scholarly journals The value of community technology workers for LPG use: A pilot in Shirati, Tanzania

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Annelise Gill-Wiehl ◽  
Sara Sievers ◽  
Daniel M. Kammen
Keyword(s):  
Low Income ◽  
Qualitative Interviews ◽  
Baseline Survey ◽  
Fuel Use ◽  
Clean Fuel ◽  
Rural Tanzania ◽  
Health Community ◽  
Community Technology ◽  
Technology Workers ◽  
Continued Use

Abstract Background Sustainable Development Goal (SDG) 7 calls for the adoption and continued use of clean-burning stoves by the 2.9 billion people relying on unclean fuels (both solid biomass and kerosene). However, to date, the clean cooking literature has found low rates of efficient stove adoption and continued use. This paper presents the application of a public health community engagement model to the use of clean cooking fuels. We implemented a pilot study with Community Technology Workers (CTWs) as a means to overcome maintenance, education, and behavioral barriers to clean fuel use in rural Tanzania. Methods The intervention was a free 6 kg Liquified Petroleum Gas (LPG) cylinder and stove coupled with education from a local technically trained CTW on LPG use. We evaluated the training, work, and impact of a CTW on LPG use on 30 randomly selected households from two villages in a rural district of Tanzania over a 1-year period. After an initial baseline survey, technically trained local CTWs educated the households on safe LPG use and conducted 34 follow up surveys over the next year on their cooking fuel use. Additionally, we conducted qualitative interviews with all households and a focus group with six of the households. Results The results from the mixed methods approach show that 80% of families (n = 24) consistently refilled their LPG cylinders and ~ 40% of households exclusively used LPG. Households reported appreciating the CTWs’ visits for providing education and maintenance support, giving them confidence to use LPG safely, reminding them to save for their cylinder, and providing a community driven effort to use clean fuel. Conclusions The findings demonstrate the feasibility of this type of community infrastructure model to promote and facilitate consistent LPG use, but suggest the need to couple this local support with financial mechanisms (e.g., a microsavings program). This model could be a mechanism to increase LPG use, particularly in rural, low-income areas.

scholarly journals Qualitative perspectives of the North Carolina healthy food small retailer program among customers in participating stores located in food deserts

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lindsey Haynes-Maslow ◽  
Stephanie B. Jilcott Pitts ◽  
Kathryn A. Boys ◽  
Jared T. McGuirt ◽  
Sheila Fleischhacker ◽  
...  
Keyword(s):  
North Carolina ◽  
Low Income ◽  
Rural Areas ◽  
Food Access ◽  
Qualitative Interviews ◽  
Food Deserts ◽  
State Legislature ◽  
Healthy Food ◽  
The State ◽  
The North

Abstract Background The North Carolina Healthy Food Small Retailer Program (NC HFSRP) was established through a policy passed by the state legislature to provide funding for small food retailers located in food deserts with the goal of increasing access to and sales of healthy foods and beverages among local residents. The purpose of this study was to qualitatively examine perceptions of the NC HFSRP among store customers. Methods Qualitative interviews were conducted with 29 customers from five NC HFSRP stores in food deserts across eastern NC. Interview questions were related to shoppers’ food and beverage purchases at NC HFSRP stores, whether they had noticed any in-store efforts to promote healthier foods and beverages, their suggestions for promoting healthier foods and beverages, their familiarity with and support of the NC HFSRP, and how their shopping and consumption habits had changed since implementation of the NC HFSRP. A codebook was developed based on deductive (from the interview guide questions) and inductive (emerged from the data) codes and operational definitions. Verbatim transcripts were double-coded and a thematic analysis was conducted based on code frequency, and depth of participant responses for each code. Results Although very few participants were aware of the NC HFSRP legislation, they recognized changes within the store. Customers noted that the provision of healthier foods and beverages in the store had encouraged them to make healthier purchase and consumption choices. When a description of the NC HFSRP was provided to them, all participants were supportive of the state-funded program. Participants discussed program benefits including improving food access in low-income and/or rural areas and making healthy choices easier for youth and for those most at risk of diet-related chronic diseases. Conclusions Findings can inform future healthy corner store initiatives in terms of framing a rationale for funding or policies by focusing on increased food access among vulnerable populations.

scholarly journals Competing interests, clashing ideas and institutionalizing influence: insights into the political economy of malaria control from seven African countries

2020 ◽  
Author(s):  
Justin Parkhurst ◽  
Ludovica Ghilardi ◽  
Jayne Webster ◽  
Robert W Snow ◽  
Caroline A Lynch
Keyword(s):  
Decision Making ◽  
Malaria Control ◽  
Qualitative Interviews ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Health Community ◽  
Control Programmes ◽  
Control Decision ◽  
Sub Saharan ◽  
Economic Considerations

Abstract This article explores how malaria control in sub-Saharan Africa is shaped in important ways by political and economic considerations within the contexts of aid-recipient nations and the global health community. Malaria control is often assumed to be a technically driven exercise: the remit of public health experts and epidemiologists who utilize available data to select the most effective package of activities given available resources. Yet research conducted with national and international stakeholders shows how the realities of malaria control decision-making are often more nuanced. Hegemonic ideas and interests of global actors, as well as the national and global institutional arrangements through which malaria control is funded and implemented, can all influence how national actors respond to malaria. Results from qualitative interviews in seven malaria-endemic countries indicate that malaria decision-making is constrained or directed by multiple competing objectives, including a need to balance overarching global goals with local realities, as well as a need for National Malaria Control Programmes to manage and coordinate a range of non-state stakeholders who may divide up regions and tasks within countries. Finally, beyond the influence that political and economic concerns have over programmatic decisions and action, our analysis further finds that malaria control efforts have institutionalized systems, structures and processes that may have implications for local capacity development.

scholarly journals “Trailer Trash” Stigma and Belonging in Florida Mobile Home Parks

2020 ◽  
Vol 8 (1) ◽  
pp. 66-75 ◽  
Author(s):  
Margarethe Kusenbach
Keyword(s):  
United States ◽  
Sense Of Community ◽  
Low Income ◽  
Qualitative Interviews ◽  
The United States ◽  
Mobile Home ◽  
Central Florida ◽  
Discursive Strategies ◽  
Mobile Homes ◽  
Community Belonging

<p>In the United States, residents of mobile homes and mobile home communities are faced with cultural stigmatization regarding their places of living. While common, the “trailer trash” stigma, an example of both housing and neighborhood/territorial stigma, has been understudied in contemporary research. Through a range of discursive strategies, many subgroups within this larger population manage to successfully distance themselves from the stigma and thereby render it inconsequential (Kusenbach, 2009). But what about those residents—typically white, poor, and occasionally lacking in stability—who do not have the necessary resources to accomplish this? This article examines three typical responses by low-income mobile home residents—here called resisting, downplaying, and perpetuating—leading to different outcomes regarding residents’ sense of community belonging. The article is based on the analysis of over 150 qualitative interviews with mobile home park residents conducted in West Central Florida between 2005 and 2010.</p>

scholarly journals What price a welcome? Understanding structure agency in the delivery of respectful midwifery care in Uganda

2018 ◽  
Vol 23 (1) ◽  
pp. 46-59 ◽  
Author(s):  
Louise Ackers ◽  
Hannah Webster ◽  
Richard Mugahi ◽  
Rachel Namiiro
Keyword(s):  
Public Health ◽  
Low Income ◽  
Quality Care ◽  
Qualitative Interviews ◽  
Health Facilities ◽  
Content Type ◽  
Mortality And Morbidity ◽  
Private Care ◽  
Willingness To Disclose ◽  
Respectful Care

Purpose The purpose of this paper is to present the findings of research on mothers and midwives’ understanding of the concept of respectful care in the Ugandan public health settings. It focusses on one aspect of respect; namely communication that is perhaps least resource-dependent. The research found endemic levels of disrespect and tries to understand the reasons behind these organisational cultures and the role that governance could play in improving respect. Design/methodology/approach The study involved a combination of in-depth qualitative interviews with mothers and midwives together with focus groups with a cohort of midwives registered for a degree. Findings The findings highlight an alarming level of verbal abuse and poor communication that both deter women from attending public health facilities and, when they have to attend, reduces their willingness to disclose information about their health status. Respect is a major factor reducing the engagement of those women unable to afford private care, with health facilities in Uganda. Research limitations/implications Access to quality care provided by skilled birth attendants (midwives) is known to be the major factor preventing improvements in maternal mortality and morbidity in low income settings. Although communication lies at the agency end of the structure-agency continuum, important aspects of governance contribute to high levels of disrespect. Originality/value Whilst there is a lot of research on the concept of respectful care in high income settings applying this to the care environment in low resource settings is highly problematic. The findings presented here generate a more contextualised analysis generating important new insights which we hope will improve the quality of care in Uganda health facilities.

scholarly journals Financial Hardship, Motivation to Quit and Post-Quit Spending Plans among Low-Income Smokers Enrolled in a Smoking Cessation Trial

2019 ◽  
Vol 13 ◽  
pp. 117822181987876 ◽  
Author(s):  
Erin Rogers ◽  
Jose Palacios ◽  
Elizabeth Vargas ◽  
Christina Wysota ◽  
Marc Rosen ◽  
...  
Keyword(s):  
New York ◽  
Smoking Cessation ◽  
Food Insecurity ◽  
Low Income ◽  
Financial Distress ◽  
Controlled Trial ◽  
Financial Hardship ◽  
Baseline Survey ◽  
Motivation To Quit ◽  
Trial Testing

Background: Tobacco spending may exacerbate financial hardship in low-income populations by using funds that could go toward essentials. This study examined post-quit spending plans among low-income smokers and whether financial hardship was positively associated with motivation to quit in the sample. Methods: We analyzed data from the baseline survey of a randomized controlled trial testing novel a smoking cessation intervention for low-income smokers in New York City ( N = 410). Linear regression was used to examine the relationship between financial distress, food insecurity, smoking-induced deprivation (SID) and motivation to quit (measured on a 0-10 scale). We performed summative content analyses of open-ended survey questions to identify the most common plans among participants with and without SID for how to use their tobacco money after quitting. Results: Participants had an average level of motivation to quit of 7.7 ( SD = 2.5). Motivation to quit was not significantly related to having high financial distress or food insecurity ( P > .05), but participants reporting SID had significantly lower levels of motivation to quit than those without SID ( M = 7.4 versus 7.9, P = .04). Overall, participants expressed an interest in three main types of spending for after they quit: Purchases, Activities, and Savings/Investing, which could be further conceptualized as spending on Oneself or Family, and on Needs or Rewards. The top three spending plans among participants with and without SID were travel, clothing and savings. There were three needs-based spending plans unique to a small number of participants with SID: housing, health care and education. Conclusions: Financial distress and food insecurity did not enhance overall motivation to quit, while smokers with SID were less motivated to quit. Most low-income smokers, including those with SID, did not plan to use their tobacco money on household essentials after quitting.

Do institutions matter?

2019 ◽  
Vol 13 (3) ◽  
pp. 319-332
Author(s):  
Habiba Ibrahim
Keyword(s):  
Social Networks ◽  
Low Income ◽  
Qualitative Interviews ◽  
Community Support ◽  
Institutional Perspective ◽  
Content Type ◽  
Credit Line ◽  
Institutional Determinants ◽  
The Usa ◽  
Nationally Representative

Purpose Guided by the institutional theory of savings, the purpose of this study is to assess the institutional elements of rotating, savings and credit associations (ROSCAs) that enable participants to save. Design/methodology/approach The study used data from in-depth qualitative interviews (N = 10) conducted among the ROSCA group leaders from African immigrant communities in the USA. Findings The primary goal for joining the ROSCA group among participants is to achieve economic stability. The results of the study postulate that, through institutional mechanisms and social networks, ROSCAs create an environment for families to save and invest. The emphasis on the concept of “you cannot save alone” underscores the importance of supportive structures to enable low-income households to save. Although “alternative savings programs” such as ROSCAs are imagined as something that less well-to-do persons use, the findings from this study demonstrate that such strategies also appeal to some people with higher socioeconomic status. This appeal and utility speaks to the importance of ROSCAs as an institutional response, rather than just an informal arrangement among persons known to each other. Research limitations/implications It is prudent to bear in mind that the study sample is not nationally representative, and therefore, the results presented cannot be generalized to immigrants across the country. However, as one of the few ROSCA studies in the USA, the findings from this study make generous contributions to the immigrants’ savings and ROSCA practices literature. Practical implications ROSCAs could be used as a bridge to the formal financial institutions. Non-profit agencies working with these communities could work with these groups to report ROSCA payments to the major credit bureaus, to help them build a credit line in their new country. Originality/value Previous studies of ROSCAs have assessed ROSCAs as community support systems and social networks. The current study has analyzed ROSCAs from an institutional perspective by examining the institutional characteristics of ROSCAs comparable to the institutional determinants of savings that enable savings among the participants.

scholarly journals Qualitative research study on addressing barriers to healthy diet among low-income individuals at an urban, safety-net hospital

2020 ◽  
pp. bmjnph-2020-000064
Author(s):  
Erin Cahill ◽  
Stacie R Schmidt ◽  
Tracey L Henry ◽  
Gayathri Kumar ◽  
Sara Berney ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Healthy Eating ◽  
Low Income ◽  
Dietary Habits ◽  
Qualitative Interviews ◽  
Safety Net ◽  
Nutritional Knowledge ◽  
Adequate Food ◽  
Safety Net Hospital ◽  
Urban Safety

BackgroundSome American households experience food insecurity, where access to adequate food is limited by lack of money and other resources. As such, we implemented a free 6-month Fruit and Vegetable Prescription Program within a large urban safety-net hospital .Methods32 participants completed a baseline and postintervention qualitative evaluation about food-related behaviour 6 months after study completion. Deductive codes were developed based on the key topics addressed in the interviews; inductive codes were identified from analytically reading the transcripts. Transcripts were coded in MAXQDA V.12 (Release 12.3.2).ResultsThe information collected in the qualitative interviews highlights the many factors that affect dietary habits, including the environmental and individual influences that play a role in food choices people make. Participants expressed very positive sentiments overall about their programme participation.ConclusionsA multifaceted intervention that targets individual behaviour change, enhances nutritional knowledge and skills, and reduces socioeconomic barriers to accessing fresh produce may enhance participant knowledge and self-efficacy around healthy eating. However, socioeconomic factors remain as continual barriers to sustaining healthy eating over the long term. Ongoing efforts that address social determinants of health may be necessary to promote sustainability of behaviour change.

scholarly journals Relationship Between Opioid Analgesic Prescription and Unemployment in Patients Seeking Acupuncture for Chronic Pain in Urban Primary Care

Pain Medicine ◽  
2018 ◽  
Vol 20 (8) ◽  
pp. 1528-1533 ◽  
Author(s):  
Elizabeth Chuang ◽  
Eric N Gil ◽  
Qi Gao ◽  
Benjamin Kligler ◽  
M Diane McKee
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Pain Treatment ◽  
Opioid Analgesic ◽  
Opioid Analgesics ◽  
Baseline Survey ◽  
Patient Reported ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain ◽  
Analgesic Use

Abstract Objective The widespread use of opioid analgesics to treat chronic nonmalignant pain has contributed to the ongoing epidemic of opioid-related morbidity and mortality. Previous studies have also demonstrated a relationship between opioid analgesic use and unemployment due to disability. These studies have been limited to mainly white European and North American populations. The objective of this study is to explore the relationship between opioid analgesic use for chronic nonmalignant pain in an urban, mainly black and Hispanic, low-income population. Design This is a cross-sectional observational study. Setting Subjects were recruited from six urban primary care health centers. Subjects Adults with chronic neck, back, or osteoarthritis pain participating in an acupuncture trial were included. Methods Survey data were collected as a part of the Acupuncture Approaches to Decrease Disparities in Pain Treatment two-arm (AADDOPT-2) comparative effectiveness trial. Participants completed a baseline survey including employment status, opioid analgesic use, the Brief Pain Inventory, the global Patient Reported Outcomes Measurement Information Systems quality of life measure, the Patient Health Questionnaire-9 (PHQ-9), and demographic information. A multivariable logistic regression model was built to examine the association between opioid analgesic use and unemployment. Results Opioid analgesic use was associated with three times the odds of unemployment due to disability while controlling for potential confounders, including depression, pain severity, pain interference, global physical and mental functioning, and demographic characteristics. Conclusions This study adds to the growing body of evidence that opioid analgesics should be used with caution in chronic nonmalignant pain.

scholarly journals Experiences with Work and Participation in Public Programs by Low-Income Medicaid Enrollees Using Qualitative Interviews

2020 ◽  
Vol 35 (10) ◽  
pp. 2983-2989
Author(s):  
Alan Manivannan ◽  
Melissa Adkins-Hempel ◽  
Nathan D. Shippee ◽  
Katherine Diaz Vickery
Keyword(s):  
Low Income ◽  
Qualitative Interviews ◽  
Public Programs

scholarly journals Household Fuel Use for Heating and Cooking and Respiratory Health in a Low-Income, South African Coastal Community

2019 ◽  
Vol 16 (4) ◽  
pp. 550 ◽  
Author(s):  
Sikhumbuzo Buthelezi ◽  
Thandi Kapwata ◽  
Bianca Wernecke ◽  
Candice Webster ◽  
Angela Mathee ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
South African ◽  
Low Income ◽  
Respiratory Tract Infections ◽  
Respiratory Health ◽  
Informal Settlement ◽  
Energy Sources ◽  
Upper Respiratory Tract ◽  
Fuel Use ◽  
Tract Infections

In low-income communities, non-electric fuel sources are typically the main cause of Household Air Pollution (HAP). In Umlazi, a South African coastal, informal settlement, households use electric- and non-electric (coal, wood, gas, paraffin) energy sources for cooking and heating. The study aimed to determine whether respiratory ill health status varied by fuel type use. Using a questionnaire, respondents reported on a range of socio-demographic characteristics, dwelling type, energy use for cooking and heating as well as respiratory health symptoms. Multivariate Poisson regression was used to obtain the adjusted Odds Ratios (ORs) for the effects of electric and non-electric energy sources on prevalence of respiratory infections considering potential confounding factors. Among the 245 households that participated, Upper Respiratory Tract Infections (URTI, n = 27) were prevalent in respondents who used non-electric sources compared to electric sources for heating and cooking. There were statistically significant effects of non-electric sources for heating (adjusted OR = 3.6, 95% CI (confidence interval): 1.2–10.1, p < 0.05) and cooking (adjusted OR = 2.9, 95% CI: 1.1–7.9, p < 0.05) on prevalence of URTIs. There was a statistically significant effect of electric sources for heating (adjusted OR = 2.7, 95% CI: 1.1–6.4, p < 0.05) on prevalence of Lower Respiratory Tract Infections (LRTIs) but no evidence for relations between non-electric sources for heating and LRTIs, and electric or non-electric fuel use type for cooking and LRTIs. Energy switching, mixing or stacking could be common in these households that likely made use of multiple energy sources during a typical month depending on access to and availability of electricity, funds to pay for the energy source as well as other socio-economic or cultural factors. The importance of behaviour and social determinants of health in relation to HAP is emphasized.

Sign in / Sign up

Export Citation Format

Share Document