Search results for: middle income country

Authors: Loujaina Abdelwahed

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Debt relief granted to low-and middle-income countries effectively provides additional funds for governments that can be used to increase public investment on poverty-reducing services to alleviate poverty and boost economic growth. However, little is known about the extent to which the poor benefit from the increased public investment. This study aims to assess the impact of debt relief granted through multiple initiatives during the 1990s on poverty reduction. In particular, it assesses the impact on the level, depth and severity of poverty in 76 low-and middle income countries over the period 1990-2011. Debt relief is found to have a significant impact on reducing the level, the depth and the severity of poverty. Analysis of the different types of debt relief reveals that debt service relief reduces poverty, whereas debt principle relief does not have a significant impact.

Keywords: debt relief, developing countries, HIPC, poverty, system GMM estimator

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Authors: Mohammad Rahim Rahnama

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Market-transaction price for housing is the main criteria for determining municipality taxes and is determined and announced on an annual basis. Of course, there is a discrepancy between the actual value of transactions in the Bureau of Finance (P for short) or municipality (P´ for short) and the real price on the market (P˝). The present research aims to determine the real price of housing in the metropolis of Mashhad and to pinpoint the price gap with those of the aforementioned apparatuses and identify the factors affecting it. In order to reach this practical objective, Automatic Linear Modeling, which calls for an explanatory research, was utilized. The population of the research consisted of all the residential units in Mashhad, from which 317 residential units were randomly selected. Through cluster sampling, out of the 170 income blocks defined by the municipality, three blocks form high-income (Kosar), middle-income (Elahieh), and low-income (Seyyedi) strata were surveyed using questionnaires during February and March of 2015 and the information regarding the price and specifications of residential units were gathered. In order to estimate the effect of various factors on the price, the relationship between independent variables (8 variables) and the dependent variable of the housing price was calculated using Automatic Linear Modeling in SPSS. The results revealed that the average for housing price index is 788$ per square meter, compared to the Bureau of Finance’s prices which is 10$ and that of municipality’s which is 378$. Correlation coefficient among dependent and independent variables was calculated to be R²=0.81. Out of the eight initial variables, three were omitted. The most influential factor affecting the housing prices is the quality of Quality of construction (Ordinary, Full, Luxury). The least important factor influencing the housing prices is the variable of number of sides. The price gap between low-income (Seyyedi) and middle-income (Elahieh) districts was not confirmed via One-Way ANOVA but their gap with the high-income district (Kosar) was confirmed. It is suggested that city be divided into two low-income and high-income sections, as opposed three, in terms of housing prices.

Keywords: automatic linear modeling, housing prices, Mashhad, Iran

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Authors: Hasan Bulent Kantarci

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This paper examine how Zakat provide a fair income redistribution and struggle with poverty. To provide a fair income redistribution and struggle with poverty take place among the fundamental tasks of all countries. Each country seeks a solution for this problem according to their political, economical and administrative styles through applying various economic and financial policies. The same situation gets handled via zakat association in the Islam. Nowadays, we observe different versions of zakat in developed countries. The applications such as negative income tax denote merely a difference from the zakat being applied almost the same way under changed names. But the minimum values to donate the zakat (e.g. 85 gr. gold and 40 animals) get altered and various amounts are put into practice. It might be named as negative income tax instead of zakat, nonetheless, these applications are based on the Holy Koran and the hadith released 1400 years ago. Besides, considering the savage and slavery in the world at those times, we might easily recognize the true value of the zakat applied the first time then in Islamic system. Through zakat is enabled an income transfer by the government so that the poor could reach the minimum level of life standard. To whom the zakat would be donated was not left to people’s heart and encouraged to determine according to objective criteria. Since the zakat is obligatory, the transfer do not get forward by hand but via the government and get distributed, which requires a vast government organization. Through applying the zakat as it must be would achieve to reduce the poverty mostly and ensuring the fair income redistribution.

Keywords: Islamic finance, zakat, income redistribution, circle of poverty, negatif income tax

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Authors: Ibragim Issabekov, Byron Crape, Lyazzat Toleubekova

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Background: Palliative care substantially improves the quality of life of terminally-ill patients. Symptom control is one of the keystones in the management of patients in palliative care settings, lowering distress as well as improving the quality of life of patients with end-stage diseases. The most common symptoms causing significant distress for patients are pain, nausea and vomiting, increased respiratory secretions and mental health issues like depression. Aims are: 1. to identify best practices in symptom management in palliative patients in accordance with internationally approved guidelines and compare aforementioned with actual practices in Kazakhstan; to evaluate the criteria for assessing symptoms in terminally-ill patients, 2. to review the availability and utilization of pharmaceutical agents for pain control, management of excessive respiratory secretions, nausea, and vomiting, and delirium and 3. to develop recommendations for the systematic approach to end-of-life symptom management in Kazakhstan. Methods: The use of qualitative research methods together with systematic literature review have been employed to provide a rigorous research process to evaluate current approaches for symptom management of palliative patients in Kazakhstan. Qualitative methods include in-depth semi-structured interviews of the healthcare professionals involved in palliative care provision. Results: Obstacles were found in appropriate provision of palliative care. Inadequate education and training to manage severe symptoms, poorly defined laws and regulations for palliative care provision, and a lack of algorithms and guidelines for care were major barriers in the effective provision of palliative care. Conclusion: Assessment of palliative care in this medium-income transitional-economy country is one of the first steps in the initiation of integration of palliative care into the existing health system. Achieving this requires identifying obstacles and resolving these issues.

Keywords: end-of-life care, middle income country, palliative care, symptom control

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Authors: Ali Asghar Sotoudeh

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Mediation Diplomacy has emerged as one of the main pillars of China's foreign policy goals and practices, and Beijing has established itself as a peacekeeping force in regional conflicts and crises such as Afghanistan, Syria, Sudan, Yemen, and the Arab-Israeli peace process. China is deepening and intensifying its diplomatic interventions in the Middle East and trying to shape the security and political developments in the Middle East. On the other hand, economically, China has become one of the most important trading partners with Middle Eastern governments. China is also seeking to expand its foreign policy and economic interests in the Middle East through the New Silk Road initiative and has signed cooperation agreements with 17 Arab countries. In this regard, due to the importance of the subject, this research focuses on answering this question; what is the basis of China's political mediation and economic expansionism in the Middle East? In parallel with this question, this study follows the hypothesis that the mediating role of peace is a legitimate way for China to intervene in Middle East political crises, Without causing China to deviate from its traditional guiding principles based on non-interference in the internal affairs of other actors in the international system. This policy also promotes the security of economic interests and increases the country's political influence in the Middle East. The research method is descriptive-analytical based on the qualitative method, and the data collection method is library and internet resources.

Keywords: China, middle east, political mediation, economic expansionism

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Authors: Anita Richter

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Innovation is one of the key foundations of competitive advantage, generating growth and welfare worldwide. Consequently, all firms should innovate to bring new ideas to the market. Innovation is a vital growth driver, particularly for transition countries to move towards knowledge-based, high-income economies. However, numerous barriers, such as financial, regulatory or infrastructural constraints prevent, in particular, new and small firms in transition countries from innovating. Thus SMEs’ innovation output may benefit substantially from government support. This research paper aims to assess the effect of government interventions on innovation activities in SMEs in emerging countries. Until now academic research related to the innovation policies focused either on single country and/or high-income countries assessments and less on cross-country and/or low and middle-income countries. Therefore the paper seeks to close the research gap by providing empirical evidence from 8,500 firms in 15 transition countries (Eastern Europe, South Caucasus, South East Europe, Middle East and North Africa). Using firm-level data from the Business Environment and Enterprise Performance Survey of the World Bank and EBRD and policy data from the SME Policy Index of the OECD, the paper investigates how government interventions affect SME’s likelihood of investing in any technological and non-technological innovation. Using the Standard Linear Regression, the impact of government interventions on SMEs’ innovation output and R&D activities is measured. The empirical analysis suggests that a firm’s decision to invest into innovative activities is sensitive to government interventions. A firm’s likelihood to invest into innovative activities increases by 3% to 8%, if the innovation eco-system noticeably improves (measured by an increase of 1 level in the SME Policy Index). At the same time, a better eco-system encourages SMEs to invest more in R&D. Government reforms in establishing a dedicated policy framework (IP legislation), institutional infrastructure (science and technology parks, incubators) and financial support (public R&D grants, innovation vouchers) are particularly relevant to stimulate innovation performance in SMEs. Particular segments of the SME population, namely micro and manufacturing firms, are more likely to benefit from an increased innovation framework conditions. The marginal effects are particularly strong on product innovation, process innovation, and marketing innovation, but less on management innovation. In conclusion, government interventions supporting innovation will likely lead to higher innovation performance of SMEs. They increase productivity at both firm and country level, which is a vital step in transitioning towards knowledge-based market economies.

Keywords: innovation, research and development, government interventions, economic development, small and medium-sized enterprises, transition countries

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Authors: Vasuki Rayapati, Bhanu Duggal

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Trans catheter aortic valve replacement (TAVR) is the recommended treatment over surgical aortic valve replacement (SAVR) for high-risk groups, patients >75 years of age with severe symptomatic Aortic stenosis (AS). In high income countries TAVR is more cost effective because of – i) Reduction in total length of stay including less number of days in ICU ii) Non-procedural costs like cost of general anaesthesia are higher for SAVR. In India, there are two kinds of hospitals – Public and Private. Most patients visit public sector hospitals than private sector hospitals. In a LMIC like India, especially in the Public health sector cost of TAVR is prohibitive. In a small study from three (public) hospitals in India, it was envisaged that cost of TAVR should decrease at least by 2/3 to be a cost effective option in Public health sector for severe AS.

Keywords: cost effectiveness, TAVR vs SAVR, LMIC, HTA

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Authors: D. Tappi

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In the past decades, the idea of innovation moved from being considered the result of development to being seen as its means. Innovation and its diffusion are indeed keys to the development and economic catch-up of a country. However, the process of diffusing existing innovation in low income countries has demonstrated dependent on inadequate infrastructures and institutions. The paper examines the role of disruptive innovation in bridging the technology gap between high- and low-income countries, overcoming the lack in infrastructures and institutions. In particular, the focus of this paper goes to the role of disruptive innovation in people transportation in Nigeria. Uber, Taxify, and Smartcab are covering a small and interesting market that was underserved, between the high-end private driver markets, the personal car owners and the low-priced traditional cab and the Keke (tricycle). Indeed the small Nigerian middle class and international community have found in the sharing people transportation market a safe, reasonably priced means of transportation in Nigerian big cities. This study uses mainly qualitative data collection methods in the form of semi-structured interviews with major players and users and quantitative data analysis in the form of a survey among users in order to assess the role of these new transportation modes in shaping the market and even creating a new niche. This paper shows how the new sharing economy in people transportation is creating new solutions to old problems as well as creating new challenges for both the existing market players and institutions. By doing so, the paper shows how disruptive innovations applied to low income countries, not only can overcome the lacking infrastructure problem but could also help bridge the technology gap between those and high income countries. This contribution proves that it is indeed exactly because the market presents these obstacles that disruptive innovations can succeed in countries such as Nigeria.

Keywords: development, disruptive innovation, sharing economy, technology gap

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Authors: R. G. Ariyawansa, M. A. N. R. M. Perera

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“House” is a powerful symbol of socio-economic background of individuals and families. In fact, housing provides all types of needs/wants from basic needs to self-actualization needs. This phenomenon can be realized only having analyzed hidden motives of buyers and sellers of the housing market. Hence, the aim of this study is to examine the socio-economic insight of the secondary housing market in Colombo suburbs. This broader aim was achieved via analyzing the general pattern of the secondary housing market, identifying socio-economic motives of sellers of the secondary housing market, and reviewing sellers’ experience of buyer behavior. A purposive sample of 50 sellers from popular residential areas in Colombo such as Maharagama, Kottawa, Piliyandala, Punnipitiya, and Nugegoda was used to collect primary data instead of relevant secondary data from published and unpublished reports. The sample was limited to selling price ranging from Rs15 million to Rs25 million, which apparently falls into middle and upper-middle income houses in the context. Participatory observation and semi-structured interviews were adopted as key data collection tools. Data were descriptively analyzed. This study found that the market is mainly handled by informal agents who are unqualified and unorganized. People such as taxi/tree-wheel drivers, boutique venders, security personals etc. are engaged in housing brokerage as a part time career. Few fulltime and formally organized agents were found but they were also not professionally qualified. As far as housing quality is concerned, it was observed that 90% of houses was poorly maintained and illegally modified. They are situated in poorly maintained neighborhoods as well. Among the observed houses, 2% was moderately maintained and 8% was well maintained and modified. Major socio-economic motives of sellers were “migrating foreign countries for education and employment” (80% and 10% respectively), “family problems” (4%), and “social status” (3%). Other motives were “health” and “environmental/neighborhood problems” (3%). This study further noted that the secondary middle income housing market in the area directly related with the migrants who motivated for education in foreign countries, mainly Australia, UK and USA. As per the literature, families motivated for education tend to migrate Colombo suburbs from remote areas of the country. They are seeking temporary accommodation in lower middle income housing. However, the secondary middle income housing market relates with the migration from Colombo to major global cities. Therefore, final transaction price of this market may depend on migration related dates such as university deadlines, visa and other agreements. Hence, it creates a buyers’ market lowering the selling price. Also it was revealed that the buyers tend to trust more on this market as far as the quality of construction of houses is concerned than brand new houses which are built for selling purpose.

Keywords: informal housing market, hidden motives of buyers and sellers, secondary housing market, socio-economic insight

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Authors: Yakubu Abdulai, Kenichi Matsui

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The agricultural industry has faced a variety of challenges in meeting the expanding income demand of the rural population. As a result, rural households must diversify their income sources to meet their income demand. Although income diversification strategies help rural households, it contributes to total household income, and the socio-demographic determinants are not known in the Upper East Region of Ghana. For these reasons, the purpose of this study was to determine the contribution of income diversification strategies to household income and the socio-demographic factors influencing it. We conducted a questionnaire survey among 360 rural households in the Upper East Region of Ghana. We asked about their socio-demographic information, their choice of income diversification strategies, and their remittances through rural-city migration. The questionnaire survey findings demonstrate that the main livelihood income source contributes 22%, and on-farm income diversification contributes the most to household total income (47%), followed by non-farm diversification income (16%) and off-farm diversification income (15%). Calculations from the income diversity index showed that the average income diversification strategy was 0.5 out of 1. The calculation of the income dependence index also showed that the average dependent on a particular source of income was 0.2 out of 1. All the respondents said household members temporarily migrate to contribute to household income through remittances. The results further reveal that their choice of income diversification is influenced by their age, educational background, experience, and farm size. The paper recommends the promotion of rural development policies that increase income-generating activities and educate rural households on how to increase returns from their investment.

Keywords: income diversification, poverty alleviation, rural households, upper east region

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Authors: Davood Karimipour

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Since long ago, Russia has been one of the most influential actors in regional equations in South West Asia. The geographic affinity of its vital interests with Western Asia has caused Moscow to have a high sensitivity to the balance of power in the Middle East, as its role in the Syrian crisis clearly demonstrated the importance. In recent years, Moscow has tried to use the energy diplomacy tool in maintaining the balance of power between the major powers in the region. The paper, based on the qualitative case study method, investigates how Russia’s energy diplomacy plays a role in the balance of regional forces in the Middle East, studying the country’s conduct towards Iran, Saudi Arabia, Turkey, and Israel. The hypothesis presented that Russia, using energy tools, is trying to push the regional powers toward cooperation in order to increase the influence in the region, increase power in global markets, and controlling the US to restore power balance in the region. Its cooperation in the Iranian gas industry, the country’s relations with Saudis in the framework of OPEC, cooperation with the Turkish Kurds and the presence in the Israeli gas industry are an example of these Russian energy diplomacy initiatives in West Asia, which is the common point of the Moscow approach to South West Asia.

Keywords: Russia, balance of power, energy diplomacy, Middle East

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Authors: Ankita Shukla

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The promotion and support of breastfeeding is a global priority with benefits for maternal and infant health, especially in low income and middle-income countries where the probability of child survival is still very low. In India too it has been well established that breastfeeding increases the survival of the child. However, the breastfeeding levels are quite low in the country. Examining the socio-economic inequality in breastfeeding pattern can help to the causal pathways responsible for early breastfeeding termination. This paper tries to understand the socio-economic differential in breastfeeding patterns among Indian women. Data is used from nationally representative National Family Health Survey-3. Using Cox regression modelling techniques, the analysis found that the likelihood of having small breastfeeding duration increased with increasing household wealth status similarly education also has negative effect on breastfeeding duration. The considerable gender difference is also visible in India, likelihood of stopping breastfeeding was significantly higher among female children compared with male children. To understand the cultural factors or norms responsible for the early termination of breastfeeding more in depth/qualitative studies are needed.

Keywords: breastfeeding, India, socio-economic inequality, women education

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Authors: Chang Liu, Hanwen Zhang, Vikash Sharma, Don Eliseo Lucerno-Prisno III, Emmanuel Yujuico, Maulik Chokshi, Prashanthi Krishnakumar, Bach Xuan Tran, Giang Thu Vu, Kamilla Anna Pinter, Shenglan Tang

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Background and Aims: Globally, many health systems focus on hospital-based healthcare models targeting acute care and disease treatment, which are not effective in addressing the challenges of ageing populations, chronic conditions, multi-morbidities, and increasingly unhealthy lifestyles. Recently, integrated care programs on chronic diseases have been developed, piloted, and implemented to meet such challenges. However, integrated care programs in the Asia-Pacific region vary in the levels of integration from linkage to coordination to full integration. This study aims to identify and analyze existing cases of integrated care in the Asia-Pacific region and identify the facilitators and barriers in order to improve existing cases and inform future cases. Methods: The study is a comparative study, with a combination approach of desk-based research and key informant interviews. The selected countries included in this study represent a good mix of lower-middle income countries (the Philippines, India, Vietnam, and Fiji), upper-middle income country (China), and high-income country (Singapore) in the Asia-Pacific region. Existing integrated care programs were identified through the scoping review approach. Trigger, history, general design, beneficiaries, and objectors were summarized with barriers and facilitators of integrated care based on key informant interviews. Representative case(s) in each country were selected and comprehensively analyzed through deep-dive case studies. Results: A total of 87 existing integrated care programs on chronic diseases were found in all countries, with 44 in China, 21 in Singapore, 12 in India, 5 in Vietnam, 4 in the Philippines, and 1 in Fiji. 9 representative cases of integrated care were selected for in-depth description and analysis, with 2 in China, the Philippines, and Vietnam, and 1 in Singapore, India, and Fiji. Population aging and the rising chronic disease burden have been identified as key drivers for almost all the six countries. Among the six countries, Singapore has the longest history of integrated care, followed by Fiji, the Philippines, and China, while India and Vietnam have a shorter history of integrated care. Incentives, technologies, education, and performance evaluation would be crucial for developing strategies for implementing future programs and improve already existing programs. Conclusion: Integrated care is important for addressing challenges surrounding the delivery of long-term care. To date, there is an increasing trend of integrated care programs on chronic diseases in the Asia-Pacific region, and all six countries in our study set integrated care as a direction for their health systems transformation.

Keywords: integrated healthcare, integrated care delivery, chronic diseases, Asia-Pacific region

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Authors: Begzod Nishanov, Farhod Karimov

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Globalization and the internet have completely changed the way in which businesses operate as well as has equipped customers with endless potential. Today, consumers’ product choice is not only affected by branding, price and quality of the product, but also by the country-of-origin information. Precisely, ‘Made In’ label is considered as one of the driving factors which directly impact on consumers’ preferences. Generally, it is obvious that products manufactured in less developed countries are considered to be of lower quality and riskier compared to the products made in developed countries. In this regard, it is worth to note that this phenomenon is mainly applicable to western developed countries. However, there is a lack of empirical research on underlying the influence of country-of-origin phenomenon in emerging economies such as Uzbekistan. Today, Uzbek market is being dominated by growing number of foreign made products. Uzbek manufacturers are facing intense competition not only from local producers but also from the availability of foreign goods suppliers. Consequently, consumers are given wider choice of products than ever before. In this regard, it is important to define the importance of country-of-origin information in order to understand Uzbek consumers’ preference. The methodology of the research is formulated based on the methodology of previous papers. A total 527 online questionnaires were completed. Data analysis was conducted using factor analysis and analysis of variance test (ANOVA). Findings of the research support the view that Uzbek consumers attach great importance to the country-of-origin information of products. Precisely, it can be stated that Uzbek people perceive product quality by its ‘Made in...’ label, especially when buying high involvement goods such as car or refrigerator. Another findings of the paper show that products manufactured in developed countries including Germany, Japan and USA are found to be of high quality, while products manufactured in less developed countries are considered to be of lower quality. Marketers can use this information for segmentation purposes. For example, products manufactured in less developed countries can be targeted for low-to-middle income families while goods manufactured in developed countries can be targeted for higher income families. In conclusion, it can be stated that perceived product quality of products that are made in Uzbekistan has slightly increased since 18 years. It implies that nowadays products under ‘Made in Uzbekistan’ label is continually becoming available to many consumers in foreign markets, especially among Commonwealth of Independent States (CIS) countries. Therefore, conducting further research to explore the phenomenon of country-of-origin information and perceived product quality in emerging markets is of paramount importance.

Keywords: country-of-origin, consumer behavior, product evaluation, perceived quality

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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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Authors: Jesus D. Cortes Gil, Fernanda Ewerling, Leonardo Ferreira, Aluisio J. D. Barros

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Background: The sustainable development goals call for inclusive, equitable, and quality learning opportunities for all. This is especially important for children, to ensure they all develop to their full potential. We studied the prevalence and inequalities of suspected delay in child development in 63 low- and middle-income countries. Methods and Findings: We used the early child development module from national health surveys, which covers four developmental domains (physical, social-emotional, learning, literacy-numeracy) and provides a combined indicator (early child development index, ECDI) of whether children are on track. We calculated the age-adjusted prevalence of suspected delay at the country level and stratifying by wealth, urban/rural residence, sex of the child, and maternal education. We also calculated measures of absolute and relative inequality. We studied 330.613 children from 63 countries. The prevalence of suspected delay for the ECDI ranged from 3% in Barbados to 67% in Chad. For all countries together, 25% of the children were suspected of developmental delay. At regional level, the prevalence of delay ranged from 10% in Europe and Central Asia to 42% in West and Central Africa. The literacy-numeracy domain was by far the most challenging, with the highest proportions of delay. We observed very large inequalities, and most markedly for the literacy-numeracy domain. Conclusions: To date, our study presents the most comprehensive analysis of child development using an instrument especially developed for national health surveys. With a quarter of the children globally suspected of developmental delay, we face an immense challenge. The multifactorial aspect of early child development and the large gaps we found only add to the challenge of not leaving these children behind.

Keywords: child development, inequalities, global health, equity

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Authors: Shoji Katagiri

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This paper is to clarify the relationship between ICT and income inequality. To do so, we develop the general equilibrium model with ICT investment, obtain the equilibrium solutions, and then simulate the model with these solutions for some OECD countries. As a result, generally, during the corresponding periods we confirm that the relationship between ICT investment and income inequality is positive. In this mode, the increment of the ratio of ICT investment to the aggregated investment in stock enhances the capital’s share of income, and finally leads to income inequality such as the increase of the share of the top decile income. Although we confirm the positive relationship between ICT investment and income inequality, the upward trend for that relationship depends on the values of parameters for the making use of the simulations and these parameters are not deterministic in the magnitudes on the calculated results for the simulations.

Keywords: ICT, inequality, capital accumulation, technology

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Authors: Vijayabhaskar Reddy Kandula, Peter Provost Taillac, Balasubramanya M. A., Ram Krishnan Nair, Gokul Toshnival, Vibhu Dhawan, Vijaya Karanam, Buffy Cramer

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Introduction: The lack of Emergency Care Services (ECS) is a cause of extensive and serious public health problems in low- and middle-income countries (LMIC), Many LMIC countries have ambulance services that allow timely transfer of ill patients but due to poor care during the ‘Golden Hour’ many deaths occur which are otherwise preventable. Lack of adequate training as evidenced by a study in India is a major reason for poor care during the ‘Golden Hour’. Adapting developed country models which includes staffing specialty-trained doctors in emergency care, is neither feasible nor guarantees cost-effective ECS. Methods: Based on our assessment and felt needs by first-line doctors providing emergency care in 2014, Rajiv Gandhi Health Sciences University’s JeevaRaksha Trust in partnership with the University of Utah, USA, designed, piloted and successfully implemented a 4-day Comprehensive-Emergency Care and Life Support course (C-ECLS) for allopathic doctors. 1730 doctors completed the 4-day course between June 2014 and December- 2020. Subsequently, we conducted a survey to investigate the utilization rates and usefulness of the training. 1662 were contacted but only 309 completed the survey. The respondents had the following designations: Senior faculty (33%), junior faculty (25), Resident (16%), Private-Practitioners (8%), Medical-Officer (16%) and not-working (11%). 51% were generalists (51%) and the rest were specialists (>30 specialties). Results: 97% (271/280) felt they are better doctors because of C-ECLS. 79% (244/309) reported that training helped to save life- specialists more likely than generalists (91% v/s 68%. P<0.05). 64% agreed that they were confident of managing COVID-19 symptomatic patients better because of C-ECLS. 27% (77) were neutral; 9% (24) disagreed. 66% agreed that training helps to be confident in managing COVID-19 critically ill patients. 26% (72) were neutral; 8% (23) disagreed. Frequency of use of C-ECLS skills: Hemorrhage-control (70%), Airway (67%), circulation skills (62%), Safe-transport and communication (60%), managing critically ill patients (58%), cardiac arrest (51%), Trauma (49%), poisoning/animal bites/stings (44%), neonatal-resuscitation (39%), breathing (36%), post-partum-hemorrhage and eclampsia (35%). Among those who used the skills, the majority (ranging from (88%-94%) reported that they were able to apply the skill more effectively because of ECLS training. Conclusion: JeevaRaksha’s C-ECLS is the world’s first comprehensive training. It improves the confidence of front-line doctors and enables them to provide quality care during the ‘Golden Hour’ of emergency. It also prepares doctors to manage unknown emergencies (e.g., COVID-19). C-ECLS was piloted in Morocco, and Uzbekistan and implemented countrywide in Bhutan. C-ECLS is relevant to most settings and offers a replicable model across LMIC.

Keywords: comprehensive emergency care and life support, training, capacity building, low- and middle-income countries, developing countries

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Authors: Dinesha Siriwardhane, Indralal De Silva, Sampath Amaratunge

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Objective of this study is to explore the recent trends, patterns and the structural changes in the labour migration from Sri Lanka to Middle East countries and to discuss the possible impacts of those changes on the remittance flow. Study uses secondary data published by Sri Lanka Bureau of Foreign Employment and Central Bank. Thematic analysis of the secondary data revealed that the migration for labour has increased rapidly during past decades. Parallel with that the gender and the skill composition of the migration flow has been changing. Similarly, the destinations for male migration have changed over the period. These show positive implications on the international remittance receipts to the country.

Keywords: migration, middle east, Sri Lanka, social sciences

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Authors: Ali Arabkheradmand, Enayat A. Shabani, Shabnam Ranjbar Nikkhoo

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Historical and ancestral bonds of the countries in the Middle East have led to similarities in culture and context of their societies. In addition, economic resources, such as the oil industry, have generally been an integrative point in the region. Higher education of a country is influenced by different national and international factors and regarding the mentioned bonds, it is inviting to study the development of the countries of the Middle East in higher education and draw some practical implications which can be used in the educational policy-making of the region. This review includes a data analysis on the population of international students in the countries of the Middle East. As its second objective, a review study on the successful countries, that is those which host the highest number of international students and the strategies they have developed to reach this state among the countries of the region has been conducted. Suggestions are made as to the strategies in higher education systems of these countries which could prove useful and practical in the development of internationalization of higher education in the region, specifically with regard to the recruitment of international students.

Keywords: internationalization of higher education, international student recruitment, Middle East countries, educational policy making

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Authors: Tesfaye Dagne, Dagmawit Solomon, Firmaye Bogale, Yosef Gebreyohannes, Samson Mideksa, Mamuye Hadis, Desalegn Ararso, Ermias Woldie, Tsegaye Getachew, Sabit Ababor, Zelalem Kebede

Abstract:

Globally, road traffic accident (RTA) is causing millions of deaths and injuries every year. It is one of the leading causes of death among people of all age groups and the problem is worse among young reproductive age group. Moreover the problem is increasing with an increasing number of vehicles. The majority of the problem happen in low and middle income countries (LMIC), even if the number of vehicles in these countries is low compared to their population. So, the objective of this paper is to summarize the best available evidence on interventions that can reduce road traffic accidents in low and middle income countries (LMIC). Method: A rapid evidence synthesis approach adapted from the SURE Rapid Response Service was applied to search, appraise and summarize the best available evidence on effective intervention in reducing road traffic injury. To answer the question under review, we searched for relevant studies from databases including PubMed, the Cochrane Library, TRANSPORT, Health system evidence, Epistemonikos, and SUPPORT summary. The following key terms were used for searching: Road traffic accident, RTA, Injury, Reduc*, Prevent*, Minimiz*, “Low and middle-income country”, LMIC. We found 18 articles through a search of different databases mentioned above. After screening for the titles and abstracts of the articles, four of them which satisfy the inclusion criteria were included in the final review. Then we appraised and graded the methodological quality of systematic reviews that are deemed to be highly relevant using AMSTAR. Finding: The identified interventions to reduce road traffic accidents were legislation and enforcement, public awareness/education, speed control/ rumble strips, road improvement, mandatory motorcycle helmet, graduated driver license, street lighting. Legislation and Enforcement: Legislation focusing on mandatory motorcycle helmet usage, banning cellular phone usage when driving, seat belt laws, decreasing the legal blood alcohol content (BAC) level from 0.06 g/L to 0.02 g/L bring the best result where enforcement is there. Public Awareness/Education: focusing on seat belt use, child restraint use, educational training in health centers and schools/universities, and public awareness with media through the distribution of videos, posters/souvenirs, and pamphlets are effective in the short run. Speed Control: through traffic calming bumps, or speed bumps, rumbled strips are effective in reducing accidents and fatality. Mandatory Motorcycle Helmet: is associated with reduction in mortality. Graduated driver’s license (GDL): reduce road traffic injury by 19%. Street lighting: is a low-cost intervention which may reduce road traffic accidents.

Keywords: evidence synthesis, injury, rapid review, reducing, road traffic accident

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Authors: Erdal Eroğlu, Özhan Çetinkaya

Abstract:

The purpose of this paper is to show how state plays a regulatory role in the relations of distribution by analyzing tax and expenditure in Turkey. This paper has two main arguments. First, state intervenes in economic and social life via budget policies and steers the relations of distribution within the scope of the reproduction of the capital accumulation and legitimacy. Secondly, a great amount of public expenditure benefits capital owners while state gains its tax income mainly from low and middle income groups.

Keywords: distribution, public expenditure, state budget, taxes

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Authors: Wei-Neng Wang, Jhy-Yuan Shieh, Jhy-Hwa Chen, Juin-Jen Chang

Abstract:

This paper incorporate tax evasion into a one-sector real business cycle (RBC) model to explores the quantitative interrelations between income tax rate and equilibrium (in)determinacy, and income tax rate is endogenously determined in order to balance the government budget. We find that the level of the effective income tax rate is key factor for equilibrium (in)determinacy, instead of the level of income tax rate in a tax evasion economy. Under an economy with tax evasion, the higher income tax rate is not sufficiently to lead to equilibrium indeterminate, it must combine with a necessary condition which is the lower fraction of tax evasion and that can result in agents' optimistic expectations to become self-fulfilling and sunspot fluctuation more likely to occur. On the other hand, an economy with tax evasion can see its macroeconomy become more stabilize, and a higher fraction of income tax evasion may has a stronger stabilizing effect.

Keywords: tax evasion, balanced-budget rule, equlibirium (in)determinacy, effective income tax rate

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Authors: Ya-Hui Lee, Ching-Yi Lu, Hui-Chuan Wei

Abstract:

The purpose of this research was to explore the relation between proactive coping and well-being of middle-aged adults. We conducted survey research that with t-test, one way ANOVA, Pearson correlation and stepwise multiple regression to analyze. This research drew on a sample of 395 participants from the senior learning centers of Taiwan. The results provided the following findings: 1.The participants from different residence areas associated significant difference with proactive coping, but not with well-being. 2. The participants’ perceived of financial level associated significant difference with both proactive coping and well-being. 3. There was significant difference between participants’ income and well-being. 4. The proactive coping was positively correlated with well-being. 5. From stepwise multiple regression analysis showed that two dimensions of proactive coping had positive predictability. Finally, these results of this study can be provided as references for designing older adult educational programs in Taiwan.

Keywords: middle-age and older adults, learners, proactive coping, well-being

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Authors: Poonam Magu, Kumud Khanna, P. Seetharaman

Abstract:

A kitchen is a major workplace in any home. A large variety of tasks, mainly related to meal preparation is performed here. The types of activities performed are varied and vast. In a way, it is the activities performed that determine the way the space within the kitchen is going to be utilised. A study was conducted in 510 Indian kitchens belonging to middle-income group families living in Delhi. It was conducted in three phases. In the first phase, 510 non-working homemakers were interviewed and questions pertaining to their personal characteristics, meal preparation and physical aspects related to the kitchen were asked. In the second phase, the technique of Path Process Chart was developed. Subsequently, a sub-sample of 50 homemakers was selected from the larger group. The activity of meal preparation was carried out by the homemakers themselves in their kitchens. A time and motion study was conducted using the technique of Path Process Chart. The results were analysed using the appropriate analysis sheets and conclusions were drawn. It was found that the entire kitchen and more specifically, the counter had been 'divided' into a number of workplaces. These workplaces were being used either for performing operations or for the purpose of storage. In many cases, it was used for both. On the whole, in 50 kitchens studied, 21 workplaces were identified which were used for performing operations related to meal preparation and 17 for storage It was also observed that almost the entire kitchen was used for the purpose of storage of some item or the other. The major workplaces where operations were performed were the range, workplaces to the right and left of range and sink and workplaces to the right or left of the sink. The same workplaces were also used for the purpose of storage. There were some workplaces outside the kitchen too, which were used for operations or storage. These were the dining table, courtyard or balcony, bedroom cupboard. On the whole, the range centre and the sink centre were found to be the two most important centres in an Indian kitchen belonging to urban middle-income group family.

Keywords: kitchen, workplace, meal preparation, path process chart

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Authors: Li Sheng

Abstract:

Based on an extended post-Keynesian model, we find that the association between the savings rate and income inequality is negative if savers’ funds are borrowed by spending households for consumption but positive if savings are channeled to investing firms for production. A negative association, such as the one that exists in the U.S., hinges on an income illusion created by an asset bubble and cheap credit. Thus, financial globalization leads consumption and income inequality to diverge, and the divergence is more extreme if lower-income groups have higher debt ratios. A positive association, such as the one that exists in China, relates to liquidity constraints faced by consumers such that consumption inequality closely follows income inequality. Our results imply that income inequality must be reduced in both types of countries to increase savings in deficit economies with negative associations and to reduce savings in surplus economies with positive associations.

Keywords: savings rate, income inequality, financial globalization, global imbalances

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Authors: Oladipo Joseph Ajayi, Yakubu Muhammed, Caleb Galadima

Abstract:

This study was conducted to examine the income diversification of smallholder farmers in Bosso Local Government area of Niger state, Nigeria. The specific objectives were to examine the socio-economic characteristics of the farmers, identify the sources of income among the farmers, determine the pattern of income diversification and evaluate the determinants of income diversification of farmers in the study area. A multi-stage sampling technique was used to select 94 respondents for the study. Primary data were used, and these were collected with aid of a well structured interview schedule. Descriptive statistics, diversity index, and Tobit regression model were employed to analyze the data. The mean age of the farmers was 44 years. The average household size was 8 members per household, and the average farming experience was 12 years. 21.27 percent did not have formal education. It was further found that 69.1 percent of the respondents had an income diversity index of 0.3-0.4. This indicated that their level of income diversification was moderately low. The determinants of income diversification in the study area were education, household size, marital status, and primary income. These variables were positively related to income diversification. The study revealed that diversification into various income sources has helped to increase household income to sustain the family demands even though their level of income diversification was low within the study area.

Keywords: diversification, income, households, smallholder farmers

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Authors: Ragy Raafat Gaber Attaalla

Abstract:

Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health.

Keywords: low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Karl Peltzer, Supa Pengpid

Abstract:

Introduction: The aim of this study was to assess suicidal ideation and associated factors in school-going adolescents in the Association of Southeast Asian Nations (ASEAN) Member States. Methods: The analysis included 30284 school children aged 13-15 years from seven ASEAN that participated in the cross-sectional Global School-based Student Health Survey (GSHS) between 2007 and 2013. Results: The overall prevalence of suicidal ideation across seven ASEAN countries (excluding Brunei) was 12.3%, significantly higher in girls (15.1%) than boys (9.3%). Among eight ASEAN countries with the highest prevalence of suicidal ideation was in the Philippines (17.0%) and Vietnam (16.9%) and the lowest in Myanmar (1.1%) and Indonesia (4.2%). In multivariate logistic regression analysis, female gender, older age (14 or 15 years), living in a low income or lower middle income country, having no friends, loneliness, bullying victimization, having been in a physical fight in the past 12 months, lack of parental or guardian support, tobacco use and having a history of ever got drunk were associated with suicidal ideatiion. Conclusion: Different rates of suicidal ideation were observed in ASEAN member states. Several risk factors for suicidal ideation were identified which can help guide preventive efforts.

Keywords: adolesents, ASEAN, correlates, suicidal behaviour

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Authors: Titus Wuyah Yunana

Abstract:

This study analyzed the impact of commercial agricultural credit scheme on income of beneficiary farmers in Kaduna State using the Net farm income and double difference method. A questionnaire was used to source the data from 306 farmers comprising of 153 beneficiaries and 153 non-beneficiaries. The results indicated that the net farm income of the commercial agricultural credit scheme beneficiaries increases from N15,006,352.00 before scheme to N24,862,585.00 after the first and the second phases of the scheme. There was also an increase in the net farm income of the non-beneficiaries from N9, 670,385.40 to N14, 391,469.00 during the scheme. The double difference method analysis indicated a positive mean income difference value between beneficiaries and nonbeneficiaries after the first and the second phases of the scheme. The study recommends expansion in the number of beneficiaries and efficient allocation and utilization of the resources. The government should also introduce more programs that will assist the farmers to increase their productivity, income and the economy as a whole.

Keywords: agriculture, credit scheme, farmers, income, beneficiary

Procedia PDF Downloads 296