Geographical Challenges Research Articles

Regional variation in trajectories of colon cancer mortality, 2012-2021.

41 Background: Colorectal cancer (CRC) is the fourth most common cancer by incidence in the United States in 2024, and the second most common cause of cancer mortality in Texas. Rates of advanced CRC at diagnosis and cancer related mortality are higher in rural areas. Here we explore the variation in mortality trends across the eleven public health regions (PHR) of Texas from 2012 to 2021. Methods: We conducted a population-based cohort study of colon cancer mortality in Texas over the period 2012 through 2021. We queried the National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER) for county level colon cancer deaths in Texas over the most recent available decade. Counties were aggregated into the eleven public health regions defined by the Texas Department of State Health Services. We calculated age-adjusted mortality rates (AAMRs) per 100,000 population using the direct standardization method based on the age group weights from the 2000 standard US population. Confidence intervals for AAMR were derived by estimating the standard error as the AAMR divided by square root of number of mortalities. The annual percent changes (APC) in AAMR were tested using negative binomial regression. Subgroup analyses included age group, sex, and race/ethnicity. Results: A total of 33,591 colon cancer mortalities were included in the study. Total colon cancer mortalities rose from 2,973 in 2012 to 3,800 in 2021. The statewide AAMR was initially 12.4 (95% CI 12.0 to 12.9), and did not change over the study period (APC -0.1% [95% CI -0.5% to 0.2%]; p = 0.5155) ending at (AAMR 12.5 [95% CI 12.1 to 12.9]). Divergent trajectories for AAMR across public health regions were observed. The largest decline in AAMR (APC -3.9% [95% CI -6.3 to -1.6]; p = 0.0013) occurred in region 10, where the AAMR fell from 14.2% [95% CI 8.6 to 19.7]) to AAMR 11.0 [95% CI 6.8 to 15.1]. Region 6 also saw a significant decrease (APC -1.1% [95% CI -1.8% to -0.4%]; p = 0.0029) falling from AAMR 12.2 [95% CI 11.3 to 13.2] to AAMR 11.2 [95% CI 10.4 to 11.9]. The largest significant increasing trend (APC +2.3% [95% CI 0.6% to 4.1%]; p = 0.0089) for AAMR was observed for region 9 rising from AAMR 12.4 (95% CI 9.6 to 15.3) to AAMR 15.4 (95% CI 12.3 to 18.4). Conclusions: Our analysis showed a significant and increasing trend in CRC related mortality in PHR 9. This region, colloquially termed West Texas, consists of 30 counties of which over 86% are designated as rural. Rural areas struggle with higher poverty, lower degree of higher education attainment, less access to healthcare and physicians, and a higher frequency of uninsured status. West Texas in particular also has a higher rate of smoking and obesity. However, PHR 10, which shares many similarities with PHR 9 such as rurality (83.3%) and similar socioeconomic and geographic challenges, witnessed the greatest decline in AAMR of the eleven PHR's in the same time frame, suggesting the presence of other factors which may be contributing to this increase.

A blueprint for large language model-augmented telehealth for HIV mitigation in Indonesia: A scoping review of a novel therapeutic modality.

Background: The HIV epidemic in Indonesia is one of the fastest growing in Southeast Asia and is characterised by a number of geographic and sociocultural challenges. Can large language models (LLMs) be integrated with telehealth (TH) to address cost and quality of care? Methods: A literature review was performed using the PRISMA-ScR (2018) guidelines between Jan 2017 and June 2024 using the PubMed, ArXiv and semantic scholar databases. Results: Of the 694 records identified, 12 studies met the inclusion criteria. Although the role of eHealth interventions as well as telehealth in HIV management appears well established, there is a significant literature gap on the integration of telehealth and LLM technology. To address this, we provide a blueprint for the safe and ethical integration of LLM-TH into triage, history taking, patient education highlighting opportunities for reduced consultation time and improved quality of care. Conclusions: Variable access to mobile technology and the need for empirical validation stand out as limitations for LLM-TH. However, we argue that the current evidence base suggests the benefits far outweigh the challenges in applying LLM-TH for HIV care in Indonesia. We also argue this novel therapeutic modality is broadly applicable to the subacute general practice setting.

A Novel Evolutionary Deep Learning Approach for PM2.5 Prediction Using Remote Sensing and Spatial–Temporal Data: A Case Study of Tehran

Forecasting particulate matter with a diameter of 2.5 μm (PM2.5) is critical due to its significant effects on both human health and the environment. While ground-based pollution measurement stations provide highly accurate PM2.5 data, their limited number and geographic coverage present significant challenges. Recently, the use of aerosol optical depth (AOD) has emerged as a viable alternative for estimating PM2.5 levels, offering a broader spatial coverage and higher resolution. Concurrently, long short-term memory (LSTM) models have shown considerable promise in enhancing air quality predictions, often outperforming other prediction techniques. To address these challenges, this study leverages geographic information systems (GIS), remote sensing (RS), and a hybrid LSTM architecture to predict PM2.5 concentrations. Training LSTM models, however, is an NP-hard problem, with gradient-based methods facing limitations such as getting trapped in local minima, high computational costs, and the need for continuous objective functions. To overcome these issues, we propose integrating the novel orchard algorithm (OA) with LSTM to optimize air pollution forecasting. This paper utilizes meteorological data, topographical features, PM2.5 pollution levels, and satellite imagery from the city of Tehran. Data preparation processes include noise reduction, spatial interpolation, and addressing missing data. The performance of the proposed OA-LSTM model is compared to five advanced machine learning (ML) algorithms. The proposed OA-LSTM model achieved the lowest root mean square error (RMSE) value of 3.01 µg/m3 and the highest coefficient of determination (R2) value of 0.88, underscoring its effectiveness compared to other models. This paper employs a binary OA method for sensitivity analysis, optimizing feature selection by minimizing prediction error while retaining critical predictors through a penalty-based objective function. The generated maps reveal higher PM2.5 concentrations in autumn and winter compared to spring and summer, with northern and central areas showing the highest pollution levels.

Outpatient surgical management of head and neck keratinocyte cancers in a regional centre: an updated analysis of costs and outcomes.

Australia has the highest global incidence of keratinocyte cancer. Surgically managing keratinocyte cancers in regional Australia presents geographic and economic challenges, which necessitate cost-effective resource allocation. Previous work has outlined the cost benefit for outpatient day surgical excision of head and neck skin lesions that can be closed primarily. We expand on this analysis with the inclusion of graft and local flap reconstructions. A retrospective analysis was completed in a single regional centre across 24 months from July 2022 to June 2024. Patient demographics, lesion characteristics, margin status, cost comparison, and complication rates were recorded. There were 256 excisions for proven or suspected keratinocyte cancers. Basal cell carcinomas comprised 73.1% of lesions, squamous cell carcinoma for 21.9% of lesions, and intra-epidermal carcinoma for 5.1%. Lesion defects were closed primarily in 63.8% while 23.0% underwent full thickness graft reconstruction and 13.2% required local flaps. Involved margins were reported in 8.1% of excisions. Follow-up wound review was undertaken in primary care for 26.1% of all lesion excisions. Average indicative costs were three-to-four times higher for procedures performed in theatre compared to the outpatient setting, and these savings were greatest for graft and local flap reconstructions. There were 20 recorded complications including 16 partial or complete graft failures and one partial flap failure. This study demonstrates further cost effectiveness for graft and local flap reconstruction of head and neck skin excisions under local anaesthetic in the regional outpatient setting, while maintaining low complication and incomplete excision rates.

Machine Learning and the GR2M Model for Monthly Runoff Forecasting

This article presents the results of an analysis of monthly rainfall into monthly runoff using Machine Learning algorithms, including Multiple Linear Regression, Multilayer Perceptron, and Support Vector Machine, which were compared with the GR2M hydrologic model to identify the most suitable approach for rainfall-runoff analysis in watersheds in the lower southern region of Thailand. This region is characterized by its unique geographic location at the border between Thailand and Malaysia. It faces challenges due to uncertainty in rainfall data, measured only on the Thai side, leading to a lack of corresponding data from Malaysia. The analysis found that the Machine Learning Support Vector Machine algorithm consistently provided the most accurate results across all sub-basins. Sub-basin TU02 achieved an MAE of 2.63 mm/month, while sub-basin X.119A had an MAE of 68.10 mm/month, sub-basin X.184 had an MAE of 145.05 mm/month, and sub-basin X.274 had an MAE of 66.08 mm/month. This research demonstrated the utility of advanced algorithms in rainfall-runoff analysis for areas with partial or incomplete data coverage. The findings confirm that the Machine Learning Support Vector Machine algorithm outperformed the Hydrologic Model (GR2M) in terms of accuracy and reliability. Therefore, this study concludes that applying the Machine Learning Support Vector Machine algorithm is an optimal approach for runoff prediction in the southern region of Thailand and provides a framework for potential applications in other areas with similar data and geographic challenges. Doi: 10.28991/CEJ-2025-011-01-022 Full Text: PDF

Development of an Importance Scale for Seawater Intake Types Based on Physical Parameters Database

This article presents an advanced Geographic Information Systems (GIS) based interface that innovates coastal water resource management in Morocco, with specific application to the ASSILAH region. This solution integrates spatial analysis with multi-criteria decision support, particularly focusing on the geographical distribution and territorial challenges of the Moroccan coastline, using programming tools such as Excel Visual Basic for Applications (VBA). The methodology combines GIS spatial analysis capabilities with the Analytic Hierarchy Process (AHP) to evaluate complex geographical parameters including bathymetry and coastal infrastructure. The integration of geospatial data provides a clear and precise visualization of potential areas for seawater intake installations, thereby facilitating the understanding of territorial issues for decision-makers. The AHP method, known for its robustness in multi-criteria decision support, allows for choosing the optimal type of seawater intake. The interface, developed through Excel and VBA, transforms complex spatial and analytical data into an accessible decision support tool. The resulting system offers regional planners a comprehensive framework for coastal sustainable infrastructure development in the Assilah coastal region as a pilot case for Morocco's unique geographical context.

The open Border Dilemma: Assessing Nepal's Security

This article examines the realities and solutions surrounding the Nepal-India open border issue, focusing on its implications for Nepal's security. Using a qualitative approach, the study draws on secondary literature, case studies, interviews, and focus group discussions. It highlights the challenges posed by Nepal’s landlocked geography and historical context. King Prithvi Narayan Shah's "Yam between two stones" approach exemplifies Nepal’s diplomatic balancing act between India and China. The open border with India spans 1,880 kilometers, while the Himalayas form a natural barrier along the 1,414-kilometer northern frontier with China. Nepal’s small size, population, and limited economic resources, including restricted access to sea routes, exacerbate its vulnerabilities. However, its strategic location offers opportunities for regional cooperation. Strengthening ties with both India and China, while positioning Nepal as a gateway to South Asia, can promote peace, stability, and development, transforming geographical challenges into prospects for progress.

Scope of work and contributions of female community health volunteers in Nepal’s healthcare sector: a qualitative study

ObjectivesTo determine the perception of female community health volunteers (FCHVs) in terms of their scope of work, impact of work on their professional experiences and their coping strategies and stakeholders’...

The availability of essential medicines in public health facilities in Afghanistan: navigating socio-political and geographical challenges.

During the past two decades, the Afghan government, along with international community, has developed a system aimed at improving access to essential health services under Afghanistan's challenging socio-political and geographical circumstances. In 31 provinces, non-state actors competed for fixed-term contracts to implement a predefined package of health services. In three provinces, the government organised the provision of health services. An independent third party monitored service provision, including access to medicines. This study examines the availability of essential medicines in Afghanistan's public health facilities and how this is shaped by socio-political challenges, geographical barriers, and the organisation of the health system. Between March and July 2021, enumerators collected data at 885 health facilities across Afghanistan. For our analysis, we combined data about medicine availability and the functioning of the health system with publicly available information about geographical and socio-political factors, including security incidents. Using regression analysis, we identified facility, district, and province-level factors related to medicines availability in public health facilities. On average, 70% of 31 selected essential medicines were available in 2021. The availability of medicines varies significantly between provinces and was considerably higher in those where services were contracted out to non-state actors (n=34; 91%) compared to provinces where service provision was organised by the government (n=3; 9%). The most important drivers of variation in medicine availability included geographical barriers, securing and allocating funds on the provincial level, and organising and sustaining physical capacity on the facility level. Insecurity was not a key factor driving variation in medicine availability. Despite the socio-political challenges in 2021, the availability of essential medicines in public health facilities was relatively high. The results suggest that decentralized procurement of medicines by non-state actors and timely payment of funds contribute to medicines availability. Strategies to improve medicines availability should target hard-to-reach areas and lower-level facilities.

GAPS IN THE IMPLEMENTATION OF GOVERNMENT-PRIVATE PARTNERSHIPS (PPP) IN INFRASTRUCTURE DEVELOPMENT

Infrastructure is one of the most important pillars in the development of a civilization, especially for archipelagic countries like Indonesia, which faces unique geographical challenges. The gap in the implementation of Government and Business Entity Cooperation (KPBU) in infrastructure development in Indonesia has become an increasingly pressing issue to address. This research discusses the importance of regulatory renewal in Government-Private Partnerships (PPP) to address existing gaps. The research utilized various data sources, including legislative texts, government regulations, legal documents, and policy papers relevant to PPP in Indonesia. The analytical approach allowed for a deeper exploration of the dynamics and implications of the existing regulations, focusing on their effectiveness and applicability in real-world scenarios. The author was able to articulate the challenges faced in the application of PPP regulations and propose targeted recommendations for regulatory renewal and improvement. This study could involve comparative analyses of best practices in regulatory frameworks from other countries that have successfully addressed similar infrastructure challenges, providing valuable insights for the Indonesian context. Ultimately, this research could contribute to creating a more responsive and adaptive regulatory framework that supports sustainable and equitable infrastructure solutions in Indonesia, ensuring that the needs of society are met while fostering a conducive environment for investment.

Connecting care in a community forgotten: a poetic representation of tuberculosis prevention, detection, and treatment for women in East Kwaio, Solomon Islands

ABSTRACT This found poem seeks to connect care as we work towards a fairer world. Barriers to preventing, detecting and treating tuberculosis (TB) in mountainous East Kwaio, Malaita, Solomon Islands persist, while gendered issues remain largely unexplored. A qualitative study explored women's experience of TB in East Kwaio, using the Melanesian method of tok stori. Twenty-four women and 12 men shared about women's experience of living with TB and caring for someone with TB. Tok storis were audio recorded and orally analysed. While cultural concepts of love and community promote support, systematic health system exclusion and geographic isolation compound health challenges. These findings are presented in a found poem.

Ocular Cystinosis Experience in Southwestern Ontario

Purpose To evaluate ocular treatment adherence and its impact on clinical outcomes in patients with cystinosis in southwestern Ontario, where the disease incidence is higher due to a founder effect in the Old Order Amish population. Methods This was a retrospective case series of patients with ocular cystinosis seen at Victoria Hospital and the Ivey Eye Institute at St Joseph's Health Care in London, Ontario, Canada, from 2008 to 2023. The authors investigated the demographics, ocular manifestations, and visual outcomes and characteristics in pediatric patients with ocular cystinosis. They also conducted qualitative analysis to characterize medication compliance and identify treatment barriers to compliance. Results This study included 14 patients with ocular cystinosis. In southwestern Ontario, the incidence of cystinosis is approximately 1 in 4,700 live births. Most patients were Old Order Amish, with a family history of cystinosis and consanguineous parents. During treatment, patients were typically asymptomatic, but photophobia was the most reported symptom. Slit-lamp examination revealed cystine crystals in the cornea of all patients; however, best corrected visual acuity and intraocular pressure were unremarkable in every case. A Fisher's exact test revealed a trend toward lower compliance in Amish patients compared to non-Amish patients (odds ratio: 0.067, P = .103). Significant treatment barriers for patients with ocular cystinosis were identified, including compliance issues with frequent eye drop regimens, educational and financial burdens, and geographical and cultural challenges, all impacting patient care and follow-up. Conclusions This study highlights the need for improved strategies to improve treatment compliance and overcome barriers to care for patients with ocular cystinosis, particularly within the Old Order Amish population in southwestern Ontario, to ensure better clinical outcomes and quality of life. [ J Pediatr Ophthalmol Strabismus . 20XX;XX(X):XXX–XXX.]

Barriers to Cochlear Implant Uptake in Adults: A Scoping Review.

Cochlear implants (CIs) provide access to sound and help mitigate the negative effects of hearing loss. As a field, we are successfully implanting more adults with greater amounts of residual hearing than ever before. Despite this, utilization remains low, which is thought to arise from barriers that are both intrinsic and extrinsic. A considerable body of literature has been published in the last 5 years on barriers to adult CI uptake, and understanding these barriers is critical to improving access and utilization. This scoping review aims to summarize the existing literature and provide a guide to understanding barriers to adult CI uptake. Inclusion criteria were limited to peer-reviewed articles involving adults, written in English, and accessible with a university library subscription. A cutoff of 20 years was used to limit the search. Barriers uncovered in this review were categorized into an ecological framework. The initial search revealed 2,315 items after duplicates were removed. One hundred thirty-one articles were reviewed under full-text, and 68 articles met the inclusion criteria. Race, ethnicity, and reimbursement are policy and structural barriers. Public awareness and education are societal barriers. Referral and geographical challenges are forms of organizational barriers. Living context and professional support are interpersonal barriers. At the individual level, sound quality, uncertainty of outcome, surgery, loss of residual hearing, and irreversibility are all barriers to CI uptake. By organizing barriers into an ecological framework, targeted interventions can be used to overcome such barriers.

Comparing telesimulation-based learning and e-learning as remote education delivery methods in pre-hospital practice

Introduction: Pre-hospital practitioners based at rural and geographically spread-out regions often find it difficult to access education and training for continuous professional development. Distance learning can resolve the dilemma of how to provide high-quality education where the number of participants is small and widely scattered. E-learning is an established teaching modality that has been widely used, whereas telesimulation is a novel teaching tool that has been evolving throughout the past decade. This study aimed to evaluate the experience of e-learning compared to telesimulation for pre-hospital practitioners.Methods: This study was conducted from January to June 2021. Twenty-six pre-hospital responders were randomly allocated to complete either an e-learning module or a telesimulation session based on acute paediatric asthma. Each participant completed a post-session satisfaction questionnaire for quantitative and qualitative analysis. For the telesimulation session, all participants attended remotely, while the faculty were based on site. The e-learning module was accessed by the participants via the internet.Results: Both modalities were positively received, with participants agreeing that the learning objectives were met. However, telesimulation was rated significantly higher in terms of engagement (p = 0.044) and suitability (p = 0.033). Qualitative feedback highlighted the immersive and realistic nature of telesimulation as key advantages, while e-learning was appreciated for its flow and stimulating questions.Conclusion: Telesimulation and e-learning can help learners with restricted availability and geographical challenges. Telesimulation allows learners to work as a multi-disciplinary team despite being scattered across a large geographical area, while e-learning gives learners the flexibility to access education at a convenient time.

Reimagining Pune with urban greenways integration

Abstract India’s unique geographical, economic, and cultural landscapes present distinct challenges and opportunities for developing greenways. Unlike their counterparts in the United States and Europe, Indian greenways must navigate fragmented and varied green spaces across different regions. This paper delves into the ecological, environmental, and planning advantages of greenways, proposing a methodology tailored for the Indian context. It outlines a comprehensive template for greenway design, drawing upon academic literature, satisfaction surveys, and insights from local ecological experts. The methodology is applied to a case study in Pune, Maharashtra, resulting in a template design for greenways network that seamlessly integrates the existing fragmented network of green paths. This paper further explores the integration of urban infrastructure by defining a non-motorized traffic network that connects metropolitan centers to the region’s rich cultural heritage resources. Embark on a journey to discover how greenways can revolutionize sustainable non-motorized transportation in India, transforming urban landscapes and fostering a healthier environment for all. Highlights for public administration, management and planning: The impacts of Urban Greenways in a city are nodal for non-motorized transportation with conservation of ecology. Spatial assessment of Greenways is one of the important tasks for preparation of Development plan in Urban and Peri urban region. An integrated Greenway design template has been prepared by taking into consideration various factors for the integration of greenway within the development plan with assessment of greenways as future scope

Strategi Pembangunan Kekuatan TNI di Natuna Utara Dalam Menghadapi Konflik Laut Cina Selatan (LCS)

Tensions in the Asia-Pacific region have escalated due to the aggressive actions of the People's Republic of China (PRC) regarding its South China Sea (SCS) claims. This situation has prompted regional countries to enhance their defense capabilities, further complicated by the involvement of the United States and the formation of the AUKUS pact, which has created a security dilemma. Indonesia faces several challenges in building its national defense capacity as a non-party to the direct conflict. These challenges include: (1) a relatively low defense budget allocation, less than 1% of GDP, despite its vast territory and significant maritime threats; (2) a budget focus skewed towards personnel development rather than modernizing primary weapons systems and investing in defense technology research; and (3) inconsistencies in defense procurement planning due to domestic and international political factors. To address the potential escalation of the SCS conflict, Indonesia requires a national defense strategy that can act as a balance of power in the region. This study employs a qualitative method with a descriptive-analytical approach, utilizing primary (interviews) and secondary data. The findings reveal that VUCA conditions, geographical challenges, and an Indonesia-centric development vision influence Indonesia's defense strategy. The Archipelago Defense Strategy (SPN), formulated by the Ministry of Defense and the Indonesian Armed Forces (TNI), prioritizes the Large Islands Strategy and the development of forward bases in Natuna to counteract the PRC's aggression in the SCS.

Spatial Analysis of School Accessibility in Tarutung District and Its Policy Implications

This study evaluates the accessibility of Junior High School (SMP) educational facilities in Tarutung District, North Tapanuli Regency, with a focus on addressing socio-economic disparities and geographic challenges. Using spatial analysis methods such as buffer and overlay analysis, combined with the Neighborhood Unit theory, the research identifies critical gaps in educational access. Findings reveal that 77.41% of the district's area falls outside the ideal accessibility radius for schools, highlighting significant inequities for students in remote and underserved areas. Contributing factors include inadequate public transportation and the uneven distribution of schools, compounded by the zoning system for student admissions, which prioritizes proximity without considering geographic and infrastructural barriers. This study recommends redistributing educational facilities, enhancing transportation infrastructure, and revising zoning policies to better address regional needs. The findings underscore the importance of integrating socio-economic and spatial considerations into educational planning. By improving accessibility, these recommendations aim to foster equitable and inclusive education. This research provides a foundation for future studies and policy initiatives in other regions facing similar challenges.

TRANSFORMASI PRAKTIK AKREDITASI BAN-PDM MALUKU MELALUI PELATIHAN DARING DALAM PENERAPAN INSTRUMEN AKREDITASI TERBARU

The purpose of this community service is to enhance the capacity of BAN-PDM assessors in Maluku Province through online training on the 2024 Accreditation Instrument. This training aims to deepen assessors' understanding of key aspects of educational accreditation, such as school climate, principal leadership, the role of educators, and the learning process. By integrating online methods, it is expected that this training can address the geographical challenges in the Maluku archipelago and improve the quality of educational accreditation in the region. The results of this training show that online methods are effective in enhancing assessors' understanding of the latest accreditation instruments. Despite facing technical challenges and connectivity limitations, participants demonstrated a significant increase in their understanding and skills related to educational accreditation. The evaluation of the training results indicates that assessors can effectively apply new knowledge in their accreditation practices, making a positive contribution to improving the quality of education in Maluku Province.

The influence of natural factors on poverty in West Halmahera

Poverty remains one of the persistent social issues faced by governments in many regions, including coastal and small island communities. The poverty experienced in these areas is driven by a combination of natural, social, and economic factors. Dynamic environmental conditions, such as seasonal changes, extreme weather, wide geographic dispersion between sea and land, isolation due to limited accessibility, and vulnerability to natural disasters, often trap coastal populations in a cycle of poverty. Data from West Halmahera Regency indicates that poverty levels have shown little improvement up until 2023. This research focuses on a sample of 390 poor residents from the region, utilizing Confirmatory Factor Analysis (CFA) and Principal Component Regression Analysis (PCRA) to examine the factors affecting poverty. The findings reveal that within the Natural Capital variable (X1), the most significant indicators are the distance from the house to a clean water source (X4), with a coefficient of 0.894, the condition of the water source near the residence (X5), with a coefficient of 0.884, and accessibility to clean water sources (X3), with a coefficient of 0.89. West Halmahera, being a coastal and mountainous region, suffers from an unequal distribution of essential infrastructure, particularly in areas far from the district capital. Clean water infrastructure remains absent in many areas, and even in mountainous regions where water piping exists, geographic challenges hinder functionality. Addressing these issues requires collaboration between local governments, the private sector, universities, and the community. Solutions may include programs that incorporate local wisdom and focus on infrastructure development, sustainable water management, and environmentally friendly practices. Such initiatives could enhance access to clean water, improve the local economy, and ultimately reduce poverty in West Halmahera.

COVID-19 pandemic and food security: Strategic agricultural budget allocation in Indonesia

The COVID-19 pandemic has exposed significant vulnerabilities in Indonesia's food security, highlighting the need for more strategic agricultural budget allocation. This study addresses the issue of inadequate budgeting techniques that fail to effectively support food production and distribution during crises. The primary objective is to develop a tailored framework that optimises budget allocations to strengthen Indonesia's food security in the face of socio-economic and geographical challenges. Using a multi-dimensional research approach, the study involves key stakeholders from the Ministry of Agriculture, the Ministry of Finance, and the Ministry of National Development Planning, employing methods such as in-depth interviews, focus group discussions, and data collection from primary and secondary sources. The research utilises the Analytical Hierarchy Process (AHP) with the Expert Choice 2000 program to systematically evaluate decision-making options. Findings reveal the necessity of a resilient framework that balances short-term emergency responses with long-term strategies, focusing on increasing production capacity, improving seed quality, expanding land availability, and adopting advanced agricultural technologies. The study contributes to the policy landscape by offering a structured agricultural budgeting framework and policy recommendations aimed at mitigating disruptions, enhancing productivity, and supporting sustainable agricultural practices. It also emphasizes the importance of sensitivity analysis in budget planning to inform strategic decisions. The study recommended targeted investments in production capacity, a reevaluation of rice import regulations, and the adoption of innovative technologies to ensure a resilient and sustainable food system in Indonesia.