District Program Research Articles

Kajian Kinerja Kebijakan Program Agropolitan di Kecamatan Sumowono dan Kecamatan Bandungan Kabupaten Semarang

Sumowono and Bandungan sub-districts are parts of Semarang Regency which are designated as one of the rural developments through the agropolitan concept. The agropolitan program was established in 2003 with the aim of improving the welfare and standard of living of the community. In practice, conditions for agropolitan programs in the region are not developing optimally or are stagnant. This was conveyed according to the Central Java Province Regional Planning and Development Agency. Then, based on the report from Bappeda of Central Java Province, it shows that the agropolitan development of Semarang Regency is lagging behind that of Pemalang, Temanggung, Magelang, Brebes, Purworejo, and Karanganyar Regencies. This is because agropolitan activities only focus on land production activities (on farm). Seeing the stagnant agropolitan development, a review of the performance of agropolitan program policies was conducted in Sumowono and Bandungan districts. This study aims to examine the performance of policies in the agropolitan system in Sumowono and Bandungan districts. The results of the analysis above, it can be seen that the performance of the agropolitan program in Sumowono and Bandungan districts is in the quite successful category. This can be seen from the downstream agribusiness subsystem in the two districts which is included in the low category. The downstream agribusiness subsystem score in Sumowono District was 45.09 and Bandungan District was 49.03. This is because the knowledge and skills of farmer groups in utilizing technology for promotion and preservation are still low and marketing reach is still at the provincial level. Thus, the competitiveness of agricultural production in Sumowono and Bandungan Districts is still low.

Diagnostic accuracy of paper-based reporting of tuberculosis treatment outcomes in rural eastern Uganda

Inaccurate reporting of tuberculosis (TB) data to the district and national TB control programmes undermines effective TB control, yet this remains understudied. This study assessed the accuracy of the paper-based approach compared with the World Health Organization (WHO) standard TB treatment outcome as the gold standard for the determination of TB treatment outcome. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the paper-based approach, as well as the percentage agreement between the paper-based approach and the WHO standard TB treatment outcome, are reported. Data from 987 participants were used. Ninety-three participants were misclassified as cured and 195 were misclassified as not cured by the paper-based approach, giving 62.7% sensitivity, 80.0% specificity, 77.9% PPV, 65.5% NPV and percentage agreement of 70.8%. Treatment failure had 64.7% sensitivity, 99.9% specificity, 52.4% PPV, 99.4% NPV, and percentage agreement of 98.4%. Treatment success had 98.8% sensitivity, 96.8% specificity, 99.2% PPV and 94.8% NPV. The paper-based approach was found to report treatment success accurately, but did not report cure and treatment failure accurately. Interventions are thus required to improve the accuracy of the paper-based approach.

Early Education and Adult Health: Age 37 Impacts and Economic Benefits of the Child-Parent Center Preschool Program.

This paper evaluates the long-term impacts of the Chicago Child-Parent Center (CPC) program, a comprehensive early childhood program launched in the 1960s, on the physical and mental health outcomes. This study follows a cohort of 1539 participants born in 1979-1980 and surveyed most recently at age 35-37 by employing a matched study design created by including all students who were enrolled in kindergarten classrooms in CPC school sites as well as entire kindergarten classrooms in a matched set of similar high-poverty schools. Using propensity score weighting that addresses potential issues with differential attrition and nonrandom treatment assignment, results reveal that CPC preschool participation is associated with significantly lower rates of adverse health outcomes such as smoking and diabetes. Further, evaluating the economic impacts of the preschool component of the program, the study finds a benefit-cost ratio in the range of 1.35 to 3.66 (net benefit: $3,896) indicating that the health benefits of the program by themselves offset the costs of the program even without considering additional benefits arising from increased educational attainment and reduced involvement in crime reported in earlier cost-benefit analyses. The findings are robust to corrections for multiple hypothesis testing, sensitivity analysis using a range of discount rates, and Monte Carlo analysis to account for uncertainty in outcomes.

The Comparison of Structure of Existing Stable with Standards of Stable Requested in IPARD Program in Erzurum Central Districts, Turkey

Erzurum is one of the provinces in Turkey where the Instrument for Pre-Accession Assistance Rural Development (IPARD) program will be implemented in the first stage. In this study, we determined the status of the existing enterprises in Erzurum and measured their capacity to comply with the IPARD program in relation to the "Investments for Restructuring Agricultural Enterprises and Reaching Community Standards" measure. This was conducted in 33 barns in 11 villages in the central districts of Erzurum Province. The current situation of animal shelters in central districts of Erzurum province was compared with European Union (EU) standards required in animal shelters. In addition, rural development and the basis on which documents give directions in Turkey, IPARD, and IPARD measures related to the subject of study are given general information. It has been concluded that the existing animal shelters in Erzurum are generally far from the EU standards required within the scope of the IPARD program, and it is challenging for existing animal shelters to meet EU standards by modernizing them. Therefore, in Erzurum province, it will be appropriate for the livestock enterprises that want to take advantage of the IPARD program's “Investments for the Restructuring of Agricultural Enterprises and Reaching Community Standards” measure, instead of modernizing their existing shelters, which the Program allows, by building new animal shelters. In addition, the Agriculture and Rural Development Support Institution, which is the implementer of the IPARD program, should inform the enterprises wishing to benefit from the program to build new animal shelters.

Child Friendly Village Program as an Effort to Prevent Crimes of Violence against Children in Temusai Village, Siak Regency

Kampung Temusai has been designated as a village worthy of children designated by the Bungaraya District. The formulation of the problem in this study is, what are the forms of child-friendly village programs as an effort to prevent child abuse in Temusai village and what are the factors that become obstacles in the implementation of the child-friendly village program and what are the efforts done in coming these obstacles. This research was conducted in Temusai Village. This type of research is sociological juridical with an emphasis on field research. The sociological juridical approach is carried out because the problems studied revolve around how the law applies in society. Judging from its nature, this research is descriptive, because it intends to describe the reality clearly and systematically. The Child Friendly Village Program that has been carried out in Temusai Village is the Community-Based Integrated Child Protection Campaign (PATBM), Maghrib study Program, Collaboration and coordination with various parties in supporting the Child Friendly District Program (KRA). The factors that become obstacles in implementing the child-friendly village program in Temusai village are Lack of Professional Human Resources, Limited technical guidance, Limited budget in running existing programs, Lack of supporting facilities and infrastructure for the Child Friendly Village Program and Lack of awareness community in supporting the Child Friendly Village program. Efforts made to overcome obstacles in the implementation is Coordinating with the local government regarding the budget which is still very minimal,

Prevalence of risk factors for non-communicable diseases among the adult population of several administrative districts of Moscow before the COVID-19 pandemic

Introduction. Currently, increased attention of public policy is paid to non-communicable diseases, which are the leading causes in the structure of mortality, disability and morbidity of the population. In this connection, many government programs are currently being implemented to prevent non-communicable diseases and correct risk factors. Finland's experience in the implementation of the North Karelia project has shown the effectiveness of the prevention of noncommunicable diseases through interagency cooperation. As a result, one of the priority areas of work of the Ministry of Health of the Russian Federation has become the formation of a unified system of strengthening public health. In 2020, the Moscow Department of Health approved the Regional Program for Strengthening the Public Health of the Moscow Population, on the basis of which district programs began to be developed. Objective. Analysis of the prevalence of risk factors for non-communicable diseases among the adult population of the Northern, North-Eastern and Southern administrative districts for 2017–2019. Materials and methods. The materials used were programs to strengthen the public health of the population of the Northern Administrative District, Northern Eastern Administrative District and the Southern Administrative District of Moscow. Results. The largest number of pathological abnormalities in the course of a preventive medical examination and clinical examination is revealed during a survey (questionnaire) and examination by a general practitioner, i. e. at the beginning and at the end of the first stage of clinical examination. According to the results of preventive medical examinations and clinical examination, the greatest contribution (more than 50 %) is made by such risk factors as inappropriate nutrition, low physical activity and overweight, the smallest proportion was hyperglycemia (from 1.2 % to 2.9 %). A high percentage of identified risk factors for non-communicable diseases is noted in the age group 39–60 years old (mainly among women), about 40 % – in the elderly population (over 60 years old).

Age-appropriate feeding practices and their association with undernutrition among children aged 6-23 months in aspirational districts of India: a multinomial analysis.

'Health and nutrition' is one among the five areas covered by the Aspirational District Programme in India, which aims to achieve the Sustainable Development Goals (SDGs). The reduction of undernutrition in under-five children has remained a major focus of the SDGs, especially at the ages of 6-23 months as this affects child development. This study used National Family Health Survey 2015-16 data to examine appropriate feeding practices and their associations with undernutrition among children aged 6-23 months in the 124 aspirational districts of India. Multinomial logistic regression analysis was used to analyse the association between feeding practices and undernutrition, adjusting for covariates. A total of 13,851 children aged 6-23 months were included in the analysis. Child nutritional outcomes, and children receiving the recommended minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD), were poorer in the aspirational compared with non-aspirational districts. However, the proportions of children who continued to breastfed, i.e. currently breastfeeding and the proportion of children who were receiving appropriate breastfeeding, i.e. receiving complementary feeding, in addition to breast milk, were higher in the aspirational districts. Appropriate breastfeeding and MDD were found to be associated negatively with undernutrition. While the continuation of breastfeeding increased the odds of children being undernourished, appropriate breastfeeding lowered the odds. The significant predictors of undernourishment among the study children were the child being male, of higher birth order, older and of smaller than average birth size; mother's lower educational level, mother's lower BMI of mothers and being a teenage mother; and poor household drinking water, sanitation facilities and lower economic status. This study suggests that educating mothers, especially illiterate and poor mothers, about appropriate breastfeeding and dietary diversity could help prevent and reduce child undernutrition in the aspirational districts of India.

Evaluation of CCTV Data For Estimating Rainfall Condition

Rainfall characteristics of Indonesia's tropical climate have high variability according to space and time, so to determine the rainfall pattern of a location, an in situ rainfall measuring instrument (AWS = automatic weather station) is needed with high density. The existence of AWS also requires relatively high maintenance costs and a standard placement location (according to the rules of WMO = World Meteorological Organization) which is relatively broad and is not obstructed by other objects that can make the result of rainfall data is not representative. With the concept of computer vision, research will be carried out to estimate the rainfall condition from the CCTV cameras. The CCTV camera data which have qualitative characteristic into rainfall data which have quantitative characteristics. This research is also motivated by the large number of CCTVs that are placed in a lot of locations by local governments along with the Smart City program in districts and cities throughout Indonesia. The preliminary research was conducted in Center for Atmospheric Science and Technology office in Bandung. Rainfall data from AWS was used to validate CCTV data which placed in same location. The process of converting CCTV data into rainfall data goes through 6 stages. The first is reading the image mapping data and AWS (in rainfall accumulation data form). Second, read the image data in grayscale. Third, extract the features. Fourth, split the reference and sample data. Fifth, conducts the K-NN Mapping Reference Image and rainfall accumulation data. Sixth is to praise K-NN Testing. The accuracy is calculate with comparing the estimated number of CCTV cameras that are correct with the total sample size. The evaluation result states that the highest accuracy is obtained with K = 1. When K=1, the accuracy percentage reaching 94.8%. Accuracy decreases with increasing value of K and drastically decreases with K> 2. In the 1-10 days reference data, the highest accuracy is obtained by the number of reference data for 10 days, which is around 97%, stable until the value of K = 8. While the lowest accuracy is obtained when the reference data is 1 day with an accuracy value of about 43%. Based on the results of this study, it can be concluded that rain data from CCTV can be used to estimate the rainfall data. The best result happened when K-value is equal to 1.

The Community Action Program Works to Improve Mental Health at the District Level: The Evaluation of the Community Action Program in Districts of Iran.

Objective: Three categories of interventions are considered for reducing the prevalence of mental disorders in Iran: mental health promotion, increasing mental health and social service utilization and controlling mental health risk factors. In this regard, we designed a community action program in a national plan to provide comprehensive social and mental health services (SERAJ) that were implemented as a pilot in three districts of Iran: Bardasir, Oslo, and Quchan. In this study, we have reviewed the results of this pilot project. Method : This study was conducted based on the collaborative evaluation model; first, the program was described and the evaluation indicators of each component of the program were determined. Stakeholders were determined; also, data were collected through literature review, semi-structured interview, and focused group discussion and were analyzed by thematic analysis methods. Results: The community action program consists of four components: A Memorandum of Understanding (MoU) between the departments of the districts, People’s Participation House (PPH), Self-reliance Unit (SRU), and actions taken for stigma reduction. A total of 48% of the actions set out in the three MoU of three districts have been executed. The PPH was formed in all three districts. A total of 816 social referrals were admitted to SRU for which a self-reliance process has been initiated. Moreover, 47% of referrals have received services and at least 10 messages for stigma reduction and promoting mental disorders have been sent from different sources at the district level. Conclusion: Strengthening vertical cooperation between the national and provincial levels is essential for the full implementation of the Memorandum of Understanding (MoU) and self-reliance processes. Referring individuals for receiving social support with collaboration between the primary and secondary programs reported to be successful, but feedback to the primary and secondary levels which provides basic and specialized services, is not transparent. Therefore, we suggest an electronic system as an option to solve this problem. The careful selection of representatives of the people's network and empowerment of PPH and directors of the district on community action skills are essential. The experiences of the governors and chairs of health networks of the three districts should be presented at a national conference.

Local Dynamics of Collaboration for Maternal, Newborn and Child Health: A Social Network Analysis of Healthcare Providers and Their Managers in Gert Sibande District, South Africa.

Accountability for maternal, newborn and child health (MNCH) is a collaborative endeavour and documenting collaboration dynamics may be key to understanding variations in the performance of MNCH services. This study explored the dynamics of collaboration among frontline health professionals participating in two MNCH coordination structures in a rural South African district. It examined the role and position of actors, the nature of their relationships, and the overall structure of the collaborative network in two sub-districts. Cross-sectional survey using a social network analysis (SNA) methodology of 42 district and sub district actors involved in MNCH coordination structures. Different domains of collaboration (eg, communication, professional support, innovation) were surveyed at key interfaces (district-sub-district, across service delivery levels, and within teams). The overall network structure reflected a predominantly hierarchical mode of clustering of organisational relationships around hospitals and their referring primary healthcare (PHC) facilities. Clusters were linked through (and dependent on) a combination of district MNCH programme and line managers, identified as central connectors or boundary spanners. Overall network density remained low suggesting potential for strengthening collaborative relationships. Within cluster collaborative patterns (inter-professional and across levels) varied, highlighting the significance of small units in district functioning. SNA provides a mechanism to uncover the nature of relationships and key actors in collaborative dynamics which could point to system strengths and weaknesses. It offers insights on the level of fragmentation within and across small units, and the need to strengthen cohesion and improve collaborative relationships, and ultimately, the delivery of health services.

Local community’s perception on the existing home stay program in Terai and Hilly districts of Nepal

Homestay tourism program is a new part of tourism sector which involved local community in tourism development within their own and surrounding area. It is also lately emerging tourism concept in the world. Nepal is known as an important tourist’s destination and can be a model homestay country with its abundant natural resources, multi culture, multi religion, multi ethnic, tradition life style, archeological heritage, innocent society and community. Due to all these above factors homestay tourism program became the dream for the lover of nature and experts of tourism in Nepal. Homestay program can be easily established, Promoted and developed by minimum investment and based on many aspects such as good service, safety, security, souvenir, family and attractions. It is a major tourism industry for the development of rural economy by generating huge number of employment and social benefits. The major objective of the study is the perception of community towards homestay tourism program. Descriptive and exploratory research design, cross-sectional study design and deductive approach with mixed method have been used in this study. Both primary and secondary data are used simultaneously. Primary data are collected from 348 respondents with three categories of nine study Districts. Similarly, secondary data are collected from various publications of central, state, local Governments, different articles in international journals, books, credible magazines, newspaper, reports prepared by research scholars, experts and universities and different websites etc. Finally, majority of community people have a positive perception towards on existing homestay program in Nepal.

The Early Impact of COVID-19 on a Cardiovascular Disease Prevention Program in Mukono and Buikwe Districts in Uganda: A Qualitative Study

<strong>Background:</strong> In 2011, the United Nations set out an ambitious plan to dramatically reduce the effect of non-communicable diseases (NCDs) including cardiovascular diseases (CVD) in all regions of the world. However, the outbreak of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-Cov-2) is slowing current efforts and the set targets may not be achieved, yet NCDs have been associated with the risk of more severe COVID-19 disease. In the current study, we explore the early impact of the COVID-19 pandemic on a CVD prevention program in Mukono and Buikwe districts in Uganda. <strong>Methods:</strong> We collected qualitative data through interviews and mini focus group discussions (FGDs) in the months of May and June 2020. A total of 39 community health workers (CHWs) and 10 healthcare workers (HCW) participated in the study. The data were transcribed verbatim and analysed with the help of the ATLAS.ti software following a content analysis approach. Emerging themes and sub themes were generated and these exemplified with quotations from the transcripts. <strong>Results:</strong> Negative and positive impact themes were observed. The negative observations were: (1) Disruption of CVD prevention services including halting screening for CVD risk factors at the community and health facility, halting sensitisation and health promotion activities at the community; (2) Reduction in patient health seeking behaviours; (3) Acute health facility staff absenteeism (4) Disruption in reporting and referral mechanisms; and (5) Disruption in supply chain. On the other hand, two positive attributes were observed: (1) Perceived reduction in alcohol consumption; and (2) perceived reduction in crime related psychosocial stress. <strong>Conclusion:</strong> COVID-19 disrupted the implementation of CVD prevention activities in this low-income context. Screening programs and CVD prevention activities at the community and health facility levels were literally halted mainly due to fear, the non-discriminatory lockdown measures and a lack of medicines and supplies – including personal protective equipment. There is need for a balance in measures to sustain CVDs interventions while controlling the COVID-19 pandemic.

Discontinuation of tuberculosis treatment among children in the Kampala Capital City Authority health facilities: a mixed-methods study

IntroductionDiscontinuation of tuberculosis treatment (DTT) among children in sub-Saharan Africa is a major obstacle to effective tuberculosis (TB) control and has the potential to worsen the emergence of multi-drug resistant TB and death. DTT in children is understudied in Uganda. We examined the level and factors associated with DTT among children at four large health facilities in Kampala Capital City Authority and documented the reasons for DTT from treatment supporters and healthcare provider perspectives.MethodsWe conducted a retrospective analysis of records for children < 15 years diagnosed and treated for TB between January 2018 and December 2019. We held focus group discussions with treatment supporters and key informant interviews with healthcare providers. We defined DTT as the stoppage of TB treatment for 30 or more consecutive days. We used a stepwise generalized linear model to assess factors independently associated with DTT and content analysis for the qualitative data reported using sub-themes.ResultsOf 312 participants enrolled, 35 (11.2%) had discontinued TB treatment. The reasons for DTT included lack of privacy at healthcare facilities for children with TB and their treatment supporters, the disappearance of TB symptoms following treatment initiation, poor implementation of the community-based directly observed therapy short-course (CB-DOTS) strategy, insufficient funding to the TB program, and frequent stock-outs of TB drugs. DTT was more likely during the continuation phase of TB treatment compared to the intensive phase (Adjusted odds ratio (aOR), 5.22; 95% Confidence Interval (CI), 1.76–17.52) and when the treatment supporter was employed compared to when the treatment supporter was unemployed (aOR, 3.60; 95% CI, 1.34–11.38).ConclusionMany children with TB discontinue TB treatment and this might exacerbate TB morbidity and mortality. To mitigate DTT, healthcare providers should ensure children with TB and their treatment supporters are accorded privacy during service provision and provide more information about TB symptom resolution and treatment duration versus the need to complete treatment. The district and national TB control programs should address gaps in funding to TB care, the supply of TB drugs, and the implementation of the CB-DOTS strategy.

Cancer care system strengthening (Pendharkar model) offers uninterrupted care continuum during COVID19 pandemic.

e13540 Background: District cancer care programme is operational in more than 150 districts of India. This programme has created nodal cancer units n government run district general hospitals offering cancer related services including chemotherapy and palliative care. During pandemic (COVID19), due lockdown, cancer patients were not able to access tertiary level specialised cancer centres. Aim of this presentation is to reaffirm the necessity of health system strengthening at peripheral level. Methods: With the aim of decentralization and task shifting, district cancer care programme is being implemented in 8 states of India. One general duty medical officers and paramedical staff is trained to assist cancer patients. The physician work under 24 x7 mentorship of oncology team. The government has created a physical cancer care unit with availability of some essential chemotherapy drugs as well. Cancer patients can access these units for assistance in diagnostics, follow-up, toxicity care, chemotherapy and palliative care. Results: We analysed data from few districts in year 2020. The number of patients vesting the units showed an increase during months of total lockdown. Data from 14 districts were analysed. It shows that number of outpatient visits and chemotherapy sessions were higher during strict lockdown. From January 2020 to December 2020 there were 19,273 outpatient visits, and 9,788 inpatient visits. During months of a strict lockdown-March, April, May, June the number increased.7,729 sessions of chemotherapy were performed and more than 2,230 new cases were registered during this year. Conclusions: The pandemic has brought new challenges and has compelled us to learn ways of care continuum. The most important has been the necessity of decentralisation of specialised care, its evenly and equitable distribution. District cancer care programme, as a measure of health system strengthening, which is being evolved in India has further emphasized the importance of such a system building.

Fighting mosquito bite during a crisis: capabilities of Florida mosquito control districts during the COVID-19 pandemic

BackgroundThe stay-at-home orders imposed in early April 2020 due to the COVID-19 pandemic in various states complicated mosquito control activities across the United States (US), and Florida was no exception. Mosquito control programs are the first line of defense against mosquito-borne pathogens. The purpose of this study was to examine the capabilities of Florida mosquito programs to implement key mosquito measures during the COVID-19 pandemic lockdown.MethodsUsing a self-administered online survey, we examined the capabilities of all Florida mosquito control programs (both state-approved mosquito districts, N = 63; and open programs, N = 27) at a time when the state of Florida was still under heightened awareness of, stay-at-home orders and planning a phase 1 reopening over the COVID-19 pandemic (June to July 2020). The final sample included mosquito control programs structured as the Board of County Commissioners (BOCC) (n = 42), independent tax district (n = 16), municipal (n = 10), and health or emergency department (n = 5). We used descriptive statistics to summarize information about the characteristics of responding programs, their implemented mosquito control and surveillance activities. wWe used bivariate analysis to compare the characteristics of responding programs and the self-reported mosquito measures.ResultsOf the recruited mosquito control programs, 73 completed the survey (81.1% response rate; 73/90). Of these, 57.5% (n = 42) were Board of County Commissioners (BOCC) mosquito control programs, 21.9% (n = 16) were independent tax district programs, 13.7% (n = 10) were municipal mosquito control programs, and only 6.8% (n = 5) were either health or emergency department mosquito control programs. Except for arbovirus surveillance, most programs either fully or partially performed larval (61.8%) and adult (78.9%) surveillance; most programs conducted species-specific control for Aedes aegypti (85.2%, n = 54), Aedes albopictus (87.3%, n = 55), Culex quinquefasciatus (92.1%, n = 58), and Culex nigripalpus (91.9%, n = 57).ConclusionsFindings underscore the importance of ongoing mosquito control activities, and suggest that Florida mosquito control programs are vigilant and have significant capability to handle potential mosquito-borne disease threats, but arbovirus surveillance systems (laboratory testing of mosquito pools and testing of human and nonhuman specimens for arboviruses) are needed during pandemics as well.

A participatory approach to address within\u2010country cross\u2010border malaria: the case of Menoreh Hills in Java, Indonesia

BackgroundMalaria remains a significant public health issue in Indonesia. Most of the endemic areas are in the eastern parts of Indonesia, but there are a few remaining foci of persistent endemic malaria in Java, particularly in Menoreh Hills, a region bordering three districts of two provinces on this island. Despite a commitment to build a partnership to eliminate cross-border malaria, there is a lack of understanding of how this partnership might be translated into an implementable strategic plan. The study aims to provide evidence of how a participatory approach was used to strengthen the cross-border collaboration and stakeholders’ capacity to develop a joint strategic, operational, and costing plan for cross-border malaria elimination.MethodsA participatory action research was conducted from January to August 2017, involving participants from the village, district, provincial, and national levels. This study was conducted in seven phases, including document review, focus group discussions (FGDs), planning and costing workshops, and a dissemination meeting. A total of 44 participants from primary health centres (PHC) and 27 representatives of affected villages in three districts, 16 participants from the district and provincial malaria programmes and planning bureaus, and 11 participants from the national level were involved in the processes. Data on priority issues, costing, programme coverage, and administration were collected. Thematic coding and feedback were used for analysis.ResultsProblems identified by stakeholders included low community awareness and participation in malaria prevention, high mobility across three districts, lack of financial and human resources, lack of inter-district coordination, and poor implementation of migration surveillance. Cross-border strategies identified to address malaria were improving cross-border migration surveillance, strengthening the network, governance, and advocacy of malaria control implementation across borders, and developing the malaria information system. A working group composed of the three districts’ representatives authorized to decide on cross-border issues will be created.ConclusionsThe participatory approach was applicable in cross-border malaria planning for within-country settings and useful in enhancing stakeholders’ capacities as implementers. While done in a participatory way, the joint plan crafted was a non-binding agreement; stakeholders should advocate to ensure adequate funds are poured into mobilizing the programme.

Participation, Income Effect and Challenges of Village Savings and Loans Program in Garu and Tempane Districts of the Upper East Region, Ghana

Village Savings and Loans Associations (VSLAs), have the aim of reducing poverty and creating assets to rural dwellers who have limited access to formal finance due to high collateral requirements. However, since the implementation of VSLAs in the Garu and Tempane districts for over a decade, there is inadequate evidence as to the impact of VSLAs on the lives of the participants. Not only that, there is the need to find out the current and anticipated challenges faced by the participants in the program. This study analyzed the effect of VSLAs on the income of households in Garu and Tempane districts. Data was collected from 100 respondents, 50 direct beneficiaries and 50 non beneficiaries from 3 and 2 communities in Garu and Tempane districts respectively. A Heckman treatment effect model was used to analyze the determinants of participation and the effect of participation on income. The results showed that participants of the VSLA program had an annual income of about GH₵ 2016.60 more than the non-participants. Decision to join VSLAs is mainly influenced by age, the years a respondent spends in the community, the number of active labor force in a household and whether a respondent is a native or migrant. However, based on the challenges identified, it is recommended that the government and other institutions interested in rural development should institute appropriate policies that will help enhance participation in the program. Also, the associations should enforce tougher sanctions on members who absent themselves from meetings without prior notice.

Key Drivers to Implement an Evidence-based Tobacco Control Programme in Schools of India: A Mixed-Methods Study.

Background:Adolescence is an influential stage in students’ lives when lifelong behaviours such as tobacco use are formed. During these years, school teachers are important role models for tobacco control among students. A study was conducted among school personnel and administrators to understand the key drivers for implementing an evidence-based school tobacco control program. Methodology:A cross-sectional, mixed-method study was conducted in five districts of Assam, India. The quantitative study was conducted among 565 school personnel across 40 Government-aided schools. Data was collected by means of an anonymous, self-administered questionnaire. Qualitative data was generated from 15 focus group discussions (FGDs) among 146 participants - District Program Officers, Block Education Officers, Cluster Coordinators, Headmasters and Teachers. Results:While the prevalence of smoked tobacco was low (3%), the use of smokeless tobacco was higher (40%), and the prevalence of use of areca nut without tobacco (65%) was still higher among school personnel. They were aware of the school policies prohibiting the use of tobacco among students within or outside school buildings or during school-sponsored activities (81%); they had rather limited knowledge about policy for themselves (58%). There was lack of access to training materials about prevention of tobacco use among youth. The FGDs amongst school personnel resulted in several constructive suggestions on tobacco control in schools mainly in training school teachers, monitoring the program and incentives for execution of the program. However, there was a reluctance to implement a smokeless tobacco control programme since many were current users of smokeless tobacco and areca nut. Conclusion:Tobacco control policies as well as training school personnel in schools need to improve and further measures must be taken to prohibit use of areca nut, which contains carcinogens. The existing system of the education department can be utilised to implement tobacco control programmes effectively.

Are Historic Districts A Backdoor for Segregation? Yes and No

Historic districts preserve the heritage of designated areas and tend to attract tourism income. However, these districts also come with specific restrictions and increased housing prices that could result in segregation. We study how two historic district programs impact residential segregation in Denver. We find that home buyers are more likely to be White within historic districts, but that the official designation has no effect on this probability. Similarly, when examining seller-to-buyer housing transactions, we find that most transactions flow from White sellers to White buyers, regardless of the official designation. Thus, while historic districts tend to be more segregated than their surrounding areas, the legal restrictions and housing premium that come with historic designations do not seem to amplify this existing problem.

A Proposed Evaluation Plan for the Diabetes Prevention and Control Program

Introduction: India is projected to be the diabetes capital by the next decade, and Asians are predisposed to central obesity and visceral adiposity which puts them at additional risk for diabetes. Materials and Methods: The proposed evaluation plan draws reference from the non-communicable disease prevention and control program, implemented by the Karnataka Health Systems Development &amp; Reforms Project (KHSDRP), Directorate of Health Services, Government of Karnataka (GoK) in collaboration with the World Bank, New Delhi, during the period 2012 to 2016. This evaluation will be conducted by an external agency in consultation with the Medical Officer/Investigator. Results: The relevant reports will officially benefit the District Program Officer and District Health Officer of Davangere and Dakshina kannda districts, Karnataka, India, where the program is being implemented. Conclusion: The results of this plan will benefit health promotion planning by the Health Department including building of community advocacy for the promotional initiatives.