Search results for: rural hospitals

Authors: Desta Brhanu Gebrehiwot

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The purpose of this review was to analyze the overall or combined effect of scholarly studies conducted on the impacts of Food for work (FFW) and Productive Safety Net Program (PSNP) on farm households’ livelihood (agricultural investment on the adoption of fertilizer, food security, livestock holding, nutrition and its’ disincentive effect) in Ethiopia. In addition, to make a critical assessment of the internal and external validity of the existing studies, the review also indicates the possibility to redesign the program. The method of selecting eligible studies for review was PICOS (Participants, Intervention, Comparison, Outcomes, and Settings) framework. The method of analysis was the fixed effects model under Meta-Analysis. The findings of this systematic review confirm the overall or combined positive significant impact of PSNP on fertilizer adoption (combined point estimate=0.015, standard error=0.005, variance=0.000, lower limit 0.004 up to the upper limit=0.026, z-value=2.726, and p-value=0.006). And the program had a significant positive impact on the child nutrition of rural households and had no significant disincentive effect. However, the program had no significant impact on livestock holdings. Thus, PSNP is important for households whose livelihood depends on rain-fed agriculture and are exposed to rainfall shocks. Thus, better to integrate the program into the national agricultural policy. In addition, most of the studies suggested that PSNP needs more attention to the design and targeting issued in order to be effective and efficient in social protection.

Keywords: meta-analysis, fixed effect model, PSNP, rural-livelihood, Ethiopia

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Authors: Antwi Kwaku Dei, Lyford Conrad Power

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This paper investigates the outcome of participating in the government of Ghana block farm program on rural households’ farm productivity, income, food security and nutritional status in Northern Ghana using cross-sectional data. Data analysis was done using the Instrumental Variable and the Heckman Selection Bias procedures. Our analysis indicates that participation in the block farm program significantly increased directly the productivity of maize, rice, and soybean by 21.3 percent, 15.8 percent, and 12.3 percent respectively. Also, the program participation was found to increase households’ farm income by 20 percent in northern Ghana. Furthermore, program participation was found to improve household food security and nutrition by 19 percent and 14 percent respectively through income effect. Based on the benefit-cost ratio of 1.59 the results from the study recommends that the program is expanded to other communities in the northern region. Further analysis indicates that rural households’ decision to participate in food security intervention programs is significantly influenced by factors including the gender of the household head, the age of the household head, and household size. Results of the study further show that gender of household head, household size, household monthly income, household assets, women educational status, the age of women, marital status of women, are significant determinants of food security and nutrition status in Northern Ghana.

Keywords: block farm program, farm productivity, , household food security, Northern Ghana

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Authors: Anju Batta Sehgal

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Climate change is a major challenge in terms of agriculture, food security and rural livelihood for thousands of people especially the poor in Himachal, which falls in North-Western Himalayas. Agriculture contributes over 45 per cent to net state domestic product. It is the main source of income and employment. Over 93 per cent of population is dependent on agriculture which provides direct employment to 71 percent of its people. Area of operation holding is about 9,79 lakh hectares owned by 9.14 lakh farmers. About 80 per cent area is rain-fed and farmers depend on weather gods for rains. Region is a home of diverse ethnic communities having enormous socio-economic and cultural diversities, gifted with range of farming systems and rich resource wealth, including biodiversity, hot spots and ecosystems sustaining millions of people living in the region. But growing demands of ecosystem goods and services are posing threats to natural resources. Climate change is already making adverse impact on the indigenous people. The rural populace is directly dependent for all its food, shelter and other needs on the climate. Our aim should be to shift the focus to indigenous people as primary actors in terms of global climate change monitoring, adaptations and innovations. Objective of this paper is to identify the climate change related threats and vulnerabilities associated with agriculture as a sector and agriculture as people’s livelihood. Broadly it analyses the connections between the nature and rural consumers the ethnic groups.

Keywords: climate change, agriculture, indigenous people, Himachal Pradesh

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Authors: William Coburn, Dylan Hauchard, Amel Naouali

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Background: The nature of the HIV epidemic in Puerto Rico (PR) is less understood than in the continental U.S. There is evidence to suggest that there are differences in health care access based on geographical location, such that rural areas are less underserved and have less immediate access to HIV prevention resources. Methods: The current study consists of a cross-sectional online survey of self-reporting HIV-negative sexual minority men (SMM) residing in PR. Results: In this sample, there were no differences between urban and rural-based services for SMM. However, more than half of the sample reported that they have never disclosed their gender identity and sexual practices to a physician. Conclusion: HIV is a significant public health concern affecting Latinos/Hispanics in the U.S. Findings in this paper can have implications for HIV prevention services in PR specifically, as few studies have directly focused on the impact of HIV and health care services in PR outside of the continental U.S.

Keywords: HIV, Puerto Rico, infectious diseases , public health

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Authors: Khader A. Almhdawi, Hassan Alrabbaie

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Background: Musculoskeletal disorders (MSDs) represent a significant challenge for registered nurses. To our best knowledge, there is no published study that investigated the prevalence of MSDs among nurses and their associated factors comprehensively in Jordan. This study aimed to find the prevalence of MSDs, their possible predictors among registered nurses in Jordanian hospitals. Methods: A cross-sectional design was used. Outcome measures included Nordic Musculoskeletal Questioner (NMQ), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), IPAQ, and sociodemographic data. Prevalence of musculoskeletal complaints was reported using descriptive analysis. Logistic regression analyses were conducted to identify predictors of MSDs. Results: 597 nurses from different hospitals in Jordan participated in this study. Reported MSDs prevalence was the highest at neck (61.1%), followed by upper back (47.2%), shoulder (46.7%), wrist and hands (27.3%), and elbow (13.9%). Significant predictors of MSDs among Jordanian nurses included: being a female, poor sleep quality, high physical activity levels, poor ergonomics, increased workload, and mental stress. Conclusion: This study showed a high prevalence of MSDs among Jordanian nurses and identified their significant predictors. Future studies are needed to investigate the progressive nature of MSDs and their effective treatment strategies.

Keywords: musculoskeletal disorders, nursing, ergonomic, occupational stress

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Authors: Forhana Rahman Noor, Shafia Jannat Khanam

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A girl’s schooling is disrupted by the very act of marriage which requires her to move away from home and her school area to live with her husband’s family, according to custom and practice. Once in her new home, her husband or her in-laws decide her continuation of schooling. A plethora of research has confirmed the inter-relationship between education and age at marriage of girls. The primary data was collected from both urban and rural area in Bangladesh. The study revealed that mean age at marriage for girls was 15.69 years, as a whole and it was lower (15.21 years) in the rural area than that of the urban area (17.13 years). These readings confirm early marriage still exists. The most important determinant of age at marriage was found as low education level of the girls. The bi-variate analysis of this study discovered the relationship or association between education and age at marriage. The study also found the education level of husbands of girls has a significant effect on age at marriage of a girl.

Keywords: education, girl, age at marriage, correlate, Bangladesh

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Authors: Kibret Berhanu Getinet

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Off-farm income diversification by farm rural households has gained the attention of researchers and policymakers due to the fact that agriculture failed to meet the needs of people in developing countries like Ethiopia. The objective of this study was to investigate income diversification strategies into off-farm activities among rural households in Hawassa Zuria Woreda, Sidama National Regional State, Ethiopia. The study used primary and secondary data sources for the primary data collection questionnaire employed as a data collection instrument. A multistage sampling technique was used to collect data from a total of 197 sample households from four kebeles of the study area. Descriptive statistics, as well as econometrics methods of data analysis, were employed. The descriptive statistics result indicates that the majority of sample rural households (68.53 %) have engaged in off-farm income diversification activities while the remaining 31.47% of households did not participate in the diversification in the study area. The choice of participants among the strategies indicates that 6.60% of respondents participated in off-farm wage employment, 30.46% participated in off-farm self-employment, and about 31.47% of them participated in both off-farm wage employment. The study revealed that the share of off-farm income in total annual earnings of households was about 48.457%, and thus, the off-farm diversification significantly contributes to the rural household income. Moreover, binary and multinomial logistic regression models were employed to identify factors that affect the participation and the choices of the off-farm income diversification strategies, respectively. The binary logit model result indicated that agro-ecological zone, education status of the households, available technical skills of the household, household saving, total livestock owned by the households, access to electricity, road access and being married of household head were significant and positively affected the chance of diversification in off-farm activities while the on-farm income of households is negatively affected the chance of diversification. Similarly, the multinomial logistic regression model estimate revealed that agroecological zone, on-farm income, available technical skills, household savings, and access to electricity are positively related and significantly influenced the household’s choice of employment into off-farm wage employment. The off-farm self-employment diversification choice is significantly influenced by on-farm income, available technical skills, household savings, total livestock owned, and access to electricity. Moreover, the result showed that the factors that affect the choice of farm households to engage in both off-farm wage and self-employment are ecological zone, education status, on-farm income, available technical skills, household own saving, market access, total livestock owned, access to electricity and road access. Thus, due attention should be given to addressing the demographic, socio-economic, and institutional constraints to strengthen off-farm income diversification strategies to improve the income of rural households.

Keywords: off-farm, incoem, diversification, logit model

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Authors: Betty Kibirige

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Students entering the University of Zululand (UNIZULU) Science Faculty mostly come with skills that allow them to prepare for exams and pass them in order to satisfy requirements for entry into a tertiary Institution. Some students hail from deep rural schools with limited facilities, while others come from well-resourced schools. Personal experience has shown that it may take a student the whole time at a tertiary institution following the same skills as those acquired in high school as a sure means of entering the next level in their development, namely a postgraduate program. While it is apparent that at this point in human history, it is totally impossible to teach all the possible content in any one subject, many academics approach teaching and learning from the traditional point of view. It therefore became apparent to explore ways of developing a graduate that will be able to approach life with skills that allows them to navigate knowledge by applying conceptual and critical thinking skills. Recently, the Science Faculty at the University of Zululand introduced two Engineering programs. In an endeavour to approach the development of the Engineering graduate in this institution to be able to tackle problem-solving in the present-day excessive information availability, it became necessary to study and review approaches used by various academics in order to settle for a possible best approach to the challenge at hand. This paper focuses on the development of a deep rural child in a graduate with conceptual and critical thinking skills as major attributes possessed upon graduation. For this purpose, various approaches were studied. A combination of these approaches was repackaged to form an approach that may appear novel to UNIZULU and the rural child, especially for the Engineering discipline. The approach was checked by offering quiz questions to students participating in an engineering module, observing test scores in the targeted module and make comparative studies. Test results are discussed in the article. It was concluded that students’ graduate attributes could be tailored subconsciously to indeed include conceptual and critical thinking skills, but through more than one approach depending mainly on the student's high school background.

Keywords: graduate attributes, conceptual skills, critical thinking skills, traditional approach

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Authors: Fahad Alam

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Work stress directly affects job performance, specifically in a worse environment. Consequently, a social provision plays a crucial part for enhancement. Therefore, the current research investigates the direct and moderating effect between religious activities, sustainability and peer support on job performance at hospitals in Khyber PakhtunKhwa (KPK), Pakistan. Both primary and secondary data are collected through 261 questionnaires of medical employees from four district hospitals in Khyber PakhtunKhwa, Pakistan, in 2018. The analysis was carried out by SPSS16 and SMART PLS3, to test the direct effect of religious activities, sustainability and social support on job performance and the effect of moderating variable 'work environment' on job performance. The finding confirmed that direct and moderating variables play a significant positive effect among religious activities, sustainability and peer support on job performance, the variables help to diminish the strain level or the stress level, consequently helps in the job completed. Affirmative social approaches produce desirable effects on job performance. The research revealed that social provisions are significant triggers for superior practices. Moreover, the results are stimulating because some of the past literature revealed an insignificant correlation between social provision and performance. This study found that there is a significant relationship which persuades health care organizations.

Keywords: job performance, peer’s support, religious activities, sustainability, work environment

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Authors: Izani Uzair Zubair, Mohd Ismail Ibrahim, Mohd Nazri Shafei, Hassan Merican Omar Naina Merican, Mohamad Sabri Othman, Mohd Izmi Ahmad Ibrahim, Rasilah Ramli, Rajpal Singh Karam Singh

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Nurses experience a higher prevalence of low back pain (LBP) and musculoskeletal complaints as compared to other hospital workers. Due to no proper policy related to LBP, the job has exposed them to the problem. Thus, the current study aims to look at the intensity of the problem and factors associated with development of LBP. Method and Tools: A cross sectional study was carried out among 1292 nurses from six public hospitals in Penang. They were randomly selected and those who were pregnant and have been diagnosed to have LBP were excluded. A Malay validated BACK Questionnaire was used. The associated factors were determined by using multiple logistic regression from SPSS version 20.0. Result: Most of the respondents were at mean age 30 years old and had mean working experience 86 months. The prevalence of LBP was identified as 76% (95% CI 74, 82). Factors that were associated with LBP among nurses include lifting a heavy object (OR2.626 (95% CI 1.978, 3.486) p =0.001 and the estimation weight of the lifted object (OR1.443 (95% CI 1.056, 1.970) p =0.021. Conclusion: Nurses who practice lifting heavy object and weight of the object lifted give a significant contribution to the development of LBP. The prevalence of the problem is significantly high. Thus, a proper no weight lifting policy should be considered.

Keywords: low back pain, nurses, Penang public hospital, Penang

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Authors: Vidya Yadav

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Migration is the demographic process that links rural to urban areas, generating or spurring the growth of cities. Evidence shows the role of the city as a production processes. It looks the city as a power of centre, and a centre of change. It has been observed that not only the professionals want to settle down in an urban area but rural labourers are also coming to cities for employment. These are the people who are compelled to migrate to metropolises because of lack of employment opportunities in their place of residence. However, the cities also fail to provide adequate employment because of limited job opportunity creation and capital-intensive industrialization. So these masses of incoming migrants are force to take up whatever employment absorption is available to them particularly in urban informal activities. Ultimately with this informal job they are compelled to stay in the slum areas, which is another form of deprived housing colonies. The paper seeks to examine the evidences of poverty induced migration from rural to urban areas (particularly in urban agglomeration). The present paper utilizes an abundant rich source of census migration data (D-Series) of 1991-2001. Result shows that Mumbai remain as the most attractive place to migrate. The migrants are mainly from the major states like Uttar Pradesh, Bihar, West Bengal, Jharkhand, Odisha, and Rajasthan. Male dominated migration is related mostly for employment and females due to marriages. The picture of occupational absorption of migrants who moved for employment, cross classified with educational status. Result shows that illiterate males are primarily engaged in low grade production processing work. Illiterate’s females engaged in service sectors; but these are actually very low grade services in urban informal sectors in India like maid servants, domestic help, hawkers, vendors or vegetables sellers. Among the higher educational level, a small percentage of males and females got absorbed in professional or clerical work but the percentage has been increased in the period 1991-2001.

Keywords: informal, job, migration, urban

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Authors: Sibusiso Buthelezi, Rugira Regis Marie-Modeste, Deliwe Rene Phetlhu

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Introduction: Mother-to-child transmission persists owing to inadequate implementation of prevention of mother-to-child transmission programmes, particularly in rural areas. To achieve a target of zero new HIV infection in children born from women living with HIV, the involvement of mothers and caregivers is undeniable. Therefore, there is a need to explore the views of the mothers because of the role they play in their own right when it comes to preventing their children from contracting HIV by consistently adhering to the guidelines of the prevention of mother-to-child transmission programme. Thus, this study sought to explore and describe the perceptions of mothers on their role in the prevention of HIV to their children exposed to HIV and further explore their perceptions of the childcare received in the healthcare facility. Methods: The study was conducted in November-December 2019 in Ngaka Modiri Molema in North West Province in South Africa. A qualitative exploratory, descriptive research design was used. Purposive sampling was used to select the mothers of children exposed to HIV during the mother`s clinic attendance. Data collection was done through semi-structured individual interviews with mothers of children exposed to HIV. Colaizzi`s method of data analysis was used to analyse data in this study. Results: Seven themes emerged from data analysis, namely: health benefits from coming to the healthcare facility, communication, information needs, attitude of healthcare workers, healthcare administration system, the role of a mother, and disclosure of HIV status. Conclusion: This study revealed systematic gaps that exist in the programme, which hinder the childcare services of children exposed to HIV and socio-economically related hindrances. Mothers’ roles, such as exclusive breastfeeding, taking their own medication, and child follow-up visits, remain inadequate. The study findings show that there is a need to develop a contextual-tailored intervention strategy that would improve the implementation of prevention of mother-to-child transmission in rural areas.

Keywords: children exposed to HIV, mothers’ role to prevent MTCT, mothers’ perceptions on childcare, PMTCT in rural areas

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Authors: Luojie Tang, Libin Ouyang, Yihang Gao

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The natural landscape and urban-rural structure, with their attractiveness in the Dali area around Erhai Lake, exhibit striking similarities with Howard's Garden City. With the emergence of the unique phenomenon of the first large-scale gathering of digital nomads in China in Dali, an analysis of Dali's natural, economic, and cultural representations and structures reveals that the Garden City model can no longer fully explain the current overall human living environment in Dali. By interpreting the bottom-up local construction process in Dali based on landscape identity, the transformation of production and lifestyle under new technologies such as ICT(Information and Communication Technology), and the values and lifestyle reshaping embodied in the "reverse urbanization" phenomenon of the middle class in Dali, it is believed that Dali has moved towards a "contemporary garden city influenced by new technology." The article summarizes the characteristics and connotations of this Garden City and provides corresponding strategies for its continued healthy development.

Keywords: dali, ICT, rural-urban relationship, garden city model

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Authors: Chiao-Wen Lan, David Gere

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Background and Significance: Performance has a rich history of imparting information and encouraging reflection, yet there is a paucity of literature on applying performance as a method of analysis and not as a medium for health education. This study aimed to apply ethnodrama strategies to the issue of HIV-related stigma in rural China and to use a critical performance as a vehicle for communication of health research. Methods: The program, titled 'STOP STIGMA,' included dance, narratives and original quotes from people living with HIV/AIDS in China, and spectacle such as photographs, set, and props corresponding to the history of HIV in rural China. Results: The performance represented a step away from a completely textual interpretation of data towards a theatrical style that begins to privilege what arts-based research scholars Rossiter and colleagues have termed 'an embodied, theatrical representation of data.' It offered an opportunity to deliver individual and collective stories that represent how HIV-positive people experience living with HIV/AIDS in China, which could play an integral part in the formulation of actions to effect change. Discussion: This method of communicating health research has implications for fostering dialogue among researchers, community members, and medical practitioners. Although arts-based approaches are not new to the scientific community, the integration of dance, video, ethnodrama, and sciences provides opportunities to innovate in non-traditional research dissemination and communication.

Keywords: health communication, HIV/AIDS, stigma, vulnerable populations

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Authors: Rasha Shoumar

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Background: Since the onset of the Syria crisis in 2011, Jordan has hosted many Syrian refugees, many of which are residing in urban and rural areas. Vulnerability of refugees has increased due to the COVID-19 pandemic, adding to their already existing challenge in access to medical services, rendering them vulnerable to the complications of untreated medical conditions and amplifying their risk for severe COVID-19 disease. To improve health outcomes and access to health care services in a COVID-19 context, IOM (The International Organization for Migration) provided health services including awareness raising, direct primary health care through mobile teams and referrals to secondary services were extended to the vulnerable populations of refugees. Method: 6 community health volunteers were trained and deployed to different governorates to provide COVID-19 and non-communicable disease awareness and collect data rated to non-communicable disease and access to medical health services. Primary health care services were extended to 7 governorates through a mobile medical team, providing medical management. The collected Data was reviewed and analyzed. Results: 2150 refugees in rural areas were reached out by community health volunteers, out of which 78 received their medications through the Ministry of Health, 121 received their medications through different non-governmental organizations, 665 patients couldn’t afford buying any medications, 1286 patients were occasionally buying their medications when they were able to afford it. 853 patients received medications and follow up through IOM mobile clinics, the most common conditions were hypertension, diabetes, hyperlipidemia, anemia, heart disease, thyroid disease, asthma, seizures, and psychiatric conditions. 709 of these patients had more than 3 of the comorbidities. Multiple cases were referred for secondary and tertiary lifesaving interventions. Conclusion: Non communicable diseases are highly prevalent among refugee population in Jordan, access to medical services have proven to be a challenge in rural areas especially during the COVID-19 era, many of the patients have multiple uncontrolled medical conditions placing them at risk for complications and risk for severe COVID-19 disease. Deployment of mobile clinics to rural areas plays an essential role in managing such medical conditions, thus improving the continuum of health care approach, physical and mental wellbeing of refugees and reducing the risk for severe COVID-19 disease among this group, taking us one step forward toward universal health access.

Keywords: COVID-19, refugees, mobile clinics, primary health care

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Authors: A. R. Shokoohi, E. A. M. Bulder, C. Th. van Alphen, D. F. den Hertog, E. J. Hin

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The Northern region of the Netherlands has beautiful landscapes, a nice diversity of green and blue areas, and dispersed settlements. However, some recent population changes can become threats to health and wellbeing in these areas. The rural areas in the three northern provinces -Groningen, Friesland, and Drenthe, see youngsters leave the region for which reason they are aging faster than other regions in the Netherlands. As a result, some villages have faced major population decline that is leading to loss of facilities/amenities and a decrease in accessibility and social cohesion. Those who still live in these villages are relatively old, low educated and have low-income. To develop a deeper understanding of the health status of the people living in these areas, and help them to improve their living environment, the GO!-Method is being applied in this study. This method has been developed by the National Institute for Public Health and the Environment (RIVM) of the Netherlands and is inspired by the broad definition of health by Machteld Huber: the ability to adapt and direct control, in terms of the physical, emotional and social challenges of life, while paying extra attention to vulnerable groups. A healthy living environment is defined as an environment that residents find it pleasant and encourages and supports healthy behavior. The GO!-method integrates six domains that constitute a healthy living environment: health and lifestyle, facilities and development, safety and hygiene, social cohesion and active citizens, green areas, and air and noise pollution. First of all, this method will identify opportunities for a healthier living environment using existing information and perceptions of residents and other local stakeholders in order to strengthen social participation and quality of life in these rural areas. Second, this approach will connect identified opportunities with available and effective evidence-based interventions in order to develop an action plan from the residents and local authorities perspective which will help them to design their municipalities healthier and more resilient. This method is being used for the first time in rural areas to our best knowledge, in close collaboration with the residents and local authorities of the three provinces to create a sustainable process and stimulate social participation. Our paper will present the outcomes of the first phase of this project in collaboration with the municipality of Westerkwartier, located in the northwest of the province of Groningen. And will describe the current situation, and identify local assets, opportunities, and policies relating to healthier environment; as well as needs and challenges to achieve goals. The preliminary results show that rural demographic changes in the northern Netherlands have negative impacts on service provisions and social cohesion, and there is a need to understand this complicated situation and improve the quality of life in those areas.

Keywords: population decline, rural areas, healthy environment, Netherlands

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Authors: Pankaj Kumar Kalita

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Ineffectiveness of formal institutional mechanisms such as official audit to improve public service delivery has been a serious concern to scholars working on governance reforms in developing countries. Scholars argue that public service delivery in local self-governing institutions can be improved through application of informal mechanisms such as social accountability. Social accountability has been reinforced with the engagement of citizens and civic organizations in the process of service delivery to reduce the governance gap in developing countries. However, there are challenges that may impede the scope of establishing social accountability initiatives in the performance of local self-governing institutions. This study makes an attempt to investigate the factors that may impede the scope of establishing social accountability, particularly in culturally heterogeneous societies like India. While analyzing the implementation of two rural development schemes by Panchayats, the local self-governing institutions functioning in rural Assam in India, this study argues that the scope of establishing social accountability in the performance of local self-governing institutions, particularly in culturally heterogeneous societies in developing countries will be impeded by the absence of inter-caste and inter-religion networks. Data has been collected from five selected districts of Assam using in-depth interview method and survey method. The study further contributes to the debates on 'good governance' and citizen-centric approaches in developing countries.

Keywords: citizen engagement, local self-governing institutions, networks, social accountability

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Authors: Teo Hao Jing, Shane Ho Ken Wae, Lee Jin Yu, Burra Venkata Durga Kumar

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Current distributed healthcare systems face the challenge of interoperability of health data. Storing electronic health records (EHR) in local databases causes them to be fragmented. This problem is aggravated as patients visit multiple healthcare providers in their lifetime. Existing solutions are unable to solve this issue and have caused burdens to healthcare specialists and patients alike. Blockchain technology was found to be able to increase the interoperability of health data by implementing digital access rules, enabling uniformed patient identity, and providing data aggregation. Consortium blockchain was found to have high read throughputs, is more trustworthy, more secure against external disruptions and accommodates transactions without fees. Therefore, this paper proposes a blockchain-based model for data management applications. In this model, a consortium blockchain is implemented by using a delegated proof of stake (DPoS) as its consensus mechanism. This blockchain allows collaboration between users from different organizations such as hospitals and medical bureaus. Patients serve as the owner of their information, where users from other parties require authorization from the patient to view their information. Hospitals upload the hash value of patients’ generated data to the blockchain, whereas the encrypted information is stored in a distributed cloud storage.

Keywords: blockchain technology, data management applications, healthcare, interoperability, delegated proof of stake

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Authors: Musa Ogah Ari

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Poverty has engaged the attention of the global community. Both the rich and poor countries are concerned about its prevalence and impacts. This phenomenon is more pervasive among developing countries with the greater challenges manifesting among African countries. In Nigeria people live with very low income, and so decent three-square meals, clothes, shelter and other basic necessities are very difficult to come by for most of the population. Qualitative health facilities are seriously lacking to over 160 million population in the state. Equally lacking are educational and social infrastructures that can be available to the people at affordable rates. Roads linking the interior parts of the state are generally in deplorable conditions, particularly in the rainy season. Safe drinking water is hard to come by as the state is not properly placed and equipped to function in full capacity to serve the interest of the people. The challenges of poverty is definitely enormous for both the national and state governments consequently, debilitating scourge of poverty. As the ruling elites in Nigeria claim to reduce the rising profile of poverty through series of policies and programmes, food production, promotion and funding of co-operatives for agriculture, improvement of infrastructures at the rural areas to guaranteeing employment through skill acquisition, assistance of rural women to break away from poverty and the provision of small scale credit facilities to poor members of the public were abysmally low. It is observed that the poverty alleviation programmes and policies failed because they were by nature, character and implementation pro-elites and anti-masses. None of the programmes or policies engaged the rural poor either in terms of formulation or implementation.

Keywords: the state, poverty, government policies, strategies, social amenities, corruption

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Authors: Mera Ababneh, Sayer Al-Azzam, Karem Alzoubi, Abeer Rababa'h

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Background: Medication errors are among the most common medical errors. Their occurrences result in patient’s mortality, morbidity, and additional healthcare costs. Continuous monitoring and detection is required. Objectives: The aim of this study was to compare medication errors in outpatient’s prescriptions in two different hospitals (paper system vs. electronic system). Methods: This was a cross sectional observational study conducted in two major hospitals; King Abdullah University Hospital (KAUH) and Princess Bassma Teaching Hospital (PBTH) over three months period. Data collection was conducted by two trained pharmacists at each site. During the study period, medication prescriptions and dispensing procedures were screened for medication errors in both participating centers by two trained pharmacist. Results: In the electronic prescription hospital, 2500 prescriptions were screened in which 631 medication errors were detected. Prescription errors were 231 (36.6%), and dispensing errors were 400 (63.4%) of all errors. On the other side, analysis of 2500 prescriptions in paper-based hospital revealed 3714 medication errors, of which 288 (7.8%) were prescription errors, and 3426 (92.2%) were dispensing errors. A significant number of 2496 (67.2%) were inadequately and/or inappropriately labeled. Conclusion: This study provides insight for healthcare policy makers, professionals, and administrators to invest in advanced technology systems, education, and epidemiological surveillance programs to minimize medication errors.

Keywords: medication errors, prescription errors, dispensing errors, electronic prescription, handwritten prescription

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Authors: Thomas Ogilegwu Orohu

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This paper highlights the effect of education on farmers’ productivity in rural Nigeria which includes potential to obtain paid employment or generate income through self-help employment using skills learnt in school. The paper emphasizes that education help farmers’ in agro-processing units in production to reduce post harvest wastage. It highlights the benefits of schooling for farmers’ productivity, particularly in terms of efficiency gains and increased farm productivity. As technological innovation spread more widely within the country, the importance of formal education in farm production ought to become more apparent. Education help farmers to improve attitudes, beliefs and habits that may lead to greater willingness to accept risk, adopts innovation, save investment and generally to embrace productive practices. Finally factors affecting farmers’ education and appropriate recommendation were given with the hope that if resolutely implemented would bring the attainment of desired farm education to farmers to improve farm productivity outputs.

Keywords: benefit, education, effect, productivity

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Authors: Vathsala Kaluarachchi, Oshani Wimalarathna, Charith Vandebona, Gayani Chandrarathna, Lakmal Rupasinghe, Windhya Rankothge

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It is the fundamental function of a monitoring system to allow users to collect and process data. A worldwide threat, the corona outbreak has wreaked havoc in Sri Lanka, and the situation has gotten out of hand. Since the epidemic, the Sri Lankan government has been unable to establish a systematic system for monitoring corona patients and providing emergency care in the event of an outbreak. Most patients have been held at home because of the high number of patients reported in the nation, but they do not yet have access to a functioning medical system. It has resulted in an increase in the number of patients who have been left untreated because of a lack of medical care. The absence of competent medical monitoring is the biggest cause of mortality for many people nowadays, according to our survey. As a result, a smartphone app for analyzing the patient's state and determining whether they should be hospitalized will be developed. Using the data supplied, we are aiming to send an alarm letter or SMS to the hospital once the system recognizes them. Since we know what those patients need and when they need it, we will put up a desktop program at the hospital to monitor their progress. Deep learning, image processing and application development, natural language processing, and blockchain management are some of the components of the research solution. The purpose of this research paper is to introduce a mechanism to connect hospitals and patients even when they are physically apart. Further data security and user-friendliness are enhanced through blockchain and NLP.

Keywords: blockchain, deep learning, NLP, monitoring system

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Authors: Soma Sarkar

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A number of authors have recently argued that there are strong links between ecosystem services and sustainable development, particularly development efforts that aim to reduce rural poverty. We see two distinct routes by which the science of ecosystem services can contribute to both nature conservation and sustainable development. First, a thorough accounting of ecosystem services and a better understanding of how and at what rates ecosystems produce these services can be used to motivate payment for nature conservation. At least part of the generated funds can be used to compensate people who suffer lost economic opportunities to protect these services. For example, if rural poor are asked to take actions that reduce farm productivity to protect and regulate water supply, those farmers could be compensated for the reduced productivity they experience. When the benefits of natural ecosystems are explicitly quantified, those benefits are more valued both by the people who directly interact with the ecosystems and the governmental and other agencies that would have to pay for substitute sources of these services if these ecosystems should become impaired. Appreciating the value of ecosystem services can motivate increased conservation investment to prevent having to pay for substitutes later. This approach could be characterized as a ‘‘government investment’’ approach because the payments will generally come from beneficiaries outside of the local area, and a governmental or other agency is typically responsible for collecting and redistributing the funds. Second, a focus on the conservation of ecosystem services could improve the success of projects that attempt to both conserve nature and improve the welfare of the rural poor by fostering markets for the goods and services that local people produce or extract from ecosystems. These projects could be characterized as more ‘‘community based’’ because the goal is to foster the more organic, or grassroots, development of cottage industries, such as ecotourism, or the production of non-timber forest products, that are enhanced by better protection of local ecosystems. Using this framework, we discuss the factors that may have contributed to failure or success for several projects in the district of Purulia, one of the most backward districts of India and inhabited by indigenous group of people. A large majority of people in this district are dependent on environment based incomes for their sustenance. The erosion of natural resource base owing to poor governance in the district has led to the reductions in the household incomes of these people. The scale of our analysis is local or project level. The plight of poor has little to do with the production functions of ecosystem services. But for rural poor, at the local level, the status of ecosystem services can make a big difference in their daily lives.

Keywords: ecosystem services, governance, rural poor, community based natural resource management

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Authors: Narottam Puri, Bishnu Panigrahi, Narayan Pendse

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Background: Clinical Outcomes are the globally agreed upon, evidence-based measurable changes in health or quality of life resulting from the patient care. Reporting of outcomes and its continuous monitoring provides an opportunity for both assessing and improving the quality of patient care. In 2012, International Consortium Of HealthCare Outcome Measurement (ICHOM) was founded which has defined global Standard Sets for measuring the outcome of various treatments. Method: Monitoring of Clinical Outcomes was identified as a pillar of Fortis’ core value of Patient Centricity. The project was started as an in-house developed Clinical Outcomes Reporting Portal by the Fortis Medical IT team. Standard sets of Outcome measurement developed by ICHOM were used. A pilot was run at Fortis Escorts Heart Institute from Aug’13 – Dec’13.Starting Jan’14, it was implemented across 11 hospitals of the group. The scope was hospital-wide and major clinical specialties: Cardiac Sciences, Orthopedics & Joint Replacement were covered. The internally developed portal had its limitations of report generation and also capturing of Patient related outcomes was restricted. A year later, the company provisioned for an ICHOM Certified Software product which could provide a platform for data capturing and reporting to ensure compliance with all ICHOM requirements. Post a year of the launch of the software; Fortis Healthcare has become the 1st Healthcare Provider in Asia to publish Clinical Outcomes data for the Coronary Artery Disease Standard Set comprising of Coronary Artery Bypass Graft and Percutaneous Coronary Interventions) in the public domain. (Jan 2016). Results: This project has helped in firmly establishing a culture of monitoring and reporting Clinical Outcomes across Fortis Hospitals. Given the diverse nature of the healthcare delivery model at Fortis Network, which comprises of hospitals of varying size and specialty-mix and practically covering the entire span of the country, standardization of data collection and reporting methodology is a huge achievement in itself. 95% case reporting was achieved with more than 90% data completion at the end of Phase 1 (March 2016). Post implementation the group now has one year of data from its own hospitals. This has helped identify the gaps and plan towards ways to bridge them and also establish internal benchmarks for continual improvement. Besides the value created for the group includes: 1. Entire Fortis community has been sensitized on the importance of Clinical Outcomes monitoring for patient centric care. Initial skepticism and cynicism has been countered by effective stakeholder engagement and automation of processes. 2. Measuring quality is the first step in improving quality. Data analysis has helped compare clinical results with best-in-class hospitals and identify improvement opportunities. 3. Clinical fraternity is extremely pleased to be part of this initiative and has taken ownership of the project. Conclusion: Fortis Healthcare is the pioneer in the monitoring of Clinical Outcomes. Implementation of ICHOM standards has helped Fortis Clinical Excellence Program in improving patient engagement and strengthening its commitment to its core value of Patient Centricity. Validation and certification of the Clinical Outcomes data by an ICHOM Certified Supplier adds confidence to its claim of being leaders in this space.

Keywords: clinical outcomes, healthcare delivery, patient centricity, ICHOM

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Authors: Muhammad Imran Nisar, Fyezah Jehan, Tauseef Akhund, Sadia Shakoor, Kanwal Nayani, Furqan Kabir, Asad Ali, Anita Zaidi

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Pneumococcal Vaccine -10 (PCV 10) was included in the Expanded Program of immunization (EPI) in Sindh, Pakistan in February 2013. This study was carried out immediately before the introduction of PCV 10 to establish baseline pneumococcal carriage and prevalent serotypes in naso-pharynx of children 3-11 months of age in an urban and rural community in Sindh, Pakistan. An additional sample of children aged 12 to 59 months was drawn from the urban community. Nasopharyngeal specimens were collected from a random sample of children. Samples were processed in a central laboratory in Karachi. Pneumococci were cultured on 5% Sheep Blood Agar and serotyping was performed using CDC standardized sequential multiplex PCR assay on bacterial colonies. Serotypes were then categorized into vaccine (PCV-10 and PCV-13) type and non-vaccine types. A total of 670 children were enrolled. Carriage rate for pneumococcus based on culture positivity was 74% and 79.5 % in the infant group in Karachi and Matiari respectively. Carriage rate was 78.2% for children aged 12 to 59 months in Karachi. Proportion of PCV 10 serotypes in infants was 38.8% and 33.5% in Karachi and Matiari respectively. In the older age group in Karachi, the proportion was 30.6%. Most common serotypes were 6A, 6B, 23F, 19A and 18C. This survey establishes vaccine and non-vaccine serotype carriage rate in a vaccine-naïve pediatric population among rural and urban communities in Sindh province. Annually planned surveys in the same communities will inform change in carriage rate after the introduction and uptake of PCV 10 in these communities.

Keywords: Naso-Pharyngeal carriage, Pakistan, PCV10, Pneumococcus

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Authors: Marco Magasic

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This article examines how a local newspaper’s closure impacts the way everyday people in a rural Australian town are informed about and engage with political affairs. It draws on a two-month focused ethnographic study in the outback town of Lighting Ridge, New South Wales and explores people’s media-related practices following the closure of the towns’ only newspaper, The Ridge News, in 2015. While social media is considered to have partly filled the news void, there is an increasingly fragmented and less vibrant local public sphere that has led to growing complacency among individuals about political affairs. Local residents highlight a dearth of reliable, credible information and lament the loss of the newspaper and its role in community advocacy and fostering people’s engagement with political institutions, especially local government.

Keywords: public sphere, political participation, local news, democratic deficit

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Authors: Kara Gianina D. Rosas, Jade Emily L. Tong

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This study assesses the vulnerability of households to food price shocks. Using the Philippines as a case study, the researchers aim to understand how such shocks can cause food insecurity in different types of households. This paper measures the impact of actual food price changes during the food crisis of 2006-2009 on poverty in relation to their spatial location. Households are classified as rural or urban and agricultural or non-agricultural. By treating food prices and consumption patterns as heterogeneous, this study differs from conventional poverty analysis as actual prices are used. Merging the Family, Income and Expenditure Survey (FIES) with the Consumer Price Index dataset (CPI), the researchers were able to determine the effects on poverty measures, specifically, headcount index, poverty gap, and poverty severity. The study finds that, without other interventions, food inflation would lead to a significant increase in the number of households that fall below the poverty threshold, except for households whose income is derived from agricultural activities. It also finds that much of the inflation during these years was fueled by the rise in staple food prices. Essentially, this paper aims to broaden the economic perspective of policymakers with regard to the heterogeneity of impacts of inflation through analyzing the deeper microeconomic levels of different subgroups. In hopes of finding a solution to lessen the inequality gap of poverty between the rural and urban poor, this paper aims to aid policymakers in creating projects targeted towards food insecurity.

Keywords: poverty, food inflation, agricultural households, non-agricultural households, net consumption ratio, urban poor, rural poor, head count index, poverty gap, poverty severity

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Authors: Sankhanil Das, Arunava Dasgupta, Keya Mitra

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This paper investigates the relationship between natural ecological systems and modern urban morphology. Over years, ecological conditions represented by natural resources such as natural landforms, systems of water, urban geography and land covers have been a significant driving factor of how settlements have formed, expanded and functioned. These have played a pivotal role in formation of the community character and the cultural identity of the urban spaces, and have steered cultural behavior within these settings. Such cultural behaviors have been instrumental in transforming mere spaces to places with meaning and symbolism. The natural process of city formation is principally founded upon the idea of balance and harmony, mostly in a subconscious manner. Reimaging such processes of natural evolution, this paper systematically builds a development model that generates a balance between environment and development, with specific focus on the Urban-Rural fringe areas in the Temple Town of Puri, in Eastern India. Puri represents a unique cross section of ecological landscape, cultural practices and religious symbolism with a very rich history and a vibrant heritage. While the city centre gets more and more crowded by tourists and pilgrims to accommodate related businesses, the original residents of Puri relocate to move towards the urban peripheral areas for better living conditions, gradually converting agricultural lands into non agricultural uses. This rapid spread into the rural hinterland is devoid of any connection with the rich cultural identity of Puri. These past four decades of ‘development’ has been at the cost of 810 Hectares of ecological Lake systems in the region. Invaluable ecological resources at urban rural edges are often viewed as hindrances to development and conceptualized as taking away from the image of the city. This paper attempts to understand the language of development over years on existing natural resources through topo-analysis and proposes a sustainable approach of development using different planning tools, with ecological resources as the pivotal factor of development.

Keywords: livability, sustainable development, urbanization, urban-rural edge

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Authors: Sujit Kumar

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Historicity of inter-caste relations can be traced in the early stages of evolution of rural community in the Indian society. These have witnessed vicissitudes during long drawn interactions between caste groups. Inter-caste relations evolved in a more organized form in the guise of Jajmani system. This is a system of permanent and hereditary inter-caste relations and gives a kaleidoscopic view of socio-economic relations among various caste groupings. Universality of its prevalence in rural India for centuries is well recognized and documented. But it has been undergoing metamorphic change in some regions and changing at a slower pace in the others during post-independence period. An empirical study was conducted with the objectives to know whether Jajmani system is in vogue in the rural areas and type and intensity of socio-economic ties among different caste categories and to find out the change in inter-caste relations, if any owing to industrialization and modernization. Information was elicited from 225 respondents using interview schedule designed for this purpose. It is discernible that in majority of cases, inter-caste social relations which find better expression on the occasions like marriage, death, birth and festivals etc. among Brahmins and lower castes vis-à-vis other caste categories have grown weak. The data further unearth that economic relations as maintained on the occasions of marriage, sacred thread ceremony, mundan sacrament, birthday, death, yajna, katha, routine hair cut, manufacture and repair of various iron, earthen, wooden and leather articles between members of higher castes (general category) and lower castes (scheduled castes) are moderate but weak in case of Other Backward Classes vis-à-vis all other caste categories. Overwhelming majority of informants believe that decline in hereditary occupations, depreciation of old products and services and their availability from the market being made by industry are main reasons in descending order for change in inter caste relations. Modernization, westernization, industrialization, transportation and communications, growing materialism and consumerism together have brought change in relations among caste groups affecting about a billion population inhabiting rural India.

Keywords: inter-caste, Jajmani, sacrament, Yajna

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Authors: Niranjan Devkota , Ram Kumar Phuya, Durga Lal Shreshta

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This paper estimates cost and benefit of adoption of climate change adaptation options available to the rural rice farmers of Nepal. Adoption of adaptation strategies, intensity of use of adaptation options, identification of labor and non-labor cost and finally per unit cost and benefit analysis of climate change adaptation were made. Multi-stage sampling technique was used to source respondents for the study and used structured questionnaire techniques to collect data from 773 households from seven districts; 3 from Terai and 4 from Hilly region of Nepal. The result revealed that there are 13 major adaptation options rice farmers practice in order to protect themselves from climatic risk. Among the given adaptation options, the first three popular adaptation options practiced by rice farmers are (i) increasing use of chemical fertilizer (60.93%) (ii) use of climate smart verities (49.29%) and (iii) change in nursery date (32.08%). Adaptation cost is obvious, based on that, the first three costly adaptation options are the alternative irrigation practice which incurred average cost of US $69.95 (US$ 1 = 102.84 Nepalese Rupees) followed by a denser plantation of local seeds ($ 20.69) and using climate smart varieties ($ 18.06). 88% farmers practiced more than one adaptation strategies on the same farm with the aim of reducing the effect of extreme climatic conditions. Total cost and revenue revealed that per unit total cost ranges from $28.34 to $32.79 whereas per unit total revenue ranges $33.4 to $49.02. Surprisingly, it is observed that farmers who do not adopt any adaptation options are able to receive highest income from per unit production. As Net Present Value (NPV) is positive and Benefit Cost Ration (BCR) is greater than one for every adaptation options that indicates the available adaptation options are profitable to the rice farmers.

Keywords: climate change, adaptation options, cost benefit analysis, rural rice farmers, Nepal

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