Basic Services Research Articles

Enhancing Socio-Economic Sustainability in South Africa: A Review of Local Municipalities in Managing Inward Migration from the Periphery to the Core

This conceptual paper aims to examine the prevailing patterns of migration from local municipalities to metropolitan areas in the context of socio-economic transformations. Emphasizing the crucial role of local municipalities in addressing and mitigating migration towards urban cores, the paper underscores that the effectiveness of such efforts relies on factors like good governance, enhanced economic prospects, basic service provision, infrastructure development, and tailored skills training within the unique context of each municipality. Migration is a multifaceted phenomenon entwining economic, socio-cultural, and security dimensions. The unsustainable influx from the periphery burdens metropolitans, particularly in rural regions, challenging the mandated responsibilities. The failure of local municipalities to adequately deliver services exacerbates the strain on metropolitans already grappling with limited resources. The migration exodus from rural to urban centers often stems from pervasive socio-economic disparities, making migration a perceived solution to enhance the quality of life. Despite the advent of democracy, developmental progress in rural areas remains limited, necessitating a comprehensive approach that integrates rural development strategies with urban planning, job creation in urban areas, and the resolution of systemic issues. It is crucial to acknowledge that addressing migration requires a holistic perspective, as rural development alone may not suffice to deter migration to urban centers, given the diverse opportunities and amenities they offer. The paper advocates for a coordinated, multi-stakeholder approach involving governmental bodies, local communities, NGOs, and the private sector to achieve meaningful and sustainable results in curbing migration from local municipalities to metropolitan areas. In conclusion, the study underscores the importance of achieving a more balanced and sustainable population distribution across municipalities for overall societal well-being.

Budgeting and Advocacy to Improve Water, Sanitation, and Hygiene in Health Care Facilities: A Case Study in Nepal.

Barriers to achieving and sustaining access to water, sanitation, hygiene, cleaning, and waste management (WASH) in health care facilities include a lack of supportive policy environment and adequate funding. While guidelines exist for assessing needs and making initial infrastructure improvements, there is little guidance on how to develop budgets and policies to sustain WASH services. We conducted costing and advocacy activities in Thakurbaba municipality, Nepal, to develop a budget and operations and maintenance policy for WASH in health care facilities in partnership with the municipal government. Our objectives for this study were to (1) describe the process and methods used for costing and advocacy, (2) report the costs to achieve and maintain basic WASH services in the 8 health care facilities of Thakurbaba municipality, and (3) report the outcomes of advocacy activities and policy development. We applied bottom-up costing to enumerate the resources necessary to achieve and maintain basic WASH services and their costs. The annual costs to achieve, operate, and maintain basic access to WASH services ranged from US$4881-US$9695 per facility. Cost findings were used to prepare annual budgets recommended to achieve, operate, and maintain basic services, which were presented to the municipal government and incorporated into an operations and maintenance policy. To date, the municipality has adopted the policy and established a recovery fund of US$3831 for repair and maintenance of infrastructure and an additional US$153 per facility for discretionary WASH spending, which were to be replenished as they were spent. Advocacy at the national level for WASH in health care facilities is currently being championed by the municipality, and findings from this project have informed the development of a nationally costed plan for universal access. This study is intended to provide a roadmap for how cost data can be collected and applied to inform policy.

Implementation barriers and facilitators for referral from the hospital to community-based lifestyle interventions from the perspective of lifestyle professionals: A qualitative study

Purpose A lifestyle front office (LFO) in the hospital is a not yet existing, novel concept that can refer patients under treatment in the hospital to community-based lifestyle interventions (CBLI). The aim of this study was to identify implementation barriers and facilitators regarding the implementation of an LFO in the hospital from the perspective of CBLI-professionals and to develop evidence-based implementation strategies to reduce these identified barriers. Methods We conducted semi-structured interviews until data saturation, with 23 lifestyle professionals working in the community. A semi-structured topic guide was used, inquiring about (1) community-based lifestyle interventions; (2) their views about referral from the LFO; and (3) their preferences, needs and recommendations for collaboration with the LFO in the hospital. The online interviews lasted on average 46 minutes, were audio-recorded and transcribed verbatim. A thematic content analysis was conducted. Found barriers and facilitators regarding the LFO where mapped using the consolidated framework for implementation research (CFIR) whereafter evidence based strategies were developed using the CFIR-Expert Recommendations for Implementing Change Strategy Matching Tool V.1.0 (CFIR-ERIC). Results Barriers and facilitators were divided into two main themes: 1) barriers and facilitators related to the referral from LFO to CBLI (i.e. financial, cultural, geographical, quality) and 2) barriers and facilitators related to the collaboration between LFO and CBLI (i.e. referral, communication platform and partnership). Thirty-seven implementation strategies concerning 15 barriers were developed and clustered into six overarching strategies: identify referral options, determine qualifications lifestyle professionals, develop support tools, build networks, facilitate learning collaboratives, and optimize workflow. Conclusions In this study, barriers and facilitators for the development of the LFO were found and matching implementation strategies were developed. Practical improvements, like identifying specific referral options or develop support tools, can be implemented immediately. The implementation of other strategies, like connecting care pathways in basic services, primary, secondary and tertiary care, will take more time and effort to come to full potential. Future research should evaluate all implemented strategies.

Онтологічний підхід в системі забезпечення безпеки використання IP-телефонії

In today's information world, the use of VoIP has become an attractive option for user communication. With the downward trend in paying for basic broadband services and the rapid increase in internet speeds, the use of VoIP should only continue to grow in popularity. However, as the use of VoIP increases, so do the potential threats to ordinary users. This article examines the peculiarities of organizing corporate VoIP telephony systems, highlights the main problems in information protection systems in VoIP telephony, and outlines ways to solve them. The development of methods for speech analysis and corresponding processing of natural language, which allows for creating more accurate and effective systems for detecting anomalous traffic and potentially dangerous communications, is especially relevant. With the continuous development of artificial intelligence technologies, the direction of using intelligent means for content analysis in the VoIP system is becoming interesting. A method for detecting anomalies in IP-telephony traffic, based on grouping VoIP messages through context-frequency analysis, is proposed. Additionally, a method for automated filling of the ontology of thematic messages in corporate IP-telephony systems is proposed, based on the formalized presentation of messages using tree-like structures and the description of interaction operations through tuple algebra. Furthermore, a software implementation for converting voice messages into text representations using the SpeechRecognition library for voice-to-text conversion in the Python programming language was created. Experimental studies of the proposed approaches were conducted, and a software subsystem for detecting anomalous messages based on the ontological approach was implemented in the current corporate IP-telephony system.

Implementasi Metode Mobile D pada E-Posyandu berbasis Android sebagai Alat Literasi dalam Mencegah Stunting Anak Usia Dini

Stunting is a worldwide health problem that impacts children's physical growth and development. According to the latest Indonesian Nutrition Status Survey (SSGI), the stunting rate in Indonesia will reach 21.6% by 2022. Due to its high prevalence, stunting is a major concern. This condition can affect the future of society, the quality of life and the productivity of children. Among the factors causing stunting are inadequate nutrition, unhealthy pregnancies, improper feeding methods, lack of hygiene and sanitation, economic and social factors, infections and chronic diseases, lack of access to health services, and lack of knowledge about the importance of maintaining health for growing children. To solve this problem, an Android-based application is needed that can be accessed anywhere. In this research, the method used is Mobile D consisting of five phases: exploration, Initialization, Production, Stabilization, and System Testing and Fix. It is hoped that the E-Posyandu Application can improve community access to basic health services. With this application, the danger of stunting can be avoided because pregnant women, mothers of toddlers, and other posyandu members can easily access information about child growth and development info, immunization info at each developmental period, info on the location of the nearest RSIA, and complementary food information for toddlers over the age of 6 (six).

Pre-hospital ultrasonography screening for biliary disease in remote settings

AbstractScreening ultrasound, including Point of Care Ultrasonography (POCUS), is widely utilized for rapid clinical guidance in diverse healthcare settings. In this case report, a 34-year-old male with recurrent biliary colic symptoms underwent a Basic Emergency Service ultrasound, revealing a 13 mm gallbladder calculus and signs of inflammation, and was promptly referred to the hospital for further evaluation and treatment. Medical specialist confirmation at the hospital underscored the significance of early detection through POCUS. Despite inconclusive laboratory results, the detailed ultrasound assessment provided a comprehensive understanding, emphasizing the tool's value in averting complications. Thus, screening ultrasound played a pivotal role in justifying the hospital referral, showcasing its vital role in healthcare, especially in resource-limited settings. The judicious use of POCUS can lead to superior outcomes, avoiding unnecessary referrals for non-emergent cases.

The Re-socialization Path of the Community Elderly from the Perspective of Active Aging: Take Community B as an Example

The 20th report pointed out that “implement the national strategy of actively responding to the aging of the population, develop the pension cause and industry, optimize the services for the elderly, and promote the realization of all the elderly enjoy the basic pension services”. It is estimated that during the 14th Five-Year Plan period, China’s population will enter a moderate stage of aging. In the current situation of the population aging trend, in addition to the establishment of relevant institutional guarantees for the elderly, we should also promote the social participation of the elderly and promote the re-socialization of the elderly. Community is the basic unit of social organizations and social population gathering. With the functions of socialization, psychological support, social participation and mutual assistance, it is an important field for the re-socialization of the elderly. Community social work is based on the community, through the use of relevant resources, mobilize the community strength, promote the social participation of the elderly in the form of community activities and volunteer services of the elderly. Based on the theory of active aging and re-socialization, this study conducted a questionnaire survey and in-depth interview on the B community in Lanzhou to understand the re-socialization level and re-socialization dilemma of the elderly in community B. On the basis of the analysis of relevant data, from the three dimensions of “participation”, “health” and “guarantee”, the beneficial measures of the community in promoting the re-socialization of the elderly are summarized, and targeted suggestions are put forward.

The poverty trap: a grounded theory on the price of survival for the urban poor in Mexico

People living in poverty inhabit the outskirts of Mexican cities. They struggle and survive but cannot overcome poverty. The present article seeks to understand how the survival tactics of the urban poor keep them in poverty and, with this understanding, inform future interventions. A study based on qualitative grounded theory was conducted in 10 impoverished neighbourhoods in three main regions and cities in Mexico. Observational accounts and in-depth individual and group interviews were conducted with diverse social actors for 115 participants (75 women and 40 men) aged between 12 and 76 years. The data were analysed using an interpretative thematic analysis. Research findings revealed that the urban poor tackle adversities, such as a lack of basic services, health, education, environment, and nutrition. The strength, patience, and hard work employed by these individuals to survive were evident, but their actions to tackle these threats were costly. Ultimately, the urban poor remain in a cycle of poverty, or poverty traps. Interventions to fight poverty, improve life conditions, and general development must include integrated and participatory plans that consider the knowledge and strengths of the urban poor.

Implementing IWRM approaches with climate-change adaptation on riverside slum upgrading, Indonesia

ABSTRACT Characterized by limited access to basic services, slums are particularly vulnerable to the impacts of climate change. The Integrated Water Resources Management (IWRM) approach plays a vital role in addressing these challenges by improving urban resilience. This paper discusses the implementation of the IWRM approach with a climate-change adaptation (CCA) outlook on riverside slum upgrading in Indonesia using the qualitative methodology and a case-study approach. These implementations are analyzed in two layers, at the river-basin and the kampung level. The study found that a multilayered continuation of policy is required to plan the whole-basin water resources management, while the practices at the kampung level require scaling down and contextualization for specific locations. The involvement of multisector stakeholders collaborating with communities at different levels and secured land-tenure status are crucial for success. Different strategies linking water resources management in urban riverside slums with prioritization in addressing hazard control above other pillars of IWRM are a prerequisite for a safe settlement. The paper also highlights the need for more effective implementation, the importance of bridging the gaps between policy orientation and management, and implementations at all levels to ensure success.

Redefining Poverty Line: An Analysis

According to the World Bank, Poverty is pronounced deprivation in well-being and comprises many dimensions. It includes low incomes and the inability to acquire the basic goods and services necessary for survival with dignity. Poverty also encompasses low levels of health and education, poor access to clean water and sanitation, inadequate physical security, lack of voice, and insufficient capacity and opportunity to better one’s life. The main objective of the research is to analyse the current area included under poverty line, analyse if the present poverty class meets the calorie norm and analyse the criteria which has to be included in redefining poverty. The research method followed here is empirical research. The Total number samples collected are 200 which is taken through convenient sampling. The independent variable taken here age and gender. The independent variable is the age and gender. The dependent variables are Redefining, Food not a criteria, Living standard, Income level, Shelter and sanitation facility, Calorie norms, Basic needs. The statistical tool used for this research is correlation analysis and graphical representation. Along with the usage of inferential tools used here is chi-square. Health index of the people in the current scenario will play a crucial role in defining the poverty line. Health service accessible for every citizen of the country would be one of the major factors for defining the poverty line in our country. Through this research we conclude that the poverty-line should be redefined considering health, education, sanitation, education and other intangible factors of human life

Impact of digital infrastructure construction on the migrants’ utilization of basic public health services in China

BackgroundGlobal digitalization significantly impacts public health by improving healthcare access for marginalized populations. In China, socioeconomic disparities and the Hukou system create significant barriers for the migrant population to access basic public health services (BPHS). This study aimed to assess how digital infrastructure construction (DIC) affects BPHS utilization among China’s migrant populations, filling a gap in the literature regarding the relationship between digital advancements and health service accessibility.MethodsThis research used micro-level data from the 2018 China Migrants Dynamic Survey and incorporated variables aligned with the Broadband China policy to employ a comprehensive empirical strategy. It included baseline regressions, robustness checks through propensity score matching and machine learning techniques, and heterogeneity analysis to explore the differential impacts of DIC based on gender, age, education level, and Hukou status.ResultsThe findings revealed that DIC significantly enhances the likelihood of migrants establishing health records and registering with family doctors, demonstrating quantifiable improvements in health service utilization. Heterogeneity analysis further indicated that the beneficial impacts of DIC were more pronounced among female migrants, those with higher education levels, younger populations, and urban Hukou holders.ConclusionsDIC plays a crucial role in bridging the accessibility gap to BPHS for migrant populations in China, contributing to narrowing health disparities and advancing social equity. These results emphasize the significance of digital infrastructure in public health strategies and offer valuable insights for policymakers, healthcare providers, and researchers. Future research should prioritize longitudinal studies on the sustained effects of DIC and tailor digital health initiatives to meet the unique needs of migrant populations, promoting inclusive health policy planning and implementation.

TRANSFORMASI PELAYANAN DATA PENDIDIKAN MELALUI EFEKTIVITAS KERJA PEGAWAI DI SULAWESI TENGGARA

The purpose of this writing is to determine the effectiveness of employee work in basic education data services at the Southeast Sulawesi Province Education and Culture Service. This research uses a descriptive qualitative approach method with data collection using interviews, observations and document studies. Using interactive data analysis techniques according to Milles Huberman and Saldana. The research results show that basic education data entry in Southeast Sulawesi Province is carried out by the DAPODIK admin via the official link, with data validation in the DAPODIK room of the Ministry of Education and Culture. Data sorting is managed by the Education and Culture Bureau system and DAPODIK staff. Data services are carried out manually and online according to SOP, even though they are hampered by network problems and power outages. The DAPODIK program has helped speed up the resolution of school, teacher and student data problems, provided convenience for schools and teachers, and reduced community accumulation and paper usage, showing real changes in the education administration process.

Alternative household water affordability metrics using water bill delinquency behavior

Rising water prices threaten affordable access to basic water service in the U.S., especially in low-income communities. Faced with unaffordable water bills, households may use less water than is healthy, forgo other essential services, or fall behind on water bill payments, risking water shutoffs. Affordability ratios (ARs), which express water bills as a fraction of income, are the most common measure of water affordability. However, ARs can underestimate unaffordability due to both spatial aggregation bias and their reliance on indirect proxies for ability to pay. New metrics are needed to identify households at risk of water insecurity due to affordability challenges. Here we investigate alternative water affordability metrics that use water bill late payments and debt to track actual payment behavior at the household level. We define metrics that capture the frequency, duration, and severity of water bill delinquency. We apply these metrics to a case study in Santa Cruz, California, using monthly billing data for approximately 40 000 households from 2009 through 2021. We find large variation in delinquency across households and over time, with higher delinquency linked to proxies for low wealth such as lower assessed home value. Census blocks with similar ARs often have distinct patterns of delinquency behavior, suggesting that block-level median affordability estimates may be masking sub-populations facing affordability challenges. These results highlight the benefits of using multiple, household-level metrics to capture the role affordability plays in household water security.

Gum Arabic Producers' Opinions and Views towards Gum Arabic Marketing Policies-and Strategies, Sudan

The study aimed to conduct a comparative analysis of the opinions and views of gum Arabic producers towards Gum Arabic marketing policies in Sudan. Primary data were collected in 2016, using a structured questionnaire and 150 gum Arabic producers were interviewed, representing 20% of the targeted population in the study. Secondary data were collected from related official documents. Descriptive statistical analysis was used to investigate the opinions views and socio-economic characteristics of the stakeholders. The results indicated that about (97%) of the respondents preferred the free-trade policy to concession as it gives more price incentives to producers (98%), encouraging producers (98%). There are 98 % of the producers conserve and reforest instead of cutting Hashab trees. All the respondents confirmed the prices are higher post-free-trade than pre-free-trade period. 74% of the gum producers were economically active including the young; this indicated continuing to preserve indigenous knowledge techniques of gum Arabic production across generations. The study recommended continuing the free-trade policy in the production and marketing of gum Arabic, involving the private sector to provide credit to the gum Arabic producers to expand their gum production area. Improve infrastructure and basic services in the gum Arabic production areas.

'We thought supporting was strengthening': re-examining the role of external assistance for health systems strengthening in Zimbabwe post-COVID-19.

Zimbabwe has received substantial external assistance for health since the early 2000s, including funding earmarked for, or framed as, health systems strengthening (HSS). This study sought to examine whether external assistance has strengthened the health system (i.e. enabled comprehensive changes to health system performance drivers) or has just supported the health system (by increasing inputs and improving service coverage in the short term). Between August and October 2022, we conducted in-depth key informant interviews with 18 individuals and reviewed documents to understand: (1) whether external funding has supported or strengthened Zimbabwe's health system since the 2000s; (2) whether the experience of COVID-19 fosters a re-examination of what had been considered as HSS during the pre-pandemic era; and (3) areas to be reconsidered for HSS post COVID-19. Our findings suggest that external funders have supported Zimbabwe to control major epidemics and avert health system collapse. However, the COVID-19 pandemic showed that supporting the health system is not the same as strengthening it, as it became apparent at that time that the health sector is plagued with several system-wide bottlenecks. External funding is fragile and highly unsustainable, which reinforces the oft-ignored reality that HSS is a sovereign mandate of country-level authorities, and one that falls outside the core interests of external funders. The key positive lesson from the pandemic is that Zimbabwe is capable of raising domestic resources to fund HSS. However, there is no guarantee that such funding will be maintained. There is a need, then, to reconsider government's stewardship for HSS. External funders need to re-examine whether their funding really strengthens the national health system or just supports the country to provide basic services in their areas of interest.

საჯარო-კერძო პარტნიორობის შესაძლებლობები და გამოწვევები საქართველოს მაგალითზე

In the modern world, public-private partnerships (PPPs) are becoming an increasingly popular tool for infrastructure and public service delivery worldwide. As an innovative approach to public procurement, PPPs, the possibilities of public-private partnerships in public administration have also attracted significant attention from academic circles, which makes the study of the issue even more interesting and relevant. In general, the governance literature emphasizes the role of markets, networks, and non-state actors. In doing so, it weakens the distinction between states and other spheres of social order. All social and political regimes seem to depend on a model or form of government, however informal it may be. Global support for public-private partnerships (PPPs) in infrastructure appears stronger than ever. Discussions at a number of summits over the past few years have increasingly focused on the need for massive infrastructure investment in developing countries, particularly low-income countries. Governments in developing countries face enormous challenges in financing, implementing and maintaining the infrastructure to provide and maintain basic services for their citizens and promote economic growth. Despite significant strides in recent years in emerging markets, many people still lack access to reliable and secure basic services. PPPs have shown that they can, under the right circumstances, promote growth and improve service delivery, clearly indicating the importance of PublicPrivate Partnerships (PPPs) for Georgia.

Environmental, Economic and Social Perceptions of Community Members on The Role of Water, Soil and Natural Grasslands as A Basis for Local Development in Acopalca, Peru

The concept of ecosystem services has gained popularity among academics, researchers and policymakers to support environmental management and biodiversity conservation, so that many development projects in rural areas have merited investment for restoration and improvement of grassland ecosystems accompanied by training programs for the beneficiaries, With this criterion in mind, the study investigated the perception of puna pastoralists in Acopalca, Peru, regarding the degree of knowledge about the significance of the ecosystem services provided by soil-water-grasslands, with the objective of characterizing the environmental, social and economic dimensions of this local perception, through the application of a survey to the representative of the livestock family affiliated to two producers' associations. It was evidenced that cattle-raising families have a limited understanding of the role of the natural resources they directly access and little clarity on the relationship between natural pastures, family income and access to basic services. The results revealed limitations in environmental perception, evidencing a lack of knowledge about the multifaceted contribution of pastures. Social perception showed neutrality in the relationship between pastures and family income, and a discrepancy in access to basic services. The comparison between associations highlighted significant differences, indicating the need for training strategies adapted to the local idiosyncrasies of the beneficiaries. In conclusion, addressing the deficiencies identified in community understanding was essential to strengthening sustainable natural resource management in Acopalca. It highlights the importance of designing specific training programs, considering the particularities of each group, to promote self-management and community participation and thus achieve more comprehensive and sustainable local development.

Renal screening sonography-A comparative study in a Portuguese basic emergency service.

Renal Point-of-Care Ultrasound (POCUS) is a screening modality that aids in clinical decision-making for patients with suspected renal colic. This study intends to compare the accuracy and pertinence of sonographic findings obtained by a sonographer in a Basic Emergency Service (BES) with the imaging findings at the Referral Hospital (RH). Thirty-one patients suspected of having renal pathology underwent initial sonography screening with POCUS at the BES and were subsequently referred to the RH for additional imaging examinations. The results of both examinations were compared to verify whether the findings from the BES were confirmed by the radiologist in the RH and to ensure that the patient referrals from BES to RH were appropriate. In our sample, the majority of patients (80%) exhibited varying degrees of pyelocaliceal distension, with nearly half (48%) patients presenting obstructions. A strong association between the sonographic findings in the BES and the RH was found in the variables 'Dilatation of pyelocaliceal system' (V = 0.895; P = 0.00), 'Simple cystic formation' (V = 0.878; P = 0.000), respectively. There was a statistically significant correlation between BES and RH findings, indicating a strong association between these two variables, respectively (k = 0.890; P = 0.000) and (k = 0.870; P = 0.000). There was also a strong statistically significant correlation in the ultrasonographic findings between BES and RH performers (k = 0.890; P = 0.000 and k = 0.870; P = 0.000). In this research, an achieved sensitivity of 96% and a specificity of 85% were demonstrated in the identification of pyelocaliceal dilatation. Renal POCUS screening successfully detected abnormalities in the urinary system of patients suspected of having renal colic. The sonographic findings at the BES had a good correlation with the complementary imaging results obtained at the RH in Portugal. These results suggest that Radiographers/Sonographers can have an important role in the preliminary assessment of urgent renal pathology in remote areas, contributing to a correct referral and early treatment.

LMIC-17. DIAGNOSTIC DELAY IN CHILDREN WITH CNS TUMORS IN A TERTIARY HOSPITAL IN MEXICO

Abstract BACKGROUND Delays in diagnosis of central nervous system (CNS) tumors have been associated with increased morbidity and mortality. We aimed to describe the time intervals for diagnosis and explore factors related to diagnostic delays in a tertiary public hospital in a middle-income country. METHODS A retrospective study was carried out, collecting data from patients diagnosed with brain tumors between 2000 and 2021 at the National Medical Center “20 de Noviembre” in Mexico City. The data were analyzed using descriptive statistics. RESULTS Data were collected from 163 patients with a median age of 8 years (range 0-18 years). 81 (49.7%) patients were diagnosed with gliomas, 47 (28.8%) with embryonal tumors, 20 (12.3%) with ependymomas, 10 (6.1%) with germ cell tumors of the central nervous system, 3 (1.8%) with choroid plexus carcinoma, and 2 (1.2%) with other diagnoses. The median time of symptom start and first visit with a physician was 20 days (rage 1 to 180 days). The median time in which the patients arrived at the tertiary hospital after the first visit to a physician was 184 days (range 1 to 2520). The population served by the institution, included the 32 states, with 153 patients (93.9%) coming from an urban location, with easy access to medical services. 145 (89%) of the 163 patients had parents with a medium socio-economic level (urban housing, all basic services, at least one of the parents with higher education.) Of the patients studied, 75 (46%) died, 18 (11%) abandoned treatment, 65 (39.9%) survived and 5 (3.1%) were lost to follow-up. CONCLUSION An important delay was found in the start of treatment from the moment patients begin symptoms. The identified delays warrant local and national strategies that allow prompt referrals.

Work environment adversity and non-communicable Disease risk among drivers working for application-based-cab-aggregators in an Indian metropolis

BackgroundBengaluru, a metropolis in Southern India, is one of the largest markets for cab aggregator companies. Drivers working for these companies play a vital role in urban transportation but unlike other drivers, their work pattern is stressful, which could increase their proneness to NCD risk factors. Understanding associations between work environment adversity and NCD risk factors among these drivers will help to plan specific health promotion and NCD prevention programs including provision of basic occupational health services.ObjectivesThe study aims to test for an association between work environment adversity and selected Non-communicable Disease (NCD) risk factors among Application Cab Aggregator drivers in Bengaluru city and to estimate the prevalence of selected NCD risk factors among the ABCA drivers.MethodologyThis cross-sectional study was conducted in Bengaluru city among 340 eligible and consenting ABCA drivers with at least one-year experience. Drivers were recruited through a multi-stage sampling procedure and time-period sampling, from transportation and leisure zones in the city. Data was collected through interviews using specifically developed semi-structured tools to assess work environment adversity and NCD risk factors. Prevalence of NCD risk factors is presented per 100 drivers with 95% confidence intervals. Multivariate Logistic regression analysis was conducted to quantify the strength of the association between work environment adversity categories and NCD risk factors. Ethical clearance was obtained from the NIMHANS Ethics Committee.ResultsNearly 97% of the 340 drivers reported having one or more NCD risk factors. Working more than 5 days a week, more than 7 + hours a day, staying away from family, and working night shifts were closely associated with higher risk for NCD risk factors among ABCA drivers. Drivers with work environment adversity scores between 5 and 10 were associated with higher odds of Physical Inactivity (OR = 3.1), Unhealthy diets (OR = 1.62), and Tobacco Use (OR = 3.06).ConclusionThe study highlights the association between work environment adversity and NCD risk factors and indicates a dire need for NCD prevention programs, basic occupational health services, and social security provisions for ABCA cab drivers.