Search results for: rural armed banditry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1939

Search results for: rural armed banditry

1159 Policy Recommendations for Reducing CO2 Emissions in Kenya's Electricity Generation, 2015-2030

Authors: Paul Kipchumba

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Kenya is an East African Country lying at the Equator. It had a population of 46 million in 2015 with an annual growth rate of 2.7%, making a population of at least 65 million in 2030. Kenya’s GDP in 2015 was about 63 billion USD with per capita GDP of about 1400 USD. The rural population is 74%, whereas urban population is 26%. Kenya grapples with not only access to energy but also with energy security. There is direct correlation between economic growth, population growth, and energy consumption. Kenya’s energy composition is at least 74.5% from renewable energy with hydro power and geothermal forming the bulk of it; 68% from wood fuel; 22% from petroleum; 9% from electricity; and 1% from coal and other sources. Wood fuel is used by majority of rural and poor urban population. Electricity is mostly used for lighting. As of March 2015 Kenya had installed electricity capacity of 2295 MW, making a per capital electricity consumption of 0.0499 KW. The overall retail cost of electricity in 2015 was 0.009915 USD/ KWh (KES 19.85/ KWh), for installed capacity over 10MW. The actual demand for electricity in 2015 was 3400 MW and the projected demand in 2030 is 18000 MW. Kenya is working on vision 2030 that aims at making it a prosperous middle income economy and targets 23 GW of generated electricity. However, cost and non-cost factors affect generation and consumption of electricity in Kenya. Kenya does not care more about CO2 emissions than on economic growth. Carbon emissions are most likely to be paid by future costs of carbon emissions and penalties imposed on local generating companies by sheer disregard of international law on C02 emissions and climate change. The study methodology was a simulated application of carbon tax on all carbon emitting sources of electricity generation. It should cost only USD 30/tCO2 tax on all emitting sources of electricity generation to have solar as the only source of electricity generation in Kenya. The country has the best evenly distributed global horizontal irradiation. Solar potential after accounting for technology efficiencies such as 14-16% for solar PV and 15-22% for solar thermal is 143.94 GW. Therefore, the paper recommends adoption of solar power for generating all electricity in Kenya in order to attain zero carbon electricity generation in the country.

Keywords: co2 emissions, cost factors, electricity generation, non-cost factors

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1158 Poverty Alleviation and Agricultural Management Policies in Nasarawa State of Nigeria: Lessons from the Roots and Tuber Crops Expansion for Increased Food Production (1996-2011)

Authors: Yahaya Abdullahi Adadu, Canice Erunke Esidene

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The problems of socio-economic development have been a major challenge bedeviling the Nigerian post-colonial state since her political independence from Britain in October I,1960. Critics have argued that the dilemma of Nigeria’s economic survival started since the early 1970s when the agricultural sector which supposedly was the economic mainstay has been literally substituted with the gains of the oil petro-dollars coming from the foreign exchange earnings. Agriculture therefore, which used to be a major player in terms of human and national upliftment in Nigeria have been given a back seat while oil and gas has taken over the front burner in virtually every aspect of Nigeria’s national life. This study is therefore an exposition of the efforts of the Nasarawa state government in reversing the dangerous trend in which the over reliance on oil wealth has caused to persons, individuals and groups in terms of the prevailing levels of poverty and other attendant vices therein. The study focuses on the management policies of the various regimes in the state since its inception in 1996, with particular reference to the regime types-military and civilian alike in propelling the needed policy change, which could transform the economy in line with international best practices. Particular emphasis will be paid to the BADA-KOSHI agricultural scheme whose interest was to recover the lost glory of rural agriculture through series of roots and tuber expansion, and particularly such crops as yam minissetts, cassava, sweet potatoes and coco-yam, respectively. The paper covers the period between 1996 -2011, a period considered to be critical in the agricultural revolution of the state. The study adopts a theoretical approach via secondary methods of analysis for the efficient explanations of the burning issues under consideration. The paper sums up with policy recommendations and conclusion.

Keywords: poverty, agriculture, Badakoshi, rural policy management

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1157 Assessment-Assisted and Relationship-Based Financial Advising: Using an Empirical Assessment to Understand Personal Investor Risk Tolerance in Professional Advising Relationships

Authors: Jerry Szatko, Edan L. Jorgensen, Stacia Jorgensen

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A crucial component to the success of any financial advising relationship is for the financial professional to understand the perceptions, preferences and thought-processes carried by the financial clients they serve. Armed with this information, financial professionals are more quickly able to understand how they can tailor their approach to best match the individual preferences and needs of each personal investor. Our research explores the use of a quantitative assessment tool in the financial services industry to assist in the identification of the personal investor’s consumer behaviors, especially in terms of financial risk tolerance, as it relates to their financial decision making. Through this process, the Unitifi Consumer Insight Tool (UCIT) was created and refined to capture and categorize personal investor financial behavioral categories and the financial personality tendencies of individuals prior to the initiation of a financial advisement relationship. This paper discusses the use of this tool to place individuals in one of four behavior-based financial risk tolerance categories. Our discoveries and research were aided through administration of a web-based survey to a group of over 1,000 individuals. Our findings indicate that it is possible to use a quantitative assessment tool to assist in predicting the behavioral tendencies of personal consumers when faced with consumer financial risk and decisions.

Keywords: behavior-based advising, financial relationship building, risk capacity based on behavior, risk tolerance, systematic way to assist in financial relationship building

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1156 Criticality of Socio-Cultural Factors in Public Policy: A Study of Reproductive Health Care in Rural West Bengal

Authors: Arindam Roy

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Public policy is an intriguing terrain, which involves complex interplay of administrative, social political and economic components. There is hardly any fit-for all formulation of public policy as Lindbloom has aptly categorized it as a science of muddling through. In fact, policies are both temporally and contextually determined as one the proponents of policy sciences Harold D Lasswell has underscored it in his ‘contextual-configurative analysis’ as early as 1950s. Though, a lot of theoretical efforts have been made to make sense of this intricate dynamics of policy making, at the end of the day the applied area of public policy negates any such uniform, planned and systematic formulation. However, our policy makers seem to have learnt very little of that. Until recently, policy making was deemed as an absolutely specialized exercise to be conducted by a cadre of professionally trained seasoned mandarin. Attributes like homogeneity, impartiality, efficiency, and neutrality were considered as the watchwords of delivering common goods. Citizen or clientele was conceptualized as universal political or economic construct, to be taken care of uniformly. Moreover, policy makers usually have the proclivity to put anything into straightjacket, and to ignore the nuances therein. Hence, least attention has been given to the ground level reality, especially the socio-cultural milieu where the policy is supposed to be applied. Consequently, a substantial amount of public money goes in vain as the intended beneficiaries remain indifferent to the delivery of public policies. The present paper in the light of Reproductive Health Care policy in rural West Bengal has tried to underscore the criticality of socio-cultural factors in public health delivery. Indian health sector has traversed a long way. From a near non-existent at the time of independence, the Indian state has gradually built a country-wide network of health infrastructure. Yet it has to make a major breakthrough in terms of coverage and penetration of the health services in the rural areas. Several factors are held responsible for such state of things. These include lack of proper infrastructure, medicine, communication, ambulatory services, doctors, nursing services and trained birth attendants. Policy makers have underlined the importance of supply side in policy formulation and implementation. The successive policy documents concerning health delivery bear the testimony of it. The present paper seeks to interrogate the supply-side oriented explanations for the failure of the delivery of health services. Instead, it identified demand side to find out the answer. The state-led and bureaucratically engineered public health measures fail to engender demands as these measures mostly ignore socio-cultural nuances of health and well-being. Hence, the hiatus between supply side and demand side leads to huge wastage of revenue as health infrastructure, medicine and instruments remain unutilized in most cases. Therefore, taking proper cognizance of these factors could have streamlined the delivery of public health.

Keywords: context, policy, socio-cultural factor, uniformity

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1155 Revolutionary Violence and Echoes of the «Thou Shalt Not Kill» Debate: A Tragic Reading of the Class Conflict in Colombia

Authors: Jaime Otavo

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Oscar del Barco, a former member of Los Montoneros, an Argentine guerrilla group of the 1970s, published a letter in 2004 that sparked a heated debate in his country about revolutionary violence. Del Barco, on the subject of «No matarás» (Thou shalt not kill) –as this debate was known– wrote to Sergio Schmucler, his addressee, the following: "There is no 'ideal' that justifies the death of a man. The founding principle of any community is 'Thou shalt not kill'. Thou shalt not kill the man because every man is sacred, and every man is all men".In this paper, the «No matarás» debate will be used to problematize two interconnected ideas that, in Colombia, underpinned the use of revolutionary violence by the guerrilla movements that emerged in the 1970s. On the one hand, an anthropological optimism; on the other, a theological scheme of converting violence into justice. Based on this, two arguments are put forward: 1) that revolutionary violence arose from an ethical-political certainty, namely: the confidence in being on the right side of history (because the violent ones were others), but 2) that its persistence over time made visible a tragic element, that is, that the bipolarity between victim and executioner, good and evil, or friend and foe that is inscribed in the class struggle is a false dilemma for in the context of revolutionary violence –as in the context of Greek tragedy–, no one ever has to make a decision, nor can he do so. For this reason, it is maintained that the fundamental aspect about guerrilla violence in Colombia is that it imposed itself as a violence of negativity which not only exceeded the capacity of the extreme left to control its revolutionary praxis but also exploited the link with the political subjectivation to which it aspired, the proletariat as the gravedigger of the bourgeoisie.

Keywords: marxism, social movements, armed struggle, debate thou shalt not kill

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1154 Disparity in New Born Care Practices Reducing in Uttar Pradesh: Evidences from NFHS and DLHS

Authors: Gudakesh Yadav

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Utter Pradesh, which is one of the largest states of India with unequal distribution of resources and different socioeconomic and cultural characteristics, level of different new born health care indicators varies a lot from one district to another district. State shared more than 21 percent of total live births of India; whereas, it accounts for 28 percent of total infant deaths of the country, with the 53 per thousand infant mortality rate. The present paper attempts to examine tempo-spatial changes in new born care practices during NFHS-1 to NFHS-3 and DLHS-2 to DLHS-3 in Uttar Pradesh and different regions. Descriptive statistics, rate-ratios, concentration index, multivariate and decomposition analysis has been used for the study. Findings of the study reveal that new born care practices have improved over the time in the state and across all the regions because of giving more emphasis on venerable groups like poor, rural, less educated mothers and scheduled caste & tribes but still it did not achieve the desired successes. Regional analysis of third rounds of DLHS shows that, coverage of intuitional delivery was the lowest in the central region. Performance of the southern region was the lowest in terms of initiation of breastfeeding, keeping baby warm and dry after the birth. The study calls for proper follow up of new born children to accelerate new born and child health care service and prioritises increasing antenatal check-ups and institutional delivery, which helps to improve level of other new born care services. At the policy level there is need to reach venerable groups like scheduled caste and tribes, poor and uneducated, and new mother especially in rural areas. High focused district should be allocated for better implementation of new born care promotion programme in low performing districts. Partnership with the private sector health professional is necessary to reach the every part of population.

Keywords: decomposition, inequality, initiation of breastfeeding, institutional delivery

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1153 Effective, Affordable, and Accessible Treatment for Pregnancy’s Commonest Complication: Online Synchronous Interpersonal Psychotherapy for Mothers with Postpartum Depression

Authors: Vivian Polak, Lena Verdeli, Wendy Lou, Caroline Lovett

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Postnatal depression (PND) is a common complication of childbirth that increases the risk of future depressive episodes in women, postpartum depression in partners, as well as social, emotional, behavioural, language, and cognitive problems in offspring. Although psychotherapy, and in particular Group Interpersonal Psychotherapy (IPT-G), has been proven effective in treating PND, it remains largely inaccessible. However, research has indicated that online synchronous group therapy can be equally as effective as in-person therapy and is a more affordable and accessible modality of treatment. This study aimed to ascertain whether delivering IPT-G virtually when compared to treatment as usual, could more effectively reduce depressive and anxiety symptoms, enhance mother-infant attachment, improve the couple relationship, augment social support, improve overall functioning, and enhance the quality of life for women in rural and northern Ontario who are suffering from PND. By bridging the gap in access to mental health services during the postpartum period, this study seeks to improve the well-being of mothers and their families in rural and northern Ontario, Canada. A randomized controlled trial was conducted to determine whether virtual IPT-G plus treatment as usual would be more effective than treatment as usual alone in treating women with PND in Ontario, Canada. Preliminary results indicate that women who received virtual IPT-G had a clinically and statistically significant decrease in overall depressive symptoms compared to their counterparts who received only the treatment as usual. As such, providing online synchronous IPT-G in the perinatal period not only has the potential to improve women's outcomes in the present but also to decrease future health costs, reduce the burden on the educational and justice systems, and decrease the number of disability life years lost to postnatal depression.

Keywords: family wellbeing, group psychotherapy, interpersonal psychotherapy, postnatal depression, virtual psychotherapy

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1152 Building Climate Resilience in the Health Sector in Developing Countries: Experience from Tanzania

Authors: Hussein Lujuo Mohamed

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Introduction: Public health has always been influenced by climate and weather. Changes in climate and climate variability, particularly changes in weather extremes affect the environment that provides people with clean air, food, water, shelter, and security. Tanzania is not an exception to the threats of climate change. The health sector is mostly affected due to emergence and proliferation of infectious diseases, thereby affecting health of the population and thus impacting achievement of sustainable development goals. Methodology: A desk review on documented issues pertaining to climate change and health in Tanzania was done using Google search engine. Keywords included climate change, link, health, climate initiatives. In cases where information was not available, documents from Ministry of Health, Vice Presidents Office-Environment, Local Government Authority, Ministry of Water, WHO, research, and training institutions were reviewed. Some of the reviewed documents from these institutions include policy brief papers, fieldwork activity reports, training manuals, and guidelines. Results: Six main climate resilience activities were identified in Tanzania. These were development and implementation of climate resilient water safety plans guidelines both for rural and urban water authorities, capacity building of rural and urban water authorities on implementation of climate-resilient water safety plans, and capacity strengthening of local environmental health practitioners on mainstreaming climate change and health into comprehensive council health plans. Others were vulnerability and adaptation assessment for the health sector, mainstreaming climate change in the National Health Policy, and development of risk communication strategy on climate. In addition information, education, and communication materials on climate change and to create awareness were developed aiming to sensitize and create awareness among communities on climate change issues and its effect on public health. Conclusion: Proper implementation of these interventions will help the country become resilient to many impacts of climate change in the health sector and become a good example for other least developed countries.

Keywords: climate, change, Tanzania, health

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1151 A Case Study of Physical and Psychological Forces in the Nigerian Criminal and Military Interrogations

Authors: Onimisi Ekuh Abdullahi, Lasbat Omoshalewa Akinsemoyin

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In Nigeria, over two decades now, there has been a steady increase in the insecurity of human lives and physical properties. In the South-South Nigeria, there is an acute insecurity of militants destroying oil pipe-lines and kidnapping cases; in the Middle-Belt zone, insecurity centers on kidnapping and in a few states crises between Herdsmen and Farmers range like wildfire; in the South-Western zone, kidnapping is vile, in the North-East zone the issue of Boko Haram has become World-wide concern, and in North-west zone, cattle rustlers and religious crisis are of great concern. At the initial stage, the Nigerian Police Force was called upon to quell the crisis. It soon became obvious that the dimension of the crisis was beyond police force. The Nigerian Armed Forces were called to maintain peace and order because the magnitude of the crisis was threatening the national unity and cohesion. The main objective of this paper, was to examine the investigative techniques of criminal by the military in Nigeria. Specifically to examine the physical and psychological force; the abusive techniques and tactics; and suggest modern psychological techniques of interrogating criminals accepted to Human Right Activists and the rule of law. The process is to create room behaviour and practices that carefully monitored the trust and reliability of admissions produced by Psychological manipulative process in Nigeria.

Keywords: military, Nigerian criminal, physical, psychological force

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1150 Fast Approximate Bayesian Contextual Cold Start Learning (FAB-COST)

Authors: Jack R. McKenzie, Peter A. Appleby, Thomas House, Neil Walton

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Cold-start is a notoriously difficult problem which can occur in recommendation systems, and arises when there is insufficient information to draw inferences for users or items. To address this challenge, a contextual bandit algorithm – the Fast Approximate Bayesian Contextual Cold Start Learning algorithm (FAB-COST) – is proposed, which is designed to provide improved accuracy compared to the traditionally used Laplace approximation in the logistic contextual bandit, while controlling both algorithmic complexity and computational cost. To this end, FAB-COST uses a combination of two moment projection variational methods: Expectation Propagation (EP), which performs well at the cold start, but becomes slow as the amount of data increases; and Assumed Density Filtering (ADF), which has slower growth of computational cost with data size but requires more data to obtain an acceptable level of accuracy. By switching from EP to ADF when the dataset becomes large, it is able to exploit their complementary strengths. The empirical justification for FAB-COST is presented, and systematically compared to other approaches on simulated data. In a benchmark against the Laplace approximation on real data consisting of over 670, 000 impressions from autotrader.co.uk, FAB-COST demonstrates at one point increase of over 16% in user clicks. On the basis of these results, it is argued that FAB-COST is likely to be an attractive approach to cold-start recommendation systems in a variety of contexts.

Keywords: cold-start learning, expectation propagation, multi-armed bandits, Thompson Sampling, variational inference

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1149 Constructing Digital Memory for Chinese Ancient Village: A Case on Village of Gaoqian

Authors: Linqing Ma, Huiling Feng, Jihong Liang, Yi Qian

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In China, some villages have survived in the long history of changes and remain until today with their unique styles and featured culture developed in the past. Those ancient villages, usually aged for hundreds or thousands of years, are the mirror for traditional Chinese culture, especially the farming-studying culture represented by the Confucianism. Gaoqian, an ancient village with a population of 3,000 in Zhejiang province, is such a case. With a history dating back to Yuan Dynasty, Gaoqian Village has 13 well-preserved traditional Chinese houses with a courtyard, which were built in the Ming and Qing Dynasty. It is a fine specimen to study traditional rural China. In China, some villages have survived in the long history of changes and remain until today with their unique styles and featured culture developed in the past. Those ancient villages, usually aged for hundreds or thousands of years, are the mirror for traditional Chinese culture, especially the farming-studying culture represented by the Confucianism. Gaoqian, an ancient village with a population of 3,000 in Zhejiang province, is such a case. With a history dating back to Yuan Dynasty, Gaoqian Village has 13 well-preserved traditional Chinese houses with a courtyard, which were built in the Ming and Qing Dynasty. It is a fine specimen to study traditional rural China. Then a repository for the memory of the Village will be completed by doing arrangement and description for those multimedia resources such as texts, photos, videos and so on. Production of Creative products with digital technologies is also possible based a thorough understanding of the culture feature of Gaoqian Village using research tools for literature and history studies and a method of comparative study. Finally, the project will construct an exhibition platform for the Village and its culture by telling its stories with completed structures and treads.

Keywords: ancient villages, digital exhibition, multimedia, traditional culture

Procedia PDF Downloads 572
1148 A Composite Indicator to Monitoring European Water Policies Using a Flexible Sustainability Approach

Authors: De Castro-Pardo M., Cabello J. M., Martin J. M., Ruiz F.

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In this paper, we propose a new Water Sustainability Indicator based on a Multi-Reference methodology that permits modeling compensation between the analysed criteria and provides a participative approach. The proposed indicator provides results based on 19 variables grouped into 5 dimensions: availability, access, resilience, good governance and economic capacity. The indicator was applied to assess water sustainability in 27 European countries. The results showed that Finland, the Netherlands, Sweden and the United Kingdom obtained the best global results in terms of weak water (compensatory) sustainability. In terms of strong water (non-compensatory) sustainability, no country gained acceptable results in terms of strong sustainability. Climate change and the state of freshwater resources were detected as especially vulnerable in all the analysed countries. The results identified some eastern European countries with low GDP and good performance of availability and cost of water, with bad results in terms of governance and water productivity. These results could jeopardize water sustainability in the event of a potential economic development if these limitations are not addressed. In a context of economic and political instability due to the current armed conflict in nearby countries such as Ukraine, it is especially important to pay attention to these countries, whose good governance indicators could worsen even more. The proposed indicator allowed to the identification of warning signs and could contribute to the improvement in decision-making processes. Moreover, it could improve the monitoring of international water policies.

Keywords: water sustainability, composite indicators, compensatory approach, sustainability European policies

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1147 Integrated Planning, Designing, Development and Management of Eco-Friendly Human Settlements for Sustainable Development of Environment, Economic, Peace and Society of All Economies

Authors: Indra Bahadur Chand

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This paper will focus on the need for development and application of global protocols and policy in planning, designing, development, and management of systems of eco-towns and eco-villages so that sustainable development will be assured from the perspective of environmental, economical, peace, and harmonized social dynamics. This perspective is essential for the development of civilized and eco-friendly human settlements in the town and rural areas of the nation that will be a milestone for developing a happy and sustainable lifestyle of rural and urban communities of the nation. The urban population of most of the town of developing economies has been tremendously increasing, whereas rural people have been tremendously migrating for the past three decades. Consequently, the urban lifestyle in most towns has stressed in terms of environmental pollution, water crisis, congested traffic, energy crisis, food crisis, and unemployment. Eco-towns and villages should be developed where lifestyle of all residents is sustainable and happy. Built up environment of settlement should reduce and minimize the problems of non ecological CO2 emissions, unbalanced utilization of natural resources, environmental degradation, natural calamities, ecological imbalance, energy crisis, water scarcity, waste management, food crisis, unemployment, deterioration of cultural heritage, social, the ratio among the public and private land ownership, ratio of land covered with vegetation and area of settlement, the ratio of people in the vehicles and foot, the ratio of people employed outside of town and village, ratio of resources recycling of waste materials, water consumption level, the ratio of people and vehicles, ratio of the length of the road network and area of town/villages, a ratio of renewable energy consumption with total energy, a ratio of religious/recreational area out of the total built-up area, the ratio of annual suicide case out of total people, a ratio of annual injured and death out of total people from a traffic accident, a ratio of production of agro foods within town out of total food consumption will be used to assist in designing and monitoring of each eco-towns and villages. An eco-town and villages should be planned and developed to offer sustainable infrastructure and utilities that maintain CO2 level in individual homes and settlements, home energy use, transport, food and consumer goods, water supply, waste management, conservation of historical heritages, healthy neighborhood, conservation of natural landscape, conserving bio-diversity and developing green infrastructures. Eco-towns and villages should be developed on the basis of master planning and architecture that affect and define the settlement and its form. Master planning and engineering should focus in delivering the sustainability criteria of eco towns and eco village. This will involve working with specific landscape and natural resources of locality.

Keywords: eco-town, ecological habitation, master plan, sustainable development

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1146 A Simple, Precise and Cost Effective PTFE Container Design Capable to Work in Domestic Microwave Oven

Authors: Mehrdad Gholami, Shima Behkami, Sharifuddin B. Md. Zain, Firdaus A. B. Kamaruddin

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Starting from the first application of a microwave oven for sample preparation in 1975 for the purpose of wet ashing of biological samples using a domestic microwave oven, many microwave-assisted dissolution vessels have been developed. The advanced vessels are armed with special safety valve that release the excess of pressure while the vessels are in critical conditions due to applying high power of microwave. Nevertheless, this releasing of pressure may cause lose of volatile elements. In this study Teflon bottles are designed with relatively thicker wall compared to commercial ones and a silicone based polymer was used to prepare an O-ring which plays the role of safety valve. In this design, eight vessels are located in an ABS holder to keep them stable and safe. The advantage of these vessels is that they need only 2 mL of HNO3 and 1mL H2O2 to digest different environmental samples, namely, sludge, apple leave, peach leave, spinach leave and tomato leave. In order to investigate the performance of this design an ICP-MS instrument was applied for multi elemental analysis of 20 elements on the SRM of above environmental samples both using this design and a commercial microwave digestion design. Very comparable recoveries were obtained from this simple design with the commercial one. Considering the price of ultrapure chemicals and the amount of them which normally is about 8-10 mL, these simple vessels with the procedures that will be discussed in detail are very cost effective and very suitable for environmental studies.

Keywords: inductively coupled plasma mass spectroscopy (ICP-MS), PTFE vessels, Teflon bombs, microwave digestion, trace element

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1145 Efficiency of Secondary Schools by ICT Intervention in Sylhet Division of Bangladesh

Authors: Azizul Baten, Kamrul Hossain, Abdullah-Al-Zabir

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The objective of this study is to develop an appropriate stochastic frontier secondary schools efficiency model by ICT Intervention and to examine the impact of ICT challenges on secondary schools efficiency in the Sylhet division in Bangladesh using stochastic frontier analysis. The Translog stochastic frontier model was found an appropriate than the Cobb-Douglas model in secondary schools efficiency by ICT Intervention. Based on the results of the Cobb-Douglas model, it is found that the coefficient of the number of teachers, the number of students, and teaching ability had a positive effect on increasing the level of efficiency. It indicated that these are related to technical efficiency. In the case of inefficiency effects for both Cobb-Douglas and Translog models, the coefficient of the ICT lab decreased secondary school inefficiency, but the online class in school was found to increase the level of inefficiency. The coefficients of teacher’s preference for ICT tools like multimedia projectors played a contributor role in decreasing the secondary school inefficiency in the Sylhet division of Bangladesh. The interaction effects of the number of teachers and the classrooms, and the number of students and the number of classrooms, the number of students and teaching ability, and the classrooms and teaching ability of the teachers were recorded with the positive values and these have a positive impact on increasing the secondary school efficiency. The overall mean efficiency of urban secondary schools was found at 84.66% for the Translog model, while it was 83.63% for the Cobb-Douglas model. The overall mean efficiency of rural secondary schools was found at 80.98% for the Translog model, while it was 81.24% for the Cobb-Douglas model. So, the urban secondary schools performed better than the rural secondary schools in the Sylhet division. It is observed from the results of the Tobit model that the teacher-student ratio had a positive influence on secondary school efficiency. The teaching experiences of those who have 1 to 5 years and 10 years above, MPO type school, conventional teaching method have had a negative and significant influence on secondary school efficiency. The estimated value of σ-square (0.0625) was different from Zero, indicating a good fit. The value of γ (0.9872) was recorded as positive and it can be interpreted as follows: 98.72 percent of random variation around in secondary school outcomes due to inefficiency.

Keywords: efficiency, secondary schools, ICT, stochastic frontier analysis

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1144 The Gender Digital Divide in Education: The Case of Students from Rural Area from Republic of Moldova

Authors: Bărbuță Alina

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The inter-causal relationship between social inequalities and the digital divide raises the relation issue of gender and information and communication technologies (ICT) - a key element in achieving sustainable development. In preparing generations as future digital citizens and for active socio-economic participation, ICT plays a key role in respecting gender equality. Although several studies over the years have shown that gender plays an important role in digital exclusion, in recent years, many studies with a focus on economically developed or developing countries identify an improvement in these aspects and a gap narrowing. By measuring students' digital competencies level, this paper aims to identify and analyse the existing gender digital inequalities among students. Our analyses are based on a sample of 1526 middle school students residing in rural areas from Republic of Moldova (54.2% girls, mean age 14,00, SD = 1.02). During the online survey they filled in a questionnaire adapted from the (yDSI) ”The Youth Digital Skills Indicator”. The instrument measures the level of five digital competence areas indicated in The European Digital Competence Framework (DigiCom 2.3.). Our results, based on t-test, indicate that depending on gender, there are no statistically significant differences regarding the levels of digital skills in 3 areas: Information navigation and processing; Communication and interaction; Problem solving. However, were identified significant differences in the level of digital skills in the area of ”Digital content creation” [t(1425) = 4.20, p = .000] and ”Safety” [t(1421) = 2.49, p = .000], with higher scores recorded by girls. Our results contradicts the general stereotype regarding the low level of digital competence among girls, in our sample girls scores being on pear with boys and even bigger in knowledge related to digital content creation and online safety skills. Additional investigations related to boys competence on digital safety are necessary as the implication of their low scores on this dimension may suggest boys exposure to digital threats.

Keywords: digital divide, education, gender digital divide, digital literacy, remote learning

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1143 In the Conundrum between Tradition and Modernity: A Socio-Cultural Study to Understand Crib Death in Malda, West Bengal

Authors: Prama Mukhopadhyay, Rishika Mukhopadhyay

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The twentieth century has seen the world getting divided into three distinct blocks, created by the proponents of the mainstream developmental discourse. India, which has now gained the label of being a ‘developing nation’, stands in between these three groups, as it constantly tries to ‘catch up’ and emulate the developmental standards of the ‘west’. In this endeavour, we find our country trying really hard to blindly replicate the health care infrastructures of the ‘first worlds’, without realizing the needs of evaluating the ground reality. In such a situation, the sudden outbreak of child death in the district of Malda, WB, poses an obvious questions towards the kind of development that our country has been engaging in, ever since its Post Colonial inception. Through this paper we thus try to understand the harsh veracity of the health care facility that exists in rural Bengal, and thereby challenge the conventional notion of ‘health-care’ as is normally discussed in the mainstream developmental discourse. Grounding our research work on detailed ethnography and through the help of questionnaire, interviews and focus group discussions with the local government officials(BDOs), health workers (ICDS, ASHA workers, ANHM and BMOHs) and members of families with experiences of child deaths, we have tried to find out the real and humane factors behind the sudden rise of reported infant deaths in the district, issues which are normally neglected and left out while discussing and evaluating IMR in the mainstream studies on health care and planning in our nation. Therefore the main aim of this paper is to try and look at child death from a ‘wider perspective’, where it is seen from an eye not bounded by the common registers of caste, class and religion. This paper, would thus be an eye opener in some sense, bringing in stories from the rural belt of the country; where the people are regularly torn between the binaries of the developing and shining modernity of ‘India’ which now gets ready to run the last lap and gain the status of becoming a ‘developed nation’ by 2020, and the staggering, dark traditional ‘ Bharat, which lags behind.

Keywords: child mortality, development discourse, health care, tradition and modernity

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1142 Biological Hazards and Laboratory inflicted Infections in Sub-Saharan Africa

Authors: Godfrey Muiya Mukala

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This research looks at an array of fields in Sub-Saharan Africa comprising agriculture, food enterprises, medicine, organisms genetically modified, microbiology, and nanotechnology that can be gained from biotechnological research and development. Findings into dangerous organisms, mainly bacterial germs, rickettsia, fungi, parasites, or organisms that are genetically engineered, have immensely posed questions attributed to the biological danger they bring forth to human beings and the environment because of their uncertainties. In addition, the recurrence of previously managed diseases or the inception of new diseases are connected to biosafety challenges, especially in rural set-ups in low and middle-income countries. Notably, biotechnology laboratories are required to adopt biosafety measures to protect their workforce, community, environment, and ecosystem from unforeseen materials and organisms. Sensitization and inclusion of educational frameworks for laboratory workers are essential to acquiring a solid knowledge of harmful biological agents. This is in addition to human pathogenicity, susceptibility, and epidemiology to the biological data used in research and development. This article reviews and analyzes research intending to identify the proper implementation of universally accepted practices in laboratory safety and biological hazards. This research identifies ideal microbiological methods, adequate containment equipment, sufficient resources, safety barriers, specific training, and education of the laboratory workforce to decrease and contain biological hazards. Subsequently, knowledge of standardized microbiological techniques and processes, in addition to the employment of containment facilities, protective barriers, and equipment, is far-reaching in preventing occupational infections. Similarly, reduction of risks and prevention may be attained by training, education, and research on biohazards, pathogenicity, and epidemiology of the relevant microorganisms. In this technique, medical professionals in rural setups may adopt the knowledge acquired from the past to project possible concerns in the future.

Keywords: sub-saharan africa, biotechnology, laboratory, infections, health

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1141 Overcoming Barriers to Improve HIV Education and Public Health Outcomes in the Democratic Republic of Congo

Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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1140 Effect of Climate Change and Water Sources: Sustainability of Rural Water Sanitation and Hygiene of Tanahun District

Authors: Bharat Sapkota

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Nepal is the one of the victim country of climate change. Decreasing snow line, sometimes higher and sometime non-rain fall are common phenomena in hill area. Natural flood disaster and drought is also common every year in certain place of the country. So this paper analyze the effect of climate and natural water sources for sustainability of water sanitation and hygiene of Tanahun district. It is one of the Rural Water Supply and Sanitation Project Western Nepal Phase-II (RWSSP-WN Phase-II) project district out of 14 project districts of western and mid-western Nepal. RWSSP-WN II is a bilateral development cooperation of governments of Nepal and Finland. Big investment is still going on in water sanitation and hygiene sector but sustainability is still a challenge throughout the country. So RWSSP-WN has started the strengthen of the capacity of local Governments to deliver services in water supply, sanitation and hygiene and its sustainability through the implementation of cross cutting approach of climate change and disaster risk reduction. The study shows that the average yield in 685 natural point sources were around 0.045 l/s in 2014 but it was twice as high in 2004 i.e. 0.09 l/s. The maximum measured yield in 2014 was 1.87 l/s, whereas, the maximum yield was 3 l/s in 2004. Likewise, spring source mean and maximum yield measured in 2014 were 0.16 l/s and 3.33 l/s respectively, whereas, mean and maximum yields in 2004 were 0.204 l/s and 3 l/s respectively. Small streams average yield measured in 2014 was 0.32 l/s with the maximum of around 4.99 l/s. In 2004, mean and maximum yields of streams were 0.485 l/s and 5 l/s respectively. The overall climate between years 2002 to 2013 and measured yield data between 2004 and 2014 shows climate as one of the causes of water source decline. The temperature is rising with pace of 0.041°C per year and rainfall is decreased by 16.8 mm/year. The Khosla’s empirical formula shows decrease of 1.7 cm/year in runoff. At present sustainability of water, sanitation and hygiene is more challenge due to sources decreasing in the district. Sanitation and hygiene total behavior change and watershed conservation as well as design and implementation of recharge pound construction are the way forward of sustainability of water, sanitation and hygiene.

Keywords: water sanitation, hygiene, sustainability, climate change

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1139 Transit Facility Planning in Fringe Areas of Kolkata Metropolitan Region

Authors: Soumen Mitra, Aparna Saha

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The perceived link between the city and the countryside is evolving rapidly and is getting shifted away from the assumptions of mainstream paradigms to new conceptual networks where rural-urban links are being redefined. In this conceptual field, the fringe interface is still considered as a transitional zone between city and countryside, and is defined as a diffused area rather than a discrete territory. In developing countries fringe areas are said to have both rural and urban characteristics but are devoid of basic municipal facilities. Again, when the urban core areas envelopes the fringe areas along with it the character of fringe changes but services are not well facilitated which in turn results to uneven growth, rapid and haphazard development. One of the major services present in fringe areas is inter-linkages in terms of transit corridors. Planning for the appropriate and sustainable future of fringe areas requires a sheer focus on these corridors pertaining to transit facility, for better accessibility and mobility. Inducing a transit facility plan enhances the various facilities and also increases their proximity for user groups. The study focuses on the western fringe region of Kolkata metropolis which is a major source of industrial hub and housing sector, thus converting the agricultural lands into non-agricultural use. The study emphasizes on providing transit facilities both physical (stops, sheds, terminals, etc.) and operational (ticketing system, route prioritization, integration of transit modes, etc.), to facilitate the region as well as accelerate the growth pattern systematically. Hence, the scope of this work is on the basis of prevailing conditions in fringe areas and attempts for an effective transit facility plan. The strategies and recommendations are in terms of road widening, service coverage, feeder route prioritization, bus stops facilitation, pedestrian facilities, etc, which in turn enhances the region’s growth pattern. Thus, this context of transit facility planning acts as a catalytic agent to avoid the future unplanned growth and accelerates it towards an integrated development.

Keywords: feeder route, fringe, municipal planning, transit facility

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1138 Supporting Women's Economic Development in Rural Papua New Guinea

Authors: Katja Mikhailovich, Barbara Pamphilon

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Farmer training in Papua New Guinea has focused mainly on technology transfer approaches. This has primarily benefited men and often excluded women whose literacy, low education and role in subsistence crops has precluded participation in formal training. The paper discusses an approach that uses both a brokerage model of agricultural extension to link smallholders with private sector agencies and an innovative family team’s approach that aims to support the economic empowerment of women in families and encourages sustainable and gender equitable farming and business practices.

Keywords: women, economic development, agriculture, training

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1137 Epidemiology of Congenital Heart Defects in Kazakhstan: Data from Unified National Electronic Healthcare System 2014-2020

Authors: Dmitriy Syssoyev, Aslan Seitkamzin, Natalya Lim, Kamilla Mussina, Abduzhappar Gaipov, Dimitri Poddighe, Dinara Galiyeva

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Background: Data on the epidemiology of congenital heart defects (CHD) in Kazakhstan is scarce. Therefore, the aim of this study was to describe the incidence, prevalence and all-cause mortality of patients with CHD in Kazakhstan, using national large-scale registry data from the Unified National Electronic Healthcare System (UNEHS) for the period of 2014-2020. Methods: In this retrospective cohort study, the included data pertained to all patients diagnosed with CHD in Kazakhstan and registered in UNEHS between January 2014 and December 2020. CHD was defined based on International Classification of Diseases 10th Revision (ICD-10) codes Q20-Q26. Incidence, prevalence, and all-cause mortality rates were calculated per 100,000 population. Survival analysis was performed using Cox proportional hazards regression modeling and the Kaplan-Meier method. Results: In total, 66,512 patients were identified. Among them, 59,534 (89.5%) were diagnosed with a single CHD, while 6,978 (10.5%) had more than two CHDs. The median age at diagnosis was 0.08 years (interquartile range (IQR) 0.01 – 0.66) for people with multiple CHD types and 0.39 years (IQR 0.04 – 8.38) for those with a single CHD type. The most common CHD types were atrial septal defect (ASD) and ventricular septal defect (VSD), accounting for 25.8% and 21.2% of single CHD cases, respectively. The most common multiple types of CHD were ASD with VSD (23.4%), ASD with patent ductus arteriosus (PDA) (19.5%), and VSD with PDA (17.7%). The incidence rate of CHD decreased from 64.6 to 47.1 cases per 100,000 population among men and from 68.7 to 42.4 among women. The prevalence rose from 66.1 to 334.1 cases per 100,000 population among men and from 70.8 to 328.7 among women. Mortality rates showed a slight increase from 3.5 to 4.7 deaths per 100,000 in men and from 2.9 to 3.7 in women. Median follow-up was 5.21 years (IQR 2.47 – 11.69). Male sex (HR 1.60, 95% CI 1.45 - 1.77), having multiple CHDs (HR 2.45, 95% CI 2.01 - 2.97), and living in a rural area (HR 1.32, 95% CI 1.19 - 1.47) were associated with a higher risk of all-cause mortality. Conclusion: The incidence of CHD in Kazakhstan has shown a moderate decrease between 2014 and 2020, while prevalence and mortality have increased. Male sex, multiple CHD types, and rural residence were significantly associated with a higher risk of all-cause mortality.

Keywords: congenital heart defects (CHD), epidemiology, incidence, Kazakhstan, mortality, prevalence

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1136 The Formation of the Diminutive in Colloquial Jordanian Arabic

Authors: Yousef Barahmeh

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This paper is a linguistic and pragmatic analysis of the use of the diminutive in Colloquial Jordanian Arabic (CJA). It demonstrates a peculiar form of the diminutive in CJA inflected by means of feminine plural ends with -aat suffix. The analysis shows that the pragmatic function(s) of the diminutive in CJA refers primarily to ‘littleness’ while the morphological inflection conveys the message of ‘the plethora’. Examples of this linguistic phenomenon are intelligible and often include a large number of words that are culture-specific to the rural dialect in the north of Jordan. In both cases, the diminutive in CJA is an adaptive strategy relative to its pragmatic and social contexts.

Keywords: Colloquial Jordanian Arabic, diminutive, morphology, pragmatics

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1135 Optimization of Waste Plastic to Fuel Oil Plants' Deployment Using Mixed Integer Programming

Authors: David Muyise

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Mixed Integer Programming (MIP) is an approach that involves the optimization of a range of decision variables in order to minimize or maximize a particular objective function. The main objective of this study was to apply the MIP approach to optimize the deployment of waste plastic to fuel oil processing plants in Uganda. The processing plants are meant to reduce plastic pollution by pyrolyzing the waste plastic into a cleaner fuel that can be used to power diesel/paraffin engines, so as (1) to reduce the negative environmental impacts associated with plastic pollution and also (2) to curb down the energy gap by utilizing the fuel oil. A programming model was established and tested in two case study applications that are, small-scale applications in rural towns and large-scale deployment across major cities in the country. In order to design the supply chain, optimal decisions on the types of waste plastic to be processed, size, location and number of plants, and downstream fuel applications were concurrently made based on the payback period, investor requirements for capital cost and production cost of fuel and electricity. The model comprises qualitative data gathered from waste plastic pickers at landfills and potential investors, and quantitative data obtained from primary research. It was found out from the study that a distributed system is suitable for small rural towns, whereas a decentralized system is only suitable for big cities. Small towns of Kalagi, Mukono, Ishaka, and Jinja were found to be the ideal locations for the deployment of distributed processing systems, whereas Kampala, Mbarara, and Gulu cities were found to be the ideal locations initially utilize the decentralized pyrolysis technology system. We conclude that the model findings will be most important to investors, engineers, plant developers, and municipalities interested in waste plastic to fuel processing in Uganda and elsewhere in developing economy.

Keywords: mixed integer programming, fuel oil plants, optimisation of waste plastics, plastic pollution, pyrolyzing

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1134 Simplifying Writing Composition to Assist Students in Rural Areas: An Experimental Study for the Comparison of Guided and Unguided Instruction

Authors: Neha Toppo

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Method and strategies of teaching instruction highly influence learning of students. In second language teaching, number of ways and methods has been suggested by different scholars and researchers through times. The present article deals with the role of teaching instruction in developing compositional ability of students in writing. It focuses on the secondary level students of rural areas, whose exposure to English language is limited and they face challenges even in simple compositions. The students till high school suffer with their disability in writing formal letter, application, essay, paragraph etc. They face problem in note making, writing answers in examination using their own words and depend fully on rote learning. It becomes difficult for them to give language to their own ideas. Teaching writing composition deserves special attention as writing is an integral part of language learning and students at this level are expected to have sound compositional ability for it is useful in numerous domains. Effective method of instruction could help students to learn expression of self, correct selection of vocabulary and grammar, contextual writing, composition of formal and informal writing. It is not limited to school but continues to be important in various other fields outside the school such as in newspaper and magazine, official work, legislative work, material writing, academic writing, personal writing, etc. The study is based on the experimental method, which hypothesize that guided instruction will be more effective in teaching writing compositions than usual instruction in which students are left to compose by their own without any help. In the test, students of one section are asked to write an essay on the given topic without guidance and another section are asked to write the same but with the assistance of guided instruction in which students have been provided with a few vocabulary and sentence structure. This process is repeated in few more schools to get generalize data. The study shows the difference on students’ performance using both the instructions; guided and unguided. The conclusion of the study is followed by the finding that writing skill of the students is quite poor but with the help of guided instruction they perform better. The students are in need of better teaching instruction to develop their writing skills.

Keywords: composition, essay, guided instruction, writing skill

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1133 The Misuse of Social Media in Order to Exploit "Generation Y"; The Tactics of IS

Authors: Ali Riza Perçin, Eser Bingül

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Internet technologies have created opportunities with which people share their ideologies, thoughts and products. This virtual world, named social media has given the chance of gathering individual users and people from the world's remote locations and establishing an interaction between them. However, to an increasingly higher degree terrorist organizations today use the internet and most notably social-network media to create the effects they desire through a series of on-line activities. These activities, designed to support their activities, include information collection (intelligence), target selection, propaganda, fundraising and recruitment to name a few. Meanwhile, these have been used as the most important tool for recruitment especially from the different region of the world, especially disenfranchised youth, in the West in order to mobilize support and recruit “foreign fighters.” The recruits have obtained the statue, which is not accessible in their society and have preferred the style of life that is offered by the terrorist organizations instead of their current life. Like other terrorist groups, for a while now the terrorist organization Islamic State (IS) in Iraq and Syria has employed a social-media strategy in order to advance their strategic objectives. At the moment, however, IS seems to be more successful in their on-line activities than other similar organizations. IS uses social media strategically as part of its armed activities and for the sustainability of their military presence in Syria and Iraq. In this context, “Generation Y”, which could exist at the critical position and undertake active role, has been examined. Additionally, the explained characteristics of “Generation Y” have been put forward and the duties of families and society have been stated as well.

Keywords: social media, "generation Y", terrorist organization, islamic state IS

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1132 Insights into the Annotated Genome Sequence of Defluviitoga tunisiensis L3 Isolated from a Thermophilic Rural Biogas Producing Plant

Authors: Irena Maus, Katharina Gabriella Cibis, Andreas Bremges, Yvonne Stolze, Geizecler Tomazetto, Daniel Wibberg, Helmut König, Alfred Pühler, Andreas Schlüter

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Within the agricultural sector, the production of biogas from organic substrates represents an economically attractive technology to generate bioenergy. Complex consortia of microorganisms are responsible for biomass decomposition and biogas production. Recently, species belonging to the phylum Thermotogae were detected in thermophilic biogas-production plants utilizing renewable primary products for biomethanation. To analyze adaptive genome features of representative Thermotogae strains, Defluviitoga tunisiensis L3 was isolated from a rural thermophilic biogas plant (54°C) and completely sequenced on an Illumina MiSeq system. Sequencing and assembly of the D. tunisiensis L3 genome yielded a circular chromosome with a size of 2,053,097 bp and a mean GC content of 31.38%. Functional annotation of the complete genome sequence revealed that the thermophilic strain L3 encodes several genes predicted to facilitate growth of this microorganism on arabinose, galactose, maltose, mannose, fructose, raffinose, ribose, cellobiose, lactose, xylose, xylan, lactate and mannitol. Acetate, hydrogen (H2) and carbon dioxide (CO2) are supposed to be end products of the fermentation process. The latter gene products are metabolites for methanogenic archaea, the key players in the final step of the anaerobic digestion process. To determine the degree of relatedness of dominant biogas community members within selected digester systems to D. tunisiensis L3, metagenome sequences from corresponding communities were mapped on the L3 genome. These fragment recruitments revealed that metagenome reads originating from a thermophilic biogas plant covered 95% of D. tunisiensis L3 genome sequence. In conclusion, availability of the D. tunisiensis L3 genome sequence and insights into its metabolic capabilities provide the basis for biotechnological exploitation of genome features involved in thermophilic fermentation processes utilizing renewable primary products.

Keywords: genome sequence, thermophilic biogas plant, Thermotogae, Defluviitoga tunisiensis

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1131 An Observation of Patient-Professional Communication in the Cambodian Dental Setting

Authors: Christina Tran, Lu Khoo, Andrea Waylen

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Introduction: The evolution of the dental consultation from paternalism to partnership has been well documented in developed Western countries. Great emphasis is now placed on the importance of empowering patients to make decisions regarding their care, obtaining informed consent, and maintaining patient privacy and confidentiality. With the majority of communication occurring non-verbally, clinicians often adopt behaviours which suggest an approachable and positive attitude. However, evidence indicates that in Asia, a paternalistic model may be favored in medicine. The power imbalance occurring in doctor-patient relationships worldwide may be exacerbated by various factors in Southeast Asia: the strong hierarchical culture, and the large education gap between doctor and patient. Further insight into this matter can be gained by observing patient-dentist communication in Cambodia. The dentist:population ratio in Cambodia is approximately 1:33,000, with rural areas remaining extremely underserviced. We have carried out an observational study of communication in a voluntary dental clinic in Cambodia with the aim of describing whether the patient-dentist relationship follows a paternalistic or patient-centred model. Method: Over a period of two weeks, two clinicians provided dental care as part of a voluntary program in two Cambodian settings: a temporary, rural clinic and a permanent clinic in Phnom Penh. The clinicians independently recorded their experiences in diaries, making observations on the verbal and non-verbal communication between patients and staff. General observations such as the clinic environment were also made. The diaries were then compared and analyzed using a thematic approach. Results: The overall themes that emerged were regarding the clinic environment, verbal communication, and non-verbal communication. Regarding the clinic environment, the rural clinic was arranged in order to easily direct patients from one dentist to another, with little emphasis on continuous patient care. There was also little consideration for patient privacy: patients were often treated in the presence of many observers, including other waiting patients. However, the permanent clinic was structured to allow greater patient privacy, with continuous patient care occurring throughout the appointment. Regarding verbal communication, there was a strongly paternalistic approach to gaining consent and giving instruction. Patients rarely asked questions regarding their treatment, with dentists doing little to encourage patient involvement. Non-verbal communication between patients and dentists was generally paternalistic, with the dentist often addressing the supine patient from above. Patients often avoided making eye-contact, which may have indicated discomfort or lack of engagement. Both adult and paediatric patients rarely raised verbal concerns regarding pain during treatment, despite displaying non-verbal signs of experiencing pain. Anxious paediatric patients were sometimes managed with physical restraint by their mothers to facilitate treatment. Conclusion: Patient-professional communication in the Cambodian dental setting was observed to be generally paternalistic in nature, although more patient-centred aspects were observed in the established, urban setting. However, it should be noted that these observations are subjective in nature, and that the patients’ actual perceptions of their communication experience were unexplored. Further observations in variety of dental settings in Cambodia are needed before any definitive conclusions can be made.

Keywords: patient-dentist communication, paternalism, patient-centered, non-verbal communication

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1130 Wealth-Based Inequalities in Child Health: A Micro-Level Analysis of Maharashtra State in India

Authors: V. Rekha, Rama Pal

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The study examines the degree and magnitude of wealth-based inequalities in child health and its determinants in India. Despite making strides in economic growth, India has failed to secure a better nutritional status for all the children. The country currently faces the double burden of malnutrition as well as the problems of overweight and obesity. Child malnutrition, obesity, unsafe water, sanitation among others are identified as the risk factors for Non-Communicable Diseases (NCDs). Eliminating malnutrition in all its forms will catalyse improved health and economic outcomes. The assessment of the distributive dimension of child health across various segments of the population is essential for effective policy intervention. The study utilises the fourth round of District Level Health Survey for 2012-13 to analyse the inequalities among children in the age group 0-14 years in Maharashtra, a state in the western region of India with a population of 11.24 crores which constitutes 9.3 percent of the total population of India. The study considers the extent of health inequality by state, districts, sector, age-groups, and gender. The z-scores of four child health outcome variables are computed to assess the nutritional status of pre-school and school children using WHO reference. The descriptive statistics, concentration curves, concentration indices, correlation matrix, logistic regression have been used to analyse the data. The results indicate that magnitude of inequality is higher in Maharashtra and child health inequalities manifest primarily among the weaker sections of society. The concentration curves show that there exists a pro-poor inequality in child malnutrition measured by stunting, wasting, underweight, anaemia and a pro-rich overweight inequality. The inequalities in anaemia are observably lower due to the widespread prevalence. Rural areas exhibit a higher incidence of malnutrition, but greater inequality is observed in the urban areas. Overall, the wealth-based inequalities do not vary significantly between age groups. It appears that there is no gender discrimination at the state level. Further, rural-urban differentials in gender show that boys from the rural area and girls living in the urban region experience higher disparities in health. The relative distribution of undernutrition across districts in Maharashtra reveals that malnutrition is rampant and considerable heterogeneity also exists. A negative correlation is established between malnutrition prevalence and human development indicators. The findings of logistic regression analysis reveal that lower economic status of the household is associated with a higher probability of being malnourished. The study recognises household wealth, education of the parent, child gender, and household size as factors significantly related to malnutrition. The results suggest that among the supply-side variables, child-oriented government programmes might be beneficial in tackling nutrition deficit. In order to bridge the health inequality gap, the government needs to target the schemes better and should expand the coverage of services.

Keywords: child health, inequality, malnutrition, obesity

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