Affordable Access Research Articles

Pemanfaatan Artificial Intellegence (AI) dalam Meningkatkan Inklusi Ekonomi dan Keuangan

In the current digital era, economic and financial inclusion is a crucial issue in various countries including Indonesia. The use of artificial intelligence (AI) has great potential to improve economic and financial inclusion by providing easier, more efficient, and affordable access to financial and economic services for those who were previously marginalized. This research aims to identify Artificial Intelligence (AI) can be used to provide more inclusive financial services to those who are underserved, as well as to analyze its impact on the overall economic welfare of the community, especially Gorontalo city. This research used a descriptive qualitative approach, involving case studies and interviews with stakeholders. The results show that the utilization of Artificial Intelligence (AI) chatbots and virtual assistants has a significant impact on service and user satisfaction, as well as providing confidence in decision making so as to increase economic and financial inclusion for the community

Managing the challenges of paying for gene therapy: strategies for market action and policy reform in the United States.

Gene therapies delivered through a single administration have revolutionized treatment possibilities for many patients living with serious or fatal conditions such as spinal muscular atrophy, hemophilia and sickle cell disease. However, shadowing the excitement about the transformational potential of many gene therapies has been widespread concern about the combination of uncertainty in the durability of their benefits over the long term and the short-term financial shock of high prices. As the healthcare payment ecosystem prepares for the growing number of gene therapies entering the market, three key interconnected challenges must be addressed: determining a fair price, managing clinical uncertainty and managing short-term budget impacts. This paper identifies specific policy reforms and market-based tools to help the US health system address these challenges to achieve more equitable and affordable access for patients to the growing number of gene therapies expected to be approved in the coming years.

Voluntary information and price sharing database: a scoping review of the pricing and procurement landscape across eight commonwealth member states

Abstract Introduction Launched in 2021, the Voluntary Information and Price Sharing Database (VIPSD) aims to support procurement methods with an emphasis on price transparency, reducing costs, and sharing information on health products, suppliers, and supply chains amongst Commonwealth member states. The creation and implementation of the VIPSD has been endorsed by successive Commonwealth Ministries of Health, during their annual meetings, in 2021 and 2022. To date, there has been limited deployment of the database in member states, in part due to various pooled procurement initiatives that were set up during and post-pandemic. In 2023, the Commonwealth Health Ministers meeting highlighted several issues around medicines shortages, of which pricing and price transparency were cited as some contributory factors1-3. VIPSD was seen as a valuable resource to help address some of these issues. Aim This scoping review aimed to explore the procurement landscape of medical products and establish how VIPSD can support procurement systems in select Commonwealth member states. Methods Eight Commonwealth member states (out of 56) were selected from the regions of Africa, Asia, Europe, Pacific, the Caribbean, and the Americas: Bangladesh, Dominica, Kenya, Malaysia, Malta, Solomon Islands, South Africa, St. Vincent and the Grenadines. Selected countries represented health systems’ diversity, larger and smaller populations, established and developing procurement pathways and Commonwealth regionality. Data collection was conducted using a standardised proforma and predefined inclusion criteria: procurement/pricing of pharmaceuticals, vaccines and other goods; public sector stakeholders; IT systems/databases and their scope; issues to consider e.g. registration, regulation, detection of substandard medicines. Evidence was screened using Excel and thematically analysed until saturation. No ethical approval was required for this review. Results The results of the pricing landscapes, in the 8 countries chosen for the scoping review, showed a diverse range of pricing policies and approaches to ensure affordable access to medicines. Three (3) countries (Malaysia, Malta and South Africa) had national pricing policies, 3 countries (Bangladesh, Dominica and Kenya) did not have any national pricing policy and for 2 countries (Solomon Island, and St Vincent and Grenadines) this information was unclear. The scoping also showcased a diverse array of legislative frameworks, models and successes of the procurement landscapes in the various countries. Across the 8 countries there were numerous pricing and procurement systems/databases currently in use, mainly led and managed by their respective governments, through centralised teams. Some of the challenges in the pricing and procurement landscape included: lack of comprehensive framework leading to medicine price disparities, stock-outs and shortages, budgetary constraints and delayed procurement process. Discussion/ Conclusion Across all 8 countries scoped, our review highlighted that a database such as VIPSD would be valuable in supporting pricing and procurement in key areas such as enhanced transparency and fair pricing, collaboration for improved access, mitigating price disparities, equitable access to innovative health commodities, routine reporting and data driven decision making. However, several challenges of VIPSD, such as the scope and remit of VIPSD, issues around data completeness and transparency in pricing, and funding for VIPSDs’ development, deployment and maintenance also need to be addressed.

Editorial: Towards continued and affordable accessibility of innovative drugs: sustainable development and efficient use of medicines

Editorial: Towards continued and affordable accessibility of innovative drugs: sustainable development and efficient use of medicines

Optimal planning for hybrid renewable energy systems under limited information based on uncertainty quantification

Developing hybrid renewable energy systems (HRES) is crucial for ensuring affordable, sustainable, and reliable energy access in remote rural and island regions. Rich and detailed data play a pivotal role in the optimal design of HRES. However, remote areas often face data limitations due to inadequate metering infrastructure, which further increases uncertainties in HRES design. This paper proposes a planning optimization method that quantifies multiple uncertainties, requiring only limited information for the optimal HRES design. First, uncertainties in HRES planning are classified into different types based on intrinsic randomness, data availability, and impact level. Then, by integrating uncertainty quantification with credibility theory, knowledge-based scenario generation models are developed to leverage limited available information to generate extreme and typical operating conditions for a tailored HRES design. Finally, a fuzzy credibility-constrained stochastic-robust optimization model is proposed to optimize the design of HRES. A practical case facing significant data scarcity and gaps is used to validate the effectiveness of the proposed method. The proposed approach reduces the loss of load probability for HRES to 0.02% and lowers the levelized cost of energy to $0.16/kWh—33% lower than that of the deterministic method and 79% lower than that of the traditional stochastic method.

Home Health Care and Place of Death in Medicare Beneficiaries With and Without Dementia.

Home health care supports patient goals for aging in place. Our objective was to determine if home health care use in the last 3 years of life reduces the risk of inpatient death without hospice. We analyzed the characteristics of 2,065,300 Medicare beneficiaries who died in 2019 and conducted multinomial logistic regression analyses to evaluate the association between the use and timing of home health care, dementia diagnosis, and place of death. Receiving any home health care in the last 3 years of life was associated with a lower probability of inpatient death without hospice (Pr 23.3% vs 31.5%, p < .001), and this effect was stronger when home health care began prior to versus during the last year of life (Pr 22.5% vs 24.3%, p < .001). Among all decedents, the probability of death at home with hospice compared to inpatient death with hospice was greater when any home health care was used (Pr 46.0% vs 36.5%, p < .001), and this association was strongest among beneficiaries with dementia who started home health care at least 1 year prior to death (Pr 55.6%, p < .001). Use of home health care during the last 3 years of life was associated with reduced rates of inpatient death without hospice, and increased rates of home death with hospice. Increasing affordable access to home health care can positively affect end-of-life care outcomes for older Americans and their family caregivers, especially those with dementia.

Achieving universal energy access in remote locations using HOMER energy model: a techno-economic and environmental analysis of hybrid microgrid systems for rural electrification in northeast Nigeria

The developing world continues to face substantial obstacles to achieving affordable and dependable electricity access. This issue is especially pertinent for Nigeria, where diesel generators are widely relied upon in urban and rural regions because of an underdeveloped and unreliable national grid. The lack of grid reliability is worsened in Northeastern Nigeria, an area plagued by conflict, extreme poverty, and grid infrastructure deterioration. This study investigates the feasibility of implementing community-scale microgrids in rural areas without grid connection access. It focuses on assessing the technical, economic, and environmental aspects of utilizing these microgrids to deliver inexpensive and dependable electricity to underserved populations to increase energy access. A case study was conducted in Kabuiri, a village with an estimated population of 2,300 residents and an estimated load demand of 610 kWh per day. A hybrid microgrid system was designed and optimized to meet the community’s load demand using HOMER software, sized to produce 610 kWh/day of electricity with a renewable penetration of 99%. The optimal solar PV/battery/generator system had a levelized cost of electricity (LCOE) of $ 0.093 per kWh, a net present cost (NPC) of $266,709, and an annual operating cost of $9,110. The system contributed 1,624 kg CO2 eq/year of global warming potential and 56.81 kg O3 eq/year of smog formation during operation. Sensitivity analysis showed that the system could effectively react to or adapt to substantial increases in diesel prices, requiring only marginal increases in photovoltaic capacity and reduced generator usage to maintain the most cost-efficient operation. Additionally, the system model can be adapted based on the population of the remote community without substantially impacting the LCOE, however, the NPC increases with increase in population size. This research will aid in increasing energy access in remote locations by providing insights to stakeholders and energy access project developers.

The cost of not getting care: income disparities in the affordability of health services across high-income countries

Abstract This presentation will present findings from the Commonwealth Fund 2023 International Health Policy Survey of the General Population, focusing on financial barriers in accessing healthcare among adults across 10 countries. It highlights significant income-related disparities in healthcare affordability, particularly in the United States, where nearly a quarter of the population lacks affordable access to care. While disparities exist in other countries, Germany and the Netherlands demonstrate lower rates of affordability issues and income disparities, possibly due to their universal health coverage models and cost-sharing caps based on income levels. These countries also prioritize mental health and dental care within their public health plans. The analysis emphasizes the critical need for affordable and comprehensive healthcare coverage to ensure equitable health outcomes. It suggests that policies such as cost-sharing caps and income-based subsidies could mitigate financial barriers to care, drawing insights from successful models in Germany and the Netherlands. Ultimately, addressing affordability is vital for achieving health equity and improving overall population health.

Multidimensional energy poverty and its effects on household consumption and savings: Evidence from Nepal

This study examines the impact of multidimensional energy poverty (MDEP) on household consumption and savings, with a focus on potential differences by the gender of the household head. Using data from the Household Risk and Vulnerability Survey (HRVS) 2016–2018, a three-year panel dataset from Nepal covering 6000 households, we apply pooled OLS, dynamic panel fixed effects (FE), panel instrumental variable (IV), and Lewbel's (Lewbel, 2012) 2SLS methods. Our findings reveal that MDEP significantly reduces both household consumption and savings, with more pronounced effects on savings. The corresponding coefficients range from −0.376 to −0.092 for consumption and from – 0.722 to −3.213 for savings, suggesting that fully transitioning out of MDEP could increase household savings by 72.2 %–321.3 %. The effects of MDEP are consistent across households, regardless of the gender of the household head. This study underscores the importance of addressing MDEP to enhance household welfare and recommends that policymakers focus on expanding reliable and affordable energy access as part of broader economic development strategies to improve overall living standards in developing countries.

Promoting Equitable and Affordable Patient Access to Safe and Effective Innovations in Donation and Transplantation of Substances of Human Origin and Derived Therapies.

Innovation is a hallmark of organ, tissue, and cell transplantation. The development of new treatments derived from these substances of human origin (SoHO) has rapidly evolved in recent years. Despite the great benefits that these innovative therapies could bring to patients, significant difficulties have arisen in making them equitably and widely accessible. Herein, we identify and address 4 challenges to promote innovation in this field in a collaborative, sustainable, and transparent manner and propose some concrete solutions applicable to SoHO-derived treatments, ranging from cell therapies to solid organ transplantation. Regulators, health policymakers, and government officials are recommended to incorporate specific elements into the regulatory frameworks of their respective jurisdictions, although regulatory convergence and equivalent quality and safety standards applicable to SoHO at a global level would be needed. An innovation-driven regulatory environment, respectful with the human origin and in accordance with the altruistic donation of SoHO, should be encouraged to improve the safety, effectiveness, accessibility, and affordability of SoHO and to promote collaboration between countries and between public and private sectors. This overview is the outcome of a working group focused on "Innovation in the donation and clinical application of SoHO" as part of the international Summit "Towards Global Convergence in Transplantation: Sufficiency, Transparency and Oversight" convened by the Organización Nacional de Trasplantes under the Spanish Presidency of the Council of the European Union in November 2023 and cosponsored by the Council of Europe, the World Health Organization, the Transplantation Society, and the European Society for Organ Transplantation.

Utility-Scale Grid-Connected Microgrid Planning Framework for Sustainable Renewable Energy Integration

Microgrids have emerged as a crucial focus in power engineering and sustainable energy research, with utility-scale microgrids playing a significant role in both developed and developing countries like the Philippines. This study presents a comprehensive framework for utility-scale microgrid planning, emphasizing the sustainable integration of renewable energy resources to the distribution grid. The framework addresses the operational modes of grid-connected and islanded microgrids, emphasizing the seamless transition between these modes to ensure a continuous power supply. By leveraging local distributed energy resources, the microgrid aims to reduce dependence on the main transmission grid while enhancing resilience and reliability. The proposed planning framework not only eases the economic burden of constructing renewable energy sources but also aids distribution utilities in maximizing local resources to achieve sustainable energy goals. Through a detailed network analysis and modeling, the framework provides a robust foundation for optimizing the energy mix and enhancing the overall system performance. This research contributes to advancing microgrid technology as a key driver towards achieving UN Sustainable Development Goals, particularly in promoting clean and affordable energy access.

Association Between Quality of Life and Drug Adherence Among Patients With Diabetes in India.

Diabetes represents a significant global health concern. Effective diabetes management necessitates substantial behavioral and psychological modifications, including regular glucose monitoring, dietary adjustments, and medication adherence. However, treatment adherence remains suboptimal, particularly in developing countries, leading to poor glycaemic control, increased healthcare costs, and diminished quality of life (QoL). Common factors influencing medication nonadherence include lack of medication knowledge, age, education of patients, polypharmacy, duration of disease, cost of therapy, complexity of dosing regime, and the presence of comorbidities. So, the study aims to assess the adherence status to antidiabetic medication and its association with QoL among diabetes patients in the Anand district of Gujarat state. A study was carried out in Anand district, Gujarat, from 2023 to 2024, focusing on community-based cross-sectional research. In the eight blocks of Anand district, a two-stage cluster sampling method was utilized, with one village or town randomly chosen from each taluka, and 25 diabetes patients interviewed per area. Data collection involved visiting 200 participants' houses, starting with a randomly selected house and continuing until the target was met. The interviews, conducted in the local language, lasted around 45 minutes and utilized a pre-validated and pretested questionnaire. The questionnaire covered demographic details, disease characteristics, and medication adherence using the semi-structured scale from Adherence to Refills and Medications Scale (ARMS-D), as well as the assessment of QoL using the WHOQoL-BREF questionnaire. Descriptive and inferential statistics were used for data analysis. Sociodemographic attributes were presented in terms of percentages (%) and frequencies (N). The means and standard deviation (SD) of health-related QoL and adherence to anti-diabetic medication were reported. Multiple linear regression analysis was used to assess the impact of adherence to antidiabetic medication within each QoL area after adjusting for a few sociodemographic variables. P values below 0.05 were considered statistically significant. The study included predominantly older participants (58.1 years) with 53.5% being male. Most participants (65.5%) had diabetes for more than 5 years, 60.0% had comorbidities, and 29.0% experienced complications. Nonadherence to treatment was observed in 37.0% of patients. The study found that factors like age, education, occupation, family history of diabetes, smoking, alcohol consumption, exercise habits, and medication adherence significantly influenced the QoL in diabetic patients, with medication adherence showing the strongest positive association with all QoL domains. This study shows a high percentage of nonadherence to antidiabetic medications. Poor adherence had significantly lower mean scores across all domains of QoL. Community-based educational programs targeting older and less-educated individuals should promote regular physical activity. Developing strategies to improve medication adherence and ensuring affordable access to essential medications, along with prioritizing enhancements in the QoL through psychosocial support and lifestyle counseling are imperative for diabetic patients.

From Potential to Power: Advancing Nigeria’s Energy Sector through Renewable Integration and Policy Reform

Nigeria is a nation endowed with both abundant renewable and non-renewable energy resources. Despite its vast potential, Nigeria struggles with a consistent power supply due to various systemic issues, such as inadequate funding, infrastructural decay, corruption, technical skill shortages, and macroeconomic instability. These challenges hinder the effective harnessing and distribution of energy resources, particularly renewable ones like wind, solar, biomass, and hydropower. This study assesses the existing energy policies and their efficacy in promoting sustainable energy development towards achieving universal electricity access by 2030. It highlights the necessity for a just energy transition that integrates a substantial proportion of renewable energy into the national grid, aiming to meet up to 60% of the country’s energy demands with clean sources by 2050. This transition is critical not only for energy security and reducing the environmental impact but also for fostering socioeconomic equity. Recommendations include overhauling the legal and regulatory frameworks to support renewable energy growth, particularly in off-grid areas, to ensure clean, affordable, and secure energy access. Strategic investments, enhanced infrastructure, and robust public–private partnerships are essential to overcome the current barriers and realize Nigeria’s energy potential. This paper calls for a comprehensive approach that addresses both the technical and socioeconomic dimensions of the energy crisis, laying the groundwork for a sustainable and prosperous energy future for Nigeria.

Affordable Pricing of CRISPR Treatments is a Pressing Ethical Imperative.

Casgevy, the world's first approved CRISPR-based cell therapy, has been priced at $2.2 million per patient. Although this hefty price tag was widely anticipated, the extremely high cost of this and other cell and gene therapies poses a major ethical issue in terms of equitable access and global health. In this Perspective, we argue that lowering the prices of future CRISPR therapies is an urgent ethical imperative. Although we focus on Casgevy as a case study, much of our analysis can be extrapolated to the controversies over affordable access to other gene and cell therapies. First, we explain why this first-of-its-kind CRISPR therapy might be so expensive. We then analyze the ethical issues of equity and global health of early CRISPR treatments. Next, we discuss potential solutions to lower the prices of CRISPR gene therapies. We conclude that the approval of CRISPR transforms our obligations of justice and compels us to bring future gene therapies to the maximum possible number of patients with serious genetic diseases at affordable prices.

Energy Security and Women’s Empowerment: A Generalized Method of Moments Approach from a Global Perspective

The importance of energy security is emphasized in Goal 7 of the 17 Sustainable Development Goals (SDGs) of the 2030 Agenda to guarantee that everyone has affordable, dependable, and contemporary energy access. In addition to transforming human life, whole economies, and even the planet, sustainable energy offers a chance for a better future. The absence of energy security impacts serious health problems, education, and household difficulties. Research on energy security has emphasized various angles worldwide. However, investigations of the impact of energy security on women’s empowerment are still scant. This study thus investigates the relationship between energy security and women’s empowerment (WE) in 167 countries from 2002 to 2021, as well as the influence of urbanization development levels on this nexus. Moreover, this study explores the variation in women’s empowerment between geographical regions by referencing the MENA, OECD, and SAARC countries. A two-step system GMM was used to achieve the objectives of this research. The findings show first that renewable energy availability has a significant effect on WE worldwide. Secondly, in terms of energy security, the variables total availability of natural resource rents and renewable energy both have a positive impact on women’s empowerment in the MENA, while in the OECD and SAARC countries, they have an indirect link with WE. Third, the integrating effect of total natural resource rents with urbanization significantly affects WE in all five models. Fourth, we used access to electricity to represent resource affordability. Unexpectedly, the results show its negative and significant association with WE. Fifth, in terms of energy security, both energy availability and affordability favor WE in OECD countries. Finally, the coefficient of integration of access to electricity and urbanization shows a positive and significant association with WE in the OECD, MENA, and SAARC regions. However, it is noteworthy to mention that access to electricity alone does not influence WE worldwide. Additionally, a series of tests confirm the robustness of the results. This research provides insight into the development and implications of energy security-related women’s empowerment policies.

How Online Patient-Provider Communication Alleviates Psychological Distress Among Patients with Chronic Diseases: The Role of Perceived Patient-Centered Communication and Adaptive Coping Strategies

ABSTRACT Chronic diseases, which require long-term continuous care due to the long clinical courses, may cause severe harm to the psychological well-being of a large population in the U.S. Providing convenient and affordable access to healthcare, online patient-provider communication (OPPC) is considered a potentially effective means in safeguarding psychological well-being among patients with chronic diseases. However, what underlying mechanism OPPC helps patients deal with psychological issues is largely unknown in the context of chronic diseases. Thus, drawing on the health communication pathway model, this study seeks to address the gap by investigating the psychological and behavioral mechanism of how OPPC alleviates psychological distress among patients with chronic diseases. Analyzing secondary data derived from the Health Information National Trends Survey (HINTS 5, Cycle 3, N = 879), this study reveals that OPPC can elicit perceptions of patient-centered communication (PCC) and facilitate patients to take adaptive coping strategies, including problem-oriented and emotion-oriented coping, thus alleviating psychological distress among patients with chronic diseases. However, only emotion-oriented coping in this process significantly reduces psychological distress. On this basis, this study advances the understanding of the therapeutic effect of OPPC among patients with chronic diseases and extends the health communication pathway model by examining the role of patient-provider communication in facilitating adaptive coping strategies.

Characterization of sleep apnea among a sample of adults from Samoa

Sleep apnea is a global public health concern, but little research has examined this issue in low- and middle-income countries, including Samoa. The purpose of this study was to examine the sample prevalence and characteristics of sleep apnea using a validated home sleep apnea device (WatchPAT, Itamar) and explore factors that may influence sleep health in the Samoan setting. This study used data collected through the Soifua Manuia (“Good Health”) study, which investigated the impact of the body mass index (BMI)-associated genetic variant rs373863828 in CREBRF on metabolic traits in Samoan adults (sampled to overrepresent the obesity-risk allele of interest). A total of 330 participants had sleep data available. Participants (53.3 % female) had a mean (SD) age of 52.0 (9.9) years and BMI of 35.5 (7.5) kg/m2, and 36.3 % of the sample had type 2 diabetes. Based on the 3 % and 4 % apnea hypopnea indices (AHI) and the 4 % oxygen desaturation index (ODI), descriptive analyses revealed moderate to severe sleep apnea (defined as ≥15 events/hr) in 54.9 %, 31.5 %, and 34.5 % of the sample, respectively. Sleep apnea was more severe in men (e.g., AHI 3 % ≥15 in 61.7 % of men and 48.9 % of women). Correction for non-representational sampling related to the CREBRF obesity-risk allele resulted in only slightly lower estimates. Multiple linear regression linked a higher number of events/hr to higher age, male sex, higher BMI, higher abdominal-hip circumference ratio, and geographic region of residence. Further research and an increased focus on equitable and affordable diagnosis and access to treatment are crucial to addressing sleep apnea in Samoa and globally.

Barriers to Meaningful Connectivity

Community networks risk failure when they attempt to emulate models from elsewhere without engaging the community in the process and making appropriate adaptations. These ‘build it and they will come’ models rarely work over the long term. This research project explored claims from residents of a low-income neighbourhood in the “North End” of Winnipeg in Manitoba, Canada, that inadequate and unaffordable Internet connectivity limits their access to critical communication tools, resources, and information. Through the research, we identified the need for a sustainable model of affordable, accessible Internet connectivity that centers on building a cooperative-owned and operated community network with Indigenous and newcomer families at its heart. Findings revealed that high connectivity costs, limited digital literacy, and inadequate infrastructure are the primary barriers to meaningful connectivity in the community. The intent of the “North End Connect” research project was to work directly with the residents, to learn about their connectivity needs and wants, inform the project’s technical team as to how and where to build a solution that works for the community, removing explicit and implicit barriers to access. Through our research, we validated that digital connectivity is a problem in the community. Utilizing a CBPAR approach provided a more nuanced understanding of the barriers to access from the resident’s perspective and lived experience. This allowed for the development of a strengths-based roadmap that utilized existing assets to provide affordable, accessible, trustworthy, and secure Internet access to anyone who wants it. The research acted as the catalyst to motivate the community and led to ongoing interventions aimed at addressing each of the identified barriers. As we investigate these barriers, it becomes evident that addressing these issues is not just a matter of technological access but a crucial step toward fostering a more inclusive and equitable society. The project serves as a model for community-driven digital inclusion efforts and contributes to global conversations about equitable access to the internet.

Tackling local environmental challenges with livelihoods strategies: insights from small-scale farmers in the vulnerable region of Ghana

ABSTRACT Climate risks pose significant challenges to farmers' livelihoods, particularly in sub-Saharan Africa, where the complex interplay of factors intensifies the impact on small-scale farmers (SSFs). While there is a broad understanding of climate change's effects on agriculture, there is a need for deeper insights into the key determinants and preferences influencing SSFs' adaptation strategies in vulnerable regions to better inform agricultural policy and planning. Data were collected from 325 SSF randomly selected in Juaben Municipality, Ghana. Quantitative analysis was done using descriptive and inferential statistics, while qualitative data were analyzed through content analysis. The study identified shifting planting dates, altering farm operation timings and mulching as primary adaptation strategies. Significant associations were found between socio-economic factors and the adaptation strategies employed by SSFs, with the Relative Importance Index highlighting affordable tools, land ownership and access to fertile land as crucial for enhancing livelihoods and adaptation. The findings underscore the need for training programmes to equip extension officers with the knowledge to support SSFs in developing skills and efforts related to adaptation and viable livelihood options.

E-waste Management Using Blockchain Technology

Introduction; Bridging the digital divide requires the provision of affordable, fair and quality ICT. With nearly two-thirds of the world’s population still offline, there is a need to provide affordable web access for everyone. For developing countries, increasing the popularity of information and communication technology has become the most important factor in reducing poverty. The danger of electrical and electronic waste disposal contains hazardous substances, but most of the electrical and electronic equipment is still disposed of in an unhealthy environment in the field development area, affecting the level of contamination in Water, Air and Soil ultimately affecting people’s health. Eliminating E-waste responsibility and protecting the environment is a challenge for countries. Smart cities can solve environmental problems through proper waste management for improving human health, protecting water resources, and reducing pollution. Objective; In this paper, we explore how blockchain technology can help smart cities to manage E-waste by providing consistency, immutability, transparency, and accountability control in a distributed, reliable, and secure manner. We discussed the advantages of blockchain technology in various aspects of E-waste management, such as instant tracking and monitoring, E-waste disposal and E-waste management regulation compliance, proper disposal management, E-waste management, and material handling, etc. All examples of disposal services, but in our study we have found that there is no fool proof system to check the disposal of E-waste whether it has been disposed off Fully or Partially. We mainly focused on the tracking of E-waste management system for 100% safe and eco-friendly disposal from the originating point of E-waste to end disposal point of total disposal. Methods; For this, we have used machine-learning model to find the existing percentage of disposal of E-waste at the end-point which reveals that it is never 100%. And partial disposal of E-waste means we have still partial E-waste around us in different forms, which will be a threat for the society to be indulged in hazardous after effects of randomly dumping E-waste.Results; After this we have modelled a Disposal Tracking System(DTS) using blockchain technology to create an E-waste data storage as Decentralized Shareable Ledger (DSL) which records the quantity and state of E-waste data from its originating point to a different level of disposal unit and finally reflect the balance of E-waste data as NIL at the end of last disposal point.Conclusion; This system will helpful for safe and ecofriendly E-waste management and it provides complete transparency and traceability of E-waste during the life cycle of complete disposal. After implementation of this system any district or Block or Village authority can ensure to its citizens for E-waste hazards free environment and safety of natural resources