Objectives: This study assessed the on-farm Musa germplasm diversity across different agro-ecologies of Rwanda and the socio-economic utilization options and selection practices that create/maintain this diversity on-farm. Methodology and results: A Musa germplasm diagnostic survey was carried out in 2007 in five Rwandan districts on a transect from Lake Kivu (West) to Kirehe district (East) bordering Tanzania. Across all sites, 118 farms, each having at least 50 mats were sampled for determining Musa diversity. Forty three Musa cultivars were recorded across the five districts. Higher diversity was observed in the east declining westwards to the Lake Kivu region as reflected by the number of cultivars and their relative abundance. Nearly half of the recorded cultivars had a low diversity index (Gini-Simpson 1-D < 0.2) and therefore prone to genetic erosion. Cooking cultivars only dominate in the district of Kirehe, while beer cultivars dominate the banana production landscape in the other districts. Taste/flavor, bunch size and market demand were the most important criteria for banana cultivar selection and thus greatly influenced cultivar conservation and distribution on-farm. Diseases such as Fusarium wilt and Xanthomonas wilt greatly contributed to genetic erosion. Conclusion and application of results: Musa cultivar diversity in Rwanda is under threat. Ex-situ conservation of the menaced cultivars is of crucial importance. Beer cultivars dominated the landscape. Cultivar diversity on-farm was influenced by the prevailing altitude; taste/flavor, bunch size, and market demand of the cultivars; and their susceptibility to diseases especially Fusarium and Xanthomonas wilt. Banana breeding or adaptation strategies therefore should take into account the farmer preferred traits. In addition, strategies for managing these diseases are critical for preventing the genetic erosion of the affected cultivars.

Objective In humanitarian settings, children of pastoralists usually are the increased risk of malnutrition and its related complications. Consequently, as part of the program’s targeted response to the burgeoning malnutrition caseloads, a nutrition and mortality survey was conducted using a global standardized methodology in humanitarian settings in Ikwotos country of the Eastern Equatoria of South Sudan. Additionally, in understanding the intricacies of food diversity consumed in the households, we used infants as a proxy of household feeding and collected information on the range of foods consumed by households. Data description Data contained in this note is a standard cross-sectional survey conducted in South Sudan with children between the ages of 6 and 59 months, although the mortality component covered all members of the household. While data for mortality and infant feeding practices were self-reported, the assessment of nutritional status were in accordance to the World Health Organisation’s guidelines for nutrition assessment. Age, sex, height and mid-upper arm circumference data were assessment and malnourished children were classified as those with Z-score between − 2 and − 3 and those above − 3 were classified as severely malnourished.

Background With a fertility rate of 5.4 children per woman, Burundi ranked as seventh country with the highest fertility rate in the world. Family planning is an effective way of achieving desirable family size, appropriate birth spacing and significant reduction in unintended pregnancies. Furthermore, family planning has been linked to improvements in maternal health outcomes. Yet, in spite of the overwhelming evidence on the benefits of family planning and despite high knowledge and free services, utilisation is low especially in rural communities with conservative people. Employing a mixed methods approach, this study first quantifies contraceptive prevalence and second, explores the contextual multilevel factors associated with low family planning utilisation among community members. Methods An explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members composed of married men and women, administrative and religious leaders (n = 132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in Bururi and Rumonge provinces in Burundi. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes. Results The overall contraceptive prevalence was 22.6%. From logistic modelling analysis, it was found that women aged 25 to 29 (aOR 5.04 (95% CI 2.09–10.27 p = 0.038), those that have completed secondary school and having four or less children were significantly associated with use of family planning (aOR 1.72 (95%1.35–2.01) p = 0.002). Among factors why family planning was unused included experience with side effects and costs associated with its management in the health system. Religious conceptualisation and ancestral negative beliefs of family planning had also shaped how people perceived it. Furthermore, at the household level, gender imbalances between spouses had resulted in break in communication, also serving as a factor for non-use of family planning. Conclusion Given that use of family planning is rooted in negative beliefs emanating mainly from religious and cultural practices, engaging local religious leaders and community actors may trigger positive behaviours change needed to increase its use.

Background Burundi has one of the highest rates of malnutrition in the world, particularly chronic malnutrition, which affects 55% of all children &lt;5 y of age. Although it rolled out a national treatment programme to combat all forms of malnutrition, enrolment of children remains difficult. In this study, we use observational data from two screening approaches to assess the effectiveness in detection and enrolment into treatment. Methods Individual data from each screening approach was classified as either acutely malnourished or normal and either chronically malnourished or normal using a cut-off z-score between −2 and 2. Results While the Global Acute Malnutrition rate for the community-based mass screening was 8.3% (95% CI 5.6 to 11), with 8% enrolled in treatment, that of clinic-based systematic screening was 14.1% (95% CI 12.2 to 16.1), 98% of which were enrolled in treatment. Clinic systematic screening was 1.82 times (OR, 95% CI 1.26 to 2.62, p&lt;0.001) and 1.35 times (95% CI 1.09 to 1.68, p=0.06) more likely to detect acute and chronic malnutrition, respectively, than community-based mass screening. Conclusions Although different mechanisms are relevant to proactively detect cases, strengthening the health system to systematically screen children could yield the best results, as it remains the primary contact for the sicker population, who may be at risk of increased infection as a result of underlying malnutrition.

Background With a fertility rate of 5.4 children per woman, Burundi has been ranked as seventh highest country with the highest fertility rate in the world. Family planning is known to allow couples to achieve the desired family size, appropriate space birth and the limitation of pregnancies. Also, family planning can contribute to mitigating some health issues such as unintended pregnancies and abortions all of which, are often associated with multi-parity. In conservative community in rural Burundi, knowledge on family planning is high and such services are free yet utilisation is low. Employing a mixed methods, this study first quantifies contraceptive prevalence and second, explore the contextual multilevel factors associated with low family planning utilisation among married women.Methods An explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members composed of married men and women, administrative and religious leaders (n=132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in provinces of Bururi and Rumonge respectively. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes.Results The overall contraceptive prevalence was 22.6%. Injectables (40%), Implants (24.6%), Male condom (10.8%) and pills (6.2%) were the major contraceptive methods utilized by study participants. Factors inhibiting family planning use emanated from a range of issues which were identified during the qualitative phase. Notable among those was experiencing side effects and costs associated with its management in the health system. Religious conceptualisation and ancestral negative beliefs of family planning had also shaped how people perceived it. Furthermore, at the household level, gender imbalances between spouses had resulted in break in communication, also serving as a factor for non-use of family planning. Conclusion The study suggests that low uptake of family planning can be attributed to perceived or experienced side effects as well as deeply rooted negative beliefs which are reinforced by religious beliefs. Men and religious leaders’ involvement in family planning initiatives can positively impact behaviour change and increase family planning acceptance.

BackgroundWith a fertility rate of 5.4 children per woman, Burundi has been ranked as seventh highest country with the highest fertility rate in the world. Family planning is known to allow couples to achieve the desired family size, appropriate space birth and the limitation of pregnancies. Also, family planning can contribute to mitigating some health issues such as unintended pregnancies and abortions all of which, are often associated with multi-parity. In conservative community in rural Burundi, knowledge on family planning is high and such services are free yet utilisation is low. Employing a mixed methods, this study first quantifies contraceptive prevalence and second, explore the contextual multilevel factors associated with low family planning utilisation among married women.Methods An explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members composed of married men and women, administrative and religious leaders (n=132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in Bururi and Rumonge provinces in Burundi. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes.ResultsThe overall contraceptive prevalence was 22.6%. From logistic modelling analysis, it was found that women aged 25 to 29, those completed secondary school and having four or less children was significantly associated with use of family planning. Among factors why family planning was unused included experience with side effects and costs associated with its management in the health system. Religious conceptualisation and ancestral negative beliefs of family planning had also shaped how people perceived it. Furthermore, at the household level, gender imbalances between spouses had resulted in break in communication, also serving as a factor for non-use of family planning. ConclusionGiven that use of family planning is rooted in negative beliefs emanating mainly from religious and cultural practices, engaging local religious leaders and community actors may trigger positive behaviours change needed to increase its use.

Background Burundi has one of the poorest child health outcomes in the world. With an acute malnutrition rate of 5% and a chronic malnutrition rate of 56%, under five death is 78 per 1000 live births and 47 children for every 1000 children will live until their first birthday. In response to this grim statistics, Village Health Works, a Burundian-American organisation has invested in an integrated clinical and community intervention model to improve child health outcomes. The aim of this study is to measure and report on child health indicator ahead of implementing this model. Methods A cross sectional design was employed, adopting the Demographic Health Survey methodology. We reached out to a sample of 952 households comprising of 2675 birth, in our study area. Mortality data was analysed with R package for mortality computation and other outcomes using SPSS. Principal component analysis was used to classify households into wealth quintiles. Logistic regression was used to assess strength of associations and significance of association was considered at 95% confidence level. Results The incidence of low birth weight (LBW) was 6.4% at the study area compared to 10% at the national level with the strongest predictor being malnourished women (OR 1.4 95%CI 1.2–7.2 p = 0.043). Fever incidence was higher in the study area (50.5%) in comparison to 39.5% nationally. Consumption of minimum acceptable diet was showed a significant protection against fever (OR 0.64 95%CI 0.41–0.94 p = 0.042). Global Acute Malnutrition rate was 7.6% and this significantly reduced with increasing age of child. Under-five mortality rate was 32.1 per 1000 live births and infant mortality was 25.7 per 1000 in the catchment with most deaths happening within the first 28 days of life (57.3%). Conclusion Improving child health status is complex, therefore, investing into an integrated intervention for both mother and child could yield best results. Given that most under-five deaths occurred in the neonatal period, implementing integrated clinical and community newborn care interventions are critical.

BackgroundWith a fertility rate of 5.5 children per woman, Burundi has been ranked as fourth highest country with the highest fertility rate in the world. Family planning is known to allow couples to achieve the desired family size, appropriate space birth and the limitation of pregnancies. Also, family planning can contribute to mitigating some health issues such as unintended pregnancies and abortions all of which, are often associated with multi-parity. In conservative community in rural Burundi, knowledge on family planning is high and such services are free yet utilisation is low. Employing a mixed methods, this study first quantifies contraceptive prevalence and second, explore the contextual multilevel factors associated with low family planning utilisation MethodsAn explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members (n=132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in provinces of Bururi and Rumonge respectively. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes.ResultsThe overall contraceptive prevalence was 22.6%. Injectables (40%), Implants (24.6%), Male condom (10.8%) and pills (6.2%) were the major contraceptive methods utilized by study participants. Natural contraceptive methods were used by 13.8% of women interviewed. The reasons for not using modern contraceptive methods were side effects (51%), perceived postpartum (18.8%), religious beliefs (12.9%), partner’s opposition (8.4%), partner absenteeism (6.4%) and lack of awareness (2.5%). The qualitative component identified fear of side effects, religious beliefs, cultural barriers, spousal communication gap and refusal of family planning services by health practitioners as factors.ConclusionThe study suggests that low uptake of family planning can be attributed to perceived or experienced side effects as well as deeply rooted negative beliefs which are reinforced by religious beliefs. Men and religious leaders’ involvement in family planning initiatives can positively impact behaviour change and increase family planning acceptance.