A comparative analysis of the role of foreign aid in post-conflict reconstruction of Rwanda and Sierra Leone

Foreign aid is an essential policy instrument used to transform post-conflict countries. The purpose of this study is to measure the effectiveness of foreign aid in two post-conflict countries, Rwanda and Sierra Leone. The research seeks to deepen the knowledge of foreign aid and the structures of dependency and neoliberal policies. The study employed secondary sources of data to assess various variables such as poverty reduction, governance, education, and economic development to evaluate the effectiveness of aid. The issue of aid in post-conflict reconstruction is a complex; the management of the aid is contingent on both the donors and receipt, hence foreign aid does not automatically equate to economic growth and development. The findings of the study suggest political stability, foreign assistance, and investor-friendly policies have contributed to Rwanda’s reconstruction and economic growth. Nevertheless, Rwanda’s dependency on foreign aid remains a challenge. In contrast, Sierra Leone’s post-conflict reconstruction experience has been less successful, on one hand, foreign aid has played a positive role in the peacebuilding process, on the other hand, it has economically crippled the country and created a relationship of dependency. Foreign aid has failed to promote long-term sustainable development, and instead, has induced corruption and created a dependency syndrome. Political instability and years of prolonged war, ineffective economic policies, the mismanagement and exploitation of resources and funds, aid and the inefficiency of diversifying the economy have impaired economic growth and development. Keywords: Rwanda, Sierra Leone, foreign aid, development, exploitatio

Out-of-Wedlock Pregnancy Among Single Mothers in Khartoum, Sudan: Sociodemographic Characteristics, Causes, and Consequences

Background: Out-of-wedlock childbearing is a global phenomenon that has lifelong consequences on the lives of both mothers and their children. The aim of this study is to identify the sociodemographic characteristics, causes, and consequences of outof- wedlock pregnancy among single mothers in Khartoum, Sudan.Methods: This descriptive, cross-sectional study was conducted at the Mygoma Orphanage Center (MOC) and Shamaa Rehabilitation Center (SRC) using convenience sampling among 200 participants. A validated questionnaire with 25 items was used to collect data. The data were entered into Epi-Data Manager and analyzed using the SPSS. Results: The study found that most of the single mothers in Khartoum who gave birth out of wedlock were young and had just completed their university education. Most of them discovered their pregnancy during the second or third trimester, and nearly half of them did not receive any antenatal care. The majority of the children born to these mothers were preterm and had a low birth weight. Additionally, many mothers reported experiencing social stigma and rejection from their families due to their out-of-wedlock pregnancy. The study also highlighted loneliness, stress, and romantic relations as the main causes of out-of-wedlock pregnancy among single mothers in Khartoum, Sudan.Conclusion: The study provides useful insights into the sociodemographic characteristics, causes, and consequences of out-of-wedlock pregnancy among single mothers in Khartoum, Sudan. Social stigma and lack of support were identified as significant barriers to the reintegration of single mothers and their children into society. Future research should focus on investigating the long-term effects of outof- wedlock pregnancy on mothers and their children

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely