Injury is a major cause of death in Rwanda, with many deaths occurring before hospital admission. Timely transport of injured patients to appropriate hospitals is crucial, ideally within an hour for severely injured patients. However, delays in reaching treatment facilities are common, with ambulance services using inefficient mobile phone communication. This project aims to evaluate the effectiveness and implementation of an innovative electronic communication platform (912Rwanda).

The study will be conducted through the public ambulance service, Service d’Aide Médicale d’Urgence (SAMU), and receiving health facilities in Kigali city and Musanze district in Rwanda. The 912Rwanda intervention will be rolled out in the two locations at different times. The primary effectiveness outcome is the time from ambulance deployment to patient arrival at the health facility. Secondary effectiveness outcomes include disaggregated times of the primary outcome and clinical outcomes, such as length of stay and requirement for intensive care. These outcomes will be evaluated using an interrupted time series analysis, accounting for non-homogeneous variances, auto-regressive errors and non-linear trends where appropriate. Implementation outcomes will be evaluated using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Qualitative Evaluation for Systematic Translation (QuEST) framework. Cost-effectiveness will be evaluated using a cost-consequence analysis with consequences as determined by the interrupted time series analysis.

Ethical approval was obtained from the Rwanda National Research Ethics Committee (Ref No: 99/RNEC/2023). Dissemination will occur through open-access peer-reviewed publications, relevant national and international conferences.

ISRCTN97674565.

This study aimed to estimate the prevalence of depression and anxiety and associated risk factors among non-communicable diseases (NCD) clinic attendees in rural Rwanda.

Cross-sectional.

44 health centres in three rural districts in Rwanda.

Adults aged 18 years and older with a clinical diagnosis of diabetes, hypertension and/or asthma, who were attending a follow-up appointment during the study period (n=595).

Primary outcome measures were depression (measured by Patient Health Questionnaire-9) and anxiety (measured by Generalised Anxiety Disorder-7). Explanatory measures included sociodemographic and behavioural risk factors associated with depression and anxiety.

Of 595 participants, 265 (44.5%) had depression (95% CI: 40.5% to 48.6%) and 202 (33.9%) had anxiety (95% CI: 30.1% to 37.9%). Comorbidity of depression and anxiety was found in 137 participants (23%). Participants with no formal education had significantly higher odds of reporting depression and anxiety compared with those with primary and secondary/higher education (adjusted OR (aOR)=2.08; 95% CI=1.27 to 3.33, p=0.004, aOR=5.00; 95% CI=1.12 to 25.00, p=0.035, respectively). In addition, participants who were unemployed were more likely to report depression and anxiety (aOR=3.03; 95% CI=1.62 to 5.67, p

The overall prevalence of depression and anxiety was found to be significantly high among the study participants. The risk factors that were associated with depression and anxiety included level of education, district of residence, employment status and past trauma exposure. The findings emphasise the need for integrating mental health screening into NCD care, district-specific interventions, employment support services and trauma-focused care.