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Aim: The aim of this discursive paper was to describe and expound on how paediatric nurses will be able to address the needs of children and adolescents through the lens of selected Sustainable Development Goals (SDGs) in Rwanda. Design: A discursive analysis of SDGs relating to the roles of paediatric nurses in the context of Rwanda. Methods: A discursive method using SDGs as a guiding framework is used in this paper. We drew on our own experiences and supported them with the available literature. Results: A collection of contextually relevant examples of how paediatric nurses will be able to address the needs of children and adolescents through the lens of selected SDGs in Rwanda was discussed. The selected SDGs expounded on were: no poverty, good health and well‐being, quality of education, decent work and economic growth, reduced inequalities, and partnerships for the goals. Conclusions: There is no doubt that the paediatric nurses in Rwanda play undeniable key roles in attaining SDGs and their targets. Thus, there is a need to train more paediatric nurses with the support of the interdisciplinary partners. Collaboratively, this is possible in the bid to ensure equitable and accessible care to the current and future generations. Public contribution: This discursive paper is intended to inform the different stakeholders in nursing practice, research, education and policy to support and invest in the advanced education of paediatric nurses for attainment of the SDGs. [ABSTRACT FROM AUTHOR]

Understanding the drivers of improvements in child undernutrition at only the national level can mask subnational differences. This paper aimed to understand the contributions of factors in the enabling environment to observed differences in stunting reduction between districts in Rwanda. In 2017, we conducted 58 semi‐structured interviews with mid‐level actors (n = 38) and frontline workers (n = 20) implementing Rwanda's multi‐sectoral nutrition policy in five districts in which stunting decreased (reduced districts) and five where it increased or stagnated (non‐reduced districts) based on Rwanda's 2010 and 2014/15 Demographic and Health Surveys. Mid‐level actors are government officials and service providers at the subnational level who represent the frontline of government policy. Interviews focused on political commitment to and policy coherence in nutrition, and contributors to nutrition changes. Responses were coded to capture themes on the changes and challenges of these topics and compared between reduced and non‐reduced districts. Descriptive statistics described district characteristics. Political commitment to nutrition was high in both reduced and non‐reduced districts. Respondents from reduced districts were more likely to define commitment to nutrition as an optimal implementation of policy, whereas those from non‐reduced districts focused more on financial commitment. Regarding coherence, respondents from reduced compared to non‐reduced districts were more likely to report the optimal implementation of multi‐sectoral nutrition planning meetings, using data to assess plans and progress in nutrition outcomes and integration of nutrition into the agriculture sector. In contrast, respondents from non‐reduced districts more often reported challenges in their relationships with national‐level stakeholders and nutrition and/or monitoring and evaluation capacities. Enhancing the integration of nutrition in different sectors and improving mid‐level actors' capacity to plan and advocate for nutrition programming may contribute to reductions in stunting. Key messages: Understanding the lens through which policy implementers at subnational levels view multi‐sectoral nutrition strategies and their role in these strategies provides useful information on the facilitators and constraints of implementation for nutrition actions.Differences in leadership and responsiveness to prioritise nutrition at the subnational levels are important in decentralised governance systems where responsibilities in nutrition planning, coordination and implementation shift to mid‐level actors.Mainstreaming nutrition responsibilities across sectors and administrative levels requires investments in capacities to plan, monitor and advocate for multi‐sectoral nutrition programming, including for mid‐level actors. [ABSTRACT FROM AUTHOR]

Childhood malnutrition, which is endemic in rural areas of low‐income countries, leads to a host of deleterious outcomes such as poor cognitive development, low educational attainment and lower lifetime wages. Promoting the consumption of eggs among young children has emerged as a promising strategy to combat childhood malnutrition, though pathways to scale remain unclear. In this paper, we evaluate the impact of a social and behaviour change communication (SBCC) campaign combined with a program in which rural families purchased chickens on credit (poultry + SBCC; n = 769) relative to an arm in which families only received the poultry intervention (poultry only; n = 750), using a difference‐in‐difference estimation strategy with propensity score matching. The SBCC consisted of radio messages, in‐person training, text message reminders and posters. We found a relatively modest but statistically significant increase in the number of times per week respondents in the poultry + SBCC arm reported feeding eggs to children of 0.28 (p = 0.02) compared to the poultry‐only arm. The increase in egg feeding, however, was more pronounced for boys (0.42, p < 0.01) than for girls (0.14, p = 0.26). In addition, the campaign increased egg feeding more for those who were already feeding eggs to children (0.63, p < 0.01) than those who were not engaging in those practices at baseline (0.26, p < 0.01). However, the difference in these differences was not statistically significant. Future campaigns should ensure higher saturation of messaging and include specific messaging around the importance of feeding girls as well as boys. Campaigns seeking to scale up egg feeding quickly could potentially target the easier‐to‐reach segment of caregivers who already occasionally feed eggs to children though these might not be the neediest group. Key messages: A multi‐pronged social and behaviour change communication campaign increased egg consumption among young children in rural Rwanda.While the egg consumption gains were modest, the social behaviour change campaign was not fully implemented due to COVID‐19 and other challenges, so it is possible that a more fully implemented campaign could achieve greater impacts.Effects appeared to be most pronounced for boys and those who were already feeding eggs to children. [ABSTRACT FROM AUTHOR]

Countries across the world continue to invest in social protection programs with the goal of ending poverty by 2030. It is important to examine these programs to know whether they are serving the purpose of reducing poverty. In Rwanda, the impact of the Vision Umurenge Program (VUP) regarding poverty‐related outcomes has not been consistently revealed. This leads to uncertainty about the program's effectiveness in achieving the stated goals. This paper intends to fill this gap by estimating the impact of the VUP Direct Support on poverty outcomes. It uses the Propensity Score Matching method to compare the effects of the VUP with a counterfactual outcome. The findings show that the program is benefitting households in response to economic risks. However, the scheme is not lifting them above the national poverty lines. The main contribution of the paper is that it uses a novel method using the latest statistics to evaluate the VUP. In addition, it uses the most recent household data. The study provides a significant contribution to evaluation of the effectiveness of anti‐poverty interventions in Rwanda, as well as the Sub‐Saharan region, where the journey towards achieving the goal of reducing poverty is demanding. [ABSTRACT FROM AUTHOR]

The density of lightning flashes is quite high in Rwanda and its neighboring countries in Africa. In rural areas of these countries, there are still many clay‐wall houses. Sometimes people in clay‐wall houses are fatally injured by direct lightning strikes to the houses. In this paper, the electric field in a clay‐wall house and the step voltage on the floor, associated with a direct lightning strike to the house, are analyzed using the finite‐difference time‐domain (FDTD) method. Also, the electric field and the step voltage in the same clay‐wall house but with a horizontal air termination conductor connected to buried vertical bar earth conductors or a square ring earth conductor via bare or insulated down conductors are analyzed using the FDTD method. It has been shown that installing these protection systems reduces the inside electric field and the step voltage on the floor particularly if insulated down conductors are employed. © 2024 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

In contrast to their use in warfare and surveillance, there is growing interest in the potential of "drones for good" to deliver societal benefits, for example by delivering medical products and other essential goods. Yet development of medical and commercial delivery has been limited globally by restrictive regulation to protect airspace safety and security. In this paper we examine how certain African countries have become testbeds for new forms of drone infrastructure and regulation, driven by the overlapping interests of governments, drone operators, and international development agencies. In particular we explore the factors that have led to the development of an advanced medical delivery network in Rwanda and contrast that with the closing down of airspace for drones in Tanzania. The paper makes a distinctive contribution to research on the ongoing constitution of dronespace as a sphere of commercial and governmental activity. Rwanda's drone delivery system is seen as the forerunner for the wider enclosure and parcelling up of the lower atmosphere into designated drone corridors that limit the democratic and disruptive potential of drone activity in line with prevailing logics of airspace regulation. In this paper we examine how certain African countries have become testbeds for new forms of drone infrastructure and regulation, driven by the overlapping interests of governments, drone operators, and international development agencies. In particular we explore the factors that have led to the development of an advanced medical delivery network in Rwanda and contrast that with the closing down of airspace for drones in Tanzania. The paper makes a distinctive contribution to research on the ongoing constitution and enclosure of dronespace as a sphere of commercial and governmental activity. [ABSTRACT FROM AUTHOR]

In recent years, fall armyworm (FAW), Spodoptera frugiperda, has emerged as one of the most serious invasive species in many countries across Africa, Asia and Oceania. The pest is causing extensive damage to maize production and the intensification of pesticide use. In this paper, we examined the effectiveness of three mass‐extension channels (plant health rallies, radio drama and SMS) in enhancing farmers' knowledge and management of FAW and in increasing maize productivity. Applying matching techniques to data from 720 smallholder farmers and 1077 maize plots in Eastern Rwanda, we found that exposure to the information channels is significantly associated with increased knowledge outcomes, including knowledge of the correct identification of FAW and the use of cultural practices as the first resort to pest management. Moreover, the information channels showed positive effects on the adoption of environmentally friendly management practices. Generally, the treatment effects are larger for households exposed to multiple (especially all) channels, indicating complementary effects of the channels. We also found suggestive evidence that the information channels are associated with maize yield increases ranging from 10% to 34%, depending on the channel. Overall, the results imply that multi‐channel information campaigns can be effective in enhancing farmers' knowledge on how to identify and sustainably manage the FAW pest. Our findings also suggest that while there is a growing popularity in the use of digital extension approaches to deliver timely information to farmers in a cost‐effective manner, much greater gains can be achieved if they are combined with other low‐cost face‐to‐face extension methods, such as plant health rallies. [ABSTRACT FROM AUTHOR]

In this study, we measured Rwandan men's engagement in HIV services based on the UNAIDS 90‐90‐90 targets and assessed factors associated with linkage to HIV services. We analyzed the Rwanda Population‐based HIV Impact Assessment (RPHIA) data for 15‐ to 64‐year‐old males. We conducted bivariate analysis to assess the distribution and association of sociodemographic characteristics with UNAIDS 90‐90‐90 targets. We adjusted multivariable models to understand the effect measurement of associated factors and determine the factors that best predict the achievement of UNAIDS 90‐90‐90. Of 13 780 males aged 15–64 years who participated in the RPHIA and consented to the blood draw and HIV testing, 302 had a positive HIV result, while 301 had valid responses to all variables analyzed in this paper and were included in the analysis. We found that age group was an explanatory and predictive factor for achievement of UNAIDS 90‐90‐90. Younger men living with HIV (MLHIV) are less likely to have achieved UNAIDS 90‐90‐90 compared to MLHIV 50–64 years old: adjusted odds ratio (aOR) for MLHIV aged 15–34 years was 0.21 (0.08–0.53) and aOR for MLHIV aged 35–49 years was 0.77 (0.36–1.66). To close the UNAIDS 90‐90‐90 gap in Rwanda, innovative service delivery strategies are needed to support young MLHIV to reach 90‐90‐90. [ABSTRACT FROM AUTHOR]

Introduction/Background: Safe and quality surgery is crucial for child health. In Rwanda, district hospitals serve as primary entry points for pediatric patients needing surgical care. This paper reports on the organizational readiness and facility capacity to provide pediatric surgery in three district hospitals in rural Rwanda. Methods: We administered the Children's Surgical Assessment Tool, adapted for a Rwandan district hospital, to assess facility readiness across 5 domains (infrastructure, workforce, service delivery, financing, and training) at three Partners in Health supported district hospitals (Kirehe, Rwinkwavu, and Butaro District Hospitals). We used the Safe Surgery Organizational Readiness Tool (SSORT) to measure perceived individual and team readiness to implement surgical quality improvement interventions across 14 domains. Results: None of the facilities had a dedicated pediatric surgeon, and the most common barriers to pediatric surgery were lack of surgeon (68%), lack of physician anesthesiologists (19%), and inadequate infrastructure (17%). There were gaps in operating and recovery room infrastructure and information management for pediatric outpatients and referrals. In SSORT interviews (n = 47), the highest barriers to increasing pediatric surgery capacity were facility capacity (mean score = 2.6 out of 5), psychological safety (median score = 3.0 out of 5), and resistance to change (mean score = 1.5 out of 5 with 5 = no resistance). Conclusions: This study highlights challenges in providing safe and high‐quality surgical care to pediatric patients in three rural district hospitals in Rwanda. It underscores the need for targeted interventions to address facility and organizational barriers prior to implementing interventions to expand pediatric surgical capacity. [ABSTRACT FROM AUTHOR]

The world's 1063 mountain gorillas (Gorilla beringei beringei) live in two subpopulations at the borders of the Democratic Republic of Congo, Rwanda, and Uganda. The majority of mountain gorillas are human‐habituated to facilitate tourism and research, which brings mountain gorillas into close proximity of people daily. Wild great apes are proven to be susceptible to human pathogens, including viruses that have caused fatal respiratory disease in mountain gorillas (e.g., human metapneumovirus1). This is the result of the close genetic relatedness of humans and gorillas as species, and the structural and genetic similarity in molecular receptors that allow viruses to infect cells2. At the time of writing, there is no evidence that severe acute respiratory syndrome coronavirus 2, the coronavirus that causes coronavirus disease 19 (COVID‐19), has infected a mountain gorilla. However, due to the significant potential for human‐to‐gorilla transmission, mountain gorilla range States took immediate steps to minimize the COVID‐19 threat. These actions included a combination of preventive practice around gorillas and other great apes (e.g., mandatory face mask use, increased "social" minimum distancing from gorillas) as well as human public health measures (e.g., daily health/fever screenings, COVID‐19 screening, and quarantines). Minimization of the COVID‐19 threat also required socioeconomic decision‐making and political will, as all gorilla tourism was suspended by late March 2020 and guidelines developed for tourism reopening. A consortium that collaborates and coordinates on mountain gorilla management and conservation, working within an intergovernmental institutional framework, took a multifaceted One Health approach to address the COVID‐19 threat to mountain gorillas by developing a phased contingency plan for prevention and response. The aim of this paper is to describe how range States and partners achieved this collaborative planning effort, with intent that this real‐world experience will inform similar actions at other great ape sites. REASEARCH HIGHLIGHTS: Endangered mountain gorillas are at risk for coronavirus disease 19 (COVID‐19)COVID‐19 risk is high because of daily close proximity of humans.National parks and NGOs developed a contingency plan to ensure best practices for prevention and readiness for response. [ABSTRACT FROM AUTHOR]

In this paper, a system comprising a solar photovoltaic (PV)/micro‐hydropower/battery bank/converter has been designed, modelled, simulated, and optimized for the rural area of Wimana village, Rwanda. The total load has been fairly estimated for the residential electric utility needs. To satisfy the load demand, solar photovoltaic (4 kW) and micro‐hydro (15 kW) power capacity were considered as the main sources of energy to supply electricity. Either in peak load times or during low generation of primary sources, storage battery banks can also be discharged. The simulation and optimization were done based on the load demand, climatic data, the economics of integrated system components, and other parameters in which the total net present cost has to be minimized to select an economically feasible and technically capable hybrid power system. Based on the load profile of the data collected for the village, the daily energy consumption was found to be 180.99 kWh/day with a peak load demand of 18.56 kW. The net present cost and the cost of energy for the optimized power system amount to $78,763.26 and $0.0757/kWh respectively. HOMER Pro simulating software tool was used to design optimal off‐grid and energy management systems. [ABSTRACT FROM AUTHOR]

Infants born preterm, low birthweight or with other perinatal complications require frequent and accurate growth monitoring for optimal nutrition and growth. We implemented an mHealth tool to improve growth monitoring and nutritional status assessment of high risk infants. We conducted a pre–post quasi‐experimental study with a concurrent control group among infants enrolled in paediatric development clinics in two rural Rwandan districts. During the pre‐intervention period (August 2017–January 2018), all clinics used standard paper‐based World Health Organization (WHO) growth charts. During the intervention period (August 2018–January 2019), Kirehe district adopted an mHealth tool for child growth monitoring and nutritional status assessment. Data on length/height; weight; length/height‐for‐age (L/HFA), weight‐for‐length/height (WFL/H) and weight‐for‐age (WFA) z‐scores; and interval growth were tracked at each visit. We conducted a 'difference‐in‐difference' analysis to assess whether the mHealth tool was associated with greater improvements in completion and accuracy of nutritional assessments and nutritional status at 2 and 6 months of age. We observed 3529 visits. mHealth intervention clinics showed significantly greater improvements on completeness for corrected age (endline: 65% vs. 55%; p = 0.036), L/HFA (endline: 82% vs. 57%; p ≤ 0.001), WFA (endline: 93% vs. 67%; p ≤ 0.001) and WFL/H (endline: 90% vs. 59%; p ≤ 0.001) z‐scores compared with control sites. Accuracy of growth monitoring did not improve. Prevalence of stunting, underweight and inadequate interval growth at 6‐months corrected age decreased significantly more in the intervention clinics than in control clinics. Results suggest that integrating mHealth nutrition interventions is feasible and can improve child nutrition outcomes. Improved tool design may better promote accuracy. [ABSTRACT FROM AUTHOR]

Aim: The aim of this prospective meta‐analysis was to synthesize the results of three cluster‐randomized trials of an intervention designed to teach lower‐secondary school students (age 14–16) to think critically about health choices. Methods: We conducted the trials in Kenya, Rwanda, and Uganda. The intervention included a 2‐ to 3‐day teacher training workshop, digital resources, and ten 40‐min lessons. The lessons focused on nine key concepts. We did not intervene in control schools. The primary outcome was a passing score on a test (≥9 of 18 multiple‐choice questions answered correctly). We performed random effects meta‐analyses to estimate the overall adjusted odds ratios. Secondary outcomes included effects of the intervention on teachers. Results: Altogether, 244 schools (11,344 students) took part in the three trials. The overall adjusted odds ratio was 5.5 (95% CI: 3.0–10.2; p < 0.0001) in favor of the intervention (high certainty evidence). This corresponds to 33% (95% CI: 25–40%) more students in the intervention schools passing the test. Overall, 3397 (58%) of 5846 students in intervention schools had a passing score. The overall adjusted odds ratio for teachers was 13.7(95% CI: 4.6–40.4; p < 0.0001), corresponding to 32% (95% CI: 6%–57%) more teachers in the intervention schools passing the test (moderate certainty evidence). Overall, 118 (97%) of 122 teachers in intervention schools had a passing score. Conclusions: The intervention led to a large improvement in the ability of students and teachers to think critically about health choices, but 42% of students in the intervention schools did not achieve a passing score. [ABSTRACT FROM AUTHOR]

To address high rates of malnutrition among children from vulnerable households in Rwanda, the government initiated a national food supplementation programme. A before and after evaluation, using repeat cross‐sectional surveys in randomly selected villages was conducted; aimed at assessing the effectiveness of providing fortified blended food (FBF) to children 18–23 months of age, pregnant and lactating women in the lowest tier of Rwanda's social support system. Data were collected in 2017, 2018 and 2021 through interviews with caregivers; anthropometric measurements and a capillary blood sample were obtained from children. The primary statistical analysis compared the nutritional status of children before and after the introduction of FBF. We enroled 724 children during each survey. The prevalence of stunting declined from 47% to 35% between 2017 and 2021; in 2018, the prevalence of stunting was 43%. Children had a 42% reduction in the odds of being stunted (adjusted odds ratio [AOR]: 0.58, 95% confidence interval [CI]: 0.47–0.74, p < 0.001) from 2017 to 2021 even after adjusting for inherent, distal, proximal, and intermediate covariates. The reduction in stunting observed within the first year of the programme was not statistically significant (AOR: 0.83, 95% CI: 0.67–1.03, p < 0.091). We observed meaningful reductions in the prevalence of stunting among children which coincided with the introduction of Government‐led initiative to reduce malnutrition. The Rwandan Government has committed to improving the living conditions of vulnerable households and has made strong investments in reducing malnutrition. The impact of these investments can be seen in the overall trend towards improved nutritional status highlighted in this evaluation. Key messages: The national distribution of fortified blended food (FBF) to pregnant and lactating women and 6‐ to 23‐month‐old children living in the most vulnerable households was associated with a meaningful reduction in stunted linear growth, iron deficiency and anaemia among young children after 5 years.This study indicates that stunted linear growth, in early childhood, can be reduced over 5 years when the government is committed to and invests in improving the living conditions of vulnerable households, including the national food supplementation programme.It was attainable to distribute FBF to vulnerable pregnant and lactating women and 6‐ to 23‐month‐old children, in a national programme, over the 5‐year evaluation period, including during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

The original article can be found online at https://doi.org/10.1007/s00268-020-05571-6. Correction to: World J Surg (2020) 44:2903-2918 https://doi.org/10.1007/s00268-020-05571-6 The following acknowledgment is missing from the original article: The authors would like to acknowledge Jean Marie Uwitonze as an active contributor to this paper. [Extracted from the article]

Caesarean section (C‐section) is the most performed major surgery worldwide. About 15% of births are delivered through C‐section in Rwanda. The post‐caesarean surgical section is one of the most frequent complications that follow a C‐section. The purpose of this systematic review and meta‐analysis is to estimate the pooled prevalence of surgical site infections following caesarean section deliveries in Rwanda. A comprehensive search was conducted across PubMed/MEDLINE, Google Scholar, DOAJ, AJOL and the Cochrane Library to identify primary studies on post‐caesarean surgical site infections in Rwanda. Studies meeting predetermined criteria were included, and their quality was assessed using the JBI Critical Appraisal Tools. Heterogeneity was evaluated using I2 statistics, while publication bias was examined via funnel plots and statistical tests. Pooled prevalence was calculated using Jamovi 2.3.28 software, with subgroup analysis conducted to identify sources of heterogeneity. Statistical significance was set at p < 0.05. From 139 articles initially searched from the databases, only 17 studies with 8, 082 individuals were finally included in the systematic review and meta‐analysis. Using the random‐effects model, the pooled estimate of post C‐section SSIs prevalence in Rwanda was 6.85% (95% CI 5.2, 8.5). Subgroup analysis based on publication year, sample size, hospital and study design showed no much difference in SSI prevalence. The current systematic review and meta‐analysis indicates that post‐caesarean surgical site infections are significant in Rwanda. A collaborative effort is required to lower post‐C‐section SSIs and provide the best surgical care in the country. [ABSTRACT FROM AUTHOR]

Rhizobia diversity in the rhizosphere is one of the key promoters of biological nitrogen fixation between host legumes and microsymbionts, although related complex interaction may depend on various factors. This research was intended to assess the abundance of indigenous rhizobia isolates under various soil conditions, as well as their effectiveness to nodulate legumes such as soybeans. Factors such as soil properties and legume species influence the volume and symbiotic effectiveness of native rhizobia to nodulate crop legumes. To investigate the abundance of rhizobia isolates, legume crops were uprooted to obtain nodules for most probable number (MPN) determination of rhizobia isolates, and soybean (Glycine max.) was used to verify the presence of suitable and efficient rhizobia strains for nitrogen fixation. Soil samples were obtained from the holes out of which nodules were collected, and the laboratory analysis included pH, Mg, K, available P, organic C, Ca, and N to establish the correlation between the soil status and number of rhizobia isolates' cells. Significant variations (p‐value <.05) were observed in the cell counts of Rhizobia isolates from Glycine max, Phaseolus vulgaris, Pisum sativum, and Vigna unguiculata, particularly when compared to Arachis hypogaea isolates under acidic conditions. Notably, Pisum sativum and Vigna unguiculata showed consistent performance across all pH conditions. The number of rhizobia isolates was found to be significantly linked to total N and P deficiencies (p <.05). It was also established that total N was dependent on the number of rhizobia cells and that there is a strong correlation between organic carbon and N content. This study highlights the crucial role of understanding and optimizing conditions for rhizobia nodulation in diverse soil environments, emphasizing its potential impact on enhancing biological nitrogen fixation in legumes. [ABSTRACT FROM AUTHOR]

The sale, only the second by Rwanda, at an interest rate of 5.5%, follows lower than expected interest rates on paper issued by B Ghana b and B Benin b in July, and dollar debt sales by B Cameroon, Kenya b and B Senegal b in June. But emerging markets analysts Tellmer say that there is "generally strong investor buy-in to Rwanda's growth and reform story, despite a high and rising debt burden" adding that "we view the issuance as a positive signal for Rwanda's debt management". Rwanda became the latest African sovereign to benefit from money markets issuing US$620m of international bonds on August 2nd. [Extracted from the article]

Infant and young child feeding (IYCF) plays a crucial role in early childhood growth and development. This study summarizes recent IYCF practices in multiple refugee settings and compares them to those in the host countries. We analyzed 203 surveys conducted among refugees residing in 15 countries and 120 unique sites and assessed eight IYCF indicators available from those surveys. A total of 146 surveys were conducted in Eastern and Southern Africa (ESA) and 50 in Western and Central Africa (WCA) regions. The median prevalence across surveys of all four indicators describing intake of breast milk was relatively high: 96.6% for ever breastfed, 81.2% for initiation of breastfeeding within 1 h of birth, 76.9% for exclusive breastfeeding 0–5 months, and 75.0% for continued breastfeeding 12–23 months. The median prevalence of early initiation and exclusive breastfeeding was markedly higher in ESA than in WCA (85.0% vs. 37.5% and 83.5% vs. 56.1%, respectively). Conversely, the overall median prevalence of timely introduction of solid and semisolid foods and flesh food consumption was low: 51.8% and 16.1%, respectively. Flesh food consumption was higher in WCA than in ESA (27.4% vs. 11.6%). The median prevalence of mixed milk feeding at 0–5 months and bottle feeding was very low: 2.4% and 3.8%, respectively. Indicators describing breast milk intake were generally either similar or higher in refugees than in the host country populations, whereas the other indicators were generally higher in the host populations than in refugees. The low prevalence of timely introduction of solids and of flesh food consumption in refugees is concerning and requires substantial improvement. Key Messages: Infant and young child feeding practices need to be monitored in refugee settings where access to nutritious foods may be limited.We analyzed infant and young child feeding data from 203 population representative surveys in refugee settings conducted during 2013–2019.Prevalence of indicators describing breast milk consumption in refugees was relatively high overall and similar or higher than in local populations.Prevalence of indicators describing the consumption of other complementary foods or liquids in refugees was low overall and generally lower than in the host populations, documenting a need for improved access to such foods and change in feeding practices. [ABSTRACT FROM AUTHOR]

I (Rwandan franc 1000 = £0.77/$0.96/€0.90) i B The aim is to return growth to pre-pandemic levels. b The government of Rwanda is expected to spend an estimated Rwandan francs 4,658.4bn in the next fiscal year (2022/2023), representing an increase of Rwf217.8bn or 4.7% compared to Rwf4,440.6bn of the revised budget of the current fiscal year. The disclosure was made on May 19th by Uzziel Ndagijimana, minister of finance and economic planning, while presenting the 2022-2023 Budget Framework Paper, and the annual budget estimates to both chambers of parliament. While presenting the proposed financial plan to legislators, Ndagijimana said that the next financial year budget, which will start on July 1st, 2022, will focus on the implementation of government strategies meant to resuscitate the economy from the Covid-19 pandemic so that it reaches the pre-pandemic growth level. [Extracted from the article]

Aim: The aim of this trial was to evaluate the effects of the Informed Health Choices intervention on the ability of students in Rwandan to think critically and make Informed Health Choices. Methods: We conducted a two‐arm cluster‐randomized trial in 84 lower secondary schools from 10 districts representing five provinces of Rwanda. We used stratified randomization to allocate schools to the intervention or control. One class in each intervention school had ten 40‐min lessons taught by a trained teacher in addition to the usual curriculum. Control schools followed the usual curriculum. The primary outcome was a passing score (≥ 9 out of 18 questions answered correctly) for students on the Critical Thinking about Health Test completed within 2 weeks after the intervention. We conducted an intention‐to‐treat analysis using generalized linear mixed models, accounting for the cluster design using random intercepts. Results: Between February 25 and March 29, 2022, we recruited 3,212 participants. We assigned 1,572 students and 42 teachers to the intervention arm and 1,556 students and 42 teachers to the control arm. The proportion of students who passed the test in the intervention arm was 915/1,572 (58.2%) compared to 302/1,556 (19.4%) in the control arm, adjusted odds ratio 10.6 (95% CI: 6.3–17.8), p < 0.0001, adjusted difference 37.2% (95% CI: 29.5%–45.0%). Conclusions: The intervention is effective in helping students think critically about health choices. It was possible to improve students' ability to think critically about health in the context of a competence‐based curriculum in Rwanda, despite challenging postpandemic conditions. [ABSTRACT FROM AUTHOR]

This study examines the mechanisms fostering sustainable value propositions of implemented e‐Governments projects in sub‐Saharan Africa (SSA) as a research focus. Value propositions identify how public organizations use e‐Government to fulfill citizens' needs across different roles. Using a concept‐centric systematic review, we identified such value propositions as effective public organizations, quality service delivery, open government and democratic values, as well as social values and well‐being. We chose some selected e‐Government projects in Nigeria and Rwanda; adopted realist evaluation (RE) multiple case studies as a methodology and introduced affordance actualization, self‐determination theory, and sustainability framework for e‐Government success as theoretical lenses. To collect data, we adopted a mixed method RE approach and used a contingent valuation method (CVM) as a quantitative aspect to identify the actualized value propositions in operations in the implemented e‐Government projects in Nigeria and Rwanda as outcomes. Sequentially followed by a realist interview as a qualitative approach to collect and analyze data we uncovered the generative mechanisms causing such outcomes to exist and be sustainable. Our findings revealed technological cognizance and autonomy as well as competence as individual mechanisms identified for sustaining such outcomes. While organizational mechanisms revealed are continuous availability of funds, institutional, administrative, and coordinating capacity with leadership and political support. Other organizational mechanisms include institutionalizing the technology within local settings with ongoing monitoring and improvement evaluation enabled by both internal and external contextual conditions. We synthesized our findings into an actualized value sustainability framework for implemented e‐Government projects in SSA to contribute to academics and practice in ICT4D, particularly RE application in e‐Government study, which is nascent. [ABSTRACT FROM AUTHOR]

Objectives: Hundreds of thousands of Rwandans were conceived during the 1994 genocide against the Tutsi, including thousands conceived by genocidal rape. We explore whether the duration of first trimester exposure to the genocide is associated with variation in adult mental health outcomes in individuals exposed to varying degrees of genocide‐related stress in utero. Materials and Methods: We recruited 30 Rwandans conceived via genocidal rape, 31 Rwandans conceived by genocide survivors not raped, and 30 individuals of Rwandan‐descent who were conceived outside of Rwanda at the time of the genocide (control group). Individuals were age‐ and sex‐matched across groups. Adult mental health was assessed through standardized questionnaires for vitality, anxiety, and depression. Results: Among the genocide only group, a longer duration of first trimester prenatal exposure was associated with higher anxiety scores and lower vitality (both p < 0.010), and higher depression scores (p = 0.051). Duration of first trimester exposure was not associated with any measures of mental health among the genocidal rape or control group. Discussion: Duration of exposure to genocide in the first trimester of gestation was associated with variation in adult mental health among the genocide only group. The lack of association between duration of first trimester exposure to genocide and adult mental health in the genocidal rape group may reflect the fact that stress associated with conception through rape persisted beyond the genocide period itself, encompassing all of gestation and likely beyond. Geopolitical and community interventions are needed in the context of extreme events during pregnancy to mitigate adverse intergenerational outcomes. [ABSTRACT FROM AUTHOR]

Local Indicators of Spatial Association (LISA) are a class of spatial statistical methods that have been widely applied in various scientific fields. When applying LISA to make longitudinal comparisons of spatial data, a common way is to run LISA analysis at each time point, then compare the results to infer the distributional dynamics of spatial processes. Given that LISA hinges on the global mean value that often varies across time, the LISA result generated at time Ti reflects the spatial patterns strictly with respect to Ti. Therefore, the typical comparative cross‐sectional analysis with LISA can only characterize the relative distributional dynamics. However, the relative perspective alone is inadequate to comprehend the full picture, as the patterns are not directly associated with the changes of the spatial process's intensity. We argue that it is important to obtain the absolute distribution dynamics to complement the relative perspective, especially for tracking how spatial processes evolve across time at the local level. We develop a solution that modifies the significance test when implementing LISA analysis of longitudinal data to reveal and visualize the absolute distribution dynamics. Experiments were conducted with Mongolian livestock data and Rwanda population data. [ABSTRACT FROM AUTHOR]

We help to unravel how smallholder farmers in agricultural cooperatives can address the consequences of climate change. Climate change‐oriented actions often pose an extra challenge to cooperative members in time‐poverty, that is, to those who have no choice but to work long hours yet remain consumption poor. Tackling climate change requires future‐oriented action toward unpredictable events, whereas time‐poverty requires people to deal with the bare necessities of the present. Through a qualitative inductive study of Rwandan smallholder farmers in agricultural cooperatives, we observe that climate change increases time‐poverty, especially for women, and that smallholder farmers are hesitant to invest their time in making climate change adaptations. We find that smallholder farmers can overcome these challenges through membership of agricultural cooperatives, which can help in pacing climate change actions. [ABSTRACT FROM AUTHOR]

This article describes the migration, resettlement and integration challenges and strengths of members of the African Diaspora in Canada who identify as survivors of the 1994 genocide against the Tutsi of Rwanda. Data were generated from semi‐structured interviews with 16 adult community members and a thematic analysis conducted inductively and collectively with the research team consisting of academics and representative community members. This article provides insights into the unique long‐term impacts of genocide on migration, resettlement and community‐level functioning for this group of African migrants living in a mid‐Western city in Canada. Results highlight how Canadian immigration policies limit migration options and prevent family reunification for migrants with none or few remaining family members and the associated resettlement challenges experienced by this group. Results also show the vital role the Rwandan Diaspora community, and particularly other survivors, play in supporting resettlement, integration and overall well‐being of genocide survivors. [ABSTRACT FROM AUTHOR]

At 33% of under‐5s, stunting rates in Rwanda remain stubbornly high, as do figures for maternal (25% of pregnant women) and childhood anaemia (37%). Intensive communication and education campaigns have provided caregivers with high levels of knowledge about best practices in Maternal, Infant and Young Child Nutrition (MIYCN), but this is not translating into the improved diets which could contribute to reducing rates of stunting. Deploying an anthropological approach via multi‐module Focused Ethnographic Studies carried out within household case studies, the research team sought to understand drivers of suboptimal feeding practices in a sample of 30 households across all of Rwanda's districts. The sample included households with pregnant women as well as children in the 6–60 month age range. Analysed against a framework of proximal and underlying causes of under‐nutrition, our results reveal gaps in the knowledge‐capability‐practice chain resulting from decisions and prioritisations taken by caregivers and heads‐of‐household. Pregnant women and mothers of young children possess high levels of knowledge about feeding themselves and their young children, but this is not reflected in decision‐making and prioritisation around the acquisition and feeding of animal source foods, whose consumption is low among both groups. This was found to be true even in households which own and raise livestock. Turning to policy and programmes, we argue for a move towards incentivized human capital programming focusing on the 'last mile' behaviour change which is needed to translate knowledge and capability into better dietary choices. Key messages: Results of this study point to a combination of behavioural drivers of under‐nutrition, particularly in infants and young children. Results reveal gaps in the knowledge‐capability‐practice chain resulting from decisions and prioritizations taken by caregivers.We are seeking a shift towards greater diversity of micronutrient‐rich foods including more animal source foods in the diets of pregnant and lactating women and young children. Household level behavioural change, reinforced by social norm change at the community level, is required to help caregivers make better decisions around both cultivar and market choices.In policy and programme terms, we argue for a move towards incentivized human capital programming focusing on the 'last mile' behaviour change which is needed to translate both knowledge and capability into better dietary choices and prioritisations. [ABSTRACT FROM AUTHOR]

Sustainability certification has become an important tool for promoting sustainable agricultural value chains. Nevertheless, its economic and environmental effects on the producer level remain unclear. We investigate the relationship of Rainforest Alliance Certification with socio‐economic and environmental outcomes in Rwanda and consider potential tradeoffs between dimensions. To reduce potential selection bias in the econometric estimation, we use inverse probability weighted regression adjustment. We find no significant association between certification and socio‐economic indicators but a significant correlation between certification and good agricultural practices and biodiversity‐related practices. Effects on economic outcomes and biodiversity‐related practices are linked; their relationship differs across climatic regions. [ABSTRACT FROM AUTHOR]

Summary: Motivation: Young people's futures are at risk. Global crises such as armed conflict, climate change, mass displacement, and public health emergencies are threatening the education and wellbeing of adolescents all over the world. But young people are also resilient and innovative. It is vital that they have opportunities to develop relevant skills and knowledge, to build resilience, and overcome these challenges now and in the future. Purpose: This special issue brings together researchers and practitioners in the field of international education. Its purpose is twofold: to illustrate how current global challenges shape the types of skills needed to build resilience; and to offer possible solutions to supporting young people's development of such skills. Methods and approach: The articles in this special issue draw on both quantitative and qualitative data, including surveys and interviews with students, parents, teachers, school leaders, nonformal education providers, and government officials. Most studies present evidence from sub‐Saharan Africa. Findings The findings presented in this special issue address a range of skills, including foundational literacy and numeracy, hard skills in digital literacy, financial literacy, and entrepreneurship, and soft skills, such as critical thinking, confidence, voice and agency. Policy implications: With the special issue we aim to draw more attention to the need for research and policy that equip youth with relevant skills and that see them not just as subjects of the challenges they encounter, but also as active agents of change. We also highlight the importance of an intersectional lens that addresses not just gender, but also other individual and household characteristics, such as student age, disability status, and poverty to support youth resilience and skills development. [ABSTRACT FROM AUTHOR]

Summary: Motivation: The development of life skills has been increasingly recognized in formal and non‐formal education programmes as critical to enabling young people to flourish in personal relationships, the workplace, and wider society. Recent competency‐based curricular reform reflects a growing consensus on the importance of developing a combination of socioemotional, cognitive, and practical skills to overcome contemporary social, environmental, and economic global challenges. Yet there is limited research examining the pedagogical practices that lead to the effective development of such skills. Purpose: This article seeks to fill that gap by drawing on lessons from Rwanda's 12+ programme, a non‐formal life skills programme for adolescent girls. Examining potential links between pedagogical practices and the programme's impacts on adolescent girl participants, it enquires into lessons that can be learnt for both formal and non‐formal schooling. Methods and approach: Insights from focus groups and interviews with 12+ graduates (ages 15–17) and mentors were triangulated with analysis of project documentation including teaching and learning materials. Findings Five insights are highlighted: structured teaching and learning materials and scaffolded support for mentors; the use of dialogic teaching; experiential learning opportunities; the importance of safe spaces and trusting relationships; and the engagement of mentors as role models. These combined ingredients of effective life skills programming were perceived to have led to the development of adolescent girls' skills, knowledge, and attitudes, including confidence, voice and agency, financial literacy, self‐efficacy, and self‐care. Policy implications: Teacher education and ongoing professional development should focus on strengthening teachers' capacity to use learner‐centred, interactive methods, and to foster positive social relationships with and among learners. Sharing of materials and approaches between non‐formal programmes and the formal education system should be encouraged. [ABSTRACT FROM AUTHOR]

Summary: Motivation: Aid fungibility and aid ownership have largely been discussed separately in the development literature. This is unfortunate because donors have often aimed to reduce the former and to increase the latter, without fully understanding the relationship between them. Purpose: We analyse what happens to aid fungibility when the recipient government takes ownership of its development process by examining the case of Rwanda. Methods and approach: We use a mixed‐methods approach for our analysis. We start with an econometric model to determine if aid fungibility is present in Rwanda. To complement and explore quantitative insights, we interviewed key informants in Rwanda. We used the principal–agent framework to help interpret our findings. Findings We find that aid is fungible, albeit in a U‐shaped relationship. Initially an increase in development assistance causes government development expenditure to fall, but subsequent increases in assistance cause government development expenditure to increase as well. We conclude that the government took over its development process through: (1) stimulating the donor to align their spending to its priorities; and (2) urging donors to switch from project aid to budget support. Policy implications: While government taking ownership of its development process should reduce concerns about fungibility, it could also contribute to marginalization of certain sectors or themes if this ownership is not inclusive. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Ecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Ecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In rural Africa where access to medical personnel is limited, telemedicine can be leveraged to empower community health workers (CHWs) to support effective postpartum home-based care after cesarean section (c-section). As a first step toward telemedicine, we assessed the sensitivity, specificity, and interrater reliability of image-based diagnosis of surgical site infections (SSIs) among women delivering via c-section at a rural Rwandan Hospital. Methods: Women ≥18 years who underwent c-section from March to October 2017 at Kirehe District Hospital (KDH) were enrolled. On postoperative day 10 at KDH, participants underwent a physical examination by a general practitioner, who provided a diagnosis of SSI or no SSI. Trained CHWs photographed patients' incisions and the collected images were shown to six physicians, who upon review, assigned one of the following diagnoses to each image: definite SSI, suspected SSI, suspected no SSI, and definite no SSI, which were compared with the diagnoses based on physical exam. We report the sensitivity and specificity and assessed reviewer agreement using Gwet's AC1. Results: 569 images were included, with 61 women (10.7%) diagnosed with an SSI. Of the 3414 image-reviews, 49 (1.4%) could not be assigned diagnoses due to image quality. The median sensitivity and specificity were 0.83 and 0.69, respectively. The Gwet's AC1 estimate for binary classification was 0.46. Conclusions: We demonstrate decent accuracy but only moderate consistency for photograph-based SSI diagnosis. Strategies to improve overall agreement include providing clinical information to accompany photographs, providing a baseline photograph for comparison, and implementing photograph-taking processes aimed at improving image quality. [ABSTRACT FROM AUTHOR]

When a sediment laden river flows into a stratified water body, the water mass can either intrude as an overflow, interflow or underflow, depending upon the density contrast. Different modes of sediment driven convection occur in each case. For the case of overflows, convective sedimentation occurs beneath the plume, whereby sediment rich plumes rapidly transport fine materials to depth. If underflow of dense sediment laden waters initially occurs, then after sediment has been deposited, the light interstitial material can subsequently loft and potentially mixes the entire water column. For an interflow, both lofting and sediment driven convection can occur above and below the pycnocline. All of these different regimes can be described in terms of two dimensionless parameters: namely RS = ΔρS/ΔρC and RA = ΔρA/ΔρC, where ΔρA is the density contrast between the upper layer and the river inflow (due to just salinity or temperature differences), ΔρC is the density contrast due to sediment between river and upper‐layer, and ΔρS is the density contrast between upper and lower layers (due to just salinity or temperature differences). Laboratory experiments were used to describe the vigour of convection in terms of these dimensionless parameters, which then allows behaviour of various inflows to be predicted. In most cases the convective velocities observed were an order of magnitude faster than Stokes settling velocities. These observations are also applied to predict how a turbidity current could lead to lofting and possible overturn of the stratification of Lake Kivu, a large meromictic lake between Rwanda and the Democratic Republic of the Congo. [ABSTRACT FROM AUTHOR]

Maternal undernutrition remains a major public health concern in Rwanda despite significant gains and progress. An integration of nutrition‐specific and nutrition‐sensitive interventions was implemented in five districts of Rwanda to improve maternal and child nutrition. The package included nutrition education and counselling, promotion of agricultural productivity, promotion of financial literacy/economic resilience and provision of Water, Hygiene and Sanitation services. However, there is limited evidence about the effect of such interventions in reducing maternal undernutrition. A postintervention quasi‐experimental study was conducted among pregnant women to determine the effect of the integrated intervention on their nutritional status. It was carried out in two intervention districts, namely Kicukiro and Kayonza, and two control districts, namely Gasabo and Gisagara between November 2020 and June 2021. Five hundred and fifty‐two women were recruited for the intervention arm, while 545 were recruited for the control arm. Maternal undernutrition was defined as either having low mid‐upper arm circumference (<23 cm) during delivery or low body mass index (<18.5 kg/m2) in the first trimester or both. A multivariable logistic regression model was used to assess the effect of the integrated interventions. The prevalence of maternal undernutrition was significantly lower in the intervention group compared with the control group (4.7% vs. 18.2%; p < 0.001). After controlling the potential confounders, the risk of maternal undernutrition was 77.0% lower in the intervention group than in the control group [adjusted odds ratio= 0.23; 95% confidence interval = 0.15–0.36; p < 0.001]. Further studies are therefore recommended to establish causation and inform the potential scale‐up of these interventions nationally in Rwanda. Key messages: Empirical evidence on the effect of integrated nutrition‐specific and nutrition‐sensitive interventions on maternal undernutrition is limited as existing studies are mainly directed at the effectiveness of nutritional interventions on improving child nutritional status.The results indicated that the integrated nutrition‐specific and nutrition‐sensitive intervention package was significantly associated with low maternal undernutrition.This study adds more evidence to the 2008, 2013 and 2021 Lancet Series regarding the proposed effectiveness of integrated nutrition‐sensitive and nutrition‐specific interventions.Further research should focus on follow‐up randomized controlled trials and the cost‐effectiveness of these integrated nutrition‐specific and nutrition‐sensitive interventions. [ABSTRACT FROM AUTHOR]

Summary: Motivation: Localization is an elusive target of international development, aimed at strengthening local ownership through equitable partnerships and redistribution of resources and decision‐making. While this is a long‐standing objective, it remains unachieved. In light of these limitations in global governance, the transformative potential of Agenda 2030 is questioned. Purpose: This article observes policy shifts triggered by Agenda 2030 by analysing its domestication in institutional and national contexts in Kenya, Rwanda, and Uganda. By asking "Can Agenda 2030 bring about localization?" the article examines the policy potential of Agenda 2030 to transform the traditional international development paradigm, as David Slater theorized in 1993. Methods and approach: The article offers interpretive policy analysis and presents insights drawn from 172 interviews and 11 focus group discussions (FGDs) conducted with international and national civil servants, civil society actors, and academics in Kenya, Rwanda, and Uganda, as well as headquarters and regional offices of selected United Nations and donor agencies. Findings: Agenda 2030 emerges as a legitimate framework that creates new policy avenues of national agenda‐setting and multi‐stakeholder co‐ordination. Across all three national contexts, Agenda 2030 was integrated into national agendas, considered to be central development anchors that, however, largely depend on change‐resistant donor structures. This is intensifying critiques of development paradigms among development practitioners, particularly from historically disadvantaged countries. Policy implications: While triggering meaningful shifts in development agenda‐setting, Agenda 2030 has not resulted in political commitments to transform inequitable global development mechanisms that would enable its achievement. Key bottlenecks, in fact, are found not in the insufficient implementation of countries receiving official development assistance, but in the lack of institutional reforms to donor and global governance mechanisms. Political, rather than policy, solutions are required. [ABSTRACT FROM AUTHOR]

After the 1994 genocide against the Tutsi, many grassroots initiatives in Rwanda have focused on reconciliation. The current study examined the relationships between survivor readiness to reconcile and génocidaire shame, guilt, and self‐forgiveness and survivor traumatic stress, desire for outgroup interaction, and beliefs about outgroup members. Survivors (n = 45) and their direct perpetrators (n = 46) who participated as a dyad in a local peacebuilding program were interviewed at four strategic phases. No significant relationship was found between survivor readiness to reconcile and génocidaire shame and guilt; génocidaire self‐forgiveness did not mediate this relationship. Higher survivor traumatic stress symptoms were associated with lower readiness to reconcile, and greater survivor desire for outgroup interaction was associated with greater readiness to reconcile. Fewer survivor prejudicial beliefs towards génocidaires were significantly associated with higher readiness to reconcile. Decades after the genocide, reconciliation follows a non‐linear trajectory and may be more influenced by intrapersonal than interpersonal factors. [ABSTRACT FROM AUTHOR]

Background: Abortions cause tremendous economic losses in food‐producing animals and may lead to food insecurity. Objectives: This study aimed to characterize Brucella spp. and other abortigenic pathogens from aborted tissues of cattle. Methods: For cattle, aborted tissues (n = 19) were cultured, and Brucella spp. were detected using the genus‐specific 16S‐23S ribosomal DNA interspacer region (ITS) assay and speciated using Brucella abortus, Brucella melitensis, Brucella ovis, and Brucella suis (AMOS) and Bruce‐ladder PCR assays. Brucella negative samples were screened using the eight abortigenic pathogens PCR panel. Samples from an abortion outbreak that occurred within a goat tribe were included in this investigation. Sera of females (n = 8) and males (n = 2) were analyzed using the Rose Bengal Test (RBT) and indirect enzyme‐linked immunosorbent assay (i‐ELISA), while vaginal swabs (n = 3) and aborted tissues (n = 1) were cultured and characterized. Results: The ITS‐PCR detected Brucella DNA in cultures from two aborted tissues of cattle (10.5%, [2/19]), which were identified as B. melitensis (n = 1), and B. abortus (n = 1) using AMOS and Bruce‐ladder PCR assays. Campylobacter fetus (n = 7) and Leptospira spp. (n = 4) including co‐infections (n = 2) of C. fetus and Leptospira spp. were identified from the Brucella negative samples of cattle. Goats (100.0%, 10/10) were brucellosis seropositive on RBT and i‐ELISA. Mixed infections caused by B. melitensis and B. abortus were isolated from the vaginal swabs (n = 3) and aborted tissues (n = 1). Discussion and conclusions: This is the first identification of abortion‐associated pathogens in aborted cattle indicating the enormous financial losses and a threat to public health. It is therefore essential to include these identified pathogens in the surveillance scheme of veterinary and human services. [ABSTRACT FROM AUTHOR]

Background: Previous studies focusing on high‐income countries have shown that young people often face greater barriers to accessing healthcare than older adults. However, in low‐middle income countries (LMICs), there have been a paucity of cross‐country, quantitative studies highlighting these barriers. Aim: This exploratory study aims to provide a scoping review of the publicly available Demographic and Heath Survey (DHS) data with a view to form the basis for further work. Materials and methods: Data on insurance coverage, agency, and access to evidence‐based family planning from 30 countries in the DHS were compared between age groups. Data on 586,250 participants 15–24 years (33% male) and 854,660 participants 25–49 years (16% male) from 30 LMICs were analyzed. Results: Significantly greater barriers to accessing healthcare were observed across six variables in younger population when compared to older adults across all survey questions with an average of 8.4% point difference. Also, there was wide country‐level variation: the maximum differences between age groups were 33% points; Rwanda was the only country with no age differences. Discussion: This study highlights several possible themes for future research into improving access to healthcare for young people. These themes include more detailed evaluation of country‐specific policies to reduced barriers to healthcare for young people and further research into the causative factors that can influence healthcare utilization by young people. Conclusion: Our analysis showcases increased barriers to healthcare access for young people in LMICs. We argue that they can only be improved by targeted policies and direct community engagement. [ABSTRACT FROM AUTHOR]

This study analyzes smallholder farmers' decisions to adopt beans with higher levels of dietary iron developed through a conventional breeding technique called biofortification. We approach this study by applying spatial econometric techniques to estimate neighborhood influence and to determine the factors driving the adoption of iron‐biofortified beans (IBB). We employ a cross‐sectional, nationally representative survey of bean producing households from 2015 bean growing season B in Rwanda, and present results for growers of both bush and climbing varieties of beans. The results show geographic diffusion of iron bean planting material occurs among neighboring farmers that exhibit interdependent decision‐making patterns, as well as similar characteristics relative to the group. Some policy implications can be drawn from the results. First, a differentiated geographical targeting strategy for bush and climbing bean varieties as a function of farmer and farm characteristics should increase iron bean adoption rates. Second, strengthening partnerships with delivery agents and extensionists should stimulate the adoption of IBB varieties. And finally, technology‐promotion programs that consider progressive farmers and strengthen social interactions and group activities among peer networks should increase the spread of information and diffusion of IBB. [ABSTRACT FROM AUTHOR]

Radiotherapy is an essential component of cancer treatment, yet many countries do not have adequate capacity to serve their populations. This mismatch between demand and supply creates the need for priority setting. There is no widely accepted system to guide patient prioritization for radiotherapy in a low resource context. In the absence of consensus on allocation principles, fair procedures for priority setting should be established. Research is needed to understand what elements of procedural fairness are important to decision makers in diverse settings, assess the feasibility of implementing fair procedures for priority setting in low resource contexts, and improve these processes. This study presents the views of decision makers engaged in everyday radiotherapy priority setting at a cancer center in Rwanda. Semi‐structured interviews with 22 oncology physicians, nurses, program leaders, and advisors were conducted. Participants evaluated actual radiotherapy priority setting procedures at the program (meso) and patient (micro) levels, reporting facilitators, barriers, and recommendations. We discuss our findings in relation to the leading Accountability for Reasonableness (AFR) framework. Participants emphasized procedural elements that facilitate adherence to normative principles, such as objective criteria that maximize lives saved. They ascribed fairness to AFR's substantive requirement of relevance more than transparency, appeals, and enforcement. They identified several challenges unresolved by AFR, such as conflicting relevant rationales and unintended consequences of publicity and appeals. Implementing fair procedure itself is resource intensive, a paradox that calls for innovative, context‐appropriate solutions. Finally, socioeconomic and structural barriers to care that undermine procedural fairness must be addressed. [ABSTRACT FROM AUTHOR]

Summary: Motivation: Despite its status as a low‐income country in an unfavourable location for economic conduct, and being overshadowed by the devastating genocide of 1994, Rwanda has been recognized for its efforts to improve its business environment via several reforms and regulations according to various indicators. Purpose: We contribute an analysis of the extent of improvements which Rwanda's regulatory reforms have yielded in the business environment. We also identify four interconnected drivers of change which account for the government's capability to implement successful reforms in the economy. Methods and approach: We adopt a quantitative and qualitative approach. Findings: We find that Rwanda's regulatory reforms in the business environment are rather a mixture of true progress and window dressing. The drivers of change accounting for the progress in Rwanda's economy are the pressure on the government to generate economic growth, the country's leadership, the pre‐colonial institutional framework, and Rwanda's aid effectiveness. Policy implications: The close interconnectedness of political and economic entities makes it inefficient to implement integral changes to Rwanda's current system. The Rwandan government should rather credibly commit to its own policies and developmental approaches and continue its progress in private sector transformations without crowding out small‐ and medium‐sized enterprises. [ABSTRACT FROM AUTHOR]

Timely, high‐quality mortality data have allowed for assessments of the impact of the novel coronavirus disease 2019 (COVID‐19) on life expectancies in upper‐middle‐ and high‐income countries. Extant data, though imperfect, suggest that the bulk of the pandemic‐induced mortality might have occurred elsewhere. This article reports on changes in life expectancies around the world as far as they can be estimated from the evidence available at the end of 2021. The global life expectancy appears to have declined by 0.92 years between 2019 and 2020 and by another 0.72 years between 2020 and 2021, but the decline seems to have ended during the last quarter of 2021. Uncertainty about its exact size aside, this represents the first decline in global life expectancy since 1950, the first year for which a global estimate is available from the United Nations. Annual declines in life expectancy (from a 12‐month period to the next) appear to have exceeded two years at some point before the end of 2021 in at least 50 countries. Since 1950, annual declines of that magnitude had only been observed on rare occasions, such as Cambodia in the 1970s, Rwanda in the 1990s, and possibly some sub‐Saharan African nations at the peak of the acquired immunodeficiency syndrome (AIDS) pandemic. [ABSTRACT FROM AUTHOR]

We report Avibacterium paragallinarum and Klebsiella pneumoniae coinfection in a grey crowned crane (Balearica regulorum). The crane was recovered from illegal captivity and released at a grey crowned crane (GCC) rehabilitation facility located at Akagera National Park in Rwanda. One year after being transferred, the bird presented with clinical signs suggesting a respiratory disease. Those signs included severe dyspnoea with mouth breathing, sneezing and nasal discharge. The crane was put on a 3‐day treatment with antibiotics (ceftiofur 200 mg/ml at 50 mg/kg intramuscularly) and anti‐inflammatory drug (meloxicam, intramuscular injection at a dose of 2 mg/kg), after which the crane seemed to have recovered. A month later, the same crane presented similar clinical signs and was treated with enrofloxacin at 10 mg/kg intramuscularly. Despite the treatment, the crane died 19 h later. At necropsy, adhesive air sacculitis and hydroperitoneum were observed, and a reddish fluid in air sacs and in the abdominal cavity was found. Also, a marked hepatomegaly and splenomegaly were observed. Samples were collected for laboratory examination. Molecular tests done on the tracheal and cloacal swabs revealed A. paragallinarum and K. pneumoniae, respectively. This is the first case of A. paragallinarum and K. pneumoniae coinfection reported in a grey crowned crane. Our study contributes to knowledge on the ecological distribution of both these pathogens in wild birds. It provides an opportunity to investigate further the clinical significance of infectious coryza in Rwanda's wild and domestic birds. Avibacterium paragallinarum and Klebsiella pneumoniae are the main causes of respiratory infections in domestic bird species. These pathogens are rarely reported in coinfection and never reported in wild birds. While Avibacterium paragallinarum only causes disease in avian species, Klebsiella pneumoniae is zoonotic and causes human infections including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis. Illegal captivity and keeping wildlife as pets could potentially be a source of pathogen spillover events between wildlife, humans, and other livestock species. [ABSTRACT FROM AUTHOR]

Edge habitats, where the African wildcats were photographed, could place them at increased risk of human-wildlife conflict or disease transmission, as seen in other species (Bloomfield et al., 2020; Mardaraj & Sethy, 2015). Additionally, it is important to know more about the remaining population of wildcats in and around this park as well as other carnivoran species remaining in the NNP to conserve these species and update management efforts. Dowsett (1990) recorded the African wildcat in his survey of fauna and flora of Nyungwe National Park (NNP). Keywords: camera traps; landowners; Nyungwe National Park; wildcat EN camera traps landowners Nyungwe National Park wildcat 71 74 4 02/28/22 20220301 NES 220301 INTRODUCTION The African wildcat ( I Felis lybica i , Forster, 1780) has a large geographical distribution, stretching throughout the African continent, excluding tropical forests and true deserts (Boitani et al., 1999; Nowell & Jackson, 1996). [Extracted from the article]

Summary: Warming climate increases the risk for harmful leaf temperatures in terrestrial plants, causing heat stress and loss of productivity. The heat sensitivity may be particularly high in equatorial tropical tree species adapted to a thermally stable climate.Thermal thresholds of the photosynthetic system of sun‐exposed leaves were investigated in three tropical montane tree species native to Rwanda with different growth and water use strategies (Harungana montana, Syzygium guineense and Entandrophragma exselsum). Measurements of chlorophyll fluorescence, leaf gas exchange, morphology, chemistry and temperature were made at three common gardens along an elevation/temperature gradient.Heat tolerance acclimated to maximum leaf temperature (Tleaf) across the species. At the warmest sites, the thermal threshold for normal function of photosystem II was exceeded in the species with the highest Tleaf despite their higher heat tolerance. This was not the case in the species with the highest transpiration rates and lowest Tleaf. The results point to two differently effective strategies for managing thermal stress: tolerance through physiological adjustment of leaf osmolality and thylakoid membrane lipid composition, or avoidance through morphological adaptation and transpiratory cooling.More severe photosynthetic heat stress in low‐transpiring montane climax species may result in a competitive disadvantage compared to high‐transpiring pioneer species with more efficient leaf cooling. [ABSTRACT FROM AUTHOR]

This article analyses diaspora mobilization for transitional justice as efforts to gain recognition for victim‐based identities. Building on research among diaspora groups from Rwanda and Sri Lanka in North America and Europe, the article investigates how diaspora actors in their quest for victimhood recognition navigate, make use of and challenge labels such as "victim", "perpetrator", "genocide", "survivor" and "terrorist". The article uses Jacoby's theory of victimhood to draw attention to the diasporic space as particularly conducive for recognition struggles, and discuss the different stages through which victim‐based identities are constructed. The empirical examples reveal how serveral competing and interrelated processes towards victimhood recognition are simultaneously at work, and how diaspora actors both refute and creatively make use of categories that assign blame or signal victimhood and resilience. [ABSTRACT FROM AUTHOR]

Background: Emergency laparotomy is a common procedure with high morbidity and mortality. The aim of this study was to assess if the time of surgery (day versus night and weekend) affects the morbidity and mortality in a low-resource setting. Methods: A retrospective study was conducted in 2 university teaching hospitals in Rwanda. Patient characteristics, time of laparotomy, operative details and postoperative outcomes were recorded. Chi-square and Wilcoxon rank sum tests were used to determine factors and outcomes associated with time of surgery. Logistic regression was used to determine factors associated with mortality. Results: In 309 patients, who underwent emergency laparotomy, 147 (48%) patients were operated during the daytime, 123 (40%) patients were operated during the night shift and 39 (12%) patients were operated on the weekend. Common diagnoses were intestinal obstruction (n = 141, 46%), peritonitis (n = 101, 33%) and abdominal trauma (n = 40, 13%). The overall mortality rate was 16% with 14% in patients operated during day and 17% in patients operated during night and weekends (p = 0.564). Overall, the morbidity rate was 30% with 27% in patients operated during the day compared with 32% in patients operated during night/weekends (p = 0.348). After controlling for confounding factors, there was no association between time of operation and mortality or morbidity. Conclusion: Morbidity and mortality associated with emergency laparotomy are high but the time of day for emergency laparotomy did not affect outcome in Rwandan referral hospitals. [ABSTRACT FROM AUTHOR]

The increasing demand for high‐value agricultural products such as fresh fruit presents opportunities for farmers in developing countries due to their higher market value compared with traditional staple crops. This study uses data on trust, risk, and time preferences obtained through behavioral experiments, combined with a discrete choice experiment to understand their effect on farmers' choices of marketing attributes, collecting data from 252 farmers from Eastern Rwanda. The results reveal that farmers, overall, have positive attitudes toward collective marketing channels with guaranteed immediate payments, written contracts, provision of inputs, credit, and training, a personal relationship with a buyer, and low investment costs. Additionally, farmers with lower levels of risk aversion were found to have a greater preference for immediate payment than farmers with higher levels of risk aversion. Farmers with higher future orientation are more likely to choose contracts that guarantee inputs and/or services and written contracts, and they attach lower relative importance to immediate payments than farmers with lower future orientation. Farmers with higher trust levels attach lower relative importance to immediate payments, written contracts, and a personal relationship with a buyer than farmers with lower trust levels. [ABSTRACT FROM AUTHOR]