Factors associated with differential community prevalence of hepatitis E in two sub-counties in Kitgum District in Northern Uganda: A comparative cross-sectional study

Background: Hepatitis E is one of the leading causes of acute viral hepatitis worldwide. During 2009, an epidemic of hepatitis E resulted in 10,437 infections and 167 deaths in Kitgum district.Objective: To investigate factors associated with the differential community prevalence of hepatitis E in two sub-counties in Kitgum District.Methods: We conducted a community survey during the 4th-31st of May 2012 in two Sub Counties in Kitgum District in Northern Uganda. A total of 474 heads of household were recruited using a probability proportional to size through multistage and random sampling methods. Two hundred thirty-four (49.26%) heads of household were from Mucwini, and 241 (50.74%) were from Kitgum Matidi Sub Counties. The questionnaire had an internal validity of Cronbach’s α=0.85. The study was approved by a local IRB. STATA version 10.0 was used for data analysis, and a p-value less than 0.05 was considered significant.Results: The prevalence of hepatitis E was significantly higher in Mucwini Subcountry 97 (41.99%) than in Kitgum Matidi 63 (26.47%); χ2=12.6; p=0.000. Factors associated with differential prevalence were hand washing after latrine use with Adjusted Odds Ratio (AoR)=0.23,95%CI:0.110-0.646; p=0.003; frequency of communal hand washing AoR=0.53,95%CI:0.330-0.860; p=0.01; patients’ handling by health workers AoR=1.91,95%CI:1.410-2.610; p<0.001; frequency of village health meetings held AoR=0.69,95%CI:0.56-0.85; p<0.001 and awareness of the cause of Hepatitis E AoR=1.42, 95%CI:0.710-1.880; p=0.015.Conclusions: Factors associated with the differential community prevalence of hepatitis E in the two communities were poor personal hygiene, poor community practices and a low level of community awareness about the virus. District and health authorities should put in place measures to improve personal and household hygiene and strengthen community health education on hepatitis E.

Hunger and Its Associated Factors in the Western Brazilian Amazon: a Population-based Study

Background Hunger affects millions of people worldwide. In the current pandemic scenario of coronavirus disease 2019 (COVID-19) Brazil experienced an epidemic peak of hunger, amplifying existing prepandemic vulnerabilities, mainly in the North Region of the country. The aim of the present study was to investigate the prevalence of food insecurity and its associated factors in homes with children under five years of age in an urban area of a municipality of the Western Brazilian Amazon. Methods A household survey was conducted with a probabilistic sample of 557 children and their families. Food insecurity (FI) was determined using the Brazilian Food Insecurity Scale. Associations between variables were analysed based on the prevalence ratio (PR) and respective 95% confidence intervals (CI) calculated through multiple Poisson regression analysis. Variables with a P value <0.05 after adjustments were considered significantly associated with the outcome. Results A prevalence of 76.5% (CI: 1.36-2.67) food insecurity was found among the families in the study; 42.9% had moderate (CI: 1.31-2.83) and severe (CI: 1.10-1.83) food insecurity. Moderate and severe FI were associated with low family income (P=0.00), participation in governmental income transfer programs (P=0.01), and heads of household with less than seven years of schooling (P=0.02). Moreover, substantial frequencies of height deficit and being overweight were found among the children. Conclusions The high prevalence of hunger and food insecurity and its associated factors reflects the context of geographic isolation and social exclusion in which these families live, suggesting that a substantial portion of the population under five years of age had experienced episodes of hunger in the 90 days prior to the survey. The prevalence of height deficit and being overweight among the children reveals a scenario of epidemiological/nutritional polarization, requiring the formulation of specific public policies for this population.

Quality of Work Life and Work Process of Assistance Nurses

Background: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. Objective: to analyze the Work Process and QWL of assisting nurses in public health. Methods: Research in a critical paradigm, descriptive, exploratory with a qualitative approach. The population corresponds to Nurses who work in care work. Semi-structured guiding questions were applied and were analyzed with content analysis. Results: seven participants declared female; all Chilean; seven are young adults; six singles; only one has children, and one has a person dependent on her care; six are heads of household, and five receive help with housework. All have a nursing degree, five have a diploma, but none have a postgraduate. Work Process has three subcategories: work object, instrument, organization, and work conditions; the QWL category has six subcategories: definition and perception of QWL, QWL potentiating factors, QWL exhausting factors, QWL improvement strategies, the emotional burden associated with QWL, and Health problems. Conclusions: In this way, the lifestyle built by the assistance in the health area has repercussions on the quality of life and health in general.

Accessibility and development in rural Sarawak. A case study of the Baleh river basin, Kapit District, Sarawak, Malaysia

<p>To what degree does accessibility to markets correlate with levels of development? This is an important question for those living in remote, underdeveloped parts of Southeast Asia during the final phases of de-agrarianisation. My study recounts the experience of rural-based Iban households living in the Baleh river basin of the Kapit District (population of 54,200) within a day or less travel by river to the small market town of Kapit (with a population of 18,000). With no connecting roads to the rest of Sarawak and reliant almost entirely on river transport, the local economy remains underdeveloped and is losing population. My field work among 20 villages in three accessibility zones of the Baleh river basin was undertaken over the three month period of May-July 2014. Structured interviews were conducted with 20 village headmen (tuai rumah), 82 heads of household, and 82 individuals within the households. Data was also systematically collected on 153 other individuals, including both residents and non-resident members of these bilik-families. My conceptual framework draws on von Thünen’s model of agricultural land use in order to generate expectations about the possible effects of market accessibility. While the sale of vegetables and other commodities accords with expected patterns, most rural households are in fact dependent on other, largely non-agricultural sources of income. As a result there has emerged a disjuncture between the nominal and actual residence as those working age family members with residential rights to the bilik undertake paid work well beyond the agricultural margin. Unable to achieve desired standards of living by accessing local markets and services in a division with no cities or roads, the working age members of the bilik sustain their families by dividing their residence between two or more locations in what I call multi-local living. The income of nominally rural households is being increasingly determined by the human capital that individuals now apply to non-agricultural labour markets. This, in turn, is leading to a widening distribution of levels of ‘development’, across individuals, their multi-generational families and their rural communities. Multi-local living is unsustainable beyond the transitional phase of de-agrarianisation and as labour shifts out of agriculture and people move to towns, connections with rural residence are likely to diminish, notwithstanding the cultural ties, and disputes over realising market values of largely untitled land will continue to complicate the transition.</p>

Characterizing multidimensional poverty in Migori County, Kenya and its association with depression

Introduction Narrow, unidimensional measures of poverty often fail to measure true poverty and inadequately capture its drivers. Multidimensional indices of poverty more accurately capture the diversity of poverty. There is little research regarding the association between multidimensional poverty and depression. Methods A cross-sectional survey was administered in five sub-locations in Migori County, Kenya. A total of 4,765 heads of household were surveyed. Multidimensional poverty indices were used to determine the association of poverty with depression using the Patient Health Questionnaire (PHQ-8) depression screening tool. Results Across the geographic areas surveyed, the overall prevalence of household poverty (deprivation headcount) was 19.4%, ranging from a low of 13.6% in Central Kamagambo to a high of 24.6% in North Kamagambo. Overall multidimensional poverty index varied from 0.053 in Central Kamagambo to 0.098 in North Kamagambo. Of the 3,939 participants with depression data available, 481 (12.2%) met the criteria for depression based on a PHQ-8 depression score ≥10. Poverty showed a dose-response association with depression. Conclusions Multidimensional poverty indices can be used to accurately capture poverty in rural Kenya and to characterize differences in poverty across areas. There is a clear association between multidimensional poverty and depressive symptoms, including a dose effect with increasing poverty intensity. This supports the importance of multifaceted poverty policies and interventions to improve wellbeing and reduce depression.

Accessibility and development in rural Sarawak. A case study of the Baleh river basin, Kapit District, Sarawak, Malaysia

<p>To what degree does accessibility to markets correlate with levels of development? This is an important question for those living in remote, underdeveloped parts of Southeast Asia during the final phases of de-agrarianisation. My study recounts the experience of rural-based Iban households living in the Baleh river basin of the Kapit District (population of 54,200) within a day or less travel by river to the small market town of Kapit (with a population of 18,000). With no connecting roads to the rest of Sarawak and reliant almost entirely on river transport, the local economy remains underdeveloped and is losing population. My field work among 20 villages in three accessibility zones of the Baleh river basin was undertaken over the three month period of May-July 2014. Structured interviews were conducted with 20 village headmen (tuai rumah), 82 heads of household, and 82 individuals within the households. Data was also systematically collected on 153 other individuals, including both residents and non-resident members of these bilik-families. My conceptual framework draws on von Thünen’s model of agricultural land use in order to generate expectations about the possible effects of market accessibility. While the sale of vegetables and other commodities accords with expected patterns, most rural households are in fact dependent on other, largely non-agricultural sources of income. As a result there has emerged a disjuncture between the nominal and actual residence as those working age family members with residential rights to the bilik undertake paid work well beyond the agricultural margin. Unable to achieve desired standards of living by accessing local markets and services in a division with no cities or roads, the working age members of the bilik sustain their families by dividing their residence between two or more locations in what I call multi-local living. The income of nominally rural households is being increasingly determined by the human capital that individuals now apply to non-agricultural labour markets. This, in turn, is leading to a widening distribution of levels of ‘development’, across individuals, their multi-generational families and their rural communities. Multi-local living is unsustainable beyond the transitional phase of de-agrarianisation and as labour shifts out of agriculture and people move to towns, connections with rural residence are likely to diminish, notwithstanding the cultural ties, and disputes over realising market values of largely untitled land will continue to complicate the transition.</p>

Geo-hydrological Risk Awareness and Disaster Preparedness in a Mountainous Area of Southern Peru Vulnerable to Disaster

Disaster risk management involves reducing disaster damage to homes, critical infrastructure and the interruption of basic services and developing their resilience. This work analyzes the perception of geohydrological risk by the population living or working in the town of Cuyocuyo (southern Peru), which was affected in previous years by events of landslides, debris flow and floods. In order to analyze the effect of the social perception of geohydrological risk on disaster preparedness in areas under threat from landslides and debris flow, a survey was applied to 65 adult heads of household. The method for estimating results was logit regression. The results show the following: First, the preparation through the acquisition of items necessary to avoid the impact of the disaster is related to indicators of perception of disaster risk and the age of the population. Second, the knowledge and prevention of disaster mitigation significantly depends on indicators of dependency of the place and the affection of the place. Third, the participation of households in trainings and drills to prevent disasters organized by the government depends significantly on the indicators of the perception of probability of the disaster, threat of disaster risk and the identity of the place and Fourth, the modification and reinforcement of the buildings of the settlers depends positively on the dependence of the place.

COVID-19 and heterogeneous vulnerabilities in the Peruvian labor market: implications for social inequalities and for gender gaps

Using quarterly data from the 2020 Peruvian National Household Survey (ENAHO), this paper estimates the differentiated impacts of the COVID-19 pandemic on a set of labor market indicators, such as labor participation, occupational categories, informality, and number of hours worked. The impacts are calculated from an individual perspective (effects on the activities of the heads of household and their spouses, distinguishing them according to sex) and also from a joint strategy perspective among the partners. The results indicate that the intersectionalities of vulnerability considered (rural/urban area, and those contained in the type of households and in the situation of single-parenting or two-parenting of household heads and their spouses) determine that women, who live in rural areas, have children and do not have a partner were the most affected by the global health crisis.

Gender Incidence in the Salary of Informal Workers for the Management of Socioeconomic Strategies

This research examined the problems experienced by women who work in the informal sector of the city of Riobamba due to receiving poor and lower incomes than men. The main objective was to analyze the influence that gender has on wages of women in this sector, to establish strategies that can promote more equitable development. Qualitative and quantitative approaches were used using inductive and deductive methods. Data were collected through a survey and analyzed using the Chi square test. The results showed that women's wages were dependent on their gender, conditioned by a sociocultural environment that has not evolved, especially in the informal sectors made up mostly of rural population. Also, the presence of child labor was evident, and wages could not cover the basic needs of women who identified as heads of household with family responsibilities of between three to five people. The strategy identified to promote equity in the recognition and value of fair work without distinction of gender was based on the following elements: the implementation of inclusion policies and control, training of young women in non-traditional trades, promotion of changes in traditional patterns in households, and policies to combat poverty with a gender focus for sustainable social development. Keywords: gender, equity, salary, strategies, socioeconomic, management. Resumen La investigación plantea la problemática que viven las mujeres que trabajan en el sector informal de la ciudad de Riobamba debido a su condición de género para percibir ingresos deficientes e inferiores a los hombres, el objetivo principal es analizar la incidencia que tiene el género en el salario de las mujeres de este sector para el establecimiento de estrategias que promuevan un desarrollo más equitativo. La metodología investigativa considera estudios analíticos, correlacionales, exploratorios, de campo, un enfoque cuali- cuantitativo, con métodos inductivos y deductivos, usando técnicas como la encuesta, considerado la relación de dependencia a través del Chi cuadrado para la comprobación de la hipótesis, como resultados principales se puede encontrar que la incidencia del género en los salarios de las mujeres es dependiente, condicionado por un ambiente sociocultural que no ha evolucionado sobre todo en los sectores informales conformados en su mayoría por población rural, se evidencia la presencia del trabajo infantil y salarios que no pueden cubrir las necesidades básicas de mujeres que se identifican como jefes de hogar con cargas familiares de entre 3 a 5 personas, se plantea como solución la estrategia para promover la equidad en el reconocimiento y puesta en valor del trabajo equitativo sin distinción de género basada en 5 elementos: la implementación de políticas de inclusión y control, la capacitación de las jóvenes en oficios no tradicionales, promoción de cambios de patrones tradicionales en los hogares, políticas de combate a la pobreza con enfoque de género para un desarrollo social sustentable. Palabras clave: género, equidad, salario, estrategias, socioeconómicas, gestión.