Abstract 1122‐000134: Social and Cultural Barriers to Global Stroke Care

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Alexandria Naftchi ◽  
Alexandria Naftchi ◽  
Akash Thaker ◽  
Jason Singh ◽  
Eric Feldstein ◽  
...  
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Middle Eastern ◽  
Stroke Care ◽  
Public Hospitals ◽  
Cultural Barriers ◽  
Therapeutic Window ◽  
Search Term ◽  
Stroke Services ◽  
The Government

Introduction : Comprehensive stroke centers require resource‐intensive patient care and supportive divisions. Resource underutilization can include: traditional beliefs about etiology of stroke, transportation barriers, or an inability to recognize early symptoms of stroke. We explore the available literature to determine region‐specific social and cultural barriers to obtaining stroke care. Methods : A literature review was performed to identify studies that described stroke care in low‐income and middle‐income countries (LMICs). We used the search term “stroke” along with the following terms: “burden”, “incidence”, “prevalence”, “awareness”, “transportation”, “stroke services”, “rehabilitation” “tissue plasminogen activator”, “acute stroke”, “emergency care”, “infrastructure”, “stroke services”, “quality improvement”, and “stroke units”, between January 1st, 2015 and August 1st, 2021. Forty‐five articles were identified. Results : We identified two broad limitations to expanding stroke care across the globe: infrastructure and education/ culture. We subdivided stroke care regionally into Middle East and North Africa (MENA), Europe, Asia, Latin America, and Subsaharan Africa. In MENA, religious health fatalism scores on questionnaires are negatively correlated with adherence to rehabilitative protocols and stroke outcome. Increased faith engagement conversely is strongly correlated with improved psychiatric outcome following stroke, indicating a role in properly educating Middle Eastern citizens regarding stroke etiology and urgency of treatment. In Europe stroke mortality and incidence is greater in rural areas in the region, likely indicating transit‐related difficulties in obtaining stroke care or deficits in education regarding lifestyle‐based measures to reduce vascular disease. Low per capita numbers of stroke‐specific care units in southern and eastern countries indicate a significant care access need in rural and low‐resource regions. For Asia, a lack of major infrastructure obstacles to wider accessibility of EVT, especially among developing countries. Only 6.5% in a nationwide survey in China were aware that there was a therapeutic window for thrombolytic therapy in 2016, increased to 32.8% after a 2 year nationwide campaign. The adept use of social media to target high‐risk populations can improve awareness of therapeutic windows. Ethnic and socioeconomic disparities are especially pronounced in this region. The RESILIENT trial demonstrated the effectiveness of EVT in Brazilian public hospitals, which helped convince the government to change policy and promote the use of EVT. Similar trials could be used to convince other governments to shift policy and promote the use of EVT as standard of care in public hospital systems. Some African communities consider stroke to be an illness of debilitating/ paralytic, ghost, or shivering etiology. Many communities rely on non medical means of care. A survey at Ignance Deen Neurology ward in 2014 revealed that only 2% of stroke patients arrived in an ambulance while 46% came by public transport and 27% arrived by personal car. Conclusions : Social and cultural barriers to obtaining stroke care are based on lack of availability and patient trust. Trust in care and compliance with preventive/rehabilitative measures may be helped by connecting NGOs such as Stroke Angels and Mission Thrombectomy 2020 with community‐based/ religious leaders to correct assumptions about origin and treatment. Targeted, culturally‐relevant messaging may help to increase awareness about symptoms, risk factors, and etiology.

scholarly journals Food Decisions of Low-Income Families in the Era of COVID-19: A Qualitative Exploration

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 250-250
Author(s):  
Eleni Spyreli ◽  
Michelle McKinley ◽  
Jayne Woodside ◽  
Colette Kelly
Keyword(s):  
Northern Ireland ◽  
Low Income ◽  
Rural Areas ◽  
Economically Disadvantaged ◽  
Food Shopping ◽  
Food Planning ◽  
Low Income Families ◽  
The Government ◽  
The Impact ◽  
Disadvantaged Families

Abstract Objectives The first lockdown enforced in the United Kingdom to limit the spread of COVID-19 had serious financial consequences for some lower-income households, which were already at risk of suboptimal food choices. Particularly in Northern Ireland, where 10% of the population live in food insecure households, the pandemic has potentially further exacerbated the nutritional challenges experienced by low-income families. This paper aimed to explore the impact of the COVID-19 lockdown on food-related decisions as experienced by economically disadvantaged families in Northern Ireland, UK. Methods A qualitative study collected data through online individual interviews. Participation was open to parents of children 2–17 years old who self-identified as living on a tight budget in urban and rural areas of Northern Ireland. A sampling matrix enabled equal representation of single- and two-parent households, as well as younger (<12 y) and older children (>12 y). Photovoice and participatory mapping techniques were employed to capture participant data. A thematic approach was utilised for data analysis. Results A total of 12 interviews were conducted. Five distinct themes were found, reflecting families’ food-related decisions that were affected by the COVID-19 lockdown: 1) food planning; 2) food purchasing; 3) meal preparation; 4) eating and feeding behaviours and 5) eating food prepared outside the house. Changes included an increase in home food preparation, but also in unhealthy snacking. Fear of being exposed to carriers of the virus led to infrequent food shopping and greater reliance on supermarket home deliveries. Long waiting times in-between food shops encouraged food planning but were also a barrier to providing daily fresh foods including fruit and vegetables to their families. Financial constraints were exacerbated during lockdown and led to a search for new ways to budget when food shopping. Food donations from the community and the government were important to maintain food security, particularly in single-parent families. Conclusions This study highlights that the COVID-19 lockdown influenced a broad range of dietary decisions of economically disadvantaged families and offers an insight into the nutritional challenges they experienced. Funding Sources The work was completed with financial support from internal funds of Queens University Belfast.

scholarly journals Government-business alliances in state capitalist economies: evidence from low-income markets in China

2013 ◽  
Vol 15 (2) ◽  
pp. 245-274 ◽  
Author(s):  
Genia Kostka ◽  
Jianghua Zhou
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Local Governments ◽  
Governance Structure ◽  
Business Partnerships ◽  
Capitalist System ◽  
Resource Complementarity ◽  
Complementary Resources ◽  
Policy Objectives ◽  
The Government

Based on three in-depth case studies, the study analyzes how and why Chinese enterprises partner with governments in cooperative ventures which aim to simultaneously achieve poverty alleviation objectives and establish profitable business ventures in rural areas. The analysis draws out specific characteristics of three government-business partnerships in China, which vary in terms of governance structure, resource complementarity and incentives. The findings show that in this state capitalist system, outcomes of government-business partnerships depend on firms having unique resources and capabilities that serve particular policy objectives of the government. By the same token, in order to make partnerships attractive to firms, national and local governments must hold the keys to unique resources needed by enterprises looking to do business in low-income markets. The cases further illustrate that, in order to build and maintain successful government-business partnerships over time, the alignment of incentives plays an important role. In sum, complementary resources and well-aligned interests between firms and governments help to explain why some government-enterprise partnerships are more successful than others.

scholarly journals A Legal Analysis of the Use of Innovative Technology in the Promotion of Financial Inclusion for Low-Income Earners in South Africa

2021 ◽  
Vol 24 ◽  
pp. 1-27
Author(s):  
Howard Chitimira ◽  
Phemelo Magau
Keyword(s):  
South Africa ◽  
Financial Institutions ◽  
Low Income ◽  
Rural Areas ◽  
Financial Services ◽  
Informal Settlements ◽  
Financial Inclusion ◽  
Innovative Technology ◽  
Financial Exclusion ◽  
The Government

The promotion of financial inclusion is important for the combating of financial exclusion in many countries, including South Africa. Nonetheless, most low-income earners living in rural areas and informal settlements are still struggling to gain access to basic financial products and financial services in South Africa. This status quo has been caused by a number of factors such as the absence of an adequate financial inclusion policy, the geographical remoteness of financial institutions to most low-income earners, rigid identity documentary requirements, a lack of access to reliable and affordable Internet connection by low-income earners living in informal settlements and rural areas, a lack of financial illiteracy, the high costs of financial services, unemployment and poverty, over-indebtedness, and cultural and psychological hindrances to low-income earners in South Africa. Consequently, these factors have somewhat limited the access to financial services offered by financial institutions to low-income earners living in rural areas and informal settlements. In many countries, including South Africa, the financial sector is relying on innovative technology, especially in banking institutions, to aid in the offering of financial services to their customers. It is against this background that this article discusses selected legal and related challenges affecting the regulation and use of innovative technology to promote financial inclusion for low-income earners in South Africa. The article further discusses possible measures that could be adopted by the government, financial institutions and other relevant regulatory bodies to promote the use of innovative technology to combat the financial exclusion of low-income earners in South Africa.

scholarly journals FINANCIAL INCLUSION: A PRELUDE TO ECONOMIC STATUS OF VULNERABLE GROUP

2016 ◽  
Vol 4 (12) ◽  
pp. 147-154
Author(s):  
Mukesh Kumar Sharma
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Financial Services ◽  
Financial Stability ◽  
Financial Inclusion ◽  
Current Status ◽  
Easy Access ◽  
Resource Base ◽  
Banking Services ◽  
The Government

India is a country where a sizeable amount of population lives in rural areas. They are engaged in agriculture and allied activities. Most of the people living in rural areas are poor. They do not have any access to the banks. The awareness and access of the poor to the banking services is important for the alleviation of the poverty. Their access to the banking services will contribute a lot to the growth and development of our country’s economy. Financial inclusion is a great weapon to overcome the financial backwardness as well as the establishment of good governance.It broadens the resource base of the financial system by developing a culture of savings among large segment of rural population, disadvantaged group and plays an essential role in the process of economic development. The Government of India and the Reserve Bank of India (RBI) have been making concentrated efforts periodically to overcome such vicious problems by promoting Financial Inclusion, being one of the important national objectives of the country. Since first phase of nationalization (1969) GoI continuously promoting financial inclusion through self-help groups, no frills account, simplification of KYC, Business correspondents etc., but no palpable effect could be seen in the plight of these financially vulnerable people. To mitigate this long drawn financial sufferings, Prime Minister Narendra Modi announced a new scheme in his Independence Day speech on 15th Aug 2014 called Pradhan Mantri Jan DhanYojana (PMJDY). Mission of PMJDY is to ensure easy access of financial services for the excluded section i.e. weaker section and the low income group. This effort will certainly go a long way in promoting economic growth and reducing poverty, while mitigating systematic risk and maintaining financial stability. This article focuses on the RBI, GoI initiatives, current status and future prospects of financial inclusion in India on the basis of facts and data provided by various secondary sources. It is concluded that financial inclusion shows positive and valuable changes.

Organization of Stroke Care in Pakistan

2019 ◽  
Vol 15 (5) ◽  
pp. 565-566
Author(s):  
Arsalan Anwar ◽  
Sidra Saleem ◽  
Alifiya Aamir ◽  
Mufaddal Diwan
Keyword(s):  
Health Problem ◽  
Rural Areas ◽  
Stroke Care ◽  
The Government ◽  
Urban And Rural Areas ◽  
Government Level ◽  
Care System

In Pakistan, stroke is one of the major contributors to the health problem. The increasing incidence of stroke and lack of infrastructure in both urban and rural areas requires immediate attention. Multiple societies and groups have been established to highlight the growing problem, but necessary steps must be taken at the government level to improve and design a better stroke care system in the country.

scholarly journals Research on the Impact of Land Circulation on the Income Gap of Rural Households: Evidence from CHIP

Land ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 781
Author(s):  
Congjia Huo ◽  
Lingming Chen
Keyword(s):  
Income Inequality ◽  
Low Income ◽  
Rural Areas ◽  
Household Income ◽  
Labor Mobility ◽  
Rural Households ◽  
Income Gap ◽  
Land Circulation ◽  
The Government ◽  
The Impact

With the continued development of the economy, the income gap among Chinese rural households continues to widen. The land system plays a decisive role in developing “agriculture, rural areas and farmers” and land circulation is a factor in the increase in income inequality among farm households. Based on the 2013 China Household Income Project (CHIP), this article used the re-centered influence function (RIF) regression method to empirically test the impact of rural land circulation on the income gap of rural households in China in three regions: the central, eastern and western regions. The quantile regression tested the impact mechanism of income inequality of rural households from the perspective of labor mobility and land circulation. The empirical results showed that land circulation increases the income inequality of rural households. The theoretical mechanism test proved that the dynamic relationship between land circulation and labor mobility increases rural household income. However, this increase has a greater effect on rural households with a high income and a small effect on rural households with a low income, resulting in a further widening of the income gap. Therefore, while increasing the income of rural households through land circulation, the government should also consider income equity. Finally, this article puts forward the policies and opinions on land reform and provides a brief discussion on the future direction of development.

scholarly journals Does Income Inequality Impair Health? Evidence from Rural China

Agriculture ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 203
Author(s):  
Wencong Cai ◽  
Yuanjie Deng ◽  
Qiangqiang Zhang ◽  
Haiyu Yang ◽  
Xuexi Huo
Keyword(s):  
Income Inequality ◽  
Low Income ◽  
Rural Areas ◽  
Relative Deprivation ◽  
Social Trust ◽  
Negative Impact ◽  
Income Group ◽  
Mediating Effect ◽  
Self Rated Health ◽  
The Government

In the context of the Healthy China strategy and the targeted poverty alleviation policy, based on the survey data of 1710 apple planters in Shandong, Yunnan, Shaanxi, and Gansu provinces, we selected the Probit model and the mediating effect test model to analyze the impact of income inequality on the self-rated health of farmers in this paper. The main results are as follows: First, income inequality within villages and townships had a significant negative impact on self-rated health, with both showing inverted U-shaped relationships, while income inequality within counties had no significant impact on self-rated health. Second, income inequality can impact the health of farmers, in terms of tobacco and alcohol behaviors, social trust, and sense of relative deprivation, where the mediating effect ratio of these three factors combined accounted for 32.4% of the total effect. Furthermore, the effect of income inequality on health was heterogeneous among different income groups, where the negative impact of income inequality on the self-rated health of the high-income group was less than that of the low-income group, indicating that an increase in income inequality serves to aggravate the degree of health inequality. Therefore, the government should adopt differentiated policies to improve the health of farmers. In rural areas with high income inequality, the government should focus on increasing the income of low-income groups, guide them to develop a healthy lifestyle, improve their social trust, and reduce their sense of relative deprivation. In rural areas where incomes are generally low, the government should first guide qualified farmers to become rich, then encourage others to become rich later.

scholarly journals The Challenge of Inequality in University Education: Is the District Quota Scheme Addressing Socio-Economic Disparities in Access to University Education in Uganda?

2021 ◽  
Vol 11 (3) ◽  
pp. 110
Author(s):  
Godfrey Bagonza ◽  
Yuda Taddeo Kaahwa ◽  
Nicholas Itaaga
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Social Inequalities ◽  
Economic Status ◽  
University Education ◽  
Quantitative And Qualitative Research ◽  
Socially Disadvantaged ◽  
The Social ◽  
Low Income Families ◽  
The Government

Access to university education is one of the fundamental educational questions in contemporary educational debates. This is because university education is seen as having an array of benefits to individuals, their households, and their nations. However, the challenge of inequality in terms of gender, income, location, and socio-economic status has constrained some individuals and households to access quality university education. In 2005 the government of Uganda introduced the District Quota Scheme to address the social inequalities in accessing university education. This study examined how the District Quota Scheme is addressing the rural-urban divide in access to university; how the District Quota Scheme has increased access to university education for children with parents who have low levels of education; and whether the District Quota Scheme is improving access to university education for children from low-income families. Following the social constructivist research paradigm and integrating both quantitative and qualitative research methods, the study found a change in access to university education by students from rural areas, students whose parents have lower levels of education, and those from low-income families as a result of introducing the District Quota Scheme. The study recommends that the government of Uganda and other stakeholders in the higher education sector should address the structural challenges to ensure that mainly the socially disadvantaged students take the biggest advantage of this scheme. 

scholarly journals The Cancellation of the Community Access Program and the Digital Divide(s) in Canada: Lessons Learned and Future Prospects

2013 ◽  
Vol 10 (2) ◽  
Author(s):  
Chris Blanton
Keyword(s):  
Information And Communication Technologies ◽  
Low Income ◽  
Rural Areas ◽  
Internet Access ◽  
Future Internet ◽  
Well Being ◽  
Lessons Learned ◽  
The Government ◽  
Community Access ◽  
Access Program

The Government of Canada's recent termination of its Community Access Program eliminated a major source of funding for organizations that connect disadvantaged individuals and communities to the Internet. Nevertheless, inequalities in Internet access and usage continue to exist. In the absence of a coordinated national policy to address digital divides, responsibility for providing Internet access to low-income Canadians devolves primarily onto large civic and regional libraries. This devolution works to the particular disadvantage of remote and rural areas, which tend to have neither an affordable supplier of residential broadband nor the economic base to support library systems large enough to provide community access sites. For communities in this situation, the First Mile paradigm offers some hope. In the broader context, future Internet connectivity initiatives in Canada should look beyond simply providing "access," and link the individual's effective use of information and communication technologies to the well-being of the community in which the individual is situated. 

scholarly journals The Trade-Off Between Child Quantity and Child Quality and the Public Provision of Education: A Case Study in Rural Terengganu, Malaysia

2020 ◽  
Author(s):  
Nor Azam Abdul Razak ◽  
Roslan Abdul Hakim ◽  
Russayani Ismail
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Public Provision ◽  
Child Quality ◽  
Trade Off ◽  
The Public ◽  
Standards Of Living ◽  
The Government ◽  
Baseline Estimation

The objective of this paper is to examine whether the theory of the child quantity-quality (CQQ) trade-off developed by Becker and Lewis (1973) is borne out by the data from a developing country. In brief, the theory states that households behave differently with respect to their mixture of child quantity and child quality depending on their standards of living (i.e. low-income households tend to choose child quantity at the expense of child quality, and the converse is true for high-income households). If the government provides enough support for education, however, this trade-off might be undermined. Using a sample of 885 children from a survey of 2,500 households in rural areas in Terengganu in 2009, we conducted an empirical analysis on the relationship between child quantity and child quality. In the baseline estimation as well as in a series of robustness check, our key findings are that there is a positive yet insignificant impact of child quantity on child quality. Accordingly, we take these results as mild evidence against the CQQ trade-off which, in turn, can be attributed to the magnitude of the public provision of education in Malaysia.  

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