Environment In Developing World Research Articles

E-Business Strategy in Developing Countries: A Framework and Checklist for the Small Business Sector

Since the turn of the century, there has been a growth in the use of e-business by both large and small companies worldwide, a trend that has been given further impetus by the move to online trading in the COVID-19 pandemic era. For small companies, there are the potential benefits of increased efficiencies and market share gain, associated with the re-engineering of selling and marketing processes; but in developing countries, such as Nigeria, research into how small businesses are using e-business systems and technologies is limited. This article builds upon earlier case study research in the Nigerian small business sector to develop a framework for e-business strategy development, implementation and review. Using an inductive approach, data was collected from six small businesses, using interviews and questionnaires, to profile the e-business operations of these companies. This study found that e-business strategy was generally lacking in these companies, but interview material was used to support the development and validation of the strategy framework, which provides a process and a checklist for small businesses pursuing e-business initiatives in developing world environments.

E-government and digital transformation in Libyan local authorities

This article reports on e-government in local authorities in Libya, and discusses the issues involved in digital transformation. The study builds upon existing models and frameworks to establish a technology-organisation-process (TOP) maturity model for assessing e-government status in three case studies in Libya, which reveal major problems in adopting e-government in Libya. The current technology deployment remains basic, with inadequate information systems and networks, out of date personal computers and office software, and unreliable access to the internet. Organisational capabilities, skill levels, lack of funding, management support and process inefficiencies are other factors hampering progress in the adoption of e-government. A step-change to digital government that employs emergent technologies such as artificial intelligence, big data, analytics and cloud computing is currently out of reach. The TOP maturity model provides a framework for assessing e-government readiness in a developing world environment and gives a multi-dimensional perspective on local authority capabilities.

From informal to formal: an exploration of firm-level sectoral change in El Salvador

PurposeEnterprises in developed and developing world environments often begin life in the informal sector operating outside the purview of government oversight. Sectoral firm change, however, from the informal to the formal sector is not well studied. The purpose of this paper is to answer the following research question: “What firm-level markers help explain the movement of firms from the informal to the formal sector?”Design/methodology/approachData from 719 urban formal enterprises included in the 2016 El Salvador Enterprise Survey undertaken by the World Bank forms the basis of the empirical analyses. The survey questionnaire comprehensively encompasses business practices and performance and the overall business environment.FindingsMultivariate results reveal location, firm maturity, problems with land acquisition, a line of credit or active business loan, extortion by street gangs and practices of informal competitors increase the odds of informal firms becoming formal enterprises. Lessening the odds of once informal firms moving to the formal sector include the lack of access to public utilities, visitation by tax officials, formation as a corporation, bank accounts, number of employees and time spent focused upon government regulations.Originality/valueContextualized within the national setting of El Salvador, the integration of informal enterprises into the formal economy and related public policy implications of informal firm regularization are discussed.

Outcomes of segmental tibia fractures treated with circular external fixation at a single centre in a developing world setting

Background: Segmental tibia fractures historically are treated with special consideration due to their complexity, high complication rate and the propensity for associated injuries. Circular external fixators (CEFs) offer several potential advantages in this situation due to their modularity and minimally invasive application. These advantages have been demonstrated in several developed countries but not as yet in the developing world. This analysis aimed to evaluate if these beneficial outcomes are reproducible in a developing world environment. Methods: We retrospectively assessed the data pertaining to skeletally mature patients who sustained segmental tibia fractures and were treated with CEFs between January 2008 to December 2015. These cases were performed in our tertiary hospital and overseen by a consultant with limb reconstruction experience. Union rates, time to union and complications encountered over a median of 10 months (range 6–20 months) follow-up period were among the outcomes measured. Results: Fourteen male and three female patients with a median age of 34 years were included. Sixteen patients (94%) were injured as a result of high energy trauma, nine patients (53%) had associated injuries, fourteen cases (83%) were compound injuries and there were no cases of compartment syndrome. Fifteen patients (88%) united with the use of the initial CEF at a median of 25 weeks (16–52 weeks), the two cases of non-union were treated with adjustments to the CEF and distraction across the affected fracture site with ultimate union. Two cases (12%) of superficial pin infection were encountered and one case (6%) of deep infection occurred after union of the fractures necessitating removal of the CEF. Three cases (18%) developed malunion. Conclusion: Circular external fixators used for segmental tibia fractures, when applied in a developing setting by clinicians with limb reconstruction experience, display a satisfactory union rate and acceptable complication frequency, as compared to that achieved in developed countries. Level of evidence: Level 4

Mortality due to Respiratory Syncytial Virus. Burden and Risk Factors.

Respiratory syncytial virus (RSV) is the most frequent cause of hospitalization and an important cause of death in infants in the developing world. The relative contribution of social, biologic, and clinical risk factors to RSV mortality in low-income regions is unclear. To determine the burden and risk factors for mortality due to RSV in a low-income population of 84,840 infants. This was a prospective, population-based, cross-sectional, multicenter study conducted between 2011 and 2013. Hospitalizations and deaths due to severe lower respiratory tract illness (LRTI) were recorded during the RSV season. All-cause hospital deaths and community deaths were monitored. Risk factors for respiratory failure (RF) and mortality due to RSV were assessed using a hierarchical, logistic regression model. A total of 2,588 (65.5%) infants with severe LRTI were infected with RSV. A total of 157 infants (148 postneonatal) experienced RF or died with RSV. RSV LRTI accounted for 57% fatal LRTI tested for the virus. A diagnosis of sepsis (odds ratio [OR], 17.03; 95% confidence interval [CI], 13.14-21.16 for RF) (OR, 119.39; 95% CI, 50.98-273.34 for death) and pneumothorax (OR, 17.15; 95% CI, 13.07-21.01 for RF) (OR, 65.49; 95% CI, 28.90-139.17 for death) were the main determinants of poor outcomes. RSV was the most frequent cause of mortality in low-income postneonatal infants. RF and death due to RSV LRTI, almost exclusively associated with prematurity and cardiopulmonary diseases in industrialized countries, primarily affect term infants in a developing world environment. Poor outcomes at hospitals are frequent and associated with the cooccurrence of bacterial sepsis and clinically significant pneumothoraxes.

Mapping to Support Fine Scale Epidemiological Cholera Investigations: A Case Study of Spatial Video in Haiti.

The cartographic challenge in many developing world environments suffering a high disease burden is a lack of granular environmental covariates suitable for modeling disease outcomes. As a result, epidemiological questions, such as how disease diffuses at intra urban scales are extremely difficult to answer. This paper presents a novel geospatial methodology, spatial video, which can be used to collect and map environmental covariates, while also supporting field epidemiology. An example of epidemic cholera in a coastal town of Haiti is used to illustrate the potential of this new method. Water risks from a 2012 spatial video collection are used to guide a 2014 survey, which concurrently included the collection of water samples, two of which resulted in positive lab results “of interest” (bacteriophage specific for clinical cholera strains) to the current cholera situation. By overlaying sample sites on 2012 water risk maps, a further fifteen proposed water sample locations are suggested. These resulted in a third spatial video survey and an additional “of interest” positive water sample. A potential spatial connection between the “of interest” water samples is suggested. The paper concludes with how spatial video can be an integral part of future fine-scale epidemiological investigations for different pathogens.

Small Intestine Bacterial Overgrowth and Environmental Enteropathy in Bangladeshi Children.

ABSTRACTRecent studies suggest small intestine bacterial overgrowth (SIBO) is common among developing world children. SIBO’s pathogenesis and effect in the developing world are unclear. Our objective was to determine the prevalence of SIBO in Bangladeshi children and its association with malnutrition. Secondary objectives included determination of SIBO’s association with sanitation, diarrheal disease, and environmental enteropathy. We performed a cross-sectional analysis of 90 Bangladeshi 2-year-olds monitored since birth from an impoverished neighborhood. SIBO was diagnosed via glucose hydrogen breath testing, with a cutoff of a 12-ppm increase over baseline used for SIBO positivity. Multivariable logistic regression was performed to investigate SIBO predictors. Differences in concomitant inflammation and permeability between SIBO-positive and -negative children were compared with multiple comparison adjustment. A total of 16.7% (15/90) of the children had SIBO. The strongest predictors of SIBO were decreased length-for-age Z score since birth (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.03 to 0.60) and an open sewer outside the home (OR, 4.78; 95% CI, 1.06 to 21.62). Recent or frequent diarrheal disease did not predict SIBO. The markers of intestinal inflammation fecal Reg 1β (116.8 versus 65.6 µg/ml; P = 0.02) and fecal calprotectin (1,834.6 versus 766.7 µg/g; P = 0.004) were elevated in SIBO-positive children. Measures of intestinal permeability and systemic inflammation did not differ between the groups. These findings suggest linear growth faltering and poor sanitation are associated with SIBO independently of recent or frequent diarrheal disease. SIBO is associated with intestinal inflammation but not increased permeability or systemic inflammation.

TimmyCare: an electronic medical record for resource-poor environments

Abstract Background Research of electronic medical records (EMR) shows the minimum use of EMR systems by medical service providers in the developing world. Insufficient EMRs restrict the ability of service providers to manage patients' conditions, track patients' outcomes, and use or share data. Methods To improve the quality of medical service provision, enhance data collection, and enable data-driven decision-making, Timmy Global Health created TimmyCare. Complete with an intuitive, web-based, localised user-interface, mainly customisable data gathering platform, cloud-based and encrypted data storage, and minimum hardware and technical requirements, TimmyCare can bring EMR technology to challenging areas of the developing world. TimmyCare has been tested in a variety of developing world environments, including in mobile clinics in the Amazon basin, locally run primary-care medical clinics in Ecuador and Guatemala, and in a rural health-care programme focused on migrants close to the border of Haiti and the Dominican Republic Findings TimmyCare has improved service provision for roughly 14 000 patients from developing countries. The services has improved Timmy Global Health's ability to monitor patients' conditions, by provision of accessible patient histories; decreased patients' waiting time in Timmy Global Health's medical clinics (in some instances from 3 h to 1 h); and improved patients' follow-up by easy identification of patients with chronic or complex conditions. TimmyCare also enables collection and analysis of population health measurements, thus improving Timmy Global Health's ability to tailor service provision in response to data-backed trends. Interpretation In view of TimmyCare's scalable, customisable, intuitive design, and the potential size of the need for EMR's in the developing world, TimmyCare could enhance service provision in a cost-effective and administratively efficient manner. Funding Timmy Global Health.

Irritable Bowel Syndrome and Gastrointestinal Parasite Infection in a Developing Nation Environment

Postinfectious IBS is defined in the industrialized world as IBS onset following a sentinel gastrointestinal infection. In developing nations, where repeated bacterial and parasitic gastrointestinal infections are common, the IBS pathophysiology may be altered. Our aim was to investigate the relationship between intestinal parasite infection and IBS in the “nonsterile” developing world environment. IBS subjects were identified from a population-based sample of 1624 participants using the Rome II Modular Questionnaire. Stool samples from cases and randomly selected controls were examined for ova and parasites. Logistic regression models explored the relationship between IBS and parasite infection. The overall IBS prevalence among participants was 13.2% (9.3% males, 15.9% females). There was no difference in parasite carriage between IBS cases and controls, 16.6% versus 15.4% (P = 0.78), nor among IBS subtypes. The pathophysiology of post-infectious IBS may be altered in the developing world as compared to industrialized nations and warrants investigation.

Challenging social enterprise debates in Bangladesh

PurposeThe purpose of the paper is to highlight key issues for the social enterprise field in Bangladesh, which are not sufficiently addressed in current social enterprise debates and discourse.Design/methodology/approachThe paper reviews key economic and political debates in the current social enterprise literature. It then attempts to demonstrate how these are insufficient for critical analysis of social enterprise in Bangladesh. The paper draws on field research and literature on the Grameen social enterprises to inform this argument.FindingsThe paper finds that this review of the main debates in a Bangladeshi context raises many pertinent and urgent questions about the role of social enterprise in addressing: complex market failures; the boundaries of the field in the informal and formal sectors; the conflicts caused by contending political objectives and donor/creditor expectations; and broader development issues.Research limitations/implicationsThe paper focuses on the economic and political factors, which differ between Western and developing world environments. It does this with the specific example of the Grameen Energy and Grameen Bank social enterprises from Bangladesh. Whilst this is sufficient to support the paper's aim, it limits the scope of the findings.Originality/valueThis paper highlights a gap in the literature which has had little attention in academic or practitioner fields of social enterprise.

Emergency Medicine in the Developing World: A Delphi Study

Emergency medicine (EM) as a specialty has developed rapidly in the western world, but remains largely immature in developing nations. There is an urgent need for emergency services, but no clear guidelines are available on the priorities for establishing EM in the developing world. This study seeks to establish consensus on key areas of EM development in developing world settings, with respect to scope of EM, staffing needs, training requirements, and research priorities. A three-round Delphi study was conducted via e-mail. A panel was convened of 50 EM specialists or equivalent, with experience in or interest in EM in the developing world. In the first round, panelists provided free-text statements on scope, staffing, training, and research priorities for EM in the developing world. A five-point Likert scale was used to rate agreement with the statements in Rounds 2 and 3. Consensus statements are presented as a series of synopsis statements for each of the four major themes. A total of 168 of 208 statements (81%) had reached consensus at the end of the study. Key areas in which consensus was reached included EM being a specialist-driven service, with substantial role for nonphysicians. International training courses should be adapted to local needs. EM research in developing countries should be clinically driven and focus on local issues of importance. The scope and function of EM and relationships with other specialties are defined. Unambiguous principles are laid out for the development of the specialty in developing world environments. The next step required in this process is translation into practical guidelines for the development of EM in developing world settings where they may be used to drive policy, protocols, and research.

Ethics of Surgical Training in Developing Countries

I read the article by Ramsey and Weijer [1] with interest because I sit on the other side of the ‘‘travelling resident’’ spectrum, that of supervisor at a host institution in the ‘‘Third World.’’ Our institution follows exactly the kind of recommendations for acceptance of such residents that the authors recommend in their concluding points. This letter, therefore, is to show wholehearted support for their sentiments. This is especially true with respect to adequate supervision and guidance, which we provide, yet allowing the elective residents the opportunity to undertake the procedures themselves under such guidance as would be expected of our own trainees. Indeed, over and above any ethical issues, it is a stressful time of adjustment for many foreign doctors in a developing-world environment, where less reliance is placed upon specialized investigations and more emphasis is on clinical patient care. In addition, there may be many language and cultural barriers to contend with in a new country. However, I would like to add one caveat to the reasons why elective training may be essential for residents from the First World who go to particular areas of the Third World, namely, exposure to and preceptored training in aspects of surgery that are becoming less common in the First World, such as management of penetrating trauma. In the developed world, expertise in and volume of trauma surgeries is declining so that many practicing general surgeons do not have the experience of operating on an abdomen with a gunshot wound during their entire residency training, particularly if the resident comes from a European country. Therefore, I would like to place on record my recommendation that elective residents should have a minimum of three or four years of residency training under their belt before engaging in elective residencies in the Third World. This should also include some experience in ICU management of patients, since ‘‘intensivists’’ in developing nations are in short supply so overall patient care resides squarely in the treating clinician’s hands. Finally, before arriving at the elective destination, some preparatory study of the language and culture of the patients in that country is advised.

A Critique of Distance Learning as an Educational Tool for GIS in South Africa

The advancement of distance learning as an educational tool for geographic information systems (GIS) has been at the forefront of educational development at tertiary institutions in the last decade in South Africa. Distance education is envisaged as a means whereby previously disadvantaged members of society, of all ages, can enrol either directly or remotely at a tertiary education institution at a reduced cost. The experiences of the UNIGIS distance learning programme at the University of Pretoria (UP) in South Africa have shown that logistical, technical and practical problems, including a high cancellation rate and the delayed completion of the programme in its entirety, abound when attempts are made to reproduce an internationally recognized distance-based course in a developing world environment. Critical success factors are identified and need to be fully satisfied before widespread GIS dissemination through distance education in South Africa can be achieved.

Sustaining the environment in a developing world

Sustaining the environment in a developing world

Nonclinical Distribution of the Pill in the Developing World

The death toll from pregnancy and childbirth in the developing world ranges from 200 to 600 per 1000 live births. Medical budgets are limited clinics and hospitals scarce and physicians in short supply. In Thailand for example there is an average of only 1 doctor for 20 thousand people in the rural areas where about 80% of the population lives. To require a doctors examination prior to pill prescription is unrealistic and counterproductive under these circumstances. Many powerful medications that require prescriptions in the industrialized countries are sold over the counter in the 3rd World and ways of distributing the pill outside the medical system have been developed. At least 95 programs for nonclinical distribution of contraceptives have been established most operating in 14 Asian and 20 Latin American countries with 6 in Africa. Some rely on nonphysician medical personnel such as nurse-midwives and specially trained auxiliary midwives to distribute pills often from health stations in the countryside. Other programs involve educating interested villagers about the advantages of birth control and training them to distribute pills to women who are free of conditions that would contraindicate pill use. The village distributors many using their homes as a base are provided with a list of such contraindications during their training. A 3rd type of nonclinical distribution -- social marketing -- utilizes the network of small privately owned shops that are found in most villages. Shopkeepers who agree to participate are provided with a free supply of oral contraceptives and are permitted to sell them at low cost and keep the profit. All nonclinical programs are government approved and many are government sponsored. The authors believe that such distribution efforts are ethically sound and health and life enhancing in the developing world environment. They urge that research on pill use by women in the developing world be expanded. (Authors modified) (Summary in FRE)