Acacia sieberiana Effects on Soil Properties and Plant Diversity in Songa Pastures, Rwanda

Effects of A. sieberiana trees on soil properties and plant diversity were investigated in Songa pastures, Rwanda. Tree characteristics and crown architecture of A. sieberiana were studied. Soil properties were assessed and plants were identified under and away from tree crowns. Counts of individual plants/species were done only under tree crowns. Nitrogen, P, and K were analysed in the soil, grass, and A. sieberiana leaves. Plant diversity was determined using Simpson's diversity index. Data were subjected to ANOVA. Soil organic carbon (SOC), cation exchange capacity (CEC), Ca2+, N and pH, and plant diversity were higher in soils under tree canopies than in open areas. Tree leaves were significantly richer in N and poorer in P and K as compared to grasses. Tree crowns grew wider and horizontal and developed intertwined secondary branching, reducing light intensity to as low as 38% under tree canopies compared to the open pasture. At 3 trees/ha stocking, A. sieberiana trees shaded 0.18 ha and herbaceous plants and grasses unpalatable to livestock dominated under tree canopies. A tradeoff of A. sieberiana tree value versus the loss of palatable grass due to tree presence needs to be assessed to decide whether the trees should be included in pastures and if yes, the apporpriate stocking identified

Analysis of Perceived Competitive Forces Influencing Tree Tomato Value Chains in Rwanda

The globalization of economies has added many new challenges to global agriculture. Agriculture not only needs to compete in foreign markets but also in domestic markets. The production and export of tree tomatoes remain extremely weak in Rwanda despite horticulture sector-specific economic policies in favour of the production and export of horticultural crops by the government of Rwanda. The goal of this study was to analyse the competitive performance of Rwanda's tree tomato value chain to shape the tree tomato industry in Rwanda for the benefit of smallholder farmers and the Rwandan Economy. One hundred twenty (120) respondents were surveyed for this study using a semi-structured questionnaire and focus group discussions. Participants were stratified into groups as traders (80), institutional consumers (12), and household consumers (28) all from Bugesera, Nyabihu, Rubavu districts and Kigali markets (Nyabugogo, Nyarugenge and Kimironko). Key enablers (International Centre for Research in Agroforestry, Rwanda Agricultural Board, National Agricultural Export Board, and Ministry of Commerce and Financial institutions) provided useful information related to the tree tomato value chain in Rwanda. The findings of this study show that factors that hamper the tree tomato value chain competitiveness in Rwanda are related to bargaining power. Overall 63% of respondents who were tree tomato suppliers and 58.43% of respondents who were tree tomato buyers agreed that the bargaining power of suppliers and buyers hamper the competitiveness of the value chain. The study found that 70% of traders and 57% of consumers and institutional consumers preferred the tree tomato. Therefore, tree tomato is highly linked to consumers, traders, and institutions than banana which is the 38th fruit highly scored. The severity of the threat to the tree tomato industry is new entrants into the tree tomato industry, the intensity of rivalry in existing key competitors, and the severity of the threat of substitutes. The strategies proposed to improve on the competitiveness of the tree tomato industry comprise of improving collaboration of tree tomato chain actors. This study found that 75.69% of the sampled key actors agree that the highest criteria to be considered are the product quality, and 64.74% of the sampled key actors settled on product quality as the least criteria

Cost of providing quality cancer care at the Butaro Cancer Center of Excellence in Rwanda

Purpose The cost of providing cancer care in low-income countries remains largely unknown, which creates a significant barrier to effective planning and resource allocation. This study examines the cost of providing comprehensive cancer care at the Butaro Cancer Center of Excellence (BCCOE) in Rwanda. Methods A retrospective costing analysis was conducted from the provider perspective by using secondary data from the administrative systems of the BCCOE. We identified the start-up funds necessary to begin initial implementation and determined the fiscal year 2013-2014 operating cost of the cancer program, including capital expenditures and fixed and variable costs. Results A total of $556,105 US dollars was assessed as necessary start-up funding to implement the program. The annual operating cost of the cancer program was found to be $957,203 US dollars. Radiotherapy, labor, and chemotherapy were the most significant cost drivers. Radiotherapy services, which require sending patients out of country because there are no radiation units in Rwanda, comprised 25% of program costs, labor accounted for 21%, and chemotherapy, supportive medications, and consumables accounted for 15%. Overhead, training, computed tomography scans, surgeries, blood products, pathology, and social services accounted for less than 10% of the total. Conclusion This study is one of the first to examine operating costs for implementing a cancer center in a low-income country. Having a strong commitment to cancer care, adapting clinical protocols to the local setting, shifting tasks, and creating collaborative partnerships make it possible for BCCOE to provide quality cancer care at a fraction of the cost seen in middle- and high-income countries, which has saved many lives and improved survival. Not all therapies, though, were available because of limited financial resources

Cost of treating pediatric cancer at the Butaro Cancer Center of Excellence in Rwanda

Purpose Improvements in childhood survival rates have been achieved in low- and middle- income countries that have made a commitment to improve access to cancer care. Accurate data on the costs of delivering cancer treatment in these settings will allow ministries of health and donors to accurately assess and plan for expansions of access to care. This study assessed the financial cost of treating two common pediatric cancers, nephroblastoma and Hodgkin lymphoma, at the Butaro Cancer Center of Excellence in rural Rwanda. Methods A microcosting approach was used to calculate the per-patient cost for Hodgkin lymphoma and nephroblastoma diagnosis and treatment. Costs were analyzed retrospectively from the provider perspective for the 2014 fiscal year. The cost per patient was determined using an idealized patient receiving a full course of treatment, follow-up, and recommended social support in accordance with the national treatment protocol for each cancer. Results The cost for a full course of treatment, follow-up, and social support was determined to be between $1,490 and $2,093 for a patient with nephroblastoma and between $1,140 and $1,793 for a pediatric patient with Hodgkin lymphoma. Conclusion Task shifting, reduced labor costs, and locally adapted protocols contributed to significantly lower costs than those seen in middle- or high-income countries

Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda

Background: While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. Design: The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. Results: We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Conclusions: Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use of limited resources, improve facility readiness, and ensure consistency of facility capacity to provide quality care at the district level

New insights into the indigenous knowledge of the uses of the common stinging nettle (Urtica massaica Mildbr.) in Rwanda

AbstractThe common stinging nettle (Urtica massaica Mildbr., ‘Igisura’) is one of the popular plants used for multiple purposes in Rwanda. This study aimed to get more insights into indigenous knowledge of the multiple uses of this plant in Rwanda. It was conducted in eleven administrative districts in September 2021. A semi-structured questionnaire was used to conduct in-depth interviews with 124 respondents who were chosen using the snowball sampling technique from locations where the stinging nettle grows or has been domesticated. In addition to face-to-face interviews, personal observations, and group discussions were organized at visited sites. Data were analyzed using SPSS. The uses of the common stinging nettle plant can be grouped into five categories: 1. Human medicine, 2. Veterinary medicine, 3. Human nutrition, 4. Animal feeding, and 5. Others. The stinging nettle is used in the form of cooked leaves (47%), leaf powder (39%), boiled leaves (8%), decoction (4%), infusion (1%), and fibers (1%). Stomach ulcers (37%) and hypertension (15%) are the most predominant diseases treated by stinging nettle products. Nearly all respondents (98%) agreed that domesticating the stinging nettle was important and indicated that they would be ready to grow it if they were assured of the market. Nettle products are widely sought to improve the health and well-being of both humans and animals. Yet, they are still scarce on the market. Hence, there is a need to promote the domestication of stinging nettle to increase its production and availability

New insights into the indigenous knowledge of the uses of the common stinging nettle (<i>Urtica massaica</i> Mildbr.) in Rwanda

The common stinging nettle (Urtica massaica Mildbr., ‘Igisura’) is one of the popular plants used for multiple purposes in Rwanda. This study aimed to get more insights into indigenous knowledge of the multiple uses of this plant in Rwanda. It was conducted in eleven administrative districts in September 2021. A semi-structured questionnaire was used to conduct in-depth interviews with 124 respondents who were chosen using the snowball sampling technique from locations where the stinging nettle grows or has been domesticated. In addition to face-to-face interviews, personal observations, and group discussions were organized at visited sites. Data were analyzed using SPSS. The uses of the common stinging nettle plant can be grouped into five categories: 1. Human medicine, 2. Veterinary medicine, 3. Human nutrition, 4. Animal feeding, and 5. Others. The stinging nettle is used in the form of cooked leaves (47%), leaf powder (39%), boiled leaves (8%), decoction (4%), infusion (1%), and fibers (1%). Stomach ulcers (37%) and hypertension (15%) are the most predominant diseases treated by stinging nettle products. Nearly all respondents (98%) agreed that domesticating the stinging nettle was important and indicated that they would be ready to grow it if they were assured of the market. Nettle products are widely sought to improve the health and well-being of both humans and animals. Yet, they are still scarce on the market. Hence, there is a need to promote the domestication of stinging nettle to increase its production and availability.</p