Search results for: community health worker
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12052

Search results for: community health worker

11932 Alumni Experiences of How Their Undergraduate Medical Education Instilled and Fostered a Commitment to Community-Based Work in Later Life: A Sequential Exploratory Mixed-Methods Study

Authors: Harini Aiyer, Kalyani Premkumar

Abstract:

Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

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11931 Exploring the Influence of Culture on Dietary Practices and Ethnic Inequality in Health among Migrant Nigerians in the UK

Authors: Babatunde Johnson

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The rate of diseases and death from preventable diseases among ethnic minority groups is high when compared with the wider white population in the UK. This can be due in part to the diet consumed and various cultural reasons. Changes in dietary practices and the health of ethnic minority groups can be caused by the adoption of food practices of the host culture after migration (acculturation) and generational differences among migrants. However, understanding how and why these changes occur is limited due to the challenges of data collection in research. This research utilizes the interpretive phenomenological approach, coupled with Bourdieu’s theory used as the conceptual framework, and seeks an in-depth understanding of how adult immigrant Nigerians in the UK interpret their experience of the influence of ethnic and prevailing cultures on their dietary practice. Recruiting participants from a close-knit community, such as the Nigerian population in the UK, can be complex and problematic and is determined by the accessibility to the community. Although complex, the researcher leveraged the principles of Patient and Public Involvement (PPI) in gaining access to participants within the Nigerian community. This study emphasizes the need for a culturally tailored and community-centered approach to interventions geared toward the reduction of ethnic health inequality in the UK other than the existing practice, which focuses on better healthy eating through the improvement of skills and knowledge about food groups.

Keywords: culture, dietary practice, ethnic minority, health inequality

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11930 Assessment of the Impact of Family Care Team in the District Health System of Regional Health, Thailand

Authors: Nithra Kitreerawutiwong, Sunsanee Mekrungrongwong, Artitaya Wongwonsin, Chakkraphan Phetphoom, Buaploy Phromjang

Abstract:

Background: Thailand has implemented a district health system based on the concept of primary health care. Since 2014, Family Care Team (FCT) was launched to improve the quality of care through a multidisciplinary team include not only the health sector but also social sector work together. FCT classified into 3 levels: district, sub-district, and community. This system now consists of 66,353 teams, including 3,890 teams at district level, 12,237 teams at the sub-district level, and 50,326 teams at the community level. There is a report regarding assessment the situation and perception on FCT, however, relatively few examined the operationality of this policy. This study aimed to explore the perception of district manager on the process of the implementation of FCT policy and the factors associating to implement FCT in the district health system. Methods/Results: Forty in-depth interviews were performed: 5 of primary care manager at the provincial medical health office, 5 of community hospital director, 5 of district administrative health office, 10 of sub-district health promoting hospital, and 10 of local organization. Semi-structure interview guidelines were used in the discussions. The data was analyzed by thematic analysis. This policy was formulated based on the demographic change and epidemiology transition to serve a long term care for elderly. Facilitator factors are social capital in district health systems such as family health leader and multidisciplinary team. Barrier factors are communication to the frontline provider and local organization. The output of this policy in relation to the structure of FCT is well-defined. Unanticipated effects include training of FCT in community level. Conclusion: Early feedback from healthcare manager is valuable information for the improvement of FCT to function optimally. Moreover, in the long term, health outcome need to be evaluated.

Keywords: family care team, district health system, primary care, qualitative study

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11929 Role of Basic Health Units in Provision of Primary Health Services in District Swabi

Authors: Naila Awan, Shahrukh Inam

Abstract:

This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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11928 Health Communication: A Southwest Georgia Health Literacy Project

Authors: Marsha R. Lawrence

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Introduction: In February and March of 2020, many Black Americans in Albany, Georgia, were impacted by COVID-19 compared to the rest of the country. Due to misinformation and distrust in the community, citizens were not able to make good health decisions regarding COVID-19. The city of Albany applied for a grant with the Department of Health and Human Services, specifically the Office of Minority Health and it was approved. The city of Albany partnered with Albany State University to administer the grant and implementation ensued. Method: An eleven-page electronic and paper cross-sectional survey was given to participants. Albany State University recruited community partners like health care organizations and faith-based organizations to reach the citizens of Albany, Georgia. These partners reached participants through creative community activities to educate participants about COVID-19 and provide incentives to receive a vaccine. Data collection is still in progress because activities are ongoing. Anticipated Results: By December 2023, we anticipate results of the number of participants who accepted vaccines based on participants who stated providers checked their understanding, participants who were satisfied with communication regarding COVID-19 health information about the vaccine, and participants who were involved in decisions regarding the COVID-19 vaccine. Conclusion: Health communication is a subsection of health literacy. At this point, approximately 4000 individuals have received information and education about COVID-19 in the Albany area. We expect building trusting relationships played an important part in the increase in knowledge and vaccination in Albany, Georgia.

Keywords: health literacy, health communication, vaccination, COVID-19

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11927 Family and Community Care for the Elderly: An Implementation Research in Local Community, Thailand

Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot

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Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.

Keywords: ageing, CFIR, long term care, implementation

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11926 CSR Health Programs: A Supplementary Tool of a Government’s Role in a Developing Nation

Authors: Kristine Demilou Santiago

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In a context of a developing nation, how important is the role of Corporate Social Responsibility health programs? Is there a possibility that this will render a large impact in a society where health benefits are insufficient? The Philippine government has been in an unceasing battle to provide its citizens competitive health benefits through launching various health programs. As the efforts are being claimed by the government, the numbers just show that all the health benefits being offered such as PhilHealth health cards, medical missions and other subsidized government health benefits are not effective and sufficient at the minimum level. This is a major characteristic of a developing nation which the Philippine government is focusing on addressing as it becomes a national concern under the effects of poverty. Industrial companies, through Corporate Social Responsibility, are playing an important role in the aspiration to resolve this problem on health programs as supposed to be basic services to citizens of the Philippine government. The rise of commitment by these industrial companies to render health programs to communities as part of their corporate citizenship has covered a large portion of the basic health services that the Filipino citizens are supposed to be receiving. This is the most salient subject that a developing nation should focus on determining the important contribution of industrial companies present in their country as part of the citizens’ access to basic health services. The use of survey forms containing quantitative and qualitative questions which aim to give numerical figures and support answers as to the role of CSR Health programs in helping the communities receive the basic health services they need was the methodological procedure followed in this research. A sample population in a community where the largest industrial company in a province of the Philippines was taken through simple random sampling. The assumption is that this sample population which represents the whole of the community has the highest opportunities to access both the government health services and the CSR health program services of the industrial company located in their community. Results of the research have shown a significant level of participation by industrial companies through their CSR health programs in the attainment of basic health services that should be rendered by the Philippine government to its citizens as part of the state’s health benefits. In a context of a developing nation such as the Philippines, the role of Corporate Social Responsibility is beyond the expectation of initiating to resolve environmental and social issues. It is moving deeper in the concept of the corporate industries being a pillar of the government in catering the support needed by the individuals in the community for its development. As such, the concept of the presence of an industrial company in a community is said to be a parallel progress: by which when an industrial company expands because it is becoming more profitable, so is the community gaining the same step of progress in terms of socioeconomic development.

Keywords: basic health services, CSR health program, health services in a developing nation, Philippines health benefits

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11925 Advocacy for Increasing Health Care Budget in Parepare City with DALY Approach: Case Study on Improving Public Health Insurance Budget

Authors: Kasman, Darmawansyah, Alimin Maidin, Amran Razak

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Background: In decentralization, advocacy is needed to increase the health budget in Parepare District. One of the advocacy methods recommended by the World Bank is the economic loss approach. Methods: This research is observational in the field of health economics that contributes directly to the magnitude of the economic loss of the community and the government and provides advocacy to the executive and legislative to see the harm it causes. Results: The research results show the amount of direct cost, which consists of household expenditure for transport Rp.295,865,500. Indirect Cost of YLD of Rp.14.688.000, and YLL of Rp.28.986.336.00, so the amount of DALY is Rp.43.674.336.000. The total economic loss of Rp.43.970.201.500. These huge economic losses can be prevented by increasing the allocation of health budgets for promotive and preventive efforts and expanding the coverage of health insurance for the community. Conclusion: There is a need to advocate the executive and legislative about the importance of guarantee on public health financing by conducting studies in terms of economic losses so that all strategic alliances believe that health is an investment.

Keywords: advocacy, economic lost, health insurance, economic losses

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11924 Characterization and Predictors of Community Integration of People with Psychiatric Problems: Comparisons with the General Population

Authors: J. Cabral, C. Barreto Carvalho, C. da Motta, M. Sousa

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Community integration is a construct that an increasing body of research has shown to have a significant impact in well-being and recovery of people with psychiatric problems. However, there are few studies that explore which factors can be associated and predict community integration. Moreover, community integration has been mostly studied in minority groups, and currently literature on the definition and manifestation of community integration in the more general population is scarce. Thus, the current study aims to characterize community integration and explore possible predictor variables in a sample of participants with psychiatric problems (PP, N=183) and a sample of participants from the general population (GP, N=211). Results show that people with psychiatric problems present above average values of community integration, but are significantly lower than their healthy counterparts. It was also possible to observe that community integration does not vary in terms of the socio-demographic characteristics of both groups in this study. Correlation and multiple regression showed that, among several variables that literature present as relevant in the community integration process, only three variables emerged as having the most explanatory value in community integration of both groups: sense of community, basic needs satisfaction and submission. These results also shown that those variables have increased explanatory power in the PP sample, which leads us to emphasize the need to address this issue in future studies and increase the understanding of the factors that can be involved in the promotion of community integration, in order to devise more effective interventions in this field.

Keywords: community integration, mental illness, predictors, psychiatric problems

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11923 Community Product Development of Basket Handicraft-Bag, Ang Thong Province, Thailand

Authors: Patsara Sirikamonsin

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The purposes of this study were I) to study development guidelines of community product which was basket handicraft-bag of Ang Thong province; II) to study consumer demand for the community of basket handicraft-bag products of Ang Thong province. Data were collected via group interview of the community of basket handicraft-bag and consumer in order to obtain information related to product development guidelines in line with consumer demand. The study revealed that development guidelines of community product which was basket handicraft-bag of Ang Thong province caused by the demand of consumers changed by the era which made community of basket handicraft-bag products of Ang Thong province might develop community products to be novel, stylish and accessible. The consumer demand for the product came from the need to consume goods that are like local symbols. Most of them were foreigners and tourists. The advantage of this research was that it would lead to policy implementation and lead to the development of basket handicraft-bag community products of Ang Thong to meet the needs of consumers.

Keywords: community product, product development, basket handicraft-bag, business research

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11922 Local Pricing Strategy Should Be the Entry Point of Equitable Benefit Sharing and Poverty Reduction in Community Based Forest Management: Some Evidences from Lowland Community Forestry in Nepal

Authors: Dhruba Khatri

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Despite the short history of community based forest management, the community forestry program of Nepal has produced substantial positive effects to organize the local people at a local level institution called Community Forest User Group and manage the local forest resources in the line of poverty reduction since its inception in 1970s. Moreover, each CFUG has collected a community fund from the sale of forest products and non-forestry sources as well and the fund has played a vital role to improve the livelihood of user households living in and around the forests. The specific study sites were selected based on the criteria of i) community forests having dominancy of Sal forests, and ii) forests having 3-5 years experience of community forest management. The price rates of forest products fixed by the CFUGs and the distribution records were collected from the respective community forests. Nonetheless, the relation between pricing strategy and community fund collection revealed that the small change in price of forest products could greatly affect in community fund collection and carry out of forest management, community development, and income generation activities in the line of poverty reduction at local level.

Keywords: benefit sharing, community forest, equitable, Nepal

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11921 Strengthening Factors of Family Living with Disabilities

Authors: Supranee Sittikan, Darunee Jongudomkarn, Rutja Phuphaibul

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Thai’s families with disabilities are diverse, poor economy, low education disproportionately characterized their living that includes stress and suffering. This article reports a preliminary study using a qualitative case study with six disabilities (five physical and one mental problem) Their six family caregivers who perceived they were managing well with their conditions as well. Data were collected by in-depth interviews during November-December 2017 in North-East of Thailand. Preliminary results were found factors of moving in comprised of three themes as followings Karma: the families believe that the disability happened because of bad-karma which attached to them. From the reason, the members of families have to deserve and accept it. Family attachment: the families believe in the importance of being the family so they have to take good care in one another whether happy or suffering Community support: the families can get more to received helping hands from local health care providers and community health volunteers. These activities are very important to be representative in taking the families through health accessibility, which help them face with disabling problems. Nevertheless, the study needs further exploring on other families’ and health care team's perspective in larger scales leading to develop an appropriate health care service system which can support and promote the well-being of the families living with disabilities in the future.

Keywords: families with disabilities, Karma, family attachment, community support

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11920 Decreased Non-Communicable Disease by Surveillance, Control, Prevention Systems, and Community Engagement Process in Phayao, Thailand

Authors: Vichai Tienthavorn

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Background: Recently, the patients of non-communicable diseases (NCDs) are increasing in Thailand; especially hypertension and diabetes. Hypertension and Diabetes patients were found to be of 3.7 million in 2008. The varieties of human behaviors have been extensively changed in health. Hence, Thai Government has a policy to reduce NCDs. Generally, primary care plays an important role in treatment using medical process. However, NCDs patients have not been decreased. Objectives: This study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation. Methods: Here we report that primary health care (PHC), which is a primary process to screening, rapidly seek the person's risk. The screening tool of the study was Vichai's 7 color balls model, the medical education tool to transfer knowledge from student health team to community through health volunteers, creating community engagement in terms of social participation. It was found that people in community were realized in their health and they can evaluate the level of risk using this model. Results: Projects implementation (2015) in Nong Lom Health Center in Phayao (target group 15-65 years, 2529); screening hypertension coveraged 99.01%, risk group (light green) was decreased to normal group (white) from 1806 to 1893, significant severe patient (red) was decreased to moderate (orange) from 10 to 5. Health Program in behaving change with best practice of 3Es (Eating, Exercise, Emotion) and 3Rs (Reducing tobacco, alcohol, obesity) were applied in risk group; and encourage strictly medication, investigation in severe patient (red). Conclusion: This is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in PHC.

Keywords: non-communicable disease, surveillance control and prevention systems, community engagement, primary health care

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11919 Development a Home-Hotel-Hospital-School Community-Based Palliative Care Model for Patients with Cancer in Suratthani, Thailand

Authors: Patcharaporn Sakulpong, Wiriya Phokhwang

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Background: Banpunrug (Love Sharing House) established in 2013 provides a community-based palliative care for patients with cancer from 7 provinces in southern Thailand. These patients come to receive outpatient chemotherapy and radiotherapy at Suratthani Cancer Hospital. They are poor and uneducated; they need an accommodation during their 30-45 day course of therapy. Methods: A community-participatory action research (PAR) was employed to establish a model of palliative care for patients with cancer. The participants included health care providers, community, and patients and families. The PAR process includes problem identification and need assessment, community and team establishment, field survey, organization founding, model of care planning, action and inquiry (PDCA), outcome evaluation, and model distribution. Results: The model of care at Banpunrug involves the concepts of HHHS model, in that Banpunrug is a Home for patients; patients live in a house comfortable like in a Hotel resource; the patients are given care and living facilities similarly to those in a Hospital; the house is a School for patients to learn how to take care themselves, how to live well with cancer, and most importantly how to prepare themselves for a good death. The house is also a humanized care school for health care providers. Banpunrug’s philosophy of care is based on friendship therapy, social and spiritual support, community partnership, patient-family centeredness, Live & Love sharing house, and holistic and humanized care. With this philosophy, the house is managed as a home of the patients and everyone involved; everything is costless for all eligible patients and their family members; all facilities and living expense are donated from benevolent people, friends, and community. Everyone, including patients and family, has a sense of belonging to the house and there is no authority between health care providers and the patients in the house. The house is situated in a temple and a community and supported by many local nonprofit organizations and healthcare facilities such as a health promotion hospital at sub-disctrict level and Suratthani Cancer Hospital. Village health volunteers and multi-professional health care volunteers have contributed not only appropriate care, but also knowledge and experience to develop a distinguishing HHHS community-based palliative care model for patients with cancer. Since its opening the house has been a home for more than 400 patients and 300 family members. It is also a model for many national and international healthcare organizations and providers, who come to visit and learn about palliative care in and by community. Conclusions: The success of this palliative care model comes from community involvement, multi-professional volunteers and distributions, and concepts of HHHS model. Banpunrug promotes a consistent care across the cancer trajectory independent of prognosis in order to strengthen a full integration of palliative

Keywords: community-based palliative care, model, participatory action research, patients with cancer

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11918 The Effect of Climatic and Cultural Conditions in Increasing the Sense of Community in Residential Complexes (Case Study: Saedyeh Residential Complex)

Authors: Razieh Esfandiarisedgh

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Community architecture has been proposed as an alternative approach in architecture, with three political, sociological, and psychological approaches. In community architecture, the psychological approach, as the only approach related to community design, has an important index called a sense of community. Changes in today's modern society, such as the shrinking of families, cause a decrease in the sense of community and unwillingness of people. It has become a residential complex to be present in public spaces. This issue can be increased by creating motivation with the help of design for the presence and participation of people in public spaces and taking advantage of the facilities and quality of these spaces. This research used the qualitative research method, studied and collected information, and used observation and interviews in the selected sample. Through targeted sampling and matching it with the extracted design table, it was concluded that climate and culture are known as two important factors in the collective view of housing in Hamedan.

Keywords: community architecture, sense of community, environmental psychology, architecture

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11917 Preventing Violent Extremism through Augmenting Community Resilience and Empowering Community Members in Swat

Authors: Dr. Muhammad Idris Idris, Dr. Said Saeed Saeed

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Terrorism is the chronic issue of the hour. It is the disciplined practice of vicious activities like assassinating, slaughtering, mutilating, and frightening of the innocents to attain religious, fiscal, and political goals and to question the authority of the government. Leaders of the world promised to transform the planet by empowering community members and building community resilience (CR) against terrorism. This study concentrates to explore building community resilience against terrorism and empowering community members and implement strategies for strengthening community resilience. For data collection a mixed methods methodology will be used. Means, STD deviation, Pearson correlation, and thematic analysis will be employed to analyze the gathered data. The findings of the study will be interpreted and recommendations will be furnished accordingly. Study results will be disseminated to all concerned through conferences and seminar sessions. It is predicted that after the completion, the project team will be in a robust position to start writing the report that concentrates on strengthening community resilience, which is the crucial goal of this project. The publication will contribute effectively to all stakeholders and society, particularly to the lower rungs of social order. Moreover, it is expected that this project will contribute to future research in the domain of community resilience. This project will also reveal the remarkable potential of archival research on community resilience.

Keywords: Violent Extremism, community Role, community resilience, community empowerment, Leadership role

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11916 Study of Village Scale Community Based Water Supply and Sanitation Program (Pamsimas) in Indonesia

Authors: Reza Eka Putra

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Pamsimas is a community based drinking water supply and sanitation program which is contributed by local community, local government, central government, and World Bank with the aim of achieving Water Supply and Sanitation - the Millennium Development Goals (WSS-MDGs) target. This program is supported by the Ministry of Public Works as the executing agency with the cooperation of Ministry of Interior and the Ministry of Health. Field observations were conducted in two rural samples of 2009 beneficiaries Pamsimas West Java, which is in Ponggang Village, Subang District. The study was evaluated through several parameters, including technical, health, and empowerment aspect. Evaluation was done by comparing the parameters of success that has been set by Pamsimas through Pamsimas book manuals with the parameters from Sanitation & Infrastructure course regarding the appropriate application of technology in society. The result of the study is that the potency of the community before the program is implemented in the village is the determining factor. Stronger cooperation pattern in Ponggang Vilage results in a successful program. Both villages showed a pattern of behavior changes from indiscriminate defecation to sanitary latrine use. Besides, there is a decline in the number of cases of diarrheal disease since the year of Pamsimas implementation.

Keywords: millenium development goals, community develpoment, water supply, sanitation

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11915 An Analysis on Community Based Heritage Tourism: A Resource for a Small Community in Rural County Clare, Ireland

Authors: Marie Taylor, Catriona Murphy

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The aim of this paper is to identify the factors of success in community based heritage tourism initiatives. Heritage and community are central to many tourism initiatives with heritage tourism having the potential to act as a catalyst for community development. This paper presents the findings of research that examined the relationship between heritage tourism and community development. The findings recognised that heritage tourism had economic, social and cultural benefits for a community as well as a role in strengthening concepts such as sense of identity, place, and authenticity. In addition, this paper proposes an assessment framework for sustainable community based heritage tourism to identify factors and contextual influences involved in their success or failure. In evaluating the sustainability of such initiatives, a number of issues are investigated including the continued role of stakeholders, the role of funding, the influence of collaboration and the changing role of rural development and its impact on community engagement. The research is descriptive, evaluative and explanatory research, exploring and analysing issues such as the development of community structures in community based heritage tourism. Thus, it will contribute to the development of potential tourism and community development policies and strategies at a local, national and international level. An interpretative and inductive approach is utilised, and a mixed method approach followed as it encapsulates the best of quantitative and qualitative research methods. The case studies focus on social enterprises in relation to tourism and community based tourism cooperatives as there are limited study and knowledge of these. Consequently, this research will contribute to the discourse on community based heritage tourism as an aspect of community development.

Keywords: collaboration, community-based heritage tourism, stakeholders, sustainable tourism

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11914 A Study on Local Wisdom towards Career Building of People in Kamchanoad Community

Authors: Phusit Phukamchanoad, Thananya Santithammakul, Suwaree Yordchim, Pennapa Palapin

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This research gathered local wisdom towards career building of people in Kamchanoad Community, Baan Muang sub-district, Baan Dung district, Udon Thani province. Data was collected through in-depth interviews with village headmen, community board, teachers, monks, Kamchanoad forest managers and revered elderly aged over 60 years old. All of these 30 interviewees have resided in Kamchanoad Community for more than 40. Descriptive data analysis result revealed that the most prominent local wisdom of Kamchanoad community is their beliefs and religion. Most people in the community have strongly maintained local tradition, the festival of appeasing Chao Pu Sri Suttho on the middle of the 6th month of Thai lunar calendar which falls on the same day with Vesak Day. 100 percent of the people in this community are Buddhist. They believe that Naga, an entity or being, taking the form of a serpent, named “Sri Suttho” lives in Kamchanoad forest. The local people worship the serpent and ask for blessings. Another local wisdom of this community is Sinh fabric weaving.

Keywords: local wisdoms, careers, Kamchanoad Community, career building

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11913 Variables for Measuring the Impact of the Social Enterprises in the Field of Community Development

Authors: A. Irudaya Veni Mary, M. Victor Louis Anthuvan, P. Christie, A. Indira

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In India, social enterprises are working to create social value in various fields including education; health; women and child development; environment protection and community development. Although social enterprises have brought about tremendous changes in the lives of beneficiaries, the importance of their works is not understood thoroughly. One of the ways to prove themselves is to measure the impact, which in recent times has received much attention. This paper focuses on the study of social value created by the social enterprises in the field of community development. It also aims to put forth a research tool for measuring the social value created by the social enterprises in the field of community development. A close-ended interview schedule was prepared to measure the social value creation and it was administered among 60 beneficiaries of two social enterprises who work in the field of community development. The study results show that the social enterprises have brought four types of impact in the life of their beneficiaries; economic impact, social impact, political impact and cultural impact. This study is limited to the social enterprises those who work towards community development. This empirical finding will enable the reader to understand various types of social value created by the social enterprises working in the field of community development. This study will also serve as guide for social enterprises in community development activities to measure their impact and thereby improve their operation towards the betterment of the society. This paper is derived from an empirical research carried out to describe the different types of social value created by the social enterprises in India.

Keywords: social enterprise, social entrepreneurs, social impact, social value, tool for social impact measurement

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11912 Development of Ready Reckoner Charts for Easy, Convenient, and Widespread Use of Horrock’s Apparatus by Field Level Health Functionaries in India

Authors: Gumashta Raghvendra, Gumashta Jyotsna

Abstract:

Aim and Objective of Study : The use of Horrock’s Apparatus by health care worker requires onsite mathematical calculations for estimation of ‘volume of water’ and ‘amount of bleaching powder’ necessary as per the serial number of first cup showing blue coloration after adding freshly prepared starch-iodide indicator solution. In view of the difficulties of two simultaneous calculations required to be done, the use of Horrock’s Apparatus is not routinely done by health care workers because it is impractical and inconvenient Material and Methods: Arbitrary use of bleaching powder in wells results in hyper-chlorination or hypo-chlorination of well defying the purpose of adequate chlorination or non-usage of well water due to hyper-chlorination. Keeping this in mind two nomograms have been developed, one to assess the volume of well using depth and diameter of well and the other to know the quantity of bleaching powder to b added using the number of the cup of Horrock’s apparatus which shows the colour indication. Result & Conclusion: Out of thus developed two self-speaking interlinked easy charts, first chart will facilitate bypassing requirement of formulae ‘πr2h’ for water volume (ready reckoner table with depth of water shown on ‘X’ axis and ‘diameter of well’ on ‘Y’ axis) and second chart will facilitate bypassing requirement formulae ‘2ab/455’ (where ‘a’ is for ‘serial number of cup’ and ‘b’ is for ‘water volume’, while ready reckoner table showing ‘water volume’ shown on ‘X’ axis and ‘serial number of cup’ on ‘Y’ axis). The use of these two charts will help health care worker to immediately known, by referring the two charts, about the exact requirement of bleaching powder. Thus, developed ready reckoner charts will be easy and convenient to use for ensuring prevention of water-borne diseases occurring due to hypo-chlorination, especially in rural India and other developing countries.

Keywords: apparatus, bleaching, chlorination, Horrock’s, nomogram

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11911 Knowledge, Attitudes, and Practices regarding Anthrax among Community Members, Health and Veterinary Workers in Maragua, Kenya

Authors: Isaiah Chacha, Samuel Arimi, Andrew Thaiya

Abstract:

Background: This study was conducted to assess knowledge, attitudes and practices regarding anthrax in Maragua, Kenya to provide baseline information to design interventions. Methods: A cross sectional survey was conducted among head of households, health and veterinary workers in Maragua Sub-county in August and September 2014. Administered questionnaires were used to collect data from household members and a key informant interview held with health and veterinary workers. Multi stage sampling was used to obtain participants’ knowledge, attitudes and practices. Questions were scored and descriptively analyzed using Excel spreadsheet then exported to GenStat Discovery Edition 4. Results: A total of 293 community members were recruited in this study. The overall level of knowledge was 77.9% of all community members regarding cause, transmission, symptoms and prevention of the disease in both humans and animals. Majority of the participants (96.3%) had heard about anthrax. A total of 99 (33.8%) correspondents had seen a person with anthrax and 75.1% think that anthrax is a very serious disease in the area. Of the interviewed correspondents, 14.3% of them have had their animals (mostly cattle) suffer from anthrax while 15.7% had either suffered from anthrax or have had their family member who suffered from anthrax. Conclusion: The study findings indicate above average knowledge on cause, symptoms, transmission and prevention of anthrax among community members in humans and animals. Practices in this study were still risk among community members. Veterinary and Medical health planners should design anthrax awareness interventions as a team targeting to reach these communities and the public through barazas, radio, CHW and other communication channel on a regular basis.

Keywords: anthrax, attitudes, Kenya, knowledge, Maragua, practices

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11910 Military Families’ Attachment to the Royal Guards Community of Dusit District, Bangkok Metropolitan

Authors: Kanikanun Photchong, Phusit Phukamchanoad

Abstract:

The objective of this research is to study the people’s level of participation in activities of the community, their satisfaction towards the community, the attachment they have to the community, factors that influence the attachment, as well as the characteristics of the relationships of military families’ of the Royal Guards community of Dusit District. The method used was non-probability sampling by quota sampling according to people’s age. The determined age group was 18 years or older. One set of a sample group was done per family. The questionnaires were conducted by 287 people. Snowball sampling was also used by interviewing people of the community, starting from the Royal Guards Community’s leader, then by 20 of the community’s well-respected persons. The data was analyzed by using descriptive statistics, such as arithmetic mean and standard deviation, as well as by inferential statistics, such as Independent - Samples T test (T-test), One-Way ANOVA (F-test), Chi-Square. Descriptive analysis according to the structure of the interview content was also used. The results of the research is that the participation of the population in the Royal Guards Community in various activities is at a medium level, with the average participation level during Mother’s and Father’s Days. The people’s general level of satisfaction towards the premises of the Royal Guards Community is at the highest level. The people were most satisfied with the transportation within the community and in contacting with people from outside the premises. The access to the community is convenient and there are various entrances. The attachment of the people to the Royal Guards Community in general and by each category is at a high level. The feeling that the community is their home rated the highest average. Factors that influence the attachment of the people of the Royal Guards Community are age, status, profession, income, length of stay in the community, membership of social groups, having neighbors they feel close and familiar with, and as well as the benefits they receive from the community. In addition, it was found that people that participate in activities have a high level of positive relationship towards the attachment of the people to the Royal Guards Community. The satisfaction of the community has a very high level of positive relationship with the attachment of the people to the Royal Guards Community. The characteristics of the attachment of military families’ is that they live in big houses that everyone has to protect and care for, starting from the leader of the family as well as all members. Therefore, they all love the community they live in. The characteristics that show the participation of activities within the community and the high level of satisfaction towards the premises of the community will enable the people to be more attached to the community. The people feel that everyone is close neighbors within the community, as if they are one big family.

Keywords: community attachment, community satisfaction, royal guards community, activities of the community

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11909 Community Forestry Programme through the Local Forest Users Group, Nepal

Authors: Daniyal Neupane

Abstract:

Establishment of community forestry in Nepal is a successful step in the conservation of forests. Community forestry programme through the local forest users group has shown its positive impacts in the society. This paper discusses an overview of the present scenario of the community forestry in Nepal. It describes the brief historical background, some important forest legislations, and organization of forest. The paper also describes the internal conflicts between forest users and district forest offices, and possible resolution. It also suggests some of the aspects of community forestry in which the research needs to be focused for the better management of the forests in Nepal.

Keywords: community forest, conservation of forest, local forest users group, better management, Nepal

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11908 The Typology of Social Enterprise: Case Study of Community-Development Enterprise in Indonesia

Authors: Aluisius Pratono, Deddy Marciano, Suyanto Suyanto

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The emerging model of community development social enterprise is one of the social enterprise models. However, a precise view of the community development enterprise is still lacking. Hence, this study was aimed at deepening the concept of the community development social enterprise model at the place management and development context. Multiple case studies in Indonesia context were observed to explore the typical criteria of the community development enterprise model in place-making practices. The research paradigm used interpretative approach, which involves dialectic process between the researchers and research participants. This study highlights some principles in the community-development enterprise, which cover an entrepreneurial dimension, social goals, participatory governance, and co-management. The result makes a contribution to conceptual literature occurs at the criteria of social enterprises by highlighting the typology of community development enterprise.

Keywords: community development enterprise, social purposes, economic project, participatory governance

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11907 Re-Examining the Distinction between Odour Nuisance and Health Impact: A Community’s Campaign against Landfill Gas Exposure in Shongweni, South Africa

Authors: Colin David La Grange, Lisa Frost Ramsay

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Hydrogen sulphide (H2S) is a minor component of landfill gas, but significant in its distinct odorous quality and its association with landfill-related community complaints. The World Health Organisation (WHO) provides two guidelines for H2S: a health guideline at 150 µg/m3 on a 24-hour average, and a nuisance guideline at 7 µg/m3 on a 30-minute average. Albeit a practical distinction for impact assessment, this paper highlights the danger of the apparent dualism between nuisance and health impact, particularly when it is used to dismiss community concerns of perceived health impacts at low concentrations of H2S, as in the case of a community battle against the impacts of a landfill in Shongweni, KwaZulu-Natal, South Africa. Here community members reported, using a community developed mobile phone application, a range of health symptoms that coincided with, or occurred subsequent to, odour events and localised H2S peaks. Local doctors also documented increased visits for symptoms of respiratory distress, eye and skin irritation, and stress after such odour events. Objectively measured H2S and other pollutant concentrations during these events, however, remained below WHO health guidelines. This case study highlights the importance of the physiological link between the experience of environmental nuisance and overall health and wellbeing, showing these to be less distinct than the WHO guidelines would suggest. The potential mechanisms of impact of an odorous plume, with key constituents at concentrations below traditional health thresholds, on psychologically and/or physiologically sensitised individuals are described. In the case of psychological sensitisation, previously documented mechanisms such as aversive conditioning and odour-triggered panic are relevant. Physiological sensitisation to environmental pollutants, evident as a seemingly disproportionate physical (allergy-type) response to either low concentrations or a short duration exposure of a toxin or toxins, remains extensively examined but still not well understood. The links between a heightened sensitivity to toxic compounds, accumulation of some compounds in the body, and a pre-existing or associated immunological stress disorder are presented as a possible explanation.

Keywords: immunological stress disorder, landfill odour, odour nuisance, odour sensitisation, toxin accumulation

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11906 The European Pharmacy Market: The Density and its Influencing Factors

Authors: Selina Schwaabe

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Community pharmacies deliver high-quality health care and are responsible for medication safety. During the pandemic, accessibility to the nearest pharmacy became more essential to get vaccinated against Covid-19 and to get medical aid. The government's goal is to ensure nationwide, reachable, and affordable medical health care services by pharmacies. Therefore, the density of community pharmacies matters. Overall, the density of community pharmacies is fluctuating, with slightly decreasing tendencies in some countries. So far, the literature has shown that changes in the system affect prices and density. However, a European overview of the development of the density of community pharmacies and its triggers is still missing. This research is essential to counteract against decreasing density consulting in a lack of professional health care through pharmacies. The analysis focuses on liberal versus regulated market structures, mail-order prescription drug regulation, and third-party ownership consequences. In a panel analysis, the relative influence of the measures is examined across 27 European countries over the last 21 years. In addition, the paper examines seven selected countries in depth, selected for the substantial variance in their pharmacy system: Germany, Austria, Portugal, Denmark, Sweden, Finland and Poland. Overall, the results show that regulated pharmacy markets have over 10.75 pharmacies/100.000 inhabitants more than liberal markets. Further, mail-order prescription drugs decrease the density by -17.98 pharmacies/100.000 inhabitants. Countries allowing third-party ownership have 7.67 pharmacies/100.000 inhabitants more. The results are statistically significant at a 0.001 level. The output of this analysis recommends regulated pharmacy markets, with a ban on mail-order prescription drugs allowing third-party ownership to support nationwide medical health care through community pharmacies.

Keywords: community pharmacy, market conditions, pharmacy, pharmacy market, pharmacy lobby, prescription, e-prescription, ownership structures

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11905 Contribution Of Community-based House To House (H2h) Active Tuberculosis (Tb) Case Finding (Acf) To Increase In Tb Notification In Nigeria: Kano State Experience 2012 To 2022

Authors: Ibrahim Umar, S Chindo, A Rajab

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Background: TB remains a disease of public health concern in Nigeria with an estimated incidence rate of 219/100,000. Kano has the second highest TB burden in Nigeria and is the leading state with the highest consistent yearly TB notification. House-to-house (H2H) active case search in the community was found to have major contribution to the total TB notification in the state. Aims and Objective: To showcase the impact of H2H community active TB case search (ACF) to yearly TB notification in Kano State, Northern Nigeria from 2012 to 2022. Methodology: This is a retrospective descriptive study based on the analysis of data collected during the routine quarterly and yearly TB data collected in the state. Data was analyzed using the Power BI with statistical alpha level of significance <0.05. Results: Between 2012 and 2013 there was no House-to-house active TB case search in Nigeria and Kano had zero contribution to TB notification from the community in those years. However, in 2014 with the introduction of H2H Active TB Case Search Kano notified 6,014 TB cases out of which 113 came from the community ACF that translated to 2% contribution to total TB notification. From 2014 to 2022 there was progressive increase in community contribution to TB case notification from 113 out of 6,014 total TB patients notified (2012) to 11,799 out of 26,371 TB patients notified (2022) in Kano State. This translated to 45% increase in community contribution to total TB case notification. Discussion: Remarkable increase in community contribution to total TB case notification in Kano State was achieved in 2022 with 11,799 TB cases notified from the community Active TB case search to the total of 26,731 TB cases notified in Kano State, Nigeria. Conclusion: in research has shown that Community-based H2H Active TB Case Search through Community TB Workers (CTWs) is an excellent strategy in finding the missing TB cases towards Ending TB in the world.

Keywords: tuberculosis(TB), active case search (ACF), house-to-house (H2H), community TB workers (CTWs)

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11904 Community Based Disaster Risk Reduction in Mizoram, India

Authors: Lalrokima Chenkual

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Legal provision and various guidelines issued by the National Disaster Management Authority in India strives for setting up of disaster management authority from the central government to the district level. Community-Based Disaster Risk Reduction practice is still relevant as the communities are the victim as well as the first responder in any incidents. The primary goal of Community Based Disaster Risk Reduction is to reduce vulnerability of the concerned community and strengthen its existing capacity to cope with disaster. By involving the community in the preparedness phase, it not only increases the likelihood of coordinated action by the communities to help in mitigating disasters and lessening the impact of disaster but also brings the community together to address the issue collectively. Community participation ensures local ownership, addresses local needs, and promotes volunteerism and mutual help to prevent and minimise damage. Community-Based Disaster Risk Reduction is very much relevant for Mizoram as the society is closed knit, population is very less, religion homogeneity i.e Christianity, very active and widespread community-based organization viz, Young Mizo Association, MHIP (Women Federation), MUP (Elders Clubs which are guided together by Mizo code of morals conduct termed as Tlawmngaihna.

Keywords: community, close-knit, first responder, Tlawmngaihna

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11903 Level of Sociality and Sting Autotomy

Authors: V. V. Belavadi, Syed Najeer E. Noor Khadri, Shivamurthy Naik

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Members of aculeate Hymenoptera exhibit different levels of sociality. While Chrysidoidea are primarily parasitic and use their sting only for the purpose parasitizing the host and never for defense, all vespoid and apoid (sphecid) wasps use their sting for paralysing their prey as well as for defending themselves from predators and intruders. Though most apoid bees use their sting for defending themselves, a few bees (Apis spp.) use their sting exclusively for defending their colonies and the brood. A preliminary study conducted on the comparative morphology of stings of apoid bees and wasps and that of vespid wasps, indicated that the backward projected barbs are more pronounced only in the genus Apis, which is considered as the reason why a honey bee worker, loses its sting and dies when it stings a higher animal. This raises an important question: How barbs on lancets of Apis bees evolved? Supposing the barbs had not been strong, the worker bee would have been more efficient in defending the colony instead of only once in its lifetime! Some arguments in favour of worker altruistic behaviour, mention that in highly social insects, the colony size is large, workers are closely related among themselves and a worker sacrificing its life for the colony is beneficial for the colony. However, in colonies with a queen that has mated multiple times, the coefficient of relatedness among workers gets reduced and still the workers continue to exhibit the same behaviour. In this paper, we have tried to compare the morphology of stings of aculeate Hymenoptera and have attempted to relate sting morphology with social behaviour. Species examined for sting morphology are A. cerana, Apis dorsata, A. florea, Amegilla violacea, A. zonata, Megachile anthracina, M. Disjuncta, Liris aurulentus, Tachysphex bengalensis. Our studies indicate that occurrence of barbs on lancets correlates with the degree of sociality and sting autotomy is more pronounced in swarm-founding species than in haplometrotic species. The number of barbs on the lancets varied from 0 to 11. Additionally SEM images also revealed interesting characters of barbs.

Keywords: altruistic, barbs, sociality, sting autotomy

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