One-third of the global population, mostly in sub-Saharan Africa, lacks consistent access to essential medicines. This descriptive study assessed the level of stock-outs and whether distance to district pharmacy, supervision visits or delays in drug delivery from district pharmacy to health centers were associated with stock-outs in 15 rural health centers in northern Rwanda. We extracted data from stock cards, dispensing records and health center registers. One tracer drug, mebendazole, had no stock-outs. Quinine had the most stock-outs, an average of 10.5 months of stock-outs in 10 health centers. No association was found between drug stock-out and distance, supervision visits or delays in drug delivery. We hypothesize that observed stock-outs could be attributed to availability of other dosages of the same medicine, special orders during campaigns, staff turn-over and logistical issues beyond health centers' capacity such as delays in importation. These should be explored more in future studies.
This study examined the effect of implementing Nine Year Basic Education (9YBE) policy on secondary school internal efficiency. The study followed descriptive design. Data on students’ enrolments and repetitions for consecutive school years, cohort 2014/15 and 2017/18, were collected from all five lower secondary schools in Ngoma and Tumba Sectors using survey questionnaire. Besides, focus group discussions (FGDs) were used to collect views of head-teachers on the study variables. The reconstructed cohort flow analysis technique was used to determine indicators of internal efficiency. Summary statistics are presented in tables. Qualitative data from FGDs were analysed through thematic content analysis with consideration of similarities and differences. The findings revealed (i) a positive change in students' promotion and repetition rates, (ii) students’ survival rate to the last grade increased to 69.39% for the cohort 2017/18 from 50.72% for the cohort 2014/15 and (iii) wastage ratio declined from 1.62 for cohort 2014/15 to 1.33 for cohort 2017/18. Thus, school efficiency rose to 75.19% in 2017/18. Head-teachers attributed the positive change in internal efficiency indicators to the combination of 9YBE interventions including removal of school fees, school feeding, and flexibility in student progression and increasing day secondary school in proximity of home. However, persistent high dropout rates indicated that the implementation of 9YBE policy had not alleviated all disruptive forces against students’ participation rates. It was therefore suggested to relook at policy interventions to address individual students’ challenges at school and household levels and the management of older children in the school system.
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