A model for sustainable, partnership-based telehealth services in rural India: An early process evaluation from Tuver village, Gujarat

Background Telehealth can improve access to high-quality healthcare for rural populations in India. However, rural communities often have other needs, such as sanitation or employment, to benefit fully from telehealth offerings, highlighting a need for systems-level solutions. A Business of Humanity approach argues that innovative solutions to wicked problems like these require strategic decision-making that attends to a) humaneness, e.g., equity and safety and b) humankind, or the needs and potential of large and growing markets comprised of marginalized and low-income individuals. The approach is expected to improve economic performance and long-term value creation for partners, thus supporting sustainability. Methods A demonstration project was conducted in Tuver, a rural and tribal village in Gujarat, India. The project included seven components: a partnership that emphasized power-sharing and complementary contributions; telehealth services; health promotion; digital services; power infrastructure; water and sanitation; and agribusiness. Core partners included the academic partner, local village leadership, a local development foundation, a telehealth provider, and a design-build contractor. This early process evaluation relies on administrative data, field notes, and project documentation and was analyzed using a case study approach. Results Findings highlight the importance of taking a systems perspective and engaging inter-sectoral partners through alignment of values and goals. Additionally, the creation of a synergistic, health-promoting ecosystem offers potential to support telehealth services in the long-term. At the same time, engaging rural, tribal communities in the use of technological advances posed a challenge, though local staff and intermediaries were effective in bridging disconnects. Conclusion Overall, this early process evaluation highlights the promise and challenges of using a Business of Humanity approach for coordinated, sustainable community-level action to improve the health and well-being of marginalized communities.

Dance wherever you are: the evolution of multi-modal delivery for social inclusion of rural older adults

Background and Objectives Older adult social inclusion involves meaningful participation that is increasingly mediated by information communication technology (ICT) and in rural areas requires understanding of older adults’ experiences in the context of the digital divide. This paper examines how the multi-modal streaming (live, pre-recorded, blended in-person) of the Sharing Dance Older Adults program developed by Canada's National Ballet School (NBS) and Baycrest, influenced social inclusion processes and outcomes in rural settings. Research Design and Methods Data were collected from on-site observations of dance sessions, research team reflections, focus groups and interviews with older adult participants and their carers in pilot studies in the Peterborough Region of Ontario, and the Westman Region of Manitoba, Canada (2017-2019). There were 289 participants including older adults, people living with dementia, family carers, long-term-care staff, community facilitators, and volunteers. Analytic themes were framed in the context of rural older adult social exclusion. Results Remote delivery addressed barriers of physical distance by providing access to the arts-based program and enhancing opportunities for participation. Constraints were introduced by the use of technology in rural areas and mitigated by in-person facilitators and different streaming options. Meaningful engagement in dynamic interactions in the dance was achieved by involving local staff and volunteers in facilitation of and feedback on the program and its delivery. Different streaming technologies influenced social inclusion in different ways: live-stream enhanced connectedness, but constrained technical challenges; pre-recorded was reliable, but less social; blended delivery provided options, but personalization was unsustainable. Discussion and Implications Understanding different participants’ experiences of different technologies will contribute to more effective remote delivery of arts-based programs with options to use technology in various contexts depending on individual and organizational capacities.

Creating a Scientific Solution: Local Problem Solving in the Portuguese Health Examination Survey: A Mixed Method Study

BackgroundParticipation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other similar health examination surveys. The objective of this article is to describe strategies used by the local teams to increase participation rates and to solve practical survey problems.MethodsAfter a literature search, informal interviews were conducted with 14 public health officials from local health examination teams, regional and central authorities. 41 of the local staff members also filled in a short questionnaire anonymously. The interviews and self-administered questionnaires were analysed using mixed methods, informed by thematic analysis.ResultsThe local teams believed that the detailed manual, described as a "cookbook for making a health examination survey", made it possible to maintain high scientific standards while allowing for improvising solutions to problems in the local context. The quality of the manual, supported by a series of training workshops with the central research and support team, gave the teams the confidence and knowledge to implement local solutions. Motivation and cohesion within the local teams were among the goals of the training process. Local teams felt empowered by being given large responsibilities and worked hard to incite people to attend the examination through a close and persuasive approach.Local teams praised their INSA contacts for being available for assistance throughout the survey, and said they were inspired to try harder to reach participants to please their contacts for interpersonal reasons.ConclusionsThe theory of organizational improvisation or bricolage, which means using limited resources to solve problems, was useful to discuss and understand what took place during INSEF.A detailed manual covering standard procedures, continuous monitoring of the data collection and face-to-face workshops, including role-play, were vital to assure high scientific standards and high participation rates in this health examination survey. Close contacts between the central team and local focal points in all regions and all survey sites were key to accommodating unexpected challenges and innovative solutions.

Some Important Factors Hindering the Civic Integration of Ethnic Minorities

The purpose of this article is to compile and group the list of problems that hinder the integration of ethnic minorities in the political, economic and cultural life of the country, based on research conducted by various organizations over the past 10 yearს. According to these studies, the main problem is, on the one hand, the language barrier and, on the other hand, ethnic-nationalist tendencies and stereotypes. These national mythologies and notions play one of the crucial roles in the formation of national self-identification. Ethno-nationalist tendencies are strong both in minorities and in ethnic Georgians. There are several factors behind the emergence of the ethnonationalism in Georgia First of all, it is the legacy of Soviet totalitarianism, as well as the result of the current socio-political situation. Understanding these two factors will give us a better answer as to why ethnic-nationalist sentiments are still prevailing in Georgia and why the integration of the ethnic minorities is hindered, despite being repeatedly declared by the state. The language barrier of ethnic minorities is also an important problem in the process of integration into society. The education system should make the knowledge of the state language accessible to ethnic minorities and, at the same time, ensure the protection of minority languages. To do this, the state must maximize and encourage local staff; The general system of education should ensure the upbringing of the citizen of the country and not put any group (even the majority) in an advantageous situation. show the advantage of any (even the majority) group.

Heritage Education in Myanmar – developing resilience and sustainability through community engagement | မြန်ြာနိုင်ငံ၏အမြေအနှစ်ဆိုင်ရာပညာမရး ( လူထုအားမြင့် ကြံ့ခိုင်မရးနှ ငမ့် ရရညှ ်တည်တ့နံ ုငိ မ် ရး)

Over the last decade Myanmar has experienced a strong increase in interest in Myanmar’s heritage and a demand for local expertise in heritage management. However, in Myanmar there is no formal education in heritage studies. This is recognised as a significant gap in Myanmar’s abilities to manage and develop world heritage sites, as well as national and local level heritage sites, to international standards. To address this gap a group of researchers are preparing models for Myanmar Heritage Education considering short, medium and long-term goals. The models consider local and national heritage management needs, and ways to up-skill local staff working in heritage fields so course content can be delivered by Myanmar experts and become selfsustaining. Formal government accredited courses of study will take some time to implement. In the current covid-19 environment there is opportunity to focus on the role of community groups in heritage management. This paper will discuss current activities undertaken by community groups in heritage areas, and outline opportunities to engage community more fully in the longterm management of Myanmar’s cultural heritage. The aim is to develop local resources that are resilient and sustainable. မြန်ြာနိုင်ငံ၏ အ မြေအနှစ်ထိန်းသိြ်း မေးလုပ်ငန်းြျားတေင် ဆယ်နှစ်အတေင်း စိတ်ဝင်စားြှု တိူးတက်လာပပီး မပည်တေင်းကျွြ်းကျင်သူြျားစေားေှိေန် လိုအပ်လာပါသည်။ မြန်ြာနိုင်ငံေှိ တက္ကသိုလ်ြျား တေင် ယခု အချနိ ် အထိ အမ ြေအနှစ် ထိန်းသိြ်းမ ေး ပညာေပ်အတေက် ဘေဲ့ မပးနိုင်သည့် အဆင့် ထိ သင်ကကား မပးနိုင်ြှု ြေှိ မသးပါ။ ထို အချက်သည် ကြ္ဘာ အ မြေအနှစ်၊ နိုင်ငံအ မြေအနှစ်နှင့် မေသဆိုင်ော အ မြေအနှစ်ြျားကိုထိန်းသိြ်း မစာင့် မေှာက်ောတေင် မြန်ြာနိုင်ငံ ၏ အ မေးတကကီးလိုအပ်လျက် ေှိမသာကေက်လပ် အမြစ်သတိမပုနိုင်ပါသည်။ ထိုကေက်လပ်ကို မမြေှင်းနိုင်ေန်အတေက် သု မတသနပညာေှင်တစ်စုသည် မြန်ြာ့အ မြေအနှစ်ထိန်းသိြ်း မေးပညာ အတေက် ကာလတို၊ အလယ်အလတ်နှင့် ကာလေှည် ေည်ြှန်းချက်ြျားချြှတ်ပပီး လုပ် မဆာင်နိုင်ြည့်ပုံ စံြျားကိုမပင်ဆင် မနပါသည်။ ထိုလုပ် မဆာင်နိုင်ြည့်ပုံစံြျားတေင် မေသဆိုင်ောနှင့် နိုင်ငံလုံးဆိုင်ော အ မြေအနှစ်ထိန်းသိြ်း မေးလိုအပ်ချက်ြျား၊ နိုင်ငံတေင်းသက်ဆိုင်ော လုပ်ငန်းလုပ် မဆာင် မနသူြျားကို အေည် အ မသေးမြှင့်တင်နိုင်ြည့်နည်းလြ်းြျားကို စဥ်းစားထားပပီး၊ မြန်ြာ ပညာေှင်ြျားက ပို့ချ၍ ကိုယ်တိုင် ေပ်တည်နိုင်ြည့် အ မမခအ မနကိုစဥ်းစားထားပါသည်။ အစိုးေြှ အသိအြှတ်မပု မသာ ပုံြှန် (ဘေဲ့)သင်တန်းြျားြေင့်လှစ်ေန် အချနိ ်ယူေြည် မြစ်ပါသည်။ လတ်တ မ လာ Covid 19 ကူးစက်မပန့်ပေားမ နချနိ ်တေင် အ မြေအနှစ်ထိန်းသိြ်းမ ေး အတေက် လူြှုအြေဲ့အစည်း၏ပါဝင်ြှု အခန်း ကဏ္ဍ ကိုအာရုံစိုက်ေန် အခေင့် အ မေးပင်မြစ်ပါသည်။ ဤစာတြ်းတေင် သက်ဆိုင်ော အ မြေအနှစ်မေသ အသီးသီးြှ လူြှု အြေဲ့ြျား၏ လှုပ်ေှားြှုြျား၊ မြန်ြာ့ယဥ် မကျးြှု အ မြေအနှစ်ြျား မေေှည်ထိန်းသိြ်းြှုတေင် လူြှု အြေဲ့အစည်းြျားြှ ပိုြိုပါဝင်နိုင်ြည့် အခေင့်အလြ်းြျား ချြှတ်မခင်းတို့ပါဝင်ပါသည်။ ခံနိုင်ေည်ေမှိ သာ၊ အနာဂတ်ြျုိးဆက်အတေက်လက်ေှိ စေြ်းအားြျားကို အ မကာင်းအတိုင်းချန်ထားနိုင် မသာ မပည်တေင်းစေြ်းအားစုြျားကို ပိုြို တိုးတက်လာ မအာင် မဆာင်ေွက်ေန်ေည်ေွယ်ပါသည်။

ỨNG DỤNG GIS VÀ VIỄN THÁM ĐÁNH GIÁ BIẾN ĐỘNG DIỆN TÍCH CÂY CAO SU DO ẢNH HƯỞNG CỦA BÃO SỐ 10 NĂM 2013 TẠI HUYỆN BỐ TRẠCH, TỈNH QUẢNG BÌNH GIAI ĐOẠN 2013-2019

Nghiên cứu này sử dụng ảnh vệ tỉnh Landsat LC8 của các năm 2013, 2014, và 2019 để giải đoán phân loại lớp phủ cây cao su ở huyện Bố Trạch, tỉnh Quảng Bình và đánh giá biến động diện tích cao su sau ảnh hưởng của bão số 10 (tên là Wutip) năm 2013. Kết quả giải đoán còn sử dụng để đánh giá thiệt hại diện tích trồng cây cao su do ảnh hưởng của bão số 10 năm 2013 và biến động diện tích trồng cây cao su giai đoạn 2013-2019. Các số liệu điều tra thực địa, phỏng vấn cán bộ, số liệu báo cáo thứ cấp, tài liệu phục vụ các hội thảo về phát triển cây cao su ở Quảng Bình đã được thu thập để hỗ trợ cho công việc phân tích, giải đoán ảnh vệ tinh. Nghiên cứu này kết hợp phương pháp giải đoán ảnh theo định hướng đối tượng kết hợp với thuật toán Maximum Likelihood. Kết quả giải đoán đã được đánh giá, độ chính xác giải đoán tổng thể biến động từ 82-88% và hệ số Kappa biến động từ 0,8-0,87 trong các năm nghiên cứu. Qua thống kê kết quả giải đoán ảnh viễn thám Landsat LC8, diện tích trồng cây cao su tại huyện Bố Trạch, tỉnh Quảng Bình bị thiệt hại đáng kể do ảnh hưởng của bão số 10 năm 2013, hơn 1.500 ha bị thiệt hại. Tuy nhiên, mỗi năm diện tích cây sao su được khôi phục lại và trồng mới tại huyện Bố Trạch, do đó sau bão số 10 năm 2013, diện tích cây cao su tăng lên đáng kể từ năm 2014-2019, hơn 2.500 ha. ABSTRACT This study used Landsat LC8 satellite images of 2013, 2014, and 2019 to interpret the classification of rubber tree landcover in Bo Trach district, Quang Binh province and evaluate changes in rubber area after the impact of storms number 10 (named Wutip) in 2013. The results of interpretation were also used to assess the damage of rubber plantations due to the impact of typhoon number 10 in 2013 and changes in rubber plantation area in the period of 2013- 2019. Data from field surveys, interviews with local staff, secondary report data, and documents of conference on rubber tree development in Quang Binh was collected to support analysis and interpretation. This study combined the object-oriented image analysis method combined with the Maximum Likelihood algorithm. The interpretation results were evaluated, the overall interpretation overall accuracy varied from 82-88% and the Kappa coefficient varied from 0.8-0.87 in the studied years. Through the statistical interpretation results of the Landsat LC8 detective, the rubber plantation area in Bo Trach district, Quang Binh province was significantly damaged due to the impact of typhoon number 10 in 2013, over 1500 hectares were damaged. However, each year, the area of ​​​​the rubber tree is restored and newly replanted in Bo Trach district, so after the typhoon number 10 in 2013, the area of ​​rubber trees increased significantly from 2014-2019, over 2,500 ha.

Community Engagement for Malaria Elimination in the Greater Mekong Subregion: a Qualitative Study Among Malaria Researchers and Policymakers

IntroductionCommunity engagement has increasingly received attention in malaria research and program interventions, particularly as countries approach closer to malaria elimination. Although strategies and aspects of community engagement are constantly developing, little is known about how those who implement research or programs view community engagement. This article explores the perspectives of researchers and policy makers in the Greater Mekong Subregion (GMS) on community engagement for malaria control and elimination. MethodsSemi-structured interviews were conducted among 17 policymakers and 15 senior researchers working in the field of malaria. All interviews were audio-recorded and transcribed in English. Transcribed data were analyzed using deductive and inductive approach in QSR NVivo. Themes and sub-themes were generated. ResultsResearchers and policymakers emphasized the importance of community engagement in promoting participation in malaria research and interventions. Building trust with the community was seen as crucial. Respondents emphasized involving authority/leadership structures and highlighted the need for intense and participatory engagement. Geographic remoteness, social, cultural, and linguistic diversity were identified as barriers to meaningful engagement. Local staff were described as an essential ‘connect’ between researchers or policy makers and prospective participants. Sharing information with community members, using various strategies such as visualization of message including creative and participatory methods were highlighted. ConclusionsAs malaria continues to decline across the GMS, countries have set elimination goals. In this context, policy makers and researchers involved in malaria prevention and control in the region viewed community engagement as crucial for promoting participation in research or programmatic interventions. Given the difficulties of the “last mile” to elimination, sustained investment in community engagement is needed in isolated areas of the GMS where malaria transmission continues.

Senators at Home: Local Attentiveness and Policy Representation in Congress

Is local attention a substitute for policy representation? Fenno (1978) famously described how legislators develop personal ties with their constituents through periodic visits to their districts and carefully crafted communications. Existing work suggests that such interactions insulate incumbents electorally, creating less need to represent constituents’ policy preferences. Surprisingly, this important argument has never been tested systematically. In this paper, I use data on senator travel and staffing behavior along with survey data from the 2011–2018 Cooperative Congressional Election Study to investigate this claim. In addition to showing that areas with important campaign donors are significantly more likely to receive resources, I find that local visits may decrease approval among ideologically opposed constituents. Furthermore, I find inconsistent evidence regarding the effectiveness of local staff. These results suggest that local attention does not always cultivate goodwill in the district. Under polarized politics, home style does not effectively substitute for policy representation.

The role of tacit knowledge on service quality – An applied Study on the Faisal Islamic Bank of Sudan –: أثر المعرفة الضمنية في جودة الخدمة – دراسة تطبيقية على بنك فيصل الإسلامي السوداني –

Knowledge has already been highlighted as the most crucial component for the organization and competitiveness of banking institutions. However, the role of tacit knowledge on service quality remains unclear. The purpose of this study was to understand the role of tacit knowledge dimensions including qualification, training, experience, and intuition on the quality services of Faisal Islamic Bank of Sudan. The study population consisted of various levels of employees and administrative staff. The information was collected through a questionnaire as a study tool depending on purposive sampling and descriptive-analytical method. The results showed that the bank is using knowledge dimensions to improve banking service, however, there was no variation on knowledge application among the respondents, although, the combination of tacit knowledge dimensions showed a significant impact on the quality of banking service. This finding suggests the adoption of tacit knowledge to improve the quality of service at the bank. Further, the temporary engagement of foreign experts would be a better choice for the capacity building of local staff and improvement of banking services. Further study to investigate the role of tacit knowledge on innovation management of banking services in Sudanese banks is recommended.

Antenatal Doppler ultrasound implementation in a rural sub-Saharan African setting: exploring the perspectives of women and healthcare providers

Background The World Health Organization recommends research to evaluate the effects of a single third trimester Doppler ultrasound examination on preventable deaths in unselected-risk pregnancies, particularly in low- and middle-income countries (LMICs) where the evidence base is scarce. While evaluating such technologies, researchers often ignore women and health care provider perspectives. This study explored the views and experiences of women and healthcare providers regarding the use of advanced ultrasound technology to optimize the health of mothers and their babies in a rural community in mid-western Uganda. Methods We enrolled 53 mothers and 10 healthcare providers, and captured data on their perceptions, barriers, and facilitators to the use of Doppler ultrasound technology using focus group discussions, semi-structured interviews and observations. Using qualitative content analysis, we inductively coded the transcripts in ATLAS.ti 8.0, detecting emerging themes. Results Women were afraid that ultrasound would harm them or their fetuses and many of them had never seen an ultrasound scan. The majority of the women found their partners supportive to attend antenatal care and use ultrasound services. Healthcare providers in Kagadi Hospital were unfamiliar with Doppler technology and using it to guide clinical decisions. Other barriers to the implementation of Doppler ultrasound included shortage of trained local staff, insufficient equipment, long distance to and from the hospital, and frequent power cuts. Conclusions We found limited exposure to Doppler ultrasound technology among women and healthcare providers in mid-western Uganda. Engaging male partners may potentially influence the likelihood of accepting and using it to improve the health of women and their fetuses while wide spread myths and misconceptions about it may be changed by community engagement. Healthcare workers experienced difficulties in offering follow-up care to mothers detected with complications and Doppler ultrasound required a high level of training. While introducing advanced ultrasound machines to weak health systems, it is important to adequately train healthcare providers to avoid inappropriate interventions based on misinterpretation of the findings, consider where it is likely to be most beneficial, and embed it with realistic clinical practice guidelines.