scholarly journals What factors shape surgical access in West Africa? A qualitative study exploring patient and provider experiences of managing injuries in Sierra Leone

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042402
Author(s):  
Amrit Virk ◽  
Mohamed Bella Jalloh ◽  
Songor Koedoyoma ◽  
Isaac O Smalle ◽  
William Bolton ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Community Outreach ◽  
First Aid ◽  
Cost Of Care ◽  
Supply Side ◽  
Demand Side ◽  
Surgical Services ◽  
Surgical Access ◽  
Post Conflict ◽  
Medical Facilities

IntroductionSurgical access is central to universalising health coverage, yet 5 billion people lack timely access to safe surgical services. Surgical need is particularly acute in post conflict settings like Sierra Leone. There is limited understanding of the barriers and opportunities at the service delivery and community levels. Focusing on fractures and wound care which constitute an enormous disease burden in Sierra Leone as a proxy for general surgical need, we examine provider and patient perceived factors impeding or facilitating surgical care in the post-Ebola context of a weakened health system.MethodsAcross Western Area Urban (Freetown), Bo and Tonkolili districts, 60 participants were involved in 38 semistructured interviews and 22 participants in 5 focus group discussions. Respondents included surgical providers, district-level policy-makers, traditional healers and patients. Data were thematically analysed, combining deductive and inductive techniques to generate codes.ResultsInteracting demand-side and supply-side issues affected user access to surgical services. On the demand side, high cost of care at medical facilities combined with the affordability and convenient mode of payment to the traditional health practitioners hindered access to the medical facilities. On the supply side, capacity shortages and staff motivation were challenges at facilities. Problems were compounded by patients’ delaying care mainly spurred by sociocultural beliefs in traditional practice and economic factors, thereby impeding early intervention for patients with surgical need. In the absence of formal support services, the onus of first aid and frontline trauma care is borne by lay citizens.ConclusionWithin a resource-constrained context, supply-side strengthening need accompanying by demand-side measures involving community and traditional actors. On the supply side, non-specialists could be effectively utilised in surgical delivery. Existing human resource capacity can be enhanced through better incentives for non-physicians. Traditional provider networks can be deployed for community outreach. Developing a lay responder system for first-aid and front-line support could be a useful mechanism for prompt clinical intervention.

Police in Africa

2017 ◽  
Keyword(s):  
Sierra Leone ◽  
Police Officers ◽  
Political Systems ◽  
Democratic Transitions ◽  
State Institutions ◽  
Security Issues ◽  
Self Perceptions ◽  
Post Conflict ◽  
Everyday Practices ◽  
Police Forces

State police forces in Africa are a curiously neglected subject of study, even within the framework of security issues and African states. This book brings together criminologists, anthropologists, sociologists, historians, political scientists and others who have engaged with police forces across the continent and the publics with whom they interact to provide street-level perspectives from below and inside Africa’s police forces. The contributors consider historical trajectories and particular configurations of police power within wider political systems, then examine the ‘inside view’ of police forces as state institutions – the challenges, preoccupations, professional ethics and self-perceptions of police officers – and finally look at how African police officers go about their work in terms of everyday practices and engagements with the public.The studies span the continent, from South Africa to Sierra Leone, and illustrate similarities and differences in Anglophone, Francophone and Lusophone states, post-socialist, post-military and post-conflict contexts, and amid both centralizsation and devolution of policing powers, democratic transitions and new illiberal regimes, all the while keeping a strong ethnographic focus on police officers and their work.

Application of a Tax to E-Commerce Deliveries in Barcelona

2021 ◽  
pp. 036119812110124
Author(s):  
Genís Majoral ◽  
Francesc Gasparín ◽  
Sergi Saurí
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Supply Side ◽  
Environmental Tax ◽  
Positive Outcomes ◽  
Demand Side ◽  
Benefit Analysis ◽  
Revenue Collection ◽  
Last Mile ◽  
The Impact

The number of e-commerce transactions is increasing worldwide. Deliveries of goods purchased online generate externalities throughout the whole supply chain and, particularly, the increasing concern about the last-mile distribution of goods. The escalating presence of vans in cities contributes to poor air quality, climate change, noise, and congestion. So far, the majority of solutions to address this issue are based on the supply side, such as electric vans, optimizing the routing and pick-up-points, and so forth. Even in other transport sectors, pricing solutions are well known, yet they have not been extended to e-commerce delivery. This paper aims to propose an environmental tax falling on the demand side and equaling the externalities from this activity. The analysis has been particularized for the case of Barcelona. A cost–benefit analysis to assess the impact of such a tax has been carried out. When revenue collection is reinvested in the logistics sector, and for subsidizing electric distribution vehicles, the results indicate that the levying of the tax can generate positive outcomes.

scholarly journals The position of the farm holiday in Austrian tourism

2019 ◽  
Vol 4 (1) ◽  
pp. 697-711 ◽  
Author(s):  
Erika Quendler
Keyword(s):  
Empirical Research ◽  
Relative Position ◽  
Secondary Data ◽  
Point Of View ◽  
Local Context ◽  
Supply Side ◽  
Data Sets ◽  
Demand Side ◽  
Tourist Destinations ◽  
Tourist Accommodation

AbstractTourism is vitally important to the Austrian economy. The number of tourist destinations, both farms and other forms of accommodation, in the different regions of Austria is considerably and constantly changing. This paper discusses the position of the ‘farm holiday’ compared to other forms of tourism. Understanding the resilience of farm holidays is especially important but empirical research on this matter remains limited. The term ‘farm holiday’ covers staying overnight on a farm that is actively engaged in agriculture and has a maximum of 10 guest beds. The results reported in this paper are based on an analysis of secondary data from 2000 and 2018 by looking at two types of indicator: (i) accommodation capacity (supply side) and (ii) attractiveness of a destination (demand side). The data sets cover Austria and its NUTS3 regions. The results show the evolution of farm holidays vis-à-vis other forms of tourist accommodation. In the form of a quadrant matrix they also show the relative position of farm holidays regionally. While putting into question the resilience of farm holidays, the data also reveals where farm holidays could act to expand this niche or learn and improve to effect a shift in their respective position relative to the market ‘leaders’. However, there is clearly a need to learn more about farm holidays within the local context. This paper contributes to our knowledge of farm holidays from a regional point of view and tries to elaborate on the need for further research.

The Study of Interactivity in First Aid Treatment Medical Facilities for Mobile Application

2020 ◽  
Author(s):  
Nur Syahela Hussien ◽  
Adib Ismail Khafidz ◽  
Masyarah Zulhaida Masmuzidin ◽  
Mahfuzah Mohaidin ◽  
Alia Amira Abd Rahman
Keyword(s):  
Mobile Application ◽  
First Aid ◽  
Medical Facilities

Legal pluralism in post-conflict Sierra Leone

2020 ◽  
Vol 61 ◽  
pp. 101819
Author(s):  
Pedro Naso ◽  
Erwin Bulte ◽  
Tim Swanson
Keyword(s):  
Sierra Leone ◽  
Legal Pluralism ◽  
Post Conflict

ANALYZING THE RELATIVE INFLUENCE OF SUPPLY SIDE, DEMAND SIDE AND REGULATORY FACTORS ON THE SUCCESS OF COLLABORATIVE ENERGY INNOVATION PROJECTS

2016 ◽  
Vol 20 (02) ◽  
pp. 1650029 ◽  
Author(s):  
ALEXANDRA RESE ◽  
ANKE KUTSCHKE ◽  
DANIEL BAIER
Keyword(s):  
Structural Equation ◽  
Success Factors ◽  
Relative Influence ◽  
Equation Modeling ◽  
Supply Side ◽  
Demand Side ◽  
Firm Level ◽  
Regulatory Factors ◽  
Innovation Projects ◽  
Energy Innovation

The analysis of the importance of supply side and demand side factors with regard to innovative behavior is quite old. In this paper, these two categories are used to distinguish and examine the relevance of several success factors for collaborative innovation projects on the firm level in the German energy sector. The literature emphasizes that solving environmental problems requires extensive technological change. On the other hand, due to higher prices the market push is weaker. Regulatory factors are therefore designed to stimulate environmental innovations. The relative influence of these three categories on project performance is investigated on the basis of a sample of 128 German collaborative energy innovation projects in the development phase using a scale-based approach and structural equation modeling at the firm level. The results confirm the importance of supply side factors followed by demand side factors. In contrast to literary assumptions, R&D subsidies played no significant role.

scholarly journals Causal Relations of Upscaled Urban Aquaponics and the Food-Water-Energy Nexus—A Berlin Case Study

Water ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 2029
Author(s):  
Gösta F.M. Baganz ◽  
Manfred Schrenk ◽  
Oliver Körner ◽  
Daniela Baganz ◽  
Karel J. Keesman ◽  
...  
Keyword(s):  
Urban Areas ◽  
Causal Link ◽  
Supply Side ◽  
Demand Side ◽  
Annual Fish ◽  
Causal Relations ◽  
Water Energy Nexus ◽  
Facility Level ◽  
Predominant Effect

Aquaponics, the water-reusing production of fish and crops, is taken as an example to investigate the consequences of upscaling a nature-based solution in a circular city. We developed an upscaled-aquaponic scenario for the German metropolis of Berlin, analysed the impacts, and studied the system dynamics. To meet the annual fish, tomato, and lettuce demand of Berlin’s 3.77 million residents would require approximately 370 aquaponic facilities covering a total area of 224 hectares and the use of different combinations of fish and crops: catfish/tomato (56%), catfish/lettuce (13%), and tilapia/tomato (31%). As a predominant effect, in terms of water, aquaponic production would save about 2.0 million m3 of water compared to the baseline. On the supply-side, we identified significant causal link chains concerning the Food-Water-Energy nexus at the aquaponic facility level as well as causal relations of a production relocation to Berlin. On the demand-side, a ‘freshwater pescatarian diet’ is discussed. The new and comprehensive findings at different system levels require further investigations on this topic. Upscaled aquaponics can produce a relevant contribution to Berlin’s sustainability and to implement it, research is needed to find suitable sites for local aquaponics in Berlin, possibly inside buildings, on urban roofscape, or in peri-urban areas.

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