Informal governance and social resilience in farming and fishing communities in rural Sulawesi, Indonesia

Orphaned children in poor rural communities sometimes have no adult who is able to care for them or else the adult caregiver is not able to provide adequate care. Tanzania remains one of the poorest countries in the world, and poverty frequently constrains foster care. Although HIV prevalence is declining, AIDS is still a major cause of orphaning. This article explores the challenges and coping strategies accompanying two possible life trajectories for orphaned children without adequate adult care: 1) that they remain in rural areas in child-headed households, or 2) that they are trafficked to an urban area. Antonovsky's salutogenic model is used as the theoretical framework. The data come from two separate phenomenological studies with vulnerable children. In the first study, in-depth interviews were held with 12 orphaned children in a poor rural area; data concerning three child heads of households are included here. In the second study, 15 girls who were trafficked from rural areas to Dar es Salaam gave extended life-history narrations; data are included for nine of the girls who were orphaned. Loss of parents, a lack of cash, and the need to balance school attendance with food production were chronic stressors for the children heading households, while resources included income-generation strategies and the ability to negotiate with teachers for time to cultivate. For the trafficked girls chronic stressors included exploitation, long working hours, little or no pay, isolation and rape. Resources for them, although limited, included faith networks and neighbours; escape from the exploitative situation frequently involved external help. We conclude that given physical and social assets the child-headed households were able to cope with the challenges of caring for themselves and a younger child, but isolation and dependency on employers made it difficult for the trafficked girls to cope with this exploitation. The salutogenic model proved a useful tool in analysing the coping strategies of children living without adequate adult care.

Identification and evaluation of the components and factors affecting social and economic resilience in city of Rudbar, Iran

The catchment area of River das Antas (Irati, Paraná, Brazil) is of high importance both for human consumption and irrigation. Within Irati, this river passes through a rural area and through the city of Irati, crossing both poor and rich neighbourhoods. We selected three study areas downstream (a rural area, poor community, and rich neighbourhood) in which we measured turbidity, the concentration of sediments and pH during rainy days. Our results showed downstream trends of increasing turbidity and concentrations of sediments with decreasing pH. The values of turbidity and of concentration of sediments were significantly different in the rural area, while the pH values were significantly different between the three study areas. These findings highlight the effect of agricultural activities in the generation of sediments and turbidity. The—presumably expected—effects of organic urban waste from the poor neighbourhood were also detected in the pH values. We conclude that efforts should be made to ensure that land planning and training/education programmes on sustainable farming practices are undertaken by the authorities to reduce water pollution and its effects on water bodies during rainfall events, since paving streets is not a feasible option in the short term due to the high costs associated with this measure.

Theoretical and practical aspects of demographic resilience have been studied by many scientists across different countries. However, for each country, these issues require tailored analysis and adaptation to specific conditions. The purpose of this study is to determine the place of demographic resilience and its components, analyze them with adaptation to Ukraine’s particular conditions in order to form the key directions of achieving the resilience of Ukrainian society in the post-war period. The primary methods used in this research include abstract-logical, sociological, classification-analytical methods and synergistic approach. The novelty of the study lies in the development of conceptual foundations for analyzing the demographic resilience of Ukrainian society in the current context. The authors’ definition of demographic resilience is provided: it is explained as the ability to ensure the change of generations, maintain the desired demographic balance, maintain basic functions and social structures, minimizing the negative consequences of destructions and contributing to recovery. The following components of demographic resilience are proposed: reproductive resilience, resilience of age and sex population structure, family resilience, social or age group resilience, life preservation, resilience of the healthcare system, and migration resilience. The relationships between these components and economic and social resilience, education, and the realization of the “demographic dividend” are analyzed. Criteria for assessing the components of demographic resilience are proposed. Healthcare system resilience and health resilience are treated as distinct components of demographic resilience, yet they are closely interconnected. Both are integrated and influenced by various factors. The migration component is examined in the context of immigration, emigration, and the accommodation and adaptation of internally displaced persons. Demographic resilience in Ukraine has been influenced by both the COVID-19 pandemic and, more significantly, the full-scale Russian-Ukrainian war. Their effects cause the need for further quantitative assessment of the individual components of demographic resilience and the development of specific measures to strengthen it.

IntroductionMidlife physical capability (PC) is associated with developmental factors in the populations of economically developed countries. As far as we know, there is no information for rural populations of low- and middle-income countries. The aim of the study was to investigate the influence of pre- and postnatal factors on midlife objective measures of PC in a 1966–67 birth cohort from a Mexican rural community. The hypothesis was that adverse developmental conditions are associated with low midlife PC.MethodsIn 1966–67, a birth cohort of all children from a poor Mexican rural community was assembled. Data on family socioeconomic status (SES), parental health and nutritional status, birth weight, postnatal growth and feeding patterns were registered. In 2018, out of the 336 cohort members, 118 were living in the community, and eighty-two of them underwent a comprehensive clinical evaluation. The evaluation included grip strength, gait velocity and chair-stand PC tests. In multivariable linear models, PC tests were the dependent variables, and prenatal, birth and postnatal factors were the independent variables. Adjustment for confounding was made with adult anthropometric, body composition, clinical and ageing status variables.ResultsIndependent of adult health status and other ageing indicators, lower PC was associated with family organization and SES, parental nutritional status, birth weight, infant postnatal growth velocity, and weaning time. These results indicate that adverse family and environmental conditions that are prevalent in poor rural communities are associated with low midlife PC.

BackgroundIntestinal parasitic infections (IPIs) have a worldwide distribution and have been identified as one of the most significant causes of illnesses and diseases among the disadvantaged population. In Malaysia, IPIs still persist in some rural areas, and this study was conducted to determine the current epidemiological status and to identify risk factors associated with IPIs among communities residing in rural and remote areas of West Malaysia.Methods/FindingsA total of 716 participants from 8 villages were involved, comprising those from 1 to 83 years old, 550 (76.8%) participants aged ≤12 years and 166 (23.2%) aged ≥13 years, and 304 (42.5%) male and 412 (57.5%) female. The overall prevalence of IPIs was high (73.2%). Soil-transmitted helminth (STH) infections (73.2%) were significantly more common compared to protozoa infections (21.4%) (p<0.001). The prevalence of IPIs showed an age dependency relationship, with significantly higher rates observed among those aged ≤12 years. Multivariate analysis demonstrated that participants aged ≤12 years (OR = 2.23; 95% CI = 1.45–3.45), low household income (OR = 4.93; 95% CI = 3.15–7.73), using untreated water supply (OR = 2.08; 95% CI = 1.36–3.21), and indiscriminate defecation (OR = 5.01; 95% CI = 3.30–7.62) were identified as significant predictors of IPIs among these communities.ConclusionEssentially, these findings highlighted that IPIs are highly prevalent among the poor rural communities in West Malaysia. Poverty and low socioeconomic with poor environmental sanitation were indicated as important predictors of IPIs. Effective poverty reduction programmes, promotion of deworming, and mass campaigns to heighten awareness on health and hygiene are urgently needed to reduce IPIs.

Financial technologies (fintech) are proposed to expand access to financial services in rural communities as bank branches decline; however, poor rural communities and rural communities of color have limited access to high-speed internet connections required for fintech. Leveraging the universe of U.S. rural zip codes, this paper investigates associations between communities’ poverty rates, racial makeup, and rates of fintech. Poor rural communities of color experience digital redlining by having the lowest fintech rates. Rural communities’ increasing white population is associated with higher high-speed internet rates, an advantage of whiteness observable even in the presence of high poverty. Implications are discussed.

We investigated the association between women’s weight and household per adult equivalent expenditure (proxy for permanent income) in 235 rural villages in southern Mexico. We used data from 5000 non-pregnant women (18–49 y) in families in the 2 lowest Mexican income deciles. The instrumental variables regression controlled for age, height, schooling, ethnicity and village (fixed) effects. The prevalence of O&O (BMI>25) was 60%, with 25% of women being obese (BMI>30). Household expenditure was significantly (p<0.001) associated with body weight: for a 10% increase in expenditure body weight increased by 1%. A 10% increase in expenditure was thus associated with a 2.7 and 1.7 percentage point increase in the prevalence of O&O and obesity respectively. The inclusion of the village fixed effects (even though significant) did not alter the expenditure coefficient considerably. Our findings show that the prevalence of O&O in the poorest Mexican rural villages is alarmingly high. Also, O&O increases significantly with increasing expenditure in these very poor communities. The limited importance of the fixed effects indicates that this association holds across villages and is not simply because overweight and obese women live in particular villages. Funded by SEDESOL (contract # SSPPE-AD-005-04).

Nodding disease or syndrome is one of those conditions that recently appeared to be of public health concern in some countries in Africa. The disease has been reported to occur in South Sudan, Tanzania, northern Uganda and Liberia. In South Sudan the disease is mainly concentrated along Yei River1, 2. Nodding syndrome is a mentally and physically disabling disease that affects children3, typically between the ages of 5 and 15. The disease is characterized by episodes of repetitive nodding of the head, with progression to generalized tonic-clonic seizures, mental deterioration and physical incapacity1, 3. During seizures the children lose consciousness and they may fall into fire or hurt themselves. They usually drop out of school because of deterioration in cognitive function and inability to cope with the school environment. A disease similar to nodding syndrome was first reported in Uganda by Raper 4 in 1950. This disease was called ‘nakalanga’ because of the pathological dwarfism and the affected persons were incapable of procreation. It occurred among the dwellers of Mabira forest near the source of the Nile in Uganda. The forest was heavily infested by the black fly. The disease occurred among any of the tribes living in the area provided they had lived in the forested area for a sufficient number of years. The children born by uneventful pregnancies became thin, weak and listless around the time of weaning with progressive mental and physical retardation with maximal severity occurring around 8 to 15 years. The local inhabitants, who had long recognized the disease, had incriminated the bites of the black fly. Similarly, a high number of patients with epilepsy and retarded growth was reported in an endemic area for onchocerciasis in western Uganda5. However, a study that evaluated the role of Onchocerca volvulus in the development of epilepsy in rural Tanzania reported no difference in microfilaria density between participants with epilepsy and those without6. Since 2009, about 4000 cases of nodding disease have been reported in northern Uganda. For over 20 years northern Uganda was a conflict area and most people lived in camps for the internally displaced. Following a cease-fire in 2006, most of the people have returned to their villages and this period has coincided with increased numbers of nodding disease, with some families reporting more than two cases7. In this issue of African Health Sciences, Tumwine and others8 report clinical and epidemiological characteristics of nodding syndrome in Mundri county, South Sudan. The study was carried out in poor rural communities that had been characterised by several displacements between 1994 and 1997. The prevalence of Nodding Syndrome in the study areas was 2.1% and 4.6% in the endemic communities. Similar to the epidemic in northern Uganda, some families have more than one affected child. The ratio of male to female cases was 1.2. The age at onset of suspected cases ranged from 2 to 18 years, with a median of 12 years, and the mean duration of illness had been reported to be 3.0 years. Previous case-control studies had shown a positive association between cases and infestation with Onchocerca volvulus microfilaria, evidenced by positive skin snips. The nodding was reported to be worse during meals or upon walking up in the morning, and on the traditional carbohydrate based diet compared to the western style diet. For some children, head nodding did not disrupt eating or the ability to follow commands. Episodes of abnormal behaviour associated with shouting, screaming or running were reported. Physical examination revealed stunting of growth, dwarfism, mental retardation, and poor development of secondary sexual characteristics. Electroencephalographic examination was consistent with progressive epileptic encephalopathy. The authors concluded that Nodding Syndrome was strongly associated with Onchocerca volvulus. There was no evidence to suggest an environmental pollutant, chemical agent, or other toxic factor. The authors recommend larger studies to elucidate the etiology and optimal treatment for these children. It has been proven that symptomatic treatment with anticonvulsants and other supportive measures such as nutrition rehabilitation improves the quality of life, though not a cure. On going studies in northern Uganda speculate that the disease is associated with vitamin B6 deficiency and probably high doses of vitamin B6 may be beneficial to these children. The disease seems to be more prevalent in the poor communities. Improved social economic status, environmental control measures for microfilaria will go along way to reduce morbidity due to nodding syndrome.

This thesis is about the Utilisation of Maternal and Child Health Care Services (MCH) in Rural Bangladesh. Investigations have been made to identify the underlying causes of low use of the MCH services provided through the public sector health care facilities, which is a major concern for the government of Bangladesh. This thesis focuses on the factors that are affecting the use of MCH services both from population and provider perspectives. Socio-economic condition of people, their knowledge and attitudes towards the public sector health care services are considered as population factors, while different aspects of quality of public health services, access to the service facilities and provider's behaviour are explored as the providers' factors. Aims: The aim of this research was to provide policy recommendations for improving utilisation of the public health services at the primary health care level by redesigning more accessible, acceptable and quality health care services, especially for rural women and children. Scope: Maternal health services: antenatal care; tetanus vaccination; place of child delivery; and postnatal care are considered in this study. While two major killer diseases: diarrhoea and acute respiratory infections, and immunisation of children under five years of age are included as child health care services. Methods: A combination of qualitative and quantitative methods are used to collect data /information from 360 mothers, 28 formal and informal community leaders, 44 various types of health care providers and 22 public sector facilities in a rural area of Bangladesh. The World Health Organisation (WHO) recommended 30 cluster sampling method was used in sample design. Household survey, in-depth interview, informal and formal discussion, participant observation and document analysis have been carried out to obtain necessary information/data. Data analyses: The quantitative data have been analysed by using STATA and SPSS statistical computer programme, performing descriptive, bivariate and logistic regression analysis. The qualitative information has been analysed in a descriptive way. Results: The results show that the use of government health facilities: THC, FWC and VHCP is generally very low with an exception of the use of VHCP for TT vaccination to women and child immunisation. The use of VHCP is encouraging for the government policy makers and planners. THC is partially meeting the health care need of rural people and mainly serving the interest of people of relatively high socio-economic condition. FWC is the most unused health care facility at the rural areas of Bangladesh. The majority of people (86%) received health care from non - qualified health care providers. Among the socio-economic factors - family education and income were found to be significant both individually and jointly with the variations of use of MCH services. The majority of the sample population does not have knowledge about the MCH service availability and possessed negative attitudes towards the public sector MCH services. These are attributable to the under utilisation problem. Nine gaps have been identified between peoples' `reasonable expectation' and the `existing' MCH service delivery system. Peoples' involvement in the health service organisation at the thana and union level was found almost nil. However their involvement in the operation of VHCP was encouraging. Low (2-3 minutes) consultation time, lack of privacy in treatment, unregulated involvement of public sector provider in private practice, lack of accountability, supervision and improper behaviour of providers deteriorating the quality of services hence decreases the use of public sector facilities. Unavailability of drug was found to be the single most important reason that deters people from using public facilities. Difficulties in access to quality services were found to be a major problem than access to the service facilities. Conclusions: This thesis suggests that giving priority to improving the service qualities of the existing facilities rather than construction/development of additional facilities at PHC level. It also suggests the initiation of behaviour change programmes for public sector health care providers. Secondly an effective mechanism needs to be developed to ensure peoples' involvement in the management and operation of public health care facilities to enhance accountability of public sector provider to the population and reduce the gap between them. Initiatives could be taken to improve the quality of non-qualified health care providers, as they are the main source of health care for the majority of population. Finally, increasing the education level of rural population particularly for women could increase the use of health services.

An element that can influence the actual value of risk is social resilience, however, the value of the impact of the main components of social resilience on risk is not known. The motivation for addressing the topic was the desire to develop a tool to measure social resilience in the community. The aim of the study was to determine the outflow of social resilience to community risk. Through an analysis of the literature, the main components of social resilience were classified, and then, using cause-and-effect relationships, individual activities affecting social resilience were extracted. The author of the paper anticipated that this concept could serve as a starting point for a more complex form of calculation and criteria. It should be noted that social resilience is a factor that affects both the probability of events and the consequences. The author’s concept of community risk assessment taking into account social resilience is an open concept for editing. This concept requires classifying elements that build social resilience and providing them with standards, in which they should occur.

Urban poverty in Malaysia has become a more prominent problem that is increasingly risking the quality of life. Meanwhile, resilience plays a very vital role in poor urban communities. Poverty will hinder sustainable development and a better quality of life. Improving the quality of life has always been the focus of the Malaysian government. Recent years have seen attempts to address this need for more community resilience research that investigates the impacts of poverty. Thus, examining a community’s resilience to poverty will produce communities that are resilient to urban pressures and challenges to improve their quality of life. This study aims to evaluate the social resilience of urban poverty toward quality of life in Kuala Lumpur. This study showed that higher resilience in poor communities can be justified by determining social resilience, such as participation in the community, decision-making and community trust. This study used quantitative methods for data collection. The questionnaire was administered using a sample of 400 respondents from urban poor households in Kuala Lumpur. Descriptive and correlation regression analysis was in this study. The findings of this study showed that the relationship between social resilience, participation in the community of the urban poor in Kuala Lumpur, and quality of life is significant.

This study investigated the gender-based differences in the commercialisation of rattan and bamboo in Ghana, the opportunities available to rural and urban poor communities engaged in the value chain of rattan and bamboo resource and the challenges they face in their quest to earn a living from the industry. Using snowball sampling, 106 actors in the value chain of the industry were sampled from rural and urban communities where rattan and bamboo are harvested, processed and marketed. Questionnaire and semi-structured interviews were the main data collection tools. The results showed that even though males dominate the value chain, females play two important roles: harvesting and supplying of raw rattan and bamboo to processors. Whereas rural males and females are mostly engaged in the harvesting of the resource their urban counterparts are engaged in the processing and marketing of products from the resource. The limited role played by women in the value chain was partly due to their low self-efficacy resulting from gender stereotype and their traditional roles in the home. Those involved in all the stages of the value chain reported daily income of about USD8.00 and this diminishes to 19.8%, 23%, and 36% of it for harvesters, processors and marketers, respectively. The amount accrued to harvesters was found to be lower than the average daily wage of hired labour, suggesting that the commercialisation of rattan and bamboo has not improved the economic status of rural people. Economics of scale and product quality were the main inhibiting factors for successful commercialisation of the resource. Policy interventions aimed at increasing rural participation in the value chain should include removal of gender stigmatization, providing rural artisans with technical and marketing support, and establishing cottage industry as part of effort to integrating rural businesses communities’ into local tourism. International visibility of rattan and bamboo industry in Ghana, which thus far has remained poor, requires urgent attention from governmental and non-governmental agencies.

On 11 March 2020, the World Health Organization upgraded the outbreak of COVID-19 to pandemic status. On 15 March 2020, the South African president declared a national state of disaster under the Disaster Management Act of 2002. On 26 March 2020, national lockdown, which included measures stipulated in guidelines for education in emergencies, was implemented in South Africa. The presidential declaration and subsequent lockdown came at a time when some of the universities in South Africa were already struggling either to commence the academic year, or to make up for time lost due to persistent student protests relating to several student demands. However, disaster management now entailed that all schools and institutions of higher education were forced to close immediately for extended periods, necessitating alternative ways of ensuring access to education. The qualitative case study presented in this article sought to document the intervention strategies developed by two universities located in remote parts of Eastern Cape Province to deliver education during the COVID-19 restrictions. A second aim was an examination of the challenges experienced by the two institutions’ largely rural student population. The authors collected data using a questionnaire completed by 15 educators and 30 students from the two universities. They also analysed official communications documents from the universities addressed to lecturers and students. The results indicate that access to online teaching and learning platforms and resources for students from poor rural communities in South Africa is challenging, and that there are gross inequalities in educational outcomes for learners from different socio-economic backgrounds. This affects the future plans of higher education institutions to provide teaching and learning through online-based platforms. The authors conclude their article by providing recommendations to support online learning in rural areas, which has the potential to expand higher education access post-COVID-19.

This thesis draws on findings from four case studies conducted in Kenya, East Africa, to investigate the entrepreneuring process associated with community-based tourism. This is accomplished by examining the influences of the historical, social, and political context, community needs, and the actors involved on the creation and development of community-based tourism (CBT) enterprises. The thesis is informed by a recognition that little has been written on CBT enterprise creation and development processes. Instead, the majority of CBT analyses have focused on outcomes; yet understanding how CBT enterprises are created and developed is crucial to determining not only their success, but also their importance as social institutions. Practice theory represents a suitable framework for interpreting the complex web of interactions that underlies the process of CBT enterprise establishment and functioning. Using a multiple case study approach, this thesis investigates four Kenyan CBT enterprises by drawing on in-depth interviews, supplemented by document data and participant observations. A total of 48 interview participants were drawn from across several key role-groups, including CBT founders, community members, and members of government and non-governmental organisations (NGOs). The combined data indicate that CBT enterprise creation in each of these four cases was driven by the need to address serious problems faced by the community, such as poverty, drought, human-wildlife conflict, and loss of access to traditional land. These findings strongly suggest that the creation and development of CBT enterprises is underpinned by a purposive process of creation. Viewed through an entrepreneuring lens, such creation can be interpreted as a form of coping and surviving within actors’ and communities’ lived environments. The process unearthed in these case studies is one of complex interaction between various actors from within and outside the communities, and the situational demands of these settings. Furthermore, it is characterised by drawing on learnable concepts such as practical wisdom, analogising and improvisation, being community-focused, built on trust, and addressing unequal power relations. This thesis contributes to CBT theory by articulating possible means by which CBT could address poverty, and enhance community agency and solidarity. It also highlights the significance of practice theorisation in understanding the processes of building local community institutions in marginal rural settings. The research reveals new possibilities of approaching CBT as a complex field involving innovative partnerships and collaborations that are able to address local issues in an agentic manner; it also shows CBT to be a means of community development by which historically and culturally embedded structural limitations to socio-economic change can be overcome in diverse peripheral localities. The findings may prove applicable beyond the field of CBT.