Spatial inequalities in skilled birth attendance in India: a spatial-regional model approach

Background Despite a significant increase in the skilled birth assisted (SBA) deliveries in India, there are huge gaps in availing maternity care services across social gradients - particularly across states and regions. Therefore, this study applies the spatial-regression model to examine the spatial distribution of SBA across districts of India. Furthermore, the study tries to understand the spatially associated population characteristics that influence the low coverage of SBA across districts of India and its regions. Methods The study used national representative cross-sectional survey data obtained from the fourth round of National Family Health Survey, conducted in 2015-16. The effective sample size was 259,469 for the analysis. Moran’s I statistics and bivariate Local Indicator for Spatial Association maps were used to understand spatial dependence and clustering of deliveries conducted by SBA coverage in districts of India. Ordinary least square, spatial lag and spatial error models were used to examine the correlates of deliveries conducted by SBA. Results Moran’s I value for SBA among women was 0.54, which represents a high spatial auto-correlation of deliveries conducted by SBA over 640 districts of India. There were 145 hotspots for deliveries conducted by SBA among women in India, which includes almost the entire southern part of India. The spatial error model revealed that with a 10% increase in exposure to mass media in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Interestingly, also with the 10% increase in the four or more antenatal care (ANC) in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Again, if there was a 10% increase of women with first birth order in a particular district, then the deliveries conducted by SBA significantly increased by 6.1%. If the district experienced an increase of 10% household as female-headed, then the deliveries conducted by SBA significantly increased by 1.4%. Conclusion The present study highlights the important role of ANC visits, mass media exposure, education, female household headship that augment the use of an SBA for delivery. Attention should be given in promoting regular ANC visits and strengthening women’s education.

The Business of Improving Neighborhoods. A Critical Overview of Neighborhood-Based Business Improvement Districts (NBIDs) in Sweden

This article offers an overview of neighbourhood-based BIDs (NBIDs) in Sweden. Swedish NBIDs tend to appear in stigmatized residential areas engaging with pressing sets of urban issues that have been longstanding concern of social policy. Their overarching goal is raising property values in neighborhoods on the edge between urban decline and (re)development potential. Emerging in a neoliberalizing institutional context, NBIDs present themselves as correctives to public-policy failures by promoting property-oriented solutions. The adaptation of the BID model in the Swedish ‘post-welfare’ landscape, however, exhibits, and arguably exacerbates, the shortcomings found in BID elsewhere. Their opaque institutional structure and lack of accountability contribute to curbing democratic influence over local development, thus reinforcing spatial inequalities. We argue that the growing political advocacy for the institutionalization of the BID model in Sweden presents a new milestone in the neoliberalization of urban governance, as private actors are promoted to legitimate co-creators of urban policy.

The equity implications of TOD in Curitiba

In this paper we analyze how socio-spatial inequalities have been shaped by transport and land-use planning in Curitiba (Brazil), a city internationally recognized for its Transit Oriented Development (TOD) planning based on Bus Rapid Transit (BRT). We examine how the spatial organization of the BRT system is associated with the distribution of population densities, socioeconomic groups, and real-estate values and its implications in terms of inequalities of access to employment and health services. The results show that Curitiba's TOD has had limited influence on population densities, but has shaped the concentration of high-income classes and premium real-estate along its main BRT corridors. These effects contribute to the peripheralization of low-income communities with limited accessibility benefits from the transit system. Our findings suggest that Curitiba’s success story should be seen as a cautionary tale about the consequences of TOD planning, which perpetuate the spatial concentration of resources and reinforce inequalities of access to opportunities.

Towards an Intersectional Perspective in Cycling

In recent years, concerns about climate change have elevated cycling on urban policy agendas worldwide. The rapid implementation of temporary cycling infrastructure in cities across the globe during the Covid-19 pandemic has further elevated the importance of cycling in facilitating a green and just recovery. However, if cycling is to be a key part of a green and just recovery for cities, then an intersectional perspective is needed to ensure that cycling can be an equitable and inclusive mode of transport. An intersectional perspective acknowledges that there are multiple systems of oppression, which interact in complex ways to compound inequalities and reinforce certain power dynamics. Structural and spatial inequalities contour urban mobility, as evidenced by well-documented gender, racial and socioeconomic disparities in cycling. This paper provides an overview of gender and other inequalities in urban cycling and makes the case for adopting an intersectional perspective to cycling policies and infrastructures, so that cycling in cities can be more diverse, equitable and inclusive.

The Booming Number of Museums and Their Inequality Changes in China

As the spaces for dialogue between the past and the future, museums are essential to human well-being and social sustainability. Here, we collected data from 328 cities in 31 provinces of mainland China from 1980 to 2019 to investigate the changes in number and spatial inequalities of museums. The results showed that: (1) in mainland China, there were only 137 museums in 1980, and while this increased to 5626 in 2019, China still possessed only four museums per million people; (2) the increasing number of museums lagged behind the growth rate of both the population and economy at both the province and city level; (3) the Gini coefficient of museums per million people was only 0.27 in 2019, indicating relative equality of visiting opportunities among the provinces of China; (4) the Gini coefficients of per capita museums in some provinces were higher than that of the whole nation, with the highest ~0.6 in 2010 and 0.4 in 2017; (5) the economic competitiveness and human well-being of a city were promoted by an increased number of museums. We suggest that the central government of China should increase the number of museums in all provinces, while some provinces should pay more attention to the inequality in the distribution of cultural facilities among cities.

Inclusivity insights: two urban development projects in Johannesburg

Johannesburg, which is South Africa’s largest city and economic center, is still influenced by patterns of inequality of the past. Although spatial transformation has been rapid since 1994, spatial divisions along class lines are still prevalent long after the apartheid era. This is despite the fact that societal values such as inclusivity, spatial justice and equal access to resources have become the core goals of Johannesburg’s spatial and urban development. This is particularly true when addressing housing, public open spaces, transport and social infrastructure embedded in a suitable land-use mix. However, despite the adoption of numerous policies by government, this research indicates that even recent urban development projects such as Fleurhof and Waterfall are falling short in delivering those objectives. Based on a case study analysis, we show that significant dysfunctionalities become evident when evaluating these two projects, despite their meeting relevant indicators of spatial inclusion on paper. Tensions are identified between theoretical approaches and the implementation of societally relevant policy goals. These include inclusivity and spatial justice by mostly privatized provision of housing and services, and deficiencies in public maintenance of infrastructure. The research reveals, that ‘ticking-the-boxes’ behavior on policy and project level does not produce equitable, inclusive neighborhoods and urban spatial patterns, but rather reproduces spatial inequalities of the past. If these policies are to result in real spatial change and improvement in the lives of Johannesburg residents, a more proactive approach by the public sector at different levels will be necessary.

Spatial inequalities of COVID-19 incidence and associated socioeconomic risk factors in Portugal

COVID-19 hit the world in a sudden and uneven way. Scientific community has provided strong evidence about socioeconomic characteristics of the territory associated with the geographical pattern of COVID-19 incidence. Still, the role played by these factors differs between study areas. Geographically Weighted Regression (GWR) models were applied to explore the spatially varying association between age-standardized COVID-19 incidence rate in 2020 and socioeconomic conditions in Portugal, at the municipality level. The spatial context was defined as a function of the number of neighbours; the bandwidth was determined through AIC. Prior, the validity of the GWR was assessed through ordinary least squares models. Border proximity, proportion of overcrowded living quarters, persons employed in manufacturing establishments and persons employed in construction establishments were found to be significant predictors. It was possible to observe that municipalities are affected differently by the same factor, and that this varying influence has identifiable geographical patterns, the role of each analysed factor varies importantly across the country. This study provides useful insights for policymakers for targeted interventions and for proper identification of risk factors.