Search results for: rural health delivery

Authors: Lilian A. Okeke, I. Okeke, N. Waziri, S. Balogun, P. Nguku, O. Fawole

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Background: Access to ante-natal care services promotes safe motherhood and delivery with improved maternal and neonatal outcome. We conducted this study to identify factors influencing the utilization of antenatal care (ANC) and health delivery services. Methods: We conducted a cross sectional study. Households were numbered and a one in three sample was selected using a systematic sampling method. One hundred and ninety eight women who were either pregnant or had previous deliveries were interviewed using pretested structured questionnaires to obtain information on their socio-demographic characteristics, and reasons for non-utilization of ANC and health delivery services. We performed univariate and bivariate analysis using Epi info version 3.5.3. Results: The age of respondents ranged from (17-55 years) with a median age of 29 years. One hundred and ninety two (97%) utilized antenatal care services. Ninety three (47.9%) attended ANC at second trimester. More than half (58.6%) had ≥ 4 visits to ANC. One hundred and thirty one (66.2%) had their last delivery at home by a traditional birth attendant. Factors associated with ANC and health facility delivery services utilization were: age group 45-55 (OR 0.01; 95% CI: 0.00-0.16) and > 55 years (OR 0.03; 95% CI: 0.00-0.60), wife’s educational status (OR 3.17; 95% CI: 1.66-8.30), husband’s permission (OR 11.8; 95% CI 2.19-63.62), and distance ≥ 5km (OR 0.33; 95% CI: 0.16-0.60). Conclusion: ANC services were well utilized. Most women did not book early and had their last delivery at home. Predictors of ANC use and health facility delivery were age, wife’s educational status, husband's permission and long distance from health facility. A one-day health sensitization of the benefits of ANC utilization and the dangers of delivering at home was implemented.

Keywords: ante natal care, health facility, delivery services, rural area, Plateau state

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Authors: Catherine Bernard

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The maldistribution of clinicians within countries is well documented. It is a common theme throughout the world that rural areas often struggle to recruit and retain health workers resulting in inadequate healthcare for many. This paper will concentrate on the responsibilities that medical schools may have in addressing this shortage of rural health workers. Recommendations are made with regards to targeted rural student admissions, rurally-based medical schools, rural clinical rotations and a curriculum orientated towards rural health issues. The evidence gathered suggests that individual factors are positive in encouraging health workers to practice in rural locations. However, there is strength in numbers, and combining all the recommendations will likely result in a synergistic effect, thereby increasing numbers of rural health workers and achieving accessible healthcare for those living in rural populations.

Keywords: medical education, medical education design, public health, rural health

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Authors: Rahmi Yetri Kasri, Paulus Wirutomo

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Citizen engagement approach has become increasingly important in the rural water sector. However, the question remains as to what exactly is meant by citizen engagement and how this approach can lead to sustainable service delivery. To understand citizen engagement, this paper argues that we need to understand basic elements of social life that consist of social structure, process, and culture within the realm of community’s living environment. Extracting from empirical data from Pamsimas villages in rural West Java, Indonesia, this paper will identify basic elements of social life and environment that influence and form the engagement of citizen and government in delivering and sustaining rural water supply services in Indonesia. Pamsimas or the Water Supply and Sanitation for Low Income Communities project is the biggest rural water program in Indonesia, implemented since 1993 in more than 27,000 villages. The sustainability of this sector is explored through a rural water supply service delivery life-cycle, starts with capital investment, operational and maintenance, asset expansion or renewal, strategic planning for future services and matching cost with financing. Using mixed-method data collection in case study research, this paper argues that increased citizen engagement contributes to a more sustainable rural water service delivery.

Keywords: citizen engagement, rural water supply, sustainability, Indonesia

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Authors: Virginia Dickson-Swift, Amanda Kenny, Jane Farmer, Sarah Larkins, Karen Carlisle, Helen Hickson

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In this presentation, we will focus on the methods of Remote Services Futures (RSF), an evidence-based method of community participation that was developed in Scotland. Using oral health as the focus, we will discuss the ways that RSF can be used to achieve sustainable engagement with stakeholders from various parts of the community. We will describe our findings of using RSF methods to engage with rural communities, including the steps involved and what happened when we asked people about the oral health services that they thought were needed in their community. We found that most community members started by thinking that a public dental clinic was required in every community, which is not a sustainable health service delivery option. Through a series of facilitated workshops, communities were able to discuss and prioritise their needs and develop a costed plan for their community which will ensure sustainable service delivery into the future. Our study highlights the complexities of decision making in rural communities. It is important to ensure that when communities participate in health care planning that the outcomes are practical, feasible and sustainable.

Keywords: community participation, sustainable health planning, Remote Services Futures, rural communities

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Authors: Jean Ross

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Rural nursing is not an identified professional identity in the UK, unlike the USA, Canada, and Australia which recognizes rural nursing as a specialty scope of practice. In New Zealand rural nursing is an underrepresented aspect of nursing practice, is misunderstood and does not fit easily within the wider nursing profession and policies governing practice. This study situated within the New Zealand context adds to the international studies’ aligned with rural nursing practice. The study addresses a gap in the literature by striving to identify and strengthen the awareness of and increase rural nurses’ understanding and articulation of their changing and adapting identity and furthermore an opportunity to appreciate their contribution to the delivery of rural health care. In addition, this study adds to the growing global rural nursing knowledge and theoretical base. This research is a continuation of the author’s academic involvement and ongoing relationships with the rural nursing sector, national policy analysts and health care planners since the 1990s. These relationships have led to awareness, that despite rural nurses’ efforts to explain the particular nuances which make up their practice, there has been little recognition by profession to establish rural nursing as a specialty. The research explored why nurses’ who practiced in the rural Otago region of New Zealand, between the 1990s and early 2000s moved away from the traditional identity as a district, practice or public health nurse and looked towards a more appropriate identity which reflected their emerging practice. This qualitative research situated within the interpretive paradigm embeds this retrospective study within the discipline of nursing and engages with the concepts of place and governmentality. National key informant and Otago regional rural nurse interviews generated data and were analyzed using thematic analysis. Stemming from the analyses, an analytical diagrammatic matrix was developed demonstrating rural nursing as a ‘place–based practice’ governed both from within and beyond location presenting how the nurse aligns the self in the rural community as a meaningful provider of health care. Promoting this matrix may encourage a focal discussion point within the international spectrum of nursing and likewise between rural and non-rural nurses which it is hoped will generate further debate in relation to the different nuances aligned with rural nursing practice. Further, insights from this paper may capture key aspects and issues related to identity formation in respect to rural nurses, from the UK, New Zealand, Canada, USA, and Australia.

Keywords: matrix, place, nursing, rural

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Authors: Tanmay L. Joshi

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The Mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-rounded, healthy adults. In urban area, many health professionals are working for the well being for younger population. There is so much of potential in rural area. However, the rural population is somehow neglected. Apart from lack of availability of basic needs like transport, electricity, telecommunication etc; the Psychological health is also overlooked in such area. There are no mental health professionals like Psychologists, counselors etc. So the researcher tries to throw some light on the mental health of Higher Secondary School going children in rural area. The current research tries to study the Mental Health (Confidence, Sociability and Neurotic Tendency) of Higher Secondary School going children. Researchers have used the tool Vyaktitva Shodhika (a personality inventory) by Dr. U. Khire (JPIP,Pune). The Sample size is 45 (N= 40, 24 boys/21 girls). The present study may provide a good support to inculcate emotional-management programs for higher secondary school going children in rural areas.

Keywords: mental health, neurotic tendency, rural area, school going children

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Authors: A. A. Betah

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This research was performed to evaluate the attitudes of rural women towards education, health and work outside the home. The study was based on a random sample of 147 rural women, Kafr-Rahmaniyah village was chosen for the study because its life expectancy at birth for females, education and percentage of females in the labor force, were the highest in the district. The study data were collected from rural female respondents, using a face-to-face questionnaire. In addition, the study estimated several factors like age, main occupation, family size, monthly household income, geographic cosmopolites, and degree of social participation for rural women respondents. Using Statistical Package for the Social Sciences (SPSS), data were analyzed by non-parametric statistical methods. The main finding in this study was a significant relationship between each of the previous variables and each of rural women’s attitudes toward education, health, and work outside home. The study concluded with some recommendations. The most important element is ensuring attention to rural women’s needs, requirements and rights via raising their health awareness, education and their contributions in their society.

Keywords: attitudes, education, health, rural women, work outside home

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Authors: Hussain Ali, Ahmad Ali, Syed Rashid Ali

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The maternal mortality is one of the basic health issues faced by rural women in Pakistan. There are various structural and socio-cultural determinants which confine women to domestic sphere. Such mobility restriction compels women for home delivery which causes high maternal mortality and morbidity. However, it is hard to find out the research findings and well-organized literature that explain the cultural factors act as determinant to home delivery among Pakhtun women. The overall objective of this research is to study men’s decision making within the household in Pakhtun society as determinant of home delivery among Pakhtun women in Khyber Pakhtunkhwa province of Pakistan. In the present study, researchers used the quantitative research design in which the data are collected through household survey technique from (n=503) ever-married women having reproductive age (15-49 years) by using interview schedule. The data are analyzed through SPSS, and binary logistic regression was applied to draw the association between home as a place of delivery and men’s decision making in the Pakhtun society. The results show that majority (76%) of the husbands are key decision makers about the home delivery due to their superior position within household. Similarly, majority (88%) Pakhtun women prefer to stay in home for their delivery due to their dependency on husband’s decision. The researcher concludes that men are key decision makers in Pakhtun society and their decisions affect women maternal health care. Similarly, the women are in subordinate position, and their limited decision making in the domestic sphere are greatly responsible for home delivery which causing high maternal mortality rate in the study area. In order to achieve Sustainable Development Goal No. 3, the study recommends empowering women in the decision making about accessing and utilizing maternal health care services and given financial autonomy to them.

Keywords: home delivery, men’s decision, Pakhtun women, subordinate position

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Authors: Alfred L. Guiffrida

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A review of the literature on supply chain delivery models which use delivery windows to measure delivery performance is presented. The review herein serves to meet the following objectives: (i) provide a synthesis of previously published literature on supply chain delivery performance models, (ii) provide in one paper a consolidation of research that can serve as a single source to keep researchers up to date with the research developments in supply chain delivery models, and (iii) identify gaps in the modeling of supply chain delivery performance which could stimulate new research agendas.

Keywords: delivery performance, delivery window, supply chain delivery models, supply chain performance

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Authors: Dolly Kumari, H. Lhungdim

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Maternal health is one of the crucial health indicators for any country. 5th goal of Millennium Development Goals is also emphasising on improvement of maternal health. Soon after Independence government of India realizing the importance of maternal and child health care services, and took steps to strengthen in 1st and 2nd five year plans. In past decade the other health indicator which is life expectancy at birth has been observed remarkable improvement. But still maternal mortality is high in India and in some states it is observe much higher than national average. Government of India pour lots of fund and initiate National Rural Health Mission (NRHM) in 2005 to improve maternal health in country by providing affordable and accessible health care services. Accredited Social Heath Activist (ASHA) is one of the key components of the NRHM. Mainly ASHAs are selected female aged 25-45 years from village itself and accountable for the monitoring of maternal health care for the same village. ASHA are trained to works as an interface between the community and public health system. This study tries to assess the role of ASHA in utilizing maternal health care services and to see the level of awareness about benefits given under JSY scheme and utilization of those benefits by eligible women. For the study concurrent evaluation data from National Rural health Mission (NRHM), initiated by government of India in 2005 has been used. This study is based on 78205 currently married women from 70 different districts of India. Descriptive statistics, chi2 test and binary logistic regression have been used for analysis. The probability of institutional delivery increases by 2.03 times (p<0.001) while if ASHA arranged or helped in arranging transport facility the probability of institutional delivery is increased by 1.67 times (p<0.01) than if she is not arranging transport facility. Further if ASHA facilitated to get JSY card to the pregnant women probability of going for full ANC is increases by 1.36 times (p<0.05) than reference. However if ASHA discuses about institutional delivery and approaches to get register than probability of getting TT injection is 1.88 and 1.64 times (p<0.01) higher than that if she did not discus. Further, Probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 years. The probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 year of age than before 18 years, it is also 1.28 times (p<0.001) and 1.32 times (p<0.001) higher among women have 1 to 8 year of schooling and with 9 and above years of schooling respectively than the women who never attended school. Those women who are working have 1.13 times (p<0.001) higher probability of getting benefits from JSY scheme than not working women. Surprisingly women belongs to wealthiest quintile are .53times (P<0.001) less aware about JSY scheme. Results conclude that work done by ASHA has great influence on maternal health care utilization in India. But results also show that still substantial numbers of needed population are far from utilization of these services. Place of delivery is significantly influenced by referral and transport facility arranged by ASHA.

Keywords: institutional delivery, JSY beneficiaries, referral faculty, public health

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Authors: Inas S. Khayal, Weiping Zhou, Jonathan Skinner

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Healthcare delivery systems around the world are in crisis. The need to improve health outcomes while decreasing healthcare costs have led to an imminent call to action to transform the healthcare delivery system. While Bioinformatics and Biomedical Engineering have primarily focused on biological level data and biomedical technology, there is clear evidence of the importance of the delivery of care on patient outcomes. Classic singular decomposition approaches from reductionist science are not capable of explaining complex systems. Approaches and methods from systems science and systems engineering are utilized to structure healthcare delivery system data. Specifically, systems architecture is used to develop a multi-scale and multi-dimensional characterization of the healthcare delivery system, defined here as the Healthcare Delivery System Knowledge Base. This paper is the first to contribute a new method of structuring and visualizing a multi-dimensional and multi-scale healthcare delivery system using systems architecture in order to better understand healthcare delivery.

Keywords: health informatics, systems thinking, systems architecture, healthcare delivery system, data analytics

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Authors: Arindam Roy

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

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

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Authors: Cecilia Kunseh Betek

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Managing rural water supply systems effectively and efficiently is a challenge in the O R Tambo District Municipality due to the long distances between consumers and municipal centres. This is a couple with the low income of most residents and the government's policy of free basic water which is making rural water provision very difficult. With regard to cartage, the results reveal that the majority (84.4%) of the population covers distances of about 1kilometre to fetch water, and 15.6% travel up kilometer to access water facilities. This means that the water sources are located very far from households, outside the officially legislated array of 200metres. These are many reasons to account for this situation. Firstly, this implies that there are inadequate stand pipes to cater for all the homesteads scattered across the rugged terrain of OR Tambo District municipality. Secondly, and following from the first explanation, it would be seen that funding that is made available is not adequate, or is not efficiently spent on the targeted projects. The situation in the rural areas of South Africa is fraught with cumbersome complexity when it comes to service delivery.

Keywords: water, management, government, rural

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Authors: Festus Adedoyin, Nana Mbeah Otoo, Sofia Meacham

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Hypertension is one of the main health issues in Ghana, where prevalence is higher in rural than in urban areas. This is due to the challenges rural areas have in accessing technology and healthcare services for hypertension control. This study's goal is to create a digital healthcare solution to alleviate this inequality. Through an analysis of current technology and problems, using the ring onion methodology, the study determined the needs for the intervention and evaluated healthcare disparities. An online application with teleconsultation capabilities, reminder mechanisms, and clinical decision support is part of the suggested solution. In outlying areas, mobile clinics in containers with the required equipment will be established. Heuristic evaluation and think-aloud sessions were used to assess the prototype's usability and navigational problems. This study highlights the need to develop digital health interventions to help manage hypertension in rural locations and decrease healthcare disparities. To develop and improve digital healthcare solutions for rural areas worldwide and in Ghana, this study might be used as a tool for future research.

Keywords: digital health, health inequalities, hypertension management, rural areas

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Authors: Tolu Lawal

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The genuine development of the grassroots particularly in the developing societies depends largely on the participation of the rural populace in policy conception and implementation, especially in the area of development policies, fundamentally, the rural people play a vital and significance role in economic and political development of the nation. This is because the bulk of the economic produce as well as votes come from these areas. However, the much needed development has continued to elude the rural communities inspire of the various development policies carried out by successive governments in the state. The exclusion of rural communities from planning and implementation of facilities meant to benefit them, and the international debate on sustainable rural development led Ondo State government to re-think its rural development policy with a view to establishing more effective strategies for rural development. The 31s initiatives introduced in 2009 emphasizes the important role of communities in their own development. The paper therefore critically assessed the 31s initiative of the present government in Ondo State with a view to knowing its impact on rural people. The study adopted both primary and secondary data to source its information. Interviews were conducted with the key informants, and field survey (visit) was also part of method of collecting data. Documents, reports and records on 31s initiatives in the selected villages and from outside were also consulted. The paper submitted that 31s initiative has not impacted positively on the lives of rural dwellers in Ondo-State, most especially in the areas of infrastructure and integrated development. The findings also suggested that 31s initiatives is not hopeless, but needs a different kind of investment, for example introducing measures of accountability, addressing the politicization of the initiative and exploiting key principles of development and service delivery.

Keywords: development, infrastructure, rural development, participation

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Authors: P. Chandhra Sekhar, R. A. Deshpande, T. Raghunatha

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The government of India has given special attention on rural electrification under Rajiv Gandhi Grameena Vidyuthikarana Yojana (RGGVY) during 10th plan and 11th plan. Government of India electrified about 107523 villages and 21164003 BPL Households. This paper briefs about various rural electrification programs initiated by government of India and status of RGGVY in India. The paper mainly describes about challenges in the rural electrification, new ideas recently implemented and suggestions for improvement in the rural electrification.

Keywords: rural electrification, RGGVY, NJY, BPL

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.

Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine

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Authors: Shishir Kumar, Chhaya Gangwal, Seema Raj

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Public health informatics (PHI) which has seen successful implementation in the developed world, become the buzzword in the developing countries in providing improved healthcare with enhanced access. In rural areas especially, where a huge gap exists between demand and supply of healthcare facilities, PHI is being seen as a major solution. There are factors such as growing network infrastructure and the technological adoption by the health fraternity which provide support to these claims. Public health informatics has opportunities in healthcare by providing opportunities to diagnose patients, provide intra-operative assistance and consultation from a remote site. It also has certain barriers in the awareness, adaptation, network infrastructure, funding and policy related areas. There are certain medico-legal aspects involving all the stakeholders which need to be standardized to enable a working system. This paper aims to analyze the potential and challenges of public health informatics services in rural communities.

Keywords: PHI, e-health, public health, health informatics

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Authors: Amanda Kenny, Virginia Dickson-Swift, Jane Farmer, Sarah Larkins, Karen Carlisle, Helen Hickson

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Rural ECOH (Engaging Communities in Oral Health) is a collaborative project that connects policy makers, service providers and community members. The aim of the project is to empower community members to determine what is important for their community and to design the services that they need. This three-year project is currently underway in six rural communities across Australia. This study is specifically focused on Remote Services Futures (RSF), an evidence-based method of community participation that was developed in Scotland. The findings highlight the complexities of community participation in health service planning. We assumed that people living in rural communities would welcome participation in oral health planning and engage with their community to discuss these issues. We found that to understand the relationships between community members and health service providers, it was essential to identify the formal and informal community leaders and to engage stakeholders from the various community governance structures. Our study highlights the sometimes ‘messiness’ of decision making in rural communities as well as ways to ensure that community members have the training and practical skills necessary to participate in community decision making.

Keywords: community participation, health planning, rural ECOH, Remote Services Futures

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

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

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

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Authors: Jiawei Liang

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Against the backdrop of China's burgeoning migration from rural to urban areas, a demographic group has emerged in China, which is called left-behind children. Due to many reasons, including the issue of the rural-urban education gap, the education of left-behind children has been below the national education average. In this situation, the issue has attracted the attention of researchers and policymakers. In order to gain a comprehensive understanding of this issue, this paper adopts an analytical approach to studying the rural-urban education gap and left-behind children in rural China. The paper first introduces the current situation of migration, the education gap, and left-behind children within China. Then, it further explores the causes of these two questions and barriers as well as the consequences for left-behind children. Finally, the study offers some suggestions to alleviate the urban-rural gap and the current situation of education for left-behind children in rural areas, which will hopefully shed light on the issue of left-behind children in China and the urban-rural education gap.

Keywords: left-behind children, rural China, education improvement, Hukou policy, rural-urban education gap

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Authors: Zheng Junchao, Wang Zhu

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With the advancement of China's urbanization process, the Chinese government has put forward the strategy of rural revitalization which is aiming at realizing the comprehensive integration of urban and rural areas and the comprehensive revitalization of rural areas. The path of rural revitalization in Zhejiang province put forward a typical model from four dimensions: suburban area, plain, island and mountain area. Research methods include on-the-spot investigation, visiting a number of successful demonstration villages in Zhejiang and interviewing village officials. Based on the location conditions, resource endowments, industrial forms and development foundations of Zhejiang Province, this paper introduces in detail the model of rural revitalization in Zhejiang Province and the challenges it encounters, as well as the role of building construction. The rural development model of Zhejiang province makes the rural culture flourish. Taking the construction of rural scenic spots as the carrier, the rural culture, and natural landscape are constantly improved. It provides a model and template for the country's rural revitalization. The promotion of Zhejiang rural revitalization model will improve the current rural landscape, living standard and industrial structure, which will narrow the urban-rural gap greatly.

Keywords: comprehensive rural revitalization, Zhejiang model, reproducible, comprehensive integration

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Authors: Pankaj Kumar Kalita

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Ineffectiveness of formal institutional mechanisms such as official audit to improve public service delivery has been a serious concern to scholars working on governance reforms in developing countries. Scholars argue that public service delivery in local self-governing institutions can be improved through application of informal mechanisms such as social accountability. Social accountability has been reinforced with the engagement of citizens and civic organizations in the process of service delivery to reduce the governance gap in developing countries. However, there are challenges that may impede the scope of establishing social accountability initiatives in the performance of local self-governing institutions. This study makes an attempt to investigate the factors that may impede the scope of establishing social accountability, particularly in culturally heterogeneous societies like India. While analyzing the implementation of two rural development schemes by Panchayats, the local self-governing institutions functioning in rural Assam in India, this study argues that the scope of establishing social accountability in the performance of local self-governing institutions, particularly in culturally heterogeneous societies in developing countries will be impeded by the absence of inter-caste and inter-religion networks. Data has been collected from five selected districts of Assam using in-depth interview method and survey method. The study further contributes to the debates on 'good governance' and citizen-centric approaches in developing countries.

Keywords: citizen engagement, local self-governing institutions, networks, social accountability

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Authors: Gudakesh Yadav

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

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

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Authors: Han Song, Tingting Wei, Dong Chen

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The combination of capital and rural areas in China has shown its great significance in promoting urban-rural integration and new-style urbanization, enhancing regional capacity for sustainable rural development and optimizing human settlement environment. The purpose of this study is to find capital operation mechanism in rural area and rural planning guidance in China. Based on case studies in Chinese rural areas, two types of capital operation mechanism in rural areas are summed up: intervention in the field of agriculture promoting the upgrading and innovation of agricultural industry chain, intervention in rural life and leisure areas updating rural connotation and form. In the light of experiences in Japan and Taiwan, it is proposed that government's norms and guidance, rural investment intensity and rural self-organization are three important factors for capital to drive rural development. It is also found that the unique land tenure and rural governance tradition are two important factors effecting the combination of capital and rural regions in China, which requires full attention in rational policy-making and rural planning. It comes to a conclusion as four directions of the overall reform of the rural planning: targeting at enhancing the viability of rural and sustainable capacity, encouraging differences in investment incentives and planning policies, providing land usage in the rural areas with planning support and reforming the village system. Directional guidance is also made for different types of capital investments, suggesting that capital should be rooted in agriculture and rural land to benefit farmers and update human settlements.

Keywords: capital, rural areas, rural planning, rural governance

Procedia PDF Downloads 403

Authors: Mika Kaufman

Abstract:

Behavioral health in school-age children is a great concern. Negative behaviors can affect mental and physical health and, if ignored, can lead to further problems later in life. Rural communities often lack resources for counselors, social workers, and mental health care in the hopes of intervening with children who exhibit negative behaviors. Because of this, schools in rural communities are more likely to have children with behavioral issues. Prevention programs to recognize and address these behavioral concerns can educate teachers about mental health, different negative behaviors that students might exhibit, and how to manage those behaviors and engage with students in a positive way.

Keywords: prevention programs, behavioral health, resources for teachers, rural schools

Procedia PDF Downloads 38

Authors: Shideh Mohseni Movahed, Mansoureh Safari

Abstract:

Intelligent drug delivery systems (IDDS) are innovative technological innovations and clinical way to advance current treatments. These systems differ in technique of therapeutic administration, intricacy, materials and patient compliance to address numerous clinical conditions that require different pharmacological therapies. IDDS capable of releasing an active molecule at the proper site and at a amount that adjusts in response to the progression of the disease or to certain functions/biorhythms of the organism is particularly appealing. In this paper, we describe the most recent advances in the development of intelligent drug delivery systems.

Keywords: drug delivery systems, IDDS, medicine, health

Procedia PDF Downloads 190

Authors: Pariya Sheykhmaleki, Debajyoti Pati

Abstract:

Rural areas in the United States face numerous challenges in providing quality and assessable primary healthcare services, especially during emergencies such as natural disasters or pandemics. This study showcases a cutting-edge flexible module that aims to overcome these challenges by offering adaptable healthcare facilities capable of providing comprehensive health services in remote and disaster-prone regions. According to the Health Resources and Services Administration (HRSA), approximately 62 million Americans, or 1 in 5 individuals, live in areas designated as Health Professional Shortage Areas (HPSAs) for primary care. These areas are characterized by limited access to healthcare facilities, shortage of healthcare professionals, transportation barriers, inadequate healthcare infrastructure, higher rates of chronic diseases, mental health disparities, and limited availability of specialized care, including urgent circumstances like pandemics that can exacerbate this issue. To address these challenges, the literature study began by examining primary health solutions in very remote areas, e.g., spaceships, to identify the state-of-the-art technologies and the methods used to facilitate primary care needs. The literature study on flexibility in architecture and interior design was also adapted to develop a conceptual design for rural areas. The designed flexible module provides an innovative solution. This module can be prefabricated as all parts are standardized. The flexibility of the module allows the structure to be modified based on local and geographical requirements as well as the ability to expand as required. It has been designed to stand either by itself or work in tandem with public buildings. By utilizing sustainable approaches and flexible spatial configurations, the module optimizes the utilization of limited resources while ensuring efficient and effective healthcare delivery. Furthermore, the poster highlights the key features of this flexible module, including its ability to support telemedicine and telehealth services for all five levels of urgent care conditions, i.e., from facilitating fast tracks to supporting emergency room services, in two divided zones. The module's versatility enables its deployment in rural areas located far from urban centers and disaster-stricken regions, ensuring access to critical healthcare services in times of need. This module is also capable of responding in urban areas when the need for primary health becomes vastly urgent, e.g., during a pandemic. It emphasizes the module's potential to bridge the healthcare gap between rural and urban areas and mitigate the impact of rural health challenges.

Keywords: rural health, healthcare challenges, flexible modular design, telemedicine, telehealth

Procedia PDF Downloads 37

Authors: Ying Bo Xie, Hisa Yuki Kurokawa

Abstract:

Due to the fast development, China's express delivery industry has involved in a dilemma that the service quality are keeping decreasing while the construction rate of delivery network cannot meet the customers’ demand. In order to get out of this dilemma and enjoy a succession development rate, it is necessary to understand the current situation of China's express delivery industry. Firstly, the evolution of China's express delivery industry was systematical presented. Secondly, according to the number of companies and the amount of parcels they has dealt each year, the merits and faults of tow kind of operating pattern was analyzed. Finally, based on the characteristics of these express companies, the problems of China's express delivery industry was divided into several types and the countermeasures were given out respectively.

Keywords: China, express delivery industry, status, problem

Procedia PDF Downloads 324

Authors: N. P. Tsephe, S. D. Eyono Obono

Abstract:

Rural tourism is usually associated with rural development because it has strong linkages to rural resources; but it remains underdeveloped compared to urban tourism. This underdevelopment of rural tourism serves as a motivation for this study whose aim is to examine the factors affecting the perceived satisfaction of rural tourists. The objectives of this study are: to identify and design theories and models on rural tourism satisfaction, and to empirically validate these models and theories through a survey of tourists from the Malealea Lodge which is located in the Mafeteng District, in the Mountain Kingdom of Lesotho. Data generated by the collection of questionnaires used by this survey was analyzed quantitatively using descriptive statistics and correlations in SPSS after checking the validity and the reliability of the questionnaire. The main hypothesis behind this study is the relationship between the demographics of rural tourists, the motivation, and their satisfaction of tourists, as supported by existing literature; except that motivation is measured in this study according to three dimensions: push factors, pull factors, and perceived usefulness of ICT's in the rural tourism experience. Findings from this study indicate that among the demographics factors, continent of origin and marital status influence the satisfaction of rural tourists; and their occupation affects their perceptions on the use of ICT's in rural tourism. Moreover, only pull factors were found to influence the satisfaction of rural tourists.

Keywords: digital world, motivation, rural tourism, satisfaction

Procedia PDF Downloads 383