scholarly journals RURAL LIVELIHOODS TRANSITIONS: TOWARDS AN INTEGRATION OF THE SUSTAINABLE LIVELIHOODS APPROACH AND THE MULTI-LEVEL PERSPECTIVE

2018 ◽  
Author(s):  
Hamid EL BILALI ◽  
Michael HAUSER ◽  
Sinisa BERJAN ◽  
Otilija MISECKAITE ◽  
Lorenz PROBST
Keyword(s):  
Rural Areas ◽  
Empirical Work ◽  
Sustainable Livelihoods ◽  
Rural Livelihoods ◽  
Livelihood Diversification ◽  
Sustainable Livelihood ◽  
Middle Income ◽  
Middle Income Countries ◽  
Multi Level ◽  
Agricultural Transitions

In rural areas, especially in low and middle-income countries, livelihoods have to diversify to include new on- and off-farm activities. However, sustainable livelihood concepts have so far not sufficiently accommodated transition dynamics. Mostly, rural livelihoods and sustainability transitions are addressed separately in the scientific literature. The aim of this review paper is to explore opportunities to integrate the Sustainable Livelihoods Approach (SLA) and the Multi-Level Perspective (MLP) on transitions. We provide an overview of the SLA and MLP. We then focus on the conceptual linkages between SLA and MLP, in particular regarding livelihood diversification strategies. Our review shows that the conceptual overlaps of the SLA and the MLP allow for a meaningful combination of both approaches to harness their respective strengths. Vulnerabilities from the SLA perspective (e.g. shocks, trends, changes) are considered at the landscape level in MLP. Policies, institutions, processes in SLA are part of ‘regime’ in the MLP heuristic. The livelihood diversification in SLA, e.g. the development of new on- and off-farm activities, can be described as niches in MLP. Some empirical work on agricultural transitions from the MLP perspective has adopted a territorial approach to take into consideration the pluri-activity of farms and the interactions between different subsystems (food, energy and tourism). This resonates well with the idea of livelihood diversification as a strategy in SLA. We conclude that integrating SLA and MLP will help to better understand livelihood diversification processes and we provide a preliminary proposal for a livelihood transition framework.

scholarly journals Co-morbid anaemia and stunting among children of pre-school age in low- and middle-income countries: a syndemic

2018 ◽  
Vol 22 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Thach Duc Tran ◽  
Beverley-Ann Biggs ◽  
Sara Holton ◽  
Hau Thi Minh Nguyen ◽  
Sarah Hanieh ◽  
...  
Keyword(s):  
Rural Areas ◽  
Secondary Analysis ◽  
Logistic Models ◽  
Demographic And Health Surveys ◽  
Healthy Children ◽  
Middle Income ◽  
Disadvantaged Children ◽  
Middle Income Countries ◽  
Co Morbidity ◽  
Low And Middle Income

AbstractObjectiveTo determine the prevalence of co-morbidity of two important global health challenges, anaemia and stunting, among children aged 6–59 months in low- and middle-income countries.DesignSecondary analysis of data from Demographic and Health Surveys (DHS) conducted 2005–2015. Child stunting and anaemia were defined using current WHO classifications. Sociodemographic characteristics of children with anaemia, stunting and co-morbidity of these conditions were compared with those of ‘healthy’ children in the sample (children who were not stunted and not anaemic) using multiple logistic models.SettingLow- and middle-income countries.SubjectsChildren aged 6–59 months.ResultsData from 193 065 children from forty-three countries were included. The pooled proportion of co-morbid anaemia and stunting was 21·5 (95 % CI 21·2, 21·9) %, ranging from the lowest in Albania (2·6 %; 95 % CI 1·8, 3·7 %) to the highest in Yemen (43·3; 95 % CI 40·6, 46·1 %). Compared with the healthy group, children with co-morbidity were more likely to be living in rural areas, have mothers or main carers with lower educational levels and to live in poorer households. Inequality in children who had both anaemia and stunting was apparent in all countries.ConclusionsCo-morbid anaemia and stunting among young children is highly prevalent in low- and middle-income countries, especially among more disadvantaged children. It is suggested that they be considered under a syndemic framework, the Childhood Anaemia and Stunting (CHAS) Syndemic, which acknowledges the interacting nature of these diseases and the social and environmental factors that promote their negative interaction.

scholarly journals Tracing Long- and Short-term Migrants for Participation in Demographic and Epidemiological Studies: Evidence from Senegal

Field Methods ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 38-57
Author(s):  
Mufaro Kanyangarara ◽  
Laetitia Douillot ◽  
Gilles Pison ◽  
Cheikh Tidiane Ndiaye ◽  
Valerie Delaunay ◽  
...  
Keyword(s):  
Rural Areas ◽  
Statistical Power ◽  
Epidemiological Studies ◽  
Adult Mortality ◽  
Short Term ◽  
Middle Income ◽  
Middle Income Countries ◽  
Contact Information

Migration of participants in demographic and epidemiological studies results in missing data. One approach to reduce resulting losses in statistical power and potential biases is to follow up migrants at their new residence. We describe the follow-up of migrants who were eligible for participation in a trial of a new questionnaire to measure adult mortality in Niakhar, Senegal. We conducted a short inquiry in the migrant’s last known household to obtain contact information and then attempted to contact and interview 661 migrants who resided in Dakar, Mbour, and rural areas close to Niakhar. About two-thirds of migrants were successfully enrolled in the study. Having a contact phone number and knowing the name of the head of compound at destination increased the likelihood of successful enrollment. Following up migrants in demographic studies is feasible in low- and middle-income countries, including long-term migrants who have not been contacted for extended periods of time.

Strategies used to establish palliative care in rural low- and middle-income countries: an integrative review

2020 ◽  
Vol 35 (8) ◽  
pp. 1110-1129
Author(s):  
Atsede Aregay ◽  
Margaret O’Connor ◽  
Jill Stow ◽  
Nicola Ayers ◽  
Susan Lee
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Care Home ◽  
Sub Saharan Africa ◽  
Integrative Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Globally, 40 million people need palliative care; about 69% are people over 60 years of age. The highest proportion (78%) of adults are from low- and middle-income countries (LMICs), where palliative care still developing and is primarily limited to urban areas. This integrative review describes strategies used by LMICs to establish palliative care in rural areas. A rigorous integrative review methodology was utilized using four electronic databases (Ovid MEDLINE, Ovid Emcare, Embase classic+Embase and CINAHL). The search terms were: ‘palliative care’, ‘hospice care’, ‘end of life care’, ‘home-based care’, ‘volunteer’, ‘rural’, ‘regional’, ‘remote’ and ‘developing countries’ identified by the United Nations (UN) as ‘Africa’, ‘Sub-Saharan Africa’, ‘low-income’ and ‘middle- income countries’. Thirty papers published in English from 1990 to 2019 were included. Papers were appraised for quality and extracted data subjected to analysis using a public health model (policy, drug availability, education and implementation) as a framework to describe strategies for establishing palliative care in rural areas. The methodological quality of the reviewed papers was low, with 7 of the 30 being simple programme descriptions. Despite the inclusion of palliative care in national health policy in some countries, implementation in the community was often reliant on advocacy and financial support from non-government organizations. Networking to coordinate care and medication availability near-patient homes were essential features of implementation. Training, role play, education and mentorship were strategies used to support health providers and volunteers. Home- and community-based palliative care services for rural LMICs communities may best be delivered using a networked service among health professionals, community volunteers, religious leaders and technology.

scholarly journals Changing Incidence of Uterine Cancer in Rural Egypt: Possible Impact of Nutritional and Epidemiologic Transitions

2019 ◽  
pp. 1-7
Author(s):  
Saad Alshahrani ◽  
Ahmed Hablas ◽  
Robert M. Chamberlain ◽  
Jane Meza ◽  
Steven Remmenga ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Uterine Cancer ◽  
Population Based ◽  
Urban Residence ◽  
Middle Income ◽  
Rural And Urban Areas ◽  
Middle Income Countries ◽  
Rural And Urban ◽  
Low Incidence

PURPOSE Uterine cancer is a top-ranking women’s cancer worldwide, with wide incidence variations across countries and by rural and urban areas. Hormonal exposures and access to health care vary between rural and urban areas, globally. Egypt has an overall low incidence of uterine cancer but variable rural and urban lifestyles. Are there changes in the incidence of uterine cancer in rural and urban areas in middle-income countries such as Egypt? No previous studies have addressed this question from a well-characterized and validated population-based cancer registry resource in middle-income countries. The aim of this study was to explore the differences in clinical and demographic characteristics of uterine cancer over the period of 1999 to 2010 in rural and urban Gharbiah province, Egypt. METHODS Data were abstracted for all 660 patients with uterine cancer included in the Gharbiah Population-based Cancer Registry. Clinical variables included tumor location, histopathologic diagnosis, stage, grade, and treatment. Demographic variables included age, rural or urban residence, parity, and occupation. Crude and age-adjusted incidence rates (IRs) and rate ratios by rural or urban residence were calculated. RESULTS No significant differences were observed in most clinical and demographic characteristics between rural and urban patients. The age standardized IR (ASR) was 2.5 times higher in urban than in rural areas (6.9 and 2.8 per 100,000 in urban and rural areas, respectively). The rate ratio showed that the IR in urban areas was 2.46 times the rate in rural areas. CONCLUSION This study showed that the disease IR in rural areas has increased in the past decade but is still low compared with the incidence in urban areas in Egypt, which did not show a significant increase in incidence. Nutritional transitions, obesity, and epidemiologic and lifestyle changes toward Westernization may have led to IRs increasing more in rural than in urban areas in Egypt. This pattern of increasing incidence in Egypt, which used to have a low incidence of uterine cancer, may appear in other middle-income countries that experience emerging nutritional and epidemiologic transitions. The rate of uterine cancer in urban areas in Gharbiah is almost similar to the corresponding rates globally. However, the rate in rural areas in this population has increased over the past decade but is still lower than the corresponding global rates. Future studies should examine the etiologic factors related to increasing rates in rural areas and quantify the improvement in rural case finding.

scholarly journals Collaboration between traditional healers and psychiatrists in Sudan

2010 ◽  
Vol 7 (3) ◽  
pp. 71-74 ◽  
Author(s):  
E. A. Sorketti ◽  
N. Z. Zuraida ◽  
M. H. Habil
Keyword(s):  
World Health Organization ◽  
Rural Areas ◽  
Belief System ◽  
Psychosocial Problems ◽  
Traditional Healers ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Organization ◽  
Low And Middle Income

The importance of traditional healing in low- and middle-income countries cannot be under estimated. It is generally perceived as part of the prevailing belief system and traditional healers are often seen as the primary agents for psychosocial problems in these countries; estimates of their service share range from 45% to 60% (World Health Organization, 1992). The World Health Organization (2000) estimated that 80% of people living in rural areas in low- and middle-income countries depend on traditional medicine for their health needs.

Assessing perceptions and willingness to use urine in agriculture: a case study from rural areas of eThekwini municipality, South Africa

2013 ◽  
Vol 3 (4) ◽  
pp. 582-591 ◽  
Author(s):  
A. E. Okem ◽  
S. Xulu ◽  
E. Tilley ◽  
C. Buckley ◽  
E. Roma
Keyword(s):  
South Africa ◽  
Rural Areas ◽  
Field Trials ◽  
Middle Income ◽  
Middle Income Countries ◽  
Body Of Knowledge ◽  
Agricultural Use ◽  
Willingness To Use ◽  
Faecal Sludge

In recent years there has been a growing body of knowledge exploring the benefits of using sanitation-derived nutrients. Such studies aim to uncover strategies that facilitate nutrient recovery from urine and faecal sludge for agricultural use. This paper presents the findings of a study which assessed the willingness to handle and use urine in agriculture among people living in rural areas of eThekwini Municipality, South Africa. Results show that less than 5% of participants are using urine as a fertiliser. This could be attributed to limited awareness of the value of urine in agriculture since only 9.7% are aware that urine contains essential nutrients that can support plant growth. Furthermore, health concerns, smell and the opinions of others are identified as barriers to the handling of urine. The study therefore recommends that participatory field trials and promotional activities are conducted to improve users’ awareness and acceptance. The outcome of this research is of importance to help inform low- and middle-income countries’ governments as they address urban and environmental challenges such as access to adequate sanitation, poverty and food security.

scholarly journals Prevalence and determinants of anaemia among children aged 0–59 months in a rural region of Armenia: a case–control study

2015 ◽  
Vol 19 (7) ◽  
pp. 1260-1269 ◽  
Author(s):  
Anahit Demirchyan ◽  
Varduhi Petrosyan ◽  
Viktoria Sargsyan ◽  
Kim Hekimian
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Regression Models ◽  
Severe Anaemia ◽  
Linear Regression Models ◽  
Middle Income ◽  
Middle Income Countries ◽  
Daily Diet ◽  
Younger Age ◽  
Low Middle Income Countries

AbstractObjectiveDespite the trend of increasing prevalence of childhood anaemia in Armenia, no studies exploring its risk factors have been conducted in the country. The present study aimed to investigate the prevalence and determinants of childhood anaemia in rural Armenia.DesignBlood Hb level was measured among a representative sample of children using the HemoCue Hb201+ analyser. The revealed cases with anaemia were compared with randomly selected non-anaemic controls. Mothers of cases and controls were interviewed. Logistic and linear regression models were fitted to identify the risk factors of anaemia and low Hb level, respectively.SettingTalin communities, Aragatsotn Province, Armenia.SubjectsChildren under 5 years of age in Talin region.ResultsOf the 729 studied children, 32·4 % were anaemic with 14·7 % having moderate/severe anaemia. Infants were the most affected group with 51·1 % being anaemic before 6 months and 67·9 % at 6–12 months of age. Fitted regression models identified the following predictors of anaemia: younger age, male gender, shorter birth length, anaemia during pregnancy, lower meal frequency per day, lack of meat in the diet, using dung cakes for heating and living in a community that received an incomplete set of nutrition interventions.ConclusionsThe study identified several modifiable risk factors that could be targeted to reduce childhood anaemia in rural Armenia and, possibly, in rural areas in other low-/middle-income countries. The suggested interventions include prevention and treatment of anaemia during pregnancy, provision of adequate complementary feeding to children with inclusion of meat in their daily diet and reduction of their exposure to biomass fuel smoke.

scholarly journals Smartphone microendoscopy for high resolution fluorescence imaging

2016 ◽  
Vol 09 (05) ◽  
pp. 1650046 ◽  
Author(s):  
Xiangqian Hong ◽  
Vivek K. Nagarajan ◽  
Dale H. Mugler ◽  
Bing Yu
Keyword(s):  
High Resolution ◽  
Rural Areas ◽  
Ex Vivo ◽  
Cost Effective ◽  
Internal Organs ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past

High resolution optical endoscopes are increasingly used in diagnosis of various medical conditions of internal organs, such as the cervix and gastrointestinal (GI) tracts, but they are too expensive for use in resource-poor settings. On the other hand, smartphones with high resolution cameras and Internet access have become more affordable, enabling them to diffuse into most rural areas and developing countries in the past decade. In this paper, we describe a smartphone microendoscope that can take fluorescence images with a spatial resolution of 3.1 [Formula: see text]m. Images collected from ex vivo, in vitro and in vivo samples using the device are also presented. The compact and cost-effective smartphone microendoscope may be envisaged as a powerful tool for detecting pre-cancerous lesions of internal organs in low and middle-income countries (LMICs).

scholarly journals Knowledge on tuberculosis and utilization of DOTS service by tuberculosis patients in Lalitpur District, Nepal

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245686
Author(s):  
Nirmal Gautam ◽  
Rewati Raj Karki ◽  
Rasheda Khanam
Keyword(s):  
Rural Areas ◽  
Age Groups ◽  
Directly Observed Therapy ◽  
Middle Income ◽  
Public Health Burden ◽  
The Public ◽  
Middle Income Countries ◽  
Adequate Knowledge ◽  
Short Course ◽  
Younger Age

Background Tuberculosis is one of the major infectious diseases and is both complex and serious. It is spread from person to person through the air, causing a public health burden, especially in low- and middle-income countries. This study aims to assess the knowledge on tuberculosis and the utilization of Directly-Observed Therapy, Short Course (DOTS) service from the public DOTS centers in Lalitpur district of Nepal. Method A structured questionnaire was used to collect data from 23 DOTS centers in Lalitpur district. Univariate and multivariate logistic regression was applied to assess the knowledge on tuberculosis and utilization of DOTS among people living with tuberculosis. Results Among 390 respondents, 80% of patients had knowledge of tuberculosis and 76.92% utilized the DOTS service from the DOTS center. People of higher age (50–60 years) [aOR; 13.96, 95% CI 4.79,40.68], [aOR; 10.84,95% CI 4.09,28.76] had significantly more knowledge on TB and utilization of the DOTS service compared to the younger group. Additionally, those who completed twelfth class [aOR; 2.25, 95% CI 0.46,11.07] and [aOR;2.47, 95% CI 0.51,11.28] had greater knowledge of Tuberculosis and utilization of DOTS compared to those who had not completed twelfth class. Likewise, compared to urban residents, respondents in rural areas (aOR; 0.51, 95% CI 0.27,0.97) had less knowledge of tuberculosis, (aOR; 0.57, 95% CI 0.32,1) and less chance of utilization of the DOTS service from the DOTS center. Conclusion Approximately one quarter of patients did not have adequate knowledge of tuberculosis and were not utilizing the DOTS service, particularly in younger age groups, people living in a combined family, with no education, poor economic position, and from rural areas. Findings of this study revealed that some specific programs are needed for enhancing the knowledge and utilization of DOTS, particularly for those patients whose economic situations extended from low to mid range.

scholarly journals Mobile consulting (mConsulting) as an option for accessing healthcare services for communities in remote rural areas and urban slums in low- and middle- income countries: A mixed methods study

2020 ◽  
Author(s):  
Bronwyn Harris ◽  
Motunrayo Ajisola ◽  
Raisa Alam ◽  
Jocelyn Antsley Watkins ◽  
Theodoros N Arvanitis ◽  
...  
Keyword(s):  
Rural Areas ◽  
Healthcare Workers ◽  
Urban Slums ◽  
Care Seeking ◽  
Health Coverage ◽  
Policy Document ◽  
Middle Income ◽  
Middle Income Countries ◽  
Urban Sites ◽  
Low And Middle Income

AbstractObjectiveRemote or mobile consulting (mConsulting) is being promoted to strengthen health systems, deliver universal health coverage and facilitate safe clinical communication during COVID-19 and beyond. We explored whether mConsulting is a viable option for communities with minimal resources in low- and middle-income countries (LMICs).MethodsWe reviewed evidence published since 2018 about mConsulting in LMICs and undertook a scoping study (pre-COVID) in two rural settings (Pakistan, Tanzania) and five urban slums (Kenya, Nigeria, Bangladesh), using policy/document review, secondary analysis of survey data (from the urban sites), and thematic analysis of interviews/workshops with community members, healthcare workers, digital/telecommunications experts, mConsulting providers, local and national decision-makers. Project advisory groups guided the study in each country.ResultsWe reviewed five empirical studies and seven reviews, analysed data from 5,219 urban slum households and engaged with 419 stakeholders in rural and urban sites. Regulatory frameworks are available in each country. mConsulting services are operating through provider platforms (n=5-17) and, at community-level, some direct experience of mConsulting with healthcare workers using their own phones was reported - for emergencies, advice and care follow-up. Stakeholder willingness was high, provided challenges are addressed in technology, infrastructure, data security, confidentiality, acceptability and health system integration. mConsulting can reduce affordability barriers and facilitate care-seeking practices.ConclusionsThere are indications of readiness for mConsulting in communities with minimal resources. However, wider system strengthening is needed to bolster referrals, specialist services, laboratories and supply-chains to fully realise the continuity of care and responsiveness that mConsulting services offer, particularly during/beyond COVID-19.

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