The infrastructural capacity of Ghanaian health facilities to provide safe abortion and post-abortion care: a cross-sectional study

Background Ghana is one of few countries in sub-Saharan Africa with relatively liberal abortion laws, but little is known about the availability and quality of abortion services nationally. The aim of this study was to describe the availability and capacity of health facilities to deliver essential PAC and SAC services in Ghana. Methods We utilized data from a nationally representative survey of Ghanaian health facilities capable of providing post-abortion care (PAC) and/or safe abortion care (SAC) (n = 539). We included 326 facilities that reported providing PAC (57%) or SAC (19%) in the preceding year. We utilized a signal functions approach to evaluate the infrastructural capacity of facilities to provide high quality basic and comprehensive care. We conducted descriptive analysis to estimate the proportion of primary and referral facilities with capacity to provide SAC and PAC and the proportion of SAC and PAC that took place in facilities with greater capacity, and fractional regression to explore factors associated with higher structural capacity for provision. Results Less than 20% of PAC and/or SAC providing facilities met all signal function criteria for basic or comprehensive PAC or for comprehensive SAC. Higher PAC caseloads and staff trained in vacuum aspiration was associated with higher capacity to provide PAC in primary and referral facilities, and private/faith-based ownership and rural location was associated with higher capacity to provide PAC in referral facilities. Primary facilities with a rural location were associated with lower basic SAC capacity. Discussion Overall very few public facilities have the infrastructural capacity to deliver all the signal functions for comprehensive abortion care in Ghana. There is potential to scale-up the delivery of safe abortion care by facilitating service provision all health facilities currently providing postabortion care. Conclusions SAC provision is much lower than PAC provision overall, yet there are persistent gaps in capacity to deliver basic PAC at primary facilities. These results highlight a need for the Ghana Ministry of Health to improve the infrastructural capability of health facilities to provide comprehensive abortion care.

Five years surface ozone behaviour in a semi-rural location at Mohal-Kullu in the north-western Himalaya, India

Surface ozone is one of the most important Green House Gases (GHGs). Five years (2011–2015) measurements of surface ozone (O3) and one of its precursors- oxides of nitrogen (NOx) were carried out at a semi-rural location, Mohal (77.12°E, 31.91°N, 1154 m amsl) in the north-western Indian Himalaya. The concentration of O3, NO, NO2 and NOx was measured maximum 74.6 ± 23.2 ppb in 2013, 27.5 ± 7.5 ppb in 2013, 51.8 ± 13.2 ppb in 2013, and 60.8 ± 13.2 ppb in 2012, respectively. Seasonally, O3 concentration was highest during summer while lowest in monsoon. The O3 concentration shows unimodal peak while its precursors show bimodal peaks. A reasonable decrease in percent change was found in terms of O3 (-13), NO2 (-6), and NOx (-3) due to imposing regulations imposed by local government in compliance with the order of Hon’ble National Green Tribunal (NGT) of the country in 2015. However, NO (9) is increasing due to vehicular activities in the nearby area which is one of the famous tourist spots. Washout effect due to increasing rainfall by 8% might have also affected O3 concentrations. Biomass burning for heating and cooking purposes and forest fire for tender livestock forage and transported gaseous pollutants from the Middle East countries and Indo-Gangetic Plain (IGP) could be major contributors of surface ozone and its precursors. HYSPLIT air-mass back trajectories drawn for external ozone sources showed the maximum air masses reached the study location either with the western desert countries or IGP polluted regions.

Digital literacies: A strategy of pedagogy for English language teaching to technical undergraduates

English language teaching for the engineering students in under-develop colleges of rural location encounters challenges of resources. Even the task of imparting necessary language skills becomes difficult with the help of traditional classrooms. The syllabuses for professional courses are designed to comprehend the language skill to cop-up with the entire degree course and face the placement process towards the end of the course. Hence, the paper would be discussing the solution to the problem of the lack of facilities in teaching language to the professional undergraduates in under-develop colleges. It would also bring out the scope of discovering beyond basic software programs on the computer like Grammarly and Ginger, instead discusses the implication of new literacies in learning a language in the classroom of professional college.

The Fast Lane of Internationalization of Latin American SMEs: A Location-Based Approach

This paper examines how the institutional environment (from a multi-level approach) and the moderating role of innovation networks and rural location explain which mechanism (institutional fostering or escapism) underlies the phenomenon of accelerated internationalization of small and medium-sized enterprises. By analyzing a dataset of 2289 firms from Argentina, Colombia, and Peru, the results suggest that the access of strategic resources and capabilities may either reinforce an institutional fostering or institutional escapism effect. The findings show that institutional fostering is associated with formal institutional voids and rural location, while institutional escapism is associated with local informal institutions, corporate sustainability certifications, and innovation networks. The institutional escapism effect is higher for firms that have social or environmental certifications. Implications for theory and practice are discussed.

Urban–rural differences in overweight and obesity among 25–64 years old Myanmar residents: a cross-sectional, nationwide survey

ObjectivesTo investigate whether urban–rural location and socioeconomic factors (income, education and employment) are associated with body mass index (BMI) and waist–hip ratio (W/H-ratio), and to further explore if the associations between urban–rural location and BMI or W/H-ratio could be mediated through variations in socioeconomic factors.DesignCross-sectional, WHO STEPS survey of non-communicable disease risk factors.SettingUrban and rural areas of Myanmar.ParticipantsA total of 8390 men and women aged 25 to 64 years included during the study period from September to December 2014. Institutionalised people (Buddhist monks and nuns, hospitalised patients) and temporary residents were excluded.ResultsThe prevalence of overweight and obesity was higher in the urban areas and increased with increasing socioeconomic status (SES) score. Mean BMI was higher among urban residents (ß=2.49 kg/m2; 95% CI 2.28 to 2.70; p<0.001), individuals living above poverty line, that is, ≥US$1.9/day (ß=0.74 kg/m2; 95% CI 0.43 to 1.05; p<0.001), and those with high education attainment (ß=1.48 kg/m2; 95% CI 1.13 to 1.82; p<0.001) when adjusting for potential confounders. Similarly, greater W/H-ratio was observed in participants living in an urban area, among those with earnings above poverty line, and among unemployed individuals. The association between urban–rural location and BMI was found to be partially mediated by a composite SES score (9%), income (17%), education (16%) and employment (16%), while the association between urban–rural location and W/H-ratio was found to be partially mediated by income (12%), education (6%) and employment (6%).ConclusionResidents living in urban locations had higher BMI and greater W/H-ratio, partially explained by differences in socioeconomic indicators, indicating that socioeconomic factors should be emphasised in the management of overweight and obesity in the Myanmar population. Furthermore, new national or subnational STEPS surveys should be conducted in Myanmar to observe the disparity in trends of the urban–rural differential.

Libraries in lockdown

Lara Haggerty is Keeper of Books at Scotland’s first free public lending library, the Library of Innerpeffray. A library of national significance, in a very rural location, Innerpeffray is now a museum that relies on volunteers for its day-to-day operation and visitors for income. Lara describes a library in lockdown from a different perspective.

Echoes of the Tragic in the Sacred Landscape of Ancient Salamis: A Geospatial Analysis of Hero Cult

What follows is a geospatial analysis of the sacred landscape of Ancient Salamis, an island polity located in the Saronic Gulf, which has been traditionally identified as the seat of the House of Telamon, from where Ajax the Greater (Αἴας ὁ Τελαμώνιος) reputedly launched his expedition to support the campaign against Troy (Iliad. 2.557). In particular, this analysis focuses on the relationship between two sanctuaries purported to be dedicated to Ajax and possibly coexisting during the late Classical and early Hellenistic periods (Figure 1): the first, the principal Temple of Ajax (ναὸς Αἴαντος) reported by Pausanias (Hell. Per. 1.35.3) to have been located at the Classicalperiod town at the Bay of Ampelakia; and the second, situated at a rural location some 12km away amidst the remains of a Mycenaean citadel at Kanakia and neighboring cult precinct at Pyrgiakoni at the far western side of the island excavated and identified by Yannos Lolos in 2005 (Lolos 2012: 47ff).1 Strong archaeological evidence suggests that this rural location (Figure 2) was the site of chthonic votive practice (ibid.: 49) often associated with hero or ancestor cult during the later Classical and Hellenistic periods and during a time when Athenian affiliation with the island and the figure of Ajax was officially sanctioned as a consequence of the political re-engineering of the Athenian polis under Kleisthenes.