User Committees Research Articles

Performance Assessment of Selected Farmer Managed Irrigation System in Kaski District, Nepal

The performance of three Irrigation System (IS); Arva Ghari, Tirkang Kimbesi and Hemja Sinchai Pranali was assessed using the Focus Group Discussion (FGD) and structured interview. The IS situated in the Kaski district were managed by users committee which were mainly formed by the election. The water availability is sufficient in upstream and decreases towards downstream leading to tail end deprivation, however, there was no dominance of influential person in water allocation. Proper distribution system minimizes the conflict among the users which depends on the condition of the canal along with regulating structures. The deposits of silt on bed and vegetation on banks have reduced the discharge capacity which needs the regular maintenance for the better performance of the IS. Separate fund should be raised for the repair and maintenance of canal. FMIS should be supported to strengthen its capacity as these are yet to be institutionalized and genuine farmers should be encouraged to participate for the management of the IS.

Quality of English inpatient mental health services for people with anxiety or depressive disorders: Findings and recommendations from the core audit of the National Clinical Audit of Anxiety and Depression

BackgroundClinical audit is a sustained cyclical quality improvement process seeking to improve patient care and outcomes by evaluating services against explicit standards and implementing necessary changes. National audits aim to improve population-level clinical care by identifying unwarranted variations and making recommendations for clinicians, managers and service commissioners. The National Clinical Audit of Anxiety and Depression aimed to improve clinical care for people admitted to English hospitals for treatment of anxiety and depression, to provide comparative data on quality of care, and to support local quality improvement initiatives by identifying and sharing examples of best practice. ProceduresThirteen standards were developed based on NICE guidelines, literature review and feedback from a steering committee and reference group of service users and carers. All providers of NHS inpatient mental health services in England were asked to submit details of between 20 and 100 eligible service users/patients admitted between April 2017 and September 2018. To ascertain data reliability, participating services re-audited 5 sets of case-notes with a second auditor, and the coordinating team checked 10 randomly-selected sets of case-notes from 3 services, also selected at random. The reference group and steering committee identified key findings and developed a series of recommendations, which were discussed in regional quality improvement workshops and on-line webinars. FindingsData from 3795 case notes were analysed. A sizeable proportion of records indicated that at least one important aspect of initial assessment was not documented. Many service users/patients who could have benefited from an intervention targeted at optimising physical health did not receive it. Only a minority (39%) were referred for psychological therapy. Use of outcome measures varied considerably but no single outcome measure was being used routinely. Most individuals had a care plan recorded in the notes, but a review date was documented in only two-thirds, and almost half of individuals had not received a copy. ConclusionsThere was considerable variation between English mental health services across many variables, and much scope for improvement. Clinicians should ensure that care plans are developed collaboratively with service users/patients and identified carers should be provided with information about support services. Health services should investigate the reasons for low referral rates for psychological therapies. Clinicians should ensure all service users have jointly developed crisis plans in place at discharge. Service managers should agree outcome measures to evaluate the treatment provided and clinicians should use these measures at initial assessment and review appointments. The implementation of such changes provides an opportunity for collaborative research into mental health service delivery and quality.

Human-elephant conflict in the buffer zone of Chitwan National Park, Nepal

The interaction between human and wildlife sharing same resources often result negative outcomes and are referred as the human wildlife conflict which affects not only humans but also the wild species. Such conflicts, especially from the mega-herbivores such as elephants has become one of the major management challenges for the Chitwan National Park (CNP), Nepal. Spatial and temporal patterns of human elephant conflict (HEC) in the buffer zone of CNP were analyzed using park data and questionnaire survey conducted among three hundred and ninety residents of thirteen buffer zone user committees (BZUC) within Chitwan district from October 2016 to May 2017. Five hundred and forty-three HEC incidents including three human deaths and two human injuries were reported in BZUC from January 2013 to April 2017. Crop damage was found to be the most common type of damage caused by elephants and were higher during post-monsoon. Property damage incidents were higher during the winter season. There was a negative association between the number of HEC incidents and distance from the forest edge of the national park. However, no significant relation of HEC incidents was observed with average monthly temperature and rainfall. Despite of increasing HEC incidents, majority of people (77%) had positive attitude towards elephant conservation and considered elephants as nation’s treasure.

최저임금제의 위헌성에 관한 연구 - 2017헌마1366 및 2018헌마1072(병합) 헌재 결정을 중심으로 -

The minimum wage system, as illustrated in Article 32 of the Constitution and Article 1 of the Minimum Wage law and the ILO Convention, forces wage contracts to be signed in a certain amount or more to ensure the decent living of low paid workers who are unable to negotiate their own wage. Since the minimum wage system prohibits users and workers from signing wage contracts below a certain amount of money, conflicts of basic rights arise with the freedom of users and workers to sign contracts, the property rights of users, the labour rights of workers and the freedom of business of users.<BR> The Constitutional Court said the minimum wage notice for the case was not against the Constitution because it was decided by both employers and workers members and by reviewing inflation rates and the city’s minimum cost of living.<BR> The minimum wage system can not be unconstitutional because the Constitution has delegated it’s implementation to the law. However, the minimum wage decision was not made through the agreement of the two parties of labor and management. Although the minimum wage decision was perfunctory in accordance with the minimum wage law, the government has decided on the minimum wage through members of the public interest committee. This is not in line with the procedural intent set forth by the Constitution and the Minimum Wage Act.<BR> In addition, it is problematic that the minimum wage in 2018 and 2019 has risen rapidly, damaging small business owners and freelancers, and depriving workers of jobs, ignoring the inflation rate and labor productivity stipulated by the Minimum Wage Act and simply deciding to fulfill for the president’s pledge.<BR> Members of the public interest committee should be commissioned to be independent of the government, and the members of the user committee and the workers’ committee should develop in the direction of participation in the minimum wage decision from a national economic perspective. Since the Minimum Wage Act provides for the differential application of each industry by region, we need to try to apply it in the future.

Exosome-Derived Differentiation Antagonizing Non-Protein Coding RNA Promotes Tumor Recurrences in Hepatitis C-Related Hepatocellular Carcinoma

Background & Aims: Differentiation antagonizing non-protein coding RNA (DANCR) associated with various types of neoplasms. Hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) (HCV-HCC) has a high risk of recurrence. We explored the role of DANCR in HCV-related hepatocarcinogenesis and identified potential therapeutic targets and non-invasive prognostic markers for long-term outcome of HCV-HCC after surgical resection. Methods: DANCR relevant to HCV-HCC were identified by comparative RNA-sequencing of tumor (T) and adjacent non-tumor (ANT) tissues in a screening set, validated using real-time PCR Target lncRNAs in tissues and serum exosomes were used to predict HCC recurrence of HCV-HCC after curative surgical resection in a large application cohort. Exosome-Derived DANCR was explored using JFH1-infected cells and macrophages. Results: We confirmed that DANCR was upregulated by HCV infection and identified as the lncRNA most relevant to HCV-HCC in tumor as compared to ANT tissues. In 183 HCV-HCC patients followed for 10 years after curative HCC resection, the expression level of circulating exosomal DANCR was positively associated with HCC recurrence and was the most predictive factor associated with HCC recurrence and mortality (hazard ratio/95% confidence intervals: 7.0/4.3–11.6 and 2.7/1.5–5.1, respectively). In vitro study further demonstrated that exosomal DANCR was positively associated with mesenchymal-associated β-catenin expression in HCV infectious hepatocyte and macrophages, which might consequently promote tumor cell migration and invasion abilities in the tumor microenvironment. Conclusions: The lncRNA DANCR is highly relevant to disease progression of HCV-HCC Furthermore, circulating exosomal DANCR might serve as a non-invasive prognostic biomarker for HCV-HCC. Funding Statement: This study supported by the grants from the Ministry of Science Technology (MOST) grant (108-2314-B-037-079-MY3) (106-2221-E-039-011-MY3); China medical University (CMU108-MF-93), (CMU108-Z-02), (CMU108-S-22); Kaohsiung Medical University (KMU-Q108009), (KMUQ109005), (108-CCH-KMU-001); partially by Kaohsiung Medical University Research Grant KMU-TC108A04 and KMU-TC108B06. This study was partially supported by of Liquid Biopsy and of Cancer Research, Kaohsiung Medical University, and the Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B) from The Featured Areas Research Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan. Declaration of Interests: All authors declare no support from any organization other than the below mentioned ones for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities that could appear to have influenced the submitted work. Hence, all authors declare themselves to be independent from funders with respect to this manuscript. Ethics Approval Statement: The study protocol was approved by the Institutional Review Board at each hospital and the TLCN User Committee and was carried out in accordance with the Declaration of Helsinki and the guidelines of the International Conference on Harmonization for Good Clinical Practice.

Information Technology–Assisted Screening for Gonorrhea and Chlamydia in a Pediatric Emergency Department

PurposeThe aim of the study was to design and implement a novel, universally offered, computerized clinical decision support (CDS) gonorrhea and chlamydia (GC/CT) screening tool embedded in the emergency department (ED) clinical workflow and triggered by patient-entered data. MethodsThe study consisted of the design and implementation of a tablet-based screening tool based on qualitative data of adolescent and parent/guardian acceptability of GC/CT screening in the ED and an advisory committee of ED leaders and end users. The tablet was offered to adolescents aged 14–21 years and informed patients of Centers for Disease Control and Prevention GC/CT screening recommendations, described the testing process, and assessed whether patients agreed to testing. The tool linked to CDS that streamlined the order entry process. The primary outcome was the patient capture rate (proportion of patients with tablet data recorded). The secondary outcomes included rates of patient agreement to GC/CT testing and provider acceptance of the CDS. ResultsOutcomes at the main and satellite EDs, respectively, were as follows: 1-year patient capture rates were 64.6% and 64.5%; 9.9% and 4.4% of patients agreed to GC/CT testing, and of those, the provider ordered testing for 73% and 72%. ConclusionsImplementation of this computerized screening tool embedded in the clinical workflow resulted in patient capture rates of almost two-thirds and clinician CDS acceptance rates >70% with limited patient agreement to testing. This screening tool is a promising method for confidential GC/CT screening among youth in an ED setting. Additional interventions are needed to increase adolescent agreement for GC/CT testing.

Gender mainstreaming in the Nepalese rural transport sector: working towards transformative change

Nepal is progressive in mainstreaming gender equality and social inclusion in the rural transport sector. Research studies were conducted using qualitative methods to assess the extent to which people living within the zone of influence of road and bridge projects have benefitted in two rural districts, namely, Ramechhap and Okhaldhunga. The projects in these districts were successful in meeting the quantitative targets. The project's targeting approach to provide employment to women and disadvantaged groups in construction projects had very positive impacts on their livelihoods. With increased incomes, people could send their children to schools, add wealth and start small businesses. However, heavy domestic duties constrain women's potential to participate fully in road/bridge construction. (For full participation, a worker is expected to work in road/bridge construction for 90 days in a year; the wages earned would fulfil their food sufficiency for a year for an economically poor family.) Project quotas for women in user committees have increased their representation, but they are hardly influencing decisions. Participation in training is at times constrained by factors such as women's domestic duties and distance to training venues. These wider issues need more attention in accommodating the specific needs, constraints and vulnerabilities of women to bring genuine transformations in the lives of women.

Not quite what’s on paper? Comparison between theoretical and actual information-sharing networks in the Ugandan rural water service sector

Under Uganda’s decentralised system, rural water service delivery remains to some extent problematic. Several studies attribute the possible causes of deficiencies in the water sector to governance issues. This article applies social network analysis to map upward and downward water-related information flows between the actors of local government from village to district level. Comparing the actual information-sharing network with what’s on paper reveals a less reciprocal and more centralised network than that theoretically envisaged. Some actors, such as the district water officer, are more central than expected in terms of sending and receiving information, while others seem to underperform. Our findings show, however, that it is not the political–administrative information exchange which is the biggest obstacle, but rather information flows between higher (district and sub-county) and lower (parish and village) levels of the local governance structure. Adding water users to the analysis reveals the village chairperson as the most crucial broker of information upward to duty bearers at district level. The limited role of water user committees also becomes apparent. The authors conclude that information communication technology holds potential to overcome some of the bottlenecks (eg distance) hindering the flow of water-related information between actors at different levels.

Issues and Problems of Community Water Supply Schemes with Special Reference to Nepal

Drinking water is a basic need for survival and good health of human beings as well as for any form of life on earth. In the absence of potable water, there is a high risk of transmission of serious diseases among people, like diarrhea, dysentery, cholera, and typhoid. Despite significant progress on community water schemes, worldwide still 2.2 billion people are out of access to safely managed water services. This study was conducted during the period from February to July 2020. Published literature such as paper, thesis, manuals, database, reports, and standards were collected from different sources and went on thoroughly. The conclusions are drawn based on studied materials. The study found that about 829 thousand people are estimated to die each year from diarrhea because of unsafe contaminated drinking water, sanitation, and hand hygiene. In South Asia, over 134 million people still do not have access to clean drinking water. Various studies have shown that progress on basic water supply in Nepal has reached up to 89% of the population by the end of 2019. Community drinking water schemes in Nepal are facing various types of problems, such as technical problems related to, gender equity and social inclusion (GESI), cost recovery and affordability, operation and maintenance, institutional, and legal framework. Because those problems on water schemes are not timely and appropriately addressed, there is always a high impact on un-functionality, poor service, and unsustainability. The study would like to suggest that the operation and maintenance funds should be managed after the implementation of the project. The capacity building training for the water users committee should be conducted before the handover of the schemes.

What determines the operational sustainability of rural drinking water points in Ethiopia? The case of Woliso woreda

Abstract Water is a fundamental element essential for life and health. However, more than 33.3% of rural water services in Ethiopia are not functioning and hence sustainability of rural drinking water points in the country is under question. With this in mind, this study was undertaken to investigate the factors that affect the operational sustainability of rural drinking water points in Woliso woreda, Ethiopia. A semi-structured questionnaire was administered to a randomly selected 211 households from six rural Kebeles, which were selected using stratified sampling technique. Focus group discussions and key interviews were also held along with observation. The quantitative data were analysed through descriptive statistics and binary logistic regression. The qualitative data were used to augment the results from the regression analysis. The results revealed that water service fee, willingness to pay, occurrence of conflict in the water points, monitoring by water user committees, willingness to sustain service, users' participation in the water point construction, satisfaction with the water point service, perception on the possibility of contamination, and training on maintenance are found to be significant factors that affect the operational sustainability of rural drinking water points. Therefore, these significant factors should be sufficiently addressed when planning water supply projects.

Factors Influencing Revenue Collection for Preventative Maintenance of Community Water Systems: A Fuzzy-Set Qualitative Comparative Analysis

This study analyzed combinations of conditions that influence regular payments for water service in resource-limited communities. To do so, the study investigated 16 communities participating in a new preventive maintenance program in the Kamuli District of Uganda under a public–private partnership framework. First, this study identified conditions posited as important for collective payment compliance from a literature review. Then, drawing from data included in a water source report and by conducting semi-structured interviews with households and water user committees (WUC), we identified communities that were compliant with, or suspended from, preventative maintenance service payments. Through qualitative analyses of these data and case knowledge, we identified and characterized conditions that appeared to contribute to these outcomes. Then, we employed fuzzy-set qualitative comparative analysis (fsQCA) to determine the combinations of conditions that led to payment compliance. Overall, the findings from this study reveal distinct pathways of conditions that impact payment compliance and reflect the multifaceted nature of water point sustainability. Practically, the findings identify the processes needed for successful payment compliance, which include a strong WUC with proper support and training, user perceptions that the water quality is high and available in adequate quantities, ongoing support, and a lack of nearby water sources. A comprehensive understanding of the combined factors that lead to payment compliance can improve future preventative maintenance programs, guide the design of water service arrangements, and ultimately increase water service sustainability.

SUN-215 PATIENT ENGAGEMENT IN KNOWLEDGE TRANSLATION: A COLLABORATIVE MODEL FOR MOVING KIDNEY HEALTH RESEARCH INTO PRACTICE

Effective knowledge translation is the process of moving research evidence into clinical practice. Can-SOLVE CKD is a pan-Canadian patient-oriented kidney research network with an established Knowledge User (KU) and Translation (KT) Committee that includes two patient partners as integral members. This committee provides guidance, expertise, and direction for all KT activities undertaken by research projects within the network and ensures KT approaches are patient centered. In this presentation, we will define key concepts related to KT, outline the role of the KU/KT Committee in supporting kidney health research, and highlight the contributions of patient partners on this committee. The KU/KT Committee provides core infrastructure support for 18 research projects within the Can-SOLVE CKD Network. Membership includes national representation of patients living with kidney disease, policymakers, health care professionals and researchers with KT expertise. In alignment with our strategic framework, we co-developed two KT reporting templates for research teams to complete, reviewed project KT plans, and discussed our KT assessments among the committee. In addition to providing directed KT feedback, the committee provides ongoing support for stakeholder engagement and helps projects tailor their KT strategies for communicating, implementing and sustaining their findings in practice. As the main stakeholders in health research, there are opportunities for patients to participate in KT. Two patient partners contribute as full KU/KT committee members and maintain links with the Network’s Patient Council and Indigenous Peoples’ Engagement & Research Council (IPERC). Although all committee members share the responsibility of assessing project KT plans and identifying relevant KT strategies, the patient partners are uniquely positioned to understand real-world implications of the research findings. Therefore, continued acknowledgement of the patient voice in KT will help encourage ongoing relevant research, novel approaches to KT, and the translation of evidence into practice. Our multi-stakeholder KU/KT Committee promotes patient-oriented research and supports the translation of kidney health research into practice. Patients can identify unique KT considerations, provide meaningful feedback to research teams, and encourage the generation and application of relevant research evidence.

The ESO Users Committee: Giving Users a Voice

The ESO Users Committee: Giving Users a Voice

Livestock depredation by leopards around Chitwan National Park, Nepal

Leopards are known to prey on livestock throughout their range. Depredation of livestock makes leopards vulnerable to retaliatory killings and reduces public support for conservation. We examined spatiotemporal patterns, correlates, as well as economic losses and compensation paid for livestock depredation by leopards in buffer zone of Chitwan National Park, Nepal during 2007–2016. Records of compensation applications filed by livestock owners with the park and buffer zone authorities were collected and then triangulated through a questionnaire survey (n = 123). Of the 424 livestock that were reportedly killed by leopards, goats were disproportionately represented (87.3%), 20% more than expected from their relative livestock population, followed by pigs (8.7%) and cattle (4%). A conflict map prepared depicted "depredation hotspots" and clustering of incidents in certain parts of the area. There was a general decrease in livestock killings during the ten-year period. The killings varied significantly among years and months, but not among seasons. None of the examined factors namely, human population (abundance), livestock population (abundance), forest area in buffer zone, national park boundary (defined as the length of buffer zone user committee border abutting the park), livestock depredation by tigers, rainfall, and temperature were correlated with livestock depredation. Depredation by leopards resulted in a total economic loss of US$ 24,621 ($2462 per year) and compensation amounted to a total payment of US$ 19,719 ($1972 per year). We suggest improved husbandry practices, promotion of livestock insurance scheme, and conservation education for vulnerable communities in buffer zone.

Collaboration and modelling – tools for integration in the Motueka catchment, New Zealand

A conceptual model of integrated catchment management (ICM) is presented in which ICM is defined as a process to achieve both ecosystem resilience and community resilience. It requires not only biophysical knowledge developed by hydrologists and other environmental scientists, but an active partnership with catchment communities and stakeholders to break the 'paradigm lock' described by the UNESCO-HELP programme. This paper reports observations from ICM research in the Motueka HELP demonstration basin in the upper South Island of New Zealand. The Motueka occupies 2 170 km2 of land yet the river effects are felt on the seabed more than 50 km2 off- shore, so the true 'catchment' is larger. A hydrologically temperate mountainous catchment with horticultural, agricultural, plantation forestry and conservation land uses, the Motueka also hosts an internationally recognised brown trout fishery. Land and water management issues driving ICM research include water allocation conflicts between instream and irrigation water uses, impacts on water quality of runoff from intensifying land uses, catchment impacts on coastal productivity and aquacul- ture, and how to manage catchment processes in an integrated way that addresses cumulative effects of development. Collaboration with catchment stakeholders can be viewed as having two primary purposes: • Building knowledge and commitment of resource users towards sustainable resource management (collaborative learning) • Stakeholder involvement in resource management itself (governance). Examples are presented of a Collaborative Learning Group on Sediment learning of their differing perspectives on fine sedi - ment impacts, and a Catchment Landcare Group working with scientists to improve water quality in their river. Success fac- tors for water user committees making decisions about water resource management include creating opportunities to commu- nicate and build trust, share scientific knowledge on the issue, and willingness to compromise. Functioning catchment groups have potential to take on delegated governance responsibility for meeting agreed water quality and other community goals. Finally a scenario modelling framework IDEAS (Integrated Dynamic Environmental Assessment System) is presented, in which environmental indicators such as nutrient fluxes are simulated alongside socio-economic indicators such as job num - bers and catchment GDP for a range of land and marine use options.

ASSESSMENT OF MANAGEMENT TRANSFER PROCESS OF WATER SUPPLY SYSTEMS IN SUNSARI DISTRICT OF NEPAL

Considering water is most basic need and highest consumed goods for human being. The overall objective of the study is to identify the root causes of project performance deficiency and analyze the short comings of management transfer process of the system. The functional (Itahari) and partial functional (Duhabi) water supply and sanitation projects of Sunsari district of Nepal were selected for the study. Expert Consultation and Focus Group Discussion were done for primary source of data whereas reports. Journals, project reports, similar studies, books, websites and audit reports were reviewed for secondary source of data. Comparative performance of both the projects were analyzed based on technical, financial and institutional indicators along with the causes of project performance deficiency Worsening functionality, Worsening water quality and lost information were the weakness of water supply system lack of standard process, open defecation and financial issues were the main considerations to be taken by users committee to enhance their capacity for well-functioning of the system. For effective management Transfer of the system minimizing of these short comings, the system should be calibrated and should be sterilized. Project completion document should be handed over to WUSC. WUSC's WOS (Water Operators Standard) document and Business plan should be developed by WUSC in close consultation with the experts and trained WUSC about it. Access to and use of sanitary toilet by all in project area should be promoted. Ensuring these 6 indicators would be a good initiation towards the smooth management transfer.

Study on causes of delay and cost overruns in heritage renovation of Bhaktapur

A fresh and present look at the performance and delivery of heritage projects is required because few studies have been conducted to explore the specific project management and participant issues that contributed failed elements (time and cost) in heritage projects. The major contribution of this research is in the guidance for improvement to help avoid delays and cost overruns in future heritage renovation projects. Bhaktapur municipality is rich in heritage; here the tourism market is one of the source of economy. Bhaktapur municipality has been selected for this study because many of the heritage renovation projects have been completed each year. Most of heritage renovations have been done with the help of users committee and amanat. Tourism has become an important economic factor for the region. So the heritage renovation is studied with the impact of the delay in the works. The research design for this study is more qualitative than quantitative. The main causes of delay have been found as difficulties in financing projects and poor managerial skills. Similarly, the causes of the cost overruns have been found as material cost increased due to inflation.

Spatio-temporal patterns of attacks on human and economic losses from wildlife in Chitwan National Park, Nepal.

Wildlife attacks on humans and economic losses often result in reduced support of local communities for wildlife conservation. Information on spatial and temporal patterns of such losses in the highly affected areas contribute in designing and implementing effective mitigation measures. We analyzed the loss of humans, livestock and property caused by wildlife during 1998 to 2016, using victim family’s reports to Chitwan National Park authorities and Buffer Zone User Committees. A total of 4,014 incidents were recorded including attacks on humans, livestock depredation, property damage and crop raiding caused by 12 wildlife species. In total >400,000 US dollar was paid to the victim families as a relief over the whole period. Most of the attacks on humans were caused by rhino, sloth bear, tiger, elephant, wild boar and leopard. A significantly higher number of conflict incidents caused by rhino and elephant were observed during full moon periods. An increase in the wildlife population did not coincide with an equal rise in conflict incidents reported. Underprivileged ethnic communities were attacked by wildlife more frequently than expected. Number of attacks on humans by carnivores and herbivores did not differ significantly. An insignificant decreasing trend of wildlife attacks on humans and livestock was observed with significant variation over the years. Tiger and leopard caused >90% of livestock depredation. Tigers killed both large (cattle and buffalo) and medium sized (goat, sheep, pig) livestock but leopard mostly killed medium sized livestock. Most (87%) of the livestock killing during 2012–2016 occurred within the stall but close (<500m) to the forest edge. Both the percentage of households with livestock and average holding has decreased over the years in buffer zone. Decreased forest dependency as well as conflict mitigation measures (electric and mesh wire fences) have contributed to keep the conflict incidents in control. Strengthening mitigation measures like construction of electric or mesh wire fences and predator-proof livestock corrals along with educating local communities about wildlife behavior and timely management of problem animals (man-eater tiger, rage elephant etc.) will contribute to reduce the conflict.

Health expectations of the inhabitants of a health priority area: a qualitative study

French law of 4 March 2002 instituted health democracy, making health system users a real partner and active stakeholder in the healthcare system. This role of health system users must be taken into account particularly in health priority areas in order to reduce social inequalities in health. In the context of primary care, multidisciplinary clinics would appear to be ideal places to develop the expression of health democracy. Identify the health expectations of the users of the Villejean clinic (Brittany, France) situated in a health priority area. Qualitative study based on individual and group interviews, conducted with Villejean health system users. Transcripts were analysed thematically by a grounded theory approach. Five group interviews and twenty-one individual interviews were conducted in 49 users. The interviewees described high expectations in terms of a quality relationship with healthcare professionals, who were considered to be real educative partners. Users also formulated high expectations in relation to facilitated access to cares, especially concerning financial aspects. Identification of users' expectations constitutes the first step in developing a primary care health democracy, in which access to care is a major priority. New multidisciplinary clinic projects must take these users' expectations into account. The creation of user committees could allow the citizen-users' views to be really taken into account.

Does women’s participation in water committees affect management and water system performance in rural Vanuatu?

Greater participation of women in water management and decision-making is expected to improve outcomes for both women and the wider community. Global evidence indicates that women’s participation in Water User Committees (WUCs) has been limited; yet their involvement in management has correlated with more effective water systems. This analysis of water inventory data from Vanuatu considers how women’s participation in WUCs affects water management and system functionality. Women represent only 16 per cent of committee membership; however, their involvement in key WUC roles was associated with more effective water management, including regular meetings and revenue collection, and improved functioning of water systems. This evidence of women’s involvement is proving useful in advocacy efforts to improve the gender balance in WUCs, and targets for female membership are being considered for inclusion in water supply legislation.