Development of an eHealth Nursing Intervention on Self-Care to Prevent Diabetic Foot in Rural Mexico: A Pilot Test

Diabetic foot affects nearly 6% of people living with Type 2 diabetes (T2D). It is also the most common complication of T2D and is associated with infection, ulceration. eHealth facilitation of Non-communicable diseases management has the potential to increase self-care and engage patients. The aim of this study is to develop an eHealth intervention to prevent diabetic foot.

How does urbanization affect perceptions and traditional knowledge of medicinal plants?

Background The use and knowledge of medicinal plants play an essential role in community health in rural Mexico. Medicinal plants are part of the local heritage and provide a source of economic income. Nevertheless, knowledge of their use has declined due to factors like accelerated urbanization. Some authors have proposed that by reducing natural spaces, urbanization generates changes that impact the recognition, use, and management of natural resources. Here, we evaluate how urbanization affects the knowledge, use, and perception of medicinal plants in a Biosphere Reserve in Mexico. Methods Using a mixed methodology including quantitative and qualitative analyses, we generated a list of medicinal plants, methods of preparation, prevalence of illness, and use in two communities with different degrees of urbanization. Results A total of 217 medicinal plants were identified. The more urbanized community had greater knowledge of, and used, a larger number of introduced plant species, while the less urbanized community used and had more knowledge about wild plants. One of the factors explaining these differences was occupation, with people who work outdoors showing greater knowledge of wild plants. Conclusions Urbanization can lead to a loss of knowledge of the use and management of local wild species, with implications for the conservation of biocultural heritage. Substitution of native medicinal plants by introduced species shows disinterest and disuse in the local medicinal flora, which could be reflected in their ecosystems.

Liquidity or Capital?: The Impacts of Easing Credit Constraints in Rural Mexico

This paper evaluates the effectiveness of easing credit constraints for rural producers in Mexico through loans provided by a national public development finance institution. In contrast to most of the existing literature, the study focuses on the effect of medium-sized loans over a two- to four-year time horizon. This paper looks at the effects of such loans on production and investment decisions, input use, and yields. Using a multiple treatment methodology, it explores the differential impacts of providing liquidity for working capital versus providing credit for investments in fixed assets. It finds that loans increased the likelihood that producers grow and sell certain key annual crops, in particular among recipients of working capital loans. It also finds significant effects on production value and sales (per hectare), with similar impacts for recipients of both types of loans, with gains in yields driven by changes in labor quality and more intensive use of key inputs. There is no evidence of significant effects on the purchase of large machinery, but there are impacts on the acquisition of cattle. Overall, the results reported in this paper suggest that lack of liquidity is at least as important as lack of funding for new investment in capital for rural producers in Mexico. Producers benefit from easing their credit constraints, regardless of the type of loan used for that purpose.

Protection of Nationals Abroad : The Mexican State and the Seasonal Agricultural Workers in Canada

Due to the adverse economic conditions in Mexico and the need for offshore labour in Canadian agriculture, Mexico entered the Seasonal Agricultural Worker Program (SAWP) in 1974 as a source country, becoming the country that exports the highest number of agricultural works to Canada. While abroad, these workers have genuine needs that should be addressed by the Mexican government, but unfortunately the Mexican government has failed to provide adequate protection to its nationals. This paper offers an overview of the situation in rural Mexico, the operational aspects of the program and its violations; it identifies the workers' needs and the most important national and international documents that regulate the protection of nationals abroad. This research is a critique of the role of the Mexican government in the protection of the seasonal agricultural workes in Canada, identifying the limitations that the State faces for providing protection to its nationals.

Protection of Nationals Abroad : The Mexican State and the Seasonal Agricultural Workers in Canada

Due to the adverse economic conditions in Mexico and the need for offshore labour in Canadian agriculture, Mexico entered the Seasonal Agricultural Worker Program (SAWP) in 1974 as a source country, becoming the country that exports the highest number of agricultural works to Canada. While abroad, these workers have genuine needs that should be addressed by the Mexican government, but unfortunately the Mexican government has failed to provide adequate protection to its nationals. This paper offers an overview of the situation in rural Mexico, the operational aspects of the program and its violations; it identifies the workers' needs and the most important national and international documents that regulate the protection of nationals abroad. This research is a critique of the role of the Mexican government in the protection of the seasonal agricultural workes in Canada, identifying the limitations that the State faces for providing protection to its nationals.

Economic evaluation of a novel community-based diabetes care model in rural Mexico: a cost and cost-effectiveness study

ObjectivesDiabetes is the leading cause of disability-adjusted life years in Mexico, and cost-effective care models are needed to address the epidemic. We sought to evaluate the cost and cost-effectiveness of a novel community-based model of diabetes care in rural Mexico, compared with usual care.DesignWe performed time-driven activity-based costing to estimate annualised costs associated with typical diabetes care in Chiapas, Mexico, as well as a novel diabetes care model known as Compañeros En Salud Programa de Enfermedades Crónicas (CESPEC). We conducted Markov chain analysis to estimate the cost-effectiveness of CESPEC compared with usual care from a societal perspective. We used patient outcomes from CESPEC in 2016, as well as secondary data from existing literature.SettingRural primary care clinics in Chiapas, Mexico.ParticipantsAdults with diabetes.InterventionsCESPEC is a novel, comprehensive, diabetes care model that integrates community health workers, provider education, supply chain management and active case finding.Outcome measureThe primary outcome was the incremental cost-effectiveness of CESPEC compared with care as usual, per quality-adjusted life year (QALY) gained, expressed in 2016 US dollars.ResultsThe economic cost of the CESPEC diabetes model was US$144 per patient per year, compared with US$125 for diabetes care as usual. However, CESPEC care was associated with 0.13 additional years of health-adjusted life expectancy compared with usual care and 0.02 additional years in the first 5 years of treatment. This translated to an incremental cost-effectiveness ratio (ICER) of US$2981 per QALY gained over a patient’s lifetime and an ICER of US$10 444 over the first 5 years. Findings were robust to multiple sensitivity analyses.ConclusionsCESPEC is a cost-effective, community-based model of diabetes care for patients in rural Mexico. Given the high prevalence and significant morbidity associated with diabetes in Mexico and other countries in Central America, this model should be considered for broader scale up and evaluation.

Exploring the impacts of Internet access on poverty: A regional analysis of rural Mexico

The purpose of this article is to estimate the impact of Internet access on poverty for a sample of people living in contrasting regions located across rural Mexico. Using a quasi-experimental technique, our results suggest that Internet access is an additional mechanism that contributes to decreasing poverty levels. Consequently, it could assist in increasing the proportion of people living out of poverty in rural areas; however, this is not uniform across regions (higher positive effects are estimated for less developed regions). These findings highlight the prevailing regional heterogeneity in Mexico’s rural sector and suggest that governments must design better-targeted public policies that address the uneven development in Internet diffusion typical of the rural sector. These policy improvements would allow governments to maximize the potential benefits of the Internet, as this technology alone is not sufficient to break the cycle of poverty in middle-income countries like Mexico.

How does urbanization affect perceptions and traditional knowledge of medicinal plants?

Background: Use and knowledge of medicinal plants play an essential role in community health in rural Mexico. They are part of the local inheritance and constitute an economic alternative. Nevertheless, knowledge of their use has declined due to factors like accelerated urbanization processes. Some authors have proposed that by reducing natural spaces, urbanization generates changes which will impact recognition, use and management of natural resources. We evaluate how urbanization affects knowledge, use and perception of medicinal plants in a Biosphere Reserve in Mexico. Methods: Using a mixed methodology including quantitative and qualitative analyses, we generate a list of medicinal plants, methods of preparation, prevalence of illness, and use. Results: 210 medicinal plants were identified. The more urbanized community used greater number of introduced plants; whereas the less urbanized used and had more knowledge about wild plants. One of the factors explaining these differences was occupation. People who work outdoors have greater knowledge of wild plants. The more urbanized community knew and used more introduced species. Conclusions: This can lead to a loss of knowledge of use and management of wild species, with implications for the conservation of biocultural heritage. Substitution of native by introduced plants shows disinterest and disuse, which could be reflected in their ecosystems.