Rwandan People Research Articles

The mental health impacts of othering LGBTQ+ in Rwanda and Kenya: a mixed methods exploration

Abstract Background Globally lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons experience stigma across at multiple socioecological levels with health-harming impacts. The objectives of this study were to quantify and explore how stigma shapes mental health among LGBTQ+ persons living in Rwanda and Kenya. Methods Respondent-driven sampling was used in this mixed methods study of LGBTQ+ persons. In Rwanda, we surveyed 499 and conducted focus groups with 59 persons. In Kenya, we surveyed 1,573 persons, conducted focus groups with 40 persons, and conducted 113 individual interviews. We used thematic analysis for the qualitative data to examine how LGBTQ+ discuss what shapes their mental health. Results The average depression score was 6.3, which is categorized as mild depression. Additionally, 36% (n = 744) scored as mild, 14% (n = 289) as moderate, 5% (n = 110) as moderately severe, and 2.5% as severe (n = 52). Average scores were the same in Kenya and Rwanda. In regression models, as compared to cisgender males, cisgender females’ depression scores were 2.1 points higher (95% CI 1.5, 2.8), trans male scores were 1.6 points higher (95% CI 0.7, 2.5), trans female scores were 1.9 points higher (95% CI 1.1, 2.7), and gender non-conforming scores were 1.7 points higher (95% CI 1.0, 2.4). As compared to transgender people, lesbian & gay participants had depression scores that were 0.93 points lower and bisexual 1.3 points lower (p < 0.000). In adjusted regression models, we found that for every one-unit increase in discrimination, depression scores increased by 0.44 (95% 0.36, 0.52). Qualitatively, stigma was described as a prominent factor in negatively impacting mental health. Conclusions LGBTQ+ people in Rwanda and Kenya experience elevated mental health issues that arise from discrimination due to their stigmatized identity.

6.O. Scientific session: The unmet needs of LGBTQ+ persons and communities: perspectives from across the globe

Abstract Lesbian, gay, bisexual, transgender and queer persons suffer from rising anti-LGBTQ+ stigma. Such stigma entails laws that punish being LGBTQ+ such as in Uganda, Russia, Ghana, Iran, etc. The stigmatizing contexts have numerous health-harming effects, including perpetrating mental health harms and creating environments that hamper access & quality of services. Rising global anti-LGBTQ+ stigma and the adverse health impacts require more data on the topic to adequately dispel LGBTQ+ mis- and dis-information. This workshop will give examples of studies that examine LGBTQ+ disparities and inequities in health across different social and cultural contexts, drawing from research in Czechia, Kenya, Rwanda, and Sweden. The workshop will first outline the relevant social and cultural contexts of LGBTQ+ persons in various countries, such as attitudes, beliefs, and values. The workshop will then discuss LGBTQ+ inequities and disparities that arise from health-harming attitudes, beliefs, and values. Afterward, the workshop will discuss public health-oriented solutions & policy directions, including using data for interpretation and advocacy labs and efforts, enhancing data collection, improving knowledge and attitudes, and other implications for public health practice and policy. The workshop will open a session that will situate LGBTQ+ public health for the audience. The first study will be by Andreas Malm from the Karolinska Institute, Sweden, examining LGBTQ+ differences in mental health and treatment disparities in Sweden. This will be followed by Luis Roxo from the Karolinska Institute and Universidade NOVA de Lisboa, Portugal, discussing stressors and symptoms that shape inequalities in mental health service use. Then, Michal Pitonák from the National Institute of Mental Health, Czechia, will present treatment and outcome gaps in the mental health of LGBTQ+ persons in Czechia. Lastly, Emmy Kageha Igonya from the African Population Health Research Center, Kenya, will showcase work from a mixed-methods study with LGBTQ+ people in Rwanda and Kenya, examining access to and use of healthcare services. After the individual presentations, which will each last 7-8 minutes, the audience will be invited to a moderated 20-25-minute open discussion on the papers & how the findings can help inform public health practice & policy to address the unmet needs of LGBTQ+ populations globally. The continuing rise in anti-LGBTQ+ sentiments across the globe is problematic from a public health standpoint, given the severe health-harming effects across numerous physical and mental health states and domains. Our workshop aims to facilitate a conversation on understanding the structural situations that shape LGBTQ+ health and identifying strategies to reduce gaps in services and needs that disproportionately burden LGBTQ+ persons. Key messages • LGBTQ+ people across the globe are experiencing rising stigma and discrimination. • Rising anti-LGBTQ+ backlash disproportionately harms LGBTQ+ physical and mental health and creates gaps in care.

Prevalence and neighbourhood determinants of early sexual debut and multiple sexual partnerships among young people in Rwanda, Ghana and South Africa

Background: The consequences of engaging in risky sexual behaviours (RSB) can lead to HIV infection, sexually transmitted diseases and unintended pregnancy. The relationship between neighbourhood characteristics and youth involvement in RSB such as early sexual debut and multiple sexual partnerships has been of great concern to government, researchers and policymakers. However, there are very few empirical studies using demographic and health surveys to unpack the nature of this relationship in Rwanda, Ghana and South Africa. The objective of this study was to estimate the prevalence and determinants of early sexual debut and condom use, and to explore the neighbourhood factors associated with early sexual debut and condom use in Rwanda, Ghana and South Africa. Methods: This was a cross-sectional study using the most recent Demographic and Health Survey Data (DHS 2014–2016) from Ghana, Rwanda and South Africa to investigate the relationship between neighbourhood characteristics and risky sexual behaviour among the youth. Results: The prevalence of risky sexual behaviour in the three countries ranges from 56% (South Africa), 30% (Ghana) and 12% (Rwanda). Male youth in the 20-to-24-year-old category had increased odds of engaging in multiple sexual partnerships for the three countries (AOR 4.58; 95% CI 3.40–6.16), Rwanda (AOR 2.72; 95% CI 2.04–3.68) and South Africa (AOR 4.56; 95% CI 3.33–6.24). Meanwhile, at the community level, community education significantly increased the odds of age sexual debut among female adolescents by 50% (South Africa), and 46% (Ghana), while in Rwanda, this factor had decreased odds with higher community education. Conclusion: To lower the incidence of risky sexual behaviour in the community, programmes aimed at appropriate policy options must be intensified. The implications of these findings is helpful for a developmental approach aimed at reaching Africa’s long-term development goal of eliminating STIs among young people.

Critical analysis of Rwanda’s Digital skills and entrepreneurship training toward solving youth unemployment

This study critically examines the role of digital skills and entrepreneurship training in addressing the persistent issue of youth unemployment in Rwanda. The paper primarily anchors on the Human Capital Theory and Entrepreneurship Theory to provide a solid theoretical framework, tying together education, skill development, and entrepreneurial activity as vital drivers of productivity, job creation, and economic development. By employing a qualitative methods approach that utilises qualitative stakeholder interviews, this research evaluates the effectiveness of the various policies and programs aimed at fostering digital and entrepreneurship skills to young people in Rwanda, to promote employment. The research unveils that these programs hold significant potential in equipping the Rwandan youth with relevant skills and nurturing an innovative and entrepreneurial culture. However, it also highlights key areas requiring attention: the lack of robust follow-up mechanisms and the need for continued support post-training. It advocates for policymakers and program implementers to prioritize these aspects to maximize their initiatives' impact. The implications of this study extend beyond Rwanda's borders as countries worldwide grapple with similar challenges. Therefore, the insights gleaned from Rwanda's approach could guide other nations in leveraging digital skills and entrepreneurship training to combat youth unemployment in the digital age. It concludes by recommending future research directions, including maintaining program relevance in the ever-evolving digital landscape and instituting more effective support mechanisms for venture sustainability.

Prevalence of Mental Health Disorders and Their Associated Risk Factors Among People Living with HIV in Rwanda: A Cross-Sectional Study

While life expectancy of people living with HIV is increasing, their burden of non-communicable diseases, including mental health disorders, is growing as well. The aim of this study is to investigate the prevalence and identify the risk factors associated with mental health disorders among this population in Rwanda. This cross-sectional study enrolled people living with HIV from 12 HIV clinics across Rwanda using random sampling. Trained HIV nurses conducted the Mini International Neuropsychiatric Interview to estimate the prevalence of major depressive episode, post-traumatic stress disorder, and generalized anxiety disorder. Sociodemographic, psychosocial, and HIV-related data were also collected. Associated risk factors for being diagnosed with one of the mental health disorders were assessed using modified Poisson regression with robust error variance. Of 428 participants, 70 (16.4%) had at least one mental health disorder with major depressive episode being most prevalent (n = 60, 14.0%). Almost all participants were adherent to antiretroviral therapy (n = 424, 99.1%) and virally suppressed (n = 412, 96.9%). Of those diagnosed with a mental health disorder, only few were aware of (n = 4, 5.7%) or under treatment for this mental health disorder (n = 5, 7.2%). Mental health disorders were associated with experiences of HIV-related stigma and discrimination (aRR = 2.14, 95%CI 1.30–3.53, p = 0.003). The results demonstrate underdiagnosis and undertreatment of mental health disorders among Rwandan People Living with HIV. Using HIV nurses to diagnose mental health disorders could serve as a low-cost strategy for integrating mental health care with existing HIV services and could inspire the implementation in other low-resource settings.

A re-conceptualisation of the Batwa's right to recognition as a minority and indigenous people in Rwanda: A human rights-based approach

There have been divergent views by various human rights scholars and actors on how to address the question of vulnerability among indigenous and minority groups in Rwanda. Even though factors influencing vulnerability among these groups have received increasing scholarly attention, findings from these studies fall short of reflecting on the role of identity and discrimination. Whereas the government in Rwanda after the 1994 genocide sought to enhance unity and reconciliation by outlawing all ethnic identities, and instead conflating all vulnerable groups into a nomenclature namely, a Historically Marginalised People (HMP), a divergent group of scholars, human rights activists, the United Nations and African Union's instruments of human rights describe this approach as antithetical to the promotion and protection of the rights of indigenous and minority groups. Using the human rights-based approach, this paper critically interrogates the issue of identity and how it has affected the enjoyment of the rights among the minority and indigenous Batwa people in Rwanda.The study employed a qualitative research design with data collected through Focus Group Discussions (FGDs) as well as in-depth interviews (IDIs). Respondents included members of the Batwa community, officials of selected public institutions, leaders in Non-Governmental Organisations (NGOs), and cooperative societies working towards the promotion of rights of the HMP. Data analysis involved the process of transcription and coding of data and the eventual reflexive thematic analysis.The findings show that the rights of the Batwa community to recognition and self-identity have varied meanings and implications to different members of the community as well as officials from public institutions and other relevant actors. To the existing research, the study affirms that the inconsistencies surrounding the Batwa's identity have accentuated their vulnerability.In terms of policy, the study suggests that in the short run, the Batwa community may require enhanced special temporary social protection measures in order to ameliorate their conundrum arising from identity ambiguity without compromising Rwanda's national unity. Further studies, should consider the role of land, forest and culture in further marginalising the Batwa, as well as quantitative methodology for inferential analysis.

Rwanda-Conflict, Violence, and Reconstruction

When it comes to Rwanda, most people first think of the tragic movie The Rwanda Hotel. That film recreates the bloody 1994 massacre in Rwanda, causing irreparable harm to every Rwandan people. Rwanda's history is indeed full of hatred and misery. After the massacre, the Rwandan government led the people to take national reconstruction measures for the country and achieved the desired results. Based on adjusting their own culture, the Rwandans also explored a development path that suits their national conditions and has African characteristics. After the completion of the reconstruction, Rwanda largely resumed its economic development and made all-around progress, even known as the Singapore of Africa. Rwanda's reconstruction policy is generally improving, but there are still some shortcomings that need to be adjusted and improved. Driven by those reconstruction measures, Rwanda has achieved remarkable results and is worth learning from other countries.

Abstract P430: Waist Circumference is a Key Predictor of Beta-Cell Function in Lean Rwandans With New-Onset Type 2 Diabetes Mellitus

Introduction: Type 2 diabetes mellitus (T2D) is common in Rwanda and other middle and low-income countries. Unlike high-income countries, T2D is prevalent in lean people; the reasons for this are unclear but may relate to abdominal obesity. Therefore, we examined the impact of waist circumference (WC) on insulin-resistance (IR) and insulin secretion rate (ISR) in lean, (BMI <25kg/m 2 ) Rwandan adults with and without new-onset (<1yr) T2D. Hypothesis: We hypothesized that Rwandans with T2D and normal WC would have a lower ISR than both people with T2D and elevated WC and healthy people but that ISR would not be different between Rwandans with T2D and elevated WC and healthy people. Methods: BMI, WC, and a 3-hour frequently-sampled oral-glucose tolerance-test (fsOGTT) were performed in 23 Rwandans; 15 with T2D and 8 healthy people. Normal WC was defined as <85cm for women and <90cm for men (>75 th %ile of group). ISR was determined by mathematical-modeling. Groups were compared by Student’s t-test and ANOVA. Results: Groups were well matched; glucose area under the curve (AUC) was greater and insulinogenic-index was lower in T2D overall than healthy people (Table 1). ISR area under the curve (ISR-AUC) was not different between T2D and healthy people. In contrast, Rwandans with T2D and normal WC had an ISR-AUC ~2.5 fold lower than Rwandans with T2D and elevated WC (P<0.001). Matsuda index and HOMA were greater in Rwandans with T2D and elevated WC than healthy people (P=0.09, P=0.07 respectively). Conclusions: In lean Rwandan people with new-onset T2D but normal WC, alterations in insulin secretion rather than insulin-resistance are key drivers of hyperglycemia. In T2D with elevated WC, IR rather than insulin secretion may be a major factor. This suggests that the pathogenesis of T2D differs based on WC in Rwanda with implications for prevention and therapy. Table 1. Subject Characteristics * P<0.05 vs corresponding value in other groupA, P<0.05 and B, P=0.07 vs corresponding value in other group when comparing on basis of WC.

Determinants of choices of livelihood strategies among young people in Rwanda

ABSTRACT Using data from the 2016/2017 wave of the Integrated Household Living Condition Survey, this paper assesses livelihood strategies, the return to labour and drivers of choice of livelihood strategies among rural youth in Rwanda. The findings show that youth in Rwanda pursue four livelihood strategies, namely, agriculture, non-farm wages, self-employment, and diversification. Apparently, a non-farm wage is the most rewarding strategy. Age, sex, education, household size, land size, land productivity, and distance to the nearest urban centre influence the choice of livelihood strategies. The study recommends strengthening agricultural productivity-enhancing policies and the expansion of employment frontiers in the non-farm rural economy.

FRI-130 - Low HBV treatment uptake among Rwandan people with HIV and HCV co-infections: a cohort study from 2016 to 2019

FRI-130 - Low HBV treatment uptake among Rwandan people with HIV and HCV co-infections: a cohort study from 2016 to 2019

Prevalence of dental caries and associated risk factors among People Living with HIV/AIDS and HIV uninfected adults at an HIV clinic in Kigali, Rwanda.

Dental caries is among the most frequent oral conditions in People Living with HIV/AIDS (PLWHA). There is a lack of baseline information on dental caries prevalence and associated risk factors among PLWHA in comparison to HIV uninfected people in Rwanda. This study was conducted to determine the prevalence of dental caries and associated risk factors among PLWHA and HIV uninfected adults at an HIV clinic of Kigali Teaching Hospital (CHUK) in Kigali, Rwanda. A comparative cross-sectional study was conducted among 200 PLWHA and 200 HIV uninfected adults aged 18 years and above attending an HIV clinic of CHUK. An oral examination was performed by a calibrated examiner. Dental caries were assessed using the WHO Decayed (D), Missing (M), and Filled Teeth (F) index (DMFT). Descriptive statistics, Chi-square, t-tests, and multiple binary logistic regression were used to analyze data. Overall, a higher prevalence (50.5%) of PLWHA had experienced dental caries (DMFT>0) compared to HIV uninfected counterparts (40.5%) (p = 0.045). The prevalence of Decayed teeth (D) was also higher (23.5%) among PLWHA compared to HIV uninfected persons (13.6%) (p = 0.011). The Mean(SD) DMFT scores among PLWHA and HIV uninfected participants were 2.28 (3.68) and 1.29 (2.21) respectively (p = 0.001). After performing multiple binary logistic regression analysis, the predictors of dental caries in PLWHA were being female (OR = 2.33; 95%CI = 1.14-4.75), frequent dental visits (OR = 4.50; 95% CI = 1.46-13.86) and detectable RNA viral load (OR = 4.50; 95% CI = 1.46-13.86). In HIV uninfected participants, the middle age range (36-45 years), and frequent dental visits were significantly associated with dental caries (OR = 6.61; 95%CI = 2.14-20.37) and (OR = 3.42; 95%CI: 1.337-8.760) respectively. The prevalence of dental caries was higher in PLWHA than in HIV uninfected counterparts. The reported higher prevalence of caries in PLWHA was associated with being female, detectable viral load, and frequent dental visits. Therefore, there is a need for effective oral health interventions specific to PLWHA in Rwanda to raise awareness of the risk of dental caries and provide preventive oral health services among this population. To ensure timely oral health care amongPLWHA, there is a need for an effort from policymakers and other stakeholders to integrate oral health care services within the HIV treatment program in Rwanda.

Association between Time to Antiretroviral Therapy and Loss to Care Among Newly Diagnosed Rwandan People Living with Human Immunodeficiency Virus.

Despite improved clinical outcomes of initiating antiretroviral therapy (ART) soon after diagnosis, conflicting evidence exists regarding the impact of same day ART initiation on subsequent clinical outcomes. We aimed to characterize the associations of time to ART initiation with loss to care and viral suppression in a cohort of newly-diagnosed people living with HIV (PLHIV) entering care after Rwanda implemented a national "Treat All" policy. We conducted a secondary analysis of routinely collected data of adult PLHIV enrolling in HIV care at 10 health facilities in Kigali, Rwanda. Time from enrollment to ART initiation was categorized as same day, 1-7 days, or >7 days. We examined associations between time to ART and loss to care (>120 days since last health facility visit) using Cox proportional hazards models, and between time to ART and viral suppression using logistic regression. Of 2,524 patients included in this analysis, 1,452 (57.5%) were female and the median age was 32 (IQR: 26-39). Loss to care was more frequent among patients who initiated ART on the same day (15.9%), compared to those initiating ART 1-7 days (12.3%) or >7 days (10.1%), p<0.001. In multivariable analyses, same-day ART initiation was associated with a greater hazard of loss to care compared to initiating >7 days after enrollment (aHR 1.39, 95% CI 1.04, 1.85). 1,698 (67.3%) had available data on viral load measured within 455 days after enrollment. Of these, 1,476 (87%) were virally suppressed. A higher proportion of patients initiating ART on the same day were virally suppressed (89%) compared to those initiating 1-7 days (84%) or >7 days (88%) after enrollment. This association was not statistically significant. Our findings suggest that ensuring adequate, early support for PLHIV initiating ART rapidly may be important to support retention in care for newly-diagnosed PLHIV in the era of Treat All.

Seeking to live more peacefully with painful histories

In this interview, Chaste Uwihoreye describes his work with young people in Rwanda, from collective truth-telling conversations to supporting child-headed households in ways that foster, rather than undermine, children’s leadership. Chaste draws on Rwandan songs, poems and proverbs as forms of cultural acknowledgement and comfort in workshops with very large groups of young people. These workshops begin with a ‘story gifting’ process that acknowledges what has happened to the young people and their families, and at the same time creates new stories about ways of living together with difficult histories. Metaphoric practices are described, including an umbrella exercise in which people depict the problems they are facing in the present as rain, and the skills and knowledges that they use to face these problems as a protective umbrella. Memories are transformed into a ‘usable past’ that can be used to generate songs, poems or artworks. Possession of these tangible forms provides options for action: whether to share a song, burn a poem or keep a drawing. Chaste describes solidarity camps (Ingando) in which young people can be together and witness each other’s suffering and strength, and be trained and supported to facilitate group work with other young people. In the shadow of genocide, Chaste shares the hopeful collective work of remembering painful histories in ways that enable people to act and to live good lives in the present.

Doświadczenie traumatyczne w Rwandzie

&#x0D; &#x0D; &#x0D; In the article, I redefine the traumatic experience that has been ubiquitous on both individ- ual and collective levels for people in Rwanda since the 1994 genocide. Using ethnographic and psychotraumatological methods, I point out the limitations of the Western-centric psychoanalytic approach and the presence of discursive elements derived directly from the public discourse on the Holocaust, which – too often understood as a model discourse – in practice makes it impossible to recognize the nature of a specific trauma or real identities of the injured subjects. In the text, I propose to adopt an emic/vernacular position on this issue, and to ponder the decolonization potential inherent in such a perspective.&#x0D; &#x0D; &#x0D;

Impact of COVID-19 pandemic on HCV care cascade in Rwanda: Ecological study from July 2019 to June 2021.

Content available: Author Interview and Audio Recording

Use of index testing to close the gap in HIV diagnosis among older people in Rwanda: analysis of data from a public health programme.

As Rwanda inches closer to the UNAIDS HIV first 95 of knowing one's HIV status by 2030, finding the remaining HIV-positive individuals could be difficult by use of passive methods. Index testing is an approach whereby the exposed contacts of an HIV-positive person are notified and offered an HIV test. We aimed to assess the factors related to the HIV-positive outcome among older people (aged 50 years and above) in Rwanda. In Rwanda, adults (aged ≥18 years) on antiretroviral therapy (ART) who reported having had sexual partners with unknown HIV status, and individuals with newly diagnosed HIV, described as index cases, were asked to provide details of their sexual partners and invite them to the health facility for HIV testing through client referral, provider referral, or dual referral. We used logistic regression to model the odds of identifying partners who were HIV-positive or aged 50 years or older through partner notification services and to assess predictive factors related to index case and partner, after adjusting for partner related variables (age group, gender, relationship between index and sexual partner, province of residence, notification used) and index case related variables (type of index case, multiple partnership, had unprotected sex in past 12 months, viral load suppression, age difference between notified sexual partner and index case). Written informed consent was obtained from each participant before inclusion in the study. The Rwanda National Ethics Committee approved the protocol for implementation. Between October, 2018, and September, 2021, 18 453 index cases were recruited and 31 227 partners were notified and tested, of whom 3156 (10·0%) were aged 50 years and older. Of the partners aged 50 years and older, 877 (27·8%) were female and 2279 (88·1%) were male, and 1638 (51·9%) were notified by index cases who were younger than them. Among partners aged 50 years and older, 6·0% (3156) were HIV-positive, with a higher prevalence in partners notified by newly diagnosed index cases 14·7% (46 of 313). In the multivariable analysis, among partners aged 50 years and older, the adjusted odds ratio was 2·66 (95% CI 1·78-3·98) for female partners compared with male partners, 3·14 (2·08-4·77) for partners of newly HIV-diagnosed index cases compared with those of index cases who were already taking ART, and 1·89 (1·07-3·37) for partners who were 15 years older than the index case compared with partners who were 5 years older or younger. Partners of people with newly diagnosed HIV, older individuals who engaged in sexual relationship with younger individuals, and female partners had an increased risk of being diagnosed with HIV. Index testing successfully identified older people with undiagnosed HIV. None.

Prevalence and characteristics associated with diabetes mellitus and impaired fasting glucose among people aged 15 to 64 years in rural and urban Rwanda: secondary data analysis of World Health Organization surveillance data.

Introductiondiabetes mellitus is an increasing public health burden in developing countries. The magnitude of diabetes association with traditional risk factors for diabetes have been given less attention in rural population. This study aims to determine the prevalence of diabetes and impaired fasting glucose and to assess associated characteristics to hyperglycemia in rural and urban Rwanda.Methodsthis is a secondary analysis of data from a population-based cross-sectional study of 7240 people describing risk factors for non-communicable diseases using the WHO stepwise methods (STEPS). Relative frequencies of variables of interest were compared in rural and urban residence using Pearson chi-square tests. Diabetes and impaired fasting glucose were combined in a single hyperglycemia variable and odds ratios with 95% confidence intervals were used to explore associations between hyperglycemia, socio-demographic and health factors in urban and rural populations.Resultsthe prevalence in rural and urban areas was 7.5% and 9.7% (p.005) for diabetes and 5.0% and 6.2% for impaired fasting glucose (p.079) respectively. Obesity (AOR 2.57: CI: 0.86-7.9), high total cholesterol (AOR 3.83: CI: 2.03-7.208), hypertension (AOR 1.18: CI: 0.69-2.00), increasing age were associated with hyperglycemia in urban participants but only high total cholesterol and low high density lipoproteins (HDL) cholesterol were risk factors for hyperglycemia in rural participants.Conclusionapproximately one in six people in Rwanda have hyperglycemia. The magnitude of the association with traditional risk factors for diabetes differ in rural and urban settings. Different approaches to primary and secondary prevention of diabetes may be needed in rural populations.

“Shovel-Ready”

“Shovel-Ready”

Prediction of prevalence of type 2 diabetes in Rwanda using the metropolis-hasting sampling.

In this work, we predict the prevalence of type 2 diabetes among adult Rwandan people. We used the Metropolis-Hasting method that involved calculating the metropolis ratio. The data are those reported by World Health Organiation in 2015. Considering Suffering from diabetes, Overweight, Obesity, Dead and other subject as states of mathematical model, the transition matrix whose elements are probabilities is generated using Metropolis-Hasting sampling. The numerical results show that the prevalence of type 2 diabetes increases from 2.8% in 2015 to reach 12.65% in 2020 and to 22.59% in 2025. Therefore, this indicates the urgent need of prevention by Rwandan health decision makers who have to play their crucial role in encouraging for example physical activity, regular checkups and sensitization of the masses.

Field Feasibility and Acceptability Testing of Action-Based Psychosocial Reconciliation Approach in a Post-Genocide Rural Community in Rwanda

Background: Interpersonal/psychosocial reconciliation is highly prioritized in post-Genocide Rwanda. Despite the need, empirically sound strategies have been extremely scarce. The proposed study is a segment of a broader services-research effort to develop, evaluate, and implement a novel and empirically supported interpersonal/psychosocial reconciliation approach termed Action-Based Psychosocial Reconciliation Approach (ABPRA), that is authentically founded on Rwandan people’s lived experiences of reconciliation.&#x0D; Methods/Design: The proposed study consists of two major steps. The purpose of step 1 is to develop and empirically validate a set of outcome measures, termed the psychosocial reconciliation impact scales module (PRISM) to assess beneficial impacts native to ABPRA. We will employ hermeneutic phenomenological analysis (van Manen, 2016) of pilot interview data to generate item pool. The purpose of step 2 is to field-test the delivery of ABPRA in Rwanda to evaluate the feasibility and acceptability of the intervention, exploring and illuminating potential procedural uncertainties in conducting a larger-scale evaluation of ABPRA. We will follow the guidance on pilot study by Thabane et al. (2010).&#x0D; Discussion: The study is an essential step to advance the project to a full-scale experimental evaluation of ABPRA. The project holds the possibility of making available and accessible, an empirically supported and meaningful approach to conflict resolution, genocide/war prevention and peacebuilding in Rwanda and other war/conflict-affected regions around the globe.