scholarly journals Household food sources and diarrhoea incidence in poor urban communities, Accra Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245466
Author(s):  
Reuben Tete Larbi ◽  
D. Yaw Atiglo ◽  
Maame B. Peterson ◽  
Adriana A. E. Biney ◽  
Naa Dodua Dodoo ◽  
...  
Keyword(s):  
Urban Communities ◽  
Low Income ◽  
Food Environment ◽  
Diarrhoeal Disease ◽  
Global South ◽  
Food Sources ◽  
Systematic Sampling ◽  
Structured Interviews ◽  
Multi Stage ◽  
Diarrhoeal Diseases

Diarrhoeal diseases remain a significant cause of morbidity and mortality, particularly in poor urban communities in the Global South. Studies on food access and safety have however not considered the sources of discrete food categories and their propensity to harbour and transmit diarrhoeal disease pathogens in poor urban settings. We sought to contribute to knowledge on urban food environment and enteric infections by interrogating the sources and categories of common foods and their tendency to transmit diarrhoea in low-income communities in Accra. We modelled the likelihood of diarrhoea transmission through specific food categories sourced from home or out of home after controlling for alternate transmission pathways and barriers. We used structured interviews where households that participated in the study were selected through a multi-stage systematic sampling approach. We utilized data on 506 households from 3 low-income settlements in Accra. These settlements have socio-economic characteristics mimicking typical low-income communities in the Global South. The results showed that the incidence of diarrhoea in a household is explained by type and source of food, source of drinking water, wealth and the presence of children below five years in the household. Rice-based staples which were consumed by 94.5% of respondents in the week preceding the survey had a higher likelihood of transmitting diarrhoeal diseases when consumed out of home than when eaten at home. Sources of hand-served dumpling-type foods categorized as “staple balls” had a nuanced relationship with incidence of diarrhoea. These findings reinforce the need for due diligence in addressing peculiar needs of people in vulnerable conditions of food environment in poor urban settlements in order to reap a co-benefit of reduced incidence of diarrhoea while striving to achieve the global development goal on ending hunger.

From Victim to Offender: How Nuisance Property Laws Affect Battered Women

2016 ◽  
Vol 34 (6) ◽  
pp. 1103-1126 ◽  
Author(s):  
Gretchen W. Arnold
Keyword(s):  
Domestic Violence ◽  
Battered Women ◽  
Low Income ◽  
Partner Violence ◽  
Access To Health Care ◽  
Structured Interviews ◽  
Race And Class ◽  
Qualitative Research Design ◽  
Multi Stage ◽  
Nuisance Law

Nuisance property laws, which fine people for excessive 911 calls, have become increasingly popular in cities of all sizes. However, research into how these laws affect battered women is still in its early stages. This research study was designed to address the question of whether nuisance property laws harm battered women and, if so, how. Using a qualitative research design, in-depth semi-structured interviews were conducted with 27 primarily low-income African American battered women in St. Louis metropolitan area who had come into contact with a nuisance property law because of domestic violence. Interviews addressed circumstances of contact with a nuisance law, the response of law enforcement officials, and how the law affected the participant’s housing, ability to call 911, sense of safety, finances, access to health care, and family stability. Using a multi-stage qualitative analytic procedure, each transcript was coded for themes and then descriptive categories developed for each theme. The data demonstrate that nuisance property laws harm victims of domestic violence in several ways, including by hindering their access to safe and secure housing, discouraging them from calling 911, increasing their vulnerability to violence, and compounding the trauma of the intimate partner violence. This research also reveals ways in which nuisance laws reinforce gender, race, and class inequality. The findings show that nuisance property laws enhance the abuser’s power over his victim, hold victims accountable for the abuse, exacerbate the class- and race-based risks many battered women already face, and obscure the real crime of domestic violence. Policy makers need to be informed of these consequences so that they can take action to reform nuisance laws.

scholarly journals Improving Food System Connectivity: Using Mobile Technology to Leverage Community Partnerships and Strengthen Local Food Systems

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 569-569
Author(s):  
Dahiany Zayas Toro ◽  
Kelley Koeppen ◽  
Emma Lewis ◽  
Lisa Poirier ◽  
Nina Martin ◽  
...  
Keyword(s):  
Low Income ◽  
Food Environment ◽  
Food System ◽  
Local Food ◽  
Fresh Produce ◽  
Community Partnerships ◽  
Food Distribution ◽  
Food Sources ◽  
Corner Store ◽  
Corner Stores

Abstract Objectives In low-income areas of Baltimore, corner stores are common food sources yet often lack fresh produce. Corner stores are uniquely positioned in the urban food system and offer an opportunity to intervene on the supply chain. However, there is a critical gap in our understanding of the local food distribution network and the best strategies for provisioning corner stores with produce. We sought to inform the development of the Baltimore Urban food Distribution (BUD) mobile application (app), which moves fresh produce from local suppliers to corner stores. We sought to: (1) identify existing networks of local food distribution; (2) explore barriers to increasing fresh produce access within the local food system; and (3) evaluate the potential for sustainability of the BUD app. Methods Secondary data analysis of in-depth interviews (n = 17) conducted in 2016 among local food environment experts, corner store owners, distributors, and wholesalers was completed with the purpose of understanding existing networks of local food distribution, and barriers to increasing food access among stakeholders in the Baltimore food environment. Primary data collection was conducted in 2020–2021 with local stakeholders (n = 10) to confirm and expand upon these findings. Results Existing community distributor partnerships with corner stores and producers contribute to local food networks. Community food distributors with an established connection to wholesalers and urban farmers offer more direct access to fresh produce, but delivery is costly for corner stores. The BUD app could facilitate the arrangement of collective delivery services between distributors, urban farmers and corner stores. Potential barriers include a lack of demand for produce from consumers and a need for community engagement to be incorporated into the app. Conclusions Our findings suggest that enhancing community partnerships is a viable method for distributing fresh foods to local corner stores in Baltimore. Further research is needed to identify ways to increase consumer demand for these foods at the corner store level, and to strengthen the local food distribution system in Baltimore. Funding Sources NHLBI, NIH, award number R34HL145368.

SUSTAINING FAMILY ROUTINES AFTER TRANSITIONING INTO PARENTHOOD: COUPLES’ PERCEPTIONS OF ASSISTING FACTORS

2016 ◽  
Vol 28 (1) ◽  
pp. 3-17
Author(s):  
Christine De Goede ◽  
Abraham P Greeff
Keyword(s):  
Low Income ◽  
Transition To Parenthood ◽  
Specific Problem ◽  
Family Members ◽  
Major Theme ◽  
Structured Interviews ◽  
Theory Analysis ◽  
Family Routines ◽  
Temporal Complexity ◽  
Context Specific

The aim of this qualitative study was to explore what assists couples in sustaining family routines after the transition to parenthood. Participants were recruited from two day-care centres in Cape Town, South Africa. In-depth, semi-structured interviews were conducted with 10 couples, mostly from low-income households, who had gone through this transition between one and four years previously. Grounded theory analysis revealed one major theme, Factors that decrease task and temporal complexity, with seven subthemes: Support from the wider family network; Couple cooperation and tag-teaming; Planning and pre-empting future problems; Adhering to schedules; Facilitative characteristics and skills of individual family members; Parents’ sense of commitment and responsibility towards family members; and idiosyncratic accommodations. Results underscore the need for professionals to help parents gain support from relatives; strengthen partner teamwork; foster schedule consistency; improve skills such as planning; foster their caretaker self-concepts; and facilitate context-specific problem-solving.

URBAN DISPLACEMENT AND LOW-INCOME COMMUNITIES: THE CASE OF THE AMERICAN CITY FROM THE LATE TWENTIETH CENTURY

2016 ◽  
Vol 10 (2) ◽  
pp. 06 ◽  
Author(s):  
Jason Knight ◽  
Mohammad Gharipour
Keyword(s):  
Urban Communities ◽  
Low Income ◽  
Urban Redevelopment ◽  
Minority Populations ◽  
The People ◽  
History Of ◽  
Late Twentieth ◽  
Cultural Connections ◽  
American Cities ◽  
Late Twentieth Century

How can urban redevelopment benefit existing low-income communities? The history of urban redevelopment is one of disruption of poor communities. Renewal historically offered benefits to the place while pushing out the people. In some cases, displacement is intentional, in others it is unintentional. Often, it is the byproduct of the quest for profits. Regardless of motives, traditional communities, defined by cultural connections, are often disrupted. Disadvantaged neighborhoods include vacant units, which diminish the community and hold back investment. In the postwar period, American cities entered into a program of urban renewal. While this program cleared blight, it also drove displacement among the cities’ poorest and was particularly hard on minority populations clustered in downtown slums. The consequences of these decisions continue to play out today. Concentration of poverty is increasing and American cities are becoming more segregated. As neighborhoods improve, poorer residents are uprooted and forced into even more distressed conditions, elsewhere. This paper examines the history of events impacting urban communities. It further reviews the successes and failures of efforts to benefit low-income communities.

scholarly journals “My coupons are like gold”: experiences and perceived outcomes of low-income adults participating in the British Columbia Farmers’ Market Nutrition Coupon Program

2021 ◽  
pp. 1-30
Author(s):  
Stéphanie Caron-Roy ◽  
Sayeeda Amber Sayed ◽  
Katrina Milaney ◽  
Bonnie Lashewicz ◽  
Sharlette Dunn ◽  
...  
Keyword(s):  
British Columbia ◽  
Rural Communities ◽  
Low Income ◽  
Well Being ◽  
Qualitative Description ◽  
Farmers Markets ◽  
Social Connections ◽  
Structured Interviews ◽  
Program Outcomes ◽  
Farmers Market

ABSTRACT Objective: The British Columbia Farmers’ Market Nutrition Coupon Program (FMNCP) provides low-income households with coupons valued at $21/week for 16 weeks to purchase healthy foods in farmers’ markets. Our objective was to explore FMNCP participants’ experiences of accessing nutritious foods, and perceived program outcomes. Design: This study used qualitative description methodology. Semi-structured interviews were conducted with FMNCP participants during the 2019 farmers’ market season. Directed content analysis was used to analyse the data whereby the five domains of Freedman et al’s framework of nutritious food access provided the basis for an initial coding scheme. Data that did not fit within the framework’s domains were coded inductively. Setting: One urban and two rural communities in British Columbia, Canada. Participants: 28 adults who were participating in the FMNCP. Results: Three themes emerged: Autonomy and Dignity; Social Connections and Community Building; and Environmental and Programmatic Constraints. Firstly, the program promoted a sense of autonomy and dignity through financial support, increased access to high-quality produce, food-related education and skill development, and mitigating stigma and shame. Secondly, shopping in farmers’ markets increased social connections and fostered a sense of community. Finally, participants experienced limited food variety in rural farmers’ markets, lack of transportation, and challenges with redeeming coupons. Conclusions: Participation in the FMNCP facilitated access to nutritious foods and enhanced participants’ diet quality, well-being and health. Strategies such as increasing the amount and duration of subsidies, and expanding programs may help improve participants’ experiences and outcomes of farmers’ market food subsidy programs.

scholarly journals Shaping Physical, Economic, and Policy Components of the Food Environment to Create Sustainable Healthy Diets

2020 ◽  
Vol 41 (2_suppl) ◽  
pp. 74S-86S
Author(s):  
Adam Drewnowski ◽  
Eva C. Monterrosa ◽  
Saskia de Pee ◽  
Edward A. Frongillo ◽  
Stefanie Vandevijvere
Keyword(s):  
Low Income ◽  
Food Environment ◽  
Food System ◽  
Well Being ◽  
Food Environments ◽  
Healthy Foods ◽  
Equitable Access ◽  
Nutrition Labels ◽  
Healthy Diets ◽  
Physical Spaces

Background: Sustainable healthy diets are those dietary patterns that promote all dimensions of individuals’ health and well-being; have low environmental pressure and impact; are accessible, affordable, safe, and equitable; and are culturally acceptable. The food environment, defined as the interface between the wider food system and consumer’s food acquisition and consumption, is critical for ensuring equitable access to foods that are healthy, safe, affordable, and appealing. Discussion: Current food environments are creating inequities, and sustainable healthy foods are generally more accessible for those of higher socioeconomic status. The physical, economic, and policy components of the food environment can all be acted on to promote sustainable healthy diets. Physical spaces can be modified to improve relative availability (ie, proximity) of food outlets that carry nutritious foods in low-income communities; to address economic access certain actions may improve affordability, such as fortification, preventing food loss through supply chain improvements; and commodity specific vouchers for fruits, vegetables, and legumes. Other policy actions that address accessibility to sustainable healthy foods are comprehensive marketing restrictions and easy-to-understand front-of-pack nutrition labels. While shaping food environments will require concerted action from all stakeholders, governments and private sector bear significant responsibility for ensuring equitable access to sustainable healthy diets.

scholarly journals Drivers of Broad-Spectrum Antibiotic Overuse across Diverse Hospital Contexts—A Qualitative Study of Prescribers in the UK, Sri Lanka and South Africa

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 94
Author(s):  
Carolyn Tarrant ◽  
Andrew M. Colman ◽  
David R. Jenkins ◽  
Edmund Chattoe-Brown ◽  
Nelun Perera ◽  
...  
Keyword(s):  
South Africa ◽  
Sri Lanka ◽  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Low Income ◽  
System Level ◽  
Comparative Approach ◽  
Structured Interviews ◽  
Public And Private ◽  
The Uk

Antimicrobial stewardship programs focus on reducing overuse of broad-spectrum antibiotics (BSAs), primarily through interventions to change prescribing behavior. This study aims to identify multi-level influences on BSA overuse across diverse high and low income, and public and private, healthcare contexts. Semi-structured interviews were conducted with 46 prescribers from hospitals in the UK, Sri Lanka, and South Africa, including public and private providers. Interviews explored decision making about prescribing BSAs, drivers of the use of BSAs, and benefits of BSAs to various stakeholders, and were analyzed using a constant comparative approach. Analysis identified drivers of BSA overuse at the individual, social and structural levels. Structural drivers of overuse varied significantly across contexts and included: system-level factors generating tensions with stewardship goals; limited material resources within hospitals; and patient poverty, lack of infrastructure and resources in local communities. Antimicrobial stewardship needs to encompass efforts to reduce the reliance on BSAs as a solution to context-specific structural conditions.

scholarly journals Designing Age-Friendly Communities: Exploring Qualitative Perspectives on Urban Green Spaces and Ageing in Two Indian Megacities

2021 ◽  
Vol 18 (4) ◽  
pp. 1491
Author(s):  
Deepti Adlakha ◽  
Mina Chandra ◽  
Murali Krishna ◽  
Lee Smith ◽  
Mark A. Tully
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Later Life ◽  
Healthy Ageing ◽  
World Health ◽  
Social Resilience ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Urban Green ◽  
Activity Promotion

The World Health Organization and the United Nations have increasingly acknowledged the importance of urban green space (UGS) for healthy ageing. However, low- and middle-income countries (LMICs) like India with exponential ageing populations have inadequate UGS. This qualitative study examined the relationships between UGS and healthy ageing in two megacities in India. Participants were recruited using snowball sampling in New Delhi and Chennai and semi-structured interviews were conducted with consenting participants (N = 60, female = 51%; age > 60 years; fluent in English, Hindi, or Tamil). Interviews were recorded, transcribed, translated, and analysed using inductive and thematic analysis. Benefits of UGS included community building and social capital, improved health and social resilience, physical activity promotion, reduced exposure to noise, air pollution, and heat. Poorly maintained UGS and lack of safe, age-friendly pedestrian infrastructure were identified as barriers to health promotion in later life. Neighbourhood disorder and crime constrained older adults’ use of UGS in low-income neighbourhoods. This study underscores the role of UGS in the design of age-friendly communities in India. The findings highlight the benefits of UGS for older adults, particularly those living in socially disadvantaged or underserved communities, which often have least access to high-quality parks and green areas.

scholarly journals “You run out of hope:” An Exploration of Low-Income Parents’ Experiences with Food Insecurity using Photovoice

2021 ◽  
pp. 1-21
Author(s):  
Payge Lindow ◽  
Irene H. Yen ◽  
Mingyu Xiao ◽  
Cindy W. Leung
Keyword(s):  
Food Insecurity ◽  
San Francisco ◽  
Low Income ◽  
Eating Behaviors ◽  
Comparative Method ◽  
Well Being ◽  
Structured Interviews ◽  
Unhealthy Eating ◽  
Low Income Families ◽  
The Impact

ABSTRACT Objective: Using an adaption of the Photovoice method, this study explored how food insecurity affected parents’ ability to provide food for their family, their strategies for managing household food insecurity, and the impact of food insecurity on their well-being. Design: Parents submitted photos around their families’ experiences with food insecurity. Afterwards, they completed in-depth, semi-structured interviews about their photos. The interviews were transcribed and analyzed for thematic content using the constant comparative method. Setting: San Francisco Bay Area, California, USA. Subjects: 17 parents (14 mothers and 3 fathers) were recruited from a broader qualitative study on understanding the experiences of food insecurity in low-income families. Results: Four themes were identified from the parents’ photos and interviews. First, parents described multiple aspects of their food environment that promoted unhealthy eating behaviors. Second, parents shared strategies they employed to acquire food with limited resources. Third, parents expressed feelings of shame, guilt, and distress resulting from their experience of food insecurity. And finally, parents described treating their children to special foods to cultivate a sense of normalcy. Conclusions: Parents highlighted the external contributors and internal struggles of their experiences of food insecurity. Additional research to understand the experiences of the food-insecure families may help to improve nutrition interventions targeting this structurally vulnerable population.

scholarly journals Care-seeking and managing diabetes in rural Bangladesh: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Maria Jennings ◽  
Joanna Morrison ◽  
Kohenour Akter ◽  
Hassan Haghparast-Bidgoli ◽  
Carina King ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Care Providers ◽  
Low Income ◽  
Diabetes Management ◽  
Local Health ◽  
Care Seeking ◽  
Care Providers ◽  
Structured Interviews ◽  
Rural Bangladesh

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.

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