Role of conflict in shaping fertility preferences in Rwanda

Conflicts affect the social and economic conditions that could account for the stall in fertility decline in Sub-Saharan Africa. For Rwanda, the total fertility rate decreased very rapidly to 6.1 in the eighties but stalled at that level in the nineties. Part of the stall can be attributed to a lack of fertility control, but the question is whether social upheaval also affects fertility preferences. We identify three mechanisms through which the Rwanda conflict have led to a preference for larger families: mortality experience, modernization and the attitudes of third parties.Using data from DHS, we tested the contribution of these mechanisms to the preference for small, medium or large families. With the exception of sibling mortality, there is a strong impact of these mechanisms on the preference for large families, yet they do not fully account for the shifts in preferences over the years

Prevalence of atopy, asthma and COPD in an urban and a rural area of an African country

SummaryThe objectives of this study were to determine the prevalence of asthma, atopy and COPD in Rwanda and to identify risk factors. The survey was conducted in Kigali, the Capital of Rwanda, and in Huye District, a rural area located in southern Rwanda.MethodsA total of 2138 subjects were invited to participate in the study.1920 individuals (90%) answered to questionnaires on respiratory symptoms and performed spirometry, 1824 had acceptable spirograms and performed skin-prick test. In case of airflow obstruction (defined as pre-bronchodilator ratio FEV1/FVC < LLN) a post bronchodilator spirometry was performed. Reversibility was defined as an increase in FEV1 of 200 ml and 12% above baseline FEV1 after inhalation of 400 mcg of salbutamol.ResultsThe mean age was 38.3 years; 48.1% of participants were males and 51.9% females. Airflow obstruction was found in 256 participants (14%); 163(8.9%) subjects were asthmatics and 82 (4.5%) had COPD. COPD was found in 9.6% of participants aged 45 years and above. 484 subjects had positive skin-prick tests (26.5%); house dust mite and grass pollen mix were the main allergens. Risk factors for asthma were allergy, female gender and living in Kigali. COPD was associated with cigarette smoking, age and male sex.Conclusionthis is the first study which shows the prevalence of atopy, asthma and COPD in Rwanda. Asthma and COPD were respectively diagnosed in 8.9% and 4.5% of participants. COPD was diagnosed in 9.6% of subjects aged ≥45 years.The prevalence of asthma was higher in urban compared to rural area

Changes in Fertility Decline in Rwanda: A Decomposition Analysis

After having stalled in the 1990s, fertility in Rwanda resumed its downward trajectory between 2005 and 2010. The total fertility rate declined from 6.1 to 4.6 and modern contraceptive use increased. However, it is unclear which determinants lay behind the previous stall and the recent strong drop in fertility. This paper contributes to an ongoing debate on the impact of social upheavals on fertility decline. We use a decomposition analysis, focusing on the change in characteristics and reproductive behaviour of women and their contributions to levels of fertility during 1992–2000 and 2000–2010. Results show that due to widowhood and separation the proportion of women who were married decreased between 1992 and 2000, but their fertility increased in the same period due to replacement fertility and an unmet need for family planning. After 2000, postponement of marriage and lower infant mortality contributed to lower fertility, but the most important effect is the overall lower fertility due not only to improved family planning provision but perhaps also to the sensitizing campaigns of the Rwandan government

Rwanda: National Urban Policies and City Profiles for Kigali and Huye

This research report reviews and analyses Rwanda’s planning and urban development policy documents for the last twenty years, identifying the key ideas and policies that have shaped the delivery of public services, paying particular attention to education and healthcare. This report also presents city profiles for two of Rwanda’s cities: Kigali and Huye

Rwanda: National Urban Policies and City Profiles for Kigali and Huye

This research report reviews and analyses Rwanda’s planning and urban development policy documents for the last twenty years, identifying the key ideas and policies that have shaped the delivery of public services, paying particular attention to education and healthcare. This report also presents city profiles for two of Rwanda’s cities: Kigali and Huye

Attitudes towards vaccines and intention to vaccinate against COVID-19: a cross-sectional analysis - implications for public health communications in Australia

Objective To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study. Design and setting Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021. Participants Total of 1166 Australians from general population aged 18-90 years (mean 52, SD of 19). Main outcome measures Primary outcome: responses to question € If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?'. Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions. Results Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine. Conclusions Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor's recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates