Search results for: community health commodities distribution

Authors: Nishimwe Clemence, Mchunu Gugu, Mukamusoni Dariya

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Background: Community health workers and extension workers can play an important role in supporting families to adopt health practices, encourage delivery in a health care facility, and ensure time referral of mothers and newborns if needed. Saving the lives of neonates should, therefore, be a significant health outcome in any maternal and newborn health program that is being implemented. Furthermore, about half of a million mothers die from pregnancy-related causes. Maternal and newborn deaths related to the period of postnatal care are neglected. Some authors emphasized that in developing countries, newborn mortality rates have been reduced much more slowly because of the lack of many necessary facility-based and outreach service. The aim of this review was to critically analyze the implementation and integration process of the maternal and newborn health care program by maternal community health workers, into the health care system, in Africa. Furthermore, it aims to reduce maternal and newborn mortality. We addressed the following review question: (1) what process is involved in the implementation and integration of the maternal and newborn health care program by maternal community health workers during antenatal, delivery and postnatal care into health system care in Africa? Methods: The database searched was from Health Source: Nursing/Academic Edition through academic search complete via EBSCO Host. An iterative approach was used to go through Google scholarly papers. The reviewers considered adapted Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance, and the Mixed Methods Appraisal Tool (MMAT) was used. Synthesis method in integrative review following elements of noting patterns and themes, seeing plausibility, clustering, counting, making contrasts and comparisons, discerning commons and unusual patterns, subsuming particulars into general, noting relations between variability, finding intervening factors and building a logical chain of evidence, using data–based convergent synthesis design. Results: From the seventeen of studies included, results focused on three dimensions inspired by the literature on antenatal, delivery, and postnatal interventions. From this, further conceptual framework was elaborated. The conceptual framework process of implementation and integration of maternal and newborn health care program by maternal community health workers was elaborated in order to ensure the sustainability of community based intervention. Conclusions: the review revealed that the implementation and integration of maternal and newborn health care program require planning. We call upon governments, non-government organizations, the global health community, all stakeholders including policy makers, program managers, evaluators, educators, and providers to be involved in implementation and integration of maternal and newborn health program in updated policy and community-based intervention. Furthermore, emphasis should be placed on competence, responsibility, and accountability of maternal community health workers, their training and payment, collaboration with health professionals in health facilities, and reinforcement of outreach service. However, the review was limited in focus to the African context, where the process of maternal and newborn health care program has been poorly implemented.

Keywords: Africa, implementation of integration, maternal, newborn

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Authors: Yue Wang, Fan Chen

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After the economic reform in 1978, the urbanization in China has grown fast. It urged cities to expand in an unprecedented high speed. Villages around were annexed unprepared, and it turned out to be a new type of community called 'village in city.' Two things happened here. First, the locals gave up farming and turned to secondary industry and tertiary industry, as a result of losing their land. Secondly, attracted by the high income in cities and low rent here, plenty of migrants came into the community. This area is important to a city in rapid growth for providing a transitional zone. But thanks to its passivity and low development, 'village in city' has caused lots of trouble to the city. Densities of population and construction are both high, while facilities are severely inadequate. Unplanned and illegal structures are built, which creates a complex mixed-function area and leads to a bad residential area. Besides, the locals have a strong property right consciousness for the land. It holds back the transformation and development of the community. Although the land capitalization can bring significant benefits, it’s inappropriate to make a great financial compensation to the locals, and considering the large population of city migrants, it’s important to explore the relationship among the 'village in city,' city immigrants and the city itself. Taking the example of Hangzhou, this paper analyzed the developing process, functions spatial distribution, industrial structure and current traffic system of 'village in city.' Above the research on the community, this paper put forward a common method to make urban planning through the following ways: adding city functions, building civil facilities, re-planning functions spatial distribution, changing the constitution of local industry and planning new traffic system. Under this plan, 'village in city' finally can be absorbed into cities and make its own contribution to the urbanization.

Keywords: China, city immigrant, urbanization, village in city

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Authors: Oluwayemisi O. Alaba, John O. Olaomi

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The 2013 Nigerian Demographic Health Survey (NDHS) data was used to investigate the determinants of family size in Nigeria using the geo-additive model. The fixed effect of categorical covariates were modelled using the diffuse prior, P-spline with second-order random walk for the nonlinear effect of continuous variable, spatial effects followed Markov random field priors while the exchangeable normal priors were used for the random effects of the community and household. The Negative Binomial distribution was used to handle overdispersion of the dependent variable. Inference was fully Bayesian approach. Results showed a declining effect of secondary and higher education of mother, Yoruba tribe, Christianity, family planning, mother giving birth by caesarean section and having a partner who has secondary education on family size. Big family size is positively associated with age at first birth, number of daughters in a household, being gainfully employed, married and living with partner, community and household effects.

Keywords: Bayesian analysis, family size, geo-additive model, negative binomial

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Authors: Oluwayemisi Femi-Pius, Kazeem Arogundade, Eberechukwu Eke, Jimmy Eko

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Introduction: Globally, community involvement in improving their own health has been widely adopted as a strategy in Sub-Saharan Africa principally to ensure equitable access to essential health care as well as improve the uptake of maternal and newborn health services especially in poor-resource settings. Method: The Saving Mother Giving Life (SMGL) Initiative implemented by Pathfinder International with funding support from USAID conducted a Health Facility Assessment (HFA) and found out that maternal mortality ratio in Cross River State was 812 per 100,000 live birth and perinatal mortality was 160 per 1000 live birth. To reduce maternal and perinatal mortality, Pathfinder International mobilized, selected and trained community members as community volunteers, traditional birth attendants, and emergency transport service volunteer drivers mainly to address the delay in decision making and reaching the health facility among pregnant women. Results: The results showed that maternal mortality ratio in Cross River State decrease by 25% from 812 per 100,000 live birth at baseline to 206 per 100,000 live birth at June 2018 and perinatal mortality reduced by 35% from 160 per 100,000 at baseline to 58 per 1000 live birth at June 2018. Data also show that ANC visit increased from 7,451 to 11,344; institutional delivery increased from 8,931 at baseline to 10,784 in June 2018. There was also a remarkable uptake of post-partum family planning from 0 at baseline to 233 in June 2018. Conclusion: There is clear evidence that community involvement yields positive maternal outcomes and is pivotal for sustaining most health interventions.

Keywords: maternal mortality, Nigeria, pathfinder international, perinatal mortality, saving mother giving life

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Authors: Sarkar Humayun Kabir

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This paper aims to investigate whether ethical investment instruments could contribute to stability in financial markets. In order to address the main issue, the study investigates the stability of return in seven conventional and Islamic equity markets of Asia, Europe and North America and in five major commodity markets starting from 1996 to June 2012. In addition, the study examines the unconditional correlation between returns of the assets under review to investigate portfolio diversification benefits of investors. Applying relevant methods, the study finds that investors may enjoy sustainable returns from their portfolios by investing in ethical financial instruments such as Islamic equities. In addition, it should be noted that most of the commodities, gold in particular, are either low or negatively correlated with equity returns. These results suggest that investors would be better off by investing in portfolios combining Islamic equities and commodities in general. The sustainable returns of ethical investments has important implications for the investors and markets since these investments can provide stable returns while the investors can avoid production of goods and services which believes to be harmful for human and the society as a whole.

Keywords: financial sustainability, ethical investment instruments, islamic equity, dynamic conditional correlation, conditional volatility

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Authors: Natalia Alvarado, Myldred Hernandez-Gonzalez, Mary Laird, Madeline Phillips, Elizabeth Miller, Luis Mendez, Teresa Satterfield Linares

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Objectives: Focusing on the reported levels of depressive symptoms from Hispanic individuals in the U.S. during the ongoing COVID-19 pandemic, we analyze the psychological effects of being labeled an ‘essential worker/trabajador(a) esencial.’ We situate this attribute within the complex context of how an individual’s mental health is linked to work status and his/her community’s attitude toward such a status. Method: 336 Spanish-speaking adults (Mage = 34.90; SD = 11.00; 46% female) living in the U.S. participated in a mixed-method study. Participants completed a self-report Spanish-language survey consisting of COVID-19 prompts (e.g., Soy un trabajador esencial durante la pandemia. I am an ‘essential worker’ during the pandemic), civic engagement scale (CES) attitudes (e.g., Me siento responsable de mi comunidad. I feel responsible for my community) and behaviors (e.g., Ayudo a los miembros de mi comunidad. I help members of my community), and the Center for Epidemiological Studies Depression Scale (e.g., Me sentía deprimido/a. I felt depressed). The survey was conducted several months into the pandemic and before the vaccine distribution. Results: Regression analyses show that being labeled an essential worker was correlated to CES attitudes (b= .28, p < .001) and higher CES behaviors (b= .32, p < .001). Essential worker status also reported higher levels of depressive symptoms (b= .17, p < .05). In addition, we found that CES attitudes and CES behaviors were related to higher levels of depressive symptoms (b= .11, p <.05, b = .22, p < .001, respectively). These findings suggest that those who are on the frontlines during the COVID-19 pandemic suffer higher levels of depressive symptoms, despite their affirming community attitudes and behaviors. Discussion: Hispanics/Latinxs make up 53% of the high-proximity employees who must work in person and in close contact with others; this is the highest rate of any racial or ethnic category. Moreover, 31% of Hispanics are classified as essential workers. Our outcomes show that those labeled as trabajadores esenciales convey attitudes of remaining strong and resilient for COVID-19 victims. They also express community attitudes and behaviors reflecting a sense of responsibility to continue working to help others during these unprecedented times. However, we also find that the pressure of maintaining basic needs for others exacerbates mental health challenges and stressors, as many essential workers are anxious and stressed about their physical and economic security. As a result, community attitudes do not protect from depressive symptoms as Hispanic essential workers are failing to balance everyone’s needs, including their own (e.g., physical exhaustion and psychological distress). We conclude with a discussion on alternatives to the phrase ‘essential worker’ and of incremental steps that can be taken to address pandemic-related mental health issues targeting US Hispanic workers.

Keywords: COVID-19, essential worker, mental health, race and ethnicity

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Authors: R. Rezaeipour, A. R. Mehrabi

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Recent increase of the DGs and microgrids in distribution systems, disturbs the tradition structure of the system. Coordination between protection devices in such a system becomes the concern of the network operators. This paper presents a new method for fault location detection in the active distribution networks, independent of the fault type or its resistance. The method uses synchronized voltage and current measurements at the interconnection of DG units and is able to adapt to changes in the topology of the system. The method has been tested on a 38-bus distribution system, with very encouraging results.

Keywords: fault location detection, active distribution system, micro grids, network operators

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Authors: Rancy Chepchirchir Kosgey, John Olukuru

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This study examines the impact of introduction of futures trading on the spot price volatility in the commodity market. The paper considers the United States of America, South Africa and Ethiopian economies. Three commodities i.e. coffee, maize and wheat from New York Merchantile Exchange, South African Futures Exchange and Ethiopian Commodity Exchange are analyzed. ARCH LM test is used to check for heteroskedasticity and GARCH and EGARCH are used to check for the behavior of volatility between the pre- and post-futures periods. For all the three economies, the results indicate presence of the ARCH effect in the log returns. For conditional and unconditional variances; spot price volatility for coffee has decreased after futures trading in all the economies and the EGARCH has also shown reduction in persistence of volatility in the post-futures period in the three economies; while that of maize has reduced for the Ethiopian economy while there has been an increase in both the US and South African economies. For wheat, the conditional variance has been found to rise in the post-futures period in all the three economies.

Keywords: derivatives, futures exchange, agricultural commodities, spot price volatility

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Authors: Roengchai Tansuchat, Woraphon Yamaka, Paravee Maneejuk

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From the past recent, the global financial crisis, economic instability, and large fluctuation in agricultural commodity price have led to increased concerns about the volatility transmission among them. The problem is further exacerbated by commodities volatility caused by other commodity price fluctuations, hence the decision on hedging strategy has become both costly and useless. Thus, this paper is conducted to analysis the volatility spillover effect among major agriculture including corn, soybeans, wheat and rice, to help the commodity suppliers hedge their portfolios, and manage the risk and co-volatility of them. We provide a switching regime approach to analyzing the issue of volatility spillovers in different economic conditions, namely upturn and downturn economic. In particular, we investigate relationships and volatility transmissions between these commodities in different economic conditions. We purposed a Copula-based multivariate Markov Switching GARCH model with two regimes that depend on an economic conditions and perform simulation study to check the accuracy of our proposed model. In this study, the correlation term in the cross-hedge ratio is obtained from six copula families – two elliptical copulas (Gaussian and Student-t) and four Archimedean copulas (Clayton, Gumbel, Frank, and Joe). We use one-step maximum likelihood estimation techniques to estimate our models and compare the performance of these copula using Akaike information criterion (AIC) and Bayesian information criteria (BIC). In the application study of agriculture commodities, the weekly data used are conducted from 4 January 2005 to 1 September 2016, covering 612 observations. The empirical results indicate that the volatility spillover effects among cereal futures are different, as response of different economic condition. In addition, the results of hedge effectiveness will also suggest the optimal cross hedge strategies in different economic condition especially upturn and downturn economic.

Keywords: agricultural commodity futures, cereal, cross-hedge, spillover effect, switching regime approach

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Authors: Laxuman Thakuri

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Community-based forest management is often glorified as one of the best forest management alternatives in the developing countries like Nepal. It is also believed that the transfer of forest management authorities to local communities is decisive to take efficient decisions, maximize the forest benefits and improve the people’s livelihood. The community forestry of Nepal also aims to maximize the forest benefits; share them among the user households and improve their livelihood. However, how the local communities fix the price of forest products and local pricing made by the forest user groups affects to equitable forest benefits-sharing among the user households and their livelihood improvement objectives, the answer is largely silent among the researchers and policy-makers alike. This study examines local pricing system of forest products in the lowland community forestry and its effects on equitable benefit-sharing and livelihood improvement objectives. The study discovered that forest user groups fixed the price of forest products based on three criteria: i) costs incur in harvesting, ii) office operation costs, and iii) livelihood improvement costs through community development and income generating activities. Since user households have heterogeneous socio-economic conditions, the forest user groups have been applied low pricing strategy even for high-value forest products that the access of socio-economically worse-off households can be increased. However, the results of forest products distribution showed that as a result of low pricing strategy the access of socio-economically better-off households has been increasing at higher rate than worse-off and an inequality situation has been created. Similarly, the low pricing strategy is also found defective to livelihood improvement objectives. The study suggests for revising the forest products pricing system in community forest management and reforming the community forestry policy as well.

Keywords: community forestry, forest products pricing, equitable benefit-sharing, livelihood improvement, Nepal

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Authors: Shenghui Wu, Patricia Chalela, Amelie G. Ramirez

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Background: Cervical cancer (CC), colorectal cancer (CRC), and breast cancer (BC) are diseases that can be prevented/detected through early test. Through educational programs, individuals can become better informed about these cancers and understand the importance of screening and early detection. A community-based educational program was developed to improve knowledge and awareness toward the screening of the three cancer types in a South Texas underserved population. Methods: Residents living in Laredo, Texas were invited to participate in the present study. From January 2020 to April 2021, participants were recruited using social media and flyer distributions in general community. Participants received a free live web cancer education presentation delivered by bilingual community health educators, and online pre- and post-education surveys for CC, CRC, and BC separately. Pre-post changes in knowledge for individual items were compared using McNemar’s chi-squared tests. Results: Overall, participants demonstrated increases in CC (n=237), CRC (n=59), and BC (n=56) screening knowledge and awareness after receiving the cancer screening education (Ps<0.05). After receiving the cancer screening education, 85-97% of participants had an intent to talk to a healthcare provider about CC/CRC/BC screening, 88-97% had an intent to get a CC/CRC/BC screening test in the next 12 months or at the next routine appointment, and 90-97% had an intent to talk about CC/CRC/BC with their family members or friends. Conclusion: A community-based educational program can help increase knowledge and awareness about cervical, colorectal, and breast cancer screening, promote positive changes in population's knowledge and awareness about the benefits of cancer screening.

Keywords: cervical cancer, colorectal cancer, breast cancer, educational program, health knowledge, awareness, Hispanics, screening, health education

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Authors: Ayodeji Adebayo, Tolulope Soyannwo, Oluwakemi A. Sigbeku

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Intimate Partner Violence (IPV) is a significant public health problem with adverse health consequences. There is increasing evidence of association of IPV with mental health problems. Understanding the association between IPV and mental health status of women of reproductive aged group in the rural communities in Nigeria can provide information to improve maternal health status. Therefore, this study was conducted to examine the relationship between experience of IPV and mental health status of women of reproductive aged group in a rural community in Southwest Nigeria. A community based cross-sectional survey was conducted using a cluster sampling technique to select 283 non-pregnant women of reproductive age group (15-49 years Mental health was assessed based on respondents’ experience of any symptoms of depression, anxiety and/or low self-esteem. IPV was assessed over a period of 12 months and the forms of IPV assessed were emotional, physical and sexual. An interviewer administered questionnaire was used to collect information on experience of IPV, reproductive history and factors influencing mental health. Data was analyzed using descriptive statistics, Chi-square and multivariate logistic regression at 5% level of significance. The mean age of respondents was 26.1± 7.8 with 57.1% aged 15-24years. More than half (58.0%) were married. Overall, 60.7% of respondents had mental health problems while 84.8% experienced all categories of violence. The pattern of IPV includes physical violence (10.7%), emotional violence (82.7%) and sexual violence (20.8%). Women who experienced sexual violence by a partner are most likely to suffer from all mental issues. Also, gynaecological morbidities are associated with increasing risk of mental health problems. The research demonstrates an urgent need for mental health policies to recognize the relationship between intimate partner violence, gynaecological morbidities and mental health problems in women in Nigeria.

Keywords: intimate partner violence, mental health, reproductive age group, women

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Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta

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Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.

Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care

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Authors: Pruthvi Nath Palleti, Sarmada Madhulika Kone

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Communities are formed based on the commonalities that exist in a set of individuals and when the group comes together on identifying those commonalities and to achieve their common goals. Thus, community planning with its vision to strengthen the community mostly involves with making or remaking of commons, which results in making or remaking of communities. This paper looks into different practices of planning around the world and tried to establish a link between commoning (the act of exercising the rights over commons by commoners) and participatory approach to community planning.

Keywords: commoners, commoning, community, participatory planning, urban local bodies

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Authors: Abdela Zeinu Yasin

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The current research aimed to assess the status of IMC in providing treatment for malnourished children and programs in water, sanitation, and hygiene (WASH), food and livelihood security, and comprehensive healthcare through Mobile health and nutrition programs during the last 5 years period. We have conducted 60 in-depth interviews with women during the period from conception to a child’s birthday, health facility staff, and female community health volunteers (FCHVs), as well as 12 focus group discussions with health facility staff and other household decision-makers. We employed thematic analysis using framework matrices and analytical memorandums. The study revealed that 78% of the respondents, of whom 97% were women, have benefited from the selected vulnerable areas. The use of the clear water and sanitization program has reached the 81% of selected households. The use of a modern baby delivery system among the respondent has been 68% of the women and health facilities among the decision-makers/focal person. More than 8 in 10 participants (84%) could read and understand the health facility instructions, and the majority (82%) of women, health facility staff, and male decision-makers can also read and write bulletins and instructions. We found that decision-maker women preferred participative education, whereas health facilities and the IMC desired educational and motivational bulletins. A Mobile Health and Nutrition program intervention by the IMC is acceptable in the conditions of the Ethiopian community and has the potential to improve community health and nutrition service utilization, particularly by providing clean water and sanitization; women’s birth control, and health improvement in the vulnerable regions of the country. The current research findings shall contribute to text IMC Mobile Health and Nutritional intervention design in under-resourced settings.

Keywords: clean water, health and nutrition services, hygiene, IMC, mobile health, sanitation

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Authors: Yuen Man Yan

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Peer support has been a rising prevalent mental health service in the globe. The community-based mental health services employ persons with lived experience of mental illness to be peer support workers (PSWs) to provide peer support service to those who are in the progress of recovery (PIRs). It represents the transformation of mental health service system to a recovery-oriented and person-centered care. Literatures proved the feasibility and effectiveness of the peer support service. Researchers have attempted to explore the unique good qualities of peer support service that benefit the PIRs. Empirical researches found that the strength of the relationship between those who sought for change and the change agents positively related to the outcomes in one-to-one therapies across theoretical orientations. However, there is lack of literature on investigating the relationship building between the PSWs and PIRs in the one-to-one community-based peer support service. This study aims to identify and characterise the relationship in the community-based one-to-one peer support service from the perspectives of PSWs and PIRs; and to conceptualize the components of relationship building between PSWs and PIRs in the community-based one-to-one peer support service. The study adopted the constructivist grounded theory approach. 10 pairs of the PSWs and PIRs participated in the study. Data were collected through multiple qualitative methods, including observation of the interaction and exchange of the PSWs and PIRs in the 1ₛₜ, 3ᵣ𝒹 and 9th sessions of the community-based one-to-one peer support service; and semi-structural interview with the PSWs and PIRs separately after the 3ᵣ𝒹and 9ₜₕ session of the peer support service. This presentation is going to report the preliminary findings of the study. PSWs and PIRs identified their relationship as “life alliance”. Empathy was found to be one of key components of the relationship between the PSWs and the PIRs. Unlike the empathy, as explained by Carl Roger, in which the service provider was able to put themselves into the shoes of the service recipients as if he was the service recipients, the intensity of the empathy was much greater in the relationship between PSWs and PIRs because PSWs had the lived experience of mental illness and recovery. The dimensions of the empathy in the relationship between PSWs and PIRs was found to be multiple, not only related to the mental illness but also related to various aspects in life, like family relationship, employment, interest of life, self-esteem and etc.

Keywords: person with lived experience, peer support worker, peer support service, relationship building, therapeutic alliance, community-based mental health setting

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Authors: E. Omanya, E. Mueni, G. Makau, M. Kariuki

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HIV infection is the strongest risk factor for a person to develop TB. Isoniazid preventive therapy (IPT) for People Living with HIV (PLWHIV) not only reduces the individual patients’ risk of developing active TB but mitigates cross infection. In Kenya, IPT for six months was recommended through the National TB, Leprosy and Lung Disease Program to treat latent TB. In spite of this recommendation by the national government, uptake of IPT among PLHIV remained low in Kenya by the end of 2015. The USAID/Kenya and East Africa Afya Jijini project, which supports 42 TBHIV health facilities in Nairobi County, began addressing low uptake of IPT through Quality Improvement (QI) teams set up at the facility level. Quality is characterized by WHO as one of the four main connectors between health systems building blocks and health systems outputs. Afya Jijini implements the Kenya Quality Model for Health, which involves QI teams being formed at the county, sub-county and facility levels. The teams review facility performance to identify gaps in service delivery and use QI tools to monitor and improve performance. Afya Jijini supported the formation of these teams in 42 facilities and built the teams’ capacity to review data and use QI principles to identify and address performance gaps. When the QI teams began working on improving IPT uptake among PLHIV, uptake was at 31.8%. The teams first conducted a root cause analysis using cause and effect diagrams, which help the teams to brainstorm on and to identify barriers to IPT uptake among PLHIV at the facility level. This is a participatory process where program staff provides technical support to the QI teams in problem identification and problem-solving. The gaps identified were inadequate knowledge and skills on the use of IPT among health care workers, lack of awareness of IPT by patients, inadequate monitoring and evaluation tools, and poor quantification and forecasting of IPT commodities. In response, Afya Jijini trained over 300 health care workers on the administration of IPT, supported patient education, supported quantification and forecasting of IPT commodities, and provided IPT data collection tools to help facilities monitor their performance. The facility QI teams conducted monthly meetings to monitor progress on implementation of IPT and took corrective action when necessary. IPT uptake improved from 31.8% to 61.2% during the second year of the Afya Jijini project and improved to 80.1% during the third year of the project’s support. Use of QI teams and root cause analysis to identify and address service delivery gaps, in addition to targeted program interventions and continual performance reviews, can be successful in increasing TB related service delivery uptake at health facilities.

Keywords: isoniazid, quality, health care workers, people leaving with HIV

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Authors: Manisha Singh, Padam Simkhada

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Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.

Keywords: maternal mental health, health care providers, screening, Nepal

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Authors: Balasaheb Bansode, L. Ladusingh

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The public distribution system is an important component of food security. It is a massive welfare program undertaken by Government of India and implemented by state government since India being a federal state; for achieving multiple objectives like eliminating hunger, reduction in malnutrition and making food consumption affordable. This program reaches at the community level through the various agencies of the government. The paper focuses on the accessibility of PDS at household level and how the present policy framework results in exclusion and inclusion errors. It tries to explore the sanctioned food grain quantity received by differentiated ration cards according to income criterion at household level, and also it has highlighted on the type of corruption in food distribution that is generated by the PDS system. The data used is of secondary nature from NSSO 68 round conducted in 2012. Bivariate and multivariate techniques have been used to understand the working and consumption of food for this paper.

Keywords: calories intake, entitle food quantity, poverty aliviation through PDS, target error

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Authors: Emily J. Winnall

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It is understood that China has the largest population of people living with dementia in the world; however, little is known about this culturally diverse community, specifically the Chinese Communities, which has been poorly represented in past British research Literature. Further research is needed to gain a greater understanding of the support needs of caregivers caring for a relative living with dementia from the Chinese background. Dementia care and caregivers in Chinese communities are less investigated. The study is a case study of two Chinese community centers and one housing support service. Semi-structured one-to-one interviews and a pilot questionnaire were used as the methods for the study. A toolkit will also be created as a document that provides guidance and signposting to health and social care services for Chinese communities. The findings identified three main themes. Caregivers do not receive any formal support from the UK health and social services, and they felt they would have benefited from getting advice on what support they could access. Furthermore, the data also identified that Chinese organisations do not have the knowledge of dementia, to be able to support those living with dementia and their families. Also, people living with dementia and their families rarely present to Chinese organisations and UK health and social care services, meaning they are not receiving the support they are entitled to or need. Additionally, the community center would like to see workshops/courses around dementia for people from Chinese backgrounds. The study concludes that people from Chinese cultural backgrounds do not have sufficient access to support from UK health and social care services. More information needs to be published that will benefit Chinese communities.

Keywords: Chinese, Chinese organisations, Dementia, family caregivers, social care

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Authors: Josephine Wanja Nyatia

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The relationship between vegetation and soil erosion deserves attention due to its scientific importance and practical applications. A great deal of information is available about the mechanisms and benefits of vegetation in the control of soil erosion, but the effects of soil erosion on vegetation development and succession is poorly documented. Research shows that soil erosion is the most important driving force for the degradation of upland and mountain ecosystems. Soil erosion interferes with the process of plant community development and vegetation succession, commencing with seed formation and impacting throughout the whole growth phase and affecting seed availability, dispersal, germination and establishment, plant community structure and spatial distribution. There have been almost no studies on the effects of soil erosion on seed development and availability, of surface flows on seed movement and redistribution, and their influences on soil seed bank and on vegetation establishment and distribution. However, these effects may be the main cause of low vegetation cover in regions of high soil erosion activity, and these issues need to be investigated. Moreover, soil erosion is not only a negative influence on vegetation succession and restoration but also a driving force of plant adaptation and evolution. Consequently, we need to study the effects of soil erosion on ecological processes and on development and regulation of vegetation succession from the points of view of pedology and vegetation, plant and seed ecology, and to establish an integrated theory and technology for deriving practical solutions to soil erosion problems

Keywords: soil erosion, vegetation, development, seed availability

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Authors: Bhmika Raiu

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The community forestry programme in Nepal officially started in the late 1970s. Since then concerning movement has been evolving to involve local communities in the management and utilization of forests. The policy of the government was originally intended to meet the basic forest products required by the communities through active participation in forest development and management. Later, it was expanded to include the mobilization and empowerment of the members of community forest user groups in the development of their local communities. It was observed that the trend of forest degradation has decreased since the handing over of national forests to local communities, but a number of unintended social anomalies have also cropped up. Such anomalies essentially constitute of the inequity and unfairness in the local and national level and in terms of long-term sustainability of forest resources. This paper provides an overview of various issues of community forestry, especially focusing on the major achievements made in community forestry. It calls for rethinking the community forestry programme in order to face the present day challenges of linking community forestry with livelihood promotion, good governance, and sustainable forest management. It also lays out strategies for reforms in community forestry.

Keywords: community forest, livelihood promotion, challenges, achievements

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Authors: Yan Ding, Fei Yan, Ji Liang, Hong Jiang, Xiaoguang Yang, Xu Qian

Abstract:

The health status of GonjiKolela District, Amhara Region, Ethiopia is below its national average, and a sub-project of China UK Global Health Support Programme (GHSP) is expected to increase the uptake of a suite of reproductive, maternal, newborn and child health (RMNCH) interventions there. To explore what is on the ground and what could be helpful for the uptake of RMNCH services in GonjiKolela, a qualitative study was performed as part of the baseline assessment before the implementation of the project. Nine key informants from GonjiKolela were interviewed with self-designed interview guides and they were from the district Health Office, health centers, health posts, women health development army (community volunteer groups), mothers of newborns, and also a gynecologist from the maternal and child health center which is the referral center for pregnant women for this project. The interview were transcribed into words and sorted with qualitative analysis software MAXqda. Content analysis was mainly used to analyze the data. The district health office, the health centers and the health posts all had focal persons taking care of the management and provision of RMNCH services, and RMNCH related indicators were recorded and reported at each level routinely. In addition, district government and administration at community/administrative village level kept a close eye on the reduction of maternal, neonatal and child mortality. Women Health Development Amy at household level supported health workers at community/administrative village level (called health extension workers) in tracing, recording and reporting pregnant women, newborn and under-five children,organizing events for health education, demonstrating and leading health promotion activities, and stimulating the utilization of RMNCH.

Keywords: Reproductive Maternal Newborn and Child Health, Health Care Utilization, Qualitative Study, Ethiopia

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Authors: B. Parchem, M. Watanabe, D. Modrakovic, L. Mathew, A. Franklin, M. Cao, R. E. Broudy

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Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.

Keywords: executive functioning, cognitive-behavioral therapy, dialectical behavior therapy, mindfulness, adult group therapy

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Authors: Khushboo Ejaz

Abstract:

Community Resilience to Violent Extremism gain importance in the post 9/11 scenario. Resilience is a word that came from the engineering domain. Prior to 9/11, this word community resilience has been used in disasters and natural hazards. The literature on Community Resilience has been published in different multiethnic and multi-religious communities. There is less data and research done on Pakistan’s Community resilience experience. This research is a case study; how local community showed resilience against violent extremism of Tehrik-e-Taliban Swat in the wake of Operation Rah-e- Raast. Qualitative research based on interviews and focus group discussions from male and female groups of different Tehsils of Swat has been carried out to highlight the Community Resilience to Violent Extremism of Tehrik- e- Taliban and Tehrik- e- Nifaz- e -Shariat- e-Muhamadi (TNSM) .NVivo software has been used for data analysis and highlighting all factors of Community Resilience to Violent extremism (CRVE) in Swat . Recommendations has been made in the end to suggest Civil Society Organizations, NGOs and government departments in order to facilitate and enhance community resilience of tribal and rural areas affected by violent elements in Pakistan. This study will fill the gap in literature related to CRVE policies in Pakistani context.

Keywords: community resilience, operation Rah -e Raast, counter extremism, swat, Pakistan

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Authors: Mercia I. Van Der Walt, Suzan Sayegh, Izzeldin E. L. J. Ibrahim, Mohamed G. Al-Kuwari, Manaf Kamil

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Background: Increased physical activity is associated with improvements in health conditions. Walking is recognized as an easy form of physical activity and a strategy used in health promotion. Step into Health (SIH), a national community program, was established in Qatar to support physical activity promotion through the monitoring of step counts. This study aims to assess the physical activity levels of the adult population in Qatar through a pedometer-based community program over a three-year-period. Methodology: This cross-sectional longitudinal study was conducted between from January 2013 and December 2015 based on daily step counts. A total of 15,947 adults (8,551 males and 7,396 females), from different nationalities enrolled in the program and aged 18 to 64, are included. The program involves free distribution of pedometers to members who voluntarily choose to register. It is also supported by a self-monitoring online account and linked to a web-database. All members are informed about the 10,000 steps/day target and automated emails as well as text messages are sent as reminders to upload data. Daily step counts were measured through the Omron HJ-324U pedometer (Omron Healthcare Co., Ltd., Japan). Analyses are done on the data extracted from the web-database. Results: Daily average step count for the overall community increased from 4,830 steps/day (2013) to 6,124 steps /day (2015). This increase was also observed within the three age categories (18–30), (31-45) and (>45) years. Average steps per day were found to be more among males compared with females in each of the aforementioned age groups. Moreover, males and females in the age group (>45 years) show the highest average step count with 7,010 steps/day and 5,564 steps/day respectively. The 21% increase in overall step count throughout the study period is associated with well-resourced program and ongoing impact in smaller communities such as workplaces and universities, a step in the right direction. However, the average step count of 6,124 steps/day in the third year is still classified as the low active category. Although the program showed an increase step count we found, 33% of the study population are low active, 35 % are sedentary with only 32% being active. Conclusion: This study indicates that the pedometer-based intervention was effective in increasing the daily physical activity of participants. However, alternative approaches need to be incorporated within the program to educate and encourage the community to meet the physical activity recommendations in relation to step count.

Keywords: pedometer, physical activity, Qatar, step count

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Authors: Petcharat Kerdonfag, Supunnee Thrakul

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School health services through regular screening of school students’ health status have been the main responsibility for community or school health nurses. The purposes of these retrospective study were to assess and compare health problems between government and private primary school students in the central region of Thailand. The data were collected from the school health records in October at the end of the first semester in the academic year 2018. Two thousand and fifty primary school health records from government and private primary schools were gathered to assess health problems regarding anthropometric measurements, physical examination/personal hygiene, and clinical findings for this study. Descriptive statistics and Chi-square were used to be analyzed. The results revealed that health problems of all the school students remained high magnitude. The five top ranks for prevalence rate of health problems were dental caries (36.6%), visual acuity problem (27.7%), over-nutrition (16.8%), head lice (12.8%), and under-nutrition (6.8%), respectively. However, when compared between government and private schools among five health problems; dental caries (55.0% vs 19.9%), visual acuity problem (23.1% vs 31.9%), over-nutrition (20.2% vs 13.8%), head lice (26.5% vs 0.3%), and under-nutrition (10.6% vs 3.4%) with Chi-square analysis, there were significantly different (p < .001). The problem of visual acuity seems to be more serious in private schools while other health problems tend to be more critical in government schools. The findings have suggested that parents who have children in the private primary schools should pay more attention to visual health defects whereas parents with children in the government school should pay more vigilance regards to hygiene and health behavior problems.

Keywords: community health nursing, school health service, health status, primary school children

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Authors: Vivian Isaac, A. T. Joteeshwaran, Craig McLachlan

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The University of New South Wales (UNSW) Rural Clinical School has a strategic collaborative focus on chronic disease and public health. Our objectives are to understand rural environmental and biological interactions in vulnerable community populations. The UNSW Rural Clinical School translational model is a spoke and hub network. This spoke and hub model connects rural data and biological specimens with city based collaborative public health research networks. Similar spoke and hub models are prevalent across research centers in India. The Australia-India Council grant was awarded so we could establish sustainable public health and community research collaborations. As part of the collaborative network we are developing strategies around data and biological sharing platforms between Indian Institute of Public Health, Public Health Foundation of India (PHFI), Hyderabad and Rural Clinical School UNSW. The key objective is to understand how research collaborations are conducted in India and also how data can shared and tracked with external collaborators such as ourselves. A framework to improve data sharing for research collaborations, including DNA was proposed as a project outcome. The complexities of sharing biological data has been investigated via a visit to India. A flagship sustainable project between Rural Clinical School UNSW and PHFI would illustrate a model of data sharing platforms.

Keywords: data sharing, collaboration, public health research, chronic disease

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Authors: Atikah Nurhayati, Asep A. Handaka

Abstract:

Indonesia is a world’s major fish producer which can feed not only its citizens but also the people of the world. Currently, the total annual production is 11 tons and expected to double by the year of 2050. Given the potential, fishery has been an important part of the national food security system in Indonesia. Despite such a potential, a big challenge is facing the Indonesians in making fish the reliable source for their food, more specifically source of protein intake. The long geographic distance between the fish production centers and the consumer concentrations has prevented effective supply chain from producers to consumers and therefore demands a good logistic system. This paper is based on our research, which aimed at analyzing the fish supply chain and is to suggest relevant improvement to the chain. The research was conducted in the Year of 2016 in selected locations of Java Island, where intensive transaction on fishery commodities occur. Data used in this research comprises secondary data of time series reports on production and distribution and primary data regarding distribution aspects which were collected through interviews with purposively selected 100 respondents representing fishers, traders and processors. The data were analyzed following the supply chain management framework and processed following logistic regression and validity tests. The main findings of the research are as follows. Firstly, it was found that improperly managed connectivity and logistic chain is the main cause for insecurity of availability and affordability for the consumers. Secondly, lack of quality of most local processed products is a major obstacle for improving affordability and connectivity. The paper concluded with a number of recommended strategies to tackle the problem. These include rationalization of the length of the existing supply chain, intensification of processing activities, and improvement of distribution infrastructure and facilities.

Keywords: fishery, food security, logistic, supply chain

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Authors: Marjan Majdi, MohammadAli Moradi, Elham Samarikhalaj

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Income distribution is one of the most topics in macro economic theories. There are many categories in economy such as income distribution that have the most influenced by economic policies. Human capital has an impact on economic growth and it has significant effect on income distributions. The results of this study confirm that the effects of oil revenue and human capital on income distribution are negative and significant but the value of the estimated coefficient is too small in a real sample in period time (1969-2006).

Keywords: gini coefficient, human capital, income distribution, oil revenue

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