Search results for: infrastructural facilities
1500 Numerical Investigation of Gas Leakage in RCSW-Soil Combinations
Authors: Mahmoud Y. M. Ahmed, Ahmed Konsowa, Mostafa Sami, Ayman Mosallam
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Fukushima nuclear accident (Japan 2011) has drawn attention to the issue of gas leakage from hazardous facilities through building boundaries. The rapidly increasing investments in nuclear stations have made the ability to predict, and prevent, gas leakage a rather crucial issue both environmentally and economically. Leakage monitoring for underground facilities is rather complicated due to the combination of Reinforced Concrete Shear Wall (RCSW) and soil. In the framework of a recent research conducted by the authors, the gas insulation capabilities of RCSW-soil combination have been investigated via a lab-scale experimental work. Despite their accuracy, experimental investigations are expensive, time-consuming, hazardous, and lack for flexibility. Numerically simulating the gas leakage as a fluid flow problem based on Computational Fluid Dynamics (CFD) modeling approach can provide a potential alternative. This novel implementation of CFD approach is the topic of the present paper. The paper discusses the aspects of modeling the gas flow through porous media that resemble the RCSW both isolated and combined with the normal soil. A commercial CFD package is utilized in simulating this fluid flow problem. A fixed RCSW layer thickness is proposed, air is taken as the leaking gas, whereas the soil layer is represented as clean sand with variable properties. The variable sand properties include sand layer thickness, fine fraction ratio, and moisture content. The CFD simulation results almost demonstrate what has been found experimentally. A soil layer attached next to a cracked reinforced concrete section plays a significant role in reducing the gas leakage from that cracked section. This role is found to be strongly dependent on the soil specifications.Keywords: RCSW, gas leakage, Pressure Decay Method, hazardous underground facilities, CFD
Procedia PDF Downloads 4121499 Shakespeare’s Sister and the Crisis of Women’s Autonomy: A Critical Analysis of a Room of One’s Own
Authors: Ali Mohammadi
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This study explored the root causes of women's lack of writing in literature by digging into Virginia Woolf's A Room of One’s Own. Virginia Woolf was the pioneer of feminist literary criticism in the 20th century. She was hugely preoccupied, throughout her writing life, with the role of women in history and with the relationship between women and fiction. Besides, she wrote continuously about the difficulties of women's writing and of writing as a woman. This research aims to mirror a number of key arguments concerning women’s issues: the social and economic conditions necessary for writing; the problem of a tradition of women's writing; the concept of a 'female sentence' articulating women's voices and values and the idea of the androgynous aesthetic in which an author would be able to write free from an awareness of their sex as male or female. Woolf was very wary of making any definitive assertions about women's writing, or at least in terms of its style or form. Indeed, much of the essay is taken up with her reflections on the lack of women's writing over the history of English literature. It was concluded that the reason for this absence of female writing does not just spring from the deficiency of genius, but of material circumstances and facilities. Additionally, the demands of the domestic household, the poverty of education available to women, and the laws that denied married women’s ownership of funds or property made it virtually impossible for women to take up writing as a profession.Keywords: autonomy, facilities, genius, literature, women
Procedia PDF Downloads 1861498 Recent Policy Changes in Israeli Early Childhood Frameworks: Hope for the Future
Authors: Yaara Shilo
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Early childhood education and care (ECEC)in Israel has undergone extensive reform and now requires daycare centers to meet internationally recognized professional standards. Since 1948, one of the aims of childcare facilities was to enable women’s participation in the workforce.A 1965 law grouped daycare centers for young children with facilities for the elderly and for disabled persons under the same authority. In the 1970’s, ECEC leaders sought to change childcare from proprietary to educational facilities. From 1976 deliberations in the Knesset regarding appropriate attribution of ECEC frameworks resulted in their being moved to various authorities that supported women’s employment: Ministries of Finance, Industry, and Commerce, as well as the Welfare Department. Prior to 2018, 75% of infants and toddlers in institutional care were in unlicensed and unsupervised settings. Legislative processes accompanied the conceptual change to an eventual appropriate attribution of ECEC frameworks. Position papers over the past two decades resulted in recommendations for standards conforming to OECD regulations. Simultaneous incidents of child abuse, some resulting in death, riveted public attention to the need for adequate government supervision, accelerating the legislative process. Appropriate care for very young children must center on quality interactions with caregivers, thus requiring adequate staff training. Finally, in 2018 a law was passed stipulating standards for staff training, proper facilities, child-adult ratios, and safety measures. The Ariav commission expanded training to caregivers for ages 0-3. Transfer of the ECEC to the Ministry of Education ensured establishment of basic training. Groundwork created by new legislation initiated professional development of EC educators for ages 0-3. This process should raise salaries and bolster the system’s ability to attract quality employees. In 2022 responsibility for ECEC ages 0-3 was transferred from the Ministry of Finance to the Ministry of Education, shifting emphasis from proprietary care to professional considerations focusing on wellbeing and early childhood education. The recent revolutionary changes in ECEC point to a new age in the care and education of Israel’s youngest citizens. Implementation of international standards, adequate training, and professionalization of the workforce focus on the child’s needs.Keywords: policy, early childhood, care and education, daycare, development
Procedia PDF Downloads 1081497 Construction Strategy of Urban Public Space in Driverless Era
Authors: Yang Ye, Hongfei Qiu, Yaqi Li
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The planning and construction of traditional cities are oriented by cars, which leads to the problems of insufficient urban public space, fragmentation, and low utilization efficiency. With the development of driverless technology, the urban structure will change from the traditional single-core grid structure to the multi-core model. In terms of traffic organization, with the release of land for traffic facilities, public space will become more continuous and integrated with traffic space. In the context of driverless technology, urban public reconstruction is characterized by modularization and high efficiency, and its planning and layout features accord with points (service facilities), lines (smart lines), surfaces (activity centers). The public space of driverless urban roads will provide diversified urban public facilities and services. The intensive urban layout makes the commercial public space realize the functions of central activities and style display, respectively, in the interior (building atrium) and the exterior (building periphery). In addition to recreation function, urban green space can also utilize underground parking space to realize efficient dispatching of shared cars. The roads inside the residential community will be integrated into the urban landscape, providing conditions for the community public activity space with changing time sequence and improving the efficiency of space utilization. The intervention of driverless technology will change the thinking of traditional urban construction and turn it into a human-oriented one. As a result, urban public space will be richer, more connected, more efficient, and the urban space justice will be optimized. By summarizing the frontier research, this paper discusses the impact of unmanned driving on cities, especially urban public space, which is beneficial for landscape architects to cope with the future development and changes of the industry and provides a reference for the related research and practice.Keywords: driverless, urban public space, construction strategy, urban design
Procedia PDF Downloads 1071496 Factors Relating to Travel Behavior at the Floating Market of Thai Tourists
Authors: Siri-orn Champatong
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The purpose of this research was to study factors that were related with travel behaviors of Thai tourists at the Ayothaya Floating Market, Phra Nakhon Sri Ayutthaya. The quantitative research was conducted with 400 samples of Thai tourists traveling to the Ayothaya Floating Market. The Questionnaire was a tool used to collect data, and the statistics used for data analysis were mean and Pearson product moment correlation coefficient. The results found that Thai tourists focused on attraction, easy access and facilities of the tourist spot at a high level. In addition, they gave priority to the marketing mix in the dimension of products, price, and distribution channels at a high level as well. For marketing promotion, it was at the moderate level. The results of hypothesis testing revealed that factors related to the attractions of the tourist destination, easy access to the tourist destination, the facilities of the tourist spot, and product and price of the marketing mix were associated with travel behaviors in the aspect of the number of visits used and the budget on tourism.Keywords: floating market, marketing mix, tourism attractions, travelling behavior
Procedia PDF Downloads 2781495 Impact of Sociocultural Factors on Management and Utilization of Solid Waste in Ibadan Metropolis, Nigeria
Authors: Olufunmilayo Folaranmi
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This research was carried out to examine the impact of socio-cultural factors on the management and utilization of solid waste in Ibadan Metropolis. A descriptive survey research design was adopted for the study while a systematic and stratified random sampling technique was used to select 300 respondents which were categorized into high, middle and low-density areas. Four hypothesis were tested using chi-square test on variables of unavailability of waste disposal facilities and waste management, negligence of contractors to liaise with community members, lack of adequate environmental education and waste management and utilization, low level of motivation of sanitation workers with solid wastes management, lack of community full participation with solid waste management and utilization. Results showed that significant effect of waste disposal facilities on solid waste management and utilization (X2 +16.6, P < .05). Also, there is a significant relationship between negligence of the contractors to liaise with community elites with improper disposal (X2 = 87.5, P < .05). The motivation of sanitation workers is significantly related to solid waste management (X2 = 70.4, P < .05). Adequate environmental education and awareness influenced solid waste management. There was also a significant relationship between lack of community participation with waste management disposal and improper waste disposal. Based on the findings from the study it was recommended that the quality of life in urban centers should be improved, social welfare of the populace enhanced and environment should be adequately attended to. Poverty alleviation programmes should be intensified and made to live beyond the life of a particular administration, micro-credit facilities should be available to community members to promote their welfare. Lastly, sustained environmental education programmes for citizens at all levels of education, formal and informal through the use of agencies like Ethical and Attitudinal Reorientation Commission (EARCOM) and the National Orientation Agency (NOA).Keywords: management, social welfare, socio-cultural factors, solid waste
Procedia PDF Downloads 2221494 Tracking Patient Pathway for Assessing Public Health and Financial Burden to Community for Pulmonary Tuberculosis: Pointer from Central India
Authors: Ashish Sinha, Pushpend Agrawal
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Background: Patients with undiagnosed pulmonary TB predominantly act as reservoirs for its transmission through 10-15 secondary infections in the next 1-5 Yrs. Delays in the diagnosis and treatment may worsen the disease with increase the risk of death. Factors responsible for such delays by tracking patient pathways to treatment may help in planning better interventions. The provision of ‘free diagnosis and treatment’ forms the cornerstone of the National Tuberculosis Elimination Programme (NTEP). OOPE is defined as the money spent by the patient during TB care other than public health facilities. Free TB care at all health facilities could reduce out-of-pocket expenses to the minimum possible levels. Material and Methods: This cross-sectional study was conducted among randomly selected 252 TB patients from Nov – Oct 2022 by taking in-depth interviews following informed verbal consent. We documented their journey from initial symptoms until they reached the public health facility, along with their ‘out-of-pocket expenditure’ (OOPE) pertaining to TB care. Results: Total treatment delay was 91±72 days on average (median: 77days, IQR: 45-104 days), while the isolated patient delay was 31±45 days (median: 15 days, IQR: 0 days to 43 days); diagnostic delay; 57±60 days (median: 42days, IQR 14-78 days), treatment delay 19 ± 18 days (median: 15days, IQR: 11-19 days). A patient delay (> 30 days) was significantly associated with ignorance about classic symptoms of pulmonary TB, adoption of self-medication, illiteracy, and middle and lower social class. Diagnostic delay was significantly higher among those who contacted private health facilities, were unaware of signs and symptoms, had >2 consultations, and not getting an appropriate referral for TB care. Most (97%) of the study participants interviewed claimed to have incurred some expenditure.Median total expenses were 6155(IQR: 2625-15175) rupees. More than half 141 (56%) of the study participants had expenses >5000 rupees. Median transport expenses were 525(IQR: 200-1012) rupees; Median consultation expenses were 700(IQR: 200-1600) rupees; Median investigation expenses were 1000(IQR: 0-3025) rupees and the Median medicine expenses were 3350(IQR: 1300-7525).OOPE for consultation, investigation, and medicine was observed to be significantly higher among patients who ignored classical signs& symptoms of TB, repeated visits to private health facilities, and due to self-medication practices. Transport expenses and delays in seeking care at facilities were observed to have an upward trend with OOP Expenses (r =1). Conclusion: Delay in TB care due to low awareness about signs and symptoms of TB and poor seeking care, lack of proper consultation, and appropriate referrals reported by the study subjects indicate the areas which need proper attention by the program managers. Despite a centrally sponsored programme, the financial burden on TB patients is still in the unacceptable range. OOPE could be reduced as low as possible by addressing the responsible factors linked to it.Keywords: patient pathway, delay, pulmonary tuberculosis, out of pocket expenses
Procedia PDF Downloads 561493 Statistical Variability of Soil Parameters within the Copper Belt Region of the Democratic Republic of the Congo
Authors: Stephan P. Barkhuizen, Deon Greyling, Ryan J. Miller
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The accurate determination of the engineering parameters of soil is necessary for the design of geotechnical structures, such as Tailings Storage Facilities. The shear strength and saturated permeability of soil and tailings samples obtained from 14 sites located in the copper belt in the Democratic Republic of the Congo have been tested at six commercial soil laboratories in South Africa. This study compiles a database of the test results proved by the soil laboratories. The samples have been categorised into clay, silt, and sand, based on the Unified Soil Classification System, with tailings kept separate. The effective friction angle (Φ’) and cohesion (c’) were interpreted from the stress paths, in s’:t space, obtained from triaxial tests. The minimum, lower quartile, median, upper quartile, and maximum values for Φ’,c’, and saturated hydraulic conductivity (k) have been determined for the soil sample. The objective is to provide statistics of the measured values of the engineering properties for the TSF borrow material, foundation soils and tailings of this region.Keywords: Democratic Republic of the Congo, laboratory test work, soil engineering parameter variation, tailings storage facilities
Procedia PDF Downloads 571492 Port Miami in the Caribbean and Mesoamerica: Data, Spatial Networks and Trends
Authors: Richard Grant, Landolf Rhode-Barbarigos, Shouraseni Sen Roy, Lucas Brittan, Change Li, Aiden Rowe
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Ports are critical for the US economy, connecting farmers, manufacturers, retailers, consumers and an array of transport and storage operators. Port facilities vary widely in terms of their productivity, footprint, specializations, and governance. In this context, Port Miami is considered as one of the busiest ports providing both cargo and cruise services in connecting the wider region of the Caribbean and Mesoamerica to the global networks. It is considered as the “Cruise Capital of the World and Global Gateway of the Americas” and “leading container port in Florida.” Furthermore, it has also been ranked as one of the top container ports in the world and the second most efficient port in North America. In this regard, Port Miami has made significant investments in the strategic and capital infrastructure of about US$1 billion, including increasing the channel depth and other onshore infrastructural enhancements. Therefore, this study involves a detailed analysis of Port Miami’s network, using publicly available multiple years of data about marine vessel traffic, cargo, and connectivity and performance indices from 2015-2021. Through the analysis of cargo and cruise vessels to and from Port Miami and its relative performance at the global scale from 2015 to 2021, this study examines the port’s long-term resilience and future growth potential. The main results of the analyses indicate that the top category for both inbound and outbound cargo is manufactured products and textiles. In addition, there are a lot of fresh fruits, vegetables, and produce for inbound and processed food for outbound cargo. Furthermore, the top ten port connections for Port Miami are all located in the Caribbean region, the Gulf of Mexico, and the Southeast USA. About half of the inbound cargo comes from Savannah, Saint Thomas, and Puerto Plata, while outbound cargo is from Puerto Corte, Freeport, and Kingston. Additionally, for cruise vessels, a significantly large number of vessels originate from Nassau, followed by Freeport. The number of passenger's vessels pre-COVID was almost 1,000 per year, which dropped substantially in 2020 and 2021 to around 300 vessels. Finally, the resilience and competitiveness of Port Miami were also assessed in terms of its network connectivity by examining the inbound and outbound maritime vessel traffic. It is noteworthy that the most frequent port connections for Port Miami were Freeport and Savannah, followed by Kingston, Nassau, and New Orleans. However, several of these ports, Puerto Corte, Veracruz, Puerto Plata, and Santo Thomas, have low resilience and are highly vulnerable, which needs to be taken into consideration for the long-term resilience of Port Miami in the future.Keywords: port, Miami, network, cargo, cruise
Procedia PDF Downloads 751491 Gendered Mobility: Deep Distributions in Urban Transport Systems in Delhi
Authors: Nidhi Prabha
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Transportation as a sector is one of the most significant infrastructural elements of the ‘urban.' The distinctness of an urban life in a city is marked by the dynamic movements that it enables within the city-space. Therefore it is important to study the public-transport systems that enable and foster mobility which characterizes the urban. It is also crucial to underscore the way one is examining the urban transport systems - either as an infrastructural unit in a strict physical-structural sense or as a structural unit which acts as a prism refracting multiple experiences depending on the location of the ‘commuter.' In the proposed paper, the attempt is to uncover and investigate the assumption of the neuter-commuter by looking at urban transportation in the secondary sense i.e. as a structural unit which is experienced differently by different kinds of commuters, thus making transportation deeply distributed with various social structures and locations like class or gender which map onto the transport systems. To this end, the public-transit systems operating in Urban Delhi i.e. the Delhi Metros and the Delhi Transport Corporation run public-buses are looked at as case studies. The study is premised on the knowledge and data gained from both primary and secondary sources. Primary sources include data and knowledge collected from fieldwork, the methodology for which has ranged from adopting ‘mixed-methods’ which is ‘Qualitative-then-Quantitative’ as well as borrowing ethnographic techniques. Apart from fieldwork, other primary sources looked at including Annual Reports and policy documents of the Delhi Metro Rail Corporation (DMRC) and the Delhi Transport Corporation (DTC), Union and Delhi budgets, Economic Survey of Delhi, press releases, etc. Secondary sources include the vast array of literature available on the critical nodes that inform the research like gender, transport geographies, urban-space, etc. The study indicates a deeply-distributed urban transport system wherein the various social-structural locations or different kinds of commuters map onto the way these different commuters experience mobility or movement within the city space. Mobility or movement, therefore, becomes gendered or has class-based ramifications. The neuter-commuter assumption is thus challenged. Such an understanding enables us to challenge the anonymity which the ‘urban’ otherwise claims it provides over the rural. The rural is opposed to the urban wherein urban ushers a modern way of life, breaking ties of traditional social identities. A careful study of the transport systems through the traveling patterns and choices of the commuters, however, indicate that this does not hold true as even the same ‘public-space’ of the transport systems allocates different places to different kinds of commuters. The central argument made though the research done is therefore that infrastructure like urban-transport-systems has to be studied and examined as seen beyond just a physical structure. The various experiences of daily mobility of different kinds of commuters have to be taken into account in order to design and plan more inclusive transport systems.Keywords: gender, infrastructure, mobility, urban-transport-systems
Procedia PDF Downloads 2111490 Analysis of Maternal Death Surveillance and Response: Causes and Contributing Factors in Addis Ababa, Ethiopia, 2022
Authors: Sisay Tiroro Salato
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Background: Ethiopia has been implementing the maternal death surveillance and response system to provide real-time actionable information, including causes of death and contributing factors. Analysis of maternal mortality surveillance data was conducted to identify the causes and underlying factors in Addis Ababa, Ethiopia. Methods: We carried out a retrospective surveillance data analysis of 324 maternal deaths reported in Addis Ababa, Ethiopia, from 2017 to 2021. The data were extracted from the national maternal death surveillance and response database, including information from case investigation, verbal autopsy, and facility extraction forms. The data were analyzed by computing frequency and presented in numbers, proportions, and ratios. Results: Of 324 maternal deaths, 92% died in the health facilities, 6.2% in transit, and 1.5% at home. The mean age at death was 28 years, ranging from 17 to 45. The maternal mortality ratio per 100,000 live births was 77for the five years, ranging from 126 in 2017 to 21 in 2021. The direct and indirect causes of death were responsible for 87% and 13%, respectively. The direct causes included obstetric haemorrhage, hypertensive disorders in pregnancy, puerperal sepsis, embolism, obstructed labour, and abortion. The third delay (delay in receiving care after reaching health facilities) accounted for 57% of deaths, while the first delay (delay in deciding to seek health care) and the second delay (delay in reaching health facilities) and accounted for 34% and 24%, respectively. Late arrival to the referral facility, delayed management after admission, andnon-recognition of danger signs were underlying factors. Conclusion: Over 86% of maternal deaths were attributed by avoidable direct causes. The majority of women do try to reach health services when an emergency occurs, but the third delays present a major problem. Improving the quality of care at the healthcare facility level will help to reduce maternal death.Keywords: maternal death, surveillance, delays, factors
Procedia PDF Downloads 961489 Integration of Acoustic Solutions for Classrooms
Authors: Eyibo Ebengeobong Eddie, Halil Zafer Alibaba
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The neglect of classroom acoustics is dominant in most educational facilities, meanwhile, hearing and listening is the learning process in this kind of facilities. A classroom should therefore be an environment that encourages listening, without an obstacles to understanding what is being taught. Although different studies have shown teachers to complain that noise is the everyday factor that causes stress in classroom, the capacity of individuals to understand speech is further affected by Echoes, Reverberation, and room modes. It is therefore necessary for classrooms to have an ideal acoustics to aid the intelligibility of students in the learning process. The influence of these acoustical parameters on learning and teaching in schools needs to be further researched upon to enhance the teaching and learning capacity of both teacher and student. For this reason, there is a strong need to provide and collect data to analyse and define the suitable quality of classrooms needed for a learning environment. Research has shown that acoustical problems are still experienced in both newer and older schools. However, recently, principle of acoustics has been analysed and room acoustics can now be measured with various technologies and sound systems to improve and solve the problem of acoustics in classrooms. These acoustic solutions, materials, construction methods and integration processes would be discussed in this paper.Keywords: classroom, acoustics, materials, integration, speech intelligibility
Procedia PDF Downloads 4131488 Energy Efficient Resource Allocation and Scheduling in Cloud Computing Platform
Authors: Shuen-Tai Wang, Ying-Chuan Chen, Yu-Ching Lin
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There has been renewal of interest in the relation between Green IT and cloud computing in recent years. Cloud computing has to be a highly elastic environment which provides stable services to users. The growing use of cloud computing facilities has caused marked energy consumption, putting negative pressure on electricity cost of computing center or data center. Each year more and more network devices, storages and computers are purchased and put to use, but it is not just the number of computers that is driving energy consumption upward. We could foresee that the power consumption of cloud computing facilities will double, triple, or even more in the next decade. This paper aims at resource allocation and scheduling technologies that are short of or have not well developed yet to reduce energy utilization in cloud computing platform. In particular, our approach relies on recalling services dynamically onto appropriate amount of the machines according to user’s requirement and temporarily shutting down the machines after finish in order to conserve energy. We present initial work on integration of resource and power management system that focuses on reducing power consumption such that they suffice for meeting the minimizing quality of service required by the cloud computing platform.Keywords: cloud computing, energy utilization, power consumption, resource allocation
Procedia PDF Downloads 3301487 Preliminary Study on Chinese Traditional Garden Making Based on Water Storage Projects
Authors: Liu Fangxin, Zhao Jijun
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Nowadays, China and the world are facing the same problems of flooding, city waterlogging and other environment issues. Throughout history, China had many excellent experiences dealing with the flood, and can be used as a significant reference for contemporary urban construction. In view of this, the research used the method of literature analysis to find out the main water storage measures in ancient cities, including reservoir storage and pond water storage. And it used the case study method to introduce the historical evolution, engineering measures and landscape design of 4 typical ancient Chinese cities in details. Then we found the pond and the reservoir were the main infrastructures for the ancient Chinese city to avoid the waterlogging and flood. At last this paper summed up the historical experience of Chinese traditional water storage and made conclusions that the establishment of a reasonable green water storage facilities could be used to solve today's rain and flood problems, and hoped to give some enlightenment of stormwater management to our modern city.Keywords: ancient Chinese cities, water storage project, Chinese classical gardening, stormwater management, green facilities
Procedia PDF Downloads 3321486 Missed Opportunities for Immunization of under Five Children in Calabar South County Cros River State, Nigeria, the Way Forward
Authors: Celestine Odigwe, Epoke Lincoln, Rhoda-Dara Ephraim
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Background; Immunization against the childhood killer diseases is the cardinal strategy for the prevention of these diseases all over the world in under five children, these diseases include; Tuberculosis, Measles, Polio, Tetanus, Diphthria, Pertusis, Yellow Fever, Hepatitis B, Haemophilus Influenza type B. 6.9 million children die before their fifth birthday , 80% of the worlds death in children under 5 years occur in 25 countries most in Africa and Asia and 2 million children can be saved each year with routine immunization Therefore failure to achieve total immunization coverage puts several children at risk. Aim; The aim of the study was to ascertain the prevalence, Investigate the various reasons and causes why several under five children in a suburb of calabar municipal county fail to get the required immunizations as at and when due and possibly the consequences, so that efforts can be re-directed towards the solution of the problems so identified. Methods; the study was a community based cross sectional study. The respondents were the mothers/guardians of the sampled children who were all aged 0-59 months. To be eligible for recruitment into the study, the parent or guardian was required to give an informed consent, reside within the Calabar South County with his/her children aged 0-59 months. We calculated our sample size using the Leslie-Kish formula and we used a two-staged sampling method, first to ballot for the wards to be involved and then to select four of the most populated ones in the wards chosen. Data collection was by interviewer administered structured questionnaire (Appendix I), Data collected was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Percentages were calculated and represented using charts and tables Results; The number of children sampled was 159. We found that 150 were fully immunized and 9 were not, the prevalence of missed opportunity was 32% from the study. The reasons for missed opportunities were varied, ranging from false contraindications, logistical problems resulting in very poor access roads to health facilities and poor organization of health centers together with negative health worker attitudes. Some of the consequences of these missed opportunities were increased susceptibility to vaccine preventable diseases, resurgence of the above diseases and increased morbidity and mortality of children aged less than 5 years. Conclusion; We found that ignorance on the part of both parents/guardians and health care staff together with infrastructural inadequacies in the county such as- roads, poor electric power supply for storage of vaccines were hugely responsible for most missed opportunities for immunization. The details of these and suggestions for improvement and the way forward are discussed.Keywords: missed opportunity, immunization, under five, Calabar south
Procedia PDF Downloads 3201485 Shiva's Dance: Crisis, Local Institutions, and Private Firms
Authors: João Pereira Dos Santos
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The uneven spatial distribution of start-ups and their respective survival may reflect comparative advantages resulting from the local institutional background. For the first time, we explore this idea using Data Envelopment Analysis (DEA) to assess relative efficiency of Portuguese municipalities in this specific context. We depart from the related literature where expenditure is perceived as a desirable input by choosing a measure of fiscal responsibility and infrastructural variables in the first stage. Comparing results for 2006 and 2010, we find that mean performance decreased substantially with 1) the effects of the Global Financial Crisis; 2) as municipal population increases and 3) as financial independence decreases. A second stage is then computed employing a double-bootstrap procedure to evaluate how the regional context outside the control of local authorities (e.g. demographic characteristics and political preferences) impacts on efficiency.Keywords: entrepreneurship, political economy, public finance, accountability, crisis, efficiency, Portuguese municipalities
Procedia PDF Downloads 4971484 Development a Battery of Measurements to Assess Giftedness Initiatives in Light of the Objectives of Saudi Arabia's Future Vision of Gifted Education
Authors: Saeed M. Al Qahtani, Alaa Eldin A. Ayoub
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The study aimed to develop a battery of measures to assessment gifted initiatives in Saudi Arabia. The battery consisted of 17 measures developed in light of Saudi Arabia's future vision objectives for gifted education. A battery was applied to 193 gifted students who benefit from gifted initiatives and programs, 42 teachers of gifted as well as, 40 experts of gifted. Samples were taken from three main regions: Riyadh, Sharqia, Gharbia in Saudi Arabia. The results indicated that battery measures have a reliability and stability index ranging from 0.6 to 0.87. Besides that, results showed that the educational environment lacks many basic components such as facilities, laboratories, and activities that may stimulate creativity and innovation. Furthermore, results showed that there is a weakness in private sector involvement in the construction of educational buildings, special centers for gifted people and the provision of certain facilities that support talented programs. The recommendations of the study indicate the need for the private sector participation in the provision of services and projects for the care of gifted students in Saudi Arabia.Keywords: battery of measures, gifted care initiatives, Saudi future vision, gifted student
Procedia PDF Downloads 1601483 Evaluating the Service Quality and Customers’ Satisfaction for Lihpaoland in Taiwan
Authors: Wan-Yu Liu, Tiffany April Lin, Yu-Chieh Tang, Yi-Lin Wang, Chieh-Hui Li
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As the national income in Taiwan has been raised, the life style of the public has also been changed, so that the tourism industry gradually moves from a service industry to an experience economy. The Lihpaoland is one of the most popular theme parks in Taiwan. However, the related works on performance of service quality of the park have been lacking since its re-operation in 2012. Therefore, this study investigates the quality of software/hardware facilities and services of the Lihpaoland, and aims to achieve the following three goals: 1) analyzing how various sample data of tourists leads to different results for service quality of LihpaoLand; 2) analyzing how tourists respond to the service tangibility, service reliability, service responsiveness, service guarantee, and service empathy of LihpaoLand; 3) according to the theoretical and empirical results, proposing how to improve the overall facilities and services of LihpaoLand, and hoping to provide suggestions to the LihpaoLand or other related businesses to make decision. The survey was conducted on the tourists to the LihpaoLand using convenience sampling, and 400 questionnaires were collected successfully. Analysis results show that tourists paid much attention to maintenance of amusement facilities and safety of the park, and were satisfied with them, which are great advantages of the park. However, transportation around the LihpaoLand was inadequate, and the price of the Fullon hotel (which is the hotel closest to the LihpaoLand) were not accepted by tourists – more promotion events are recommended. Additionally, the shows are not diversified, and should be improved with the highest priority. Tourists did not pay attention to service personnel’s clothing and the ticket price, but they were not satisfied with them. Hence, this study recommends to design more distinctive costumes and conduct ticket promotions. Accordingly, the suggestions made in this study for LihpaoLand are stated as follows: 1) Diversified amusement facilities should be provided to satisfy the needs at different ages. 2) Cheep but tasty catering and more distinctive souvenirs should be offered. 3) Diversified propaganda schemes should be strengthened to increase number of tourists. 4) Quality and professional of the service staff should be enhanced to acquire public praise and tourists revisiting. 5) Ticket promotions in peak seasons, low seasons, and special events should be conducted. 6) Proper traffic flows should be planned and combined with technologies to reduce waiting time of tourists. 7) The features of theme landscape in LihpaoLand should be strengthened to increase willingness of the tourists with special preferences to visit the park. 8) Ticket discounts or premier points card promotions should be adopted to reward the tourists with high loyalty.Keywords: service quality, customers’ satisfaction, theme park, Taiwan
Procedia PDF Downloads 4671482 Sleep Health Management in Residential Aged Care Facilities
Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini
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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.Keywords: registered nurses, residential aged care facilities, sedative use, sleep
Procedia PDF Downloads 1011481 Economic Environment and Entrepreneurial Development in Lagos and Ogun States, Nigeria
Authors: Jayeola Olabisi, T. Olawale Oladunjoye, Ademola A. Adewumi
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The study empirically examines the relationship that exists between the economic environment and entrepreneurial development in Nigeria. A structured questionnaire is administered on the study and data collected are analysed using Analysis of Variance and Regression. The following variables are indices of determination; Interest Rate (IR); Income Tax (IT). The results of the study show that there is a significant relationship between IR and ED in Nigeria (p < 0.5) with a positive correlation (r=0.526, r2=0.276). Also, there is a significant relationship between IT and ED in Nigeria (p < 0.05), with a positive association (r=0.546; r2=0.299). The study concludes that the emergence of the higher level of the stable economic environment is critical to entrepreneurial development in Nigeria. Therefore, government involvement in public private partnership for infrastructural development, enlargement of productive, judicious and transparent use of funds collected from income tax and affordable interest rate will galvanise the inward sourcing of raw materials that boost entrepreneurial development in Nigeria.Keywords: interest rate, income tax, business environment and entrepreneurial development
Procedia PDF Downloads 3571480 Understanding Barriers to Sports Participation as a Means of Achieving Sustainable Development in Michael Otedola College of Primary Education
Authors: Osifeko Olalekan Remigious, Osifeko Christiana Osikorede, Folarin Bolanle Eunice, Olugbenga Adebola Shodiya
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During these difficult economic times, nations are looking for ways to improve their finances, preserve the environment as well as the socio-political climate and educational institutions, which are needed to increase their economy and preserve their sustainable development. Sport is one of the ways through which sustainable development can be achieved. The purpose of this study was to examine and understanding barriers to participation in sport. A total of 1,025 students were purposively selected from five schools (School of Arts and Social Sciences, School of Languages, School of Education, School of Sciences and School of Vocational and Technical Education) in Michael Otedola College of Primary Education (MOCPED). A questionnaire, with a tested reliability coefficient of 0.71, was used for data collection. The collected data were subjected to the descriptive survey research design. The findings showed that sports facilities, funding and lecture schedules were significant barriers to sports participation. It was recommended that sports facilities be provided by the Lagos State government.Keywords: sports, sustainable development, Participation, State government, barriers
Procedia PDF Downloads 2491479 Barriers to Access among Indigenous Women Seeking Prenatal Care: A Literature Review
Authors: Zarish Jawad, Nikita Chugh, Karina Dadar
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Introduction: This paper aims to identify barriers indigenous women face in accessing prenatal care in Canada. It explores the differences in prenatal care received between indigenous and non-indigenous women. The objective is to look at changes or programs in Canada's healthcare system to reduce barriers to accessing safe prenatal care for indigenous women. Methods: A literature search of 12 papers was conducted using the following databases: PubMed, Medline, OVID, Google Scholar, and ScienceDirect. The studies included were written in English only, including indigenous females between the age of 19-35, and review articles were excluded. Participants in the studies examined did not have any severe underlying medical conditions for the duration of the study, and study designs included in the review are prospective cohort, cross-sectional, case report, and case-control studies. Results: Among all the barriers Indigenous women face in accessing prenatal care, the three most significant barriers Indigenous women face include a lack of culturally safe prenatal care, lack of services in the Indigenous community, proximity of prenatal facilities to Indigenous communities and costs of transportation. Discussion: The study found three significant barriers indigenous women face in accessing prenatal care in Canada; the geographical distribution of healthcare facilities, distrust between patients and healthcare professionals, and cultural sensitivity. Some of the suggested solutions include building more birthing and prenatal care facilities in rural areas for indigenous women, educating healthcare professionals on culturally sensitive healthcare, and involving indigenous people in the decision-making process to reduce distrust and power imbalances. Conclusion: The involvement of indigenous women and community leaders is important in making decisions regarding the implementation of effective healthcare and prenatal programs for indigenous women. However, further research is required to understand the effectiveness of the solutions and the barriers that make prenatal care less accessible for indigenous women in Canada.Keywords: indigenous, maternal health, prenatal care, barriers
Procedia PDF Downloads 1431478 Internally Displaced Persons: Implication to National Development in Nigeria
Authors: Olasunkanmi G. Jeje, John G. Laah, Eunice S. A. Jeje
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In recent times Nigeria has been bedeviled with political, religious and ethnic crises such as indigene/settler phenomena, Boko Haram etc. resulting in the emergence of internally displaced persons(IDPs), this has been a hunch on national development. Most states of the federation have had their share of one crisis or the other such as Jos, Yobe, Borno etc thereby affecting the economy of the country. These persons are uprooted from their residential locations of which they are active contributors to the national GDP. In addition, the attempt to rehabilitate them has gulped billions of naira for feeding, shelter and medicals etc., which is not adequate for such. However, the financing could have been used for projects such as capacity building and infrastructural development. Similarly, traumatic experience by this group of people is overwhelming as most of them are mainly the aged, women and children. Importantly, the active roles of youths that constitute the productive sector of the economy have also been truncated. Therefore, it is the prerogative of this research to examine the effect of IDP's on National Development and also to recommend solutions.Keywords: development, implication, internally displaced persons, Nigeria
Procedia PDF Downloads 3101477 Policy of Tourism and Opportunities of Development of Wellness Industry in Georgia
Authors: G. Erkomaishvili, R. Gvelesiani, E. Kharaishvili, M. Chavleishvili
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The topic reviews the situation existing currently in Georgia in the field of tourism in conditions of globalization: Touristic resources, the paces of development of the tourism infrastructure, tourism policy, possibilities of development of the Wellness industry in Georgia that is the newest direction of the medical tourism. The factors impeding the development of the industry of tourism, namely-existence of the conflict zones, high rates of the bank credits, deficiencies associated with the tax laws, a level of infrastructural development, quality of services, deficit in the competitive staff, increase of prices in the peak seasons, insufficient promotion of the touristic opportunities of Georgia on the international markets are studied and analyzed. Besides, the levels of development of tourism in Georgia according to the World Economic Forum, aspects of cooperation with the European Union etc. are reviewed. As a result of these studies, a strategy of development of tourism and one of its directions-Wellness industries in Georgia is introduced with the relevant conclusions, on which basis the recommendations are provided.Keywords: about tourism, tourism policy, wellness industry, business, innovation, technology
Procedia PDF Downloads 5121476 Community Resilience in Response to the Population Growth in Al-Thahabiah Neighborhood
Authors: Layla Mujahed
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Amman, the capital of Jordan, is the main political, economic, social and cultural center of Jordan and beyond. The city faces multitude demographic challenges related to the unstable political situation in the surrounded countries. It has regional and local migrants who left their homes to find better life in the capital. This resulted with random and unequaled population distribution. Some districts have high population and pressure on the infrastructure and services more than other districts.Government works to resolve this challenge in compliance with 100 Cities Resilience Framework (CRF). Amman participated in this framework as a member in December 2014 to work in achieving the four goals: health and welfare, infrastructure and utilities, economy and education as well as administration and government. Previous research studies lack in studying Amman resilient work in neighborhood scale and the population growth as resilient challenge. For that, this study focuses on Al-Thahabiah neighborhood in Shafa Badran district in Amman. This paper studies the reasons and drivers behind this population growth during the selected period in this area then provide strategies to improve the resilient work in neighborhood scale. The methodology comprises of primary and secondary data. The primary data consist of interviews with chief officer in the executive part in Great Amman Municipality and resilient officer. The secondary data consist of papers, journals, newspaper, articles and book’s reading. The other part of data consists of maps and statistical data which describe the infrastructural and social situation in the neighborhood and district level during the studying period. Based upon those data, more detailed information will be found, e.g., the centralizing position of population and the provided infrastructure for them. This will help to provide these services and infrastructure to other neighborhoods and enhance population distribution. This study develops an analytical framework to assess urban demographical time series in accordance with the criteria of CRF to make accurate detailed projections on the requirements for the future development in the neighborhood scale and organize the human requirements for affordable quality housing, employment, transportation, health and education in this neighborhood to improve the social relations between its inhabitants and the community. This study highlights on the localization of resilient work in neighborhood scale and spread the resilient knowledge related to the shortage of its research in Jordan. Studying the resilient work from population growth challenge perspective helps improve the facilities provide to the inhabitants and improve their quality of life.Keywords: city resilience framework, demography, population growth, stakeholders, urban resilience
Procedia PDF Downloads 1741475 Adoption of Electronic Logistics Management Information System for Life-Saving Maternal, Neonatal and Child Health Medicines: A Bangladesh Perspective
Authors: Mohammad Julhas Sujan, Md. Ferdous Alam
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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.Keywords: adaption, eLMIS, MNCH, live-saving medicines
Procedia PDF Downloads 1581474 Long Distance Aspirating Smoke Detection for Large Radioactive Areas
Authors: Michael Dole, Pierre Ninin, Denis Raffourt
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Most of the CERN’s facilities hosting particle accelerators are large, underground and radioactive areas. All fire detection systems installed in such areas, shall be carefully studied to cope with the particularities of this stringent environment. The detection equipment usually chosen by CERN to secure these underground facilities are based on air sampling technology. The electronic equipment is located in non-radioactive areas whereas air sampling networks are deployed in radioactive areas where fire detection is required. The air sampling technology provides very good detection performances and prevent the "radiation-to-electronic" effects. In addition, it reduces the exposure to radiations of maintenance workers and is permanently available during accelerator operation. In order to protect the Super Proton Synchrotron and its 7 km tunnels, a specific long distance aspirating smoke detector has been developed to detect smoke at up to 700 meters between electronic equipment and the last air sampling hole. This paper describes the architecture, performances and return of experience of the long distance fire detection system developed and installed to secure the CERN Super Proton Synchrotron tunnels.Keywords: air sampling, fire detection, long distance, radioactive areas
Procedia PDF Downloads 1521473 Northern Nigeria Vaccine Direct Delivery System
Authors: Evelyn Castle, Adam Thompson
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Background: In 2013, the Kano State Primary Health Care Management Board redesigned its Routine immunization supply chain from diffused pull to direct delivery push. It addressed issues around stockouts and reduced time spent by health facility staff collecting, and reporting on vaccine usage. The health care board sought the help of a 3PL for twice-monthly deliveries from its cold store to 484 facilities across 44 local governments. eHA’s Health Delivery Systems group formed a 3PL to serve 326 of these new facilities in partnership with the State. We focused on designing and implementing a technology system throughout. Basic methodologies: GIS Mapping: - Planning the delivery of vaccines to hundreds of health facilities requires detailed route planning for delivery vehicles. Mapping the road networks across Kano and Bauchi with a custom routing tool provided information for the optimization of deliveries. Reducing the number of kilometers driven each round by 20%, - reducing cost and delivery time. Direct Delivery Information System: - Vaccine Direct Deliveries are facilitated through pre-round planning (driven by health facility database, extensive GIS, and inventory workflow rules), manager and driver control panel customizing delivery routines and reporting, progress dashboard, schedules/routes, packing lists, delivery reports, and driver data collection applications. Move: Last Mile Logistics Management System: - MOVE has improved vaccine supply information management to be timely, accurate and actionable. Provides stock management workflow support, alerts management for cold chain exceptions/stock outs, and on-device analytics for health and supply chain staff. Software was built to be offline-first with user-validated interface and experience. Deployed to hundreds of vaccine storage site the improved information tools helps facilitate the process of system redesign and change management. Findings: - Stock-outs reduced from 90% to 33% - Redesigned current health systems and managing vaccine supply for 68% of Kano’s wards. - Near real time reporting and data availability to track stock. - Paperwork burdens of health staff have been dramatically reduced. - Medicine available when the community needs it. - Consistent vaccination dates for children under one to prevent polio, yellow fever, tetanus. - Higher immunization rates = Lower infection rates. - Hundreds of millions of Naira worth of vaccines successfully transported. - Fortnightly service to 326 facilities in 326 wards across 30 Local Government areas. - 6,031 cumulative deliveries. - Over 3.44 million doses transported. - Minimum travel distance covered in a round of delivery is 2000 kms & maximum of 6297 kms. - 153,409 kms travelled by 6 drivers. - 500 facilities in 326 wards. - Data captured and synchronized for the first time. - Data driven decision making now possible. Conclusion: eHA’s Vaccine Direct delivery has met challenges in Kano and Bauchi State and provided a reliable delivery service of vaccinations that ensure t health facilities can run vaccination clinics for children under one. eHA uses innovative technology that delivers vaccines from Northern Nigerian zonal stores straight to healthcare facilities. Helped healthcare workers spend less time managing supplies and more time delivering care, and will be rolled out nationally across Nigeria.Keywords: direct delivery information system, health delivery system, GIS mapping, Northern Nigeria, vaccines
Procedia PDF Downloads 3641472 Linking the Built Environment, Activities and Well-Being: Examining the Stories among Older Adults during Ageing-in-Place
Authors: Wenquan Gan, Peiyu Zhao, Xinyu Zhao
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Under the background of the rapid development of China’s ageing population, ageing-in-place has become a primary strategy to cope with this problem promoted by the Chinese government. However, most older adults currently living in old residential communities are insufficient to support their ageing-in-place. Therefore, exploring how to retrofit existing communities towards ageing-friendly standards to support older adults is essential for healthy ageing. To better cope with this issue, this study aims to shed light on the inter-relationship among the built environment, daily activities, and well-being of older adults in urban China. Using mixed research methods including GPS tracking, structured observation, and in-depth interview to examine: (a) what specific places or facilities are most commonly used by the elderly in the ageing-in-place process; (b) what specific built environment characteristics attract older adults in these frequently used places; (c) how has the use of these spaces impacted the well-being of older adults. Specifically, structured observation and GPS are used to record and map the older residents’ behaviour and movement in Suzhou, China, a city with a highly aged population and suitable as a research case. Subsequently, a follow-up interview is conducted to explore what impact of activities and the built environment on their well-being. Results showed that for the elderly with good functional ability, the facilities promoted by the Chinese government to support ageing-in-place, such as community nursing homes for the aged, day-care centre, and activity centres for the aged, are rarely used by older adults. Additionally, older adults have their preferred activities and built environment characteristics that contribute to their well-being. Our findings indicate that a complex interrelationship between the built environment and activities can influence the well-being of the elderly. Further investigations are needed to understand how to support healthy ageing-in-place, especially in addition to providing permanent elder-ly-care facilities, but to attend to the design interventions that can enhance these particularly built environment characteristics to facilitate a healthy lifestyle in later life.Keywords: older adults, built environment, spatial behavior, community activity, healthy ageing
Procedia PDF Downloads 891471 Supply Side Readiness for Universal Health Coverage: Assessing the Availability and Depth of Essential Health Package in Rural, Remote and Conflict Prone District
Authors: Veenapani Rajeev Verma
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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.Keywords: effective coverage, principal component analysis, readiness index, universal health coverage
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