Facility Assessment Research Articles

Health Facility Capacity and Health-care Worker Knowledge, Attitudes, and Practices of Hepatitis B Vaccine Birth-dose and Maternal Tetanus-Diphtheria Vaccine Administration in Nigeria: A Baseline Assessment.

Hepatitis B virus (HBV) and neonatal tetanus infections remain endemic in Nigeria despite the availability of safe, effective vaccines. We aimed to determine health facilities' capacity for hepatitis B vaccine birth dose (HepB-BD) and maternal tetanus-diphtheria (Td) vaccination and to assess knowledge, attitudes, and practices of HepB-BD and maternal Td vaccine administration among health facility staff in Nigeria. This was a cross-sectional study assessing public primary and secondary health facilities in Adamawa and Enugu States. A multistage sampling approach was used to select 40 facilities and 79 health-care workers (HCWs) from each state. A structured facility assessment tool and standardized questionnaire evaluated facility characteristics and HCW knowledge, attitudes, and practices related to HepB-BD and maternal Td vaccination. Frequencies and proportions were reported as descriptive statistics. The survey of 80 facilities revealed that 73.8% implemented HepB-BD and maternal Td vaccination policies. HepB-BD was administered within 24 h of birth at 61.3% of facilities and at all times at 57.5%. However, administration seldom occurred in labor and delivery (35%) or maternity wards (16.3%). Nearly half of the facilities (46.3%) had HCWs believing there were contraindications to HepB-BD vaccination. Among 158 HCWs, 26.5% believed tetanus could be transmitted through unprotected sex, prevented by vaccination at birth (46.1%), or by avoiding sharing food and utensils. 65% of HCWs knew HBV infection had the worst outcome for newborns. The limited implementation of national policies on HepB-BD and maternal Td vaccination, coupled with knowledge gaps among HCWs, pose significant challenges to timely vaccination, necessitating interventions to address these gaps.

Comparative analysis of embodied carbon in modular and conventional construction methods in Hong Kong

Addressing the rise in global temperatures and the associated increase in greenhouse gases, particularly carbon dioxide, is a critical challenge necessitating innovative approaches within the building sector, a significant contributor to worldwide carbon emissions. While previous studies have demonstrated the prefabrication’s potential in reducing emissions, comprehensive assessments using actual project data for buildings constructed entirely with modular methods in Hong Kong are lacking. This study bridges this gap by evaluating the modular integrated construction (MiC) method through an embodied carbon assessment of the Kai Tak Community Isolation Facility. Using comprehensive project data from China State Construction (HK) Limited, the research conducts a comparative analysis between the actual emissions of the MiC method and those of a hypothetical conventional construction approach. Quantitative analysis reveals that MiC achieves a 20.7% reduction in embodied carbon, primarily due to shortened construction timelines, decreased waste generation, and optimized material usage. This significant reduction suggests substantial potential for decreasing the construction industry’s carbon footprint. The study provides empirical evidence supporting the environmental benefits of MiC in Hong Kong construction industry, promoting its broader adoption of MiC as a strategy for achieving carbon reduction targets. The findings align with Hong Kong’s carbon neutrality goals and contribute to the global initiative to mitigate the effects of climate change.

Performance of health and wellness centre in providing primary care services in Chhattisgarh, India

IntroductionPrimary health care has regained its importance in global policy making. In 2018, the Government of India initiated the Ayushman Bharat - Comprehensive Primary Health Care (AB-CPHC) programme. It was based on upgrading the existing primary health facilities into Health and Wellness Centers (HWCs). The current study aimed to assess the readiness and performance of HWCs in providing comprehensive primary health care services in India’s Chhattisgarh state.MethodsWe conducted a cross-sectional health facility assessment with a state-representative sample of 404 HWCs. A standardized health facility survey tool was used to collect information on essential inputs and service outputs of HWCs. The expected population healthcare needs were estimated using secondary sources. The performance of HWCs was assessed by comparing the volume of services provided against the expected population need for outpatient care.ResultsOn an average, 358 outpatients including 128 non-communicable disease (NCD) patients were treated monthly at an HWC. HWCs were able to cover 31% of the total population’s health need for outpatient care, 26% for hypertension, and 21% for diabetes care. In addition to services for reproductive and child health, HWCs provided services for common acute ailments (cold, cough, fever, aches and pains); infections of skin, eye, ear, and reproductive tract, and minor injuries. HWCs were also contributing significantly to national disease control programmes. Acute ailments followed by NCDs and communicable diseases had the largest share among services provided. The key gaps were in coverage of mental illnesses and chronic respiratory diseases. Most of the HWCs showed adequate readiness for the availability of required human resources, supplies, and infrastructure.ConclusionHWCs were able to provide a comprehensive range of primary care services and able to cater to a sizable portion of the rural population’s acute and chronic health care needs. The performance was made possible by the adequate availability of medicines, staff, training programmes and tele-consultation linkages. If HWCs in other states are able to reach a similar level of performance, the initiative will prove to be a game changer for equitable primary care in India.

The environmental microbial retrieving assessment of cell-processing facilities for cell therapy in a hospital laboratory.

Cell therapy represents a promising treatment modality. A critical component in the production of cell therapy products is maintaining the sterility of cell therapy clean rooms (CTCRs). This study aimed to evaluate the environmental microbial load within CTCRs. We systematically monitored microbial load in CTCRs, following established guidelines. Cultured microbial samples underwent metagenomic sequencing, and alpha and beta diversity analyses, functional annotation, and resistance gene profiling were performed using various bioinformatics tools to assess microbial diversity and function. From November 2023 to January 2024, we collected 42 environmental microbial colony samples from various sources within the CTCR and performed metagenomic sequencing on 39 samples. Alpha diversity analysis revealed no significant differences among surface, settle_plate, and airborne categories, but significant disparities within surface subgroups were revealed. Beta diversity analysis showed notable differences between surface and airborne categories and among surface subgroups. Species distribution analysis identified Bacillus as the predominant genus on surfaces. Functional annotation and resistance gene analysis indicated distinct resistance patterns, with significant variations between subgroups, such as microscopes and transfer windows, and hands and other Grade_B environments. Resistance to hydrogen peroxide was notably higher in the transfer window group. These findings highlight the importance of stringent disinfection protocols and enhanced hand hygiene to maintain sterility in CTCRs. These findings provide valuable insights for implementing effective measures to maintain cleanliness throughout CTCRs. The annotation and study of resistance genes can help rapidly identify methods to control cellular contamination under circumstances of environmental microbial pollution.IMPORTANCEMaintaining the sterility of cell therapy clean rooms (CTCRs) is crucial for the production of safe and effective cell therapy products. Our study systematically evaluated the environmental microbial load within CTCRs, revealing significant microbial diversity and distinct resistance patterns to disinfection methods. These findings underscore the need for stringent disinfection protocols and enhanced hand hygiene practices to ensure CTCR sterility. By identifying key microbial species and their resistance genes, our research provides essential insights into controlling contamination and safeguarding the production environment, ultimately contributing to the reliability and success of cell therapy treatments.

Assessment of the readiness of health facilities in urban areas to deliver geriatric-friendly care services: a cross-sectional study in Kampala City, Uganda

BackgroundWith the global rise in the elderly population, ensuring geriatric-friendly healthcare services is paramount. This study aimed to assess the current readiness of health facilities in Kampala City, Uganda, to provide geriatric-friendly care services.MethodsWe conducted a cross-sectional study in 35 health facilities (HF) including Private for-profit (PFP), Private not-for-profit, and public (government-run) facilities at different levels i.e., Health Centre III, Health Centre IV, and Hospitals, within Kampala City, Uganda. Data was collected using a self-administered health facility assessment tool. Facilities scoring 80–100 were classified as fully ready to offer geriatric-friendly care, 51–79 indicated moderate readiness, and 0–50 indicated low readiness.ResultsThe overall readiness index (RI) across all facilities was low, 44.09 (SD ± 14.18). The National Referral Hospital (NRH), PFPs, and HFs in Kampala Central had the highest RI of 55.34. 47.63 and 51.09 respectively. The low readiness of HF to provide geriatric-friendly care was due to the low scores in leadership and governance (13.49), financing (19.29), human resource (42.66), and Health Management Information System (47.99) WHO building blocks. HCIVs had a higher readiness index than the other HF levels (Coefficient: 17.40, 95% CI: 4.16 to 30.64, p = 0.012). HFs in Kawempe had a significantly lower RI than those in Makindye and Kampala Central (Coefficient: -13.80, 95% CI: -24.48 to -3.11, p = 0.013).ConclusionThe findings of our study indicate that public and private health facilities in Kampala City are not ready enough to provide geriatric-friendly care services.

Analisis Dampak Pembangunan Lapangan Badminton Di Desa Winong Kecamatan Ngampel Kabupaten Kendal: Partisipasi Masyarakat Dan Mahasiswa KKN Dalam Meningkatkan Kesejahteraan Sosial

This study aims to analyze the impact of the construction of a badminton court, which resulted from a collaboration between students from the 18th Independent Initiative Program (MIT) Real Work Lecture (KKN) at Posko 74 of Walisongo Univercity. The collaboration between students and local residents in Winong Village (Ngampel District, Kendal Regency), particularly those residing in RT 1 RW 2 Salaman Hamlet, has been pivotal in enhancing the well-being of the community. This study employed a qualitative approach with descriptive methods, and data were gathered through in-depth interviews, participatory observation, and documentation of the development process. The findings of this study demonstrate that the construction of the badminton court in Winong Village was not only successful in providing the community with much-needed sports facilities, but it also resulted in the strengthening of social solidarity and the spirit of mutual cooperation between residents and KKN students. This article underscores the significance of community involvement and the part played by local leaders in village development initiatives, where the spirit of mutual assistance serves as a robust social capital. The assessment and enhancement of public facilities are also essential to guarantee sustainability and reinforce social networks within the community.

Assessment of the operational facilities and hygienic practices of abattoirs and butcher shops in Ethiopia

Most meat-borne outbreaks are attributed to contamination due to poor handling practices and incomplete operational facilities in the meat supply chain. A cross-sectional study, using a structured questionnaire interview and observational checklist, was conducted to assess the hygienic practices of workers from abattoirs and butcher shops and the operational facilities in the area. A total of 286 randomly selected workers from 236 butcher shops and 3 abattoirs participated in this study. The results showed that at the abattoirs, isolation pens for sick animals, stunning boxes, separate rooms for carcass and offal, cooling equipment, and laboratories were missing facilities. Inhumane stunning, inadequate hand washing, insufficient trained workers, irregular medical checkups, and unspecified roles in the slaughtering process were practices that led to the unhygienic handling of meat. At butcher shops, hand washing after meat handling (97.9%), storing leftover meat in refrigerators (80.9%), concrete/tile floors (94.5%), and white-painted walls were good practices observed. Displaying meat at room temperature, wrapping meat with plastic bags, and newspapers, and untrained workers (82.6%) were practices that could compromise the quality of meat. Training was the only factor significantly associated with the hygienic practice of workers both at abattoirs (p = 0.023) and butcher shops (p = 0.012). Our study identified substandard facilities and unhygienic practices both at abattoirs and butcher shops that lead to microbial contamination of meat, which could be enhanced through improving operational facilities, training, and implementation of quality control systems.

Computationally efficient Complete-Sampling-based fault tree analyses for seismic probabilistic safety assessment of nuclear facilities

The seismic risk of nuclear power plants (NPPs) can be assessed through seismic probabilistic safety assessment (PSA) based on fault tree analyses (FT). The conventional FT-based approach has limitations for handling the correlated relation of basic events and utilizing the sampling-based FT analysis for addressing such issues demands considerable computational cost. In particular, accurate consideration of the partial dependences between the failure probabilities of NPP components in seismic hazard events can further increase the computational cost of risk quantification. Therefore, this paper presents an improved complete-sampling-based seismic PSA risk quantification method. The novelty of this method is that it increases the efficiency of the risk quantification by introducing sequential sampling and truncation to the conventional fault tree analysis. In addition, as sub-concepts, we eliminate unrequired sampling extraction steps via integrated multivariate response distribution-based sampling for components and continual evaluation of the convergence of system failure probabilities. On three considered examples, including an actual NPP, the proposed method requires 91%–96% fewer samples than the conventional method, without sacrificing accuracy. These results indicate the efficiency of the proposed method, which is expected to become a useful tool in the future.

Feasibility Assessment of a Novel Isolation Care Tent in Uganda During the 2022 Sudan ebolavirus Outbreak.

This case study describes a feasibility assessment of a novel isolation care tent used in health facilities in Uganda during the 2022 Sudan ebolavirus outbreak. The Isolation System for Treatment and Agile Response to High-Risk Infections Model 1B (ISTARI 1B) is a single-occupancy, portable, negative-pressure isolation tent designed for the safe delivery of standard care to patients with a communicable disease, including Ebola disease (Sudan). At the request of the Uganda Ministry of Health, the Makerere University Infectious Diseases Institute and University of Nebraska Medical Center partnered to evaluate 7 health facilities across 4 districts in Uganda for infrastructure, case management, and infection prevention and control (IPC) capacity relevant to isolation care and ISTARI 1B use. A 3-day workshop was held with IPC leaders to provide familiarization and hands-on experience with the ISTARI 1B, delineate appropriate use scenarios in Ugandan healthcare settings, contextualize ISTARI 1B use in case management and IPC workflows, develop a framework for site assessment and implementation readiness, and consider ongoing monitoring, assessment, and intervention tools. Workshop participants performed a comprehensive site assessment and mock deployment of the ISTARI 1B. In this case study, we describe lessons learned from health facility assessments and workshop outcomes and offer recommendations to support successful ISTARI 1B implementation. Use scenarios and implementation strategies were identified across facility levels, including tools for site assessment, training, risk communication, and ongoing quality and safety monitoring.

Empowering the solar energy landscape: The techno-economic analysis of grid-connected PV power plants in Uganda

Solar PV power is still under-utilized despite the abundance of solar radiation in Uganda. There is need for empowering renewable energy landscape through unlocking the technical and economic feasibility of solar photovoltaic power. We analyzed data from 56 locations for the techno-economic and environmental assessment of photovoltaic power facilities in Uganda. This was based on weather data availability and accessibility to the national power grid. Analysis of the energy generation and different input factors was done using PVsyst 7.2. A three stage approach to losses was adopted: absorption of sunlight, conversion to DC and DC to AC conversion. Findings indicate that most of the countryside is suitable for construction of large scale grid-connected photovoltaic power facilities. Due to longer sunshine duration and stronger Global Horizontal Irradiance (GHI) which are associated with high energy yield, northern Uganda performed better than the rest of the country, making it a preferential siting for large scale grid-connected photovoltaic facilities. South western Uganda performed the poorest. After a thorough energy accounting and a list of all performance metrics, the viability of investing in grid-connected photovoltaic power facilities was assessed.

Techno-Economic Assessment of Small Industrial Facilities Powered by Grid-Connected Photovoltaic Systems in Algeria

Techno-Economic Assessment of Small Industrial Facilities Powered by Grid-Connected Photovoltaic Systems in Algeria

Microstructural evolution and mechanical behaviors of rock salt in energy storage: A molecular dynamics approach

The microstructure of rock salt significantly influences its macroscopic mechanical behaviors and deformation phenomena. Understanding the deformation and failure characteristics of rock salt at multiple scales is crucial for the secure and efficient functioning of energy storage in salt caverns. Although the macroscopic behaviors of rock salt are well understood, the microstructural changes occurring under uniaxial compression have not been thoroughly investigated. This study aims to investigate the evolving laws of rock salt microstructure and mechanical properties during the damage process, thereby providing a fundamental understanding of the underlying mechanism. To achieve this, a series of characterization tests on rock salt were conducted to study its microstructure and defects. Building on this, molecular dynamics simulations were utilized in rock mechanics to elucidate the mechanical behaviors, structural evolutions, and dislocation motions of rock salt during the damage process. The rock salt obtained from Qianjiang, China, is a polycrystalline material with an average subgrain size of 46 nm and an average dislocation density of 4.76 × 10−6 1/Å2. Uniaxial compression of single crystal NaCl exhibits three stages: elastic compression, rapid dislocation multiplication, and forest hardening. Scattered dislocations and isolated dislocation tangles trigger further plastic slippage, leading to decreased strength. Later, the formation of a dislocation cell network hinders further slip and reinforces the strength of rock salt. Plastic deformation is found to be a dominant factor in grain refinement and the formation of polycrystalline structures. Intergranular cracking results from cross-patterned dislocation lines on grain boundaries, which become vulnerable areas of the structure. This study describes the evolutionary process of rock salt microstructures and mechanical properties, identifies the micro-destruction mechanisms during the damage process at the ionic level, and provides insights into the micro-mechanical behavior of rock salt and for the design and stability assessment of underground energy storage facilities.

Comprehensive vulnerability assessment for environmental facility depending on spatial characteristics in South Korea

Among environmental facilities, wastewater treatment facilities have a crucial role in sustaining human life, and any occurrence of an earthquake or flood within these facilities can result in various social, economic, and environmental issues, either directly or indirectly. Therefore, a quantitative vulnerability assessment of wastewater treatment facilities is necessary to minimize and prevent damage from earthquakes and flood disasters. For this reason, this study introduces a novel indicator to assess the susceptibility of disasters, considering aspects of exposure, sensitivity, and adaptive capacity. The newly proposed indicator encompasses numerous evaluation criteria, topography, natural surroundings, hydraulic systems, structural composition, and non-structural features. Also, Weights derived using the combined weight calculation (CWC) method, which combined the analytic hierarchy process (AHP) and entropy weight method were applied to the indicator. It was tested across 23 cities to validate its efficacy, revealing a substantial correlation between the vulnerability index and the specific attributes of the city's wastewater treatment facilities. Therefore, this study analyzed wastewater treatment facilities by comparing the attributes of the urban areas under investigation, such as topological characteristics, urbanization levels, population density, infrastructure quality, and disaster preparedness resources available. The suggested methodology can facilitate the development of strategies aimed at averting damage caused by earthquakes or floods and reducing the adverse impact on wastewater treatment facilities while considering the unique characteristics of the urban setting in question.

Analysis of the Governance System of National Health Insurance Referral Patients at the Outpatient Polyclinic of Dian Harapanjayapura Hospital, Papua

The National Health Insurance (JKN) program, which has been running since January 1, 2014, has been widely benefited by most of the community. This program makes it easy for the public to access health services. However, the implementation of JKN for nine years often faces problems and challenges, one of which is governance. Many parties involved in this JKN program include BPJS Kesehatan as the organizer, the Ministry of Health as a regulator, Health Facilities (hospitals) as service providers and Professional Associations. This research is a qualitative research with a type of program review (governance system). The data collection process is carried out by conducting observations, interviews, analysis and documentation. Data analysis is in the form of an explanation of the situation being studied, while the presentation is in the form of a story explanation. This is in accordance with descriptive research which is the study of observations on the object of research to obtain an overview and actual circumstances. This research has been conducted at Dian Harapan Jayapura Hospital in Papua in February 2024. Based on the results of the study, it was found that inputs, processes and outputs related to the governance of National Health Insurance referral patients at the Outpatient Polyclinic of Dian Harapan Jayapura Hospital Papua were based on an assessment of human resources, facilities and infrastructure, Standard Operational Procedures, constraints and problem solving processes. The results of the study based on the influence of Human Resources show that training related to BPJS has not been carried out evenly for all personnel, including the evaluation of services has not been carried out regularly. The Assessment of Facilities and Infrastructure is considered to have been fulfilled only due to disturbances in the queue machine, the V-Claim application and Scan Finger interference. The assessment of SPO is considered to be available and understood, but there has been no routine evaluation to assess the progress of SPO implementation. The assessment of the obstacles that are often experienced is the disruption of the V-Claim Application and the queue system is still offline because the patient has not used the Mobile JKN Application so that the patient comes early in the morning to take the queue number. In terms of handling problems in stages starting from internal, if necessary, coordination between units or coordination with management with higher authority will be carried out. The conclusion in this study is that Human Resources have a great influence on services, in terms of the number that has been fulfilled, it is still necessary to evaluate the progress of services such as obstacles to delays in the doctor's practice schedule to be corrected according to the agreement so as not to affect service satisfaction. Regarding Facilities and Infrastructure, it is still considered good, it only needs to be added to facilitate online registration by increasing the benefits of the Mobile JKN Application, including the Queue Display facility at the Polyclinic. The applicable Standard Operational Procedures have been implemented, but there has not been a routine evaluation of the implementation of the SPO has been carried out appropriately or still requires additional SPOs to support services. Regarding obstacles and the solution of obstacles, it is considered good. Each officer is already independent in handling problems.

Prevention and management of anaemia in pregnancy: Community perceptions and facility readiness in Ghana and Uganda.

Anaemia is one of the most common conditions in low- and middle-income countries, with prevalence increasing during pregnancy. The highest burden is in Sub-Saharan Africa and South Asia, where the prevalence of anaemia in pregnancy is 41.7% and 40%, respectively. Anaemia in pregnancy can lead to complications such as prematurity, low birthweight, spontaneous abortion, and foetal death, as well as increasing the likelihood and severity of postpartum haemorrhage. Identifying and mitigating anaemia in pregnancy is a public health priority. Here we present a mixed-methods situational analysis of facility readiness and community understanding of anaemia in Ghana and Uganda. Quantitative health assessments (adapted from service availability and readiness assessments) and qualitative key informant interviews (KIIs) with district-level stakeholders, in-depth interviews (IDIs) with maternity staff, and focus group discussions (FGDs) with community members were held in 2021. We carried out facility assessments in nine facilities in Ghana and seven in Uganda. We carried out seven KIIs, 23 IDIs, and eight FGDs in Ghana and nine, 17, and five, respectively, in Uganda. Many good practices and general awareness of anaemia in pregnancy were identified. In terms of bottlenecks, there was broad consistency across both countries. In health facilities, there were gaps in the availability of haemoglobin testing-especially point-of-care testing-staffing numbers, availability of standard operating procedures/guidelines for anaemia in pregnancy, and poor staff attitudes during antenatal care. Amongst community members, there was a need for improved sensitisation around malaria and helminth infections as potential causes of anaemia and provision of education around the purpose of iron and folic acid supplementation for preventing or managing anaemia in pregnancy. Anaemia in pregnancy is a persistent challenge, but one with clear opportunities to intervene to yield improvements.

A Waste Heat Assessment of a Manufacturing Facility With Consideration for Demand Matching Through Thermal Energy Storage

Abstract A waste heat assessment of a manufacturing facility was conducted. A physical survey identified potential waste heat sources. For these sources, the temporal fluctuations in temperature and flowrate, and the frequency of occurrence of the waste heat, were determined from measurements, calculations, and company records. The energy and exergy of the waste heat were calculated. The total annual waste heat is 36.5 TJ of energy, which represents 0.84 TJ of exergy. The boiler, plant vacuums, and chiller comprise 96% of the energy rejected and are the major contributors to the rejected exergy. Using the waste heat for space heating is evaluated. Based on fuel consumption in the boiler, the annual energy for space heating is estimated at 8.5 TJ. Theoretically, waste heat from the boiler flue, polypropylene dryers, and plant vacuums could meet up to 39% of this energy without storage. Simply allowing the vacuum exhausts to cool in the building could theoretically meet up to 27%. Models are developed to investigate using waste heat recovery and thermal energy storage (TES) to provide space heating for a prototype warehouse building, and estimates for the initial costs of the recovery system are developed. Modeling indicates that TES is highly beneficial for matching short-term demand fluctuations and for smoothing the temporal oscillations in the waste heat. A nine-month heating season is simulated to determine the fraction of the load met by the recovery system. A small amount of thermal storage, e.g., 12.5–25% of daily waste heat, improved the fraction of demand that could be met. Larger sizes had diminishing returns and significantly increased the initial cost and payback period. To reduce initial cost, a refined recovery system design that uses a TES as an intermediate and for storage is proposed. The study highlights the need to consider fluctuations in the waste heat supply and sink demand, for thermal storage, and to identify relatively simple modifications to recover waste heat.

An evaluation of a multi-partner approach to increase routine immunization coverage in six northern Nigerian States

BackgroundGlobal health partnerships are increasingly being used to improve coordination, strengthen health systems, and incentivize government commitment for public health programs. From 2012 to 2022, the Bill & Melinda Gates Foundation (BMGF) and Aliko Dangote Foundation (ADF) forged Memorandum of Understanding (MoU) partnership agreements with six northern state governments to strengthen routine immunization (RI) systems and sustainably increase immunization coverage. This mixed methods evaluation describes the RI MoUs contribution to improving program performance, strengthening capacity and government financial commitment as well as towards increasing immunization coverage.MethodsDrawing from stakeholder interviews and a desk review, we describe the MoU inputs and processes and adherence to design. We assess the extent to which the program achieved its objectives as well as the benefits and challenges by drawing from a health facility assessment, client exit interview and qualitative interviews with service providers, community leaders and program participants. Finally, we assess the overall impact of the MoU by evaluating trends in immunization coverage rates.ResultsWe found the RI MoUs across the six states to be mostly successful in strengthening health systems, improving accountability and coordination, and increasing the utilization of services and financing for RI. Across all six states, pentavalent 3 vaccine coverage increased from 2011 to 2021 and in some states, the gains were substantial. For example, in Yobe, vaccination coverage increased from 10% in 2011 to nearly 60% in 2021. However, in Sokoto, the change was minimal increasing from only 4% in 2011 to nearly 8% in 2021. However, evaluation findings indicate that issues pertaining to human resources for health, insecurity that inhibits supportive supervision and vaccine logistics as well as harmful socio-cultural norms remain a persistent challenge in the states. There is also a need for a rigorous monitoring and evaluation plan with well-defined measures collected prior to and throughout implementation.ConclusionIntroducing a multi-partner approach grounded in a MoU agreement provides a promising approach to addressing health system challenges that confront RI programs.

Production of phosphate biofertilizers as a booster for the techno-economic and environmental performance of a first-generation sugarcane ethanol and sugar biorefinery

The intensive use of fertilizers and pesticides in agriculture has a significant economic and environmental impact worldwide. Biofertilizers (aka microbial inoculants) could be a potential alternative to decrease costs and the environmental footprint linked to the use of fertilizers while boosting productivity through biological processes. This work aimed to perform a techno-economic-environmental assessment of an industrial biofertilizer production facility integrated with a sugarcane ethanol biorefinery. To this end, systems engineering tools were employed concurrently with techno-economic-environmental analyses to assess the integration of the different processes and their feasibility. Three processes for biofertilizer production are proposed varying in terms of downstream processing and the use of single or double microorganisms. Our findings indicate that the integration of biofertilizer production can enhance the biorefinery's NPV by as much as 137% in the most favorable scenario and by a minimum of 69% in the most unfavorable scenario. Regarding environmental consequences, in general, all scenarios demonstrate an improvement over the base scenario. Global sensitivity analysis showed that the solid-state fermentation and composite formulation steps of the biofertilizer process have the most substantial influence on both economic and environmental outcomes. The uncertainty analysis further unveils that the scenarios without fungus separation exhibited greater resilience in the face of market volatility. The retro-techno-economic study defined the economically viable region. Ultimately, this study demonstrates that the integration of biofertilizers into an ethanol and sugar biorefinery is a more sustainable alternative than the isolated biorefinery regarding the environmental and techno-economic aspects of sustainability.

Facile synthesis, release mechanism, and life cycle assessment of amine-modified lignin for bifunctional slow-release fertilizer

Biomass-based slow-release fertilizers (SRFs) are a sustainable solution for addressing food scarcity, improving fertilizer efficiency, and reducing pollution, whereas they still face complex preparation, high costs, and low release characteristics. This study introduces a simple and innovative approach to producing bifunctional green SRFs with controlled release and conditioning properties for saline soils and harsh environments. The method involves a one-pot preparation of microsphere-structured amine-modified lignin slow-release fertilizer (L-UX) using biomass lignin as the starting material. The L-UX demonstrates an exceptional fertilizer loading rate (66.2 %) and extended slow-release performance (288 h), effectively enhancing the fertilizer's release ability. Compared to traditional fertilizers, the bifunctional L-UX significantly improves soil water retention capacity (824.3 %), plant growth, and germination percentage in challenging soil conditions (133 %). These findings highlight the potential of L-UX as a large-scale controlled-release fertilizer in harsh environments. A life cycle assessment (LCA) was also conducted to evaluate the environmental impact of L-UX from its production to disposal. This revealed that L-UX has a minimal environmental footprint compared to conventional inorganic fertilizers. This study further supports the widespread application of L-UX as an environmentally friendly alternative.

A Physics-of-Failure (PoF) model-based Dynamic Bayesian Network for considering the aging of safety barriers in the risk assessment of industrial facilities

In this work, a novel Physics-of-Failure (PoF) model-based framework is proposed for accounting for the aging of safety barriers in the risk assessment of industrial facilities. A PoF model of aging is integrated into the barriers fragility models to provide fragility surfaces as functions of both the hazard magnitude and the barrier age. Such modelling is integrated in a Dynamic Bayesian Network (DBN) for the risk assessment. The proposed framework is applied to a case study of a chemical facility exposed to Natural hazard-induced Technological (NaTech) risk due to earthquakes. The results demonstrate the feasibility and effectiveness of the framework.