Rwanda Diabetes Association

ABSTRACT Background Most births worldwide (>80%) occur in health care facilities, yet 2.3 million newborns die annually. If the know – do gap between evidence and implementation was closed, an estimated 752,000 newborn deaths could be prevented per year. To bridge this gap, we describe the co-design of the Implementation Toolkit for Small and Sick Newborn Care (Newborn Toolkit), a web platform and linked community of global implementers, facilitated by NEST360 and UNICEF. The Newborn Toolkit enables access to practical, curated resources, including tools for peer learning and adaptation to country contexts. Methods A systematic three step process was followed. Step 1) Structure: We used an organising framework of WHO and UNICEF ten core components for health systems strengthening. We then reviewed relevant knowledge management platforms to identify elements facilitating user engagement. Step 2) Content: >300 implementers collated publications and tools for ten core components. Step 3) Refining and building community: User data analytics and surveys plus direct feedback from the global communities of practice provided data to improve website and webinar content. Results Step 1) Structure: In 2020, the Newborn Toolkit website structure was co-designed based on the ten core components. Step 2) Content: Working groups, organised by core components, collated over 1,100 resources in 15 languages. Step 3) Refining and building community: Cross-country learning was facilitated through 45 webinars with multi-disciplinary speakers from all continents including caregivers, clinicians, non-governmental organisation representatives, engineers, and data scientists. French language translation and engagement was added between 2023-2025. Unique user counts increased with 28,146 in 2023 to 62,561 in 2025 from 198 countries and territories. The most viewed content includes WHO guidelines, neonatal floor plans, the ABC device costing tool, and data tools. Conclusions Given the urgency for accelerated progress for newborn survival by 2030, rapid implementation of proven solutions is needed. It is crucial that implementers can access evidence and tools to adapt for their specific context, rather than “reinventing the wheel”. Systems change is complex, requiring novel approaches to make it doable, such as standard, simplified action pathways available on the Newborn Toolkit. Gaps to address include evidence availability in multiple languages. KEY FINDINGS WHAT WAS KNOWN? 2.3 million neonatal deaths are estimated annually and 65 countries are at-risk of missing Sustainable Development Goal 3.2 of reducing the number of neonatal deaths to less than 12 per 1,000 live births by 2030 There exists a know–do gap in global newborn health referring to the inability to translate evidence, what is known to work, into practice to improve health outcomes for WHO-UNICEF level-2 Small and Sick Newborn Care Frameworks based on country experiences have been created to guide health systems strengthening such as the WHO/UNICEF core components; however, operationalisation is needed Evidence, guidelines, and resources for Small and Sick Newborn Care were available; however, there existed a gap in knowledge management platforms dedicated to enabling evidence-based implementation of health systems strengthening interventions in low-resource settings WHAT WAS DONE THAT IS NEW? We co-designed a knowledge management platform for resources including tools, readings, and case studies to bridge the know–do gap for Small and Sick Newborn Care in low-resource settings Content and resources on the site were organised according to the ten WHO/UNICEF core components for health systems strengthening plus infection prevention and control This platform was operationalised and scaled by linking to, and engaging with, a global community of practice We applied a continuous learning and feedback integration approach to develop and refine content, enable accessibility including by language, and tailor engagement initiatives to implementer needs informed by website user and webinar data analytics WHAT WAS FOUND? The platform hosts over 1,100 tools and readings with resources available in 15 languages Between 2021–2025, this platform had 157,452 unique users, from 198 countries and territories 45 webinars were hosted between 2022–2025 showcasing implementation case studies and facilitating cross-country learning Knowledge management and targeted engagement can enable uptake of information by organising content in practical, digestible, and feasible formats WHAT NEXT? The know–do gap in Small and Sick Newborn Care needs to be closed. Providing up-to-date, relevant evidence that adapts to emerging knowledge and local learning, alongside leadership and financial inputs, could facilitate quality care delivery through data-driven decision making Bridging language barriers, through content translation, is a priority and crucial to enable wider access to up-to-date evidence

The Igisoro game is utilized by Rwandan occupational therapists as a therapeutic tool for interventions in different settings, including mental health. This study used a qualitative exploratory approach to explore the perceptions of occupational therapists and their clients regarding the use and value of the Igisoro game in rehabilitation. Seventeen occupational therapists completed a questionnaire about their views on the efficacy of Igisoro as a therapeutic tool. Semi-structured interviews were conducted with twelve occupational therapy clients. The occupational therapists reported that Igisoro improves clients’ concentration, problem-solving skills and socialization. The client group reported three main sets of benefits from playing Igisoro.

This study reports for the first-time managed honey bee colony loss rates and associated risk factors during the active beekeeping season 2022/2023 in nine Sub-Saharan African countries, namely Kenya, Ethiopia, Rwanda, Uganda, Benin, Liberia, Nigeria, Cameroon and Democratic Republic of the Congo. The sustainability of bee swarm catches as a main honey bee colony source tool for operation expansion by African beekeepers was also evaluated in Kenya and Ethiopia. In this survey, the 1,786 interviewed beekeepers across these countries collectively managing 41,761 colonies registered an overall loss rate of 21.3%, which varied significantly among countries (from 9.7 to 45.3%) and hive types (from 10.6% in hives with movable frames to 17.9% in frameless hives). The perceived causes of losses in order of significance were issues beyond the beekeeper control (mainly theft, drought, and bushfire), absconding and pests (mainly wax moth, small and large hive beetles, ants and Varroa destructor mite), but this pattern varied greatly across countries. Among the management practices and characteristics, migratory operations and professional beekeepers experienced lower losses than stationary operations and semi-professionals and hobby beekeepers. Insights into the number of bee swarms caught revealed significant decreases in swarm availability over the past three years in Kenya. The opposite situation was observed in some regions of Ethiopia. These trends require further investigation. Overall, this comprehensive survey sheds light on the complexities and challenges beekeepers faced in Sub-Saharan Africa, pointing to the need for targeted interventions and sustained research to support the resilience and growth of the apicultural sector.

The accessibility of Therapeutic Patient Education (TPE) is essential to reduce social inequalities and to meet the challenges posed by the increase in chronic diseases. In France, the distribution of TPE throughout the territory is heterogeneous and patients still lack sufficient access. With these perspectives in mind, a municipal health center has developed an innovative TPE device by involving concerned patients from the outset. The objectives of this article are to present the methodology implemented to co-construct a TPE program for patients with one or more prevalent diseases in the territory, as well as the results of the co-construction. Creation of a project team with various actors: patients, health professionals, administrators, researchers. Organization of synchronous and asynchronous times. Four meetings and numerous exchanges made it possible to: define the common values and operating rules of the project team, reflect on the coordination of the care pathway, identify the specific and shared needs of patients affected by type 2 diabetes, arterial hypertension and/or obesity, agree on the principles of the device. The advantages of this device were discussed: flexible organization with numerous links with local actors, development of partnerships, expansion of the population concerned. Questions and difficulties were encountered, such as the coordination of actors and the representation of partner patients for the targeted diseases. This device will be tested and evaluated, mainly with an objective of improving it.

This article outlines the understanding of the connections made by Rwandan practitioners in the human social services between the application of conventional counselling training and local practices. Undertaken by a group of social researchers from three Canadian Schools of Social Work and academics and students from the University of Rwanda Social Work Program, this qualitative study included 18 individual interviews with practitioners, reports from meetings with a local advisory group and three annual workshop discussions held with various stakeholders in Rwanda. The findings indicate that professional counselling is a specialty of those formally trained to counsel individuals or groups of people who are severely distressed emotionally, while in a Rwandan context, counselling consists of helping practices of approaching and accompanying persons in need, strengthening their connections to local resources, and building capacity in order to help them get back on their feet. Policy, pedagogical and practice implications are discussed.

Thousands of orphaned survivors of the 1994 Rwandan Genocide against the Tutsi were not only exposed to extraordinarily severe forms of violence, but also many of these children took on the responsibility of caring and providing for other child survivors. This study describes the poverty, educational attainment, social support and mental health of orphaned heads of household (OHH) fourteen years after the genocide, and analyzes how violence exposure during the genocide and post-genocide stressors contributed to symptoms of posttraumatic stress disorder (PTSD) and distress. Participants were 61 members of an OHH community organization who were interviewed in 2002 about their genocide experiences and who provided a follow-up assessment of post-genocide risk factors and PTSD and distress symptoms in 2008. Almost all of the OHH in this study reported low social support, high levels of poverty, and high rates of PTSD and distress symptoms. Lower educational attainment predicted PTSD symptoms and partially mediated the association between exposure to genocide violence and PTSD. Distress was predicted by lack of social support and witnessing family members harmed during the genocide. Results suggest that public health and community efforts to improve educational outcomes and to strengthen and expand social support networks may improve mental health outcomes of OHH.

In 1994, more than one million people died in Rwanda in one of the worst genocides in modern times. Rwandan society, at all levels including healthcare, continues to count the human and financial costs of the tragedy--a burden which is compounded by the debilitating scarcity of resources in the nation as a whole. Most of Rwanda's 8,200,000 inhabitants are united by poverty: according to figures published by the World Bank, the yearly per capita income in Rwanda is US dollar 220. The author reports on the status of diabetes care and makes a call for cost effective collaborative solutions to the dire problems faced by people with diabetes in Rwanda.