Tsion Yohannes

This article discusses the University of Global Health Equity (UGHE)’s use of a Gender Equity and Diversity Inclusion Audit as a tool to mainstream gender and minority groups’ inclusion. The internal audit analysed gender and minority groups’ inclusiveness, sensitivity, and/or awareness in institutional programmes, projects, plans, practices, and policies and identified the gaps within. This article gives an overview on why and how UGHE (Rwanda) created a single tool for an internal audit covering both gender equity and minority inclusion, implemented by its Center for Gender Equity (CGE) with the participation of students, staff, and faculty from both its Butaro campus and Kigali headquarters in Rwanda. The tool is based on a four-part methodology that includes a desk review of official university documents, self-assessment questionnaires for employees and students, in-depth interviews, and consultative meetings with selected staff and UGHE leaders. The data collected through this robust audit allowed for the identification of gaps in the mainstreaming of gender and minority inclusion—the main ones are briefly discussed in the article, and this will guide the design of UGHE’s strategy to correct these. The gender mainstreaming strategy’s ultimate objective is advancing institutional equity.

By 2030, an estimated 80% of the world's older population (aged ≥60 years) will reside in low- and middle-income countries (LMICs). Ageing well in these regions requires addressing complex financial, health, and social care needs through evidence-based policy and practice. However, data collection in LMICs remains limited and often unrepresentative, as seen in Brazil, where nearly 70% of geriatrics and gerontology publications (2014–2019) originated from the south or southeast regions. Recognizing the diverse needs of ageing populations, it is crucial to prioritize locally informed research and targeted interventions. Urgent action is needed to expand research efforts, inform policy development, and strengthen systems that address the medical and psychosocial challenges faced by older individuals in LMICs.

Abstract Background While Sub-Saharan Africa contains nearly one third of the global burden of disease, it only contains 3.5% of the healthcare workforce. Furthermore, female medical doctors are underrepresented across the continent. Studies show that increasing gender representation in medicine not only bridges this gap but may have a positive impact on patient care. This study explores the support systems influencing female students to pursue medical school in Rwanda, aiming to recommend ways to increase female participation through support systems. Methods This is an exploratory, interpretive study employing qualitative methods. The study was conducted at thirteen secondary schools within two provinces and three universities in Rwanda that offer a medical degree program. Participants were divided into focus groups, including female and male secondary students in science and non-science combinations; teachers of secondary students; female and male students enrolled in medical school; and parents of secondary students in science and non-science combinations. Private and public, mixed and girls-only secondary schools that met the criteria were selected in each province, and all universities offering a medical degree. Participants were selected via random stratified sampling. Thirty-four semi-structured focus group discussions were conducted (28 secondary-level and 6 university-level) and 16 interviews. Data was coded inductively, with common themes identified. Results Four main themes were identified as support systems that can either serve as facilitators or barriers to pursuing an MBBS, including teacher support, parental or familial support, financial or institutional policy support, and having access to female mentors or role models. Conclusion Social support systems are enablers encouraging female students to join medical school. Integrating social support systems in schools and the community has the potential to increase female applicants to medical school in Rwanda.

Teen mothers are more susceptible to the negative consequences of pregnancy, due to system-wide and socio-cultural barriers to accessing needed services, posing higher pregnancy complications and health risks to the babies and mothers. Understanding their lived experience can inform context-specific health programs and interventions that address their needs and improve the health outcomes. Twenty-three women who had delivered her first child before the age of 18 years were interviewed using semi-structured interview guide. The transcripts were coded, categorized and summarized into four major themes: 1) Many pregnant teen girls were disadvantaged by the system from accessing the healthcare services, 2) Although being judged, many found the health care services positive and important, 3) Faced financial difficulty in accessing health services, despite most medical services are covered by community based health insurance, 4) Health care services focuses mostly on the medical health of pregnancy, the social and psychological needs were mostly not available. The study highlighted the gap in providing mental health services, financial support to the teen mothers as part of a comprehensive health services. Some of them consulted health services for the first time with and did not return for follow up if perceived the services was bad. More sensitive and targeted materials and ANC services can be offered to this unique group of clients. More acceptance training to the health care providers and the public is needed. For health facilities, there is a need to also check their psychological wellbeing when seeking ANC services. Online or mobile phone-based mental health interventions may provide some solutions to the issue. Government should re-evaluate the health insurance system to avoid unintentional exclusion of this group of population. Policy to facilitate men to take responsibilities on teen pregnancy issue is needed.

Through progressive policies, Rwanda has made significant strides in promoting girls’ education and empowerment. However, female enrollment in Bachelor of Medicine and Bachelor of Surgery (MBBS) programs remains disproportionately low. This cross-sectional study investigates the influence of gender stereotypes and girls’ self-perceptions on female engagement in MBBS programs in Rwanda. The data analyzed for this study has been used and published in BMC Medical Education in a study with a different but clearly related focus, under the title “Gender-based support systems influencing female students to pursue a bachelor of medicine, bachelor of surgery (MBBS) in Rwanda” (Neil KL, BMC Med Educ 24:641,2024). While the previous analysis focused on the presence and gaps in gender-based support systems, the current research has a new focus on gender based self-perceptions influence in girls interest in pursuing medical school training. Conducted across 13 secondary schools and 3 universities offering MBBS degrees, the study engaged 8–12 students, parents/guardians, and teachers in each focus group discussion in a total of thirty-four focus group discussions and sixteen semi-structured interviews. Twenty-eight discussions took place at the secondary school level, and six were conducted at the MBBS level. Data analysis utilized inductive coding to identify recurring themes. The study identified three overarching themes: society’s role in shaping gendered expectations about domestic and professional roles, girls’ self-perceptions regarding their ability to pursue sciences and MBBS within these norms, and internalized stereotypes affecting girls’ career aspirations. Drawing on gender schema and social cognitive theory, the research underscores how societal expectations and stereotypes shape and constrain girls’ career choices. The findings highlight the necessity of dismantling gender-based perceptions that hinder girls’ participation in scientific disciplines, including MBBS.