Rwandan Youth Research Articles

Youth health risk behavior: effects of early sexual debut on HIV incidence among Rwandan youth

Youth health risk behavior: effects of early sexual debut on HIV incidence among Rwandan youth

Applying the Exploration Preparation Implementation Sustainment (EPIS) Framework to the Kigali Imbereheza Project for Rwandan Adolescents Living With HIV.

Sub-Saharan African adolescents living with HIV face challenges to antiretroviral therapy (ART) adherence. Poor mental health drives nonadherence but can be improved with cognitive behavioral therapy (CBT). CBT delivered by peers may strengthen effects while building capacity for sustainment in low-income countries. This case study retrospectively applied the Exploration Preparation Implementation Sustainment framework to characterize the execution of the Kigali Imbereheza Project, a 2-arm individually randomized group controlled trial of Trauma-Informed Adherence-Enhanced CBT (TI-CBTe) delivered by Rwandan youth leaders (YLs) to adolescents living with HIV. YL (n = 14, 43% female, M = 22.71 years) had confirmed HIV and self-reported ART adherence >95%. Participants (n = 356, 51% female, M = 16.78 years) living with HIV were randomized to TI-CBTe or usual care. Two YLs co-led TI-CBTe sessions over 2 months for a total of 12 hours, while other YL observed and rated fidelity. Participants reported on YL competence. Additional data evaluated feasibility, acceptability, uptake, and fidelity. In the Exploration phase, focus groups, stakeholder meetings, and individual interviews revealed strong consensus for delivering TI-CBT to reduce adolescent depression and trauma and improve ART adherence. In the Preparation phase, curriculum revisions were made, YLs were successfully trained, and a cascading supervision model was established. In the Implementation phase, YL delivered TI-CBTe with close monitoring and supervision. Findings revealed strong feasibility, acceptability, uptake, and fidelity, increasing the likelihood of Sustainment. Exploration Preparation Implementation Sustainment can guide implementation planning and delivery and evaluate implementation outcomes.

Is It Always Good to Talk? The Paradoxes of Truth-Telling by Rwandan Youth Born of Rape Committed during the Genocide

ABSTRACTSocial scientists have extensively debated the virtues, pitfalls, and practical effects of open dialogue and truth-telling versus silence and concealment in global post-conflict endeavours for justice and reconciliation. This article addresses these debates not by endorsing practices of either talk or silence, but by investigating the practical dilemmas faced by Rwandan youth born of rape committed during the 1994 genocide as they find themselves caught in dual cultural imperatives to reveal and to conceal the circumstances of their origins. On the one hand, the post-genocide moment has seen the rise of truth-telling and self-revelation through testimonial practices in settings like post-genocide trials and reconciliation or peace-building workshops. On the other hand, silence and concealment are accepted and expected modes of dealing with hardship in Rwandan cultural practice, and youth participants struggled with the stigma of having been born of genocidal rape. We argue that the youths’ ambivalent and sometimes contradictory moral evaluations of talking about versus hiding their origins highlight the challenges and complexities of identity and belonging in post-genocide Rwanda, since their very existence draws them, their mothers, and their perpetrator-fathers into ongoing relationships. These youths’ lives and experiences speak to larger and powerful conundrums at the heart of what it means to live with legacies of violence, including what should be said or remain unsaid, and how the very opposition between revealing and concealing can be confounded by social and cultural variances in the meaning of “truth.”

1.10-P11Impact of Migrant Health Initiatives by Youth in Rwanda

1.10-P11Impact of Migrant Health Initiatives by Youth in Rwanda

The Role of Business Development Funds (BDF) in Creating Employment for the Youth in Rwanda

The purpose of this study was to assess the role of business development funds in creating employment for the youth in Rwanda. A case study of BDF Musanze; period of the study: 2014-2016. The general objective of this study is to establish the role of business development funds in creating employment for the youth in Rwanda. This study was also based on the following specific objectives: To examine the activities of BDF in creating youth employment in Musanze District, to identify challenges faced by business development funds in creating employment for youth in Musanze District and to establish the relationship between business development funds and youth employment creation. The study used interviews, questionnaire, and documentary methods to correct data. The sample size of 90 respondents was taken purposively from 2000 youth members of BDF in Musanze District. Both qualitative and quantitative data were employed. The study revealed that that the main activities of BDF in youth employment creation are refinancing grant, stimulating SMEs growth and advisory and access to financial service as indicated by 22.2% of the respondents while 13.3% of respondents said business evaluation and follow up, 11.1% of respondents sided with coordination of government grant fund meanwhile 8.9% of respondent agreed with business plan activities. The study founded that BDF faced some challenges in creating employment for youth in Musanze District, unskilled entrepreneur and poor planning takes the first place at 33.3% of respondents, 22.2% of respondents have an obstacle of shortage of fund while 11.1% of respondents agreed with developing new and reliable sources of revenue. Also 50% of the respondents strongly agree that youth employment creation depends on the BDF activities, 40% agree, 10% disagree; this showed the good relationship between BDF and youth employment creation. The study concluded that BDF participate in creating job for youth of Rwanda as business evaluation and follow up, refinancing grant, coordination of government grant fund, stimulating SMEs growth and advisory and access to financial service. As recommendation, BDF should train and equip the workforce with vital skills and attitude.

Dance performances in post-genocide Rwanda: remaking identity, reconnecting present and past

ABSTRACTSince it took power by putting an end to the 1994 genocide, the Rwandan Patriotic Front has initiated the project of building a new Rwanda. The latter is conceived as a de-ethnicised nation-state which, while being “modern” and open to socioeconomic development and the processes of globalisation, remains rooted in its ancestral past. Hence, Rwandan cultural heritage is integrated in this undertaking to create a unified and developed Rwanda. This article examines the current revitalisation of so-called traditional dances in Kigali as part of the endeavour to build a new national identity. It explores the changes in dance repertoire and dynamics that are brought about in current Rwandan dance performances in order to materialise the utopia of the new Rwanda. Special attention is given to the alliances between old and new, used as a way to establish continuity with an idealised precolonial past: classical pieces alternate with novel creations; long-standing dance forms are the basis for experimenting with new figures; Western-style dresses coexist with purportedly traditional costumes; and songs, performed without the need for innovation by Twa singers and considered tokens of tradition, are joined with constantly changing choreographies staged mainly by university students. While recognising the success of youth dance troupes in embodying the image of the new Rwanda, the article also critically addresses the unacknowledged effects of the imposition of the post-genocide state ideology: the growing uniformisation, spectacularisation and instrumentalisation of dances; persistent ethnic tensions within the troupes and Rwandan youth as well as an increasing divide between rich and poor, centre and periphery; and the marginalisation and exclusion of large parts of the population who cannot access the envisaged ideal.

Individual-level factors associated with mental health in Rwandan youth affected by HIV/AIDS.

Prevention of mental disorders worldwide requires a greater understanding of protective processes associated with lower levels of mental health problems in children who face pervasive life stressors. This study aimed to identify culturally appropriate indicators of individual-level protective factors in Rwandan adolescents where risk factors, namely poverty and a history of trauma, have dramatically shaped youth mental health. The sample included 367 youth aged 10-17 in rural Rwanda. An earlier qualitative study of the same population identified the constructs "kwihangana" (patience/perseverance) and "kwigirira ikizere" (self-esteem) as capturing local perceptions of individual-level characteristics that helped reduce risks of mental health problems in youth. Nine items from the locally derived constructs were combined with 25 items from an existing scale that aligned well with local constructs-the Connor-Davidson Resilience Scale (CD-RISC). We assessed the factor structure of the CD-RISC expanded scale using exploratory factor analysis and determined the correlation of the expanded CD-RISC with depression and functional impairment. The CD-RISC expanded scale displayed high internal consistency (α = 0.93). Six factors emerged, which we labeled: perseverance, adaptability, strength/sociability, active engagement, self-assuredness, and sense of self-worth. Protective factor scale scores were significantly and inversely correlated with depression and functional impairment (r = -0.49 and r = - 0.38, respectively). An adapted scale displayed solid psychometric properties for measuring protective factors in Rwandan youth. Identifying culturally appropriate protective factors is a key component of research associated with the prevention of mental health problems and critical to the development of cross-cultural strength-based interventions for children and families.

The making of a ‘superstar’: the politics of playback and live performance in post-genocide Rwanda

AbstractThis article considers the reconstruction of Rwanda's post-genocide music industry through the national music competition, Primus Guma Guma Super Star. It explores local ideas about ‘playback’ and ‘live’ music, and argues that these two performative categories can be understood as wider metaphors for the relationship between the Rwandan state and its citizens, particularly Rwandan youth. On the one hand, Guma Guma aims to create the ideal post-genocide celebrity subject who will ‘play back’ a unified, de-ethnicized Rwandan identity with body and words. On the other, during the first two seasons of the competition, audiences demanded ‘live’ performance and Guma Guma prompted heated debate about ‘taboo’ topics, revealing enduring differences along socio-economic, ethnic and regional lines. Rather than affirm an inclusive Rwandan identity, Guma Guma hinted at its fragility and underscored the multiple and conflicting ways in which young people identify themselves and evaluate ‘truth’ in the post-genocide era. The article contributes not only to literature on popular culture in Africa, but also to studies that focus on mediation and changes in recording technology. Although scholars have quite rightly attempted to dissolve the boundary between the live and the mediated, I suggest that the boundary continues to do cultural and political work, particularly in developmental states.

A comparative study of psychotic and affective symptoms in Rwandan and Kenyan students.

War and conflict are known to adversely affect mental health, although their effects on risk symptoms for psychosis development in youth in various parts of the world are unclear. The Rwandan genocide of 1994 and Civil War had widespread effects on the population. Despite this, there has been no significant research on psychosis risk in Rwanda. Our goal in the present study was to investigate the potential effects of genocide and war in two ways: by comparing Rwandan youth born before and after the genocide; and by comparing Rwandan and Kenyan adolescents of similar age. A total of 2255 Rwandan students and 2800 Kenyan students were administered the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen. Prevalence, frequency and functional impairment related to affective and psychosis-risk symptoms were compared across groups using univariate and multivariate statistics. Rwandan students born before the end of the genocide and war in 1994 experienced higher psychotic and affective symptom load (p's < 0.001) with more functional impairment compared with younger Rwandans. 5.35% of older Rwandan students met threshold for clinical high-risk of psychosis by the WERCAP Screen compared with 3.19% of younger Rwandans (χ 2 = 5.36; p = 0.02). Symptom severity comparisons showed significant (p < 0.001) group effects between Rwandan and Kenyan secondary school students on affective and psychotic symptom domains with Rwandans having higher symptom burden compared with Kenyans. Rwandan female students also had higher rates of psychotic symptoms compared with their male counterparts - a unique finding not observed in the Kenyan sample. These results suggest extreme conflict and disruption to country from genocide and war can influence the presence and severity of psychopathology in youth decades after initial traumatic events.

Mobile Banking Services Empowering Youth in Rwanda: A Case of Gisenyi Sector of Rubavu District

Mobile Banking Services Empowering Youth in Rwanda: A Case of Gisenyi Sector of Rubavu District

Drugs Use Among the Youth In Rwanda: A Public Health Concern And Family’ Challenge

Drugs Use Among the Youth In Rwanda: A Public Health Concern And Family’ Challenge

Supporting Human Dignity and Human Rights

Technical and professional communication (TPC), like human-centered design, has long been human centric. But TPC struggles with the complexities of determining which humans are at the center of our work. This article proposes that an explicit consideration of human dignity and human rights can help us to navigate these complexities by reflecting upon whether our work harmonizes with the notion that every person has intrinsic worth. To illustrate, I present findings from exploratory research with nonelite Rwandan youth in which participants conveyed the roles and effects of technology-mediated communication and information and communication technology in their lives. I assert that as TPC begins engaging more explicitly with human dignity and human rights, we should adopt a perspective inspired by human-centered design scholar Richard Buchanan: embracing human dignity and human rights as the first principle of communication and the foundational value of the TPC field.

Prevalence of psychoactive substance use among youth in Rwanda.

BackgroundSubstance use among youth is a significant public health concern worldwide. However, little is known in Rwanda about the prevalence of drug use among youth. The goal of the current study was to assess the prevalence and determinants of substance use among youth in Rwanda.MethodsA cross-sectional home survey was carried out with 2479 Rwandan youth. Youth ranging, in age from 14–35 years, were randomly selected from 20 out of the 30 districts in the country. The youth were interviewed using a questionnaire that included socio-demographic information and self-reported substance use. Misuse and dependence on alcohol, marijuana and tobacco were respectively assessed by the Alcohol Use Disorders Identification Test (AUDIT), the Cannabis Abuse Screening Test (CAST), and the Hooked on Nicotine Checklist (HONC).ResultsOverall, the prevalence rate of substance use over the month prior to the survey was 34% for alcohol, 8.5% for tobacco smoking, 2.7% for cannabis, 0.2% for glue and 0.1% for drugs such as diazepam. 7.46% (one in thirteen) of the youth were alcohol dependent, 4.88% (one in twenty) were nicotine dependent, and 2.54% (one in forty) dependent on cannabis.ConclusionsOur findings demonstrate that tobacco, alcohol, marijuana and other substance use are realities in the daily lives of youth in Rwanda. Further research is needed to monitor the evolution of this phenomenon and its determinants and in order to initiate evidenced-based interventions.

Glucose control in Rwandan youth with type 1 diabetes following establishment of systematic, HbA1c based, care and education

AimsTo assess change in glycemic control concurrent with increased clinic visits, HbA1c testing, and education. Rates of complications were also examined. MethodsA 1–2 year follow-up of 214 members of the Rwanda Life for a Child program (aged <26 years) with a first HbA1c between June 2009 and November 2010 was conducted. Data were analyzed for the entire cohort and by age (<18 years, ≥18 years). Trajectory analysis was performed to identify trends in HbA1c. ResultsMean overall HbA1c decreased significantly from baseline (11.2±2.7%; 99±30mmol/mol) to one- (10.2±2.6%; 88±28mmol/mol) and two- (9.8±26%; 84±25mmol/mol) year follow up visits. The prevalence of microalbuminuria did not significantly change (21.0%, 18.8%, and 19.6%), nor did nephropathy (4.7%, 7.8%, and 5.4%). However, rates of hypertension (31.8%, 44.9%, and 40.3%) were higher than expected. Five HbA1c groups were identified by trajectory analysis, and those with the worst control monitored their glucose significantly fewer times per week. ConclusionsThe establishment of regular care, HbA1c testing, and increased education is associated with significant improvements in glycemic control in youth with type 1 diabetes (T1D) in sub-Saharan Africa, but the high prevalence of hypertension is of concern.

Editorial

In most of the articles presented in this issue of Afrika Focus we see hopeful mes- sages about the African continent. In “Arab Spring in Morocco: Social Media and the 20 February Movement”, Brouwer &amp; Bartels explore the ways in which the offline and online worlds interconnected in order to create new forms of meaning-making during the Arab Spring. Also our second article “Modernisation néolibérale et transformation du pro l des dirigeants des entreprises publiques au Maroc. Cas de la Caisse de Dépôt et de Gestion (CDG): 1959-2009” talks about Morocco, by investigating the extent to which the directors of public enterprises underwent transformations under the heading of neoliberal modernization processes. In his article “Depoliticised Ethnicity in Tanzania: A Structural and Historical Narrative” Malipula gives the history and the rationale behind the fact that Tanzania is not characterized by politicized ethnicity, which tends to lead to cleavages and tension in a lot of other African societies. Finally, Celis et al. “Characteristics of participants in an HIV prevention intervention for youth in Rwanda: results from a longitudinal study” picture a hopeful image of HIV prevention campaigns in Rwanda by describing the ways in which participation in these interventions could be increased, mainly amongst young people.

Characteristics of participants in an HIV prevention intervention for youth in Rwanda: results from a longitudinal study

Introduction. This paper studies determinants of participation in a peer-led school-based HIV prevention intervention in Rwanda. Methods. A baseline survey among 1071 students (mean age 17 years) assessed potential determinants of participation, while a follow-up six months in the intervention measured actual participation in the intervention. Statistical models were built using multivariate linear and multinomial regression analysis predicting overall participation, par- ticipation in group discussions and individual counseling. Results. Those who recently had sex, had been tested for HIV, feel more susceptible to HIV, have a higher sexual self-concept, a more positive future perspective (only for non-sexually active), and boys, were more likely to participate in group activities. Also students from the same class as the peer educator and boarding school students were more likely to participate in group activities. Older students and those with low external health locus of control participated more in individual counseling. Discussion. Participation could be increased by investing in general well-being of young people, organizing girls-only activities, and diversifying activities. Key words: selection bias, HIV prevention, participation rate, young people, Rwanda

Developing and validating the Youth Conduct Problems Scale-Rwanda: a mixed methods approach.

This study developed and validated the Youth Conduct Problems Scale-Rwanda (YCPS-R). Qualitative free listing (n = 74) and key informant interviews (n = 47) identified local conduct problems, which were compared to existing standardized conduct problem scales and used to develop the YCPS-R. The YCPS-R was cognitive tested by 12 youth and caregiver participants, and assessed for test-retest and inter-rater reliability in a sample of 64 youth. Finally, a purposive sample of 389 youth and their caregivers were enrolled in a validity study. Validity was assessed by comparing YCPS-R scores to conduct disorder, which was diagnosed with the Mini International Neuropsychiatric Interview for Children, and functional impairment scores on the World Health Organization Disability Assessment Schedule Child Version. ROC analyses assessed the YCPS-R's ability to discriminate between youth with and without conduct disorder. Qualitative data identified a local presentation of youth conduct problems that did not match previously standardized measures. Therefore, the YCPS-R was developed solely from local conduct problems. Cognitive testing indicated that the YCPS-R was understandable and required little modification. The YCPS-R demonstrated good reliability, construct, criterion, and discriminant validity, and fair classification accuracy. The YCPS-R is a locally-derived measure of Rwandan youth conduct problems that demonstrated good psychometric properties and could be used for further research.

Posttraumatic stress reactions among Rwandan youth in the second year after the genocide: Rising trajectory among girls.

This study examines levels of traumatic stress reactions among youth attending school in the second year after the 1994 Rwandan genocide. From August to December 1995, the survey team visited 22 schools throughout Rwanda. The survey (n 942; youth aged 8 to 19 years) assessed exposure to wartime violence and symptoms of posttraumatic stress disorder (PTSD), as outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM–IV; American Psychiatric Association, 2000). Mean symptom levels and the proportion of respondents meeting DSM–IV PTSD symptom criteria (“probable PTSD”) were examined for evidence of systematic decline over time. Multivariate analyses controlled for major confounders and the complex survey design. Overall, traumatic stress reactions increased among youth interviewed at successively later time points. For example, in the first third of the survey period, the “probable PTSD” rate was 48%; in the second, 54%; and in the third, 58%. The rise was confined to females. Among females, the adjusted odds of having “probable PTSD” in the last third of the study period was 2.71 (95% CI [1.66, 4.43]) fold higher than in the first. These results suggest that in planning health services in postconflict settings, humanitarian agencies should be alert to the possibility that traumatic stress reactions among youth may not decline with passage of time. Despite limitations in design, to date, this report represents the only formal structured evaluation of the mental health of youth living in the community, in the very early aftermath of catastrophic violence.

Characteristics of participants in an HIV prevention intervention for youth in Rwanda: results from a longitudinal study

Introduction. This paper studies determinants of participation in a peer-led school-based HIV prevention intervention in Rwanda. Methods. A baseline survey among 1071 students (mean age 17 years) assessed potential determinants of participation, while a follow-up six months in the intervention measured actual participation in the intervention. Statistical models were built using multivariate linear and multinomial regression analysis predicting overall participation, participation in group discussions and individual counseling. Results. Those who recently had sex, had been tested for HIV, feel more susceptible to HIV, have a higher sexual self-concept, a more positive future perspective (only for non-sexually active), and boys, were more likely to participate in group activities. Also students from the same class as the peer educator and boarding school students were more likely to participate in group activities. Older students and those with low external health locus of control participated more in individual counseling. Discussion. Participation could be increased by investing in general well-being of young people, organizing girls-only activities, and diversifying activities.

Stuck: Rwandan Youth and the Struggle for Adulthood by Marc Sommers. Athens: University of Georgia Press, 2012. 281 pp. $68.20 (cloth). ISBN 978-0-820-33890-3.

Previous articleNext article No AccessStuck: Rwandan Youth and the Struggle for Adulthood by Marc Sommers. Athens: University of Georgia Press, 2012. 281 pp. $68.20 (cloth). ISBN 978-0-820-33890-3.Beth Lewis SamuelsonBeth Lewis Samuelson Search for more articles by this author PDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Comparative Education Review Volume 57, Number 4November 2013 Sponsored by the Comparative and International Education Society Article DOIhttps://doi.org/10.1086/674067 Views: 31Total views on this site For permission to reuse, please contact [email protected]PDF download Crossref reports no articles citing this article.