Jørn Braa

简介

Background. Diarrhoeal disease remains a leading cause of morbidity and mortality among children under five years (U5) in Rwanda, contributing substantially to healthcare utilisation and imposing considerable economic burdens on households and the health system. National estimates indicate that approximately 14.3% of children under five experienced diarrhoea in the two weeks preceding the 2019–2020 Rwanda Demographic and Health Survey, and diarrhoea has been reported as the third leading cause of death in this age group. Climate variability may influence the risk of diarrhoeal disease, but evidence on how specific climatic factors affect diarrhoeal incidence across Rwanda’s diverse ecological zones and seasons remains limited. This study examined associations between maximum temperature, m

代表成果

• Scientific articles and book chapters
• Ndagijimana, Similien; Semakula, Muhammed; Ishimwe, Christa; Sebakunzi, Thierry; Umuhire, Vivianne Niyonkuru & Hirwa, Sylvain Muzungu [Show all 24 contributors for this article] (2026). Spatial and spatio-temporal modelling of climate variability and under-five diarrhoeal disease in Rwanda. Environmental Research: Health. 4(3), p. 1–13. doi: 10.1088/2752-5309/ae8322. Full text in Research Archive Show summary Background. Diarrhoeal disease remains a leading cause of morbidity and mortality among children under five years (U5) in Rwanda, contributing substantially to healthcare utilisation and imposing considerable economic burdens on households and the health system. National estimates indicate that approximately 14.3% of children under five experienced diarrhoea in the two weeks preceding the 2019–2020 Rwanda Demographic and Health Survey, and diarrhoea has been reported as the third leading cause of death in this age group. Climate variability may influence the risk of diarrhoeal disease, but evidence on how specific climatic factors affect diarrhoeal incidence across Rwanda’s diverse ecological zones and seasons remains limited. This study examined associations between maximum temperature, minimum temperature, rainfall, and relative humidity and U5 diarrhoeal incidence at the sector level in Rwanda. Methods. Monthly counts of U5 diarrhoeal cases reported by health facilities across 416 administrative sectors in Rwanda from January 2015 to December 2024 were analysed together with satellite-derived climate data. Spatio-temporal statistical models were used to evaluate associations between standardised climate variables and diarrhoeal incidence rates while accounting for geographic and seasonal variation. Model comparison relied on both goodness-of-fit metrics and out-of-sample predictive diagnostics. Results. Diarrhoeal incidence showed clear spatial and seasonal patterns, with persistently higher rates in northern and eastern Rwanda. In the final model maximum temperature was positively associated with increased diarrhoeal incidence, with a one-standard-deviation increase corresponding to a 5.6% rise in the estimated incidence rate ratio (RR = 1.056; 95% CrI: 1.02–1.09). Relative humidity showed a protective association (RR ≈ 0.919; 95% CrI: 0.89–0.94), while rainfall showed limited immediate effects. Conclusion. Under-five diarrhoeal incidence in Rwanda showed marked spatial and seasonal variability. Maximum temperature was positively associated with diarrhoeal incidence rates, while relative humidity showed an inverse association that may partly reflect unmeasured confounding by drought, water access, and WASH infrastructure. External validation is needed before the modelling framework can be applied operationally. These findings highlight the importance of preparedness during hotter periods and strengthened prevention and surveillance efforts in high-risk areas.
• Amarakoon, Pamod Madusanka; Gundersen, Ragnhild Bassøe; Muhire, Andrew; Utvik, Vetle Alvenes & Braa, Jørn Anders (2023). Exploring health information system resilience during COVID-19 pandemic: case studies from Norway, Sri Lanka & Rwanda. BMC Health Services Research. 23(1). doi: 10.1186/s12913-023-10232-0. Full text in Research Archive Show summary The study aims at exploring health system resilience by defining the scope on health information systems, one of the six building blocks of the health system. The empirical evidence is derived using qualitative data collection and analysis in the context of Norway, Sri Lanka and Rwanda during the COVID-19 pandemic. The case studies elicit bounce back and bounce forward properties as well as the agility as major attributes of resilience present across the countries. Existing local capacity, networking and collaborations, flexible digital platforms and enabling antecedent conditions are identified as socio-technical determinants of information system resilience based on the case studies across the countries.
• Braa, Jørn Anders; Sahay, Sundeep & Monteiro, Eric (2023). Design Theory for Societal Digital Transformation: The Case of Digital Global Health. Journal of the AIS. 24(6), p. 1645–1669. doi: 10.17705/1jais.00816. Full text in Research Archive Show summary With societal challenges, including but not limited to human development, equity, social justice, and climate change, societal-level digital transformation (SDT) is of imminent relevance and theoretical interest. While building on local-level efforts, societal-level transformation is a nonlinear extension of the local level. Unfortunately, academic discourse on digital transformation has largely left SDT unaccounted for. Drawing on more than 25 years of intensive, interventionist research engagement with the digital transformation of public healthcare information management and delivery in more than 80 countries in the Global South, we contribute to theorizing SDT in the form of a design theory consisting of six interconnected design principles. These design principles articulate the interplay and tensions of accommodating over time increased diversity and flexibility in digital solutions, while simultaneously connecting local, national, and regional/ global efforts.
• Paton, Chris; Braa, Jørn Anders; Muhire, Andrew; Ruiz, Luis Marco; Kobayashi, Shinji & Fraser, Hamish [Show all 8 contributors for this article] (2022). Open Source Digital Health Software for Resilient, Accessible and Equitable Healthcare Systems. Yearbook of Medical Informatics. ISSN 0943-4747. 31(1), p. 67–73. doi: 10.1055/s-0042-1742508. Full text in Research Archive
• Amarakoon, Pamod Madusanka; Braa, Jørn Anders; Sahay, Sundeep & Muhire, Andrew (2022). Building Digital Resilience to Combat Pandemics: Comparison of South Korea, Sri Lanka and Rwanda. In Zheng, Y.; Abbott, P. & Robles-Flores, J. A. (Ed.), Freedom and Social Inclusion in a Connected World 17th IFIP WG 9.4 International Conference on Implications of Information and Digital Technologies for Development. Springer. ISSN 9783031194290. doi: 10.1007/978-3-031-19429-0_18. Full text in Research Archive
• Sahay, Sundeep; Braa, Jørn Anders & Amarakoon, Pamod Madusanka (2022). Digital Resilience for What? Case Study of South Korea. In Zheng, Y.; Abbott, P. & Robles-Flores, J. A. (Ed.), Freedom and Social Inclusion in a Connected World 17th IFIP WG 9.4 International Conference on Implications of Information and Digital Technologies for Development. Springer. ISSN 9783031194290. doi: 10.48550/arXiv.2108.09950. Full text in Research Archive
• Sahay, Sundeep; Braa, Jørn Anders & Amarakoon, Pamod Madusanka (2022). Digital Resilience for What? Case Study of South Korea. In Zheng, Y.; Abbott, P. & Robles-Flores, J. A. (Ed.), Freedom and Social Inclusion in a Connected World 17th IFIP WG 9.4 International Conference on Implications of Information and Digital Technologies for Development. Springer. ISSN 9783031194290. doi: 10.48550/arXiv.2108.09950. Full text in Research Archive