Workshop Report: Launch of Enhancing National Climate Services (ENACTS) and Rwanda Climate Services for Agriculture Project

This report presents the outputs of the joint launch of the Enhancing National Climate Services (ENACTS) program of Meteo Rwanda and the CGIAR Research Program on Climate Change, Agriculture and Food Security (CCAFS) Rwanda Climate Services for Agriculture (RCSA) project. This launch brought together key government agencies in Rwanda, research organizations, farmers’ representatives, development partners, non-governmental organizations and media. The aim of the one day workshop was to launch the ENACTS products provided by Meteo Rwanda and to introduce the RCSA project to the government and public. This was a transition from the design phase of the project to the implementation phase. The report includes the process of the launch event, presentations made and the main comments by participants

Spatial Modelling of Common Chimpanzees’ (Pan troglodytes schweinifurthii) Ecological Niche in the Western Part of Rwanda

The Western Part of Rwanda is a mountainous region that hosts two important forest parks namely the Nyungwe National Park (NNP) and Gishwati-Mukura National Park (GMNP). The two parks which are located in the Albertine Rift region are known for their high endemism and harbour several endangered plant and animal species, including particularly the Common Chimpanzees (Pan troglodytes schweinifurthii). However, these forests are facing threats including mainly habitat loss, aggravated by climate change both of which are continuously having direct and indirect effects to the Chimpanzees. While conservation of chimpanzees appears critical, there is a need to deeply understand the dynamics of their habitat. This study aimed at modelling the ecological niche of common chimpanzee by integrating species distribution data and environmental layers. Species location data collected in both NNP and GMNP were integrated with environmental variables (temperature, precipitation, altitude, and land cover) through Maximum Entropy (MaxEnt), and Generic Algorithm for Rule-based Prediction (GARP) Models. The results of both models showed that chimpanzees prefer the Southern and the Northern parts of the study area (0.5 < p < 0.87), which is characterised by high altitude, low temperature, and intensive rainfall. It was also noted that MaxEnt predictions were more accurate compared to the GARP’s. MaxEnt predictions showed that 35% (2058.61 ha) of the Western Province are suitable for chimpanzees, while GARP predicted that only 24% (1411.62 ha) are suitable. Furthermore, the study found that the high precipitation, annual and maximum precipitations, and food availability are the most determinants of chimpanzees' habitat. The land use in the Western Province has made the central part less suitable to chimpanzees and therefore, this study recommends that special efforts for the conservation of Common chimpanzees in Rwanda should be concentrated in the Southern Part (around NNP) Nyungwe National Park (main forest and Cyamudongo fragment) and the northern Part (around GMNP) Keywords: Spatial Modelling, Common Chimpanzee, Ecological Niche, Nyungwe National Park, Gishwati-Mukura National Park, Rwanda

Planning workshop for Rwanda Climate Services for Agriculture project

This report presents the outputs of the planning workshop for the Rwanda Climate Services for Agriculture Project. The main objective of this planning workshop was to engage key partners in project planning, revise the project’s specific activities, revise the timeline and work-plan for all implementation and monitoring and evaluation activities for the first year of the project. This workshop brought together all project implementation team members, and key partners such as Twigire muhinzi through which the services will be disseminated to farmers as the biggest stakeholders of the project. The implementing team was drawn from the International Center for Tropical Agriculture (CIAT), the University of Reading (UR), International Research Institute for Climate and Society (IRI), the International Livestock Research Institute (ILRI), the CGIAR Research Program on Climate Change, Agriculture and Food Security (CCAFS), Rwanda Agriculture Board (RAB) and Rwanda Meteorological Agency (Meteo-Rwanda). The two days planning meeting came up with an activity plan for all the four outcomes of the project, with responsible institutions and key partners for implementation. The report includes the process of the workshop, brief summary on presentations made, and the key summary and action points from the meeting

Analysis of Effects of Selected Aerosol Particles to the Global Climate Change and Health using Remote Sensing data: The Focus on Africa

The desert's dust and anthropogenic biomass burning's black carbon (BC) in the tropical regions are associated with many effects on climate and air quality. The dust and BC are the selected aerosols, which affect health by polluting the breathable air. This research discusses the effects of both the aerosols, especially while they interact with the clouds. The respective aerosol extinction optical thickness (AOT) extinction was analysed with the sensible heat from Turbulence. The research purposes to quantitatively study the remote sensing data for fine particulate matter, PM2.5, heterogeneously mixing both the dust and the pulverized black carbon's soot or ash, to analyse at which levels PM2.5 can endanger human health in the sub-Saharan region. The mainly analysed data had been assimilated from different remote sensing tools; the Goddard interactive online visualization and analysis infrastructure (GIOVANNI) was in the centre of data collection; GIS, the research data analysis software. In results, the rise and fall of the averaged sensible heat were associated with the rise and fall of averaged aerosol extinction AOT; the direct effects of the selected aerosols on the clouds are also presented. Regarding the health effects, PM2.5 quantities are throughout beyond the tolerably recommended quantity of 25μg/m3; thus, having referred to erstwhile research, inhabitants would consume food and drug supplements which contain vanillic acid during dusty seasons. Keywords: Geographic Information System (GIS), remotely sensed data, spatio-temporal (data) analysi

Performance-based financing as a health system reform : mapping the key dimensions for monitoring and evaluation

Peer reviewedPublisher PD

Taenia solium cysticercosis in Eastern and Southern Africa: an emerging problem in agriculture and public health

Pig production has increased tremendously in Eastern and Southern Africa (ESA), particularly in smallholder rural communities. The increase in pig production has mainly been due to land scarcity, increase in pork consumption in many areas including urban centers, and the recognition by many communities of the fast and greater return of the pig industry, compared with other domesticated livestock industries. Concurrent with the increase in smallholder pig keeping and pork consumption, there have been increasing reports of Taenia solium cysticercosis in pigs and humans in the ESA region, although the problems are under-recognized by all levels in many ESA countries. Having recognizing this, scientists researching T. solium in ESA formed a regional cysticercosis working group (CWGESA) to increase awareness of the problem and enable effective and sustainable control of T. solium. This article summarizes the status of T. solium infections in humans and pigs in the ESA countries and highlights the formation and progress of the CWGESA

Stimulating small-scale farmer innovation and adaptation with Participatory Integrated Climate Services for Agriculture (PICSA): lessons from successful implementation in Africa, Latin America, the Caribbean and South Asia

How to cope with climate variability and adapt to climate change are key challenges for smallholder farmers globally. In low-income countries, farmers have typically received little, if any locally relevant weather or climate information. Although climate services have contributed to increased availability and accessibility of climate information, this has rarely achieved the desired impacts for farmers’ decision-making, adaptation and resilience to climate variability and change. This has been attributed to a lack of engagement with intended users of climate information and a top-down approach to development and delivery of climate services that fails to adequately consider and account for farmers’ context-specific requirements. Participatory Integrated Climate Services for Agriculture (PICSA) is an approach that was developed to support and empower farmers in their decision-making processes. More than 200,000 farmers have been trained in 23 countries and this paper presents evidence from evaluations in 7 countries including that most (87%; n = 4,299) have made beneficial changes in their crops, livestock and/or livelihood enterprises. The approach has strengthened key institutions that support farmers through deliberative scoping, tailoring, and capacity-building activities with extension and meteorological services. It has been well received by those that use it and is being integrated into policy and training curricula. Key reasons for the success of the approach include the importance of supporting farmers as decision makers and empowering them to relate relatively complex weather and climate information to their own contexts. Key considerations for the future include ensuring sustainability and further scaling as well as maintaining quality

The impact of digital health technologies on tuberculosis treatment : a systematic review

Digital technologies are increasingly harnessed to support treatment of persons with tuberculosis (TB). Since in-person directly observed treatment (DOT) can be resource intensive and challenging to implement, these technologies may have the potential to improve adherence and clinical outcomes. We reviewed the effect of these technologies on TB treatment adherence and patient outcomes. We searched several bibliographical databases for studies reporting the effect of digital interventions, including short message service (SMS), video-observed therapy (VOT) and medication monitors (MMs), to support treatment for active TB. Only studies with a control group and which reported effect estimates were included. Four trials showed no statistically significant effect on treatment completion when SMS was added to standard care. Two observational studies of VOT reported comparable treatment completion rates when compared with in-person DOT. MMs increased the probability of cure (RR 2.3, 95% CI 1.6-3.4) in one observational study, and one trial reported a statistically significant reduction in missed treatment doses relative to standard care (adjusted means ratio 0.58, 95% CI 0.42-0.79). Evidence of the effect of digital technologies to improve TB care remains limited. More studies of better quality are needed to determine how such technologies can enhance programme performance

Neglected Tropical Diseases in Sub-Saharan Africa: Review of Their Prevalence, Distribution, and Disease Burden

The neglected tropical diseases (NTDs) are the most common conditions affecting the poorest 500 million people living in sub-Saharan Africa (SSA), and together produce a burden of disease that may be equivalent to up to one-half of SSA's malaria disease burden and more than double that caused by tuberculosis. Approximately 85% of the NTD disease burden results from helminth infections. Hookworm infection occurs in almost half of SSA's poorest people, including 40–50 million school-aged children and 7 million pregnant women in whom it is a leading cause of anemia. Schistosomiasis is the second most prevalent NTD after hookworm (192 million cases), accounting for 93% of the world's number of cases and possibly associated with increased horizontal transmission of HIV/AIDS. Lymphatic filariasis (46–51 million cases) and onchocerciasis (37 million cases) are also widespread in SSA, each disease representing a significant cause of disability and reduction in the region's agricultural productivity. There is a dearth of information on Africa's non-helminth NTDs. The protozoan infections, human African trypanosomiasis and visceral leishmaniasis, affect almost 100,000 people, primarily in areas of conflict in SSA where they cause high mortality, and where trachoma is the most prevalent bacterial NTD (30 million cases). However, there are little or no data on some very important protozoan infections, e.g., amebiasis and toxoplasmosis; bacterial infections, e.g., typhoid fever and non-typhoidal salmonellosis, the tick-borne bacterial zoonoses, and non-tuberculosis mycobaterial infections; and arboviral infections. Thus, the overall burden of Africa's NTDs may be severely underestimated. A full assessment is an important step for disease control priorities, particularly in Nigeria and the Democratic Republic of Congo, where the greatest number of NTDs may occur

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised