BackgroundSince 2004, malaria interventions in Rwanda have resulted in substantial decline of malaria incidence. However, this achievement is fragile as potentials for local malaria transmissions remain. The risk of getting malaria infection is partially explained by social conditions of vulnerable populations. Since vulnerability to malaria is both influenced by social and environmental factors, its complexity cannot be measured by a single value. The aim of this paper is, therefore, to apply a composite indicator approach for assessing social vulnerability to malaria in Rwanda. This assessment informs the decision-makers in targeting malaria interventions and allocating limited resources to reduce malaria burden in Rwanda.MethodsA literature review was used to conceptualize the social vulnerability to malaria and to select the appropriate vulnerability indicators. Indicators used in the index creation were classified into susceptibility and lack of resilience vulnerability domains. The main steps followed include selection of indicators and datasets, imputation of missing values, descriptive statistics, normalization and weighting of indicators, local sensitivity analysis and indicators aggregation. Correlation analysis helped to empirically evidence the association between the indicators and malaria incidence.ResultsThe high values of social vulnerability to malaria are found in Gicumbi, Rusizi, Nyaruguru and Gisagara, and low values in Muhanga, Nyarugenge, Kicukiro and Nyanza. The most influential susceptibility indicators to increase malaria are population change (r = 0.729), average number of persons per bedroom (r = 0.531), number of households affected by droughts and famines (r = 0.591), and area used for irrigation (r = 0.611). The bed net ownership (r = −0.398) and poor housing wall materials (0.378) are the lack of resilience indicators that significantly correlate with malaria incidence.ConclusionsThe developed composite index social vulnerability to malaria indicates which indicators need to be addressed and in which districts. The results from this study are salient for public health policy- and decision makers in malaria control in Rwanda and timely support the national integrated malaria initiative. Future research development should focus on spatial explicit vulnerability assessment by combining environmental and social drivers to achieve an integrated and complete assessment of vulnerability to malaria.

Despite the decline in malaria incidence due to intense interventions, potentials for malaria transmission persist in Rwanda. To eradicate malaria in Rwanda, strategies need to expand beyond approaches that focus solely on malaria epidemiology and also consider the socioeconomic, demographic and biological/disease-related factors that determine the vulnerability of potentially exposed populations. This paper analyses current levels of social vulnerability to malaria in Rwanda by integrating a set of weighted vulnerability indicators. The paper uses regionalisation techniques as a spatially explicit approach for delineating homogeneous regions of social vulnerability to malaria. This overcomes the limitations of administrative boundaries for modelling the trans-boundary social vulnerability to malaria. The utilised approach revealed high levels of social vulnerability to malaria in the highland areas of Rwanda, as well as in remote areas where populations are more susceptible. Susceptibility may be due to the populations' lacking the capacity to anticipate mosquito bites, or lacking resilience to cope with or recover from malaria infection. By highlighting the most influential indicators of social vulnerability to malaria, the applied approach indicates which vulnerability domains need to be addressed, and where appropriate interventions are most required. Interventions to improve the socioeconomic development in highly vulnerable areas could prove highly effective, and provide sustainable outcomes against malaria in Rwanda. This would ultimately increase the resilience of the population and their capacity to better anticipate, cope with, and recover from possible infection. IntroductionDespite various interventions to reduce the burden of malaria, the disease persists in many countries of the developing world. In 2012 there were approximately 562,000 malaria deaths in Africa, despite a slow decline since 2004 (WHO, 2014. Malaria decrease in Sub-Saharan Africa was generally associated with intense interventions and reduced vector density due to changing rainfall patterns (Meyrowitsch et al., 2011). Although considerable progress has been made in many countries, the general malaria burden remains high, particularly in young children and pregnant women (Roll Back Malaria, 2005). The Plasmodium (P.) falciparum prevalence rates in Rwanda increased until the late 1990s and early 2000s, after which a marked decrease was noted (Stern et al., 2011). Since 2004, interventions to prevent and control malaria in Rwanda have resulted in a substantial decline in malaria transmission, particularly as a result of improved access to effective treatment, increased use of bed nets, and indoor residual spraying (Karema et al., 2012). However, malaria incidence increased again between 2011 and 2012, revealing the fragility of the gains achieved (WHO, 2013). The results of an entomological survey of more than 50% exophile entomological inoculation rate (EIR) around Kigali City is also an indicator of potential transmission ga...

Since mid-1970s, a great number of rural-urban migrants are converging towards Kigali, the capital of Rwanda, and secondary towns, putting strain on land, especially of urban fringes. This is the case of Tumba Sector, a suburb of Butare Town, which attracts many people searching land for various uses. The purpose of this paper is to analyse the land market process in Tumba Sector. Data used in this paper were collected through desk study, survey and from non-structured interview held with the Tumba Land Bureau Officer. Findings revealed landowned was acquired through informal purchase and land sellers were mainly native people who acquired land through inheritance. Size of land to be sold is frequently fixed unilaterally by the seller. Land demarcation is done with indigenous plants. Land price is negotiable and varies greatly based on the land size and its specific location and is higher than the reference land price. Land right transfer is evidenced by a simple "sale contract". All informal land purchases are not reported to the Land Bureau though the process is very easy, clear and cheap. Land buyers are primarily local tradespeople, and secondarily civil servants. Great involvement of tradespeople in land purchase and high price suggest that there is land speculation in the area. Though informal land market benefits to the land seller and the buyer, it can be detrimental the client. Informal land market develops as a response to the failure of formal land provision which leads people not to apply to Huye District/Tumba Sector for land provision. Therefore it is important for the District and the Sector be empowered to be land provider and enforce rules and the law governing land, especially in peri-urban areas.

Rapid urbanization of Kigali City is a direct consequence of increasing development of informal settlements in the city. This research sought to identify

In Rwanda, 85% of primary energy comes from biomass. To