BackgroundCOVID-19 has exacerbated the sexual and reproductive health (SRH) needs of those affected by humanitarian emergencies, particularly affecting adolescents and youth, whose needs are often neglected during crises. In Rwanda, the situation for refugees in Mahama Refugee Camp has worsened, as COVID-19 lockdown measures have increased needs while restricting access to basic services. Few assessments have been conducted on the SRH needs of refugees in Mahama camp, including adolescents and youth, since COVID-19. To address this gap, Save the Children (SC) undertook research utilizing SenseMaker to collect data on the SRH needs of adolescents and youth in Mahama camp, as well as in the surrounding host community.MethodologySC used SenseMaker to collect 745 data entries from adolescents and youth in Mahama camp and the surrounding host community. The application was pretested with adolescents and youth in Mahama camp before initiating the research. SenseMaker asks participants to share their stories in response to a prompt; our prompt asked participants to describe their experience seeking help with their health during COVID-19. The research team analyzed the data using simultaneous coding to examine key themes. The results were discussed with SC staff to validate the coding analysis results before conducting four focus group discussions to further clarify results and propose action steps in response to the findings.ResultsMany adolescents and youth reported significant difficulties accessing SRH information and services, including stigmatization among service providers. Provider biases and negative attitudes were repeatedly cited as barriers. Stories collected during COVID-19 show how these biases and judgmental attitudes continue to adversely affect access and use of SRH services for young people. Coercive, non-consensual, and transactional sexual incidents were reported from adolescents and youth. They cited reduced time in education spaces as a source of distress as well as increasing their level of sexual activity and associated risks. Limited data exists for SRH needs among adolescents and youth during COVID-19 in humanitarian settings. This study adds to the evidence, making the case for increased SRH prioritization for adolescents and youth in humanitarian settings, particularly when facing overlapping crises like during the COVID-19 pandemic.

Diabetes mellitus is one of the non-communicable diseases that depletes the wealth of any individual directly and indirectly due to the cost associated with treating the illness and its complications. The study aims to estimate the economic burden of Diabetes mellitus in Kenya from a societal perspective using a cost-of-illness approach. The study’s results and findings for the economic burden of diabetes mellitus in Kenya relied on the cost of illness approach. The approach identifies and measures all the costs of Diabetes mellitus, including direct and indirect costs. The 552,400 adult cases reported in 2019 resulted in a total economic cost of USD 372,184,585, equivalent to USD 674 per diabetes mellitus patient. The total direct costs accounted for the highest proportion of the overall costs at 61% (USD 227,980,126), whereas indirect costs accounted for 39% of the total economic costs (USD 144,204,459). Costs of medicines accounted for the highest costs over the total economic costs at about 29%, followed by the income lost while seeking care at 19.7%. Other costs that accounted for more than 10% of the total costs include productivity losses (19%), diagnostic tests (13%), and travel (12%). The rest of the cost categories accounted for less than 5%. Efforts should be made to reduce the costs of these medicines to enhance care. The high indirect costs reported, majorly in income lost by patients while seeking medical care, are 19%. Access to affordable health services such as diabetes mellitus education, regular blood glucose screening initiatives, and increasing local manufacturing of medicines can reduce the economic burden of diabetes mellitus and increase the health outcomes of the population and their contributions to society.

Background and Objectives: A strong link between child malnutrition and poverty has been documented especially in developing countries. Considering one child under two year out of three in Rwanda suffers from some form of malnutrition, promoting community welfare seems to bring about beneficial outcomes in terms of reduction of malnutrition. This study aims to determine and estimate the risk factors associated with deprivation and infant malnutrition in Rwanda. Materials and Methods:The methodology targeted mostly households with children under two years. Using two consecutive nationally representative population-based survey data of Rwanda, Demographic and Health Survey 2010/11 and 2014/15, the risk factors associated with the outcome were determined and using stepwise logistic regression analysis, the socioeconomic determinants were predicted. Results:The findings were estimated from a sample of children under two years: 3,441 and 2,975 in Rwanda Demographic and Health Surveys 2010 and 2014/15. Households in the lowest wealth quintile were more likely to have children experiencing malnutrition (OR= 1.61, 95% CI: 1.17-2.2, p < 0.05 in 2010/11; OR= 1.7, 95% CI: 1.23-2.35, p<0.01 in 2014/15) whereas deprivation was less likely to associate with malnutrition among children under two years (OR=0.53, 95% CI: 0.35-0.8, p < 0.001 in 2014/15). Overall, the trend went down significantly with the slope of 0.1536 suggesting a decrease of deprivation between two surveys by 0.065. Conclusions:With the assumption of constancy of other factors, the trend of deprivation was significant to explain its association with infant malnutrition. Therefore, strengthening social protection interventions targeting the lowest wealth quintile category to afford food against price volatility are highly suggested.

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