) and building a low-voltage distribution grid. These companies financed their plants through their own equity and debt with support from the PSP Hydro project. This support comprised a subsidy of 30-50% of investment costs, technical and business development assistance, project monitoring and financial controlling. The experiences gained so far have important implications for similar future micro-hydro energy sector development projects and this paper puts forward three key messages: (i) institutional arrangements rather than technical quality determine the success of such projects; (ii) truly sustainable rural electrification through micro-hydro development demands a high level of local participation at all levels and throughout all project phases, not just after plant commissioning; and (iii) real impact and sustainability can be obtained through close collaboration of local private and financial sector firms requiring only limited external funds. In short, micro-hydro projects can and will be taken up by local investors as a business if the conditions are right. Applying these messages could result in an accelerated uptake of viable micro-hydro activities in Rwanda, and in the opinion of the authors elsewhere too.

Initiating Childhood Cancer Treatment in Rural Rwanda: A Partnership-Based Approach.

Science.gov (United States)

Stulac, Sara; Mark Munyaneza, Richard B; Chai, Jeanne; Bigirimana, Jean Bosco; Nyishime, Merab; Tapela, Neo; Chaffee, Sara; Lehmann, Leslie; Shulman, Lawrence N

2016-05-01

More than 85% of pediatric cancer cases and 95% of deaths occur in resource-poor countries that use less than 5% of the world's health resources. In the developed world, approximately 81% of children with cancer can be cured. Models applicable in the most resource-poor settings are needed to address global inequities in pediatric cancer treatment. Between 2006 and 2011, a cohort of children received cancer therapy using a new approach in rural Rwanda. Children were managed by a team of a Rwandan generalist doctor, Rwandan nurse case manager, Rwanda-based US-trained pediatrician, and US-based pediatric oncologist. Biopsies and staging studies were obtained in-country. Pathologic diagnoses were made at US or European laboratories. Rwanda-based clinicians and the pediatric oncologist jointly generated treatment plans by telephone and email. Treatment was provided to 24 patients. Diagnoses included lymphomas (n = 10), sarcomas (n = 9), leukemias (n = 2), and other malignancies (n = 3). Standard chemotherapy regimens included CHOP, ABVD, VA, COP/COMP, and actino-VAC. Thirteen patients were in remission at the completion of data collection. Two succumbed to treatment complications and nine had progressive disease. There were no patients who abandoned treatment. The mean overall survival was 31 months and mean disease-free survival was 18 months. These data suggest that chemotherapy can be administered with curative intent to a subset of cancer patients in this setting. This approach provides a platform for pediatric cancer care models, relying on local physicians collaborating with remote specialist consultants to deliver subspecialty care in resource-poor settings. © 2016 Wiley Periodicals, Inc.

Pharmacovigilance of artemether-lumefantrine in pregnant women followed until delivery in Rwanda

NARCIS (Netherlands)

Rulisa, Stephen; Kaligirwa, Nadine; Agaba, Steven; Karema, Corine; Mens, Petra F.; de Vries, Peter J.

2012-01-01

Background: The World Health Organization presently recommends Artemisinin-based combination therapy (ACT) as first-line therapy for uncomplicated P. falciparum malaria. Many malaria-endemic countries, including Rwanda, have adopted these treatment guidelines. The Artemisinin derivative Artemether,

Effect of precipitation on clinic-diagnosed enteric infections in children in Rwanda: an observational study

Directory of Open Access Journals (Sweden)

Miles Kirby, PhD

2018-05-01

Full Text Available Background: Enteric infections are a major cause of morbidity and mortality in low-income and middle-income countries, particularly among children younger than 5 years. Climate change projections for Rwanda predict increases in average temperature, along with increases in total precipitation and frequency of extreme rainfall events. Previous research in Rwanda has found that extreme rainfall events increase the risk of contaminated drinking water, a substantial contributor to diarrhoea in this setting. Relatively little is known about the effect of precipitation on more severe clinic-diagnosed infections in rural, low-income settings such as Rwanda. In the context of a randomised controlled trial to assess the effect of a national environmental health campaign in Rwanda, we did a substudy to assess the effect of total and extreme rainfall on enteric infections in children younger than 5 years. Methods: For this observational study, we collected data from all government health facilities in Rusizi District, Western Province, for the year 2015. Patient data for children younger than 5 years from 150 study villages were extracted from paper-based registers. Gridded daily precipitation data were downloaded from the Tropical Applications of Meteorology using SATellite and ground based observations (TAMSAT rainfall dataset in addition to local weather station data. We modelled the effect of total rainfall (in mm and occurrence of an extreme rainfall event (95th percentile in the past 2 years on daily health facility visits for enteric symptoms (diarrhoea, gastroenteritis, or vomiting, using Poisson regression with a Newey-West estimator to adjust for serial autocorrelation. We examined total and extreme rainfall within the previous 1, 2, 3, and 4 weeks, controlling for weekend day because we observed a consistent reduction in case counts on weekends. Findings: Data were extracted from 46 facilities, with a study catchment area of approximately 12�

Estimation of the size of the female sex worker population in Rwanda using three different methods.

Science.gov (United States)

Mutagoma, Mwumvaneza; Kayitesi, Catherine; Gwiza, Aimé; Ruton, Hinda; Koleros, Andrew; Gupta, Neil; Balisanga, Helene; Riedel, David J; Nsanzimana, Sabin

2015-10-01

HIV prevalence is disproportionately high among female sex workers compared to the general population. Many African countries lack useful data on the size of female sex worker populations to inform national HIV programmes. A female sex worker size estimation exercise using three different venue-based methodologies was conducted among female sex workers in all provinces of Rwanda in August 2010. The female sex worker national population size was estimated using capture-recapture and enumeration methods, and the multiplier method was used to estimate the size of the female sex worker population in Kigali. A structured questionnaire was also used to supplement the data. The estimated number of female sex workers by the capture-recapture method was 3205 (95% confidence interval: 2998-3412). The female sex worker size was estimated at 3348 using the enumeration method. In Kigali, the female sex worker size was estimated at 2253 (95% confidence interval: 1916-2524) using the multiplier method. Nearly 80% of all female sex workers in Rwanda were found to be based in the capital, Kigali. This study provided a first-time estimate of the female sex worker population size in Rwanda using capture-recapture, enumeration, and multiplier methods. The capture-recapture and enumeration methods provided similar estimates of female sex worker in Rwanda. Combination of such size estimation methods is feasible and productive in low-resource settings and should be considered vital to inform national HIV programmes. © The Author(s) 2015.

Etude linguistique chez les Baráshi/Banyaambo du Rwanda ...

African Journals Online (AJOL)

Among the main African Languages spoken in Rwanda besides Kinyarwaanda: amashí in the South, olucigá in the North and ikiráshi/ikinyaambo in the East, only olucigá has been particularly described: J.-B. Murekezi (1984), F.-X. Bangamwabo (1989); others are just mentioned in global sociolinguistic studies: B.

A typology of farm households for the Umutara Province in Rwanda

NARCIS (Netherlands)

Bidogeza, J.C.; Berentsen, P.B.M.; Graaff, de J.; Oude Lansink, A.G.J.M.

2009-01-01

For nearly 30 years, technologies for more sustainable land use have been developed and promoted in Rwanda. However, these technologies have not been fully adopted. Keeping in mind that the farming population is not homogeneous with respect to socio-economic variables, this paper typifies farm

Determinants of malaria control in a rural community in Eastern Rwanda

NARCIS (Netherlands)

Kateera, F.K.

2016-01-01

Malaria disease – particularly that caused by infection with Plasmodium falciparum parasite - remains a leading cause of severe morbidity and mortality particularly in sub-Saharan Africa, of which Rwanda is part. Infection of P. falciparum parasites into the body after a bite with in infected

Teachers' Innovative Change within Countrywide Reform: A Case Study in Rwanda

Science.gov (United States)

Uworwabayeho, Alphonse

2009-01-01

This article presents practical perspectives on mathematics teacher change through results of collaborative research with two mathematics secondary school teachers in order to improve the teaching and learning of mathematics in Rwanda. The 2006 national mathematics curriculum reform stresses pedagogies that enhance problem-solving, critical…

Hepatitis C virus and HIV co-infection among pregnant women in Rwanda.

Science.gov (United States)

Mutagoma, Mwumvaneza; Balisanga, Helene; Sebuhoro, Dieudonné; Mbituyumuremyi, Aimable; Remera, Eric; Malamba, Samuel S; Riedel, David J; Nsanzimana, Sabin

2017-02-22

Hepatitis C virus (HCV) infection is a pandemic causing disease; more than 185 million people are infected worldwide. An HCV antibody (Ab) prevalence of 6.0% was estimated in Central African countries. The study aimed at providing HCV prevalence estimates among pregnant women in Rwanda. HCV surveillance through antibody screening test among pregnant women attending antenatal clinics was performed in 30 HIV sentinel surveillance sites in Rwanda. Among 12,903 pregnant women tested at antenatal clinics, 335 (2.6% [95% Confidence Interval 2.32-2.87]) tested positive for HCV Ab. The prevalence of HCV Ab in women aged 25-49 years was 2.8% compared to 2.4% in women aged 15-24 years (aOR = 1.3; [1.05-1.59]); This proportion was 2.7% [2.37-2.94] in pregnant women in engaged in non-salaried employment compared to 1.2% [0.24-2.14] in those engaged in salaried employment (aOR = 3.2; [1.60-6.58]). The proportion of HCV Ab-positive co-infected with HIV was estimated at 3.9% (13 cases). Women in urban residence were more likely to be associated with HCV-infection (OR = 1.3; 95%CI [1.0-1.6]) compared to those living in rural setting. HCV is a public health problem in pregnant women in Rwanda. Few pregnant women were co-infected with HCV and HIV. Living in urban setting was more likely to associate pregnant women with HCV infection.

Analysis and modification of blue sapphires from Rwanda by ion beam techniques

Science.gov (United States)

Bootkul, D.; Chaiwai, C.; Tippawan, U.; Wanthanachaisaeng, B.; Intarasiri, S.

2015-12-01

Blue sapphire is categorised in a corundum (Al2O3) group. The gems of this group are always amazed by their beauties and thus having high value. In this study, blue sapphires from Rwanda, recently came to Thai gemstone industry, are chosen for investigations. On one hand, we have applied Particle Induced X-ray Emission (PIXE), which is a highly sensitive and precise analytical technique that can be used to identify and quantify trace elements, for chemical analysis of the sapphires. Here we have found that the major element of blue sapphires from Rwanda is Al with trace elements such as Fe, Ti, Cr, Ga and Mg as are commonly found in normal blue sapphire. On the other hand, we have applied low and medium ion implantations for color improvement of the sapphire. It seems that a high amount of energy transferring during cascade collisions have altered the gems properties. We have clearly seen that the blue color of the sapphires have been intensified after nitrogen ion bombardment. In addition, the gems were also having more transparent and luster. The UV-Vis-NIR measurement detected the modification of their absorption properties, implying of the blue color increasing. Here the mechanism of these modifications is postulated and reported. In any point of view, the bombardment by using nitrogen ion beam is a promising technique for quality improvement of the blue sapphire from Rwanda.

Trees and woodlots in Rwanda and their role in fuelwood supply

NARCIS (Netherlands)

Ndayambaje, J.D.

2013-01-01

Trees and woodlots on farms are prominent features of agricultural landscapes worldwide. For developing countries such as Rwanda where fuelwood is the main sources of energy for cooking, the contribution to total energy supply is important. However, little is known about their role in meeting

High Burden of Prevalent and Recently Acquired HIV among Female Sex Workers and Female HIV Voluntary Testing Center Clients in Kigali, Rwanda

NARCIS (Netherlands)

Braunstein, S.L.; Ingabire, C.M.; Geubbels, E.; Vyankandondera, J.; Umulisa, M.M.; Gahiro, E.; Uwineza, M.; Tuijn, C.J.; Nash, D.; van de Wijgert, J.H.H.M.

2011-01-01

Objectives: To estimate HIV prevalence and risk factors in population-based samples of female sex workers (FSW) and female voluntary counseling and testing (VCT) clients in Rwanda. Methods: We conducted a cross-sectional survey of 800 FSW and 1,250 female VCT clients in Rwanda, which included

Treating childhood cancer in Rwanda: the nephroblastoma example.

Science.gov (United States)

Kanyamuhunga, Aimable; Tuyisenge, Lisine; Stefan, Daniela Cristina

2015-01-01

Wilms tumor (WT) or nephroblastoma is the commonest childhood cancer in Rwanda. Nephroblastoma is regarded as one of the successes of pediatric oncology with long-term survival approaching 90%. The Objectives to evaluate the feasibility of treating childhood cancer using the nephroblastoma example and to calculate its cost of treatment in Rwanda. Prospective study over a 2 year period: 01 Jan 2010- 31 December 2011. A questionnaire was completed by all participants in the study and the following variables were collected at Kigali University Teaching Hospital: age at diagnosis, gender, transport cost, cost of investigations, staging, treatment and outcome, cost of hospitalization, type of medical, surgical, radiological interventions and their costs, number of admissions per patient and factors related to non compliance to treatment. All patients had a confirmed diagnosis on histopathology examination. The cost for treatment was calculated for early and late stage and was expressed in USA dollars. Analysis was done with SPSS 16.0. There were 25 patients diagnosed and treated for WT during the study period. Almost half of the patients 14/25 (56%) had advanced disease, seven children (28%) had stage IV, seven children stage III, six patients (24%) with stage II, while the remaining five (20%) had stage I with high risk tumor. The direct cost of management ranged from1,831.2 USD for early disease to 2,418.7 USD for advanced disease. The cost of transport, investigations and drugs were recorded as main contributing factors to the feasibility and cost of the treatment in 80% of the responses, followed by late presentation (56%) and poor compliance to treatment. Most challenges are related to unaffordable treatment and late presentation. The management of WT is feasible in Rwandan setting but efforts should be made in order to improve awareness of childhood cancer, early diagnosis and access to care. The government of Rwanda is committed to improve cancer care in the

[Overpopulation and war: the example of Rwanda].

Science.gov (United States)

Gotanegre J--

1996-01-01

The author examines the extent to which the recent events in Rwanda, including the civil war and the attempts at genocide, are related to overpopulation. In particular, three questions are considered: under what circumstances can reasonable people arrive at a situation in which they can participate in collective suicidal behavior? Do such crises arise from lack of resources, or failure to make the best use of the resources that do exist? Are such events part of a global conflict between liberal societies and societies governed by extremist idealists?

Prophylactic ampicillin versus cefazolin for the prevention of post-cesarean infectious morbidity in Rwanda.

Science.gov (United States)

Mivumbi, Victor N; Little, Sarah E; Rulisa, Stephen; Greenberg, James A

2014-03-01

To evaluate the efficacy of ampicillin versus cefazolin as prophylactic antibiotics prior to cesarean delivery in Rwanda. In a prospective, randomized, open-label, single-site study conducted between March and May 2012, the effects of prophylactic ampicillin versus cefazolin were compared among women undergoing cesarean delivery at the Centre Hospitalier Universitaire de Kigali, Rwanda. Postoperatively, participants were evaluated daily for infectious morbidity while in the hospital. Follow-up was done by phone and by appointment at the hospital within 2 weeks of delivery. During the study period, there were 578 total deliveries and 234 cesarean deliveries (40.4%). Overall, 132 women were enrolled in the study and randomized to receive either ampicillin (n=66) or cefazolin (n=66). No women were lost to follow-up. The overall infection rate was 15.9% (21/132). The infection rate in the ampicillin group and the cefazolin group was 25.8% (17/66) and 6.1% (4/66), respectively. Implementing a universal protocol in Rwanda of prophylactic cefazolin prior to cesarean delivery might reduce postoperative febrile morbidity, use of postoperative antibiotics, and number of postoperative days in hospital. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Socio-economic impact of rural farming structure in Rwanda: Case ...

African Journals Online (AJOL)

Coffee is the main source of income of the household producers of this crop in Rwanda. It contributes significantly to the inflows of foreigner currencies to the national economy. Although it is grown on only 6.3% of the total cultivated areas, it is the main activity of 500.0002 coffee growers households at countrywide3.

High burden of prevalent and recently acquired HIV among female sex workers and female HIV voluntary testing center clients in Kigali, Rwanda

NARCIS (Netherlands)

Braunstein, Sarah L.; Ingabire, Chantal M.; Geubbels, Eveline; Vyankandondera, Joseph; Umulisa, Marie-Michèle; Gahiro, Elysée; Uwineza, Mireille; Tuijn, Coosje J.; Nash, Denis; van de Wijgert, Janneke H. H. M.

2011-01-01

To estimate HIV prevalence and risk factors in population-based samples of female sex workers (FSW) and female voluntary counseling and testing (VCT) clients in Rwanda. We conducted a cross-sectional survey of 800 FSW and 1,250 female VCT clients in Rwanda, which included interviewing and testing

Six years of inclusive education at the University of Rwanda-College ...

African Journals Online (AJOL)

Inclusive education is one of the emerging challenges in the Rwandan education today, just like in many other educational systems. The College of Education of the University of Rwanda developed and implemented the inclusive education program since 2008. Thirty students with severe disabilities (SwDs) have enrolled, ...

Underdiagnosis of malnutrition in infants and young children in Rwanda: implications for attainment of the Millennium Development Goal to end poverty and hunger.

Science.gov (United States)

Binagwaho, Agnès; Agbonyitor, Mawuena; Rukundo, Alphonse; Ratnayake, Niloo; Ngabo, Fidel; Kayumba, Josephine; Dowdle, Bridget; Chopyak, Elena; Smith Fawzi, Mary C

2011-12-29

Progress towards the first Millennium Development Goal (MDG1) to end poverty and hunger has lagged behind attainment of other MDGs due to chronic poverty and worldwide inequity in access to adequate health care, food, clean water, and sanitation. Despite ongoing challenges, Rwanda has experienced economic progress and the expansion of the national public health system during the past 20 years. However, protein-energy malnutrition in children under five is still a major concern for physicians and government officials in Rwanda. Approximately 45% of children under the age of five in Rwanda suffer from chronic malnutrition, and one in four is undernourished. For years, health facilities in Rwanda have used incorrect growth references for measuring nutritional status of children despite the adoption of new standards by the World Health Organization in 2006. Under incorrect growth references used in Rwanda, a number of children under five who were severely underweight were not identified, and therefore were not treated for malnutrition, thus potentially contributing to the under five mortality rate. Given that one in ten children suffer from malnutrition worldwide, it is imperative that all countries with a burden of malnutrition adopt the most up-to-date international standards for measuring malnutrition, and that the problem is brought to the forefront of international public health initiatives. For low income countries in the process of improving economic conditions, as Rwanda is, increasing the identification and treatment of malnutrition can promote the advancement of MDG1 as well as physical and cognitive development in children, which is imperative for advancing future economic progress.

Underdiagnosis of malnutrition in infants and young children in Rwanda: implications for attainment of the Millennium Development Goal to end poverty and hunger

Directory of Open Access Journals (Sweden)

Binagwaho Agnès

2011-12-01

Full Text Available Abstract Progress towards the first Millennium Development Goal (MDG1 to end poverty and hunger has lagged behind attainment of other MDGs due to chronic poverty and worldwide inequity in access to adequate health care, food, clean water, and sanitation. Despite ongoing challenges, Rwanda has experienced economic progress and the expansion of the national public health system during the past 20 years. However, protein-energy malnutrition in children under five is still a major concern for physicians and government officials in Rwanda. Approximately 45% of children under the age of five in Rwanda suffer from chronic malnutrition, and one in four is undernourished. For years, health facilities in Rwanda have used incorrect growth references for measuring nutritional status of children despite the adoption of new standards by the World Health Organization in 2006. Under incorrect growth references used in Rwanda, a number of children under five who were severely underweight were not identified, and therefore were not treated for malnutrition, thus potentially contributing to the under five mortality rate. Given that one in ten children suffer from malnutrition worldwide, it is imperative that all countries with a burden of malnutrition adopt the most up-to-date international standards for measuring malnutrition, and that the problem is brought to the forefront of international public health initiatives. For low income countries in the process of improving economic conditions, as Rwanda is, increasing the identification and treatment of malnutrition can promote the advancement of MDG1 as well as physical and cognitive development in children, which is imperative for advancing future economic progress.

Rates, drivers and impacts of reforestation and afforestation in Western Rwanda.

Science.gov (United States)

Arakwiye, B.; Rogan, J.; Eastman, R.

2017-12-01

Within East-Africa, Rwanda is the most heavily populated, predominantly rural country where 85% of the population heavily depends on smallholder agriculture and natural resources. The biodiversity-rich, high elevation western region of Rwanda has historically experienced unprecedented forest loss and degradation, resulting in major losses of wildlife habitat, biodiversity and ecosystem services. Forest loss peaked during the 1990s civil wars and genocide when forests sheltered both civilians and combatants or were cleared to resettle refugees. Since the 2000s, national and international initiatives have encouraged reforestation and afforestation activities aiming to reconnect remnant fragments and improve environmental resiliency. However, consistent spatially- and temporally-explicit regional assessments of these afforestation and reforestation activities are still lacking. This study links satellite and in situ socio-ecological data to document the rates and drivers of reforestation and afforestation in Western Rwanda. Random Forest classification was used to map the extent of forests using multitemporal Landsat-5, -7 and -8 images covering the period from 1986 to 2016. Semi-structured interviews with stakeholders were used to identify the potential drivers of afforestation and reforestation. Preliminary results show a net increase of 0.05% in forest cover from 2001 to 2016, predominantly occurring on former croplands and pasture/grasslands. Around 90% of afforested and reforested areas are patchy monocultures of Eucalyptus and Alnus species, valued for timber and wood by-products but with relatively low potential to provide other ecosystem services compared to native tree species. These results highlight the need for an integrated approach to afforestation and reforestation to ensure the sustainable provision of diverse ecosystem services.

Interrelatedness of child health, protection and well-being: an application of the SAFE model in Rwanda.

Science.gov (United States)

Betancourt, Theresa S; Williams, Timothy P; Kellner, Sarah E; Gebre-Medhin, Joy; Hann, Katrina; Kayiteshonga, Yvonne

2012-05-01

This study examines the core components of children's basic security and well-being in order to examine issues central to improving child protection in Rwanda. Sources of data included 15 focus groups with adults, 7 focus groups with children ages 10-17, and 11 key informant interviews with child protection stakeholders, including representatives from international NGOs, community-based groups, and the Rwandan Government, all of which took place in April and May of 2010. Participants painted a complex picture of threats to children's basic security in Rwanda. Three key themes were pervasive across all interviews: (1) deterioration of social and community cohesion in post-genocide Rwanda; (2) the cascading effects of poverty; and (3) the impact of caregiver illness and death on the caregiving environment. Consistent with the SAFE (Safety/freedom from harm; Access to basic physiological needs and healthcare; Family and connection to others; Education and economic security) model of child protection, participants rarely elaborated on a child protection threat independent of other basic security needs and rights. Findings suggest a need for integrated approaches to child protection that recognize this interrelatedness and extend beyond issue-specific child protection responses. This study contributes to a growing body of work highlighting the interrelated nature of child protection threats and the implications of adaptive and dangerous survival strategies that children and families engage in to meet their basic security needs. Analysis of this interrelatedness provides a roadmap for improving policies and implementing integrated and robust child protection strategies in Rwanda and other settings. Copyright © 2012 Elsevier Ltd. All rights reserved.

Synthèse des résultats de recherche sur l'agronomie du caféier arabica (Coffea arabica L.) au Rwanda au 31 mars 1994

OpenAIRE

Rutunga, V.; Kavamahangat, F.; Nsengimana, C.

1999-01-01

Synthesis of Results on Coffee Agronomy Research in Rwanda on 31 March 1994. Arabica coffee plays an important role in the macro-economic performance of Rwanda. As a result, Agricultural Research Institutes have done research on coffee agronomy, aimed at improving coffee productivite The ecological conditions for coffee in Rwanda are characterized by inadequate rainfall and high light intensity. Soil parental material and chemical properties are variable amongst different small holders coffee...

Innovative private micro-hydro power development in Rwanda

Energy Technology Data Exchange (ETDEWEB)

Pigaht, Maurice; Van der Plas, Robert J. [MARGE-Netherlands, Brem 68, 7577 EW Oldenzaal (Netherlands)

2009-11-15

Under the 'Private Sector Participation in Micro-Hydro Development Project in Rwanda', four newly registered Rwandan companies are each constructing a micro-hydro electricity plant (100-500 kW) and building a low-voltage distribution grid. These companies financed their plants through their own equity and debt with support from the PSP Hydro project. This support comprised a subsidy of 30-50% of investment costs, technical and business development assistance, project monitoring and financial controlling. The experiences gained so far have important implications for similar future micro-hydro energy sector development projects and this paper puts forward three key messages: (1) institutional arrangements rather than technical quality determine the success of such projects; (2) truly sustainable rural electrification through micro-hydro development demands a high level of local participation at all levels and throughout all project phases, not just after plant commissioning; and (3) real impact and sustainability can be obtained through close collaboration of local private and financial sector firms requiring only limited external funds. In short, micro-hydro projects can and will be taken up by local investors as a business if the conditions are right. Applying these messages could result in an accelerated uptake of viable micro-hydro activities in Rwanda, and in the opinion of the authors elsewhere too. (author)

Integration of comprehensive women's health programmes into health systems: cervical cancer prevention, care and control in Rwanda.

Science.gov (United States)

Binagwaho, Agnes; Ngabo, Fidele; Wagner, Claire M; Mugeni, Cathy; Gatera, Maurice; Nutt, Cameron T; Nsanzimana, Sabin

2013-09-01

Although it is highly preventable and treatable, cervical cancer is the most common and most deadly cancer among women in Rwanda. By mobilizing a diverse coalition of partnerships, Rwanda became the first country in Africa to develop and implement a national strategic plan for cervical cancer prevention, screening and treatment. Rwanda - a small, landlocked nation in East Africa with a population of 10.4 million - is well positioned to tackle a number of "high-burden" noncommunicable diseases. The country's integrated response to infectious diseases has resulted in steep declines in premature mortality over the past decade. In 2011-2012, Rwanda vaccinated 227,246 girls with all three doses of the human papillomavirus (HPV) vaccine. Among eligible girls, three-dose coverage rates of 93.2% and 96.6% were achieved in 2011 and 2012, respectively. The country has also initiated nationwide screening and treatment programmes that are based on visual inspection of the cervix with acetic acid, testing for HPV DNA, cryotherapy, the loop electrosurgical excision procedure and various advanced treatment options. Low-income countries should begin to address cervical cancer by integrating prevention, screening and treatment into routine women's health services. This requires political will, cross-sectoral collaboration and planning, innovative partnerships and robust monitoring and evaluation. With external support and adequate planning, high nationwide coverage rates for HPV vaccination and screening for cervical cancer can be achieved within a few years.

Spatio-temporal distribution of mosquitoes and risk of malaria infection in Rwanda

NARCIS (Netherlands)

Hakizimana, Emmanuel; Karema, Corine; Munyakanage, Dunia; Githure, John; Mazarati, Jean Baptiste; Tongren, Jon Eric; Takken, Willem; Binagwaho, Agnes; Koenraadt, Constantianus J.M.

2018-01-01

To date, the Republic of Rwanda has not systematically reported on distribution, diversity and malaria infectivity rate of mosquito species throughout the country. Therefore, we assessed the spatial and temporal variation of mosquitoes in the domestic environment, as well as the nocturnal biting

Maternal near miss and mortality in a tertiary care hospital in Rwanda

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Rulisa, S.; Umuziranenge, I.; Small, M; van Roosmalen, J.

2015-01-01

Background: To determine the prevalence and factors associated with severe ('near miss') maternal morbidity and mortality in the University Teaching Hospital of Kigali - Rwanda. Methods: We performed a cross sectional study of all women admitted to the tertiary care University Hospital in Kigali

Linguistic Markets in Rwanda: Language Use in Advertisements and on Signs

Science.gov (United States)

Rosendal, Tove

2009-01-01

Rwanda has experienced major changes during the last decade due to the genocide in 1994. After the civil war, in addition to establishing political and economical stability, peace and reconciliation, the government was faced with the return of refugees from neighbouring, mostly English-speaking, countries. The new socio-demographic conditions…

Community Health Workers' knowledge, attitudes and practices ...

African Journals Online (AJOL)

Background: Community Health Workers (CHWs) have significantly contributed to the decrease of malaria prevalence and related mortality among under five children in Rwanda. This study aimed to explore the knowledge, attitudes and practices of CHWs about malaria prevention in a selected District of Rwanda. Methods: ...

The "Making" of Knowledge Society in Rwanda? Translations, Tensions and Transformations

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Knutsson, Beniamin

2012-01-01

In the year 2000, Rwanda launched an ambitious long-term development strategy intended to render a fundamental transformation from an agrarian to a knowledge society by 2020. Knowledge society, however, could be viewed as a "floating signifier" open for a wide range of interpretations. Guided by a policy translation perspective the aim…

Effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda: results from a non-randomized controlled trial

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Michielsen Kristien

2012-09-01

Full Text Available Abstract Background While the HIV epidemic is levelling off in sub-Saharan Africa, it remains at an unacceptably high level. Young people aged 15-24 years remain particularly vulnerable, resulting in a regional HIV prevalence of 1.4% in young men and 3.3% in young women. This study assesses the effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda on young people’s sexual behavior, HIV knowledge and attitudes. Methods In a non-randomized longitudinal controlled trial, fourteen schools were selected in two neighboring districts in Rwanda Bugesera (intervention and Rwamagana (control. Students (n = 1950 in eight intervention and six control schools participated in three surveys (baseline, six and twelve months in the intervention. Analysis was done using linear and logistic regression using generalized estimation equations adjusted for propensity score. Results The overall retention rate was 72%. Time trends in sexual risk behavior (being sexually active, sex in last six months, condom use at last sex were not significantly different in students from intervention and control schools, nor was the intervention associated with increased knowledge, perceived severity or perceived susceptibility. It did significantly reduce reported stigma. Conclusions Analyzing this and other interventions, we identified several reasons for the observed limited effectiveness of peer education: 1 intervention activities (spreading information are not tuned to objectives (changing behavior; 2 young people prefer receiving HIV information from other sources than peers; 3 outcome indicators are not adequate and the context of the relationship in which sex occurs and the context in which sex occurs is ignored. Effectiveness of peer education may increase through integration in holistic interventions and redefining peer educators’ role as focal points for sensitization and referral to experts and services. Finally, we argue that a

Restoring relationship between former genocide perpetrators and survivors of genocide against Tutsi in Rwanda through reconciliation villages

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Mafeza, F.

2013-06-01

Full Text Available Throughout the 20th century, genocide has claimed many lives across the world. In Rwanda, the Genocide against the Tutsi was perpetrated with unprecedented violence and took the lives of more than one million. In the aftermath of the genocide, the interpersonal relationships between genocide survivors and former genocide perpetrators as well as their respective family members was undermined. Through Prison Fellowship Rwanda, former genocide perpetrators and survivors of genocide were brought together in reconciliation villages as a way of restoring their relationships. Drawing on interviews and focus group discussion with members of five reconciliation villages, this study uses a qualitative approach to examine how these villages contribute to the restoration of relationship between conflicting parties in the aftermath of the genocide against the Tutsi in Rwanda. The findings indicate that living together in reconciliation village combined with economic joint activities provided a favorable space in which negative-dehumanizing attitudes were overcome, while positive-re-humanizing attitudes were fostered. Additionally, the village offered members an opportunity for communication, reduced prejudice and fear among them, and generated trust in the community.

Differentiation of Effect Across Systemic Literacy Programs in Rwanda, the Philippines, and Senegal.

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Christina, Rachel; Vinogradova, Elena

2017-03-01

In this article, we compare three localized applications (in Rwanda, Senegal, and the Philippines) of a literacy approach for resource-lean environments and examine the factors influencing its impact in each context, considering dosage, duration, and environment. In Rwanda, a bilingual early grade literacy initiative implemented in partnership with the ministry of education included literacy standards development, training for early grade teachers, materials development, leadership support, and community-based activities. In the Philippines, a primary grades trilingual curriculum was implemented in close collaboration with the Department of Education to strengthen its literacy component through standards development, teacher and school leader training, materials development, and awareness campaigns. Finally, in Senegal, a program was conducted supporting the YMCA's efforts to improve local educational outcomes by training youth volunteers to mentor students at risk and by engaging families and communities. © 2017 Wiley Periodicals, Inc.

Domestic biogas diffusion in Rwanda - Key learning for scale up

International Nuclear Information System (INIS)

2016-03-01

, increased hygiene of the kitchen, increased hygiene of toilets, reduced time to collect wood and use of bio-slurry as fertiliser agent. Impacts of the project on climate change and on livelihoods already materialise and most of them will be measurable at the end of the project. Biogas is used to cook and boil water but former cooking fuels (i.e. wood and charcoal) are still used for time consuming meals such as beans for which biogas production is insufficient. However, savings on wood, and in limited cases on charcoal, are significant even though their measurement at the pilot survey stage includes uncertainties. Significant improvements on hygiene and sanitation thanks to biogas use were proven on a qualitative basis for smoke exposure in the kitchen and for toilets hygiene in particular. The use of a baseline measurement is key to enable for proper impact assessment at the end of the project. Surveys should be conducted in the same period of the year and at the house of the farmer with the most knowledgeable person as respondent for each topic. While most of indicators tested by ENEA in the pilot survey for impact evaluation are suited and measurable, those involving the measurement of daily quantities should however be measured by biogas users directly during evaluation campaigns (cow dung fed into the digester, cooking fuels savings, daily use time of cooking and lighting devices). Although domestic biogas is suited to a limited fraction of farmers in Rwanda, the potential to scale up the project is significant if subsidies from public authorities are maintained. Adopting biogas requires holding at least 2 adult cows and subscribing to a credit which is suited to the wealthiest and most progressive part of farmers in a rural village. This automatically restricts the number of farmers who could adopt biogas. However, a target of 450 to 900 new end-users is estimated to be realistic for a scale up phase in the 3 districts currently covered and for a 5 years period (2017

Economic evaluation of a mentorship and enhanced supervision program to improve quality of integrated management of childhood illness care in rural Rwanda.

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Manzi, Anatole; Mugunga, Jean Claude; Iyer, Hari S; Magge, Hema; Nkikabahizi, Fulgence; Hirschhorn, Lisa R

2018-01-01

Integrated management of childhood illness (IMCI) can reduce under-5 morbidity and mortality in low-income settings. A program to strengthen IMCI practices through Mentorship and Enhanced Supervision at Health centers (MESH) was implemented in two rural districts in eastern Rwanda in 2010. We estimated cost per improvement in quality of care as measured by the difference in correct diagnosis and correct treatment at baseline and 12 months of MESH. Costs of developing and implementing MESH were estimated in 2011 United States Dollars (USD) from the provider perspective using both top-down and bottom-up approaches, from programmatic financial records and site-level data. Improvement in quality of care attributed to MESH was measured through case management observations (n = 292 cases at baseline, 413 cases at 12 months), with outcomes from the intervention already published. Sensitivity analyses were conducted to assess uncertainty under different assumptions of quality of care and patient volume. The total annual cost of MESH was US$ 27,955.74 and the average cost added by MESH per IMCI patient was US$1.06. Salary and benefits accounted for the majority of total annual costs (US$22,400 /year). Improvements in quality of care after 12 months of MESH implementation cost US$2.95 per additional child correctly diagnosed and $5.30 per additional child correctly treated. The incremental costs per additional child correctly diagnosed and child correctly treated suggest that MESH could be an affordable method for improving IMCI quality of care elsewhere in Rwanda and similar settings. Integrating MESH into existing supervision systems would further reduce costs, increasing potential for spread.

Adolescents and the right to health: eliminating age-related barriers to HIV/AIDS services in Rwanda.

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Binagwaho, Agnes; Fuller, Arlan; Kerry, Vanessa; Dougherty, Sarah; Agbonyitor, Mawuena; Wagner, Claire; Nzayizera, Rodrigue; Farmer, Paul

2012-01-01

Under international, regional, and domestic law, adolescents are entitled to measures ensuring the highest attainable standard of health. For HIV/AIDS, this is essential as adolescents lack many social and economic protections and are disproportionately vulnerable to the effects of the disease. In many countries, legal protections do not always ensure access to health care for adolescents, including for HIV/AIDS prevention, treatment, and care. Using Rwanda as an example, this article identifies gaps, policy barriers, and inconsistencies in legal protection that can create age-related barriers to HIV/AIDS services and care. One of the most pressing challenges is defining an age of majority for access to prevention measures, such as condoms, testing and treatment, and social support. Occasionally drawing on examples of existing and proposed laws in other African countries, Rwanda and other countries may strengthen their commitment to adolescents' rights and eliminate barriers to prevention, family planning, testing and disclosure, treatment, and support. Among the improvements, Rwanda and other countries must align its age of consent with the actual behavior of adolescents and ensure privacy to adolescents regarding family planning, HIV testing, disclosure, care, and treatment.

Twenty Years After Genocide: The Role of Psychology in the Reconciliation and Reconstruction Process in Rwanda

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Craig McGarty

2014-12-01

Full Text Available This Special Thematic Section brings together eight papers that showcase different aspects of the contribution of psychology to the processes of recovery in Rwanda following the 1994 genocide. The Section is noteworthy in part because a majority of the papers have Rwandan authors. In summarizing the contributions I make six observations about the remarkable context of the genocide and its aftermath: a it was distinctive from previous mass violence in its intensity and character; b it has been characterized by bystander inaction and the problems of positioning outsiders to help; c hundreds of thousands of accused or convicted perpetrators have lived alongside survivors; d electronic media played a profound role not only in promoting violence but also in building peace; e Rwanda has been the site of unprecedented societal interventions with political goals that have the character and content of social psychological experiments; and f the role of memorialization in repairing or sustaining harm needs further examination. I conclude by noting that the study of recovery is clear proof that the genocide in Rwanda, as is the case with genocides of the past, failed to achieve its aims.

[To be better informed: the population problem in Rwanda and the scope of its solution].

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Gakwaya, D

1993-12-01

As part of its IEC program, Rwanda's National Office of Population (ONAPO) produced a 4-volume work entitled "The Demographic problem in Rwanda and the framework of its solution". The work places Rwanda's population problem in historical context by noting the progressive acceleration of the growth rate beginning in 1940. The population increased from 1,913,000 in 1940 to 3,735,000 in 1970 and 7,149,215 in 1991. The strategies initially proposed for maintaining balance between population and production included resettlement schemes to reduce population pressure in crowded zones and increase production. ONAPO was created to address the problem more directly. The first and most important of the volumes analyzes the relationship between population problems and national development. The problems discussed in relation to population include agriculture and food supply, nutrition, health and health care, education and school attendance, employment, migration and urbanization, environment, integration of women into development, changing attitudes and customs, and family planning. The second volume discusses food production and food self-sufficiency at a time when population is increasing rapidly but food production is declining. A model produced by ONAPO attempts to analyze the interrelationships between population and food production. Population factors included in the model are fertility, mortality, and migration. Twelve vegetable crops and 7 animal products evolve in the model according to area devoted to them, yield, soil quality, fallow, deforestation, and erosion. Agricultural products are transformed in the model to calories, protein, and fats. Different scenarios result from the combination of different factors, and their effect is to reduce or increase the volume of population and consequently the number f calories available per person and per day. Volume 3, on costs and benefits of family planning in Rwanda, compares 3 situations; no family planning, realistic

A responsibility to report — The role of the media in the Rwanda ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-01-28

Jan 28, 2011 ... A responsibility to report — The role of the media in the Rwanda genocide ... at Carleton University's School of Journalism and Communications has ... In the summer of 2006, 14 Carleton students worked for two months as ...

Sexual transgression and social disconnection: healing through community-based sociotherapy in Rwanda

NARCIS (Netherlands)

Richters, A.; Rutayisire, T.; Slegh, H.

2013-01-01

A distinguishing feature of the 1994 genocide against the Tutsi and the preceding 1990-1994 war in Rwanda was the social intimacy of the crimes committed. The legacy of this kind of violence includes distrust in social relations within communities and families, an increase of violence in everyday

Indicator microorganisms in fresh vegetables from “farm to fork” in Rwanda

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Ssemanda, James Noah; Reij, Martine; Muvunyi, Claude Mambo; Joosten, Han; Zwietering, Marcel H.

2017-01-01

Microbial safety of ready-to-eat vegetables is currently a global concern. We studied indicator microorganisms in fresh vegetables from “farm to fork” in Rwanda, to identify possible trends in microbial counts along the supply chain in a developing country. A total of 453 samples were taken across

Abstract: Use of E-Learning to Advance Nursing Education in Rwanda

African Journals Online (AJOL)

As of 2011, there were 6,970 nurses in Rwanda with 90% trained at the high school level. The Ministry of Health has set the goal of upgrading high school trained nurses to a diploma by 2020. To assist in educating nurses and advancing their education, E-Learning (distance education) has been adopted as a model to ...

Supernova SN 2008iz in M82 galaxy | Kimani | Rwanda Journal

African Journals Online (AJOL)

Rwanda Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 1, No 1 (2016) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your ...

Strengthening systems for communicable disease surveillance: creating a laboratory network in Rwanda

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Ndihokubwayo Jean B

2011-06-01

Full Text Available Abstract Background The recent emergence of a novel strain of influenza virus with pandemic potential underscores the need for quality surveillance and laboratory services to contribute to the timely detection and confirmation of public health threats. To provide a framework for strengthening disease surveillance and response capacities in African countries, the World Health Organization Regional Headquarters for Africa (AFRO developed Integrated Disease Surveillance and Response (IDSR aimed at improving national surveillance and laboratory systems. IDSR emphasizes the linkage of information provided by public health laboratories to the selection of relevant, appropriate and effective public health responses to disease outbreaks. Methods We reviewed the development of Rwanda's National Reference Laboratory (NRL to understand essential structures involved in creating a national public health laboratory network. We reviewed documents describing the NRL's organization and record of test results, conducted site visits, and interviewed health staff in the Ministry of Health and in partner agencies. Findings were developed by organizing thematic categories and grouping examples within them. We purposefully sought to identify success factors as well as challenges inherent in developing a national public health laboratory system. Results Among the identified success factors were: a structured governing framework for public health surveillance; political commitment to promote leadership for stronger laboratory capacities in Rwanda; defined roles and responsibilities for each level; coordinated approaches between technical and funding partners; collaboration with external laboratories; and use of performance results in advocacy with national stakeholders. Major challenges involved general infrastructure, human resources, and budgetary constraints. Conclusions Rwanda's experience with collaborative partnerships contributed to creation of a functional

Mental Health and Antiretroviral Adherence Among Youth Living With HIV in Rwanda.

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Smith Fawzi, Mary C; Ng, Lauren; Kanyanganzi, Fredrick; Kirk, Catherine; Bizimana, Justin; Cyamatare, Felix; Mushashi, Christina; Kim, Taehoon; Kayiteshonga, Yvonne; Binagwaho, Agnes; Betancourt, Theresa S

2016-10-01

In Rwanda, significant progress has been made in advancing access to antiretroviral therapy (ART) among youth. As availability of ART increases, adherence is critical for preventing poor clinical outcomes and transmission of HIV. The goals of the study are to (1) describe ART adherence and mental health problems among youth living with HIV aged 10 to 17; and (2) examine the association between these factors among this population in rural Rwanda. A cross-sectional analysis was conducted that examined the association of mental health status and ART adherence among youth (n = 193). ART adherence, mental health status, and related variables were examined based on caregiver and youth report. Nonadherence was defined as ever missing or refusing a dose of ART within the past month. Multivariate modeling was performed to examine the association between mental health status and ART adherence. Approximately 37% of youth missed or refused ART in the past month. In addition, a high level of depressive symptoms (26%) and attempt to hurt or kill oneself (12%) was observed in this population of youth living with HIV in Rwanda. In multivariate analysis, nonadherence was significantly associated with some mental health outcomes, including conduct problems (odds ratio 2.90, 95% confidence interval 1.55-5.43) and depression (odds ratio 1.02, 95% confidence interval 1.01-1.04), according to caregiver report. A marginally significant association was observed for youth report of depressive symptoms. The findings suggest that mental health should be considered among the factors related to ART nonadherence in HIV services for youth, particularly for mental health outcomes, such as conduct problems and depression. Copyright © 2016 by the American Academy of Pediatrics.

Faecal contamination of household drinking water in Rwanda: A national cross-sectional study

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Kirby, Miles A., E-mail: miles.kirby@lshtm.ac.uk [London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT (United Kingdom); Nagel, Corey L., E-mail: nagelc@ohsu.edu [Oregon Health and Science University, School of Nursing Portland Campus, 3455 SW US Veterans Hospital Road, SN-6S, Portland, OR 97239 (United States); Rosa, Ghislaine, E-mail: ghislaine.rosa@lshtm.ac.uk [London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT (United Kingdom); Iyakaremye, Laurien, E-mail: laurieniyakaremye1@gmail.com [DelAgua Health Rwanda Implementation, Ltd., 3rd Fl KG 19 Avenue, Kibagabaga Rd, Kigali (Rwanda); Zambrano, Laura Divens, E-mail: laura.zambrano@emory.edu [Emory University Rollins School of Public Health, 1518 Clifton Road, NE, Atlanta, GA 30322 (United States); Clasen, Thomas F., E-mail: thomas.f.clasen@emory.edu [London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT (United Kingdom); Emory University Rollins School of Public Health, 1518 Clifton Road, NE, Atlanta, GA 30322 (United States)

2016-11-15

Unsafe drinking water is a leading cause of morbidity and mortality, especially among young children in low-income settings. We conducted a national survey in Rwanda to determine the level of faecal contamination of household drinking water and risk factors associated therewith. Drinking water samples were collected from a nationally representative sample of 870 households and assessed for thermotolerant coliforms (TTC), a World Health Organization (WHO)-approved indicator of faecal contamination. Potential household and community-level determinants of household drinking water quality derived from household surveys, the 2012 Rwanda Population and Housing Census, and a precipitation dataset were assessed using multivariate logistic regression. Widespread faecal contamination was present, and only 24.9% (95% CI 20.9–29.4%, n = 217) of household samples met WHO Guidelines of having no detectable TTC contamination, while 42.5% (95% CI 38.0–47.1%, n = 361) of samples had > 100 TTC/100 mL and considered high risk. Sub-national differences were observed, with poorer water quality in rural areas and Eastern province. In multivariate analyses, there was evidence for an association between detectable contamination and increased open waste disposal in a sector, lower elevation, and water sources other than piped to household or rainwater/bottled. Risk factors for intermediate/high risk contamination (> 10 TTC/100 mL) included low population density, increased open waste disposal, lower elevation, water sources other than piped to household or rainwater/bottled, and occurrence of an extreme rain event the previous day. Modelling suggests non-household-based risk factors are determinants of water quality in this setting, and these results suggest a substantial proportion of Rwanda's population are exposed to faecal contamination through drinking water. - Graphical abstract: Household drinking water quality (thermotolerant coliform colony forming units/100 m

Science-based health innovation in Rwanda: unlocking the potential of a late bloomer

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Hughes Mike

2010-12-01

Full Text Available Abstract Background This paper describes and analyses Rwanda’s science-based health product ‘innovation system’, highlighting examples of indigenous innovation and good practice. We use an innovation systems framework, which takes into account the wide variety of stakeholders and knowledge flows contributing to the innovation process. The study takes into account the destruction of the country’s scientific infrastructure and human capital that occurred during the 1994 genocide, and describes government policy, research institutes and universities, the private sector, and NGOs that are involved in health product innovation in Rwanda. Methods Case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 38 people from across the science-based health innovation system. Data was collected over two visits to Rwanda between November – December 2007 and in May 2008. A workshop was held in Kigali on May 23rd and May 24th 2009 to validate the findings. A business plan was then developed to operationalize the findings. Results and discussion The results of the study show that Rwanda has strong government will to support health innovation both through its political leadership and through government policy documents. However, it has a very weak scientific base as most of its scientific infrastructure as well as human capital were destroyed during the 1994 genocide. The regulatory agency is weak and its nascent private sector is ill-equipped to drive health innovation. In addition, there are no linkages between the various actors in the country’s health innovation system i.e between research institutions, universities, the private sector, and government bureaucrats. Conclusions Despite the fact that the 1994 genocide destroyed most of the scientific infrastructure and human capital, the country has made remarkable progress towards

Faecal contamination of household drinking water in Rwanda: A national cross-sectional study

International Nuclear Information System (INIS)

Kirby, Miles A.; Nagel, Corey L.; Rosa, Ghislaine; Iyakaremye, Laurien; Zambrano, Laura Divens; Clasen, Thomas F.

2016-01-01

Unsafe drinking water is a leading cause of morbidity and mortality, especially among young children in low-income settings. We conducted a national survey in Rwanda to determine the level of faecal contamination of household drinking water and risk factors associated therewith. Drinking water samples were collected from a nationally representative sample of 870 households and assessed for thermotolerant coliforms (TTC), a World Health Organization (WHO)-approved indicator of faecal contamination. Potential household and community-level determinants of household drinking water quality derived from household surveys, the 2012 Rwanda Population and Housing Census, and a precipitation dataset were assessed using multivariate logistic regression. Widespread faecal contamination was present, and only 24.9% (95% CI 20.9–29.4%, n = 217) of household samples met WHO Guidelines of having no detectable TTC contamination, while 42.5% (95% CI 38.0–47.1%, n = 361) of samples had > 100 TTC/100 mL and considered high risk. Sub-national differences were observed, with poorer water quality in rural areas and Eastern province. In multivariate analyses, there was evidence for an association between detectable contamination and increased open waste disposal in a sector, lower elevation, and water sources other than piped to household or rainwater/bottled. Risk factors for intermediate/high risk contamination (> 10 TTC/100 mL) included low population density, increased open waste disposal, lower elevation, water sources other than piped to household or rainwater/bottled, and occurrence of an extreme rain event the previous day. Modelling suggests non-household-based risk factors are determinants of water quality in this setting, and these results suggest a substantial proportion of Rwanda's population are exposed to faecal contamination through drinking water. - Graphical abstract: Household drinking water quality (thermotolerant coliform colony forming units/100 mL) nationally and

Susceptibility of Anopheles gambiae to insecticides used for malaria vector control in Rwanda.

Science.gov (United States)

Hakizimana, Emmanuel; Karema, Corine; Munyakanage, Dunia; Iranzi, Gad; Githure, John; Tongren, Jon Eric; Takken, Willem; Binagwaho, Agnes; Koenraadt, Constantianus J M

2016-12-01

The widespread emergence of resistance to pyrethroids is a major threat to the gains made in malaria control. To monitor the presence and possible emergence of resistance against a variety of insecticides used for malaria control in Rwanda, nationwide insecticide resistance surveys were conducted in 2011 and 2013. Larvae of Anopheles gambiae sensu lato mosquitoes were collected in 12 sentinel sites throughout Rwanda. These were reared to adults and analysed for knock-down and mortality using WHO insecticide test papers with standard diagnostic doses of the recommended insecticides. A sub-sample of tested specimens was analysed for the presence of knockdown resistance (kdr) mutations. A total of 14,311 mosquitoes were tested and from a sample of 1406 specimens, 1165 (82.9%) were identified as Anopheles arabiensis and 241 (17.1%) as Anopheles gambiae sensu stricto. Mortality results indicated a significant increase in resistance to lambda-cyhalothrin from 2011 to 2013 in 83% of the sites, permethrin in 25% of the sites, deltamethrin in 25% of the sites and DDT in 50% of the sites. Mosquitoes from 83% of the sites showed full susceptibility to bendiocarb and 17% of sites were suspected to harbour resistance that requires further confirmation. No resistance was observed to fenitrothion in all study sites during the entire survey. The kdr genotype results in An. gambiae s.s. showed that 67 (50%) possessed susceptibility (SS) alleles, while 35 (26.1%) and 32 (23.9%) mosquitoes had heterozygous (RS) and homozygous (RR) alleles, respectively. Of the 591 An. arabiensis genotyped, 425 (71.9%) possessed homozygous (SS) alleles while 158 (26.7%) and 8 (1.4%) had heterozygous (RS) and homozygous (RR) alleles, respectively. Metabolic resistance involving oxidase enzymes was also detected using the synergist PBO. This is the first nationwide study of insecticide resistance in malaria vectors in Rwanda. It shows the gradual increase of insecticide resistance to pyrethroids (lambda

HIV care continuum in Rwanda: a cross-sectional analysis of the national programme.

Science.gov (United States)

Nsanzimana, Sabin; Kanters, Steve; Remera, Eric; Forrest, Jamie I; Binagwaho, Agnes; Condo, Jeanine; Mills, Edward J

2015-05-01

Rwanda has made remarkable progress towards HIV care programme with strong national monitoring and surveillance. Knowledge about the HIV care continuum model can help to improve outcomes in patients. We aimed to quantify engagement, mortality, and loss to follow-up of patients along the HIV care continuum in Rwanda in 2013. We collated data for individuals with HIV who participated in the national HIV care programme in Rwanda and calculated the numbers of individuals or proportions of the population at each stage and the transition probabilities between stages of the continuum. We calculated factors associated with mortality and loss to follow-up by fitting Cox proportional hazards regression models, one for the stage of care before antiretroviral therapy (ART) initiation and another for stage of care during ART. An estimated 204,899 individuals were HIV-positive in Rwanda in 2013. Among these individuals, 176,174 (86%) were in pre-ART or in ART stages and 129,405 (63%) had initiated ART by the end of 2013. 82·1% (95% CI 80·7-83·4) of patients with viral load measurements (n=3066) were virally suppressed (translating to 106,371 individuals or 52% of HIV-positive individuals). Mortality was 0·6% (304 patients) in the pre-ART stage and 1·0% (1255 patients) in the ART stage; 2247 (3·9%) patients were lost to follow-up in pre-ART stage and 2847 (2·2%) lost in ART stage. Risk factors for mortality among patients in both pre-ART and ART stages included older age, CD4 cell count at initiation, and male sex. Risk factors for loss to follow-up among patients at both pre-ART and ART stages included younger age (age 10-29 year) and male sex. The HIV care continuum is a multitrajectory pathway in which patients have many opportunities to leave and re-engage in care. Knowledge about the points at which individuals are most likely to leave care could improve large-scale delivery of HIV programmes. The Bill & Melinda Gates Foundation. Copyright © 2015 Elsevier Ltd. All

Trends and social differentials in child mortality in Rwanda 1990-2010: results from three demographic and health surveys.

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Musafili, Aimable; Essén, Birgitta; Baribwira, Cyprien; Binagwaho, Agnes; Persson, Lars-Åke; Selling, Katarina Ekholm

2015-09-01

Rwanda has embarked on ambitious programmes to provide equitable health services and reduce mortality in childhood. Evidence from other countries indicates that advances in child survival often have come at the expense of increasing inequity. Our aims were to analyse trends and social differentials in mortality before the age of 5 years in Rwanda from 1990 to 2010. We performed secondary analyses of data from three Demographic and Health Surveys conducted in 2000, 2005 and 2010 in Rwanda. These surveys included 34 790 children born between 1990 and 2010 to women aged 15-49 years. The main outcome measures were neonatal mortality rates (NMR) and under-5 mortality rates (U5MR) over time, and in relation to mother's educational level, urban or rural residence and household wealth. Generalised linear mixed effects models and a mixed effects Cox model (frailty model) were used, with adjustments for confounders and cluster sampling method. Mortality rates in Rwanda peaked in 1994 at the time of the genocide (NMR 60/1000 live births, 95% CI 51 to 65; U5MR 238/1000 live births, 95% CI 226 to 251). The 1990s and the first half of the 2000s were characterised by a marked rural/urban divide and inequity in child survival between maternal groups with different levels of education. Towards the end of the study period (2005-2010) NMR had been reduced to 26/1000 (95% CI 23 to 29) and U5MR to 65/1000 (95% CI 61 to 70), with little or no difference between urban and rural areas, and household wealth groups, while children of women with no education still had significantly higher U5MR. Recent reductions in child mortality in Rwanda have concurred with improved social equity in child survival. Current challenges include the prevention of newborn deaths. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Assessing farmers' interest in agroforestry in two contrasting agro-ecological zones of Rwanda

NARCIS (Netherlands)

Bucagu, C.; Vanlauwe, B.; Wijk, van M.T.; Giller, K.E.

2013-01-01

Uptake and management of agroforestry technologies differs among farms in Rwanda and needs to be documented as a basis for shaping future research and development programs. The objective of this study was to investigate current agroforestry practices, farmers’ preferences, tree management and

Prioritizing essential surgery and safe anesthesia for the Post-2015 Development Agenda: operative capacities of 78 district hospitals in 7 low- and middle-income countries.

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LeBrun, Drake G; Chackungal, Smita; Chao, Tiffany E; Knowlton, Lisa M; Linden, Allison F; Notrica, Michelle R; Solis, Carolina V; McQueen, K A Kelly

2014-03-01

Surgery has been neglected in low- and middle-income countries for decades. It is vital that the Post-2015 Development Agenda reflect that surgery is an important part of a comprehensive global health care delivery model. We compare the operative capacities of multiple low- and middle-income countries and identify critical gaps in surgical infrastructure. The Harvard Humanitarian Initiative survey tool was used to assess the operative capacities of 78 government district hospitals in Bangladesh (n = 7), Bolivia (n = 11), Ethiopia (n = 6), Liberia (n = 11), Nicaragua (n = 10), Rwanda (n = 21), and Uganda (n = 12) from 2011 to 2012. Key outcome measures included infrastructure, equipment availability, physician and nonphysician surgical providers, operative volume, and pharmaceutical capacity. Seventy of 78 district hospitals performed operations. There was fewer than one surgeon or anesthesiologist per 100,000 catchment population in all countries except Bolivia. There were no physician anesthesiologists in any surveyed hospitals in Rwanda, Liberia, Uganda, or in the majority of hospitals in Ethiopia. Mean annual operations per hospital ranged from 374 in Nicaragua to 3,215 in Bangladesh. Emergency operations and obstetric operations constituted 57.5% and 40% of all operations performed, respectively. Availability of pulse oximetry, essential medicines, and key infrastructure (water, electricity, oxygen) varied widely between and within countries. The need for operative procedures is not being met by the limited operative capacity in numerous low- and middle-income countries. It is of paramount importance that this gap be addressed by prioritizing essential surgery and safe anesthesia in the Post-2015 Development Agenda. Copyright © 2014 Mosby, Inc. All rights reserved.

Disruptive Events and Demographic Behaviour : Explaining the Shifts in Fertility in Rwanda

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Rutayisire, P.C.

2015-01-01

The fertility transition of Rwanda stagnated between 1992 and 2005 at a total fertility rate (TFR) of 6 children per woman. After 2005 the fertility decline resumed its course and the TFR dropped remarkably fast till 4.6. The period of the fertility stall coincided with a very disruptive period in

Coping with English as Language of Instruction in Higher Education in Rwanda

Science.gov (United States)

Kagwesage, Anne Marie

2013-01-01

The present study examines strategies that multilingual university students in Rwanda use in order to successfully deal with complex academic material offered through the medium of English, a foreign language. The reported strategies emerged from group work discussions and interviews with students in the faculty of Economics and Management at a…

Emergency general surgery in Rwandan district hospitals: a cross-sectional study of spectrum, management, and patient outcomes.

Science.gov (United States)

Mpirimbanyi, Christophe; Nyirimodoka, Alexandre; Lin, Yihan; Hedt-Gauthier, Bethany L; Odhiambo, Jackline; Nkurunziza, Theoneste; Havens, Joaquim M; Omondi, Jack; Rwamasirabo, Emile; Ntirenganya, Faustin; Toma, Gabriel; Mubiligi, Joel; Bayitondere, Scheilla; Riviello, Robert

2017-12-01

Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions. We describe patient demographics, clinical characteristics, management and outcomes. In 2015, 356 patients presented with emergency general surgical conditions. The majority were male (57.2%) and adults aged 15-60 years (54.5%). The most common diagnostic group was soft tissue infections (71.6%), followed by acute abdominal conditions (14.3%). The median length of symptoms prior to diagnosis differed significantly by diagnosis type (p operated on at the district hospital, either by a general surgeon or general practitioner. Patients were more likely to receive surgery if they presented to a hospital with a general surgeon compared to a hospital with only general practitioners (75% vs 43%, p operation in a hospital with a general surgeon as opposed to a general practitioner. This provides evidence to support increasing the surgical workforce in district hospitals in order to increase surgical availability for patients.

Planning and costing adaptation of perennial crop systems to climate change: Coffee and banana in Rwanda

Energy Technology Data Exchange (ETDEWEB)

Ngabitsinze, Jean Chrysostome; Mukashema, Adrie; Ikirezi, Mireille; Niyitanga, Fidele

2011-10-15

The Rwandan economy is mainly based on agriculture. Since agricultural production in Rwanda depends almost exclusively on the quality of the rainy season and specific temperature ranges, it makes the country particularly vulnerable to climate variability and change. The study objective of evaluating and costing the most suitable climate change adaptation measures for this geographic context responds to the Rwandan Economic Development and Poverty Reduction Strategy, 2008-2012 (EDPRS) (MINECOFIN 2007), in which climate change and its adverse impacts were recently identified as a high priority. This study has particularly focused on coffee and banana farming systems and aimed at analysing shocks due to climate change from farmer to policymaker perspectives. The study found that in the last 30 years, Rwanda has experienced a series of climate fluctuations in terms of frequency, intensity, and persistence of existing extremes. Heavy rains, storms, heatwaves and droughts are the observed manifestations of climate change in specific areas of Rwanda. Changing weather patterns have an adverse impact on the country's agricultural production and thus on the country's GDP. Adaptation options for Rwanda include the following efficiency-enhancing agricultural interventions: 1. Adaption of crop calendars to new climate patterns (more effective distribution of inputs such as fertilizers and pesticides). 2. Investments in farming equipment. 3. Improvement of extension services and research. 4. Restructuring of the institutional frameworks and development plans. Integrated water resources management (IWRM); setting up information systems for early warning systems and rapid intervention mechanisms; intense agri-pastoral activities; and research on climate-resilient varieties were identified as primary requirements for agricultural adaption to climate change. In addition, developing alternative energy sources (e.g., substituting firewood) and the promotion of non

Planning and costing adaptation of perennial crop systems to climate change: Coffee and banana in Rwanda

Energy Technology Data Exchange (ETDEWEB)

Ngabitsinze, Jean Chrysostome; Mukashema, Adrie; Ikirezi, Mireille; Niyitanga, Fidele

2011-10-15

The Rwandan economy is mainly based on agriculture. Since agricultural production in Rwanda depends almost exclusively on the quality of the rainy season and specific temperature ranges, it makes the country particularly vulnerable to climate variability and change. The study objective of evaluating and costing the most suitable climate change adaptation measures for this geographic context responds to the Rwandan Economic Development and Poverty Reduction Strategy, 2008-2012 (EDPRS) (MINECOFIN 2007), in which climate change and its adverse impacts were recently identified as a high priority. This study has particularly focused on coffee and banana farming systems and aimed at analysing shocks due to climate change from farmer to policymaker perspectives. The study found that in the last 30 years, Rwanda has experienced a series of climate fluctuations in terms of frequency, intensity, and persistence of existing extremes. Heavy rains, storms, heatwaves and droughts are the observed manifestations of climate change in specific areas of Rwanda. Changing weather patterns have an adverse impact on the country's agricultural production and thus on the country's GDP. Adaptation options for Rwanda include the following efficiency-enhancing agricultural interventions: 1. Adaption of crop calendars to new climate patterns (more effective distribution of inputs such as fertilizers and pesticides). 2. Investments in farming equipment. 3. Improvement of extension services and research. 4. Restructuring of the institutional frameworks and development plans. Integrated water resources management (IWRM); setting up information systems for early warning systems and rapid intervention mechanisms; intense agri-pastoral activities; and research on climate-resilient varieties were identified as primary requirements for agricultural adaption to climate change. In addition, developing alternative energy sources (e.g., substituting firewood) and the promotion of non-agricultural income

Malaria has no effect on birth weight in Rwanda

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Karema Corine

2009-08-01

Full Text Available Abstract Background Malaria has a negative effect on pregnancy outcome, causing low birth weight, premature birth and stillbirths, particularly in areas with high malaria transmission. In Rwanda, malaria transmission intensity ranges from high to nil, probably associated with variable altitudes. Overall, the incidence decreased over the last six years (2002–2007. Therefore, the impact of malaria on birth outcomes is also expected to vary over time and space. Methods Obstetric indicators (birth weight and pregnancy outcome and malaria incidence were compared and analyzed to their association over time (2002–2007 and space. Birth data from 12,526 deliveries were collected from maternity registers of 11 different primary health centers located in different malaria endemic areas. Malaria data for the same communities were collected from the National Malaria Control Programme. Associations were sought with mixed effects models and logistic regression. Results In all health centres, a significant increase of birth weight over the years was observed (p Conclusion In Rwanda, birth weight and pregnancy outcome are not directly influenced by malaria, which is in contrast to many other studied areas. Although malaria incidence overall has declined and mean birth weight increased over the studied period, no direct association was found between the two. Socio-economic factors and improved nutrition could be responsible for birth weight changes in recent years.

The Christian Churches, the State, and Genocide in Rwanda

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Court, Anthony

2016-12-01

Full Text Available The churches in Rwanda have exercised considerable political influence during both the colonial and post-colonial periods. Although formally autonomous institutions subordinate to the state, in actuality they have cultivated political influence through their religious teachings and secular role as the loci of material and social resources. However, there is at least one key factor, which has contributed to their fluctuating political influence within Rwanda. During the colonial period, the dominant Catholic Church functioned within a colonial regime of indirect rule, predicated on sustaining the political authority of a Tutsi-dominated Central Court presiding over the territories roughly contiguous with the present-day republic. This threefold division of power and authority acted as a brake upon the hegemonic ambitions of the Church, the royal house and the colonial administrators. Following the abolition of the monarchy in 1961, the structure of political power and authority of the state was fundamentally transformed, clearing the way for the emergence of a state church whose political role in the two Hutu dominated post-colonial republics would have significant historical implications. In this essay, I argue that it was this structural transformation of the Rwandan polity - marking the shift from a trilateral to a dual relationship between state and Church -, which contributes to our understanding of how the Church became embroiled in the mass violence and genocide in the twentieth century Rwandan polity.

From Donorship to Ownership? Budget Support and Donor Influence in Rwanda and Tanzania

NARCIS (Netherlands)

Swedlund, H.J.

2013-01-01

In this article, I analyze the relationship between budget support and ownership, or recipient-country control over policy outcomes, by exploring how budget support donors in Rwanda and Tanzania attempt to exert influence over domestic policy processes. In contrast to the conventional rhetoric about

Foodborne pathogens and their risk exposure factors associated with farm vegetables in Rwanda

NARCIS (Netherlands)

Ssemanda, James Noah; Reij, Martine W.; Middendorp, van Gerrieke; Bouw, El; Plaats, van der Rozemarijn; Franz, Eelco; Muvunyi, Claude Mambo; Bagabe, Mark Cyubahiro; Zwietering, Marcel H.; Joosten, Han

2018-01-01

In this study, we tested farm vegetables and agricultural water for the presence of foodborne pathogens, and evaluated farming practices of vegetable farms in Rwanda. Farm vegetable samples were found to be contaminated with foodborne pathogens at considerably high rate (overall 15/99 = 15%).

Free education in Rwanda: Just one step towards reducing gender and sibling inequalities

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Nkurunziza, J.; Broekhuis, A.; Hooimeijer, P.

2012-01-01

In 2003, Rwanda introduced free education as part of government policy to improve school enrolment in general and the attendance of deprived children in particular. However, in addition to school fees, other factors hamper school careers of children. Shifts in attendance were analysed using binary

Soil use and management strategy for raising food and cash output in Rwanda

NARCIS (Netherlands)

Rutunga, V.; Janssen, B.H.; Mantel, S.; Janssens, M.

2007-01-01

Rwanda is a poor country and land is scarce, with only 0.65 ha of suitable farmland per household. Literature search for identifying constraints and solutions to productive and sustainable agriculture and livestock production was carried out. The country is facing with increasing soil fertility

Promotion of couples' voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia.

Science.gov (United States)

Kelley, April L; Hagaman, Ashley K; Wall, Kristin M; Karita, Etienne; Kilembe, William; Bayingana, Roger; Tichacek, Amanda; Kautzman, Michele; Allen, Susan A

2016-08-08

Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples' voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs) and influential network agents (INAs) in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. INLs were identified in the faith-based, non-governmental, private, and health sectors. Each INL recruited and mentored several INAs who promoted CVCT. INLs and INAs were interviewed about demographic characteristics, promotional efforts, and working relationships. We also surveyed CVCT clients about sources of CVCT information. In Zambia, 53 INAs and 31 INLs were surveyed. In Rwanda, 33 INAs and 27 INLs were surveyed. Most (75 %-90 %) INAs believed that INL support was necessary for their promotional work. Zambian INLs reported being more engaged with their INAs than Rwandan INLs, with 58 % of Zambian INLs reporting that they gave a lot of support to their INAs versus 39 % in Rwanda. INAs in both Rwanda and Zambia reported promoting CVCT via group forums (77 %-97 %) and speaking to a community leader about CVCT (79 %-88 %) in the past month. More Rwandan INAs and INLs reported previous joint or individual HIV testing compared with their Zambian counterparts, of which more than half had not been tested. In Zambia and Rwanda, 1271 and 3895 CVCT clients were surveyed, respectively. Hearing about CVCT from INAs during one-on-one promotions was the most frequent source of information reported by clients in Zambia (71 %). In contrast, Rwandan couples who tested were more likely to have heard about CVCT from a previously tested couple (59 %). CVCT has long been endorsed for HIV prevention but few couples have been reached. Influential social networks can successfully promote evidence-based HIV prevention in Africa. Support from

'Mama and papa nothing': living with infertility among an urban population in Kigali, Rwanda.

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Dhont, N; van de Wijgert, J; Coene, G; Gasarabwe, A; Temmerman, M

2011-03-01

Not being able to procreate has severe social and economic repercussions in resource-poor countries. The purpose of this research was to explore the consequences of female and/or male factor infertility for men and women in Rwanda. Both quantitative and qualitative methods were used. Couples presenting with female and/or male factor infertility problems at the infertility clinic of the Kigali University Teaching Hospital (n = 312), and fertile controls who recently delivered (n = 312), were surveyed about domestic violence, current and past relationships and sexual functioning. In addition, five focus group discussions were held with a subsample of survey participants, who were either patients diagnosed with female- or male-factor fertility or their partners. Domestic violence, union dissolutions and sexual dysfunction were reported more frequently in the survey by infertile than fertile couples. The psycho-social consequences suffered by infertile couples in Rwanda are severe and similar to those reported in other resource-poor countries. Although women carry the largest burden of suffering, the negative repercussions of infertility for men, especially at the level of the community, are considerable. Whether the infertility was caused by a female factor or male factor was an important determinant for the type of psycho-social consequences suffered. In Rwanda, as in other resource-poor countries, infertility causes severe suffering. There is an urgent need to recognize infertility as a serious reproductive health problem and to put infertility care on the public health agenda.

Dynamic Relationship between Gross Domestic Product and Domestic Investment in Rwanda

Science.gov (United States)

Ocaya, Bruno; Ruranga, Charles; Kaberuka, William

2012-01-01

This study uses a VAR model to analyse the dynamic relationship between gross domestic product (GDP) and domestic investment (DI) in Rwanda for the period 1970 to 2011. Several selection lag criteria chose a maximum lag of one, and a bivariate VAR(1) model specification in levels was adopted. Unit root tests show that both GDP and DI series are…

Peritonitis in Rwanda: Epidemiology and risk factors for morbidity and mortality.

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Ndayizeye, Leonard; Ngarambe, Christian; Smart, Blair; Riviello, Robert; Majyambere, Jean Paul; Rickard, Jennifer

2016-12-01

Few studies discuss causes and outcomes of peritonitis in low-income settings. This study describes epidemiology of patients with peritonitis at a Rwandan referral hospital. Identification of risk factors associated with mortality and unplanned reoperation could improve management of peritonitis. Data were collected on demographics, clinical presentation, operative findings, and outcomes for all patients with peritonitis. Multivariate regression analysis identified factors associated with in-hospital mortality and unplanned reoperation. A total of 280 patients presented with peritonitis over a 6-month period. Causes of peritonitis were complications of intestinal obstruction (39%) and appendicitis (17%). Thirty-six (13%) patients required unplanned reoperation, and in-hospital mortality was 17%. Factors associated with increased odds of in-hospital mortality were unplanned reoperation (adjusted odds ratio 34.12), vasopressor use (adjusted odds ratio 24.91), abnormal white blood cell count (adjusted odds ratio 12.6), intensive care unit admission (adjusted odds ratio 9.06), and American Society of Anesthesiologist score ≥3 (adjusted odds ratio 7.80). Factors associated with increased odds of unplanned reoperation included typhoid perforation (adjusted odds ratio 5.92) and hypoxia on admission (adjusted odds ratio 3.82). Peritonitis in Rwanda presents with high morbidity and mortality. Minimizing delays in care is important, as many patients with intestinal obstruction present with features of peritonitis. A better understanding of patient care and management prior to arrival at the referral hospital is needed to identify areas for improvement at the health center and district hospital. Copyright © 2016 Elsevier Inc. All rights reserved.

High road utilizers surveys compared to police data for road traffic crash hotspot localization in Rwanda and Sri Lanka.

Science.gov (United States)

Staton, Catherine A; De Silva, Vijitha; Krebs, Elizabeth; Andrade, Luciano; Rulisa, Stephen; Mallawaarachchi, Badra Chandanie; Jin, Kezhi; RicardoVissoci, Joao; Østbye, Truls

2016-01-20

Road traffic crashes (RTCs) are a leading cause of death. In low and middle income countries (LMIC) data to conduct hotspot analyses and safety audits are usually incomplete, poor quality, and not computerized. Police data are often limited, but there are no alternative gold standards. This project evaluates high road utilizer surveys as an alternative to police data to identify RTC hotspots. Retrospective police RTC data was compared to prospective data from high road utilizer surveys regarding dangerous road locations. Spatial analysis using geographic information systems was used to map dangerous locations and identify RTC hotspots. We assessed agreement (Cohen's Kappa), sensitivity/specificity, and cost differences. In Rwanda police data identified 1866 RTC locations from 2589 records while surveys identified 1264 locations from 602 surveys. In Sri Lanka, police data identified 721 RTC locations from 752 records while survey data found 3000 locations from 300 surveys. There was high agreement (97 %, 83 %) and kappa (0.60, 0.60) for Rwanda and Sri Lanka respectively. Sensitivity and specificity are 92 % and 95 % for Rwanda and 74 % and 93 % for Sri Lanka. The cost per crash location identified was $2.88 for police and $2.75 for survey data in Rwanda and $2.75 for police and $1.21 for survey data in Sri Lanka. Surveys to locate RTC hotspots have high sensitivity and specificity compared to police data. Therefore, surveys can be a viable, inexpensive, and rapid alternative to the use of police data in LMIC.

Spatio-temporal trend analysis of projected precipitation data over Rwanda

Science.gov (United States)

Muhire, I.; Tesfamichael, S. G.; Ahmed, F.; Minani, E.

2018-01-01

This study applied a number of statistical techniques aimed at quantifying the magnitude of projected mean rainfall and number of rainy days over Rwanda on monthly, seasonal, and annual timescales for the period 2015-2050. The datasets for this period were generated by BCM2.0 for the SRES emission scenario SRB1, CO2 concentration for the baseline scenario (2011-2030) using the stochastic weather generator (LARS-WG). It was observed that on average, there will be a steady decline in mean rainfall. Save for the short rainy season, a positive trend in mean rainfall is expected over the south-west, the north-east region, and the northern highlands. The other regions (central, south-east, and western regions) are likely to experience a decline in mean rainfall. The number of rainy days is expected to decrease in the central plateau and the south-eastern lowlands, while the south-west, the north-west, and north-east regions are expected to have a pattern of increased number of rainy days. This decline in mean rainfall and rainy days over a large part of Rwanda is an indicator of just how much the country is bound to experience reduced water supply for various uses (e.g., agriculture, domestic activities, and industrial activities).

The Gender-Based Effects of Displacement: The Case of Congolese Refugees in Rwanda

NARCIS (Netherlands)

Bilgili, O.; Loschmann, Craig; Siegel, Melissa

2017-01-01

This paper studies the effects of displacement in the case of Congolese refugees in Rwanda, with an explicit focus on gender. The analysis looks across a range of indicators related to well-being that examine labor market participation, education, social networks, and security. In addition, it

Policy without a Plan: English as a Medium of Instruction in Rwanda

Science.gov (United States)

Pearson, Pamela

2014-01-01

From the time of Belgian colonial rule, French was predominantly the medium of instruction (MOI) in Rwanda. Then, in October 2008, a Rwandan Cabinet resolution called for the immediate implementation of English as the language of instruction in all public schools at all levels--from primary to tertiary. This study reports on ethnographic interview…

Rwanda after the war: supply and rational management of biomass energy

International Nuclear Information System (INIS)

Hategeka, A.

1997-01-01

This chapter discusses the effects of the war in Rwanda on biomass energy and biomass energy supply. Seven projects identified to be carried out immediately involve rationalisation of biomass energy use in urban and rural areas, supplying charcoal from forest thinnings, rehabilitation of damaged forests, examination of the feasibility of peat extraction, urban supply of peat, wood energy conservation, and pilot production of papyrus briquettes. (UK)

Sexual risk behaviors among youth heads of household in Gikongoro, south province of Rwanda

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Ntaganira Joseph

2012-03-01

Full Text Available Abstract Background As a result of the 1994 genocide and AIDS, Rwanda has a crisis of orphans. In 2005, the Ministry of Local Governance and Social Affairs of Rwanda has reported one million vulnerable children. Many of these are not only orphans but also youth heads of households (YHH. The purpose of this study was to: (a identify risk behaviors that expose YHH to HIV infection, (b determine gender-specific high risk profiles and, (c determine predictors of sexual onset. Methods A household survey was conducted among 692 YHH, aged 12-24, all beneficiaries of a World Vision basic needs program in Gikongoro, Rwanda, from January to March 2004. Participants were interviewed using a structured questionnaire. Data was collected on socio-demographic variables, HIV/AIDS prevention knowledge and sexual risk behaviors. Bivariate analyses of the study variables were performed to examine differences between males and females. A logistic regression analysis was conducted to analyze factors that were independently associated with the debut of having sex. Results Forty-one percent of respondents reported sexual onset before age 15. Males were more likely to start earlier than females (50.4% versus 26.7% but females reported more sexual onset with an older partner. Fifty-eight percent of females had their first intercourse with a partner who was four or more years older than themselves. While sexual activity was low (1.75 mean lifetime sexual partner, 0.45 mean sexual partner last twelve months, sexual experience was related to less social connectedness and use of drugs. Having a close friend also appeared to be protective for sexual debut. The analysis also found that although YHH were aware of some prevention measures against HIV/AIDS, there was low (19.8% knowledge of the "ABC" prevention program promoted by the government. In addition, despite 85% of respondents knowing someone who had died of AIDS, only 31% perceived themselves at risk of HIV infection

The epidemiology of road traffic injury hotspots in Kigali, Rwanda from police data

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Anjni Patel

2016-08-01

Full Text Available Abstract Background Road traffic injuries (RTIs are the eighth-leading cause of death worldwide, with low- and middle-income countries sharing a disproportionate number of fatalities. African countries, like Rwanda, carry a higher burden of these fatalities and with increased economic growth, these numbers are expected to rise. We aim to describe the epidemiology of RTIs in Kigali Province, Rwanda and create a hotspot map of crashes from police data. Methods Road traffic crash (RTC report data from January 1, 2013 to December 31, 2013 was collected from Kigali Traffic Police. In addition to analysis of descriptive data, locations of RTCs were mapped and analyzed through exploratory spatial data analysis to determine hotspots. Results A total of 2589 of RTCs were reported with 4689 total victims. The majority of victims were male (94.7 % with an average age of 35.9 years. Cars were the most frequent vehicle involved (43.8 %, followed by motorcycles (14.5 %. Motorcycles had an increased risk of involvement in grievous crashes and pedestrians and cyclists were more likely to have grievous injuries. The hotspots identified were primarily located along the major roads crossing Kigali and the two busiest downtown areas. Conclusions Despite significant headway by the government in RTC prevention, there continue to be high rates of RTIs in Rwanda, specifically with young males and a vulnerable road user population, such as pedestrians and motorcycle users. Improvements in police data and reporting by laypersons could prove valuable for further geographic information system analysis and efforts towards crash prevention and targeting education to motorcycle taxis could help reduce RTIs in a severely affected population.

The epidemiology of road traffic injury hotspots in Kigali, Rwanda from police data.

Science.gov (United States)

Patel, Anjni; Krebs, Elizabeth; Andrade, Luciano; Rulisa, Stephen; Vissoci, João Ricardo N; Staton, Catherine A

2016-08-02

Road traffic injuries (RTIs) are the eighth-leading cause of death worldwide, with low- and middle-income countries sharing a disproportionate number of fatalities. African countries, like Rwanda, carry a higher burden of these fatalities and with increased economic growth, these numbers are expected to rise. We aim to describe the epidemiology of RTIs in Kigali Province, Rwanda and create a hotspot map of crashes from police data. Road traffic crash (RTC) report data from January 1, 2013 to December 31, 2013 was collected from Kigali Traffic Police. In addition to analysis of descriptive data, locations of RTCs were mapped and analyzed through exploratory spatial data analysis to determine hotspots. A total of 2589 of RTCs were reported with 4689 total victims. The majority of victims were male (94.7 %) with an average age of 35.9 years. Cars were the most frequent vehicle involved (43.8 %), followed by motorcycles (14.5 %). Motorcycles had an increased risk of involvement in grievous crashes and pedestrians and cyclists were more likely to have grievous injuries. The hotspots identified were primarily located along the major roads crossing Kigali and the two busiest downtown areas. Despite significant headway by the government in RTC prevention, there continue to be high rates of RTIs in Rwanda, specifically with young males and a vulnerable road user population, such as pedestrians and motorcycle users. Improvements in police data and reporting by laypersons could prove valuable for further geographic information system analysis and efforts towards crash prevention and targeting education to motorcycle taxis could help reduce RTIs in a severely affected population.

Trends in leprosy case detection in Rwanda, 1995–2011: analysis of 17 years of laboratory data

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Innocent Uwimana

2017-02-01

Objective: We analysed laboratory records to assess trends in prevalence rates and case detection rates (CDRs in Rwanda. Methods: A retrospective review of detected leprosy cases from the records of the Rwanda National Reference Laboratory over a 17-year period (1995–2011 was conducted. Skin biopsy samples were analysed microscopically using Ziehl-Neelsen staining technique to identify M. leprae. Results: Cumulatively, 266 suspected cases were reported between 1995 and 2011. Of the suspected cases, 77 (28.9% were laboratory confirmed as having leprosy. Among detected cases, 59 (76.6% were men and 18 (23.4% women. The male:female ratio was 3:1. There were 77 registered leprosy cases over the 17-year period of the study, and the prevalence rate was 0.005 per 10 000 population. A gradual decrease in the prevalence rate was observed from 0.015 per 10 000 population in 2003 to 0.003 per 10 000 population in 2010. From 1995 to 2011, the CDR did not exceed one per 10 000 population. Conclusion: This laboratory review demonstrates a declining trend in prevalence rates and CDR during the period of the study. Early case detection and a sustainable leprosy control programme remain the cornerstones of reducing the physical and socio-economic burden of leprosy in Rwanda.

Factors Influencing the Choice of Anesthesia as a Career by Undergraduates of the University of Rwanda.

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Chan, Denise M; Wong, Rex; Runnels, Sean; Muhizi, Epaphrodite; McClain, Craig D

2016-08-01

Rwanda currently faces a severe shortage of trained medical personnel, including physician anesthesiologists. The recruitment of residents into the anesthesia program has been consistently low. This study aimed at determining the factors that influence undergraduates' decision to pursue anesthesia as a career choice. A questionnaire was created and administered to final year undergraduate medical students at the University of Rwanda. The questionnaire was created based on factors identified from literature review and key informant interviews. The questionnaire was translated, field-tested, and refined. The final survey questionnaire contains 27 4-point Likert scale items and 4 free-text questions. Seventy-nine final year undergraduate medical students responded to the survey. Only 2 students (2.5%) chose anesthesia as their top choice for postgraduate training. The most frequently named factors for not choosing anesthesiology were long work hours and high stress level, insufficient mentorship, and low job opportunity. The issues identified by our survey must be considered when making efforts toward increasing anesthesia recruitment in Rwanda. Factors such as lack of material resources and high workload will not be easily addressed. Others can be addressed through changes in medical student anesthesiology rotations and better mentorship by anesthesiologists during formative years. Focusing on factors that can be changed now may increase enrollment into anesthesiology. Future studies will include broadening the survey population and further investigating the influencing factors elucidated by this study.

Characterization of indigenous chicken production systems in Rwanda.

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Mahoro, J; Muasya, T K; Mbuza, F; Habimana, R; Kahi, A K

2017-12-01

Characterization of indigenous chicken (IC) production systems in Rwanda was conducted from November 2015 to January 2016 with the aim of understanding socio-economic characteristics, management of IC, production parameters, feed resources, and constraints faced by farmers rearing IC. A survey involving 206 households was carried out in 5 districts with the highest populations of IC using structured questionnaires. Data were analyzed using SAS software. The results showed that the majority of respondents (62.4%) were males and 37.6% were females. The majority of respondents (83.6%) had formal education. All family members were involved in the chicken husbandry practices. However, women (78%) were highly responsible for IC management activities. The family size averaged 5 persons (ranging 2 to 13) per household. Land was privately owned by farmers (84%) with a mean holding of 0.87 ha per household. The production system was mainly extensive with minimum provision of supplementary feeds. Chickens were being housed in separate houses at night and mating was uncontrolled. Breeding and replacement stocks were mainly sourced from the hatching of eggs using broody hens (60.68% of respondents). There were no vaccination programs, and ecto- and endo-parasites control was done when need arose. Egg production, income generation, meat production, and production of breeding stock were the main reasons of keeping IC. The first 3 main challenges facing IC production were diseases outbreaks, lack of investment capital, and predators. Others challenges, such as feed shortage, thieves, fluctuation of market price, lack of information on poultry rearing, and lack of chicken houses, also were mentioned. The IC production constraints mentioned need urgent mitigation measures to sustain utilization of IC against the changing climatic and economic conditions. Therefore, individual, public institution, and non-governmental organization efforts are required to develop sustainable breeding

Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia

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April L. Kelley

2016-08-01

Full Text Available Abstract Background Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples’ voluntary counseling and testing (CVCT, fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs and influential network agents (INAs in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods INLs were identified in the faith-based, non-governmental, private, and health sectors. Each INL recruited and mentored several INAs who promoted CVCT. INLs and INAs were interviewed about demographic characteristics, promotional efforts, and working relationships. We also surveyed CVCT clients about sources of CVCT information. Results In Zambia, 53 INAs and 31 INLs were surveyed. In Rwanda, 33 INAs and 27 INLs were surveyed. Most (75 %–90 % INAs believed that INL support was necessary for their promotional work. Zambian INLs reported being more engaged with their INAs than Rwandan INLs, with 58 % of Zambian INLs reporting that they gave a lot of support to their INAs versus 39 % in Rwanda. INAs in both Rwanda and Zambia reported promoting CVCT via group forums (77 %–97 % and speaking to a community leader about CVCT (79 %–88 % in the past month. More Rwandan INAs and INLs reported previous joint or individual HIV testing compared with their Zambian counterparts, of which more than half had not been tested. In Zambia and Rwanda, 1271 and 3895 CVCT clients were surveyed, respectively. Hearing about CVCT from INAs during one-on-one promotions was the most frequent source of information reported by clients in Zambia (71 %. In contrast, Rwandan couples who tested were more likely to have heard about CVCT from a previously tested couple (59 %. Conclusions CVCT has long been endorsed for HIV prevention but few couples have been reached. Influential social networks can

Knowledge, Attitudes and Awareness of Pre-Service Teachers on Biodiversity Conservation in Rwanda

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Venuste, Nsengimana; Olivier, Habimana; Valens, Ngarukiye

2017-01-01

This research presents a case study on the knowledge of pre-service teachers of the school of lower secondary education on biodiversity conservation in Rwanda. It critically examines the implication of the level of knowledge on attitudes and behaviors towards biodiversity conservation and the potential implications of a lack of the courses…

DISASTER RISK AND CAPACITIES ASSESSMENT IN THE NORTH-WEST PARTS OF RWANDA

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J.ean Baptiste Nsengiyumva

2014-01-01

Full Text Available The Republic of Rwanda is located in the Great lakes region of the central Africa. This landlocked country has historically suffered from periodic natural and manmade disasters, mainly in the form of droughts, floods and landslides impacting the agrarian economy and the country’s efforts towards sustainable development and poverty reduction. Vulnerability to Periodic natural disasters is a long term concern. The study therefore aims at conducting an assessment of disaster risks, vulnerabilities and coping capacities in Burera, Nyabihu and Musanze Districts affected floods and landslides in order to put in place mitigation strategies for disaster risks. Different methods and techniques were used to conduct this study including interviews, questionnaires, focus group discussions, field visits and observations, GIS and remote sensing among others. The analysis comprised the disaggregation of the hazards’ characteristics including description of the hazard, Triggering factors, Frequency, seasonality, Duration, sectors affected, impacts, time of recovery, intensity of the hazard and others. In terms of vulnerability. The analysis comprised physical, environmental, social, institutional, economic, profile of the most vulnerable populations, differentiation of impacts, and level of vulnerabilities. The study results showed that the Disaster Risk reduction is very possible through a comprehensive risk management. There is also a big need to expand capacity building in terms of disaster management, risk mapping to reach cell and village levels, put in place and operationalize early warning systems or hydro-meteorological hazards and many others in order to minimize the disaster risks and where possible to transform them into opportunities. All disasters are not preventable but mitigation is always possible.

Effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance: an impact evaluation.

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Basinga, Paulin; Gertler, Paul J; Binagwaho, Agnes; Soucat, Agnes L B; Sturdy, Jennifer; Vermeersch, Christel M J

2011-04-23

Evidence about the best methods with which to accelerate progress towards achieving the Millennium Development Goals is urgently needed. We assessed the effect of performance-based payment of health-care providers (payment for performance; P4P) on use and quality of child and maternal care services in health-care facilities in Rwanda. 166 facilities were randomly assigned at the district level either to begin P4P funding between June, 2006, and October, 2006 (intervention group; n=80), or to continue with the traditional input-based funding until 23 months after study baseline (control group; n=86). Randomisation was done by coin toss. We surveyed facilities and 2158 households at baseline and after 23 months. The main outcome measures were prenatal care visits and institutional deliveries, quality of prenatal care, and child preventive care visits and immunisation. We isolated the incentive effect from the resource effect by increasing comparison facilities' input-based budgets by the average P4P payments made to the treatment facilities. We estimated a multivariate regression specification of the difference-in-difference model in which an individual's outcome is regressed against a dummy variable, indicating whether the facility received P4P that year, a facility-fixed effect, a year indicator, and a series of individual and household characteristics. Our model estimated that facilities in the intervention group had a 23% increase in the number of institutional deliveries and increases in the number of preventive care visits by children aged 23 months or younger (56%) and aged between 24 months and 59 months (132%). No improvements were seen in the number of women completing four prenatal care visits or of children receiving full immunisation schedules. We also estimate an increase of 0·157 standard deviations (95% CI 0·026-0·289) in prenatal quality as measured by compliance with Rwandan prenatal care clinical practice guidelines. The P4P scheme in Rwanda had

Iron bioavailability studies of the first generation of iron-biofortified beans released in Rwanda

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This paper represents a series of in vitro Fe bioavailability experiments, Fe content analysis and polyphenolic profile of the first generation of Fe biofortified beans (Phaseolus vulgaris) selected for human trials in Rwanda and released to farmers of that region. The objective of the present stud...

'Mama and papa nothing': living with infertility among an urban population in Kigali, Rwanda

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Dhont, N.; van de Wijgert, J.; Coene, G.; Gasarabwe, A.; Temmerman, M.

2011-01-01

Not being able to procreate has severe social and economic repercussions in resource-poor countries. The purpose of this research was to explore the consequences of female and/or male factor infertility for men and women in Rwanda. Both quantitative and qualitative methods were used. Couples

Reconciliation Sentiment among Victims of Genocide in Rwanda: Conceptualizations, and Relationships with Mental Health

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Mukashema, Immaculee; Mullet, Etienne

2010-01-01

In two studies that were conducted in Rwanda, we have examined the conceptualizations held by people who have experienced genocide with regard to reconciliation sentiment and quantitatively assessed the relationship between reconciliation sentiment and mental health. It was found that the participants have articulated conceptualizations regarding…

Pregnancy loss and neonatal mortality in Rwanda : The differential role of inter-pregnancy intervals

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Habimana Kabano, I.

2015-01-01

Rwanda has so far paid little attention to 'healthy' intervals between pregnancies awareness programs on family planning and maternal and child health. Results of this thesis shed some light on the contribution of IPI and the type of previous pregnancy outcome on fetal survival, neonatal mortality

Characterization of broiler poultry production system in Rwanda.

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Mbuza, Francis; Manishimwe, Rosine; Mahoro, Janvier; Simbankabo, Thomas; Nishimwe, Kizito

2017-01-01

A study was conducted on 37 randomly selected broiler poultry farmers in Rwanda to characterize the production system using pre-tested semi-structured questionnaires. The data were processed in SPSS and presented as means, percentages and ranges in tables and text. All respondents kept Cobb breed and young stock was mainly (73 %) imported from abroad. The majority of respondents were males (68 %) and most farmers had attended only primary level of education (40.5 %). Most of the farms were in the peri-urban (48.6 %) and urban (37.8 %) areas and hired male youth (62.2 %) mainly aged 19-35 years. The majority of respondents (68 %) kept less than 500 birds per batch. Recordkeeping was well practiced (91.9 %) and (62.6 %) had permanent poultry houses and all farmers used deep litter system. Purchased feedstuffs were reportedly (92 %) mixed at farm level as the main feed resource. Maize bran was reported (97.06 %) the main, basal feedstuff. The mortality rates of chick and growers were 12.3 and 9.4 %, respectively. The slaughter age was reportedly 60 days with an average dressing percentage of 75.67 %. The main challenges reported were scarcity and unaffordability of quality feeds (59.5 %), lack of market access (45 %) and lack of credit (21 %). The farmers had various views on improving broiler production in Rwanda ranging from establishing feed processing industries 62.2 %, improving marketing facilities 35.1 %, increasing availability of day-old chick and access credit 27 %, to intensification of farmer training 16.2 %.

Community mobilization for malaria elimination: application of an open space methodology in Ruhuha sector, Rwanda

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Ingabire, Chantal Marie; Alaii, Jane; Hakizimana, Emmanuel; Kateera, Fredrick; Muhimuzi, Daniel; Nieuwold, Ingmar; Bezooijen, Karsten; Rulisa, Stephen; Kaligirwa, Nadine; Muvunyi, Claude; Koenraadt, Constantianus J. M.; Mutesa, Leon; van Vugt, Michele; van den Borne, Bart

2014-01-01

Despite the significant reduction of malaria transmission in Rwanda, Ruhuha sector is still a highly endemic area for malaria. The objective of this activity was to explore and brainstorm the potential roles of various community stakeholders in malaria elimination. Horizontal participatory

Postgraduate and research programmes in Medicine and Public Health in Rwanda: an exciting experience about training of human resources for health in a limited resources country.

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Kakoma, Jean Baptiste

2016-01-01

The area of Human Resources for Health (HRH) is the most critical challenge for the achievement of health related development goals in countries with limited resources. This is even exacerbated in a post conflict environment like Rwanda. The aim of this commentary is to report and share the genesis and outcomes of an exciting experience about training of qualified health workers in medicine and public health as well as setting - up of a research culture for the last nine years (2006 - 2014) in Rwanda. Many initiatives have been taken and concerned among others training of qualified health workers in medicine and public health. From 2006 to 2014, achievements were as follows: launching and organization of 8 Master of Medicine programmes (anesthesiology, family and community medicine, internal medicine, obstetrics & gynecology, otorhinolaryngology, pediatrics, psychiatry and surgery) and 4 Master programmes in public health (MPH, MSc Epidemiology, MSc Field Epidemiology & Laboratory Management, and Master in Hospital and Healthcare Administration); training to completion of more than 120 specialists in medicine, and 200 MPH, MSc Epidemiology, and MSc Field Epidemiology holders; revival of the Rwanda Medical Journal; organization of graduate research training (MPhil and PhD); 3 Master programmes in the pipeline (Global Health, Health Financing, and Supply Chain Management); partnerships with research institutions of great renown, which contributed to the reinforcement of the institutional research capacity and visibility towards excellence in leadership, accountability, and self sustainability. Even though there is still more to be achieved, the Rwanda experience about postgraduate and research programmes is inspiring through close interactions between main stakeholders. This is a must and could allow Rwanda to become one of the rare examples to other more well-to-do Sub - Saharan countries, should Rwanda carry on doing that.

[Criminology and victimology of rape in context with war-like conflicts using the example of the former Yugoslavia and Rwanda].

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Nittmann, Christian; Franke, Barbara; Augustin, Christa; Püschel, Klaus

2012-01-01

The topic of this article is sexual violence in context with war-like conflicts in the former Yugoslavia and Rwanda. The fundamental categories of sexual violence in war-like conflicts are described. The authors discuss the types of sexual violence as defined in the report of the UN Commission of Experts on the war-like conflicts in the former Yugoslavia. Four criminal trials were evaluated: three held before the International Criminal Tribunal for the Former Yugoslavia (ICTY) in The Hague/Netherlands and one before the International Criminal Tribunal for Rwanda (ICTR) in Arusha/Tansania. The defendants were found guilty of torture, crime against humanity and genocide. Potential procedures with respect to similar crimes in current or prospective conflicts are discussed. An alternative may be the assignment of medical personnel (for example of the German Federal Armed Forces). Finally, the post-war cooperation between the Institute of Legal Medicine at the University Medical Centre of Hamburg-Eppendorf as well as the medical and government institutions in Rwanda is presented, which has been going on since 2005.

High HIV prevalence and associated risk factors among female sex workers in Rwanda.

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Mutagoma, Mwumvaneza; Samuel, Malamba S; Kayitesi, Catherine; Gasasira, Antoine R; Chitou, Bassirou; Boer, Kimberly; Hedt-Gauthier, Bethany; Gupta, Neil; Ntaganira, Joseph; Nsanzimana, Sabin

2017-10-01

Human immunodeficiency virus (HIV) prevalence is often high among female sex workers (FSWs) in sub-Saharan Africa. Understanding the dynamics of HIV infection in this key population is critical to developing appropriate prevention strategies. We aimed to describe the prevalence and associated risk factors among a sample of FSWs in Rwanda from a survey conducted in 2010. A cross-sectional biological and behavioral survey was conducted among FSWs in Rwanda. Time-location sampling was used for participant recruitment from 4 to 18 February 2010. HIV testing was done using HIV rapid diagnostic tests (RDT) as per Rwandan national guidelines at the time of the survey. Elisa tests were simultaneously done on all samples tested HIV-positive on RDT. Proportions were used for sample description; multivariable logistic regression model was performed to analyze factors associated with HIV infection. Of 1338 women included in the study, 1112 consented to HIV testing, and the overall HIV prevalence was 51.0%. Sixty percent had been engaged in sex work for less than five years and 80% were street based. In multivariable logistic regression, HIV prevalence was higher in FSWs 25 years or older (adjusted odds ratio [aOR] = 1.83, 95% [confidence interval (CI): 1.42-2.37]), FSWs with consistent condom use in the last 30 days (aOR = 1.39, [95% CI: 1.05-1.82]), and FSWs experiencing at least one STI symptom in the last 12 months (aOR = 1.74 [95% CI: 1.34-2.26]). There was an inverse relationship between HIV prevalence and comprehensive HIV knowledge (aOR = 0.65, [95% CI: 0.48-0.88]). HIV prevalence was high among a sample of FSWs in Rwanda, and successful prevention strategies should focus on HIV education, treatment of sexually transmitted infections, and proper and consistent condom use using an outreach approach.

Within the Box: Cross-Cultural Art Therapy with Survivors of the Rwanda Genocide

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Chu, Valerie

2010-01-01

This article discusses the creative making of boxes as a cross-cultural art therapy intervention in Kigali, Rwanda, with survivors of the 1994 Rwandan genocide. The box as an art form is particularly applicable with young adult survivors, given the nature of their prodigious trauma and the possibility of posttraumatic stress disorder, as well as…

The relationship between organized violence, family violence and mental health: findings from a community-based survey in Muhanga, Southern Rwanda

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Heide Rieder

2013-11-01

Full Text Available Background : The relationship between organized violence and family violence, and their cumulative effect on mental health in post-conflict regions remains poorly understood. Objective : The aim of the present study was to establish prevalence rates and predictors of family violence in post-conflict Rwanda. And to examine whether higher levels of war-related violence and its socio-economic consequences would result in higher levels of violence within families and whether this would be related to an increase of psychological distress in descendants. Method : One hundred and eighty-eight parent–child pairs from four sectors of the district Muhanga, Southern Province of Rwanda, were randomly selected for participation in the study. Trained local psychologists administered structured diagnostic interviews. A posttraumatic stress disorder (PTSD diagnosis was established using the PTSD Symptom Scale Interview (PSS-I and child maltreatment was assessed by means of the Childhood Trauma Questionnaire (CTQ. Additionally, the Hopkins Symptom Checklist (HSCL-25 assessed symptoms of depression and anxiety in descendants. Results : Prevalence rates of child abuse and neglect among descendants were below 10%. Ordinal regression analyses revealed that the level of child maltreatment in descendants was predicted by female sex, poverty, loss of the mother, exposure to war and genocide as well as parents’ level of PTSD and reported child maltreatment. Poor physical health, exposure to war and genocide, parental PTSD symptoms, and reported childhood trauma were significantly associated with depressive and anxious symptoms, while only exposure to war and genocide and poor physical health predicted the level of PTSD. Conclusion : The results indicate that cumulative stress such as exposure to organized violence and family violence in Rwandan descendants poses a risk factor for the development of depressive and anxious symptoms. Besides the support for families to

Effect of shortened Integrated Management of Childhood Illness training on classification and treatment of under-five children seeking care in Rwanda

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Harerimana JM

2014-05-01

Full Text Available Jean-Modeste Harerimana,1 Laetitia Nyirazinyoye,1 Jean-Bosco Ahoranayezu,2 Ferdinand Bikorimana,3 Bethany L Hedt-Gauthier,1,4 Katherine A Muldoon,5 Edward J Mills,6,7 Joseph Ntaganira1 1University of Rwanda College of Medicine and Health Sciences School of Public Health, Kigali, Rwanda; 2Community Vision Initiative, Kigali, Rwanda; 3Maternal and Child Health, Child Unit, Rwandan Ministry of Health, Kigali, Rwanda; 4Harvard Medical School, Boston, MA, USA; 5University of British Columbia, Vancouver, BC, Canada; 6University of Ottawa, Ottawa, ON, Canada; 7Stanford University, Stanford, CA, USA Background: Integrated Management of Childhood Illness (IMCI is an effective 11-day standard training; however, due to budgetary expenses and human resource constraints, many health professionals cannot take 11 days off work. As a result, shortened training curriculums (6-day have been proposed. We used a cross-sectional study to evaluate the effect of this shortened training on appropriate IMCI classification and treatment of under-five childhood illness management in Rwanda. Methods: A cross-sectional study was conducted in 22 health centers in Rwanda, comparing data from 121 nurses, where 55 nurses completed the 11-day and 66 nurses completed the 6-day training. Among 768 children, we evaluated clinical outcomes from May 2011 to April 2012. Descriptive statistics were used to display the sociodemographic characteristics of health providers; including level of education, sex, age, and professional experiences. Bivariable and multivariable analyses were used to test for differences between nurses in the 6-day versus 11-day training on the appropriate classification and treatment of childhood illness. Results: Our findings show that at the bivariable level and after controlling for confounders in the multivariable analysis, the only significant differences detected between nurses in the long and short training was the classification of fever (adjusted odds

The development of a model for dealing with secondary traumatic stress in mental health workers in Rwanda

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Jean D. Iyamuremye

2015-10-01

Aim: To develop a comprehensive model to manage the effects of STS in mental health workers operating in Rwanda. Method: An action research project was initiated to develop this model and data for the model was collected through individual interviews with mental health workers (nurses, doctors, psychologists, trauma counsellors and social workers as well as a quantitative tool measuring secondary traumatic stress (Trauma Attachment Belief Scale in these health workers. Results: The Intervention Model to Manage Secondary Traumatic Stress (IMMSTS was synthesised from these findings and includes preventive, evaluative and curative strategies to manage STS in mental health workers in Rwanda at the individual, social and organisational levels. Conclusion: The model will offer mental health professionals an effective framework for addressing the issue of STS.

Human Capital Development in Rwanda : Effects of Education, Social Protection and Rural Development Policies

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Nkurunziza, J.

2015-01-01

In 2000 the government of Rwanda launched Vision 2020, a framework for its long term development. In this document the low education level of the country’s main asset - its population - was identified as the major microeconomic structural problem that had to be addressed to facilitate the transition

Malaria parasite carriage and risk determinants in a rural population: a malariometric survey in Rwanda

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Kateera, Fredrick; Mens, Petra F.; Hakizimana, Emmanuel; Ingabire, Chantal M.; Muragijemariya, Liberata; Karinda, Parfait; Grobusch, Martin P.; Mutesa, Leon; van Vugt, Michèle

2015-01-01

Based on routine health facility case data, Rwanda has achieved a significant malaria burden reduction in the past ten years. However, community-based malaria parasitaemia burden and reasons for continued residual infections, despite a high coverage of control interventions, have yet to be

The impact of "Option B" on HIV transmission from mother to child in Rwanda: An interrupted time series analysis.

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Abimpaye, Monique; Kirk, Catherine M; Iyer, Hari S; Gupta, Neil; Remera, Eric; Mugwaneza, Placidie; Law, Michael R

2018-01-01

Nearly a quarter of a million children have acquired HIV, prompting the implementation of new protocols-Option B and B+-for treating HIV+ pregnant women. While efficacy has been demonstrated in randomized trials, there is limited real-world evidence on the impact of these changes. Using longitudinal, routinely collected data we assessed the impact of the adoption of WHO Option B in Rwanda on mother to infant transmission. We used interrupted time series analysis to evaluate the impact of Option B on mother-to-child HIV transmission in Rwanda. Our primary outcome was the proportion of HIV tests in infants with positive results at six weeks of age. We included data for 20 months before and 22 months after the 2010 policy change. Of the 15,830 HIV tests conducted during our study period, 392 tested positive. We found a significant decrease in both the level (-2.08 positive tests per 100 tests conducted, 95% CI: -2.71 to -1.45, p Option B in Rwanda contributed to an immediate decrease in the rate of HIV transmission from mother to child. This suggests other countries may benefit from adopting these WHO guidelines.

Designing mobile instant messaging for collaborative health data management in Rwanda

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Fraschetti, Yrjan Aleksander Frøyland

2017-01-01

Fast and efficient communication is crucial for workers that are required to collaborate. Instant messaging has been found to be more efficient than email and other asynchronous messaging systems when used for asking quick questions. Group chats have also been shown to stimulate collaboration between multiple users. In this thesis, we explore how mobile instant messaging can facilitate and stimulate collaboration between health data managers working in different facilities in Rwanda. An insta...

A qualitative study on perceptions of surgical careers in Rwanda: A gender-based approach.

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Yi, Sojung; Lin, Yihan; Kansayisa, Grace; Costas-Chavarri, Ainhoa

2018-01-01

Access to surgical care in low- and middle-income countries (LMICs) remains deficient without an adequate workforce. There is limited understanding of the gender gap in surgical trainees in LMICs. In Rwanda, females fill only one of 20 positions available. Understanding surgeons' experiences and perceptions of surgical careers may help facilitate support for females to contribute to the global surgical workforce. We performed qualitative analysis on perceptions of surgical careers through semi-structured interviews of all female surgeons (n = 6) and corresponding male surgeons (n = 6) who are training or have trained at University of Rwanda. Transcripts were analyzed with code structure formed through an integrated approach. Question categories formed the deductive framework, while theoretical saturation was reached through inductive grounded theory. Themes were organized within two key points of the career timeline. First, for developing interest in surgery, three main themes were identified: role models, patient case encounters, and exposure to surgery. Second, for selecting and sustaining surgical careers, four main themes emerged: social expectations about roles within the family, physical and mental challenges, professional and personal support, and finances. All female surgeons emphasized gender assumptions and surgical working culture as obstacles, with a corresponding strong sense of self-confidence and internal motivation that drew them to select and maintain careers in surgery. Family, time, and physical endurance were cited as persistent challenges for female participants. Our study reveals concepts for further exploration about gendered perceptions of surgical careers. Efforts to improve support for female surgical careers as a strategy for shaping surgical work culture and professional development in Rwanda should be considered. Such strategies may be beneficial for improving the global surgical workforce.

Assessment of antibiotic use in farm animals in Rwanda.

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Manishimwe, Rosine; Nishimwe, Kizito; Ojok, Lonzy

2017-08-01

The irrational use of antibiotics in humans and animals is highly related to the emergence and increase of antibiotic-resistant bacteria worldwide. A cross-sectional survey aimed at evaluating the current level of practices regarding antibiotic use in farm animals in Rwanda was carried out countrywide. Interviews were conducted on 229 farmers rearing different types of animals. The study has revealed that almost all respondent farmers could name at least one antibiotic used in farm animals and peni-streptomycin was named by most of them (95.6%). The use of antibiotics in farm animals was observed in the majority of respondents (97.4%). It was found that 44.4 and 26.5% of respondents reported that they used antibiotics for disease prevention and growth promotion, respectively. The use of non-prescribed antibiotics in animals was also reported by more than the half of respondent farmers (55.6%). The majority of farmers had a moderate level of practices regarding antibiotic use in farm animals (73.5%), very few had a high level (26%) and only one respondent had a low level. The high level of practices in regard to antibiotic use in animals was associated with the location of the farm, the type of reared animals, and the rearing system. The results of this study give an insight into antibiotics usage practices in farm animals in Rwanda. The generated information can guide sensitizations and promotions of the prudent use of antibiotics among farmers in order to limit the increase of antibiotic resistance in the country.

Multimedia as a Means to Enhance Teaching Technical Vocabulary to Physics Undergraduates in Rwanda

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Rusanganwa, Joseph

2013-01-01

This study investigates whether the integration of ICT in education can facilitate teaching and learning. An example of such integration is computer assisted language learning (CALL) of English technical vocabulary by undergraduate physics students in Rwanda. The study draws on theories of cognitive load and multimedia learning to explore learning…

The Role of Education in Driving Conflict and Building Peace: The Case of Rwanda

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McLean Hilker, Lyndsay

2011-01-01

This article considers the relationship between education, conflict, and peacebuilding in Rwanda. First, it examines the role that education played in the lead-up to the 1994 genocide, discussing whether and how the low levels of educational attainment, inequalities of access, curricular content, and teaching methods contributed to the conditions…

The Implementation of the New Lower Secondary Science Curriculum in Three Schools in Rwanda

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Nsengimana, Théophile; Ozawa, Hiroaki; Chikamori, Kensuke

2014-01-01

In 2006, Rwanda began implementing an Outcomes Based Education (OBE) lower secondary science curriculum that emphasises a student-centred approach. The new curriculum was designed to transform Rwandan society from an agricultural to a knowledge-based economy, with special attention to science and technology education. Up until this point in time…

Motivations and Constraints to Family Planning: A Qualitative Study in Rwanda’s Southern Kayonza District

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Farmer, Didi Bertrand; Berman, Leslie; Ryan, Grace; Habumugisha, Lameck; Basinga, Paulin; Nutt, Cameron; Kamali, Francois; Ngizwenayo, Elias; Fleur, Jacklin St; Niyigena, Peter; Ngabo, Fidele; Farmer, Paul E; Rich, Michael L

2015-01-01

Background: While Rwanda has achieved impressive gains in contraceptive coverage, unmet need for family planning is high, and barriers to accessing quality reproductive health services remain. Few studies in Rwanda have qualitatively investigated factors that contribute to family planning use, barriers to care, and quality of services from the community perspective. Methods: We undertook a qualitative study of community perceptions of reproductive health and family planning in Rwanda’s southern Kayonza district, which has the country’s highest total fertility rate. From October 2011 to December 2012, we conducted interviews with randomly selected male and female community members (n = 96), community health workers (n = 48), and health facility nurses (n = 15), representing all 8 health centers’ catchment areas in the overall catchment area of the district’s Rwinkwavu Hospital. We then carried out a directed content analysis to identify key themes and triangulate findings across methods and informant groups. Results: Key themes emerged across interviews surrounding: (1) fertility beliefs: participants recognized the benefits of family planning but often desired larger families for cultural and historical reasons; (2) social pressures and gender roles: young and unmarried women faced significant stigma and husbands exerted decision-making power, but many husbands did not have a good understanding of family planning because they perceived it as a woman’s matter; (3) barriers to accessing high-quality services: out-of-pocket costs, stock-outs, limited method choice, and long waiting times but short consultations at facilities were common complaints; (4) side effects: poor management and rumors and fears of side effects affected contraceptive use. These themes recurred throughout many participant narratives and influenced reproductive health decision making, including enrollment and retention in family planning programs. Conclusions: As Rwanda

Prudential Liquidity Regulation in Developing Countries; A Case Study of Rwanda

OpenAIRE

Sarah Sanya; A. E. Wayne Mitchell; Angelique Kantengwa

2012-01-01

This paper analyses the prudential liquidity management framework, in particular the quantitative indicators employed by the central bank of Rwanda in response to the domestic liquidity crisis in 2008/09. It emphasises that the quantitative methods used in the monitoring and assessment of systemic liquidity risk are inadequate because they did not signal the liquidity crises ex-post. There are quick gains to be made from augumenting the liquidity risk indicators with more dynamic liquidity st...

The epidemiology of HPV and HIV among high-risk women and steady couples in Kigali, Rwanda

NARCIS (Netherlands)

Veldhuijzen, N.J.

2011-01-01

Nienke Veldhuijzen beschrijft de epidemiologie van het humaan papillomavirus (HPV) en het hiv-virus bij twee verschillende bevolkingsgroepen in Kigali, Rwanda. Hoog-risico(HR)-HPV kan baarmoederhalskanker veroorzaken. Laag-risico(LR)-HPV wordt in verband gebracht met onder andere genitale wratten.

Evaluation of Adherence to a Convulsion management Protocol for Children in Rwanda

OpenAIRE

kaputu-kalal-malu, Célestin; D'Amour Birindabagabo, Jean; Walker, Timothy David; Mafuta-Musalu, Eric; Ntumba-Tshitenge, Olga; Preux, Pierre-Marie; MISSON, Jean-Paul

2014-01-01

Inappropriate seizure management may result in high morbidity and mortality. We assessed the adherence of health professionals in southern Rwanda to a national protocol for pharmacological management of seizures in children. A questionnaire featuring a 5-year-old child with generalized prolonged seizures was administered. The questions focused on the choice of initial treatment and the sequence of management following failure of the initial treatment choice. Benzodiazepine was cho...

Early childhood development in Rwanda: a policy analysis of the human rights legal framework.

Science.gov (United States)

Binagwaho, Agnes; Scott, Kirstin W; Harward, Sardis H

2016-01-12

Early childhood development (ECD) is a critical period that continues to impact human health and productivity throughout the lifetime. Failing to provide policies and programs that support optimal developmental attainment when such services are financially and logistically feasible can result in negative population health, education and economic consequences that might otherwise be avoided. Rwanda, with its commitment to rights-based policy and program planning, serves as a case study for examination of the national, regional, and global human rights legal frameworks that inform ECD service delivery. In this essay, we summarize key causes and consequences of the loss of early developmental potential and how this relates to the human rights legal framework in Rwanda. We contend that sub-optimal early developmental attainment constitutes a violation of individuals' rights to health, education, and economic prosperity. These rights are widely recognized in global, regional and national human rights instruments, and are guaranteed by Rwanda's constitution. Recent policy implementation by several Rwandan ministries has increased access to health and social services that promote achievement of full developmental potential. These ECD-centric activities are characterized by an integrated approach to strengthening the services provided by several public sectors. Combining population level activities with those at the local level, led by local community health workers and women's councils, can bolster community education and ensure uptake of ECD services. Realization of the human rights to health, education, and economic prosperity requires and benefits from attention to the period of ECD, as early childhood has the potential to be an opportunity for expedient intervention or the first case of human rights neglect in a lifetime of rights violations. Efforts to improve ECD services and outcomes at the population level require multisector collaboration at the highest echelons

A statistical investigation of wind characteristics and wind energy potential based on the Weibull and Rayleigh models in Rwanda

Energy Technology Data Exchange (ETDEWEB)

Safari, Bonfils; Gasore, Jimmy [Department of Physics, National University of Rwanda, P.O. Box 117, Huye, South Province (Rwanda)

2010-12-15

A wind energy system converts the kinetic energy of the wind into mechanical or electrical energy that can be harnessed for practical uses and transform the economy of rural areas where access to water and electricity is very restricted and industry is almost nonexistent in most of the developing countries like Rwanda. Assessing wind power potential for a location is an imperative requirement before making a decision for the installation of windmills or a wind electric generator and evaluating plans for relating projects. The aim of the present study was to evaluate the potential of wind resource in Rwanda and to constitute a database for the users of the wind power. A time series of hourly daily measured wind speed and wind direction for the period between 1974 and 1993 on five main Rwandan meteorological stations was provided by the National Meteorology Department. Statistical methods applying Weibull and Rayleigh distribution were presented to evaluate the wind speed characteristics and the wind power potential at a height of 10 m above ground level using hourly monthly average data. Those characteristics were extrapolated for higher levels in altitude. The results give a global picture of the distribution of the wind potential in different locations of Rwanda. (author)

The “treatment gap” in global mental health reconsidered: sociotherapy for collective trauma in Rwanda

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Stefan Jansen

2015-11-01

Full Text Available Background: The “treatment gap” (TG for mental disorders refers to the difference that exists between the number of people who need care and those who receive care. The concept is strongly promoted by the World Health Organization and widely used in the context of low- and middle-income countries. Although accepting the many demonstrable benefits that flow from this approach, it is important to critically reflect on the limitations of the concept of the TG and its implications for building capacity for mental health services in Rwanda. Objective: The article highlights concerns that the evidence base for mental health interventions is not globally valid, and problematizes the preponderance of psychiatric approaches in international guidelines for mental health. Specifically, the risk of medicalization of social problems and the limited way in which “community” has been conceptualized in global mental health discourses are addressed. Rather than being used as a method for increasing economic efficiency (i.e., reducing healthcare costs, “community” should be promoted as a means of harnessing collective strengths and resources to help promote mental well-being. This may be particularly beneficial for contexts, like Rwanda, where community life has been disrupted by collective violence, and the resulting social isolation constitutes an important determinant of mental distress. Conclusions: Moving forward there is a need to consider alternative paradigms where individual distress is understood as a symptom of social distress, which extends beyond the more individually oriented TG paradigm. Sociotherapy, an intervention used in Rwanda over the past 10 years, is presented as an example of how communities of support can be built to promote mental health and psychosocial well-being.

International trends in health science librarianship part 14: East Africa (Kenya, Uganda, Rwanda).

Science.gov (United States)

Gathoni, Nasra; Kamau, Nancy; Nannozi, Judith; Singirankabo, Marcel

2015-06-01

This is the 14th in a series of articles exploring international trends in health science librarianship in the 21st century. This is the second of four articles pertaining to different regions in the African continent. The present issue focuses on countries in East Africa (Kenya, Uganda and Rwanda). The next feature column will investigate trends in West Africa. JM. © 2015 Health Libraries Group.

From Policies to Implementation of Open Distance Learning in Rwanda: A Genealogical and Governmentality Analysis

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Mukama, Evode

2018-01-01

The purpose of this paper is to analyse the interplay between policy formulation and implementation in terms of the historical practices of open distance learning (ODL) in Rwanda. This paper draws on the Foucauldian genealogical and governmentality analysis. The paper examines government aspirations as depicted in policy statements starting from…

Male circumcision at different ages in Rwanda: a cost-effectiveness study.

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Agnes Binagwaho

2010-01-01

Full Text Available BACKGROUND: There is strong evidence showing that male circumcision (MC reduces HIV infection and other sexually transmitted infections (STIs. In Rwanda, where adult HIV prevalence is 3%, MC is not a traditional practice. The Rwanda National AIDS Commission modelled cost and effects of MC at different ages to inform policy and programmatic decisions in relation to introducing MC. This study was necessary because the MC debate in Southern Africa has focused primarily on MC for adults. Further, this is the first time, to our knowledge, that a cost-effectiveness study on MC has been carried out in a country where HIV prevalence is below 5%. METHODS AND FINDINGS: A cost-effectiveness model was developed and applied to three hypothetical cohorts in Rwanda: newborns, adolescents, and adult men. Effectiveness was defined as the number of HIV infections averted, and was calculated as the product of the number of people susceptible to HIV infection in the cohort, the HIV incidence rate at different ages, and the protective effect of MC; discounted back to the year of circumcision and summed over the life expectancy of the circumcised person. Direct costs were based on interviews with experienced health care providers to determine inputs involved in the procedure (from consumables to staff time and related prices. Other costs included training, patient counselling, treatment of adverse events, and promotion campaigns, and they were adjusted for the averted lifetime cost of health care (antiretroviral therapy [ART], opportunistic infection [OI], laboratory tests. One-way sensitivity analysis was performed by varying the main inputs of the model, and thresholds were calculated at which each intervention is no longer cost-saving and at which an intervention costs more than one gross domestic product (GDP per capita per life-year gained. RESULTS: Neonatal MC is less expensive than adolescent and adult MC (US$15 instead of US$59 per procedure and is cost

Resource use and food self-sufficiency at farm scale within two agro-ecological zones of Rwanda

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Bucagu, C.; Vanlauwe, B.; Wijk, van M.T.; Giller, K.E.

2014-01-01

Resource use and management are major determinants of the food self-sufficiency of smallholder farmers in sub-Saharan Africa. A study was conducted in Rwanda in two contrasting agro-ecological zones (Central plateau and Buberuka) to characterise farms, quantify their resource flows, and evaluate the

Prevention of mother-to-child transmission of HIV: cost-effectiveness of antiretroviral regimens and feeding options in Rwanda.

Directory of Open Access Journals (Sweden)

Agnes Binagwaho

Full Text Available 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 PMTCT recommending Option B (HAART for all HIV-positive pregnant women extended throughout breastfeeding and discontinued (short course-HAART only for those not eligible for life treatment. The current study aims to assess the cost-effectiveness of this policy choice.Based on a cohort of HIV-infected pregnant women in Rwanda, we modelled the cost-effectiveness of six regimens: dual ARV prophylaxis with either 12 months breastfeeding or replacement feeding; short course HAART (Sc-HAART prophylaxis with either 6 months breastfeeding, 12 months breastfeeding, or 18 months breastfeeding; and Sc-HAART prophylaxis with replacement feeding. Direct costs were modelled based on all inputs in each scenario and related unit costs. Effectiveness was evaluated by measuring HIV-free survival at 18 months. Savings correspond to the lifetime costs of HIV treatment and care avoided as a result of all vertical HIV infections averted.All PMTCT scenarios considered are cost saving compared to "no intervention." Sc-HAART with 12 months breastfeeding or 6 months breastfeeding dominate all other scenarios. Sc-HAART with 12 months breastfeeding allows for more children to be alive and HIV-uninfected by 18 months than Sc-HAART with 6 months breastfeeding for an incremental cost per child alive and uninfected of 11,882 USD. This conclusion is sensitive to changes in the relative risk of mortality by 18 months for exposed HIV-uninfected children on replacement feeding from birth and those who were breastfed for only 6 months compared to those breastfeeding for 12 months or more.Our findings support the earlier decision by Rwanda to adopt WHO Option B and could inform alternatives for breastfeeding duration. Local contexts and existing care delivery models should be part of national policy decisions.

Screening for human papillomavirus, cervical cytological abnormalities and associated risk factors in HIV-positive and HIV-negative women in Rwanda.

Science.gov (United States)

Mukanyangezi, M F; Sengpiel, V; Manzi, O; Tobin, G; Rulisa, S; Bienvenu, E; Giglio, D

2018-02-01

Cervical cancer is the major cause of death from cancer in Africa. We wanted to assess the prevalence of human papillomavirus (HPV) infections and associated risk factors and to determine whether HPV testing could serve as a screening method for squamous intraepithelial lesions (SILs) in Rwanda. We also wanted to obtain a broader understanding of the underlying risk factors for the establishment of HPV infection in Rwanda. A total of 206 HIV-positive women, 172 HIV-negative women and 22 women with unknown HIV status were recruited at the University Teaching Hospitals of Kigali (UTHK) and of Butare (UTHB) in Rwanda. Participants underwent an interview, cervical sampling for a Thinprep Pap test and a screening test analysing 37 HPV strains. Only 27% of HIV-positive women and 7% of HIV-negative women had been screened for cervical cancer before. HPV16 and HPV52 were the most common HPV strains. HIV-positive women were more commonly infected with high-risk (HR) HPV and multitype HPV than HIV-negative women. The sensitivity was 78% and the specificity 87% to detect high-grade SIL (HSIL) with HPV screening. Among HIV-negative women, being divorced was positively associated with HR-HPV infection, while hepatitis B, Trichomonas vaginalis infection and HR-HPV infection were factors positively associated with SILs. Ever having had gonorrhoea was positively associated with HR-HPV infection among HIV-positive women. HR-HPV infection and the number of live births were positively associated with SILs. The currently used quadrivalent vaccine may be insufficient to give satisfactory HPV coverage in Rwanda. HPV Screening may be effective to identify women at risk of developing cervical cancer, particularly if provided to high-risk patients. © 2017 British HIV Association.

Teacher qualification and teaching techniques in nursery schools in ...

African Journals Online (AJOL)

The scarcity of qualified teachers in Early Childhood Education in Rwanda in general, and in Kicukiro District in particular, raised interest and curiosity to conduct this study. Its main purpose was to examine the relationship between the qualification of teachers and their teaching techniques in preschools in Kicukiro District.

Child diarrhoea and nutritional status in rural Rwanda: a cross-sectional study to explore contributing environmental and demographic factors.

Science.gov (United States)

Sinharoy, Sheela S; Schmidt, Wolf-Peter; Cox, Kris; Clemence, Zachary; Mfura, Leodomir; Wendt, Ronald; Boisson, Sophie; Crossett, Erin; Grépin, Karen A; Jack, William; Condo, Jeanine; Habyarimana, James; Clasen, Thomas

2016-08-01

To explore associations of environmental and demographic factors with diarrhoea and nutritional status among children in Rusizi district, Rwanda. We obtained cross-sectional data from 8847 households in May-August 2013 from a baseline survey conducted for an evaluation of an integrated health intervention. We collected data on diarrhoea, water quality, and environmental and demographic factors from households with children <5, and anthropometry from children <2. We conducted log-binomial regression using diarrhoea, stunting and wasting as dependent variables. Among children <5, 8.7% reported diarrhoea in the previous 7 days. Among children <2, stunting prevalence was 34.9% and wasting prevalence was 2.1%. Drinking water treatment (any method) was inversely associated with caregiver-reported diarrhoea in the previous 7 days (PR = 0.79, 95% CI: 0.68-0.91). Improved source of drinking water (PR = 0.80, 95% CI: 0.73-0.87), appropriate treatment of drinking water (PR = 0.88, 95% CI: 0.80-0.96), improved sanitation facility (PR = 0.90, 95% CI: 0.82-0.97), and complete structure (having walls, floor and roof) of the sanitation facility (PR = 0.65, 95% CI: 0.50-0.84) were inversely associated with stunting. None of the exposure variables were associated with wasting. A microbiological indicator of water quality was not associated with diarrhoea or stunting. Our findings suggest that in Rusizi district, appropriate treatment of drinking water may be an important factor in diarrhoea in children <5, while improved source and appropriate treatment of drinking water as well as improved type and structure of sanitation facility may be important for linear growth in children <2. We did not detect an association with water quality. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Pharmacovigilance of artemether-lumefantrine in pregnant women followed until delivery in Rwanda

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Rulisa Stephen

2012-07-01

Full Text Available Abstract Background The World Health Organization presently recommends Artemisinin-based combination therapy (ACT as first-line therapy for uncomplicated P. falciparum malaria. Many malaria-endemic countries, including Rwanda, have adopted these treatment guidelines. The Artemisinin derivative Artemether, in combination with lumefantrine, is currently used in Rwanda for malaria during the second and third trimesters of pregnancy. Safety data on the use of ACT in pregnancy are still limited though and more data are needed. Methods In this pharmacovigilance study, the exposed group (pregnant women with malaria given artemether-lumefantrine, and a matched non-exposed group (pregnant women without malaria and no exposure to artemether-lumefantrine were followed until delivery. Data were collected at public health centres all over Rwanda during acute malaria, routine antenatal visits, after hospital delivery or within 48 hours after home delivery. Information gathered from patients included routine antenatal and peri-partum data, pregnancy outcomes (abortions, stillbirths, at term delivery, congenital malformations and other adverse events through history taking and physical examination of both mothers and newborns. Results The outcomes for the total sample of 2,050 women were for the treatment (n = 1,072 and control groups (n = 978 respectively: abortions: 1.3% and 0.4%; peri-natal mortality 3.7% and 2.8%; stillbirth 2.9% and 2.4%; neonatal death [less than or equal to]7 days after birth 0.5% and 0.4%; premature delivery 0.7% and 0.3%; congenital malformations 0.3% and 0.3%. A total of 129 obstetric adverse events in 127 subjects were reported (7.3% in the treatment group, 5.0% in the control group. In a multivariate regression model, obstetric complications were more frequent in the treatment group (OR (95% CI: 1.38 (0.95, 2.01, and in primigravidae (OR (95% CI 2.65 (1.71, 4.12 and at higher age (OR per year: 1.05 (1.01-1.09. Conclusions

Hepatitis B virus and HIV co-infection among pregnant women in Rwanda.

Science.gov (United States)

Mutagoma, Mwumvaneza; Balisanga, Helene; Malamba, Samuel S; Sebuhoro, Dieudonné; Remera, Eric; Riedel, David J; Kanters, Steve; Nsanzimana, Sabin

2017-09-11

Hepatitis B virus (HBV) affects people worldwide but the local burden especially in pregnant women and their new born babies is unknown. In Rwanda HIV-infected individuals who are also infected with HBV are supposed to be initiated on ART immediately. HBV is easily transmitted from mother to child during delivery. We sought to estimate the prevalence of chronic HBV infection among pregnant women attending ante-natal clinic (ANC) in Rwanda and to determine factors associated with HBV and HIV co-infection. This study used a cross-sectional survey, targeting pregnant women in sentinel sites. Pregnant women were tested for hepatitis B surface antigen (HBsAg) and HIV infection. A series of tests were done to ensure high sensitivity. Multivariable logistic regression was used to identify independent predictors of HBV-HIV co-infection among those collected during ANC sentinel surveillance, these included: age, marital status, education level, occupation, residence, pregnancy and syphilis infection. The prevalence of HBsAg among 13,121 pregnant women was 3.7% (95% CI: 3.4-4.0%) and was similar among different socio-demographic characteristics that were assessed. The proportion of HIV-infection among HBsAg-positive pregnant women was 4.1% [95% CI: 2.5-6.3%]. The prevalence of HBV-HIV co-infection was higher among women aged 15-24 years compared to those women aged 25-49 years [aOR = 6.9 (95% CI: 1.8-27.0)]. Women residing in urban areas seemed having HBV-HIV co-infection compared with women residing in rural areas [aOR = 4.3 (95% CI: 1.2-16.4)]. Women with more than two pregnancies were potentially having the co-infection compared to those with two or less (aOR = 6.9 (95% CI: 1.7-27.8). Women with RPR-positive test were seemed associated with HBV-HIV co-infection (aOR = 24.9 (95% CI: 5.0-122.9). Chronic HBV infection is a public health problem among pregnant women in Rwanda. Understanding that HBV-HIV co-infection may be more prominent in younger women from urban

Prototapirella ciliates from wild habituated Virunga mountain gorillas (Gorilla beringei beringei) in Rwanda with the descriptions of two new species.

Science.gov (United States)

Ito, Akira; Eckardt, Winnie; Stoinski, Tara S; Gillespie, Thomas R; Tokiwa, Toshihiro

2016-06-01

The morphology of Prototapirella fosseyi n. sp., P. rwanda n. sp. and P. gorillaeImai, Ikeda, Collet, and Bonhomme, 1991 in the Entodiniomorphida were described from the mountain gorillas, Gorilla beringei beringei, in Rwanda. The ciliates have a retractable adoral ciliary zone, four non-retractable ciliary tufts in four caudalia, and one broad skeletal plate beneath the body surface. P. rwanda has a dorsal lobe and ventral lobes in two rows whereas P. fosseyi has no lobes. These two new species have an elongated body, a flat tail flap leaning to the ventral, a macronucleus with a tapering anterior end, a round posterior end and a shallow depression on the dorsal side, a micronucleus lying near the anterior end of macronucleus, a thin left region of the skeletal plate, a distinct skeletal rod plate, and four contractile vacuoles. P. gorillae has some variations in the nuclei and the skeletal plate. The infraciliary bands of three Prototapirella species were the same as some Triplumaria species; a C-shaped adoral polybrachykinety, a slender perivestibular polybrachykinety, and paralabial kineties in their retractable adoral ciliary zone and short lateral polybrachykineties in their four caudalia. The perivestibular polybrachykinety is joined only to the right end of adoral polybrachykinety. Copyright © 2016 Elsevier GmbH. All rights reserved.

Antiretroviral therapy drug adherence in Rwanda: perspectives from patients and healthcare workers using a mixed-methods approach

NARCIS (Netherlands)

Vyankandondera, Joseph; Mitchell, Kirstin; Asiimwe-Kateera, Brenda; Boer, Kimberly; Mutwa, Philippe; Balinda, Jean-Paul; van Straten, Masja; Reiss, Peter; van de Wijgert, Janneke

2013-01-01

Rwanda has achieved high enrollment into antiretroviral therapy (ART) programs but data on adherence after enrollment are not routinely collected. We used a mixed-methods approach (standardized questionnaires, pill counts, focus group discussions, and in-depth interviews) to determine levels of and

Malaria parasite carriage and risk determinants in a rural population: a malariometric survey in Rwanda.

Science.gov (United States)

Kateera, Fredrick; Mens, Petra F; Hakizimana, Emmanuel; Ingabire, Chantal M; Muragijemariya, Liberata; Karinda, Parfait; Grobusch, Martin P; Mutesa, Leon; van Vugt, Michèle

2015-01-21

Based on routine health facility case data, Rwanda has achieved a significant malaria burden reduction in the past ten years. However, community-based malaria parasitaemia burden and reasons for continued residual infections, despite a high coverage of control interventions, have yet to be characterized. Measurement of malaria parasitaemia rates and evaluation of associated risk factors among asymptomatic household members in a rural community in Rwanda were conducted. A malariometric household survey was conducted between June and November 2013, involving 12,965 persons living in 3,989 households located in 35 villages in a sector in eastern Rwanda. Screening for malaria parasite carriage and collection of demographic, socio-economic, house structural features, and prior fever management data, were performed. Logistic regression models with adjustment for within- and between-households clustering were used to assess malaria parasitaemia risk determinants. Overall, malaria parasitaemia was found in 652 (5%) individuals, with 518 (13%) of households having at least one parasitaemic member. High malaria parasite carriage risk was associated with being male, child or adolescent (age group 4-15), reported history of fever and living in a household with multiple occupants. A malaria parasite carriage risk-protective effect was associated with living in households of, higher socio-economic status, where the head of household was educated and where the house floor or walls were made of cement/bricks rather than mud/earth/wood materials. Parasitaemia cases were found to significantly cluster in the Gikundamvura area that neighbours marshlands. Overall, Ruhuha Sector can be classified as hypo-endemic, albeit with a particular 'cell of villages' posing a higher risk for malaria parasitaemia than others. Efforts to further reduce transmission and eventually eliminate malaria locally should focus on investments in programmes that improve house structure features (that limit

A Phenomenographic Study of Students' Conceptions of Quality in Learning in Higher Education in Rwanda

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Mbabazi Bamwesiga, Penelope; Fejes, Andreas; Dahlgren, Lars-Owe

2013-01-01

The aim of this study is to understand the different ways that university students conceptualise quality in learning by drawing on a phenomenographic approach. A total of 20 students in higher education in Rwanda were interviewed and analysis of the interviews generated an outcome space of conceptions of quality in learning as transformation,…

Memory, Identity and the Politics of Curriculum Construction in Transition Societies: Rwanda and South Africa

Science.gov (United States)

Weldon, Gail

2009-01-01

A critical question for societies emerging from conflict is what should be done about the traumatic memories of the past. In post-conflict societies political issues of memory and identity are at the same time issues for curriculum construction. Using the examples of post-conflict Rwanda and South Africa, I raise questions about the competing…

Excess Fertility and Family Planning in Rwanda : Understanding the shift to a high contraceptive prevalence country

NARCIS (Netherlands)

Muhoza Ndaruhuye, Dieudonne

2014-01-01

Rwanda has experienced an impressive increase in contraceptive use and fertility decline during the last decade. Between 2005 and 2010, the contraceptive prevalence rate (CPR) has risen from 17 % to 52%, reducing unmet need and the total fertility substantially (from 6.1 to 4.6 children per women).

Tourist experiences of genocide sites: The case of Rwanda

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Sharpley Richard

2014-01-01

Full Text Available Dark tourism is not a new phenomenon. As long as people have been able to travel they have visited places associated with death, disaster and suffering. However, not only has the provision and consumption of dark tourism experiences become increasingly evident in recent years; so too has the academic study of the phenomenon. Nevertheless, despite the increasing attention paid to the subject, understanding of dark tourism remains relatively limited and theoretically fragile whilst, specifically, the significance of the consumption of or demand for dark tourism has enjoyed limited academic scrutiny. This is particularly the case with socalled 'genocide tourism' (visiting places of, or associated with, genocide, a form of dark tourism that is increasingly in evidence but the consumption of which is often misunderstood and, typically, considered to display voyeuristic tendencies on the part of tourists. Focusing on the Rwandan genocide, this paper addresses this issue. Locating genocide tourism within the context of dark tourism more generally, it reviews briefly how the Rwandan genocide is presented / memorialised before considering research into how tourists experience genocide memorial sites in Rwanda. Specifically, build­ing on an earlier study that explored visitor experiences of genocide sites in Rwanda as described in travel blogs, it considers the results of an exploratory survey into tourists' experiences of the Kigali Genocide Memorial, the country's principal memorial site. The results indicate unequivocally that tourists undertake their visits with positive, meaningful intent (albeit with trepidation and that, almost without exception, find it a challenging, powerfully emotional yet, ultimately, rewarding experience in that they begin to grasp the horror and suffering of the genocide and, indeed, leave with the desire to learn more about it.

Soil-transmitted helminths in southern highland Rwanda: associated factors and effectiveness of school-based preventive chemotherapy.

Science.gov (United States)

Staudacher, Olga; Heimer, Jakob; Steiner, Florian; Kayonga, Yvette; Havugimana, Jean M; Ignatius, Ralf; Musemakweri, Andre; Ngabo, Fidele; Harms, Gundel; Gahutu, Jean-Bosco; Mockenhaupt, Frank P

2014-07-01

Preventive chemotherapy of schoolchildren against soil-transmitted helminths (STHs) is widely implemented in Rwanda. However, data on its actual efficacy are lacking. We assessed prevalence, associated factors and manifestation of STH infection among schoolchildren in southern highland Rwanda as well as cure and reinfection rates. Six hundred and twenty-two children (rural, 301; urban, 321) were included preceding the administration of a single dose of 500 mg mebendazole. Before treatment, and after 2 and 15 weeks, STH infection was determined by Kato-Katz smears and by PCR assays for Ascaris lumbricoides. Clinical and anthropometric data, socio-economic status and factors potentially associated with STH infection were assessed. Soil-transmitted helminth (STH) infection was present in 38% of rural and in 13% of urban schoolchildren. Ascaris lumbricoides accounted for 96% of infections. Of these, one-third was detected by PCR exclusively. Factors associated with STH infection differed greatly between rural and urban children. Likewise, STH infection was associated with stunting and anaemia only among urban children. The cure rate after 2 weeks was 92%. Among eight non-cleared A. lumbricoides infections, seven were submicroscopic. Reinfection within 3 months occurred in 7%, but the rate was higher among rural children, and with initially present infection, particularly at comparatively high intensity. The rural-urban difference in factors associated with STH infection and in reinfection rates highlights the need for targeted interventions to reduce transmission. PCR assays may help in detecting low-level infections persisting after treatment. In southern Rwanda, mebendazole is highly effective against the STH infections predominated by A. lumbricoides. © 2014 John Wiley & Sons Ltd.

Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme.

Science.gov (United States)

Ngabo, Fidele; Franceschi, Silvia; Baussano, Iacopo; Umulisa, M Chantal; Snijders, Peter J F; Uyterlinde, Anne M; Lazzarato, Fulvio; Tenet, Vanessa; Gatera, Maurice; Binagwaho, Agnes; Clifford, Gary M

2016-05-24

Cervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV). To provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2508 women aged 18-69 years from the general population in Kigali, Rwanda, during 2013/14. 20 % of women were HIV-positive. Samples were used for liquid-based cytology and HPV testing (44 types) with GP5+/6+ PCR. HPV prevalence was 34 %, being highest (54 %) in women ≤19 years and decreasing to 20 % at age ≥50. Prevalence of high risk (HR) HPV and cytological abnormalities was 22 and 11 % respectively (including 2 % with high-grade squamous intraepithelial lesions, HSIL) decreasing with age. Age-standardised prevalence of HR HPV was 22 % (or 19 % among HIV-negative women), and HPV16 was the most common type. Prevalence of HPV and cytological abnormalities were significantly higher in HIV-positive than HIV-negative women, and the difference increased with age. Other significant risk factors for HPV positivity in multivariate analyses were high lifetime number of sexual partners, receiving cash for sex, and being a farmer. 40 % of women with HSIL were infected with HPV16/18 and there was no significant difference between HIV-positive and HIV-negative women. This study confirms Rwanda to be a setting of high prevalence of HPV and cervical disease that is worsened by HIV. These data will serve as a robust baseline for future evaluations of HPV vaccine programme effectiveness.

Newspaper coverage of maternal health in Bangladesh, Rwanda and South Africa: a quantitative and qualitative content analysis

Science.gov (United States)

Gugsa, Frey; Karmarkar, Ellora; Cheyne, Andrew; Yamey, Gavin

2016-01-01

Objective To examine newspaper coverage of maternal health in three countries that have made varying progress towards Millennium Development Goal 5 (MDG 5): Bangladesh (on track), Rwanda (making progress, but not on track) and South Africa (no progress). Design We analysed each country's leading national English-language newspaper: Bangladesh's The Daily Star, Rwanda's The New Times/The Sunday Times, and South Africa's Sunday Times/The Times. We quantified the number of maternal health articles published from 1 January 2008 to 31 March 2013. We conducted a content analysis of subset of 190 articles published from 1 October 2010 to 31 March 2013. Results Bangladesh's The Daily Star published 579 articles related to maternal health from 1 January 2008 to 31 March 2013, compared to 342 in Rwanda's The New Times/The Sunday Times and 253 in South Africa's Sunday Times/The Times over the same time period. The Daily Star had the highest proportion of stories advocating for or raising awareness of maternal health. Most maternal health articles in The Daily Star (83%) and The New Times/The Sunday Times (69%) used a ‘human-rights’ or ‘policy-based’ frame compared to 41% of articles from Sunday Times/The Times. Conclusions In the three countries included in this study, which are on different trajectories towards MDG 5, there were differences in the frequency, tone and content of their newspaper coverage of maternal health. However, no causal conclusions can be drawn about this association between progress on MDG 5 and the amount and type of media coverage of maternal health. PMID:26769780

Increasing maternal healthcare use in Rwanda: implications for child nutrition and survival.

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Pierce, Hayley; Heaton, Tim B; Hoffmann, John

2014-04-01

Rwanda has made great progress in improving maternal utilization of health care through coordination of external aid and more efficient health policy. Using data from the 2005 and 2010 Rwandan Demographic and Health Surveys, we examine three related questions regarding the impact of expansion of health care in Rwanda. First, did the increased use of health center deliveries apply to women across varying levels of education, economic status, and area of residency? Second, did the benefits associated with being delivered at a health center diminish as utilization became more widespread? Finally, did inequality in child outcomes decline as a result of increased health care utilization? Propensity score matching was used to address the selectivity that arises when choosing to deliver at a hospital. In addition, the regression models include a linear model to predict child nutritional status and Cox regression to predict child survival. The analysis shows that the largest increases in delivery at a health center occur among less educated, less wealthy, and rural Rwandan women. In addition, delivery at a health center is associated with better nutritional status and survival and the benefit is not diminished following the dramatic increase in use of health centers. Finally, educational, economic and residential inequality in child survival and nutrition did not decline. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mineralogy and Trace Element Chemistry of Ferberite/Reinite from Tungsten Deposits in Central Rwanda

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Philippe Muchez

2013-04-01

Full Text Available Tungsten mineralization in hydrothermal quartz veins from the Nyakabingo,Gifurwe and Bugarama deposits in central Rwanda occurs as the iron-rich endmember ofthe wolframite solid solution series (ferberite and in the particular form of reinite, whichrepresents a pseudomorph of ferberite after scheelite. Primary ferberite, reinite and latesecondary ferberite are characterized by their trace element chemistry and rare earthelement patterns. The replacement of scheelite by ferberite is also documented in the traceelement composition. Primary ferberite shows high Mg, Zn, Sc, V, Nb, In and Snconcentrations, but very low Ca, Pb, Sr and Ba contents. Reinite and late secondaryferberite display an uncommon trace element composition containing high concentrationsof Ca, Pb, Sr, Ba, As and Ga, but very low levels in Sn, Zr, Hf, In, Ti, Sc, Nb, Ta, Mg andZn. Late secondary ferberite replacing primary ferberite is characterized by additionalenrichments in Bi, Pb, As and Sb. The rare earth element patterns of reinite and secondaryferberite are also similar to hydrothermal scheelite. The formation of the tungsten depositsin central Rwanda is interpreted to be epigenetic in origin, and the hydrothermalmineralizing fluids are related to the intrusion of the G4-granites.

Work In Progress: The Role Of Higher Education In Post-Conflict Tourism Development, A Case Study From Rwanda

Directory of Open Access Journals (Sweden)

Kabera Callixte

2014-06-01

Full Text Available Tourism and hospitality have been recognized as a major economic factor worldwide and competition between destinations for present and future tourist has only become fiercer. Within such established markets as the East African safari & beach market it will not be easy for new destinations to discern themselves and offer a complimentary or new product. Especially in the case of Rwanda, that was plagued by a violent recent history and still suffers from an unclear image, this objective might not be easy to realize. However with the support from international partners and the dedication and ambitions of the national government in collaboration with local stakeholders, Rwanda is moving forward. Although this case study is related to an African example there might be suggestions and lessons learned that could inspire other destinations to proceed along a similar track.

Bird diversity and distribution in relation to urban landscape types in northern Rwanda.

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Gatesire, T; Nsabimana, D; Nyiramana, A; Seburanga, J L; Mirville, M O

2014-01-01

Using the point count method, linear mixed models, Shannon's diversity index, and Bray-Curtis cluster analysis, we conducted a study of the effect of urban fabric layout on bird diversity and distribution in northern Rwanda. The results showed a significant effect of city landscapes on bird richness and relative abundance; residential neighborhoods, institutional grounds, and informal settlements had the highest species diversity in comparison to other microlandscape types. Riversides were characterized by specialized bird species, commonly known to be restricted to wetland environments. Built-up areas and open field landscapes had comparable results. One Albertine Rift endemic bird species, the Ruwenzori Double-collared Sunbird (Cinnyris stuhlmanni), was recorded. Three migratory birds were found in Musanze city for the first time: the Common Sandpiper (Actitis hypoleucos), the Spotted Flycatcher (Muscicapa striata), and the Willow Warbler (Phylloscopus trochilus). Two bird species have not been previously reported in Rwanda: the Garden Warbler (Sylvia borin) and the Lesser Spotted Eagle (Aquila pomarina). The implications of this study are particularly relevant to urban decision makers who should consider the existence of a great diversity of avian fauna when developing and implementing master plans, especially when villages and cities are in proximity of protected areas or natural reserves.

Introducing a Morbidity and Mortality Conference in Rwanda.

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Abahuje, Egide; Nzeyimana, Innocent; Rickard, Jennifer L

To assess the structure, format, and educational features of a morbidity and mortality (M&M) conference in Rwanda. To determine factors associated with adverse events and to define opportunities for improvement. Retrospective, descriptive study of all cases presented at a surgical M&M conference over a 1-year period. Cases were reviewed for factors associated with adverse events and opportunities for improvement. Factors were characterized as delays in presentation, delays in diagnosis, delays in the operating room, errors in judgment, technical errors, advanced disease, and missing resources or malnutrition. Opportunities for improvement were categorized at the physician or hospital level. University Teaching Hospital of Kigali, a tertiary referral hospital in Rwanda. Cases presented at the surgical M&M conference over a 1-year period. Over a 1-year period, there were a total of 2231 operations with 131 in-hospital mortalities. There were 62 patients discussed at M&M conference. Of those discussed, there were 34 (55%) in-hospital deaths and 32 (52%) unplanned reoperations. Common diagnostic categories included 30 (48%) gastrointestinal, 15 (24%) trauma, and 10 (16%) neoplasm. Delays were commonly cited factors affecting outcomes. There were 22 (35%) delays in presentation, 23 (37%) delays in diagnosis or management, and 20 (32%) delays to the operating room. Errors in judgment occurred in 15 (24%) cases and technical errors occurred in 18 (29%) cases. Twenty-three (37%) patients had a critical resource missing and 17 (27%) patients had advanced disease. Malnutrition was associated with 11 (18%) adverse events. Participants identified opportunities for improvement in 48 (77%) cases. M&M conference can be used in a low-resource setting as an educational tool to address core competencies of practice-based learning and improvement and systems-based practice. It can define factors associated with surgical adverse events and opportunities for improvement at the

Results of infertility investigations and follow-up among 312 infertile women and their partners in Kigali, Rwanda

NARCIS (Netherlands)

Dhont, Nathalie; van de Wijgert, Janneke; Vyankandondera, Joseph; Busasa, Rosette; Gasarabwe, Ammiel; Temmerman, Marleen

2011-01-01

The objectives of this study were to assess the outcome of infertility investigations and an 18-month follow-up of 312 infertile women and their partners in Rwanda. Between November 2007 and May 2009, an infertility research clinic was opened. Infertile couples received basic infertility

CERN and UNESCO reach out to Rwanda

CERN Multimedia

2009-01-01

CERN already has a successful relationship with some African countries. However, much remains to be done to improve the dialogue with that continent. A recent trip to Rwanda provided a new opportunity to share knowledge and technology and create a connection that may last for many years. CERN’s Jean-Yves Le Meur, second from the right, teaches participants how to install the digital library system on their computers.In addition to physics research, CERN’s key missions also include training and international collaboration. Recently, thanks to funding from UNESCO, CERN’s Scientific Information Service was able to provide face-to-face training of digital library software developed at CERN, and the CERN Education Group organised a two-day high-school teacher training programme. "Many African countries are in the process of digitising their libraries," explains John Ellis, CERN’s Coordinator for non-Member States. "A workshop was ...

Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda.

Science.gov (United States)

Tate, Jacqueline E; Ngabo, Fidele; Donnen, Philippe; Gatera, Maurice; Uwimana, Jeannine; Rugambwa, Celse; Mwenda, Jason M; Parashar, Umesh D

2016-05-01

Rotavirus vaccine efficacy is lower in low-income countries than in high-income countries. Rwanda was one of the first low-income countries in sub-Saharan Africa to introduce rotavirus vaccine into its national immunization program. We sought to evaluate rotavirus vaccine effectiveness (VE) in this setting. VE was assessed using a case-control design. Cases and test-negative controls were children who presented with a diarrheal illness to 1 of 8 sentinel district hospitals and 10 associated health centers and had a stool specimen that tested positive (cases) or negative (controls) for rotavirus by enzyme immunoassay. Due to high vaccine coverage almost immediately after vaccine introduction, the analysis was restricted to children 7-18 weeks of age at time of rotavirus vaccine introduction. VE was calculated as (1 - odds ratio) × 100, where the odds ratio was the adjusted odds ratio for the rotavirus vaccination rate among case-patients compared with controls. Forty-eight rotavirus-positive and 152 rotavirus-negative children were enrolled. Rotavirus-positive children were significantly less likely to have received rotavirus vaccine (33/44 [73%] unvaccinated) compared with rotavirus-negative children (81/136 [59%] unvaccinated) (P= .002). A full 3-dose series was 75% (95% confidence interval [CI], 31%-91%) effective against rotavirus gastroenteritis requiring hospitalization or a health center visit and was 65% (95% CI, -80% to 93%) in children 6-11 months of age and 81% (95% CI, 25%-95%) in children ≥12 months of age. Rotavirus vaccine is effective in preventing rotavirus disease in Rwandan children who began their rotavirus vaccine series from 7 to 18 weeks of age. Protection from vaccination was sustained after the first year of life. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

A population-based national estimate of the prevalence and risk factors associated with hypertension in Rwanda: implications for prevention and control.

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Nahimana, Marie-Rosette; Nyandwi, Alypio; Muhimpundu, Marie Aimee; Olu, Olushayo; Condo, Jeanine Umutesi; Rusanganwa, Andre; Koama, Jean Baptiste; Ngoc, Candide Tran; Gasherebuka, Jean Bosco; Ota, Martin O; Okeibunor, Joseph C

2017-07-10

Hypertension is a leading cause of cardiovascular diseases and a growing public health problem in many developed and developing countries. However, population-based data to inform policy development are scarce in Rwanda. This nationally representative study aimed to determine population-based estimates of the prevalence and risk factors associated with hypertension in Rwanda. We conducted secondary epidemiological analysis of data collected from a cross-sectional population-based study to assess the risk factors for NCDs using the WHO STEPwise approach to Surveillance of non-communicable diseases (STEPS). Adjusted odds ratios at 95% confidence interval were used to establish association between hypertension, socio-demographic characteristics and health risk behaviors. Of the 7116 study participants, 62.8% were females and 38.2% were males. The mean age of study participants was 35.3 years (SD 12.5). The overall prevalence of hypertension was 15.3% (16.4% for males and 14.4% for females). Twenty two percent of hypertensive participants were previously diagnosed. A logistic regression model revealed that age (AOR: 8.02, 95% CI: 5.63-11.42, p Rwanda, suggesting the need for prevention and control interventions aimed at decreasing the incidence taking into consideration the risk factors documented in this and other similar studies.

SOTER-based soil parameter estimates for Central Africa - DR of Congo, Burundi and Rwanda (ver. 1.0)

NARCIS (Netherlands)

Batjes, N.H.

2014-01-01

This harmonized set of soil parameter estimates for Central Africa, comprising Burundi, the Democratic Republic of the Congo and Rwanda, was derived from the Soil and Terrain Database for Central Africa (SOTERCAF ver. 1.0) and the ISRIC-WISE soil profile database, using standardized taxonomy-based

[The family planning program in Rwanda: assessment of ten years (1981-1991) and prospects].

Science.gov (United States)

Munyakazi, A

1990-12-01

Rwanda's official family planning policy dates back to 1981 and creation of the National Office of Population (ONAPO). Among its other function, ONAPO monitors proper use of family planning methods and studies the integration of family planning services into public health. Pilot family planning programs began in the prefectures of Butare, Kigali, and Ruhengeri and were extended to the other 7 around 1985. The development of family planning services in Rwanda is based on their integration into existing services, especially those devoted to maternal-child health. In 1989, 277 of the 350 health centers of all kinds in Rwanda and 12 secondary posts offered family planning services. The rate of integration was 79.4%. 185 of the 277 health services with family planning services were in the public sector. As of December 1989, the rate of integration in different prefectures varied from a high of 95.5% in Kibungo to a low of 64.9% in Gisenyi. Integration is particularly weak in health facilities administered by the Catholic Church. The 2 strategies to confront this situation are continuing dialogue with Catholic Church officials and creation of secondary family planning posts to improve accessibility to family planning for populations served by Church health services. The number of new and continuing family planning users increased from 1178 and 1368 respectively in 1982 to 66,950 and 104,604 through September 1990. There is wide variation from 1 prefecture to another in recruitment of new acceptors and in the number of acceptors per health facility. Recruitment of new acceptors is greatest in Ruhengeri, followed by Kigali and Byumba. As of September 1990, 28,943 women used pills, 2037 used IUDs, 66,515 used injectables, 3051 used barrier methods, 2888 used auto-observation methods, 343 used implants, and 588 were sterilized. The overall rate of contraceptive prevalence increased from .9% in 1983 to 6.2% in 1989 and 10% in 1990. The strategy for promoting family planning

Ethical precepts for medical volunteerism: including local voices and values to guide RHD surgery in Rwanda.

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Coors, Marilyn E; Matthew, Thomas L; Matthew, Dayna B

2015-10-01

At the invitation of the Rwandan Government, Team Heart, a team of American healthcare professionals, performs volunteer rheumatic heart disease (RHD) surgery in Rwanda every year, and confronts ethical concerns that call for cultural sensitivity. This article describes how five standard bioethical precepts are applied in practice in medical volunteerism related to RHD surgery in Rwanda. The content for the applied precepts stems from semiscripted, transcribed conversations with the authors, two Rwandan cardiologists, a Rwandan nurse and a Rwandan premedical student. The conversations revealed that the criteria for RHD surgical selection in Rwanda are analogous to the patient-selection process involving material scarcity in the USA. Rwandan notions of benefit and harm focus more attention on structural issues, such as shared benefit, national reputation and expansion of expertise, than traditional Western notions. Harm caused by inadequate patient follow-up remains a critical concern. Gender disparities regarding biological and social implications of surgical valve choices impact considerations of justice. Individual agency remains important, but not central to Rwandan concepts of justice, transparency and respect, particularly regarding women. The Rwandan understanding of standard bioethical precepts is substantively similar to the traditionally recognised interpretation with important contextual differences. The communal importance of improving the health of a small number of individuals may be underestimated in previous literature. Moreover, openness and the incorporation of Rwandan stakeholders in difficult ethical choices and long-term contributions to indigenous medical capacity appear to be valued by Rwandans. These descriptions of applied precepts are applicable to different medical missions in other emerging nations following a similar process of inclusion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

Physiology Teaching and Learning Experience in a New Modular Curriculum at the National University of Rwanda

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Gahutu, Jean Bosco

2010-01-01

In the present article, I report on my experience in teaching and learning physiology in the first year of a new modular curriculum at the Faculty of Medicine of the National University of Rwanda. With self-reported questionnaires, I collected learning experience perceptions from 112 students who attended the module of physiology in 2008. The…

Yield trends in the long-term crop rotation with organic and inorganic fertilisers on Alisols in Mata (Rwanda)

NARCIS (Netherlands)

Rutunga, V.; Neel, H.

2006-01-01

A crop rotation system with various species was established on Alisols at Mata grassland site, oriental side of Zaire-Nile Watershed Divide (CZN), Rwanda. Inorganic and organic fertilizers were applied in various plots under randomized complete blocs with three replicates. Crop yield data for each

Trends in and correlates of CD4+ cell count at antiretroviral therapy initiation after changes in national ART guidelines in Rwanda

Science.gov (United States)

Mutimura, Eugene; Addison, Diane; Anastos, Kathryn; Hoover, Donald; Dusingize, Jean Claude; Karenzie, Ben; Izimukwiye, Isabelle; Mutesa, Leo; Nsanzimana, Sabin; Nashi, Denis

2015-01-01

Background Initiation of antiretroviral therapy (ART) in the advanced stages of HIV infection remains a major challenge in sub-Saharan Africa. This study was conducted to better understand barriers and enablers to timely ART initiation in Rwanda where ART coverage is high and national ART eligibility guidelines first expanded in 2007–2008. Methods Using data on 6326 patients (≥15 years) at five Rwandan clinics, we assessed trends and correlates of CD4+ cell count at ART initiation and the proportion initiating ART with advanced HIV disease (CD4+ Rwanda. However, sex disparities in late treatment initiation persisted through 2011–2012, and appeared to be driven by later diagnosis and/or delayed linkage to care among men. PMID:25562492

Estimating the impact of sericulture adoption on farmer income in Rwanda: an application of propensity score matching

NARCIS (Netherlands)

Habiyaremye, Alexis

2017-01-01

The adoption of an agricultural technology is often seen as a way to overcome the constraints imposed by the existing resources and/or production methods. As a small landlocked country, Rwanda sought to develop the capability to produce silk, a high value-to-volume ratio product, as a means to

Determinants of fertility in Rwanda in the context of a fertility transition: a secondary analysis of the 2010 Demographic and Health Survey.

Science.gov (United States)

Ndahindwa, Vedaste; Kamanzi, Collins; Semakula, Muhammed; Abalikumwe, François; Hedt-Gauthier, Bethany; Thomson, Dana R

2014-12-13

Major improvements to Rwanda's health system, infrastructure, and social programs over the last decade have led to a rapid fertility transition unique from other African countries. The total fertility rate fell from 6.1 in 2005 to 4.6 in 2010, with a 3-fold increase in contraceptive usage. Despite this rapid national decline, many women still have large numbers of children. This study investigates predictors of fertility during this fertility transition to inform policies that improve individuals' reproductive health and guide national development. We used Poisson regression to separately model number of children born to ever married/cohabitated women (n = 8,309) and never married women (n = 1,220) age 15 to 49 based on 2010 Rwanda Demographic and Health Survey data. We used backward stepwise regression with a time offset to identify individual and household factors associated with woman's fertility level, accounting for sampling weights, clustering, and stratification. In ever married/cohabitating women, high fertility was significantly associated (p Rwanda's national fertility rate and support families to achieve their desired fertility. Strategies include policies and programs that promote delayed sexual debut via educational and economic opportunities for women, improved access to reproductive health information and services at schools and via health campaigns, and involvement of men in family planning decision making.

Women's responses to intimate partner violence in Rwanda: Rethinking agency in constrained social contexts.

Science.gov (United States)

Mannell, Jenevieve; Jackson, Sharon; Umutoni, Aline

2016-01-01

This paper explores instances of agency in women's responses to intimate partner violence (IPV) in Rwanda. The literature on women's responses to IPV conceptualises agency primarily as an individual's capacity to take action by reporting violence or leaving a relationship, obscuring other ways women may respond to violence in contexts where reporting or leaving are unlikely. We aim to replace this narrow conceptualisation of agency with a social constructivist focus on the meanings women attribute to possible IPV responses. We draw on data from a study of IPV in Rwanda, which includes semi-structured interviews with women experiencing violence and four focus group discussions with women community members (n = 39). Our findings highlight sociocultural, economic, political-legal and historical constraints that shape women's actions in this context. In relation to these constraints, women describe four possible responses to IPV: reporting the violence; seeking emotional support; 'fighting back' against violence; or remaining silent. While reporting and leaving violent relationships are identified, women also discuss the social constraints that make these actions extremely difficult. In designing effective strategies, we conclude that public health strategies need to consider women's understandings of their own actions, particularly in social contexts where certain actions may be constrained.

The meaning of a poor childbirth experience - A qualitative phenomenological study with women in Rwanda.

Science.gov (United States)

Mukamurigo, Judith; Dencker, Anna; Ntaganira, Joseph; Berg, Marie

2017-01-01

Being pregnant and giving birth is a pivotal life event and one that a woman ordinarily remembers for most of her life. A negative childbirth experience can affect a woman's health well beyond the episode of the labour and birth itself. This study explored the meaning of a poor childbirth experience, as expressed by women who had given birth in Rwanda. In a cross-sectional household study conducted in Northern Province and in Kigali City, the capital of Rwanda, a structured questionnaire was answered by women who had given birth one to 13 months earlier. One question, answered by 898 women, asked them to rate their overall experience of childbirth from 0 (very bad) to 10 (very good). Of these, 28 women (3.1%) who had rated their childbirth experience as bad (≤ 4) were contacted for individual interviews. Seventeen of these women agreed to participate in individual in-depth interviews. The texts were analysed with a reflective lifeworld approach. The essential meaning of a "poor" childbirth experience was that the women had been exposed to disrespectful care, constituted by neglect, verbal or physical abuse, insufficient information, and denial of their husband as a companion. The actions of carers included abandonment, humiliation, shaming and insult, creating feelings of insecurity, fear and distrust in the women. Two of the women did not report any experience of poor care; their low rating was related to having suffered from medical complications. It is challenging that the main finding is that women are exposed to disrespectful care. In an effort to provide an equitable and high quality maternal health care system in Rwanda, there is a need to focus on activities to implement respectful, evidence-based care for all. One such activity is to develop and provide education programmes for midwives and nurses about professional behaviour when caring for and working with women during labour and birth.

The meaning of a poor childbirth experience - A qualitative phenomenological study with women in Rwanda.

Directory of Open Access Journals (Sweden)

Judith Mukamurigo

Full Text Available Being pregnant and giving birth is a pivotal life event and one that a woman ordinarily remembers for most of her life. A negative childbirth experience can affect a woman's health well beyond the episode of the labour and birth itself. This study explored the meaning of a poor childbirth experience, as expressed by women who had given birth in Rwanda.In a cross-sectional household study conducted in Northern Province and in Kigali City, the capital of Rwanda, a structured questionnaire was answered by women who had given birth one to 13 months earlier. One question, answered by 898 women, asked them to rate their overall experience of childbirth from 0 (very bad to 10 (very good. Of these, 28 women (3.1% who had rated their childbirth experience as bad (≤ 4 were contacted for individual interviews. Seventeen of these women agreed to participate in individual in-depth interviews. The texts were analysed with a reflective lifeworld approach.The essential meaning of a "poor" childbirth experience was that the women had been exposed to disrespectful care, constituted by neglect, verbal or physical abuse, insufficient information, and denial of their husband as a companion. The actions of carers included abandonment, humiliation, shaming and insult, creating feelings of insecurity, fear and distrust in the women. Two of the women did not report any experience of poor care; their low rating was related to having suffered from medical complications.It is challenging that the main finding is that women are exposed to disrespectful care. In an effort to provide an equitable and high quality maternal health care system in Rwanda, there is a need to focus on activities to implement respectful, evidence-based care for all. One such activity is to develop and provide education programmes for midwives and nurses about professional behaviour when caring for and working with women during labour and birth.

Rapid Assessment of Avoidable Blindness in Western Rwanda: Blindness in a Postconflict Setting

OpenAIRE

Mathenge, Wanjiku; Nkurikiye, John; Limburg, Hans; Kuper, Hannah

2007-01-01

Editors' Summary Background. VISION 2020, a global initiative that aims to eliminate avoidable blindness, has estimated that 75% of blindness worldwide is treatable or preventable. The WHO estimates that in Africa, around 9% of adults aged over 50 are blind. Some data suggest that people living in regions affected by violent conflict are more likely to be blind than those living in unaffected regions. Currently no data exist on the likely prevalence of blindness in Rwanda, a central African c...

Foodborne pathogens and their risk exposure factors associated with farm vegetables in Rwanda.

OpenAIRE

Ssemanda JN; Reij MW; Middendorp G van; Bouw E; van der Plaats R; Franz E; Mambo Muvunyi C; Bagabe MC; Zwietering MH; Joosten H

2018-01-01

In this study, we tested farm vegetables and agricultural water for the presence of foodborne pathogens, and evaluated farming practices of vegetable farms in Rwanda. Farm vegetable samples were found to be contaminated with foodborne pathogens at considerably high rate (overall 15/99 = 15%). Specifically, the prevalence of pathogens in farm vegetables varied from 1.0% (1/99) for Listeria monocytogenes, 3.0% (3/99) for thermo-tolerant Campylobacter spp., 5.1% (5/99) for Salmonella spp. to 6.1...

Military Integration as a Factor for Post-Conflict Stability and Reconciliation: Rwanda, 1994-2005

Science.gov (United States)

2006-09-01

slow down developmental programs, such as cultivation of land and grazing of animals . An estimated 80-110 million mines are believed to be planted in...Reality? The three social groups existed in pre-colonial Rwanda, but the question is whether these groups were cohesive ethnic groups or mythological ...reported that “we can see Caucasian skulls, and beautiful Greek profiles side by side with Semitic and Jewish features, elegant golden-red beauties

Clinical Profile and Outcome of Patients with Acute Kidney Injury Requiring Hemodialysis: Two Years’ Experience at a Tertiary Hospital in Rwanda

Directory of Open Access Journals (Sweden)

Grace Igiraneza

2018-01-01

Full Text Available Introduction. Acute kidney injury (AKI requiring renal replacement therapy is associated with high mortality. The study assessed the impact of the introduction of hemodialysis (HD on outcomes of patients with AKI in Rwanda. Methods. A single center retrospective study that evaluated the clinical profile and survival outcomes of patients with AKI requiring HD [AKI-D] at a tertiary hospital in Rwanda. Data was collected on patients who received HD for AKI from September 2014 to December 2016. Patient demographics, comorbidities, clinical presentation, laboratory tests, and mortality were reviewed and analyzed. Predictors of mortality were assessed using age and gender adjusted multivariate analyses. Results. Of the 82 eligible patients, median age was 38 years (IQR 28–57 years. Males comprised 51% of the cohort. Infectious diseases including malaria, pneumonia, and sepsis (35.1% and pregnancy-related conditions (26.9% were the most frequent comorbidities. Pulmonary oedema (54.9% and uremic encephalopathy (50% were top indications for HD. Mortality was 34.1%. On multivariate analysis, receipt of <5 sessions of HD (OR = 4.01, 95% CI 1.185–13.61, P=0.026 and hyperkalemia (OR = 3.23, 95% CI 1.040–10.065, P=0.043 were associated with mortality. Conclusion. The availability of acute hemodialysis in Rwanda has resulted in improved patient survival and persistent hyperkalemia predicted higher mortality.

Science du sol et développement agricole au Rwanda : état de la question (synthèse bibliographique

Directory of Open Access Journals (Sweden)

Rushemuka, PN.

2014-01-01

Full Text Available Soil science and agricultural development in Rwanda: state of the art. A review. Poor agricultural productivity remains a crucial problem in Rwanda in spite of numerous technological interventions, including aspects of soil management. The objective of this study was to draw lessons from the past with the view to better orient future interventions in soil fertility management. The literature review and iterative field observations were the sources of information. Findings from this study show that substantial progress has been made in the identification of different soil types and their spatial distribution. Factors related to low level of productivity have been identified and sustainable soil fertility management options have been developed at plot level. However, the widespread adoption of these technologies has been problematic. The main reason is the failure to tailor soil fertility management technologies to specific soil types. The study has demonstrated that the soil map of Rwanda (CPR for Carte Pédologique du Rwanda – 1:50,000 – offers a remarkable potential to constitute a tool to solve this problem. In practice however, the CPR remains underutilized, mainly because of its inaccessibility to its potential users (e.g. policy makers, soil fertility experts, agronomists and extensionists. For its effective use, the following is recommended: Rwandan soil scientists need to increase policy makers' awareness about the usefulness of this soil map; agricultural research needs to adapt from the conventional model to a truly participatory and integrated approach; the CPR legend should be elucidated by providing information on the land units in which soils occur and by bridging Soil Taxonomy with the farmers' soil nomenclature; regional soil reference systems should be established that allow linking soil types with the fertility status of arable land and crop yields. This implies the need for training of Rwandan soil scientists in both Soil

Beyond coverage: improving the quality of antenatal care delivery through integrated mentorship and quality improvement at health centers in rural Rwanda.

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Manzi, Anatole; Nyirazinyoye, Laetitia; Ntaganira, Joseph; Magge, Hema; Bigirimana, Evariste; Mukanzabikeshimana, Leoncie; Hirschhorn, Lisa R; Hedt-Gauthier, Bethany

2018-02-23

Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often limited by skill and knowledge gaps of the health workforce. In 2011, the Mentorship, Enhanced Supervision for Healthcare and Quality Improvement (MESH-QI) program was implemented to strengthen providers' ANC performance at 21 rural health centers in Rwanda. We evaluated the effect of MESH-QI on the completeness of danger sign assessments. Completeness of danger sign assessments was measured by expert nurse mentors using standardized observation checklists. Checklists completed from October 2010 to May 2011 (n = 330) were used as baseline measurement and checklists completed between February and November 2012 (12-15 months after the start of MESH-QI implementation) were used for follow-up. We used a mixed-effects linear regression model to assess the effect of the MESH-QI intervention on the danger sign assessment score, controlling for potential confounders and the clustering of effect at the health center level. Complete assessment of all danger signs improved from 2.1% at baseline to 84.2% after MESH-QI (p ANC screening items. After controlling for potential confounders, the improvement in danger sign assessment score was significant. However, the effect of the MESH-QI was different by intervention district and type of observed ANC visit. In Southern Kayonza District, the increase in the danger sign assessment score was 6.28 (95% CI: 5.59, 6.98) for non-first ANC visits and 5.39 (95% CI: 4.62, 6.15) for first ANC visits. In Kirehe District, the increase in danger sign assessment score was 4.20 (95% CI: 3.59, 4.80) for non-first ANC visits and 3.30 (95% CI: 2.80, 3.81) for first ANC visits. Assessment of critical danger signs improved under MESH-QI, even when controlling for nurse-mentees' education level and previous training in focused ANC. MESH

Who wants to work in a rural health post? The role of intrinsic motivation, rural background and faith-based institutions in Ethiopia and Rwanda.

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Serneels, Pieter; Montalvo, Jose G; Pettersson, Gunilla; Lievens, Tomas; Butera, Jean Damascene; Kidanu, Aklilu

2010-05-01

To understand the factors influencing health workers' choice to work in rural areas as a basis for designing policies to redress geographic imbalances in health worker distribution. A cohort survey of 412 nursing and medical students in Rwanda provided unique contingent valuation data. Using these data, we performed a regression analysis to examine the determinants of future health workers' willingness to work in rural areas as measured by rural reservation wages. These data were also combined with those from an identical survey in Ethiopia to enable a two-country analysis. Health workers with higher intrinsic motivation - measured as the importance attached to helping the poor - as well as those who had grown up in a rural area and Adventists who had participated in a local bonding scheme were all significantly more willing to work in a rural area. The main result for intrinsic motivation in Rwanda was strikingly similar to the result obtained for Ethiopia and Rwanda combined. Intrinsic motivation and rural origin play an important role in health workers' decisions to work in a rural area, in addition to economic incentives, while faith-based institutions can also influence the decision.

Malaria prevalence, spatial clustering and risk factors in a low endemic area of Eastern Rwanda: a cross sectional study

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Rulisa, Stephen; Kateera, Fredrick; Bizimana, Jean Pierre; Agaba, Steven; Dukuzumuremyi, Javier; Baas, Lisette; de Dieu Harelimana, Jean; Mens, Petra F.; Boer, Kimberly R.; de Vries, Peter J.

2013-01-01

Rwanda reported significant reductions in malaria burden following scale up of control intervention from 2005 to 2010. This study sought to; measure malaria prevalence, describe spatial malaria clustering and investigate for malaria risk factors among health-centre-presumed malaria cases and their

HIV drug resistance and hepatitis co-infections in HIV-infected adults and children initiating antiretroviral therapy in Rwanda

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Rusine-Bahunde, J.

2015-01-01

Since the roll-out of antiretroviral therapy (ART), few data have been generated on outcomes and outcome predictors of ART in adults and children in Rwanda. Equally, the extent of chronic hepatitis virus infections and their impact on the ART outcomes in the country are not known. This information

Intimate partner violence among pregnant women in Rwanda

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Siziya Seter

2008-10-01

Full Text Available Abstract Background Intimate partner violence (IPV, defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern. The prevalence and determinants of intimate partner violence (IPV against pregnant women has not been described in Rwanda. A study was conducted to identify variables associated with IPV among Rwandan pregnant women. Methods A convenient sample of 600 pregnant women attending antenatal clinics were administered a questionnaire which included items on demographics, HIV status, IPV, and alcohol use by the male partner. Mean age and proportions of IPV in different groups were assessed. Odds of IPV were estimated using logistic regression analysis. Results Of the 600 respondents, 35.1% reported IPV in the last 12 months. HIV+ pregnant women had higher rates of all forms of IVP violence than HIV- pregnant women: pulling hair (44.3% vs. 20.3%, slapping (32.0% vs. 15.3%, kicking with fists (36.3% vs. 19.7%, throwing to the ground and kicking with feet (23.3% vs. 12.7%, and burning with hot liquid (4.1% vs. 3.5%. HIV positive participants were more than twice likely to report physical IPV than those who were HIV negative (OR = 2.38; 95% CI [1.59, 3.57]. Other factors positively associated with physical IPV included sexual abuse before the age of 14 years (OR = 2.69; 95% CI [1.69, 4.29], having an alcohol drinking male partner (OR = 4.10; 95% CI [2.48, 6.77] for occasional drinkers and OR = 3.37; 95% CI [2.05, 5.54] for heavy drinkers, and having a male partner with other sexual partners (OR = 1.53; 95% CI [1.15, 2.20]. Education was negatively associated with lifetime IPV. Conclusion We have reported on prevalence of IPV violence among pregnant women attending antenatal care in Rwanda, Central Africa. We advocate that screening for IPV be an integral part of HIV and AIDS care, as well as routine antenatal care. Services for battered women should also be

La pêcherie du lac Ihema (Rwanda : production commerciale et rentabilité socio-économique (1981-1987

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Mughanda, M.

1991-01-01

Full Text Available Lake Ihema fishery (Rwanda. Commercial production and socio-economical profitability (1981-1987. Among the small lakes in the flooded area of the river Akagera, in eastern Rwanda, lake Ihema (area : 90 km2, mean depth : 4 m is the most important. The density of phytoplankton in the water is high but dissolved salts concentration is low. Ichtyofauna of the lake consists of 34 species which were occasionally exploited by tanzanian fishermen. That is why, since 1980, the government of Rwanda with the aid of the Belgian Cooperation Agency for Development have initiated an official fishery. Total yield, fishing effort and financial investments are analysed over a 7 years period (1981 to 1987 in order to precise the socio-economical efficiency of this cooperation project. Total fishery effort and total yield have increased regularly until 1983, reaching 186 tons with a fishing effort of 9.231 outings. Since that year, the production has stabilized at a level of 156-199 t/year with only two taxa exploited : Tilapia spp and Clarias gariepinus. The analysis of book-keeping and annual accountant balance of the Ihema fishery shows that the annual exploitation ratio fluctuates between 81 and 142, 5 % ; this indicates a difficult control of the expenditures at least during some years (1984, 1985 and 1986. The profit ratio shows a positive return (± 10 % since 1981 to 1983, then a depression during 1984 and a continual increase during the next years to become positive again in 1987. Continuous evaluations of these simple parameters allowed to take some actions in order to maintain the efficiency of the fishery. This new activity will be maintained if there is a good fish stock management and rigorous accounts.

Associations between perceptions of care and women's childbirth experience: a population-based cross-sectional study in Rwanda.

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Mukamurigo, Judith U; Berg, Marie; Ntaganira, Joseph; Nyirazinyoye, Laetitia; Dencker, Anna

2017-06-09

In recent years Rwanda has achieved remarkable improvement in quality of maternity care services but there is evidence of deficiencies in care quality in terms of disrespectful care. Women's overall childbirth experience is an important outcome of childbirth and a factor in assessing quality of care. The aim of this study was to investigate how women's overall childbirth experience in Rwanda was related to their perceptions of childbirth care. A cross-sectional household study of women who had given birth 1-13 months earlier (n = 921) was performed in the Northern Province and in the capital city. Data was collected via structured interviews following a questionnaire. Significant variables measuring perceptions of care were included in a stepwise forward selection logistic regression model with overall childbirth experience as a dichotomised target variable to find independent predictors of a good childbirth experience. The majority of women (77.5%) reported a good overall childbirth experience. In a logistic regression model five factors of perceived care were significant independent predictors of a good experience: confidence in staff (Adjusted OR 1.73, 95% CI 1.20-2.49), receiving enough information (AOR 1.44, 95% CI 1.03-2.00), being treated with respect (AOR 1.69, 95% CI 1.18-2.43), getting support from staff (AOR 1.75, 95% CI 1.20-2.56), and having the baby skin-to-skin after birth (AOR 2.21, 95% CI 1.52-3.19). To further improve childbirth care in Rwanda and care for women according to their preferences, it is important to make sure that the childbirth care includes the following quality aspects in national and clinical guidelines: build confidence, provide good information, treat women and families with respect, provide good professional support during childbirth and put the newborn baby skin-to-skin with its mother early after birth.

Prevalence of hepatitis B and C infection in persons living with HIV enrolled in care in Rwanda.

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Umutesi, Justine; Simmons, Bryony; Makuza, Jean D; Dushimiyimana, Donatha; Mbituyumuremyi, Aimable; Uwimana, Jean Marie; Ford, Nathan; Mills, Edward J; Nsanzimana, Sabin

2017-05-02

Hepatitis B (HBV) and C (HCV) are important causes of morbidity and mortality in people living with human immunodeficiency virus (HIV). The burden of these co-infections in sub-Saharan Africa is still unclear. We estimated the prevalence of the hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCVAb) among HIV-infected individuals in Rwanda and identified factors associated with infection. Between January 2016 and June 2016, we performed systematic screening for HBsAg and HCVAb among HIV-positive individuals enrolled at public and private HIV facilities across Rwanda. Results were analyzed to determine marker prevalence and variability by demographic factors. Overall, among 117,258 individuals tested, the prevalence of HBsAg and HCVAb was 4.3% (95% confidence interval [CI] (4.2-4.4) and 4.6% (95% CI 4.5-4.7) respectively; 182 (0.2%) HIV+ individuals were co-infected with HBsAg and HCVAb. Prevalence was higher in males (HBsAg, 5.4% [5.1-5.6] vs. 3.7% [3.5-3.8]; HCVAb, 5.0% [4.8-5.2] vs. 4.4% [4.3-4.6]) and increased with age; HCVAb prevalence was significantly higher in people aged ≥65 years (17.8% [16.4-19.2]). Prevalence varied geographically. HBV and HCV co-infections are common among HIV-infected individuals in Rwanda. It is important that viral hepatitis prevention and treatment activities are scaled-up to control further transmission and reduce the burden in this population. Particular efforts should be made to conduct targeted screening of males and the older population. Further assessment is required to determine rates of HBV and HCV chronicity among HIV-infected individuals and identify effective strategies to link individuals to care and treatment.

Molecular and Phylogeographic Analysis of Human Immuno-deficiency Virus Type 1 Strains Infecting Treatment-naive Patients from Kigali, Rwanda

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Rusine, John; Jurriaans, Suzanne; van de Wijgert, Janneke; Cornelissen, Marion; Kateera, Brenda; Boer, Kimberly; Karita, Etienne; Mukabayire, Odette; de Jong, Menno; Ondoa, Pascale

2012-01-01

This study aimed at describing the genetic subtype distribution of HIV-1 strains circulating in Kigali and their epidemiological link with the HIV-1 strains from the five countries surrounding Rwanda. One hundred and thirty eight pol (RT and PR) sequences from 116 chronically- and 22 recently-infected antiretroviral therapy (ART)-naïve patients from Kigali were generated and subjected to HIV drug resistance (HIV-DR), phylogenetic and recombinant analyses in connection with 366 reference pol sequences from Rwanda, Burundi, Kenya, Democratic Republic of Congo, Tanzania and Uganda (Los Alamos database). Among the Rwandan samples, subtype A1 predominated (71.7%), followed by A1/C recombinants (18.1%), subtype C (5.8%), subtype D (2.9%), one A1/D recombinant (0.7%) and one unknown subtype (0.7%). Thirteen unique and three multiple A1/C recombinant forms were identified. No evidence for direct transmission events was found within the Rwandan strains. Molecular characteristics of HIV-1 were similar between chronically and recently-infected individuals and were not significantly associated with demographic or social factors. Our report suggests that the HIV-1 epidemic in Kigali is characterized by the emergence of A1/C recombinants and is not phylogenetically connected with the HIV-1 epidemic in the five neighboring countries. The relatively low level of transmitted HIV-DR mutations (2.9%) reported here indicates the good performance of the ART programme in Rwanda. However, the importance of promoting couples' counseling, testing and disclosure during HIV prevention strategies is highlighted. PMID:22905148

Determinants of Increasing Duration of First Unemployment among First Degree Holders in Rwanda: A Logistic Regression Analysis

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Niragire, François; Nshimyiryo, Alphonse

2017-01-01

Unexpectedly, the duration of first unemployment among first degree holders has quickly increased in Rwanda after considerable loss of the skilled labour during the war and Genocide perpetrated against Tutsi in 1994. The time it takes a higher education graduate to land a first employment is a key indicator for the evaluation of and optimal…

Identifying gaps in the surgical training curriculum in Rwanda through evaluation of operative activity at a teaching hospital.

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Rickard, Jennifer L; Ntakiyiruta, Georges; Chu, Kathryn M

2015-01-01

To define the operations performed by surgical residents at a tertiary referral hospital in Rwanda to help guide development of the residency program. Cross-sectional study of all patients operated by surgical residents from October 2012 to September 2013. University Teaching Hospital of Kigali (Centre Hospitalier Universitaire de Kigali [CHUK]), a public, tertiary referral hospital in Kigali, Rwanda. All patient data were entered into the operative database by surgical residents at CHUK. A total of 2833 cases were entered into the surgical database. Of them, 53 cases were excluded from further analysis because no surgical resident was listed as the primary or assistant surgeon, leaving 2780 cases for analysis. There were 2780 operations involving surgical residents. Of them, 51% of procedures were classified under general surgery, 38% orthopedics, 7% neurosurgery, and 4% urology. Emergency operations accounted for 64% of the procedures, with 56% of those being general surgery and 35% orthopedic. Further, 50% of all operations were trauma, with 71% of those orthopedic and 21% general surgery. Surgical faculty were involved in 45% of operations as either the primary or the assistant surgeons, while the remainder of operations did not involve surgical faculty. Residents were primary surgeons in 68% of procedures and assistant surgeons in 84% of procedures. The operative experience of surgery residents at CHUK primarily involves emergency and trauma procedures. Although this likely reflects the demographics of surgical care within Rwanda, more focus should be placed on elective procedures to ensure that surgical residents are broadly trained. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Synthèse des résultats de recherche sur l'agronomie du caféier arabica (Coffea arabica L. au Rwanda au 31 mars 1994

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Rutunga, V.

1999-01-01

Full Text Available Synthesis of Results on Coffee Agronomy Research in Rwanda on 31 March 1994. Arabica coffee plays an important role in the macro-economic performance of Rwanda. As a result, Agricultural Research Institutes have done research on coffee agronomy, aimed at improving coffee productivite The ecological conditions for coffee in Rwanda are characterized by inadequate rainfall and high light intensity. Soil parental material and chemical properties are variable amongst different small holders coffee producers. The available results indicate that spacing in coffee planting of 2 m x 2 m or 2, 5 m x 1, 5 m are convenient. Higher density with "multicaule"planting provided better production with some varieties. Pruning regime has been established but should still be correctly followed. Mulching is the best cultural technique to improve production. It improves soil physical and chemical properties and water storage. It can also improve minerai fertilizer use efficiency. The mulching materials are variable but not enough for ail coffee plantations. Mulch is applied late (July, August in Rwanda. Living cover with different species including legumes cannot replace efficiently the mulch, although the cover of Desmodium sp. and other few species can offer some advantages. Shade trees in coffee plantations have not been successful. N fertilizer followed by K improved coffee production. The effect of P was not clear while Mg deficiency was observed in some plantations. The formula of N.P.K. and N.P.K. Mg. were recommended but their rates should vary according to the sites. Finally, a beneficial effect was observed in using rotted coffee rinds compost.

Messages of Hope: Using Positive Stories of Survival to Assist Recovery in Rwanda

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Girish Lala

2014-08-01

Full Text Available For the past twenty years, the overriding story of Rwanda has been centred around the events and consequences of the genocide. In Rwanda, public expressions of that story have occurred in the gacaca courts, where survivors and perpetrators testified about their experiences and actions, during ongoing annual remembrance and mourning commemorations, and in memorial sites across the country that act as physical reminders of the genocide. While important as mechanisms for justice, testimony, and commemoration, on their own such events and installations also have the potential to re-traumatise. Accordingly, Rwandan agencies have encouraged a focus on the future as the overarching theme of recent national commemorations. Yet, opportunities for Rwandans to recount and disseminate positive, future-oriented stories of survival and healing remain sparse. Creation and awareness of positive stories have the potential to assist in recovery by increasing feelings of hope and efficacy; and recent research has demonstrated the value of hopefulness, well-being, and social support for vulnerable people. The Messages of Hope program seeks to leverage those ideas into a framework for generating positive messages by Rwandan survivors, providing an opportunity for everyday Rwandans to record and transmit their own positive stories of survival to demonstrate recovery and growth after the genocide, and to reinforce connectedness by sharing their challenges and aspirations. We describe the development and early implementation of this initiative and its potential longer-term application in other contexts of vulnerability.

Transactional sex as a form of child sexual exploitation and abuse in Rwanda: implications for child security and protection.

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Williams, Timothy P; Binagwaho, Agnes; Betancourt, Theresa S

2012-04-01

To illuminate the different manifestations of transactional sexual exploitation and abuse among Rwanda's children in order to inform effective responses by policies, programs, and communities. Qualitative data was collected during April and May 2010. One-hundred and thirty-nine adults (56% female) and 52 children (60% female) participated in focus groups across three geographic locations in Rwanda. Eleven interviews were held with child protection stakeholders. Interview and focus group participants reported how children, primarily girls, engaged in transactional sex as a survival strategy in response to situations of adversity including economic deprivation, difficulty accessing school, and social pressure. Policy and programs should work to address the underlying social and economic determinants of transactional sexual exploitation through structural interventions that reduce gender inequalities to accessing school and securing basic needs. Further quantitative and qualitative research to better understand the complexities of this issue is warranted. Copyright © 2012 Elsevier Ltd. All rights reserved.

Street children and political violence: a socio-demographic analysis of street children in Rwanda.

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Veale, Angela; Donà, Giorgia

2003-03-01

The aims were: (1) to examine the profile of African street children and to assess the link between street children in Africa and political violence; (2) to undertake a systematic examination of causal factors of street children in postgenocide Rwanda; and (3) to situate this analysis in the context of the socio-cultural and political impact of the genocide on Rwandan communities. Observational mapping examined the profile and activities of Rwandan street children. Structured interviews were carried out with 290 children in four regional towns to obtain information on socio-demographic, familial, educational background, causal factors surrounding street life involvement, psychological well-being, and relationship to the street. Focus group discussions and key informant interviews examined the relationship between street children and the broader Rwandan society. Street children in Rwanda were predominantly adolescent boys, almost half of whom were homeless (42%), with a high proportion of orphaned children or children who had lost at least one parent. Two variables predicted homelessness: child's guardian and reason for being in street. Qualitative accounts of children conveyed the impact of death of family members, repatriation, imprisonment of parents, and poverty on their lives. The analysis highlighted the need for community based support for children in alternative guardianship care and for policies to support the reintegration of male youths in postconflict welfare strategies as prevention strategies for street migration.

TEACHERS AS AGENTS OF CHANGE: PROMOTING PEACEBUILDING AND SOCIAL COHESION IN SCHOOLS IN RWANDA

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Jolly Rubagiza

2016-12-01

Full Text Available Education is seen to play a crucial role in the reconstruction of post-conflict countries, particularly in transforming people’s mindsets and rebuilding social relations. In this regard, teachers are often perceived as key agents to bring about this transformative change through their role as agents of peace. This paper seeks to understand how teachers are positioned to promote peacebuilding and social cohesion in Rwandan schools in the aftermath of the 1994 genocide against the Tutsi. The paper draws on data collected for an on-going broader study researching the role of teachers in peacebuilding in post-conflict contexts of Rwanda and South Africa. The methods used for data collection were semi-structured interviews, focus-group discussions, questionnaires and classroom observations. Theoretically the paper is informed by the broader research framework on sustainable peacebuilding in post-conflict situations, using the four dimensions of recognition, redistribution, representation and reconciliation (4Rs. The findings show that the policy environment is conducive to peacebuilding and recognises the important role of teachers and education in general, in the social, political and economic reconstruction of post-genocide Rwanda. However, there are a number of inter-related factors that pertain to teachers’ professional development, teacher management and the school environment that pose challenges to sustainable peacebuilding and social cohesion.

Using an intervention mapping approach for planning, implementing and assessing a community-led project towards malaria elimination in the Eastern Province of Rwanda.

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Ingabire, Chantal Marie; Hakizimana, Emmanuel; Kateera, Fredrick; Rulisa, Alexis; Van Den Borne, Bart; Nieuwold, Ingmar; Muvunyi, Claude; Koenraadt, Constantianus J M; Van Vugt, Michele; Mutesa, Leon; Alaii, Jane

2016-12-16

Active community participation in malaria control is key to achieving malaria pre-elimination in Rwanda. This paper describes development, implementation and evaluation of a community-based malaria elimination project in Ruhuha sector, Bugesera district, Eastern province of Rwanda. Guided by an intervention mapping approach, a needs assessment was conducted using household and entomological surveys and focus group interviews. Data related to behavioural, epidemiological, entomological and economical aspects were collected. Desired behavioural and environmental outcomes were identified concurrently with behavioural and environmental determinants. Theoretical methods and their practical applications were enumerated to guide programme development and implementation. An operational plan including the scope and sequence as well as programme materials was developed. Two project components were subsequently implemented following community trainings: (1) community malaria action teams (CMATs) were initiated in mid-2014 as platforms to deliver malaria preventive messages at village level, and (2) a mosquito larval source control programme using biological substances was deployed for a duration of 6 months, implemented from January to July 2015. Process and outcome evaluation has been conducted for both programme components to inform future scale up. The project highlighted malaria patterns in the area and underpinned behavioural and environmental factors contributing to malaria transmission. Active involvement of the community in collaboration with CMATs contributed to health literacy, particularly increasing ability to make knowledgeable decisions in regards to malaria prevention and control. A follow up survey conducted six months following the establishment of CMATs reported a reduction of presumed malaria cases at the end of 2014. The changes were related to an increase in the acceptance and use of available preventive measures, such as indoor residual spraying and

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Results 721 - 730 of 8491 ... ... gains eroded by cultural practices and negative attitude; the Rwanda case ... Grassroots women mitigate the effects of climate change : land access ... biased green revolution policies: Manhiça district, Mozambique; ...

Utilisation of the partogram among nurses and midwives in selected health facilities in the Eastern Province of Rwanda

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Oliva Bazirete

2017-08-01

Conclusion: Nurses’ and midwives’ years of professional experience and training in managing pregnant women in labour were found to be predictors of the likelihood of proper use of the partogram. In-service training of obstetric caregivers in the Eastern Province of Rwanda is recommended to improve use of the partogram while managing women in labour.

Risk factors for homicide victimization in post-genocide Rwanda: a population -based case- control study.

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Rubanzana, Wilson; Ntaganira, Joseph; Freeman, Michael D; Hedt-Gauthier, Bethany L

2015-08-21

Homicide is one of the leading causes of mortality in the World. Homicide risk factors vary significantly between countries and regions. In Rwanda, data on homicide victimization is unreliable because no standardized surveillance system exists. This study was undertaken to identify the risk factors for homicide victimization in Rwanda with particular attention on the latent effects of the 1994 genocide. A population-based matched case-control study was conducted, with subjects enrolled prospectively from May 2011 to May 2013. Cases of homicide victimization were identified via police reports, and crime details were provided by law enforcement agencies. Three controls were matched to each case by sex, 5-year age group and village of residence. Socioeconomic and personal background data, including genocide exposure, were provided via interview of a family member or through village administrators. Conditional logistic regression, stratified by gender status, was used to identify risk factors for homicide victimization. During the study period, 156 homicide victims were enrolled, of which 57 % were male and 43 % were female. The most common mechanisms of death were wounds inflicted by sharp instruments (knives or machetes; 41 %) followed by blunt force injuries (36.5 %). Final models indicated that risk of homicide victimhood increased with victim alcohol drinking patterns. There was a dose response noted for alcohol use: for minimal drinking versus none, adjusted odds ratio (aOR) = 3.1, 95%CI: 1,3-7.9; for moderate drinking versus none, aOR = 10.1, 95%CI: 3.7-24.9; and for heavy drinking versus none, aOR = 11.5, 95%CI: 3.6-36.8. Additionally, having no surviving parent (aOR = 2.7, 95%CI: 1.1-6.1), previous physical and/or sexual abuse (aOR = 28.1, 95%CI: 5.1-28.3) and drinking illicit brew and/or drug use (aOR = 7.7, 95%CI: 2.4-18.6) were associated with a higher risk of being killed. The test of interaction revealed that the variables that

Transactional Sex as a Form of Child Sexual Exploitation and Abuse in Rwanda: Implications for Child Security and Protection

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Williams, Timothy P.; Binagwaho, Agnes; Betancourt, Theresa S.

2012-01-01

Objective: To illuminate the different manifestations of transactional sexual exploitation and abuse among Rwanda's children in order to inform effective responses by policies, programs, and communities. Method: Qualitative data was collected during April and May 2010. One-hundred and thirty-nine adults (56% female) and 52 children (60% female)…

Characteristics of participants in an HIV prevention intervention for youth in Rwanda: results from a longitudinal study

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Hanne Celis

2014-08-01

Full Text Available Introduction. This paper studies determinants of participation in a peer-led school-based HIV prevention intervention in Rwanda. Methods. A baseline survey among 1071 students (mean age 17 years assessed potential determinants of participation, while a follow-up six months in the intervention measured actual participation in the intervention. Statistical models were built using multivariate linear and multinomial regression analysis predicting overall participation, par- ticipation in group discussions and individual counseling. Results. Those who recently had sex, had been tested for HIV, feel more susceptible to HIV, have a higher sexual self-concept, a more positive future perspective (only for non-sexually active, and boys, were more likely to participate in group activities. Also students from the same class as the peer educator and boarding school students were more likely to participate in group activities. Older students and those with low external health locus of control participated more in individual counseling. Discussion. Participation could be increased by investing in general well-being of young people, organizing girls-only activities, and diversifying activities. Key words: selection bias, HIV prevention, participation rate, young people, Rwanda

Stroke Burden in Rwanda: A Multicenter Study of Stroke Management and Outcome.

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Nkusi, Agabe Emmy; Muneza, Severien; Nshuti, Steven; Hakizimana, David; Munyemana, Paulin; Nkeshimana, Menelas; Rudakemwa, Emmanuel; Amendezo, Etienne

2017-10-01

Cerebrovascular accidents or stroke constitute the second leading cause of mortality worldwide. Low- and middle-income countries bear most of the stroke burden worldwide. The main objective of this study is to determine the burden of stroke in Rwanda. This was a prospective observational study in 2 parts: 6 months baseline data collection and outcome assessment sessions at 1 year. A total of 96 patients were enrolled in our series. Stroke constituted 2100 per 100,000 population. Of all patients, 55.2% were male and most (60%) were 55 years and older. Of all patients and/or caretakers, 22% were not aware of their previous health status and 53.5% of hypertensive patients were not on treatment by the time of the event. Median presentation delay was 72 hours for patients with ischemic stroke and 24 hours for patients with hemorrhagic stroke. Most patients had hemorrhagic stroke (65% vs. 35%), and more patients with hemorrhagic stroke presented with loss of consciousness (80% vs. 51%). Many patients (62% ischemic group and 44% hemorrhagic group) presented with severe stroke scores, and this was associated with worst outcome (P = 0.004). At 1 year follow-up, 24.7% had no or mild disability, 14.3% were significantly disabled, and 61% had died. Our results show that stroke is a significant public health concern in Rwanda. Risk factor awareness and control are still low and case fatality of stroke is significantly high. The significant delay in presentation to care and presentation with severe stroke are major contributors for the high mortality and severe disability rates. Copyright © 2017 Elsevier Inc. All rights reserved.

Exploring the potential of a family-based prevention intervention to reduce alcohol use and violence within HIV-affected families in Rwanda.

Science.gov (United States)

Chaudhury, Sumona; Brown, Felicity L; Kirk, Catherine M; Mukunzi, Sylvere; Nyirandagijimana, Beatha; Mukandanga, Josee; Ukundineza, Christian; Godfrey, Kalisa; Ng, Lauren C; Brennan, Robert T; Betancourt, Theresa S

2016-03-01

HIV-affected families report higher rates of harmful alcohol use, intimate partner violence (IPV) and family conflict, which can have detrimental effects on children. Few evidence-based interventions exist to address these complex issues in Sub-Saharan Africa. This mixed methods study explores the potential of a family-based intervention to reduce IPV, family conflict and problems related to alcohol use to promote child mental health and family functioning within HIV-affected families in post-genocide Rwanda. A family home-visiting, evidence-based intervention designed to identify and enhance resilience and communication in families to promote mental health in children was adapted and developed for use in this context for families affected by caregiver HIV in Rwanda. The intervention was adapted and developed through a series of pilot study phases prior to being tested in open and randomized controlled trials (RCTs) in Rwanda for families affected by caregiver HIV. Quantitative and qualitative data from the RCT are explored here using a mixed methods approach to integrate findings. Reductions in alcohol use and IPV among caregivers are supported by qualitative reports of improved family functioning, lower levels of violence and problem drinking as well as improved child mental health, among the intervention group. This mixed methods analysis supports the potential of family-based interventions to reduce adverse caregiver behaviors as a major mechanism for improving child well-being. Further studies to examine these mechanisms in well-powered trials are needed to extend the evidence-base on the promise of family-based intervention for use in low- and middle-income countries.

First Continuous High Frequency in Situ Measurements of CO2 and CH4 in Rwanda Using Cavity Ring-down Spectroscopy

Science.gov (United States)

Gasore, J.; DeWitt, L. H.; Prinn, R. G.

2015-12-01

Recent IPCC reports emphasize the lack of ground measurements of greenhouse gases on the African continent, despite Africa's significant emissions from agriculture and biomass burning as well as ongoing land use changes. We have established a greenhouse gas monitoring station in northern Rwanda that will be part of the Advanced Global Atmospheric Gases Experiment (AGAGE), a global network of high frequency long-term remote atmospheric measurement stations. Using a Picarro G2401 cavity ring-down analyzer, continuous measurements of CO2, CH4, and CO at a frequency of five seconds are being captured at this equatorial East African site. The measurement site is located near the Virunga mountains, a volcanic range in North-West Rwanda, on the summit of Mt. Mugogo (2507 m above sea level). Mt. Mugogo is located in a rural area 70km away from Kigali, the capital of Rwanda, and about 13km from the nearest town. From HYSPLIT 7-day back-trajectory calculations, we have determined that the station measures air masses originating from East and Central Africa, the Indian Ocean and occasionally from Southern Asia. Depending on the wind direction and local boundary layer height, measurements taken at Mt Mugogo are occasionally influenced by local sources, including emissions from the nearby city and wood fires from small rural settlements around the station. Here we present the first greenhouse gas measurement data from this unique and understudied location in Africa. Using the lagrangian transport and dispersion model FLEXPART, we derive the relationship between the observed mole fractions of CO2 and CH4 and our current knowledge of their sources and sinks, across this large African footprint.

Utilizing NASA Earth Observations to Monitor Land Management Practices and the Development of Marshlands to Rice Fields in Rwanda

Science.gov (United States)

Dusabimana, M. R.; Blach, D.; Mwiza, F.; Muzungu, E.; Swaminathan, R.; Tate, Z.

2014-12-01

Rwanda, a small country with the highest population density in Sub-Saharan Africa, is one of the world's poorest countries. Although agriculture is the backbone of Rwandan economy, agricultural productivity is extremely low. Over 90 % of the population is engaged in subsistence farming and only 52 % of the total land surface area is arable. Of this land, approximately 165,000 hectares are marshlands, of which only 57 % has been cultivated. Rwandan government has invested in the advancement of agriculture with activities such as irrigation, marshland reclamation, and crop regionalization. In 2001, Ministry of Agriculture and Animal Resources (MINAGRI) released the Rural Sector Support Program (RSSP), which aimed at converting marshlands into rice fields at various development sites across the country. The focus of this project was to monitor rice fields in Rwanda utilizing NASA Earth observations such as Landsat 5 Thematic Mapper and Landsat 8 Operational Land Imager. Modified Normalized Difference Water Index (MNDWI) was used to depict the progress of marshland to rice field conversion as it highlights the presence of irrigated rice fields from the surrounding area. Additionally, Decision Support System for Agrotechnology Transfer (DSSAT) was used to estimate rice yield at RSSP sites. Various simulations were run to find perfect conditions for cultivating the highest yield for a given farm. Furthermore, soil erosion susceptibility masks were created by combining factors derived from ASTER, MERRA, and ground truth data using Revised Universal Soil Loss Equation (RUSLE). The end results, maps, and tutorials were delivered to the partners and policy makers in Rwanda to help make informed decisions. It can be clearly seen that Earth observations can be successfully used to monitor agricultural and land management practices as a cost effective method that will enable farmers to improve crop yield production and food security.

The soil information system of Rwanda: a useful tool to identify guidelines towards sustainable land management

OpenAIRE

A. Verdoodt; E. Van Ranst

2006-01-01

On the steep lands of Rwanda, overpopulation and degradation of the land resources are acute problems, especially against the background of present and future populations, food and agricultural demands, and opportunities and constraints. The ability of the land to produce is limited with the limits to production being set by climate, soil and landform conditions, and the use and management applied. Knowledge of the soils, their properties and their spatial distribution, is indispensable for t...

[Criminology and victimology of rape in context with war-like conflicts using the example of the former Yugoslavia and Rwanda].

NARCIS (Netherlands)

Nittmann, C.; Franke, B.; Augustin, C.; Puschel, K.

2012-01-01

The topic of this article is sexual violence in context with war-like conflicts in the former Yugoslavia and Rwanda. The fundamental categories of sexual violence in war-like conflicts are described. The authors discuss the types of sexual violence as defined in the report of the UN Commission of

Bovine tuberculosis in Rwanda: Prevalence and economic impact evaluation by meat inspection at Société des Abattoirs de Nyabugogo-Nyabugogo Abattoir, Kigali.

Science.gov (United States)

Habarugira, Gervais; Rukelibuga, Joseph; Nanyingi, Mark O; Mushonga, Borden

2014-11-05

Despite the significant public health burden of bovine tuberculosis (bTB) in Rwanda, the prevalence of bTB is poorly documented. This study was conducted to estimate the prevalence of bTB in cattle using gross examination of granulomatous lesions, to identify mycobacteria species in suspected samples, and to evaluate the economic impact of meat condemnation based on bTB-like lesions in the meat industry in Rwanda. Routine meat inspection was conducted at Société des Abattoirs de Nyabugogo (SABAN)-Nyabugogo Abattoir. Tissue samples including 31 lymph nodes, 3 lungs and 2 livers were obtained from cattle of different ages with gross tuberculous lesions. Mycobacterium bovis was identified using microscopy with Kinyoun staining and isolation of mycobacterial species in culture on Löwenstein-Jensen and Colestos media, further identified using biochemical tests. Our findings, based on culture and postmortem results, show that the prevalence of bTB is 0.5%(0.587*148/16753), with an overall gross tuberculous lesion prevalence of 0.9% (148/16753). The presence of lesions were higher in cattle aged 2 years and older (1.6% vs. 0.6%, p < 0.05) and higher in females than in males (1.4% vs. 0.6%, p < 0.05). Of the 36 samples tested, 26 (72.2%) were positive by microscopic examination with Kinyoun staining while M. bovis was culture-confirmed in 21 (58.7%) cases. Bovine tuberculosis caused condemnation of 1683.5 kg of meat, resulting in an estimated loss of $4810. Our findings indicate that the prevalence of bTB in Rwanda is significant, and that bTB is a major cause of meat condemnation requiring continued implementation of surveillance and control measures. Furthermore, the results from this study also show important variations in sensitivity of the different tests that were used to determine the prevalence of bTB in cattle in Rwanda.

Bovine tuberculosis in Rwanda: Prevalence and economic impact evaluation by meat inspection at Société des Abattoirs de Nyabugogo-Nyabugogo Abattoir, Kigali

Directory of Open Access Journals (Sweden)

Gervais Habarugira

2014-11-01

Full Text Available Despite the significant public health burden of bovine tuberculosis (bTB in Rwanda, the prevalence of bTB is poorly documented. This study was conducted to estimate the prevalence of bTB in cattle using gross examination of granulomatous lesions, to identify mycobacteria species in suspected samples, and to evaluate the economic impact of meat condemnation based on bTB-like lesions in the meat industry in Rwanda. Routine meat inspection was conducted at Société des Abattoirs de Nyabugogo (SABAN-Nyabugogo Abattoir. Tissue samples including 31 lymph nodes, 3 lungs and 2 livers were obtained from cattle of different ages with gross tuberculous lesions. Mycobacterium bovis was identified using microscopy with Kinyoun staining and isolation of mycobacterial species in culture on Löwenstein–Jensen and Colestos media, further identified using biochemical tests. Our findings, based on culture and postmortem results, show that the prevalence of bTB is 0.5%(0.587*148/16753, with an overall gross tuberculous lesion prevalence of 0.9% (148/16753. The presence of lesions were higher in cattle aged 2 years and older (1.6% vs. 0.6%, p < 0.05 and higher in females than in males (1.4% vs. 0.6%, p < 0.05. Of the 36 samples tested, 26 (72.2% were positive by microscopic examination with Kinyoun staining while M. bovis was culture-confirmed in 21 (58.7% cases. Bovine tuberculosis caused condemnation of 1683.5 kg of meat, resulting in an estimated loss of $4810. Our findings indicate that the prevalence of bTB in Rwanda is significant, and that bTB is a major cause of meat condemnation requiring continued implementation of surveillance and control measures. Furthermore, the results from this study also show important variations in sensitivity of the different tests that were used to determine the prevalence of bTB in cattle in Rwanda.

HIV diagnosis, linkage to HIV care, and HIV risk behaviors among newly diagnosed HIV-positive female sex workers in Kigali, Rwanda

NARCIS (Netherlands)

Braunstein, Sarah L.; Umulisa, Marie-Michèle; Veldhuijzen, Nienke J.; Kestelyn, Evelyne; Ingabire, Chantal M.; Nyinawabega, Jeanine; van de Wijgert, Janneke H. H. M.; Nash, Denis

2011-01-01

To evaluate linkage-to-care, sexual behavior change, and psychosocial experiences among newly HIV-diagnosed female sex workers (FSWs) in Rwanda. FSWs (n = 800) with unknown serostatus were screened for HIV during 2007/2008. Women testing HIV positive (n = 192) were referred to care and asked to

Applied statistical training to strengthen analysis and health research capacity in Rwanda.

Science.gov (United States)

Thomson, Dana R; Semakula, Muhammed; Hirschhorn, Lisa R; Murray, Megan; Ndahindwa, Vedaste; Manzi, Anatole; Mukabutera, Assumpta; Karema, Corine; Condo, Jeanine; Hedt-Gauthier, Bethany

2016-09-29

To guide efficient investment of limited health resources in sub-Saharan Africa, local researchers need to be involved in, and guide, health system and policy research. While extensive survey and census data are available to health researchers and program officers in resource-limited countries, local involvement and leadership in research is limited due to inadequate experience, lack of dedicated research time and weak interagency connections, among other challenges. Many research-strengthening initiatives host prolonged fellowships out-of-country, yet their approaches have not been evaluated for effectiveness in involvement and development of local leadership in research. We developed, implemented and evaluated a multi-month, deliverable-driven, survey analysis training based in Rwanda to strengthen skills of five local research leaders, 15 statisticians, and a PhD candidate. Research leaders applied with a specific research question relevant to country challenges and committed to leading an analysis to publication. Statisticians with prerequisite statistical training and experience with a statistical software applied to participate in class-based trainings and complete an assigned analysis. Both statisticians and research leaders were provided ongoing in-country mentoring for analysis and manuscript writing. Participants reported a high level of skill, knowledge and collaborator development from class-based trainings and out-of-class mentorship that were sustained 1 year later. Five of six manuscripts were authored by multi-institution teams and submitted to international peer-reviewed scientific journals, and three-quarters of the participants mentored others in survey data analysis or conducted an additional survey analysis in the year following the training. Our model was effective in utilizing existing survey data and strengthening skills among full-time working professionals without disrupting ongoing work commitments and using few resources. Critical to our

Active Science as a Contribution to the Trauma Recovery Process: Preliminary Indications with Orphans from the 1994 Genocide in Rwanda

Science.gov (United States)

Perrier, Frederic; Nsengiyumva, Jean-Baptiste

2003-01-01

Constructivist, hands-on, inquiry-based, science activities may have a curative potential that could be valuable in a psychological assistance programme for child victims of violence and war. To investigate this idea, pilot sessions were performed in an orphanage located in Ruhengeri, Rwanda, with seven young adults and two groups of 11 children…

Twenty Years After Genocide: The Role of Psychology in the Reconciliation and Reconstruction Process in Rwanda

OpenAIRE

Craig McGarty

2014-01-01

This Special Thematic Section brings together eight papers that showcase different aspects of the contribution of psychology to the processes of recovery in Rwanda following the 1994 genocide. The Section is noteworthy in part because a majority of the papers have Rwandan authors. In summarizing the contributions I make six observations about the remarkable context of the genocide and its aftermath: a) it was distinctive from previous mass violence in its intensity and character; b) it has be...

Environmental barriers experienced by stroke patients in Musanze ...

African Journals Online (AJOL)

... study highlight the need for interventions that include awareness and education of communities about disability and advocating for accessible services and physical structures for persons with disabilities. Keywords: Stroke, environmental barriers, Musanze district, Rwanda African Health Sciences 2011; 11(3): 398 - 406 ...

TEAM 1 Integrated Research Partnerships for Malaria Control ...

International Development Research Centre (IDRC) Digital Library (Canada)

IDRC CRDI

TEAM 1 Integrated Research Partnerships for Malaria Control through an Ecohealth Approach in. East Africa. Abstract: Representing East Africa, the National Institute for Medical Research (NIMR, Tanzania), icipe, the. Kigali Health Institute (Rwanda) and the Kamuli local government district authority in Uganda form.

Challenges to micro-financing PLWHA clients in Rwanda : a study based on vision finance, a world vision mico-finance institution, Kigali Branch

NARCIS (Netherlands)

Muyinda, B.

2008-01-01

The study was conducted on Vision Finance a microfinance institution of World Vision in Rwanda. The major research question focussed on determining the factors that have contributed default on loans disbursed to PLWHA clients by Vision Finance. Results show that chronic illness and death disrupt

Assessment of surface water resources availability using catchment modeling and the results of tracer studies in the meso-scale Migina Catchment, Rwanda

NARCIS (Netherlands)

Munyaneza, O.; Mukubwa, A.; Maskey, S.; Wenninger, J.W.; Uhlenbrook, S.

2013-01-01

In the last couple of years, different hydrological research projects were undertaken in the Migina catchment (243.2 km2), a tributary of the Kagera river in Southern Rwanda. These projects were aimed to understand hydrological processes of the catchment using analytical and experimental approaches

IS REBUILDING A NATION’S INTERNATIONAL IMAGE A QUESTION OF DISCOURSE? THE CONTROVERSIAL CASE OF RWANDA: A DESTINATION OF THE DARK

Directory of Open Access Journals (Sweden)

Ana CRĂCIUNESCU

2015-06-01

Full Text Available Le tourisme noir (eng. dark tourism, ou le tourisme à caractère révérenciel, est une forme contemporaine du tourisme de niche, qui prend récemment des proportions de plus en plus considérables parmi les chercheurs, de même que dans la pratique du tourisme. Rwanda nous relève une multitude de facettes que le discours peut engendrer au niveau sociopolitique. Question d’ethnie et de revendication territoriale, y compris du pouvoir, le coup d’Etat superposé au génocide, événement tragique qui a ébranlé le monde africain en 1994, représente un véritable creuset d’investigation discursive. En quête de la vérité, notre travail se penchera sur l’image que Rwanda cherche aujourd’hui à se faire à l’étranger, au-delà des voix oblitérées par des secouements totalitaristes. De cette manière, on va analyser comment ce pays réussit à s’en sortir graduellement de son drame, grâce au discours avec un message universel - le tourisme, et la manière dont cela devient visible sur les sites Internet spécialisés en conseil de voyage. En fait, le voyage au Rwanda représente l’hommage que le Monde offre, même s’il s’agit du niveau d’une expérience littéraire, car, à travers le discours littéraire, on descendra aux lieux tragiques avec l’écrivaine ivoirienne Véronique Tadjo.

A national survey of musculoskeletal impairment in Rwanda: prevalence, causes and service implications.

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Oluwarantimi Atijosan

Full Text Available BACKGROUND: Accurate information on the prevalence and causes of musculoskeletal impairment (MSI is lacking in low income countries. We present a new survey methodology that is based on sound epidemiological principles and is linked to the World Health Organisation's International Classification of Functioning. METHODS: Clusters were selected with probability proportionate to size. Households were selected within clusters through compact segment sampling. 105 clusters of 80 people (all ages were included. All participants were screened for MSI by a physiotherapist and medical assistant. Possible cases plus a random sample of 10% of non-MSI cases were examined further to ascertain diagnosis, aetiology, quality of life, and treatment needs. FINDINGS: 6757 of 8368 enumerated individuals (80.8% were screened. There were 352 cases, giving an overall prevalence for MSI of 5.2%. (95% CI 4.5-5.9 The prevalence of MSI increased with age and was similar in men and women. Extrapolating these estimates, there are approximately 488,000 MSI diagnoses in Rwanda. Only 8.2% of MSI cases were severe, while the majority were moderate (43.7% or mild (46.3%. Diagnostic categories comprised 11.5% congenital, 31.3% trauma, 3.8% infection, 9.0% neurological, and 44.4% non-traumatic non infective acquired. The most common individual diagnoses were joint disease (13.3%, angular limb deformity (9.7% and fracture mal- and non-union (7.2%. 96% of all cases required further treatment. INTERPRETATION: This survey demonstrates a large burden of MSI in Rwanda, which is mostly untreated. The survey methodology will be useful in other low income countries, to assist with planning services and monitoring trends.

Training Leadership in Kibungo District Hospital, Rwanda

African Journals Online (AJOL)

Background. Improving confidence increases creativity and self-accountability. The core of leadership is developing the skills to assess, guide, and mentor others to develop confidence in their profession. Improving leadership requires specific education. This project was developed after a Needs Assessment of the Kibungo ...

"Sinigurisha! (You are Not for Sale!):" Exploring the Relationship between Access to School, School Fees, and Sexual Abuse in Rwanda

Science.gov (United States)

Gerver, Mollie

2013-01-01

In Rwanda, many victims do not report rape to the police because the perpetrators financially support their basic living needs and/or education. Victims who are impregnated by their perpetrators are even more financially dependent on them, both because of the additional expense of raising a child and because the possibilities of returning to…

Promotion of couples? voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia

OpenAIRE

Kelley, April L.; Hagaman, Ashley K.; Wall, Kristin M.; Karita, Etienne; Kilembe, William; Bayingana, Roger; Tichacek, Amanda; Kautzman, Michele; Allen, Susan A.

2016-01-01

Abstract Background Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples’ voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs) and influential network agents (INAs) in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods INLs were identified in the f...

GIS-based multi-criteria analysis for Arabica coffee expansion in Rwanda.

Directory of Open Access Journals (Sweden)

Innocent Nzeyimana

Full Text Available The Government of Rwanda is implementing policies to increase the area of Arabica coffee production. Information on the suitable areas for sustainably growing Arabica coffee is still scarce. This study aimed to analyze suitable areas for Arabica coffee production. We analyzed the spatial distribution of actual and potential production zones for Arabica coffee, their productivity levels and predicted potential yields. We used a geographic information system (GIS for a weighted overlay analysis to assess the major production zones of Arabica coffee and their qualitative productivity indices. Actual coffee yields were measured in the field and were used to assess potential productivity zones and yields using ordinary kriging with ArcGIS software. The production of coffee covers about 32 000 ha, or 2.3% of all cultivated land in the country. The major zones of production are the Kivu Lake Borders, Central Plateau, Eastern Plateau, and Mayaga agro-ecological zones, where coffee is mainly cultivated on moderate slopes. In the highlands, coffee is grown on steep slopes that can exceed 55%. About 21% percent of the country has a moderate yield potential, ranging between 1.0 and 1.6 t coffee ha-1, and 70% has a low yield potential (<1.0 t coffee ha-1. Only 9% of the country has a high yield potential of 1.6-2.4 t coffee ha-1. Those areas are found near Lake Kivu where the dominant soil Orders are Inceptisols and Ultisols. Moderate yield potential is found in the Birunga (volcano, Congo-Nile watershed Divide, Impala and Imbo zones. Low-yield regions (<1 t ha-1 occur in the eastern semi-dry lowlands, Central Plateau, Eastern Plateau, Buberuka Highlands, and Mayaga zones. The weighted overlay analysis and ordinary kriging indicated a large spatial variability of potential productivity indices. Increasing the area and productivity of coffee in Rwanda thus has considerable potential.

Population need for primary eye care in Rwanda: A national survey.

Directory of Open Access Journals (Sweden)

Tess Bright

Full Text Available Universal access to Primary Eye Care (PEC is a key global initiative to reduce and prevent avoidable causes of visual impairment (VI. PEC can address minor eye conditions, simple forms of uncorrected refractive error (URE and create a referral pathway for specialist eye care, thus offering a potential solution to a lack of eye health specialists in low-income countries. However, there is little information on the population need for PEC, including prevalence of URE in all ages in Sub-Saharan Africa.A national survey was conducted of people aged 7 and over in Rwanda in September-December 2016. Participants were selected through two-stage probability proportional to size sampling and compact segment sampling. VI (visual acuity<6/12 was assessed using Portable Eye Examination Kit (PEEK; URE was detected using a pinhole and presbyopia using local near vision test. We also used validated questionnaires to collect socio-demographic and minor eye symptoms information. Prevalence estimates for VI, URE and need for PEC (URE, presbyopia with good distance vision, need for referrals and minor eye conditions were age and sex standardized to the Rwandan population. Associations between age, sex, socio-economic status and the key outcomes were examined using logistic regression.4618 participants were examined and interviewed out of 5361 enumerated (86% response rate. The adjusted population prevalence of VI was 3.7% (95%CI = 3.0-4.5%, URE was 2.2% (95%CI = 1.7-2.8% and overall need for PEC was 34.0% (95%CI = 31.8-36.4%. Women and older people were more likely to need PEC and require a referral.Nearly a third of the population in Rwanda has the potential to benefit from PEC, with greater need identified in older people and women. Universal access to PEC can address unmet eye health needs and public health planning needs to ensure equitable access to older people and women.

Council Districts

Data.gov (United States)

Town of Cary, North Carolina — View the location of the Town of Cary’s four Town Council districts.Please note that one district, District A, is split into two geo-spatial areas. One area is in...

Herpetofauna, Parc National des Volcans, North Province, Republic of Rwanda

Directory of Open Access Journals (Sweden)

Roelke, C. E.

2010-01-01

Full Text Available Herein is presented a list of the reptiles and anurans from the Parc National des Volcans (PNV(01°43’ S, 29°52’ W, an area in the west and north provinces of the Republic of Rwanda in the Albertine Riftregion of Africa. Fieldwork was conducted between two and six days per week from June through August2007 and 2008. We also conducted literature searches of all historical expeditions within the park for speciesrecords. Seventeen species of reptiles and anurans are recorded from the PNV. Nine of the species were anurans,distributed in five families: Arthroleptidae (3, Bufonidae (1, Hyperoliidae (3, Phrynobatrachidae (1, andPipidae (1. Eight species of reptiles were recorded from five families: Chamaeleonidae (1, Lacertidae (2,Scincidae (2, Colubridae (2, and Viperidae (1. Eight of the seventeen species found in the PNV are endemicto the Albertine Rift.

A case-control study of HIV infection and cancer in the era of antiretroviral therapy in Rwanda.

Science.gov (United States)

Mpunga, Tharcisse; Znaor, Ariana; Uwizeye, F Regis; Uwase, Aline; Munyanshongore, Cyprien; Franceschi, Silvia; Clifford, Gary M

2018-04-16

The aim of this study was to assess the association between HIV infection and cancer risk in Rwanda approximately a decade after the introduction of antiretroviral therapy (cART). All persons seeking cancer care at Butaro Cancer Center of Excellence (BCCOE) in Rwanda from 2012 to 2016 were routinely screened for HIV, prior to being confirmed with or without cancer (cases and controls, respectively). Cases were coded according to ICD-O-3 and converted to ICD10. Associations between individual cancer types and HIV were estimated using adjusted unconditional logistic regression. 2,656 cases and 1,196 controls differed by gender (80.3% vs. 70.8% female), age (mean 45.5 vs. 37.7 years), place of residence and proportion of diagnoses made by histopathology (87.5% vs. 67.4%). After adjustment for these variables, HIV was significantly associated with Kaposi Sarcoma (n = 60; OR = 110.3, 95%CI 46.8-259.6), non-Hodgkin lymphoma (NHL) (n = 265; OR = 2.5, 1.4-4.6), Hodgkin lymphoma (HL) (n = 76; OR = 5.2, 2.3-11.6) and cancers of the cervix (n = 560; OR = 5.9, 3.8-9.2), vulva (n = 23; OR = 17.8, 6.3-50.1), penis (n = 29; OR = 8.3, 2.5-27.4) and eye (n = 17; OR = 4.7, 1.0-25.0). Associations varied by NHL/HL subtype, with that for NHL being limited to DLBCL (n = 56; OR = 6.6, 3.1-14.1), particularly plasmablastic lymphoma (n = 6, OR = 106, 12.1-921). No significant associations were seen with other commonly diagnosed cancers, including female breast cancer (n = 559), head and neck (n = 116) and colorectal cancer (n = 106). In conclusion, in the era of cART in Rwanda, HIV is associated with increased risk of a range of infection-related cancers, and accounts for an important fraction of cancers presenting to a referral hospital. © 2018 International Agency for Research on Cancer (IARC/WHO); licensed by UICC.

Bridging the accountability divide: male circumcision planning in Rwanda as a case study in how to merge divergent operational planning approaches.

Science.gov (United States)

McPherson, Dacia B; Balisanga, Helene N; Mbabazi, Jennifer K

2014-10-01

When voluntary medical male circumcision (MC) was confirmed as an effective tool for HIV prevention in sub-Saharan Africa in 2007, many public health policy makers and practitioners were eager to implement the intervention. How to roll out the tool as part of comprehensive strategy however was less clear. At the time, very little was known about the capacity of health systems to scale delivery of the new intervention. Today, nearly all countries prioritized for the intervention are far behind their targets. To contribute to the discourse on why this is, we develop a historical analysis of medical MC planning in sub-Saharan Africa using our own experience of this process in Rwanda. We compare our previously unpublished feasibility analysis from 2008 with international research published in 2009, which suggested how Rwanda could reduce HIV incidence through a rapid MC intervention, and Rwanda's eventual 2010 official operational plan. We trace how, in the face of uncertainty, operational plans avoided discussing the details of feasibility and focused instead on defining optimal circumcision capacity needed to achieve country level target reductions in HIV incidence. We show a distinct gap between the targets set in the official operational plan and what we determined was feasible in 2008. With actual data from the ground now available, we show our old feasibility models more closely approximate circumcision delivery rates to date. With an eye toward the future of long-term policy planning, we discuss the mechanics of how accountability gaps like this occur in global health policy making and how practitioners can better create achievable operational targets. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013.

"GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

Science.gov (United States)

Karame, P., Sr.; Dushimiyimana, V.

2016-12-01

" Championing GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health

Water, sanitation and hygiene infrastructure and quality in rural healthcare facilities in Rwanda.

Science.gov (United States)

Huttinger, Alexandra; Dreibelbis, Robert; Kayigamba, Felix; Ngabo, Fidel; Mfura, Leodomir; Merryweather, Brittney; Cardon, Amelie; Moe, Christine

2017-08-03

WHO and UNICEF have proposed an action plan to achieve universal water, sanitation and hygiene (WASH) coverage in healthcare facilities (HCFs) by 2030. The WASH targets and indicators for HCFs include: an improved water source on the premises accessible to all users, basic sanitation facilities, a hand washing facility with soap and water at all sanitation facilities and patient care areas. To establish viable targets for WASH in HCFs, investigation beyond 'access' is needed to address the state of WASH infrastructure and service provision. Patient and caregiver use of WASH services is largely unaddressed in previous studies despite being critical for infection control. The state of WASH services used by staff, patients and caregivers was assessed in 17 rural HCFs in Rwanda. Site selection was non-random and predicated upon piped water and power supply. Direct observation and semi-structured interviews assessed drinking water treatment, presence and condition of sanitation facilities, provision of soap and water, and WASH-related maintenance and record keeping. Samples were collected from water sources and treated drinking water containers and analyzed for total coliforms, E. coli, and chlorine residual. Drinking water treatment was reported at 15 of 17 sites. Three of 18 drinking water samples collected met the WHO guideline for free chlorine residual of >0.2 mg/l, 6 of 16 drinking water samples analyzed for total coliforms met the WHO guideline of hygienic condition and accessible to patients. Regular maintenance of WASH infrastructure consisted of cleaning; no HCF had on-site capacity for performing repairs. Quarterly evaluations of HCFs for Rwanda's Performance Based Financing system included WASH indicators. All HCFs met national policies for water access, but WHO guidelines for environmental standards including water quality were not fully satisfied. Access to WASH services at the HCFs differed between staff and patients and caregivers.

Parental health shocks and schooling: The impact of mutual health insurance in Rwanda.

Science.gov (United States)

Woode, Maame Esi

2017-01-01

The goal of this study was to look at the educational spill-over effects of health insurance on schooling with a focus on the Rwandan Community Based Health Insurance Programme, the Mutual Health Insurance scheme. Using a two-person general equilibrium overlapping generations model, this paper theoretically analyses the possible effect of health insurance on the relationship between parental health shocks and child schooling. Individuals choose whether or not they want to incur a medical cost by seeking care in order to reduce the effect of health shocks on their labour market availability and productivity. The theoretical results show that, health shocks negatively affect schooling irrespective of insurance status. However, if the health shock is severe (incapacitating) or sudden in nature, there is a discernible mitigating effect of health insurance on the negative impact of parental ill health on child schooling. The results are tested empirically using secondary data from the third Integrated Household Living Conditions Survey (EICV) for Rwanda, collected in 2011. A total of 2401 children between the ages of 13 and 18 are used for the analysis. This age group is selected due to the age of compulsory education in Rwanda. Based on average treatment effect on treated we find a statistically significant difference in attendance between children with MHI affiliated parents and those with uninsured parents of about 0.044. The negative effect of a father being severely ill is significant only for uninsured household. For the case of the mother, this effect is felt by female children with uninsured parents only when the illness is sudden. The observed effects are more pronounced for older children. While the father's ill health (sever or sudden) significantly and negatively affects their working hours, health insurance plays appears to increase their working hours. The effects of health insurance extend beyond health outcomes. Copyright © 2016 Elsevier Ltd. All rights

Phased implementation of spaced clinic visits for stable HIV-positive patients in Rwanda to support Treat All.

Science.gov (United States)

Nsanzimana, Sabin; Remera, Eric; Ribakare, Muhayimpundu; Burns, Tracy; Dludlu, Sibongile; Mills, Edward J; Condo, Jeanine; Bucher, Heiner C; Ford, Nathan

2017-07-21

In 2016, Rwanda implemented "Treat All," requiring the national HIV programme to increase antiretroviral (ART) treatment coverage to all people living with HIV. Approximately half of the 164,262 patients on ART have been on treatment for more than five years, and long-term retention of patients in care is an increasing concern. To address these challenges, the Ministry of Health has introduced a differentiated service delivery approach to reduce the frequency of clinical visits and medication dispensing for eligible patients. This article draws on key policy documents and the views of technical experts involved in policy development to describe the process of implementation of differentiated service delivery in Rwanda. Implementation of differentiated service delivery followed a phased approach to ensure that all steps are clearly defined and agreed by all partners. Key steps included: definition of scope, including defining which patients were eligible for transition to the new model; definition of the key model components; preparation for patient enrolment; considerations for special patient groups; engagement of implementing partners; securing political and financial support; forecasting drug supply; revision, dissemination and implementation of ART guidelines; and monitoring and evaluation. Based on the outcomes of the evaluation of the new service delivery model, the Ministry of Health will review and strategically reduce costs to the national HIV program and to the patient by exploring and implementing adjustments to the service delivery model.

Factors affecting length of hospital stay for people with spinal cord injuries at Kanombe military hospital, Rwanda

Directory of Open Access Journals (Sweden)

PB Bwanjugu

2012-12-01

Full Text Available In patients with spinal cord injuries increased length ofhospital stay is often as a result of secondary complications such as pressuresores, urinary tract infection and respiratory infection. An increased lengthof hospital stay was observed at Kanombe Military Hospital in Rwanda.The aim of this study was to determine specific factors affecting length ofhospital stay for individuals with spinal cord injuries at Kanombe MilitaryHospital in Rwanda. The records of 124 individuals with spinal cordinjuries who were discharged from the hospital between 1st January1996and 31st December 2007 were reviewed to collect data. Information collected and captured on a data gathering sheetincluded demographic data, information relating to the injury, occurrence of medical complications and length ofhospital stay. Linear regression analysis was computed in SPSS to determine factors affecting the length of stay.The necessary ethical considerations were adhered to during the implementation of the study. Current employmentstatus and the occurrence of pressure sores were significantly associated with the length of hospital stay (p=0.021 andp=0.000 respectively. A strong relationship was noted between pressure sores and length of stay (R= 0.703. There is aneed for all members of the rehabilitation team to devise and implement effective measures to prevent the developmentof pressure sores, in patients with spinal cord injuries in the study setting.

Using provider performance incentives to increase HIV testing and counseling services in Rwanda.

Science.gov (United States)

de Walque, Damien; Gertler, Paul J; Bautista-Arredondo, Sergio; Kwan, Ada; Vermeersch, Christel; de Dieu Bizimana, Jean; Binagwaho, Agnès; Condo, Jeanine

2015-03-01

Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient. Copyright © 2014. Published by Elsevier B.V.

Have coffee reforms and coffee supply chains affected farmers' income? The case of coffee growers in Rwanda

OpenAIRE

Murekezi, Abdoul Karim; Loveridge, Scott

2009-01-01

Low prices in the international coffee markets have worsened the economic well-being among coffee farmers. In the face of this situation, the Government of Rwanda has introduced coffee sector reforms that aimed to transform the sector in a way that targets the high quality market and moves away from the bulk coffee market. The high quality coffee market has shown consistent growth over time and exhibits price premiums in international market. If these high prices are passed on to farmers who ...

[Medical policies, state and religious missions in Rwanda (1920-1940). An authoritative design of colonial medicine?].

Science.gov (United States)

Cornet, Anne

2009-01-01

The Belgian health policy set up in mandated Rwanda after the First World War was mainly centred on some campaigns taking specifically yaws as a target. The struggle against this endemic disease (not fatal, but most disabling) was organized in a very systematic and authoritarian way. This article looks into two of those yaws campaigns, questions their runnings and alterations, and finally brings to light the intra-colonial tensions between the health services and the administration on the one hand, between the colonizers and the African populations on the other hand.

Effect of pentavalent rotavirus vaccine introduction on hospital admissions for diarrhoea and rotavirus in children in Rwanda: a time-series analysis.

Science.gov (United States)

Ngabo, Fidele; Tate, Jacqueline E; Gatera, Maurice; Rugambwa, Celse; Donnen, Philippe; Lepage, Philippe; Mwenda, Jason M; Binagwaho, Agnes; Parashar, Umesh D

2016-02-01

In May, 2012, Rwanda became the first low-income African country to introduce pentavalent rotavirus vaccine into its routine national immunisation programme. Although the potential health benefits of rotavirus vaccination are huge in low-income African countries that account for more than half the global deaths from rotavirus, concerns remain about the performance of oral rotavirus vaccines in these challenging settings. We conducted a time-series analysis to examine trends in admissions to hospital for non-bloody diarrhoea in children younger than 5 years in Rwanda between Jan 1, 2009, and Dec 31, 2014, using monthly discharge data from the Health Management Information System. Additionally, we reviewed the registries in the paediatric wards at six hospitals from 2009 to 2014 and abstracted the number of total admissions and admissions for diarrhoea in children younger than 5 years by admission month and age group. We studied trends in admissions specific to rotavirus at one hospital that had undertaken active rotavirus surveillance from 2011 to 2014. We assessed changes in rotavirus epidemiology by use of data from eight active surveillance hospitals. Compared with the 2009-11 prevaccine baseline, hospital admissions for non-bloody diarrhoea captured by the Health Management Information System fell by 17-29% from a pre-vaccine median of 4051 to 2881 in 2013 and 3371 in 2014, admissions for acute gastroenteritis captured in paediatric ward registries decreased by 48-49%, and admissions specific to rotavirus captured by active surveillance fell by 61-70%. The greatest effect was recorded in children age-eligible to be vaccinated, but we noted a decrease in the proportion of children with diarrhoea testing positive for rotavirus in almost every age group. The number of admissions to hospital for diarrhoea and rotavirus in Rwanda fell substantially after rotavirus vaccine implementation, including among older children age-ineligible for vaccination, suggesting

A new species of Dystacta Saussure, 1871 from Nyungwe National Park, Rwanda (Insecta, Mantodea, Dystactinae).

Science.gov (United States)

Tedrow, Riley; Nathan, Kabanguka; Richard, Nasasira; Svenson, Gavin J

2014-01-01

A recent targeted entomological survey in the Republic of Rwanda has produced two conspecific male and female specimens of an undescribed species of praying mantis (Mantodea). The specimens were collected in Nyungwe National Park in May of 2013. The species is closest morphologically to Dystacta alticeps (Schaum, 1853). Therefore, a new species is described, Dystacta tigrifrutex sp. n., along with the first instar nymphs and ootheca. In addition, the previously monotypic genus Dystacta Saussure, 1871 is re-described to provide a broader definition of the genus group. Habitus images, measurement data, a key to species, natural history information, and locality data are provided.

Supporting young entrepreneurs | CRDI - Centre de recherches ...

International Development Research Centre (IDRC) Digital Library (Canada)

13 mars 2015. Image. GRAHAM HOLLIDAY / NVTC. A conference held in Kigali, Rwanda, recommended establishing technical schools in every district to ... To capture youth perspectives, research looked at the types of business activities they engage in, how the experiences of young men and women differ, how they ...

Poultry production and constraints in Eastern Province of Rwanda: case study of Rukomo sector, Nyagatare district.

Science.gov (United States)

Mazimpaka, Eugene; Tukei, Micheal; Shyaka, Anselme; Gatari, Eugene N

2018-04-01

A study was conducted in Rukomo sector, Nyagatare district, to determine the status of poultry production. A structured questionnaire was used to collect data from 100 poultry farmers randomly as 20 farmers from each of the five cells. Data were analyzed using SPSS version 16 and presented in chart and tables. The majority of the farmers (84%) reared their poultry in free range system while 10% practiced semi-intensive and only 6% did intensive production. Only 12% of the respondents kept exotic poultry breeds. The breeding stock were mostly obtained from local markets (63%) and the average flock size was about 1-10 birds per homestead (70%). The confinement of poultry at night was either in the main domestic house (33%), in kitchen (32%), or in separate poultry house (35%). Flock records were rare and kept by only 9% of respondents. Poultry products were reportedly at high demand by 87% of respondents and 89% farmers reported profit from their enterprises. Lack of veterinary and financial assistance was reported by 72% of respondents. Newcastle disease (57%) was the main health constraint followed by ectoparasites and internal worms. Many farmers (50%) were in dire need of veterinary assistance and financial support to improve their poultry enterprises. Poor management practices were reported to be one of the crucial factors leading to poor production. Lack of quality feeds (38%) and feeding of poultry, credit (20%), and poor market accessibility (19%) were the main challenges reported.

Traumatic episodes and mental health effects in young men and women in Rwanda, 17 years after the genocide.

Science.gov (United States)

Rugema, Lawrence; Mogren, Ingrid; Ntaganira, Joseph; Krantz, Gunilla

2015-06-24

To investigate mental health effects associated with exposure to trauma in Rwanda during the 1994 genocide period, and over the lifetime, in Rwandan men and women aged 20-35 years. This was a cross-sectional population-based study conducted in the southern province of Rwanda. Data was collected during December 2011 to January 2012. A total population of 917 individuals were included, 440 (48%) men and 477 (52%) women aged 20-35 years. Number of households for inclusion in each village was selected proportional to the total number of households in each selected village. The response rate was 99.8%. Face-to-face interviewing was done by experienced and trained clinical psychologists, following a structured questionnaire. Women were slightly less exposed during the genocide period (women 35.4% and men 37.5%; p=0.537), but more women than men were exposed to traumatic episodes over their lifetime (women 83.6%, n=399; men 73.4%, n=323; pwomen as in men. Traumatic episodes experienced in the genocide period severely affected men's current mental health status with relative risk (RR) 3.02 (95% CI 1.59 to 5.37) for MDE past and with RR 2.15 (95% CI 1.21 to 3.64) for suicidality. Women's mental health was also affected by trauma experienced in the genocide period but to an even higher extent, by similar trauma experienced in the lifetime with RR 1.91 (95% CI 1.03 to 3.22) for suicidality and RR 1.90 (95% CI 1.34 to 2.42) for generalised anxiety disorder, taking spousal physical/sexual violence into consideration. Depression, post-traumatic stress disorder, anxiety and suicidal attempts are prevalent in Rwanda, with rates twice as high in women compared with men. For women, exposure to physical and sexual abuse was independently associated with all these disorders. Early detection of gender-based violence through homes and community interventions is important. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

"Championing GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

Science.gov (United States)

Karame, P., Sr.

2016-12-01

"GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health sector

A controlled study of funding for human immunodeficiency virus/acquired immunodeficiency syndrome as resource capacity building in the health system in Rwanda.

Science.gov (United States)

Shepard, Donald S; Zeng, Wu; Amico, Peter; Rwiyereka, Angelique K; Avila-Figueroa, Carlos

2012-05-01

Because human inmmunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) receives more donor funding globally than that for all other diseases combined, some critics allege this support undermines general health care. This empirical study evaluates the impact of HIV/AIDS funding on the primary health care system in Rwanda. Using a quasi-experimental design, we randomly selected 25 rural health centers (HCs) that started comprehensive HIV/AIDS services from 2002 through 2006 as the intervention group. Matched HCs with no HIV/AIDS services formed the control group. The analysis compared growth in inputs and services between intervention and control HCs with a difference-in-difference analysis in a random-effects model. Intervention HCs performed better than control HCs in most services (seven of nine), although only one of these improvements (Bacille Calmette-Guérin vaccination) reached or approached statistical significance. In conclusion, this six-year controlled study found no adverse effects of the expansion of HIV/AIDS services on non-HIV services among rural health centers in Rwanda.

A decade later, how much of Rwanda's musculoskeletal impairment is caused by the war in 1994 and by related violence?

Directory of Open Access Journals (Sweden)

Hannah Kuper

Full Text Available BACKGROUND: In 1994 there was a horrific genocide in Rwanda following years of tension, resulting in the murder of at least 800,000 people. Although many people were injured in addition to those killed, no attempt has been made to assess the lasting burden of physical injuries related to these events. The aim of this study was to estimate the current burden of musculoskeletal impairment (MSI attributable to the 1994 war and related violence. METHODOLOGY/PRINCIPAL FINDINGS: A national cross-sectional survey of MSI was conducted in Rwanda. 105 clusters of 80 people were selected through probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Enumerated people answered a seven-question screening test to assess whether they might have an MSI. Those who were classed as potential cases in the screening test were examined and interviewed by a physiotherapist, using a standard protocol that recorded the site, nature, cause, and severity of the MSI. People with MSI due to trauma were asked whether this trauma occurred during the 1990-1994 war or during the episodes that preceded or followed this war. Out of 8,368 people enumerated, 6,757 were available for screening and examination (80.8%. 352 people were diagnosed with an MSI (prevalence=5.2%, 95% CI=4.5-5.9%. 106 cases of MSI (30.6% were classified as resulting from trauma, based on self-report and the physiotherapist's assessment. Of these, 14 people (13.2% reported that their trauma-related MSI occurred during the 1990-1994 war, and a further 7 (6.6% that their trauma-related MSI occurred during the violent episodes that preceded and followed the war, giving an overall prevalence of trauma-related MSI related to the 1990-1994 war of 0.3% (95% CI=0.2-0.4%. CONCLUSIONS/SIGNIFICANCE: A decade on, the overall prevalence of MSI was relatively high in Rwanda but few cases appeared to be the result of the 1994 war or related violence.

Data for Program Management: An Accuracy Assessment of Data Collected in Household Registers by Community Health Workers in Southern Kayonza, Rwanda.

Science.gov (United States)

Mitsunaga, Tisha; Hedt-Gauthier, Bethany L; Ngizwenayo, Elias; Farmer, Didi Bertrand; Gaju, Erick; Drobac, Peter; Basinga, Paulin; Hirschhorn, Lisa; Rich, Michael L; Winch, Peter J; Ngabo, Fidele; Mugeni, Cathy

2015-08-01

Community health workers (CHWs) collect data for routine services, surveys and research in their communities. However, quality of these data is largely unknown. Utilizing poor quality data can result in inefficient resource use, misinformation about system gaps, and poor program management and effectiveness. This study aims to measure CHW data accuracy, defined as agreement between household registers compared to household member interview and client records in one district in Eastern province, Rwanda. We used cluster-lot quality assurance sampling to randomly sample six CHWs per cell and six households per CHW. We classified cells as having 'poor' or 'good' accuracy for household registers for five indicators, calculating point estimates of percent of households with accurate data by health center. We evaluated 204 CHW registers and 1,224 households for accuracy across 34 cells in southern Kayonza. Point estimates across health centers ranged from 79 to 100% for individual indicators and 61 to 72% for the composite indicator. Recording error appeared random for all but the widely under-reported number of women on modern family planning method. Overall, accuracy was largely 'good' across cells, with varying results by indicator. Program managers should identify optimum thresholds for 'good' data quality and interventions to reach them according to data use. Decreasing variability and improving quality will facilitate potential of these routinely-collected data to be more meaningful for community health program management. We encourage further studies assessing CHW data quality and the impact training, supervision and other strategies have on improving it.

District heating in Switzerland

International Nuclear Information System (INIS)

Herzog, F.

1991-01-01

District heating has been used in Switzerland for more than 50 years. Its share of the heat market is less than 3% today. An analysis of the use of district heating in various European countries shows that a high share of district heating in the heat market is always dependent on ideal conditions for its use. Market prospects and possible future developments in the use of district heating in Switzerland are described in this paper. The main Swiss producers and distributors of district heating are members of the Association of District Heating Producers and Distributors. This association supports the installation of district heating facilities where ecological, energetical and economic aspects indicate that district heating would be a good solution. (author) 2 tabs., 6 refs

Ethics in Community-Based Research with Vulnerable Children: Perspectives from Rwanda.

Directory of Open Access Journals (Sweden)

Theresa Betancourt

Full Text Available A "risk of harm" protocol to identify youth in need of immediate emergency assistance in a study on mental health and HIV in Rwanda among 680 youth ages 10-17 is described. Cases are presented that describe the experience in using this protocol to ensure safety of participants, with ethical and logistical challenges considered. Among the population of the study, 3.2% were deemed "risk of harm." The most prevalent presenting problem was non-fatal suicidal behavior (91% of risk of harm cases, with 36% having a history of a reported previous attempt. Challenges included: acute food insecurity/significant poverty; lack of support/adequate supervision from family members; family violence; alcohol abuse; and HIV-related stigma. Development of a "risk of harm" protocol and collaboration between study staff, community leadership, health authorities, and health workers are critical to ensuring participants' safety in research among vulnerable populations.

Could the Outcome of the Genocide in Rwanda be Different with an Operational Planning Cell in the United Nations?

Science.gov (United States)

2012-06-08

South West Africa. The German army in Rwanda was less than 2000 troops with a majority of African soldiers, with three canons , and twelve machine guns...they were no match for the Belgian army that included 7,700 troops, fifty-two artillery canons , and fifty-two machine guns. The Belgian colonials...best. The government must work with mainly with them.”11 Belgium developed the Rwandans’ population to be individualist, by introducing taxation

Supporting young entrepreneurs | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

2015-03-13

Mar 13, 2015 ... A conference held in Kigali, Rwanda, recommended establishing technical schools in every district to address the youth unemployment challenge. INSIGHT | INCLUSIVE GROWTH. ​New entrants to the labour force are often “the last hired, first fired.” As an alternative, many young people launch their own ...

ISSN 2073-9990 East Cent. Afr. J. s East Cent. Afr. J. s

African Journals Online (AJOL)

dell

The Prevalence of HIV Infection among Pregnant Women at Kabutare District Hospital -. Rwanda. R. Kabera 1,L. ... with the risks of worsening the current mother immunodepressed state due to pregnancy and to the infection. During .... in HIV-1 and HIV-2 prevalence and risk factors in pregnant women in Harare, Zimbabwe.

Farmers' breeding practices and traits of economic importance for indigenous chicken in RWANDA.

Science.gov (United States)

Mahoro, J; Muasya, T K; Mbuza, F; Mbuthia, J; Kahi, A K

2018-01-01

Data on breeding practices and traits of economic importance for the indigenous chicken (IC) were collected through personal interviews using structured questionnaires and direct observations of chicken management practices. The study was conducted from November 2015 to January 2016 in Rwamagana, Rulindo, Ruhango, Kicukiro and Muhanga districts of Rwanda. Data were collected and analysed through computation of indices, which represented a weighted average of all rankings of a specific trait. Spearman's non-parametric rank correlation was calculated for ranking of traits of economic importance to indicate the directional effects. The results on chicken ecotypes and their attributes showed that prolificacy, mature weight, disease tolerance, egg number and heat tolerance were highly preferred. The dwarf ecotype was most abundantly reared (38.84%) and considered to be significantly smaller and to have poorer growth rate, but to have better prolificacy than other indigenous chicken ecotypes. Selection of breeding cock and hen was based on disease tolerance, body weight at sexual maturity, body size and growth rate. In addition, for hen, mothering ability and egg fertility (Fer) were considered. Indices for the traits perceived by farmers as of primary economic importance were egg yield (0.093), disease tolerance (0.091), high growth rate (0.089), prolificacy (0.088), high body weight (0.087) and egg fertility (0.083). The most important traits considered by the marketers were body weight (BW), disease tolerance (Dtol), plumage colour (Pcol), egg yolk colour (EYC), meat quality (MQ), growth rate (GR) and egg yield (EY) whereas for consumers, meat quality, egg yolk colour, egg yield, body weight and growth rate were considered. Among traits perceived as important by farmers, a positive and significant correlation was found between BW and GR and Fer. Correlation was moderate for BW and prolificacy, drought tolerance (Drtol), Dtol and EYC. BW was negatively correlated with

Intégration spatiale des marchés ruraux et urbains de la banane à cuire dans le Sud-Est de la Province du Sud du Rwanda

Directory of Open Access Journals (Sweden)

Niyitanga, F.

2016-01-01

Full Text Available Integration of Rural and Urban Cooking Banana Markets in the South-East of Rwanda Southern Province. This study consists of the analysis of spatial integration of rural and urban markets of cooking banana iin the South-East of Southern province of Rwanda. It uses time series of 2001-2006 period resulting from a survey on agricultural products commercialization in rural and urban markets. The analysis used the methods of co-integration and error correction model (ECM. The results of the study show that there is, in general, weak price transmission between rural and urban markets of cooking banana. Hence rural and urban markets of cooking banana are weakly integrated. The weak integration of markets means that there exist unexploited opportunities of arbitration that would have led to the creation of "geographical monopolies" because, on each rural market, there are traders who collect the cooking banana to sell it only on the same market. This weak spatial integration of rural and urban markets can result from poor commercial infrastructures (roads and communication infrastructures and the lack of information on market (supply, demand and price. It would be necessary to develop and improve the commercial infrastructures for improving the spatial integration of cooking banana rural and urban markets in the South-East of the Southern province of Rwanda. Market integration can in turn lead to the specialization of producers of cooking banana and to the increase of cooking banana production.

The doing and undoing of male household decision-making and economic authority in Rwanda and its implications for gender transformative programming.

Science.gov (United States)

Stern, Erin; Heise, Lori; McLean, Lyndsay

2017-12-01

This paper explores two key norms that underpin intimate partner violence in Rwanda: men's roles as economic providers and decision-making authorities in the household. It describes the political, legal and socio-economic factors affecting these norms and how they create opportunities and barriers to 'undoing' restrictive gender norms. Findings are drawn from an evaluation of Inadshyikirwa, an intimate partner violence prevention programme operating in Rwanda. Across three intervention sectors, 24 focus groups were conducted with unmarried and married men and women residing in intervention communities. Thirty interviews with couples and nine interviews with opinion leaders were conducted before they completed programme training designed to shift gender norms underlying intimate partner violence. The data indicate a strong awareness of and accountability to Rwandan laws and policies supporting women's economic empowerment and decision-making, alongside persisting traditional notions of men as household heads and primary breadwinners. Transgression of these norms could be accommodated in some circumstances, especially those involving economic necessity. The data also identified increasing recognition of the value of a more equitable partnership model. Findings highlight the importance of carefully assessing cracks in the existing gender order that can be exploited to support gender equality and non-violence.

Determinants of Mortality and Loss to Follow-Up among Adults Enrolled in HIV Care Services in Rwanda

Science.gov (United States)

Wang, Chunhui; Lahuerta, Maria; Nuwagaba-Biribonwoha, Harriet; Tayebwa, Edwin; Ingabire, Eugenie; Ingabire, Pacifique; Sahabo, Ruben; Twyman, Peter; Abrams, Elaine J.

2014-01-01

Background Antiretroviral therapy (ART) improves morbidity and mortality in patients with HIV, however high rates of loss to follow-up (LTF) and mortality have been documented in HIV care and treatment programs. Methods We analyzed routinely-collected data on HIV-infected patients ≥15 years enrolled at 41 healthcare facilities in Rwanda from 2005 to 2010. LTF was defined as not attending clinic in the last 12 months for pre-ART patients and 6 months for ART patients. For the pre-ART period, sub-distribution hazards models were constructed to estimate LTF and death to account for competing risks. Kaplan-Meier (KM) and Cox proportional hazards models were used for patients on ART. Results 31,033 ART-naïve adults were included, 64% were female and 75% were WHO stage I or II at enrollment. 17,569 (56%) patients initiated ART. Pre-ART competing risk estimates of LTF at 2 years was 11.2% (95%CI, 10.9–11.6%) and 2.9% for death (95%CI 2.7–3.1%). Among pre-ART patients, male gender was associated with higher LTF (adjusted sub-hazard ratio (aSHR) 1.3, 95%CI 1.1–1.5) and death (aSHR 1.7, 95%CI 1.4–2.1). Low CD4 count (CD4Rwanda but greater efforts are needed to retain patients in care prior to ART initiation, particularly among those who are healthy at enrollment. PMID:24454931

Rainfall variation and child health: effect of rainfall on diarrhea among under 5 children in Rwanda, 2010.

Science.gov (United States)

Mukabutera, Assumpta; Thomson, Dana; Murray, Megan; Basinga, Paulin; Nyirazinyoye, Laetitia; Atwood, Sidney; Savage, Kevin P; Ngirimana, Aimable; Hedt-Gauthier, Bethany L

2016-08-05

Diarrhea among children under 5 years of age has long been a major public health concern. Previous studies have suggested an association between rainfall and diarrhea. Here, we examined the association between Rwandan rainfall patterns and childhood diarrhea and the impact of household sanitation variables on this relationship. We derived a series of rain-related variables in Rwanda based on daily rainfall measurements and hydrological models built from daily precipitation measurements collected between 2009 and 2011. Using these data and the 2010 Rwanda Demographic and Health Survey database, we measured the association between total monthly rainfall, monthly rainfall intensity, runoff water and anomalous rainfall and the occurrence of diarrhea in children under 5 years of age. Among the 8601 children under 5 years of age included in the survey, 13.2 % reported having diarrhea within the 2 weeks prior to the survey. We found that higher levels of runoff were protective against diarrhea compared to low levels among children who lived in households with unimproved toilet facilities (OR = 0.54, 95 % CI: [0.34, 0.87] for moderate runoff and OR = 0.50, 95 % CI: [0.29, 0.86] for high runoff) but had no impact among children in household with improved toilets. Our finding that children in households with unimproved toilets were less likely to report diarrhea during periods of high runoff highlights the vulnerabilities of those living without adequate sanitation to the negative health impacts of environmental events.

The impact of reducing financial barriers on utilisation of a primary health care facility in Rwanda

Science.gov (United States)

Dhillon, Ranu S.; Bonds, Matthew H.; Fraden, Max; Ndahiro, Donald; Ruxin, Josh

2011-01-01

This study investigates the impact of subsidising community-based health insurance (mutuelle) enrolment, removing point-of-service co-payments, and improving service delivery on health facility utilisation rates in Mayange, a sector of rural Rwanda of approximately 25,000 people divided among five ‘imidugudu’ or small villages. While comprehensive service upgrades were introduced in the Mayange Health Centre between April 2006 and February 2007, utilisation rates remained similar to comparison sites. Between February 2007 and April 2007, subsidies for mutuelle enrolment established virtually 100% coverage. Immediately after co-payments were eliminated in February 2007, patient visits levelled at a rate triple the previous value. Regression analyses using data from Mayange and two comparison sites indicate that removing financial barriers resulted in about 0.6 additional annual visits for curative care per capita. Although based on a single local pilot, these findings suggest that in order to achieve improved health outcomes, key short-term objectives include improved service delivery and reduced financial barriers. Based on this pilot, higher utilisation rates may be affected if broader swaths of the population are enrolled in mutuelle and co-payments are eliminated. Health leaders in Rwanda should consider further studies to determine if the impact of eliminating co-payments and increasing subsidies for mutuelle enrolment as seen in Mayange holds at greater levels of scale. Broader studies to better elucidate the impact of enrolment subsidies and co-payment subsidies on utilisation, health outcomes, and costs would also provide policy insights. PMID:21732708

Punishing Genocide: A Comparative Empirical Analysis of Sentencing Laws and Practices at the International Criminal Tribunal for Rwanda (ICTR, Rwandan Domestic Courts, and Gacaca Courts

Directory of Open Access Journals (Sweden)

Barbora Hola

2016-12-01

Full Text Available This article compares sentencing of those convicted of participation in the 1994 genocide in Rwanda. With over one million people facing trial, Rwanda constitutes the world’s most comprehensive case of criminal accountability after genocide and presents an important case study of punishing genocide. Criminal courts at three different levels— international, domestic, and local—sought justice in the aftermath of the violence. In order to compare punishment at each level, we analyze an unprecedented database of sentences given by the ICTR, the Rwandan domestic courts, and Rwanda’s Gacaca courts. The analysis demonstrates that sentencing varied across the three levels—ranging from limited time in prison to death sentences. We likewise find that sentencing at the domestic courts appears to have been comparatively more serious than sentencing at the ICTR and at the Gacaca courts, which calls into question consistency of sentences across levels of justice and should be explored in future research.

Women are considerably more exposed to intimate partner violence than men in Rwanda: results from a population-based, cross-sectional study.

Science.gov (United States)

Umubyeyi, Aline; Mogren, Ingrid; Ntaganira, Joseph; Krantz, Gunilla

2014-08-26

Intimate partner violence (IPV) against women is an important, yet often neglected public health issue. The existence of gender norms imbalance expressed by men's and women's attitudes in relation to power and decision-making in intimate relationships may influence the magnitude of IPV. The aim of this study was to investigate the prevalence and potential risk factors of physical, sexual and psychological IPV in young men and women in Rwanda. This population-based, cross-sectional study included a representative sample of men and women from the Southern Province of Rwanda. Face-to-face interviews were performed using the World Health Organization (WHO) questionnaire for violence exposure to estimate past year and earlier in life IPV occurrence. Risk factor patterns were analyzed by use of bi- and multivariate logistic regression. Women were, to a considerably higher extent, exposed to physical, sexual and psychological IPV than men. Of the women, 18.8% (n = 78) reported physical abuse in the past year, compared to 4.3% (n = 18) of men. The corresponding figures for women and men for sexual abuse were 17.4% (n = 71) and 1.5% (n = 6), respectively, and for psychological abuse, the corresponding figures were 21.4% (n = 92) and 7.3% (n = 32). Findings illustrate that violence against women was recurrent, as the highest frequency (>3 times) dominated in women for the various acts of all forms of violence. Identified risk factors for women's exposure to physical violence were being low educated, having poor social support, being poor and having many children. For men exposed to physical violence, no statistically significant risk factor was identified. In this setting, IPV exposure was more common in women than men in the Southern Province of Rwanda. Promotion of gender equality at the individual level is needed to make a positive difference in a relatively short term perspective. Men's lower reporting of IPV confirms women's subordinate position

Evaluation of Membrane Ultrafiltration and Residual Chlorination as a Decentralized Water Treatment Strategy for Ten Rural Healthcare Facilities in Rwanda

Directory of Open Access Journals (Sweden)

Alexandra Huttinger

2015-10-01

Full Text Available There is a critical need for safe water in healthcare facilities (HCF in low-income countries. HCF rely on water supplies that may require additional on-site treatment, and need sustainable technologies that can deliver sufficient quantities of water. Water treatment systems (WTS that utilize ultrafiltration membranes for water treatment can be a useful technology in low-income countries, but studies have not systematically examined the feasibility of this technology in low-income settings. We monitored 22 months of operation of 10 WTS, including pre-filtration, membrane ultrafiltration, and chlorine residual disinfection that were donated to and operated by rural HCF in Rwanda. The systems were fully operational for 74% of the observation period. The most frequent reasons for interruption were water shortage (8% and failure of the chlorination mechanism (7%. When systems were operational, 98% of water samples collected from the HCF taps met World Health Organization (WHO guidelines for microbiological water quality. Water quality deteriorated during treatment interruptions and when water was stored in containers. Sustained performance of the systems depended primarily on organizational factors: the ability of the HCF technician to perform routine servicing and repairs, and environmental factors: water and power availability and procurement of materials, including chlorine and replacement parts in Rwanda.

Empowerment Zones and Enterprise Districts - MDC_CommunityDevelopmentDistrict

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Community Development Districts (CDDs) are special taxing districts or local units of special-purpose government. A CDD may charge separate non-ad valorem special...

Ten-year clinical experience of humanitarian cardiothoracic surgery in Rwanda: Building a platform for ultimate sustainability in a resource-limited setting.

Science.gov (United States)

Swain, JaBaris D; Sinnott, Colleen; Breakey, Suellen; Hasson Charles, Rian; Mody, Gita; Nyirimanzi, Napthal; Patton-Bolman, Ceeya; Come, Patricia; Ganza, Gapira; Rusingiza, Emmanuel; Ruhamya, Nathan; Mucumbitsi, Joseph; Borges, Jorge; Zammert, Martin; Muehlschlegel, Jochen D; Oakes, Robert; Leavitt, Bruce; Bolman, R Morton

2018-06-01

Despite its near complete eradication in resource-rich countries, rheumatic heart disease remains the most common acquired cardiovascular disease in sub-Saharan Africa. With a ratio of physicians/population of 1 per 10,500, including only 4 cardiologists for a population of 11.4 million, Rwanda represents a resource-limited setting lacking the local capacity to detect and treat early cases of strep throat and perform lifesaving operations for advanced rheumatic heart disease. Humanitarian surgical outreach in this region can improve the delivery of cardiovascular care by providing sustainability through mentorship, medical expertise, training, and knowledge transfer, and ultimately the creation of a cardiac center. We describe the experience of consecutive annual visits to Rwanda since 2008 and report the outcomes of a collaborative approach to enable sustainable cardiac surgery in the region. The Ferrans and Powers Quality of Life Index tool's Cardiac Version (http://www.uic.edu/orgs/qli/) was administered to assess the postoperative quality of life. Ten visits have been completed, performing 149 open procedures, including 200 valve implantations, New York Heart Association class III or IV, with 4.7% 30-day mortality. All procedures were performed with the participation of local Rwandan personnel, expatriate physicians, nurses, residents, and support staff. Early complications included cerebrovascular accident (n = 4), hemorrhage requiring reoperation (n = 6), and death (n = 7). Quality of life was assessed to further understand challenges encountered after cardiac surgery in this resource-limited setting. Four major domains were considered: health and functioning, social and economic, psychologic/spiritual, and family. The mean total quality of life index was 20.79 ± 4.07 on a scale from 0 to 30, for which higher scores indicated higher quality of life. Women had significantly lower "social and economic" subscores (16.81 ± 4.17) than men (18.64 ± 4

District nurse training

OpenAIRE

Elliott, Arnold; Freeling, Paul; Owen, John

1980-01-01

Training for district nursing is being reviewed. By 1981 district nurses will have a new administrative structure, a new curriculum, and a new examination. Training for nursing, like that for general practice, is to become mandatory. The history of the development of district nurse training is briefly described.

Assessing Landslide Characteristics and Developing a Landslide Potential Hazard Map in Rwanda and Uganda Using NASA Earth Observations

Science.gov (United States)

Sinclair, L.; Conner, P.; le Roux, J.; Finley, T.

2015-12-01

The International Emergency Disasters Database indicates that a total of 482 people have been killed and another 27,530 have been affected by landslides in Rwanda and Uganda, although the actual numbers are thought to be much higher. Data for individual countries are poorly tracked, but hotspots for devastating landslides occur throughout Rwanda and Uganda due to the local topography and soil type, intense rainfall events, and deforestation. In spite of this, there has been little research in this region that utilizes satellite imagery to estimate areas susceptible to landslides. This project utilized Landsat 8 Operational Land Imager (OLI) data and Google Earth to identify landslides that occurred within the study area. These landslides were then added to SERVIR's Global Landslide Catalog (GLC). Next, Landsat 8 OLI, the Tropical Rainfall Measuring Mission (TRMM), the Global Precipitation Measurement (GPM), and Shuttle Radar Topography Mission Version 2 (SRTM V2) data were used to create a Landslide Susceptibility Map. This was combined with population data from the Socioeconomic Data and Applications Center (SEDAC) to create a Landslide Hazard map. A preliminary assessment of the relative performance of GPM and TRMM in identifying landslide conditions was also performed. The additions to the GLC, the Landslide Susceptibility Map, the Landslide Hazard Map, and the preliminary assessment of satellite rainfall performance will be used by SERVIR and the Regional Centre for Mapping of Resources for Development (RCMRD) for disaster risk management, land use planning, and determining landslide conditions and moisture thresholds.

Rainfall variation and child health: effect of rainfall on diarrhea among under 5 children in Rwanda, 2010

Directory of Open Access Journals (Sweden)

Assumpta Mukabutera

2016-08-01

Full Text Available Abstract Background Diarrhea among children under 5 years of age has long been a major public health concern. Previous studies have suggested an association between rainfall and diarrhea. Here, we examined the association between Rwandan rainfall patterns and childhood diarrhea and the impact of household sanitation variables on this relationship. Methods We derived a series of rain-related variables in Rwanda based on daily rainfall measurements and hydrological models built from daily precipitation measurements collected between 2009 and 2011. Using these data and the 2010 Rwanda Demographic and Health Survey database, we measured the association between total monthly rainfall, monthly rainfall intensity, runoff water and anomalous rainfall and the occurrence of diarrhea in children under 5 years of age. Results Among the 8601 children under 5 years of age included in the survey, 13.2 % reported having diarrhea within the 2 weeks prior to the survey. We found that higher levels of runoff were protective against diarrhea compared to low levels among children who lived in households with unimproved toilet facilities (OR = 0.54, 95 % CI: [0.34, 0.87] for moderate runoff and OR = 0.50, 95 % CI: [0.29, 0.86] for high runoff but had no impact among children in household with improved toilets. Conclusion Our finding that children in households with unimproved toilets were less likely to report diarrhea during periods of high runoff highlights the vulnerabilities of those living without adequate sanitation to the negative health impacts of environmental events.

Deriving causes of child mortality by re–analyzing national verbal autopsy data applying a standardized computer algorithm in Uganda, Rwanda and Ghana

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Li Liu

2015-06-01

Full Text Available Background To accelerate progress toward the Millennium Development Goal 4, reliable information on causes of child mortality is critical. With more national verbal autopsy (VA studies becoming available, how to improve consistency of national VA derived child causes of death should be considered for the purpose of global comparison. We aimed to adapt a standardized computer algorithm to re–analyze national child VA studies conducted in Uganda, Rwanda and Ghana recently, and compare our results with those derived from physician review to explore issues surrounding the application of the standardized algorithm in place of physician review. Methods and Findings We adapted the standardized computer algorithm considering the disease profile in Uganda, Rwanda and Ghana. We then derived cause–specific mortality fractions applying the adapted algorithm and compared the results with those ascertained by physician review by examining the individual– and population–level agreement. Our results showed that the leading causes of child mortality in Uganda, Rwanda and Ghana were pneumonia (16.5–21.1% and malaria (16.8–25.6% among children below five years and intrapartum–related complications (6.4–10.7% and preterm birth complications (4.5–6.3% among neonates. The individual level agreement was poor to substantial across causes (kappa statistics: –0.03 to 0.83, with moderate to substantial agreement observed for injury, congenital malformation, preterm birth complications, malaria and measles. At the population level, despite fairly different cause–specific mortality fractions, the ranking of the leading causes was largely similar. Conclusions The standardized computer algorithm produced internally consistent distribution of causes of child mortality. The results were also qualitatively comparable to those based on physician review from the perspective of public health policy. The standardized computer algorithm has the advantage of

Production algale et consommation par le Tilapia, Oreochromis niloticus L., au Lac Muhazi (Rwanda. Résumé de thèse de doctorat

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Mukankomeje, R.

1992-01-01

Full Text Available Algal production and consumption by the Tilapia Oreochromis niloticus L., in Lake Muhazi (Rwanda. The article describes shortly the objectives of a Food Early Warning System (FEWS project, as well as its organisation. The specifie case of Somalia, where the project had to evolve in increasingly difficult situations, and the solutions used so as to preserve the output, are described.

Fertility and HIV following universal access to ART in Rwanda: a cross-sectional analysis of Demographic and Health Survey data

OpenAIRE

Remera, Eric; Boer, Kimberly; Umuhoza, Stella M.; Hedt-Gauthier, Bethany L.; Thomson, Dana R.; Ndimubanzi, Patrick; Kayirangwa, Eugenie; Mutsinzi, Salomon; Bayingana, Alice; Mugwaneza, Placidie; Koama, Jean Baptiste T.

2017-01-01

Background: HIV infection is linked to decreased fertility and fertility desires in sub-Saharan Africa due to biological and social factors. We investigate the relationship between HIV infection and fertility or fertility desires in the context of universal access to antiretroviral therapy introduced in 2004 in Rwanda. Methods: We used data from 3532 and 4527 women aged 20–49 from the 2005 and 2010 Rwandan Demographic and Health Surveys (RDHS), respectively. The RDHSs included blood-tests for...

7 CFR 917.14 - District.

Science.gov (United States)

2010-01-01

... District. (g) Contra Costa District includes and consists of Contra Costa County. (h) Santa Clara District... Ventura County. (l) Stockton District includes and consists of San Joaquin County, Amador County...

Legislative Districts, Four layers - One State Assembly district, one State Senate district, one US House of Rep district, and one US Senate district showing the locations in the County of Polk, WI., Published in 2007, 1:24000 (1in=2000ft) scale, Polk County Government.

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Legislative Districts dataset current as of 2007. Four layers - One State Assembly district, one State Senate district, one US House of Rep district, and one US...

Focused assessment with sonography for HIV-associated tuberculosis (FASH case series from a Rwandan district hospital

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Gabin Mbanjumucyo

2016-12-01

Discussion: This case series demonstrates the additional clinical information obtained. It describes how management was changed using POCUS and the FASH in a resource-limited setting in Rwanda and calls for further FASH protocol validation studies.

State and district policy influences on district-wide elementary and middle school physical education practices.

Science.gov (United States)

Chriqui, Jamie F; Eyler, Amy; Carnoske, Cheryl; Slater, Sandy

2013-01-01

To examine the influence of state laws and district policies on district-wide elementary school and middle school practices related to physical education (PE) time and the percentage of moderate-to-vigorous physical activity (MVPA) time during PE. Multivariate, cross-sectional analysis of state laws, district wellness and PE policies, and district PE practices for school year 2010-2011 controlling for district-level urbanicity, region, size, race/ethnicity of students, and socioeconomic status and clustered on state. One hundred ninety-five public school districts located in 42 states. District-level PE coordinators for the included districts who responded to an online survey. Minutes and days of PE per week and percent time spent in MVPA during PE time. District PE coordinators reported significantly less PE time than national standards-82.9 and 189.6 minutes at the elementary school and middle school levels, respectively. Physical education was provided an average of 2.5 and 3.7 days per week, respectively; and the percentage of MVPA time in PE was 64.4% and 65.7%, respectively. At the elementary school level, districts in either states with laws governing PE time or in a state and district with a law/policy reported significantly more days of PE (0.63 and 0.67 additional days, respectively), and districts in states with PE time laws reported 18 more minutes of PE per week. At the middle school level, state laws were associated with 0.73 more days of PE per week. Neither state laws nor district policies were positively associated with percent MVPA time in PE. State laws and district policies can influence district-level PE practices-particularly those governing the frequency and duration of PE-although opportunities exist to strengthen PE-related laws, policies, and practices.

Water, sanitation, and hygiene in schools: Status and implications of low coverage in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia.

Science.gov (United States)

Morgan, Camille; Bowling, Michael; Bartram, Jamie; Lyn Kayser, Georgia

2017-08-01

Adequate access to water, sanitation, and hygiene (WaSH) in schools impacts health, educational outcomes, and gender disparities. Little multi-country research has been published on WaSH in rural schools in Sub-Saharan Africa. In this multi-national cross-sectional WaSH study, we document WaSH access, continuity, quality, quantity, and reliability in 2270 schools that were randomly sampled in rural regions of six Sub-Saharan African countries: Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. Data collection included: school WaSH surveys containing internationally established WaSH indicators, direct observation, and field- and laboratory-based microbiological water quality testing. We found 1% of rural schools in Ethiopia and Mozambique to 23% of rural schools in Rwanda had improved water sources on premises, improved sanitation, and water and soap for handwashing. Fewer than 23% of rural schools in the six countries studied met the World Health Organization's recommended student-to-latrine ratios for boys and for girls. Fewer than 20% were observed to have at least four of five recommended menstrual hygiene services (separate-sex latrines with doors and locks, water for use, waste bin). The low access to safe and adequate WaSH services in rural schools suggest opportunities for WaSH interventions that could have substantive impact on health, education, and gender disparities. Copyright © 2017 Elsevier GmbH. All rights reserved.

Giardia in mountain gorillas (Gorilla beringei beringei), forest buffalo (Syncerus caffer), and domestic cattle in Volcanoes National Park, Rwanda.

Science.gov (United States)

Hogan, Jennifer N; Miller, Woutrina A; Cranfield, Michael R; Ramer, Jan; Hassell, James; Noheri, Jean Bosco; Conrad, Patricia A; Gilardi, Kirsten V K

2014-01-01

Mountain gorillas (Gorilla beringei beringei) are critically endangered primates surviving in two isolated populations in protected areas within the Virunga Massif of Rwanda, Uganda, the Democratic Republic of Congo, and in Bwindi Impenetrable National Park in Uganda. Mountain gorillas face intense ecologic pressures due to their proximity to humans. Human communities outside the national parks, and numerous human activities within the national parks (including research, tourism, illegal hunting, and anti-poaching patrols), lead to a high degree of contact between mountain gorillas and wildlife, domestic animals, and humans. To assess the pathogen transmission potential between wildlife and livestock, feces of mountain gorillas, forest buffalo (Syncerus caffer nanus), and domestic cattle (Bos taurus) in Rwanda were examined for the parasites Giardia and Cryptosporidium. Giardia was found in 9% of mountain gorillas, 6% of cattle, and 2% of forest buffalo. Our study represents the first report of Giardia prevalence in forest buffalo. Cryptosporidium-like particles were also observed in all three species. Molecular characterization of Giardia isolates identified zoonotic genotype assemblage B in the gorilla samples and assemblage E in the cattle samples. Significant spatial clustering of Giardia-positive samples was observed in one sector of the park. Although we did not find evidence for transmission of protozoa from forest buffalo to mountain gorillas, the genotypes of Giardia samples isolated from gorillas have been reported in humans, suggesting that the importance of humans in this ecosystem should be more closely evaluated.

California Political Districts

Data.gov (United States)

California Natural Resource Agency — This is a series of district layers pertaining to California'spolitical districts, that are derived from the California State Senateand State Assembly information....

District nursing in Dominica

NARCIS (Netherlands)

Kolkman, PME; Luteijn, AJ; Nasiiro, RS; Bruney, [No Value; Smith, RJA; Meyboom-de Jong, B

1998-01-01

District nurses constitute the basis of the primary health care services in Dominica. All encounters of three district nurses were registered using the international classification of primary care. Information on other aspects of district nursing was collected by participating observation and the

Musculoskeletal impairment survey in Rwanda: Design of survey tool, survey methodology, and results of the pilot study (a cross sectional survey

Directory of Open Access Journals (Sweden)

Simms Victoria

2007-03-01

Full Text Available Abstract Background Musculoskeletal impairment (MSI is an important cause of morbidity and mortality worldwide, especially in developing countries. Prevalence studies for MSI in the developing world have used varying methodologies and are seldom directly comparable. This study aimed to develop a new tool to screen for and diagnose MSI and to pilot test the methodology for a national survey in Rwanda. Methods A 7 question screening tool to identify cases of MSI was developed through literature review and discussions with healthcare professionals. To validate the tool, trained rehabilitation technicians screened 93 previously identified gold standard 'cases' and 86 'non cases'. Sensitivity, specificity and positive predictive value were calculated. A standardised examination protocol was developed to determine the aetiology and diagnosis of MSI for those who fail the screening test. For the national survey in Rwanda, multistage cluster random sampling, with probability proportional to size procedures will be used for selection of a cross-sectional, nationally representative sample of the population. Households to be surveyed will be chosen through compact segment sampling and all individuals within chosen households will be screened. A pilot survey of 680 individuals was conducted using the protocol. Results: The screening tool demonstrated 99% sensitivity and 97% specificity for MSI, and a positive predictive value of 98%. During the pilot study 468 out of 680 eligible subjects (69% were screened. 45 diagnoses were identified in 38 persons who were cases of MSI. The subjects were grouped into categories based on diagnostic subgroups of congenital (1, traumatic (17, infective (2 neurological (6 and other acquired(19. They were also separated into mild (42.1%, moderate (42.1% and severe (15.8% cases, using an operational definition derived from the World Health Organisation's International Classification of Functioning, Disability and Health

Private Water Districts

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California Natural Resource Agency — Private Water District boundaries are areas where private contracts provide water to the district in California. This database is designed as a regions polygon...

MOBILE MONEY TRANSFER DIGITAL ECONOMY IN GAINING COMPETITIVE ADVANTAGE OVER MFIS IN RWANDAN CONTEXT: AS A CASE STUDY OF SACCOS IN RWANDA

Directory of Open Access Journals (Sweden)

2014-01-01

Full Text Available The Government of Rwanda has adopted a very ambitious financial sectordevelopment plan which is at the implementation stage. This has made the administration to create atleast one SACCO at every administrative level hence known as '' umurenge''. This plan is captured in the vision 2020 under the Economic Development and Poverty Reduction Strategy (EDPRS. It is realized that micro financial institutions MFIs is an important sector in mobilising savings and availability of credit at reasonable rates and other financial services for investment to the rural majority. However, despite all these effort by Government, the level of domestic savings remains very low and the financial exclusion highly alarming. MFIs is a strategy to eradicate poverty amongst the vulnerable youth and women. Mobile money is a tool to allow individuals to transact using cell phone technology. The study will explore how Digital Economy has gained competitive advantage over SACCOs/ MFIs. The study is motivated by the acceptance and embracing of technology (ICT amongst low income earners giving it competitive advantage and encouraging e-commerce services in Rwanda. A qualitative analysis will be undertaken, and an in depth examination of the variables using business models to establish a relationship in the Rwandan context.

Use of Traditional Botanical Medicines During Pregnancy in Rural Rwanda.

Science.gov (United States)

Beste, Jason; Asanti, Daniel; Nsabimana, Damien; Anastos, Kathryn; Mutimura, Eugene; Merkatz, Irwin; Sirotin, Nicole; Nathan, Lisa M

To evaluate the perceptions of healthcare and traditional medicine providers regarding the type, indications, side effects, and prevalence of traditional medicine use amongst pregnant women in a rural Rwandan population. Six focus groups with physicians, nurses, and community health workers and four individual in-depth interviews with traditional medicine providers were held. Qualitative data was gathered using a structured questionnaire querying perceptions of the type, indications, side effects, and prevalence of use of traditional medicines in pregnancy. The healthcare provider groups perceived a high prevalence of traditional botanical medicine use by pregnant women (50-80%). All three groups reported similar indications for use of the medicines and the socioeconomic status of the pregnant women who use them. The traditional medicine providers and the healthcare providers both perceived that the most commonly used medicine is a mixture of many plants, called Inkuri. The most serious side effect reported was abnormally bright green meconium with a poor neonatal respiratory drive. Thirty-five traditional medicines were identified that are used during pregnancy. Perceptions of high prevalence of use of traditional medicines during pregnancy with possible negative perinatal outcomes exist in areas of rural Rwanda.

The health system cost of post-abortion care in Rwanda

Science.gov (United States)

Vlassoff, Michael; Musange, Sabine F; Kalisa, Ina R; Ngabo, Fidele; Sayinzoga, Felix; Singh, Susheela; Bankole, Akinrinola

2015-01-01

Based on research conducted in 2012, we estimate the cost to the Rwandan health-care system of providing post-abortion care (PAC) due to unsafe abortions, a subject of policy importance not studied before at the national level. Thirty-nine public and private health facilities representing three levels of health care were randomly selected for data collection from key care providers and administrators for all five regions. Using an ingredients approach to costing, data were gathered on drugs, supplies, material, personnel time and hospitalization. Additionally, direct non-medical costs such as overhead and capital costs were also measured. We found that the average annual PAC cost per client, across five types of abortion complications, was $93. The total cost of PAC nationally was estimated to be $1.7 million per year, 49% of which was expended on direct non-medical costs. Satisfying all demands for PAC would raise the national cost to $2.5 million per year. PAC comprises a significant share of total expenditure in reproductive health in Rwanda. Investing more resources in provision of contraceptive services to prevent unwanted or mistimed pregnancies would likely reduce health systems costs. PMID:24548846

Love matters: exploring conceptions of love in Rwanda and Swaziland and relationship to HIV and intimate partner violence.

Science.gov (United States)

Ruark, Allison; Stern, Erin; Dlamini-Simelane, Thandeka; Kakuze, Marie Fidele

2017-12-01

Health risks such as intimate partner violence (IPV) and HIV infection often occur within intimate sexual relationships, yet the study of love and intimacy is largely absent from health research on African populations. This study explores how women and men in Rwanda and Swaziland understand and represent love in their intimate sexual partnerships. In Rwanda, 58 in-depth interviews with 15 couples, 12 interviews with activists, and 24 focus group discussions were carried out during formative and evaluative research of the Indashyikirwa programme, which aims to reduce IPV and support healthy couple relationships. In Swaziland, 117 in-depth, life-course interviews with 14 women and 14 men focused on understanding intimate sexual partnerships. We analysed these qualitative data thematically using a Grounded Theory approach. Participants described love as being foundational to their intimate sexual partnerships. Women and men emphasised that love is seen and expressed through actions and tangible evidence such as gifts and material support, acts of service, showing intentions for marriage, sexual faithfulness, and spending time together. Some participants expressed ambivalent narratives regarding love, gifts, and money, acknowledging that they desired partners who demonstrated love through material support while implying that true love should be untainted by desires for wealth. IPV characterised many relationships and was perceived as a threat to love, even as love was seen as a potential antidote to IPV. Careful scholarship of love is critical to better understand protective and risk factors for HIV and IPV and for interventions that seek to ameliorate these risks.

Determinants of poor utilization of antenatal care services among recently delivered women in Rwanda; a population based study.

Science.gov (United States)

Rurangirwa, Akashi Andrew; Mogren, Ingrid; Nyirazinyoye, Laetitia; Ntaganira, Joseph; Krantz, Gunilla

2017-05-15

In Rwanda, a majority of pregnant women visit antenatal care (ANC) services, however not to the extent that is recommended. Association between socio-demographic or psychosocial factors and poor utilization of antenatal care services (≤2 visits during the course of pregnancy irrespective of the timing) among recently pregnant women in Rwanda were investigated. This population-based, cross sectional study included 921 women who gave birth within the past 13 months. Data was obtained using an interviewer-administered questionnaire. For the analyses, bi-and multivariable logistic regression was used and odds ratios were presented with their 95% confidence intervals. About 54% of pregnant women did not make the recommended four visits to ANC during pregnancy. The risk of poor utilization of ANC services was higher among women aged 31 years or older (AOR, 1.78; 95% CI: 1.14, 2.78), among single women (AOR, 2.99; 95% CI: 1.83, 4.75) and women with poor social support (AOR, 1.71; 95% CI: 1.09, 2.67). No significant associations were found for school attendance or household assets (proxy for socio-economic status) with poor utilization of ANC services. Older age, being single, divorced or widowed and poor social support were associated with poor utilization of ANC services. General awareness in communities should be raised on the importance of the number and timing of ANC visits. ANC clinics should further be easier to access, transport should be available, costs minimized and opening hours may be extended to facilitate visits for pregnant women.

State Water Districts

Data.gov (United States)

California Natural Resource Agency — State Water Project District boundaries are areas where state contracts provide water to the district in California. This database is designed as a regions polygon...

Taking stock of monitoring and evaluation systems in the health sector: findings from Rwanda and Uganda.

Science.gov (United States)

Holvoet, Nathalie; Inberg, Liesbeth

2014-07-01

In the context of sector-wide approaches and the considerable funding being put into the health sectors of low-income countries, the need to invest in well-functioning national health sector monitoring and evaluation (M&E) systems is widely acknowledged. Regardless of the approach adopted, an important first step in any strategy for capacity development is to diagnose the quality of existing systems or arrangements, taking into account both the supply and demand sides of M&E. As no standardized M&E diagnostic instrument currently exists, we first invested in the development of an assessment tool for sector M&E systems. To counter the criticism that M&E is often narrowed down to a focus on technicalities, our diagnostic tool assesses the quality of M&E systems according to six dimensions: (i) policy; (ii) quality of indicators and data (collection) and methodology; (iii) organization (further divided into iiia: structure and iiib: linkages); (iv) capacity; (v) participation of non-government actors and (vi) M&E outputs: quality and use. We subsequently applied the assessment tool to the health sector M&E systems of Rwanda and Uganda, and this article provides a comparative overview of the main research findings. Our research may have important implications for policy, as both countries receive health sector (budget) support in relation to which M&E system diagnosis and improvement are expected to be high on the agenda. The findings of our assessments indicate that, thus far, the health sector M&E systems in Rwanda and Uganda can at best be diagnosed as 'fragmentary', with some stronger and weaker elements. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia and Rwanda.

Science.gov (United States)

Wang, Wenjuan; Temsah, Gheda; Mallick, Lindsay

2017-04-01

While research has assessed the impact of health insurance on health care utilization, few studies have focused on the effects of health insurance on use of maternal health care. Analyzing nationally representative data from the Demographic and Health Surveys (DHS), this study estimates the impact of health insurance status on the use of maternal health services in three countries with relatively high levels of health insurance coverage-Ghana, Indonesia and Rwanda. The analysis uses propensity score matching to adjust for selection bias in health insurance uptake and to assess the effect of health insurance on four measurements of maternal health care utilization: making at least one antenatal care visit; making four or more antenatal care visits; initiating antenatal care within the first trimester and giving birth in a health facility. Although health insurance schemes in these three countries are mostly designed to focus on the poor, coverage has been highly skewed toward the rich, especially in Ghana and Rwanda. Indonesia shows less variation in coverage by wealth status. The analysis found significant positive effects of health insurance coverage on at least two of the four measures of maternal health care utilization in each of the three countries. Indonesia stands out for the most systematic effect of health insurance across all four measures. The positive impact of health insurance appears more consistent on use of facility-based delivery than use of antenatal care. The analysis suggests that broadening health insurance to include income-sensitive premiums or exemptions for the poor and low or no copayments can increase use of maternal health care. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

A transdisciplinary approach to understanding the causes of wicked problems such as the violent conflict in Rwanda

Directory of Open Access Journals (Sweden)

Andreas Velthuizen

2012-07-01

Full Text Available The paper is presented against a background of many wicked problems that confront us in the world today such as violent crime, conflict that emanates from political power seeking, contests for scarce resources, the increasing reaction all over the world to the deterioration of socio-economic conditions and the devastation caused by natural disasters. This article will argue that the challenge of violent conflict requires an innovative approach to research and problem solving and proposes a research methodology that follows a transdisciplinary approach. The argument is informed by field research during 2006 on the management of knowledge in the Great Lakes region of Africa, including research on how knowledge on the 1994 genocide in Rwanda is managed. The paper will make recommendations on how transdisciplinary research is required to determine the causes of violent conflict in an African context and how practitioners and academics should engage in transdisciplinarity. It was found that trans- disciplinary research is required to gain better insight into the causes of violent conflict in an African context. It requires from the researcher to recognise the many levels of reality that has to be integrated towards a synthesis to reveal new insights into the causes of violent conflict, including recognising the existence of a normative-spiritual realm that informs the epistemology of Africa. It furthermore requires a methodology that allows us to break out of the stifling constraints of systems thinking and linear processes into the inner space at the juncture where disciplines meet (the diversity of African communities. Keywords: Africa, conflict, Rwanda, crime, genocide, violence, transdisciplinary Disciplines: politics, education, law, epistemology, sociology, theology, management science

Bubble CPAP to support preterm infants in rural Rwanda: a retrospective cohort study.

Science.gov (United States)

Nahimana, Evrard; Ngendahayo, Masudi; Magge, Hema; Odhiambo, Jackline; Amoroso, Cheryl L; Muhirwa, Ernest; Uwilingiyemungu, Jean Nepo; Nkikabahizi, Fulgence; Habimana, Regis; Hedt-Gauthier, Bethany L

2015-09-24

Complications from premature birth contribute to 35% of neonatal deaths globally; therefore, efforts to improve clinical outcomes of preterm (PT) infants are imperative. Bubble continuous positive airway pressure (bCPAP) is a low-cost, effective way to improve the respiratory status of preterm and very low birth weight (VLBW) infants. However, bCPAP remains largely inaccessible in resource-limited settings, and information on the scale-up of this technology in rural health facilities is limited. This paper describes health providers' adherence to bCPAP protocols for PT/VLBW infants and clinical outcomes in rural Rwanda. This retrospective chart review included all newborns admitted to neonatal units in three rural hospitals in Rwanda between February 1st and October 31st, 2013. Analysis was restricted to PT/VLBW infants. bCPAP eligibility, identification of bCPAP eligibility and complications were assessed. Final outcome was assessed overall and by bCPAP initiation status. There were 136 PT/VLBW infants. For the 135 whose bCPAP eligibility could be determined, 83 (61.5%) were bCPAP-eligible. Of bCPAP-eligible infants, 49 (59.0%) were correctly identified by health providers and 43 (51.8%) were correctly initiated on bCPAP. For the 52 infants who were not bCPAP-eligible, 45 (86.5%) were correctly identified as not bCPAP-eligible, and 46 (88.5%) did not receive bCPAP. Overall, 90 (66.2%) infants survived to discharge, 35 (25.7%) died, 3 (2.2%) were referred for tertiary care and 8 (5.9%) had unknown outcomes. Among the bCPAP eligible infants, the survival rates were 41.8% (18 of 43) for those in whom the procedure was initiated and 56.5% (13 of 23) for those in whom it was not initiated. No complications of bCPAP were reported. While the use of bCPAP in this rural setting appears feasible, correct identification of eligible newborns was a challenge. Mentorship and refresher trainings may improve guideline adherence, particularly given high rates of staff turnover

?A constant struggle to receive mental health care?: health care professionals? acquired experience of barriers to mental health care services in Rwanda

OpenAIRE

Rugema, Lawrence; Krantz, Gunilla; Mogren, Ingrid; Ntaganira, Joseph; Persson, Margareta

2015-01-01

BACKGROUND: In Rwanda, many people are still mentally affected by the consequences of the genocide and yet mental health care facilities are scarce. While available literature explains the prevalence and consequences of mental disorders, there is lack of knowledge from low-income countries on health care seeking behavior due to common mental disorders. Therefore, this study sought to explore health care professionals' acquired experiences of barriers and facilitators that people with common m...

Factors associated with postnatal care utilisation in Rwanda: A secondary analysis of 2010 Demographic and Health Survey data.

Science.gov (United States)

Rwabufigiri, Bernard N; Mukamurigo, Judith; Thomson, Dana R; Hedt-Gautier, Bethany L; Semasaka, Jean Paul S

2016-05-31

Postnatal care (PNC) in the first seven days is important for preventing morbidity and mortality in mothers and new-borns. Sub-Saharan African countries, which account for 62 % of maternal deaths globally, have made major efforts to increase PNC utilisation, but utilisation rates remains low even in countries like Rwanda where PNC services are universally available for free. This study identifies key socio-economic and demographic factors associated with PNC utilisation in Rwanda to inform improved PNC policies and programs. This is a secondary analysis of the 2010 Demographic and Health Survey, a national multi-stage, cross-sectional survey. In bivariate analysis, we used chi-square tests to identify demographic and socio-economic factors associated with PNC utilisation at α = 0.1. Pearson's R statistic (r > 0.5) was used to identify collinear covariates, and to choose which covariate was more strongly associated with PNC utilisation. Manual backward stepwise logistic regression was performed on the remaining covariates to identify key factors associated with PNC utilisation at α = 0.05. All analyses were performed in Stata 13 adjusting for sampling weights, clustering, and stratification. Of the 2,748 women with a live birth in the last two years who answered question about PNC utilisation, 353 (12.8 %) returned for PNC services within seven days after birth. Three factors were positively associated with PNC use: delivering at a health facility (OR: 2.97; 95 % CI: 2.28-3.87), being married but not involved with one's own health care decision-making (OR: 1.69; 95 % CI: 1.17, 2.44) compared to being married and involved; and being in the second (OR: 1.46; 95 % CI: 1.01-2.09) or richest wealth quintile (OR: 2.04; 95 % CI: 1.27-3.29) compared to the poorest. Mother's older age at delivery was negatively associated with PNC use (20-29 - OR: 0.51, 95 % CI: 0.29-0.87; 30-39 - OR: 0.47, 95 % CI: 0.27-0.83; 40-49 - OR: 0.32, 95 % CI: 0.16-0.64). Low PNC

Leveraging community health worker system to map a mountainous rural district in low resource setting: a low-cost approach to expand use of geographic information systems for public health.

Science.gov (United States)

Munyaneza, Fabien; Hirschhorn, Lisa R; Amoroso, Cheryl L; Nyirazinyoye, Laetitia; Birru, Ermyas; Mugunga, Jean Claude; Murekatete, Rachel M; Ntaganira, Joseph

2014-12-06

Geographic Information Systems (GIS) have become an important tool in monitoring and improving health services, particularly at local levels. However, GIS data are often unavailable in rural settings and village-level mapping is resource-intensive. This study describes the use of community health workers' (CHW) supervisors to map villages in a mountainous rural district of Northern Rwanda and subsequent use of these data to map village-level variability in safe water availability. We developed a low literacy and skills-focused training in the local language (Kinyarwanda) to train 86 CHW Supervisors and 25 nurses in charge of community health at the health center (HC) and health post (HP) levels to collect the geographic coordinates of the villages using Global Positioning Systems (GPS). Data were validated through meetings with key stakeholders at the sub-district and district levels and joined using ArcMap 10 Geo-processing tools. Costs were calculated using program budgets and activities' records, and compared with the estimated costs of mapping using a separate, trained GIS team. To demonstrate the usefulness of this work, we mapped drinking water sources (DWS) from data collected by CHW supervisors from the chief of the village. DWSs were categorized as safe versus unsafe using World Health Organization definitions. Following training, each CHW Supervisor spent five days collecting data on the villages in their coverage area. Over 12 months, the CHW supervisors mapped the district's 573 villages using 12 shared GPS devices. Sector maps were produced and distributed to local officials. The cost of mapping using CHW supervisors was $29,692, about two times less than the estimated cost of mapping using a trained and dedicated GIS team ($60,112). The availability of local mapping was able to rapidly identify village-level disparities in DWS, with lower access in populations living near to lakes and wetlands (p villages even in mountainous rural areas. These data

Geothermal exploration in the Virunga Prospect, Northern Rwanda

Science.gov (United States)

Jolie, E.

2009-04-01

German technical cooperation has taken the initiative to support partner countries in geothermal energy use. Therefore the Federal Institute for Geosciences and Natural Resources (BGR) on behalf of the Federal Ministry for Economic Cooperation and Development (BMZ) is carrying out the technical cooperation programme GEOTHERM. As an example of the ongoing project activities, preliminary results of studies carried out in the Virunga geothermal prospect in Northern Rwanda will be presented. The study area is located along the Western branch of the East African Rift System. Weak geothermal surface manifestations, e.g. hot springs and bubbling pools, indicate an existing hydrothermal system. Previous studies did not determine location, distribution, quality and quantity of the heat source. Consequently the aim of this study is to detect and assess the heat source with a multi method approach. Remote sensing techniques, geochemical analyses and geophysical measurements have been applied to make a first serious attempt. More detailed geophysical investigations and gas measurements are planned to start in spring 2009. Aerial photographs and satellite images were used for a high-resolution structural analysis to determine major fault zones, which are dominating the flow paths of hydrothermal fluids. In the frame of a regional geophysical survey (Magnetotellurics and Transient Electromagnetics) a zone of low resistivity values could be detected SW of the Karisimbi stratovolcano, which is corresponding with the results of the geochemical analyses. Assumptions are made that a magmatic body may exist in a depth of 5 km below surface.

Zero Energy Districts

Energy Technology Data Exchange (ETDEWEB)

Polly, Benjamin J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2018-05-04

This presentation shows how NREL is approaching Zero Energy Districts, including key opportunities, design strategies, and master planning concepts. The presentation also covers URBANopt, an advanced analytical platform for district that is being developed by NREL.

Assessment of traditional ecological knowledge and beliefs in the utilisation of important plant species: The case of Buhanga sacred forest, Rwanda

Directory of Open Access Journals (Sweden)

Runyambo Irakiza

2016-07-01

Full Text Available Traditional ecological knowledge is an integrated part of the African people and indeed the Rwandese for cultural purpose. Buhanga sacred forest is a relict forest of tremendous ecological importance to Rwandan society located in Musanze District. The aim of this study was to assess the traditional ecological knowledge and belief in the utilisation of some important plant species for the conservation of Buhanga sacred forest. Ecological information about ethnomedicinal and traditional practices were collected following structured questionnaire through interview involving eight traditional healers and three focus group discussions. Data were collected from the natural habitats, home gardens, farmlands and roadsides of Buhanga sacred forest. A total of 45 botanical taxa belonging to 28 families were reported to be used by the local community. Species such as Brillantaisia cicatricosa and Senna septemtrionalis were the popular species cited by traditional healers to treat human and animal diseases and ailments, respectively. The results of the study indicated that because of the cultural norms and values associated with the sacred forest, this has led to non-exploitation. The study presents key sites and plant species in which their use and belief can lead to their conservation. However, not only is it imperative to conserve traditional local knowledge for biocultural conservation motives but there is also need to train traditional healers on how to domesticate indigenous species as conservation measure because some species have become susceptible to extinction. Conservation implications: Highlighting indigenous species investigated in this research will provide a powerful tool for ensuring biodiversity conservation through community participation in a country of high population density in Africa. Some plant species that provided satisfactory Local Health Traditions among communities surrounding Buhanga can contribute as good material for further

"Waiting for DAAs": A retrospective chart review of patients with untreated hepatitis C in Rwanda.

Directory of Open Access Journals (Sweden)

Neil Gupta

Full Text Available Access to treatment for hepatitis C virus (HCV in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs, highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs.We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda. Patient charts at these centers were reviewed, and routinely collected data were recorded and analyzed. Overall, 253 patients were identified; median age was 56 years (IQR: 43, 65, and 149 (58.9% were female. Median viral load was 688,736 IU/ml and 96.7% were HCV genotype 4. As classified by FIB-4 score, 64.8% of the patients had moderate to severe fibrosis. Fibrosis stage was associated with age (OR 1.12, CI 1.09-1.17, but not with time since diagnosis, gender, treatment center, or type of insurance. There was a low frequency of documented co-morbid conditions, including hypertension, diabetes, HIV, and hepatitis B virus.Compared to an estimated 55,000 patients eligible for HCV treatment in Rwanda, this study identified only 253 patients currently diagnosed and engaged in care, highlighting an immense treatment gap in HCV, likely due to the lack of accessible and affordable screening, diagnostic, and treatment modalities. The patients that were enrolled in care had a disproportionately advanced fibrosis stage, possibly indicating late presentation to care or lack of treatment options. In the context of newly available and effective treatment options, this study supports the overall need to accelerate access to HCV screening, diagnostics, and care and treatment services in resource-limited settings in sub-Saharan Africa.

Future Services for District Heating Solutions in Residential Districts

Directory of Open Access Journals (Sweden)

Hannele Ahvenniemi

2014-06-01

Full Text Available The underlying assumption of this study is that in order to retain the competitiveness while reaching for the EU targets regarding low-energy construction, district heating companies need to develop new business and service models. How district heating companies could broaden their perspective and switch to a more service-oriented way of thinking is a key interest of our research. The used methods in our study are house builder interviews and a questionnaire. With the help of these methods we discussed the potential interest in heating related services acquiring a comprehensive understanding of the customer needs. The results indicate the importance of certain criteria when choosing the heating system in households: easiness, comfort and affordability seem to dominate the house builders’ preferences. Also environmental awareness seems to be for many an important factor when making a decision about the heating of the house. Altogether, based on the results of this study, we suggest that the prospects of district heating could benefit from highlighting certain aspects and strengths in the future. District heating companies need to increase flexibility, readiness to adopt new services, to invest in new marketing strategies and improving the communication skills.

TRACnet Internet and Short Message Service Technology Improves Time to Antiretroviral Therapy Initiation Among HIV-infected Infants in Rwanda.

Science.gov (United States)

Kayumba, Kizito; Nsanzimana, Sabin; Binagwaho, Agnes; Mugwaneza, Placidie; Rusine, John; Remera, Eric; Koama, Jean Baptiste; Ndahindwa, Vedaste; Johnson, Pamela; Riedel, David J; Condo, Jeanine

2016-07-01

Delays in testing HIV-exposed infants and obtaining results in resource-limited settings contribute to delays for initiating antiretroviral therapy (ART) in infants. To overcome this challenge, Rwanda expanded its national mobile and Internet-based HIV/AIDS informatics system, called TRACnet, to include HIV polymerase chain reaction (PCR) results in 2010. This study was performed to evaluate the impact of TRACnet technology on the time to delivery of test results and the subsequent initiation of ART in HIV-infected infants. A retrospective cohort study was conducted on 380 infants who initiated ART in 190 health facilities in Rwanda from March 2010 to June 2013. Program data collected by the TRACnet system were extracted and analyzed. Since the introduction of TRACnet for processing PCR results, the time to receive results has significantly decreased from a median of 144 days [interquartile range (IQR): 121-197 days] to 23 days (IQR: 17-43 days). The number of days between PCR sampling and health facility receipt of results decreased substantially from a median of 90 days (IQR: 83-158 days) to 5 days (IQR: 2-8 days). After receiving PCR results at a health facility, it takes a median of 44 days (IQR: 32-77 days) before ART initiation. Result turnaround time was significantly associated with time to initiating ART (P technology for communication of HIV PCR results, coupled with well-trained and skilled personnel, can reduce delays in communicating results to providers. Such reductions may improve timely ART initiation in resource-limited settings.

Nankana West District of Ghana

African Journals Online (AJOL)

Agribotix GCS 077

Local governments in Ghana play very important roles with actors in the ... Metropolitan, Municipal and District Chief Executives (MMDCEs), the .... District Budget Officer, District Finance Officer, Presiding Member, members of the Works Sub-.

Modeling wind speed and wind power distributions in Rwanda

Energy Technology Data Exchange (ETDEWEB)

Safari, Bonfils [Department of Physics, National University of Rwanda, P.O. Box 117, Huye District, South Province (Rwanda)

2011-02-15

Utilization of wind energy as an alternative energy source may offer many environmental and economical advantages compared to fossil fuels based energy sources polluting the lower layer atmosphere. Wind energy as other forms of alternative energy may offer the promise of meeting energy demand in the direct, grid connected modes as well as stand alone and remote applications. Wind speed is the most significant parameter of the wind energy. Hence, an accurate determination of probability distribution of wind speed values is very important in estimating wind speed energy potential over a region. In the present study, parameters of five probability density distribution functions such as Weibull, Rayleigh, lognormal, normal and gamma were calculated in the light of long term hourly observed data at four meteorological stations in Rwanda for the period of the year with fairly useful wind energy potential (monthly hourly mean wind speed anti v{>=}2 m s{sup -1}). In order to select good fitting probability density distribution functions, graphical comparisons to the empirical distributions were made. In addition, RMSE and MBE have been computed for each distribution and magnitudes of errors were compared. Residuals of theoretical distributions were visually analyzed graphically. Finally, a selection of three good fitting distributions to the empirical distribution of wind speed measured data was performed with the aid of a {chi}{sup 2} goodness-of-fit test for each station. (author)

Posttraumatic growth and religion in Rwanda: individual well-being vs. collective false consciousness

Science.gov (United States)

Williamson, Caroline

2014-01-01

Some scholars include changes in spirituality, such as a greater commitment to their religious beliefs or an enhanced understanding of spiritual matters, in the definition of posttraumatic growth; others conclude that questions of spirituality should be excluded from this definition. This article highlights the fundamental difference of religion to other domains of posttraumatic growth because religions are ideologies (and other domains of growth are not). As ideologies, it is argued that religions can affect different levels of identity in different ways. Based on testimonial evidence from Rwandan genocide survivors, the article demonstrates that although religious beliefs can bring existential comfort at the individual level, they can also lead to a state of false consciousness at the collective level. In Rwanda, the dominant religious ideology facilitated the spiritual and moral climate in which genocide became possible. Today, religious interpretations of the Rwandan Patriotic Front's (RPF) leadership provide spiritual backing to a government which has become increasingly authoritarian. PMID:25705116

District Energy Windsor

Energy Technology Data Exchange (ETDEWEB)

NONE

2002-07-01

This paper presents a summary of how District Energy Windsor operates. It includes a system site map and reasons why it is advantageous to get connected to a district heating system. District Energy Windsor is a division of the Windsor Utilities Commission. It was developed in 1996 and was the first in North America to supply both heating and cooling requirements. It supplies nearly 2 million square feet of heating and cooling for Windsor's city centre. The district energy system produces hot water or chilled water at a central plant. Energy is then piped out to buildings in the area, including the Art Gallery of Windsor, the Royal Bank Business Centre, the Windsor Justice Facility, the Windsor Casino, and Northwind Windsor. The energy, which is transferred through heat exchangers, is used for space heating, domestic hot water heating, and air conditioning. The 8 reasons for getting connected are: (1) less management costs, (2) lower energy costs, (3) lower level of risk management, (4) stable energy rates, (5) better use of building space, (6) reliable service, (7) reduced expansion costs, and (8) a cleaner environment. District heating improves air quality through reduced carbon dioxide and nitrogen oxide emissions. In addition, fuel delivery and storage are eliminated. figs.

Revisiting "Rodriguez v. Los Angeles Unified School District": A Case of Intra-District Inequities

Science.gov (United States)

Espinosa, Ruben W.

2010-01-01

The educational community and the courts continue to struggle with the challenges of intra-district resource inequality revealed by the California Supreme Court landmark case "Rodriguez v. Los Angeles Unified School District" (1992). Intra-district school resource inequality is one of the remaining bastions of major inequalities in the…