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The 1998 UNESCO World Conference on Higher Education in Paris recommended that global higher education institutions should internationalize and reduce inequalities between developed and emerging countries. Since then, universities strive to incorporate an international dimension in their service. The aim was initially guided by the 20th century understanding of internationalization being just, fair, and an equitable process that promotes peace and mutual understanding. However, under the influence of the General Agreement on Trade in Services and competition, internationalization changed focus and became less inclusive. This paper explores inclusive international education in East Africa using narrative review methodology. Findings suggest that rather than promoting access and equity in higher education, internationalization, for example, excludes economically disadvantaged, disabled, and adult learners. Thus, in addition to internationalization at home, inclusive internationalization abroad strategies should be devised. Internationalization of higher education is more valuable if it translates into fair, just, and peaceful social systems.

Amid a rise of misinformation worldwide, this paper examines digital misinformation literacy as it relates to COVID-19 news in East Africa. The study is grounded in inoculation theory and contributes to the body of scholarship examining misinformation literacy beyond the Western world. Data came from a comparative, cross-national survey in Kenya, Uganda and Rwanda (N = 3,203), making this the largest known empirical investigation into digital misinformation literacy in the region within the context of a pandemic. Paper surveys were distributed throughout all three countries in 2021. The data revealed differences in actual and perceived misinformation literacy levels. Kenyans and Rwandans were better at detecting false COVID-19 statements in the media, whereas Ugandans were better at detecting true messages. Similarly, Kenyans' and Rwandans' perceived levels of digital misinformation literacy were higher than Ugandans'. Regarding perceived exposure to COVID-19 information, Kenyans felt they were exposed to fake COVID-19 news online more often than Ugandans, who felt more exposed than Rwandans. This research contributes to the growing literature on digital misinformation literacy, an area which isn't significantly studied in many world regions, especially in Africa. [ABSTRACT FROM AUTHOR]

This study compares an ideal model of a sustainable research institution and the dominating model used by Sida. It uses a complementary capacity building (CCB) model aimed to promote an improved research culture for strengthening the sustainability of research partnerships in economics and management disciplines. This study uses bibliometric data to show post-graduation publication results from graduated Ph.D. students from the Sida supported research partnership in Rwanda and data from public records to show results from the implementation of the CCB model in the same country. The results show an increased publication activity among a significant proportion of the faculty members targeted by the CCB model and its contribution to improved research culture. Based on the evidence, the paper provides some recommendations to induce improvements in outcomes, including activities promoting a more active research culture in research partnerships with sub-Saharan African institutions.

Purpose: In developing countries, local buyers often rely on relational contracting based on reciprocity and trust. This paper analyzes relational contracting and global value chain (GVC) governance by focusing on how domestic and foreign coffee exporters in Rwanda confront challenges. Design/methodology/approach: Semi-structured interviews were conducted with 25 representatives of Rwandan private, Rwandan cooperative-owned and foreign exporters, and four coffee sector stakeholders. Findings: Foreign firms export most Rwandan coffee, and local exporters express concerns about their ability to compete. Rwandan exporters face challenges accessing capital, competing with foreign firms and managing high transaction costs. They use relational contracts to reduce transaction costs, and they benefit from a monopsony zoning regulation that reduces competition. Foreign exporters face regulatory challenges: a government-set coffee price and the zoning regulation. They vertically integrate to reduce costs and lock in suppliers through prefinancing. Research limitations/implications: Future research should analyze differences between local and foreign exporters in other contexts to advance understanding of the different challenges faced and contracting approaches used. Originality/value: Few GVC governance studies address the role of relational contracts in contexts where enforcement is costly. Considering relational contracts within GVCs can improve value chain analysis, specifically in the developing countries where many GVCs start. [ABSTRACT FROM AUTHOR]

In this data paper, we present a specimen-based occurrence dataset compiled in the framework of the Conservation of Endemic Central African Trees (ECAT) project with the aim of producing global conservation assessments for the IUCN Red List. The project targets all tree species endemic or sub-endemic to the Central African region comprising the Democratic Republic of the Congo (DR Congo), Rwanda, and Burundi. The dataset contains 6361 plant collection records with occurrences of 8910 specimens from 337 taxa belonging to 153 genera in 52 families. Many of these tree taxa have restricted geographic ranges and are only known from a small number of herbarium specimens. As assessments for such taxa can be compromised by inadequate data, we transcribed and geo-referenced specimen label information to obtain a more accurate and complete locality dataset. All specimen data were manually cleaned and verified by botanical experts, resulting in improved data quality and consistency. [ABSTRACT FROM AUTHOR]

Introduction: timely access to safe cesarean section (c-section) delivery can save the lives of mothers and neonates. This paper explores how distance affects c-section access in rural sub-Saharan Africa, where women in labor present to health centers before being referred to district hospitals for surgical care. Methods: this study included all adult women delivering via c-section between April 2017 and March 2018 in Kirehe District, Rwanda. We assessed the association between travel times and village-level c-section rates. Results: the estimated travel time from home-to-health center was 26 minutes (IQR: 13, 41) and from health center-to-hospital was 43 minutes (IQR: 2, 59). There was no significant association between travel time from home-to-health center and c-section rates (RR=1.01, p=0.42), but the association was significant for health center-to-hospital travel times (RR=0.96, p=0.01); for every 15-minute increase in travel time, there was a 4% decrease in c-sections for a health center catchment area. Conclusion: in the context of decentralized health services, minimizing health center to hospital referral barriers is of utmost importance for improving c-section access in rural sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Pesticides are an important and widely used tool for crop protection, but they also pose significant risks to agricultural sustainability, human health and the environment. In this paper, we examine whether mass media campaigns can help improve pesticide knowledge and change pesticide use behaviour among smallholder farmers in Rwanda and Uganda. We also assess the individual and combined effects of the campaign channels, which include interactive radio, plant health rallies, mobile SMS and video screenings. Applying a doubly robust method to survey data from 1327 maize-producing households across the two countries, we find that the mass media campaigns are significantly associated with improved farmer knowledge of pesticide risks and safety precautions. While the campaigns appear not to have discouraged the use of synthetic pesticides, they are significantly associated with increased adoption of safer alternatives to pesticides, including sustainable integrated pest management practices. The campaigns are also significantly correlated with increased use of protective equipment against pesticide exposure in both countries and reduced incidence of pesticide-related illnesses in Rwanda. We conclude that mass media campaigns (particularly using multiple complementary channels) can be effective in enhancing farmers' knowledge about pesticide risks and safety measures, and promote the adoption of safer pest management strategies. • The effects of mass media campaigns on pesticide use behaviour among farmers are studied. • Campaigns improve farmers' knowledge of pesticide risks and safety measures. • Campaigns boost the adoption of environmentally safer alternatives to synthetic pesticides. • Campaigns are associated with increased use of personal protective equipment items. • Effects are more pronounced for farmers exposed to multiple ICT channels. [ABSTRACT FROM AUTHOR]

This study examines how journalists in Rwanda, Uganda and Kenya perceive their journalistic role orientations in light of the countries' differing political systems, Rwanda representing the nation with the most restrictive political system, Uganda sitting in the middle and Kenya illustrating the nation that is home to the least restrictive political system. Data were analyzed from a comparative, quantitative online survey completed by 424 journalists from the three East African nations. Overall, the journalistic role orientations that emerged in each country align with the freedoms afforded by the political system in each country, revealing a trend that journalists in non-Western countries lean toward more interventionist roles (at times to the point of actively supporting their government), and journalists in countries with less restrictive political systems lean toward more adversarial roles (keeping their government in check). [ABSTRACT FROM AUTHOR]

In the past decade, many governments around the world have strayed neoliberal prescriptions to get closer to the East Asian governance model – the developmental state. Rwanda, which becomes a model for rapid socio-economic development in Africa, is considered as one of these states that take its inspiration from East Asia. Using an adapted theoretical framework and a rich dataset, we investigate whether the actions of the Rwandan state compare with the East Asian ideal-typical developmental state. Our analysis indicates that post-2000 Rwanda possesses two central features of the developmental state: a developmentally-oriented leadership and an efficient public administration that proved capable to implement its ambitious vision. We elaborate on the transformation of the development paradigm in Rwanda that goes beyond its ultra-market-friendly approach and its welcoming private sector environment. Our findings suggest that it is possible to reproduce the developmental state model today, leaving room for context-dependent adaptations. [ABSTRACT FROM AUTHOR]

Introduction Cancer is a major public health problem in Rwanda and other low- and middle-income countries (LMICs). While there have been some improvements in access to cancer treatment, the cost of care has increased, leading to financial toxicity and treatment barriers for many patients. This study explores the financial toxicity of cancer care in Rwanda. Methods This prospective cross-sectional study was conducted at 3 referral hospitals in Rwanda, which deliver most of the country's cancer care. Data were collected over 6 months from June 1 to December 1, 2022 by trained research assistants (RAs) using a modified validated data collection tool. RAs interviewed consecutive eligible patients with breast cancer, cervical cancer, colorectal cancer, Hodgkin's and non-Hodgkin's lymphoma who were on active systemic therapy. The study aimed to identify sources of financial burden. Data were analyzed using descriptive statistics. Results 239 patients were included; 75% (n  = 180/239) were female and mean age was 51 years. Breast, cervix, and colorectal cancers were the most common diagnoses (42%, 100/239; 24%, 58/239; and 24%, 57/239, respectively) and 54% (n  = 129/239) were diagnosed with advanced stage (stages III-IV). Financial burden was high; 44% (n  = 106/239) of respondents sold property, 29% (n  =  70/239) asked for charity from public, family, or friends, and 16% (n  = 37/239) took loans with interest to fund cancer treatment. Conclusion Despite health insurance which covers many elements of cancer care, a substantial proportion of patients on anti-cancer treatment in Rwanda experience major financial toxicity. Novel health financing solutions are needed to ensure accessible and affordable cancer care. [ABSTRACT FROM AUTHOR]

Current measures for monitoring progress towards universal health coverage (UHC) do not adequately account for populations that do not have the same level of access to quality care services and/or financial protection to cover health expenses for when care is accessed. This gap in accounting for unmet health care needs may contribute to underutilization of needed services or widening inequalities. Asking people whether or not their needs for health care have been met, as part of a household survey, is a pragmatic way of capturing this information. This analysis examined responses to self-reported questions about unmet need asked as part of 17 health, social and economic surveys conducted between 2001 and 2019, representing 83 low-, middle- and high-income countries. Noting the large variation in questions and response categories, the results point to low levels (less than 2%) of unmet need reported in adults aged 60+ years in countries like Andorra, Qatar, Republic of Korea, Slovenia, Thailand and Viet Nam to rates of over 50% in Georgia, Haiti, Morocco, Rwanda, and Zimbabwe. While unique, these estimates are likely underestimates, and do not begin to address issues of poor quality of care as a barrier or contributing to unmet need in those who were able to access care. Monitoring progress towards UHC will need to incorporate estimates of unmet need if we are to reach universality and reduce health inequalities in older populations. [ABSTRACT FROM AUTHOR]

Many African countries have encouraged the creation of local cooperatives in their efforts to legalize artisanal and small-scale mining. This exploratory case study of Rwanda's largest mining cooperative examines how cooperative business models, rather than direct company employment, might mitigate women's vulnerabilities in extractive industries. Through feminist political ecology's intersectionality framework, this research asks how cooperatives might improve women's outcomes along three lines—financial gains, gender violence reduction, and legal awareness and empowerment. Qualitative inquiry directly draws from semi-structured interviews, focus-group discussions, and participant observations, and indirectly from mapmaking workshops, with women who are full-time employees, seasonal miners, and farmers near six extraction sites. Based on content analysis in NVivo, this study finds the selected cooperative does not improve women's financial outcomes or lower violence rates compared to private companies in Rwanda. A specific form of gender violence, coerced transactional employment sex, is higher in the cooperative. However, cooperative work may expand women's rights conceptions and legal consciousness. Cooperative members demonstrated a greater understanding of supply chains, government functions, and conflict resolution pathways. These results indicate that cooperatives are not a panacea for rural women's marginalization but are a starting point for enhanced understandings of socio-economic and legal equities. [ABSTRACT FROM AUTHOR]

Eastern DRC is seriously affected by a protracted warfare involving illicit exploitation of natural resources, corruption, humanitarian crisis and terrorism carried out by armed groups including the Allied Democratic Forces (ADF) and the Movement of 23 March (M23). According to DRC government, M23 is a terrorist group supported by Rwanda Defence Forces (RDF). Invasion and terrorism drive the war and the chaos. For Rwanda, fighting and chaos derive from ethnic conflicts over land, citizenship, local political power, and state failures. To many observers, ongoing violence and fighting are driven by rent seeking by Congolese military commanders, lack of State authority, distorted rule of law at both national and local levels, the abuse of public office for private gain (corruption), failed defence/security and justice sector reforms, undisciplined civilian armed and unarmed combatants, warlords and opportunist warmongers. Overall, state failures combined with globalized war diseconomy as conducted by multinational companies, failed multiparty system regarding democratic governance system drive ongoing chaos and armed violence, beyond government control and defence capabilities, despite peace agreements and the involvement of international and regional peace peacekeeping initiatives. Our analysis suggests that the war strategy being used resembles to what McKew refers to as the Gerasimov Doctrine, a chaos theory of political warfare which is used by Russia in Ukraine war. [ABSTRACT FROM AUTHOR]

Peste des petits ruminants (PPR), a contagious viral disease affecting small ruminants, has been targeted by the global community for eradication within the next 10 years. However, eradication will require substantial money, human resources, coordination among actors, and individual commitments. The objective was to estimate the cost of PPR at a household level, thereby providing information on the potential economic benefits of PPR eradication and the incentives for small ruminant keepers to actively participate in the PPR Global Eradication Programme. This study focused on four sub‐Saharan countries: Ethiopia, Malawi, Mali and Rwanda. Publicly available household level data assembled by FAO were used. A bioeconomic model was built to estimate impacts of PPR for a standardized theoretical area, where each household raised an average small ruminant herd or flock. Model outputs were used to estimate, at a household level, income loss due to a PPR outbreak. We constructed various income scenarios to account for the variability of small ruminant income as a proportion of total household annual income. Household income losses ranged from 2% to 40% of total annual income; percentages varied depending on the income scenario and on the gross annual economic impact of PPR on small ruminant production, which ranged from 20% to 80%, based on results of the bioeconomic model. As expected, the more small ruminant production contributed to household income the greater the impact. Estimates provided herein warn decision makers that, given the heterogeneous impact of PPR on household income, the willingness of small ruminant decision makers to participate in the PPR Global Eradication Programme may vary widely and tailored approaches should be devised and implemented. [ABSTRACT FROM AUTHOR]

The degradation of soil, vegetation and socio-economic transformations are a huge threat to Africa's land production. This study aimed to (i) assess the soil and land productivity of standing biomass and (ii) determine the effect of rainfall on the standing biomass in Eastern Africa. Soil productivity was determined using the Soil Productivity Index (SPI) and a simplified model was developed to estimate the Net Primary Productivity (NPP). The SPI indicators used included soil-organic matter, texture, soil moisture, base-saturation, pH, cation-exchange-capacity, soil-depth and drainage. The inputs of the simplified model are: MODIS Soil Adjusted Vegetation Index (SAVI), soil erosion, soil nutrient content and input, rainfall, land-use/cover and agro-ecological zones. The findings reveal that the countries with the most productive soils are Mauritius, Rwanda and South Sudan—while, for standing biomass, the countries with the highest spatial extent are Mauritius (97%), Rwanda (96%), Uganda (95%), South Sudan (89%), Ethiopia (47%) and Kenya (36%). Standing biomass is dominant in biomes such as natural forests, woodlands, croplands, grasslands, wetlands and tree-plantations. High land productivity was attributed to soil quality and management, land policy reforms, favourable climatic conditions and sustainable land husbandry activities. Rainfall was significantly correlated with standing biomass in most of the studied countries (p < 0.05) except Djibouti and Rwanda. Therefore, monitoring soil health, use and land reforms are key to sustaining vegetative biomass. [ABSTRACT FROM AUTHOR]

• Rwanda's government implemented a zoning policy in its coffee industry. • Mixed methods are used to analyze how zoning affected buyer-farmer relationships. • Buyers were more likely to give farmers bonuses where zoning was well-implemented. • We do not find evidence that zoning increased coffee farmer investment. • Buyers believed that zoning improved their relationships with farmers. Contract farming has the potential to both connect farmers to global markets and limit farmers' sale channel choices. In countries where contract enforcement is weak, some governments have enforced monopsony zoning systems in which farmers within a zone must sell to a specific buyer. There is variance in zoning systems' effectiveness in improving relationships between suppliers and buyers. In 2016, Rwanda implemented a zoning system aimed at reducing side-selling by coffee farmers and improving service provision to farmers by coffee mills. This paper analyzes the impacts of zoning on contracting between farmers and mills. We use data from farmer surveys from before and after the shift to zoning to estimate a difference-in-differences model analyzing the effects of zoning on second payments (i.e., bonuses) paid to farmers out of mill profits. We use the share of farmers aware of zoning at the local level as a proxy for the relative strength of zoning implementation and analyze the effect of zoning on farmers being promised or receiving second payments by coffee mills. We find that an increase in the degree of zoning implementation (proxied by the proportion of local coffee farmers that know about zoning) is associated with an increase in the probability that a farmer is promised or receives a second payment. Consistent with quantitative findings, interviews with mill managers suggest that zoning motivated mills to improve service provision. We do not find evidence that zoning increased farmer investment in their coffee plantations in the short run. However, qualitative evidence suggests that zoning reduced local trader activity and farmer side-selling, which benefited mills. [ABSTRACT FROM AUTHOR]

Objectives: Effective coverage of non-communicable disease (NCD) care in sub-Saharan Africa remains low, with the majority of services still largely restricted to central referral centres. Between 2015 and 2017, the Rwandan Ministry of Health implemented a strategy to decentralise outpatient care for severe chronic NCDs, including type 1 diabetes, heart failure and severe hypertension, to rural first-level hospitals. This study describes the facility-level implementation outcomes of this strategy.Methods: In 2014, the Ministry of Health trained two nurses in each of the country's 42 first-level hospitals to implement and deliver nurse-led, integrated, outpatient NCD clinics, which focused on severe NCDs. Post-intervention evaluation occurred via repeated cross-sectional surveys, informal interviews and routinely collected clinical data over two rounds of visits in 2015 and 2017. Implementation outcomes included fidelity, feasibility and penetration.Results: By 2017, all NCD clinics were staffed by at least one NCD-trained nurse. Among the approximately 27 000 nationally enrolled patients, hypertension was the most common diagnosis (70%), followed by type 2 diabetes (19%), chronic respiratory disease (5%), type 1 diabetes (4%) and heart failure (2%). With the exception of warfarin and beta-blockers, national essential medicines were available at more than 70% of facilities. Clinicians adhered to clinical protocols at approximately 70% agreement with evaluators.Conclusion: The government of Rwanda was able to scale a nurse-led outpatient NCD programme to all first-level hospitals with good fidelity, feasibility and penetration as to expand access to care for severe NCDs. [ABSTRACT FROM AUTHOR]