Lessons Learned from Rwanda: Innovative Strategies for Prevention and Containment of COVID-19

Karim, Naz; Ling, Jing; Lee, J. Austin; Kharel, Ramu; Lubetkin, Derek; Clancy, Camille M; Uwamahoro, Doris; Nahayo, Ernest; Biramahire, Joseph; Aluisio, Adam R.; Ndebwanimana, Vincent

doi:10.5334/aogh.3172

Cited by 48 publications

(30 citation statements)

References 6 publications

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“…Even in the public health literature, calls have been made to moderate the containment measures in order to protect livelihoods, food security, and wellbeing ( Adams et al, 2021 ; Meyerowitz-Katz et al, 2021 ). For example, Rwanda and Vietnam have been rightly praised for exemplary containment of COVID-19 ( Karim et al, 2021 , Van Tan, 2021 ), but during the periods of stringent restrictions, we observed severe food insecurity outcomes. Media analysis from five African countries has shown that popular narratives often framed the situation as a balance between containment of the COVID-19 virus and food security; and that this was a hot topic in all five of the locations studied ( Birner et al, 2021 ).…”

Section: Discussionmentioning

confidence: 70%

“…Vietnam and Rwanda both implemented very well organised and stringent containment measures, including curfews, contact tracing, and strict social distancing regulations; operating a “go hard and go fast” approach which has been widely praised in both popular and academic literature (e.g. Karim et al, 2021 ; Van Tan, 2021 ; Cahan, 2020 ).…”

Section: Methodsmentioning

confidence: 99%

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Perceived effects of COVID-19 restrictions on smallholder farmers: Evidence from seven lower- and middle-income countries

Hammond

Siegal²,

Milner

et al. 2022

Agricultural Systems

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CONTEXT The COVID-19 pandemic caused unprecedented global disruption and continues to wreak havoc. Dire predictions were made about the risks to smallholder farmers in lower- and middle- income, but hard data have been lacking. We present the results from 9201 interviews with smallholder farmers from seven countries. OBJECTIVE The objectives are to describe: i) how farmers perceive the key effects of the COVID-19 pandemic and containment measures on livelihoods and food security; ii) the effects on agricultural activities; iii) the coping strategies households deployed. METHODS Household surveys were conducted as part of ongoing monitoring programs during the latter half of 2020. Sites in seven countries were covered: Burundi; Kenya; Rwanda; Tanzania; Uganda; and then Vietnam and Zambia. Findings are representative of smallholder farmers across multiple districts per country. RESULTS AND CONCLUSIONS Our results show that the effects of the COVID-19 containment measures were widespread and often perceived to be severe. Food purchase, off farm income, sale of farm produce, and access to crop inputs were all affected. In locations under more stringent restrictions during the time of the survey, up to 80% of households had to reduce food consumption or variety. Almost all households with off-farm incomes reported reductions, by half on average. A half to three-quarters of households (depending on the location) with income from farm sales reported losses compared to the pre-pandemic situation. In locations with more relaxed containment measures in place during the time of the survey, less frequent and less severe economic and food security outcomes were perceived by the respondent, with around 20% of households reporting negative outcomes. Mobility restrictions, reduced market access, crashes in sale price for agricultural goods, and soaring prices for food purchase were key factors. Sale prices generally dropped for all agricultural products in any given location, and affected not only high value perishable products, but also staple crops such as maize and cassava. Depending on the location, between 30% and 90% of the households applied coping strategies in response to the pandemic during 2020. There was an almost complete absence of official aid amongst households interviewed. SIGNIFICANCE Our results raise the thorny issue of how best to balance containment of COVID-19 against the wellbeing of the vulnerable rural population in lower- and middle-income countries. There is a risk that the buffering capacity of rural people will become exhausted. Possible policy measures to limit negative outcomes include i) tiered mobility restrictions with travel allowed for economic reasons; ii) short-term price guarantee schemes to stabilise the food system; iii) direct aid; iv) the timely re-installation of distribution channels for agricultural inputs.

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Section: Discussionmentioning

confidence: 70%

Section: Methodsmentioning

confidence: 99%

Perceived effects of COVID-19 restrictions on smallholder farmers: Evidence from seven lower- and middle-income countries

Hammond

Siegal²,

Milner

et al. 2022

Agricultural Systems

View full text Add to dashboard Cite

show abstract

“…The pandemic, including the development of innovative management and treatment approaches [ 43 ] coupled with innovative approaches to teaching, has also provided an opportunity for African universities to showcase their skills to attract future investment. We have already seen apps being developed in South Africa to rapidly assess the use of antimicrobials among patients in hospitals given current concerns [ 17 , 110 , 139 , 140 ], with such approaches likely to grow, building on the greater use of technologies to manage patient care across Africa and the wider world [ 43 , 75 , 141 , 142 , 143 ].…”

Section: Discussionmentioning

confidence: 99%

Challenges and Innovations Brought about by the COVID-19 Pandemic Regarding Medical and Pharmacy Education Especially in Africa and Implications for the Future

Etando¹,

Amu²,

Haque

et al. 2021

Healthcare

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Background: Multiple measures introduced early to restrict COVID-19 have dramatically impacted the teaching of medical and pharmacy students, exacerbated by the lack of infrastructure and experience with e-learning at the start of the pandemic. In addition, the costs and reliability of the Internet across Africa pose challenges alongside undertaking clinical teaching and practical programmes. Consequently, there is a need to understand the many challenges and how these were addressed, given increasingly complex patients, to provide future direction. Method: An exploratory study was conducted among senior-level medical and pharmacy educators across Africa, addressing four key questions, including the challenges resulting from the pandemic and how these were dealt with. Results: Staff and student members faced multiple challenges initially, including adapting to online learning. In addition, concerns with the lack of equipment (especially among disadvantaged students), the costs of Internet bundles, and how to conduct practicals and clinical teaching. Multiple activities were undertaken to address these challenges. These included training sessions, developing innovative approaches to teaching, and seeking ways to reduce Internet costs. Robust approaches to practicals, clinical teaching, and assessments have been developed. Conclusions: Appreciable difficulties to teaching arising from the pandemic are being addressed across Africa. Research is ongoing to improve education and assessments.

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“…Everyone tested COVID-19 positive, laboratory system automatically sends his or her details to contact tracing system that enables the tracers to start investigation immediately. 8 Investigation is performed by interviewing persons at the treatment centre or at home for those under home-based care programme. However, extra information about contacts are also generated through algorithms in place that are using combination of telephone numbers and network connectivity used by a positive case in the last 7 days prior to test positive.…”

Section: Data Sourcementioning

confidence: 99%

The secondary transmission pattern of COVID-19 based on contact tracing in Rwanda

et al. 2021

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IntroductionCOVID-19 has shown an exceptionally high spread rate across and within countries worldwide. Understanding the dynamics of such an infectious disease transmission is critical for devising strategies to control its spread. In particular, Rwanda was one of the African countries that started COVID-19 preparedness early in January 2020, and a total lockdown was imposed when the country had only 18 COVID-19 confirmed cases known. Using intensive contact tracing, several infections were identified, with the majority of them being returning travellers and their close contacts. We used the contact tracing data in Rwanda for understanding the geographic patterns of COVID-19 to inform targeted interventions.MethodsWe estimated the attack rates and identified risk factors associated to COVID-19 spread. We used Bayesian disease mapping models to assess the spatial pattern of COVID-19 and to identify areas characterised by unusually high or low relative risk. In addition, we used multiple variable conditional logistic regression to assess the impact of the risk factors.ResultsThe results showed that COVID-19 cases in Rwanda are localised mainly in the central regions and in the southwest of Rwanda and that some clusters occurred in the northeast of Rwanda. Relationship to the index case, being male and coworkers are the important risk factors for COVID-19 transmission in Rwanda.ConclusionThe analysis of contact tracing data using spatial modelling allowed us to identify high-risk areas at subnational level in Rwanda. Estimating risk factors for infection with SARS-CoV-2 is vital in identifying the clusters in low spread of SARS-CoV-2 subnational level. It is imperative to understand the interactions between the index case and contacts to identify superspreaders, risk factors and high-risk places. The findings recommend that self-isolation at home in Rwanda should be reviewed to limit secondary cases from the same households and spatiotemporal analysis should be introduced in routine monitoring of COVID-19 in Rwanda for policy making decision on real time.

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Lessons Learned from Rwanda: Innovative Strategies for Prevention and Containment of COVID-19

Cited by 48 publications

References 6 publications

Perceived effects of COVID-19 restrictions on smallholder farmers: Evidence from seven lower- and middle-income countries

Perceived effects of COVID-19 restrictions on smallholder farmers: Evidence from seven lower- and middle-income countries

Challenges and Innovations Brought about by the COVID-19 Pandemic Regarding Medical and Pharmacy Education Especially in Africa and Implications for the Future

The secondary transmission pattern of COVID-19 based on contact tracing in Rwanda

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