Grassroots Level Research Articles

Lifestyle practices and associated factors among adults with hypertension: Conquering Hypertension in Vietnam-solutions at the grassroots level study

Lifestyle practices and associated factors among adults with hypertension: Conquering Hypertension in Vietnam-solutions at the grassroots level study

The Influence of Continuance Commitment on Job Satisfaction of Barangay Health Workers in Malaybalay City, Bukidnon

This study examined the influence of organizational commitment on the job satisfaction among Barangay Health Workers (BHWs) in Malaybalay City, Bukidnon, calendar year 2022-2023. A total of 140 BHWs were selected through a simple random sampling. A survey questionnaire from Allen and Meyer (1990), and Taylor and Bowers (1972) were adapted and pilot-tested obtaining a Cronbach’s alpha of 0.838. Descriptive and inferential statistics such as frequency, percentage, mean, standard deviation, Pearson product-moment correlation, and simple linear regression were used to treat the data. Based from the data gathered, the demographic profile of the respondents revealed that majority of BHWs are aged between 31 to 35 years, females, high school graduates, and with a length of service between 11 to 15 years. The findings further showed that BHWs exhibit a remarkably very high level of attachment and commitment to their roles and responsibilities, attributed to their strong motivation, dedication, and passion to serve the community's health needs and very high job satisfaction. In addition, the test of correlation revealed that organizational commitment of BHWs had significant positive relationship with job satisfaction, thus the first null hypothesis was rejected. Meanwhile, the study’s regression analysis exhibited that continuance had a significant impact toward job satisfaction. This implied that they are committed that is why they are satisfied, apart from the norm that employees are satisfied that is why they are committed. This fact highlighted that BHWs feel that they will lose more when they leave their job than they will gain despite their meager honorarium. Hence, this research underscores the importance of fostering and sustaining organizational commitment among BHWs, as it directly influenced their job satisfaction and, ultimately, the quality of healthcare services provided to the community. It is worthy to note that policymakers and healthcare administrators may recognize the significance of these factors in supporting and retaining a dedicated and effective healthcare workforce at the grassroots level.

The Process of Triple Elimination Program Implementation in Antenatal Care Batang Regency: Qualitative Study

Introduction: The Maternal Mortality Rate (MMR) of Batang Regency in 2023 is still high. Many efforts have been made to reduce the mortality of pregnant women and babies born with integrated ANC services, but have not received optimal results. Objective: The purpose of this study is to analyze aspects of the process including planning, organizing, implementing and assessing in the triple elimination program. Methods: The study used qualitative methods with process variables consisting of planning, organizing, implementing and assessing in a triple elimination program. Data collection through in-depth interviews with 8 main informants and 10 triangulation informants. The main informants are Midwives, Coordinators, and Analysts of the triple elimination program in 4 selected Puskesmas. Triangulated informants are selected based on management level. District level to the Head of Kesga and P2P Dinkes Batang, Puskesmas level to 4 selected Puskesmas Heads and grass-root level to 4 mothers who receive integrated ANC service benefits at Puskesmas. The instrument uses an interview guide. Analysis using qualitative descriptive methods. Results: Planning is carried out in stages from the implementation of activities, namely the integrated ANC team of the Puskesmas by calculating needs. Furthermore, it was discussed with the team and submitted to the Head of the Puskesmas which was then submitted to the District through the Batang Health Office. Organizing is done from the Coordinator Midwife who manages his team. Team management is discussed together and approved by the Head of Puskesmas. Implementation is carried out in accordance with applicable SOPs. The triple elimination assessment is good but there needs to be improvement. Especially in the refusal of triple elimination examination from pregnant women during the implementation of the program. Conclusion: The triple elimination program process in Batang Regency has been good. There needs to be a strategy to invite all pregnant women so that there is no rejection of the triple elimination program.

The psychological impact of the COVID-19 epidemic among healthcare workers at the grassroots level in Vietnam

The COVID-19 pandemic has significantly affected the mental health of healthcare workers (HCWs). Therefore, an immediate priority is to monitor rates of mental health issues to understand related factors and inform interventions. The main purpose of this study was to evaluate the psychological and mental health impact of COVID-19 and some related factors among HCWs at the grassroots level in Vietnam. A cross-sectional study was conducted on 675 HCWs working at health facilities through questionnaires. The finding showed the rate of HCWs who were psychologically affected by the COVID-19 pandemic was 37.2%, of which 64.1% of HCWs were afraid to tell their families about the risk of exposure to COVID-19 at work. The 31.0% of HCWs had difficulty sleeping deeply/insomnia due to the COVID-19 epidemic. No statistically significant differences were found in the psychological impact of COVID-19 between HCW groups by age, gender, seniority, and professional qualifications. Some groups of HCWs were found to have poor psychological health. Our research suggests that during the COVID-19 pandemic, HCWs working in healthcare facilities experienced an increased psychological burden; psychological interventions for those at high risk and with common mental disorders should be included to reduce this burden and protect HCWs' mental health.

Exploring the Interplay of Pastureland Governance Degradation and Livelihood Vulnerability: A Study in Southern Rajasthan, India

Pastureland in Rajasthan has a special significance for a range of reasons. The state has acute adverse biophysical and climatic conditions where income from agriculture is uncertain. As a result, most rural inhabitants make ends meet by raising livestock. This study attempts to understand the biophysical condition, governance of the pastureland, and its impact on the livelihood of the rural poor. It uses an exploratory research design to explore the key drivers of deteriorating pastureland. The study was conducted in 15 villages in southern Rajasthan spread across three districts: Bhilwara, Chittorgarh, and Pratapgarh. To fulfil the study objectives, Focus Group Discussions and individual interviews were conducted with community members and Gram Panchayat (Village Council) officials. The findings depict the dismal picture of pastureland governance at the grassroots level, resulting from multiple factors such as overgrazing, the ineffectiveness of protection rules, and encroachment. The study suggests that appropriate management and protection of the pastureland are urgently needed to sustain the rural community’s livestock and livelihood.

Ethnic Conflict Resolution in Post-Conflict Societies in Bosnia

Purpose: The aim of the study was to analyze ethnic conflict resolution in post-conflict societies in Bosnia. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Studies on ethnic conflict resolution in post-conflict Bosnia emphasize intergroup dialogue, economic development, and transitional justice. Contact initiatives foster trust, while economic empowerment reduces tensions. Truth and reconciliation processes acknowledge past wrongs, and diaspora involvement aids peacebuilding. Unique Contribution to Theory, Practice and Policy: Identity theory, contact theory & structural violence theory may be used to anchor future studies on ethnic conflict resolution in post-conflict societies in Bosnia. Practitioners should prioritize initiatives that promote interethnic dialogue, reconciliation, and community engagement at the grassroots level. Policymakers must prioritize inclusive governance structures that ensure the meaningful participation of all ethnic groups in decision-making processes.

Diagnostic Accuracy of Mid-Upper Arm Circumference for the Detection of Acute Malnutrition Among Children Aged 6-60 Months: A Diagnostic Accuracy Study.

Timely and accurate screening of malnutrition at the community level is essential to identifying malnourished children. The World Health Organization (WHO) guidelines classify non-oedematous acute malnutrition among children using mid-upper arm circumference (MUAC) or weight-for-height Z-score (WHZ). Study Design: A cross-sectional study. This study was conducted among children aged 6‒60 months. After necessary exclusions, 433 participants were selected using a multi-stage simple random sampling method. Using WHO guidelines for global acute malnutrition (GAM) [WHZ<-2, MUAC<12.5 cm], the sensitivity (Se), specificity (Sp), predictive values, likelihood ratios, Youden index, and receiver operating characteristic (ROC) curve were calculated for MUAC using WHZ as the criterion. Out of 433 participants, 30% were diagnosed with GAM using WHZ, while 17.6% were found malnourished using MUAC measurements. As per WHO cut-offs, the Se, Sp, positive predictive value (PPV), negative predictive value (NPV), Youden index, positive likelihood ratio (LR+), and negative likelihood ratio (LR-) of MUAC were 48%, 96%, 83%, 81%, 0.44, 12, and 0.54, respectively. The ROC curve displayed an area under the curve of 0.86 (95% confidence interval=0.83, 0.90) for MUAC<12.5 cm. Bivariate Pearson correlation also demonstrated a positive linear relationship (R2=0.302) between the WHZ and MUAC variables. Based on the findings, 48% of the children were correctly identified by the MUAC with an 83% probability of GAM (PPV=0.83). Moreover, there was 96% Sp in non-malnourished children, with only 4% false positives. Therefore, personnel at the grassroots level can use MUAC for timely and accurate screening of children in Anganwadi centers (AWCs) due to its ease of use and simplicity.

Algorithm Investigation of the Principles of Governance of Interactive Social Psychological Services at the Grassroots Level Based on Emotion Regulation

Algorithm Investigation of the Principles of Governance of Interactive Social Psychological Services at the Grassroots Level Based on Emotion Regulation

#2425 A change in deceased donor allocation policy may provide gender equality in kidney transplantation

Abstract Background and Aims Overcoming gender disparity in access to kidney transplantation is a well-established universal challenge. The SRTR data showed a greater proportion of males than females for kidney transplant waitlists (61% vs 39%). Similarly, of 831 deceased donor kidney transplants (DDKT) conducted between 1997 and 2018 at IKDRC-ITS, 68% have been male and 32% female recipients while majority of donors in living donor kidney transplants (LDKT) were females. Prior to 2020, there duration on transplantation waitlist was the only criteria for deceased donor kidney allocation. In January 2020, SOTTO Gujarat was formed which implements a point system based deceased donor allocation policy including HLA mismatch, Panel Reactive Antibody, Donor Specific Antibody, age and duration on dialysis, amongst others. 2 additional points are allocated to female recipients in this allocation system. The aim is to study the impact of change in DDKT allocation policy on gender disparity. Method This is a retrospective, single-center, observational study. Number of male and female kidney transplant recipients was collected from the medical records held by the department of nephrology between January 2014 to December 2023. The data was categorized as before and after implementation of SOTTO Gujarat guidelines and analyzed. Results A total of 3182 kidney transplants were conducted at our centre over the study period, 2231 were LDKT while only 951 were DDKT. We found the percentage of female LDKT recipients to have remained disproportionately low as compared to male DDKT throughout the study period, while there was a gradually progressive increase in the percentage of female DDKT recipients with almost a doubling of female DDKT recipients from 27.57% in 2019 to 54.19% in 2023. This may be attributed to the compounding effect of allocating points to DSA, PRA, age of patient and gender as female patients tend to have higher PRA and DSA level after sensitization. Conclusion This study provides new insights into steps that can be taken to bridge the gender gap in DDKT. It shows that implementing a point based system for DDKT allocation policy with extra points for female recipients may increase the number of kidney transplants in them. Similar policy may be undertaken by other transplant centers as a bridge to achieve temporary solution till underlying factors leading to gender disparity are better understood and ways to overcome them are formed. Action should be taken to provide for equitable access to females at all stages, from diagnosis to treatment such as intensive and timely counselling. Policies for social empowerment of women must be formed including literacy, better maternal and child healthcare and financial independence. Raising awareness and education at a grassroot level must remain the key component to change public attitude regarding organ donation and ensure equitable access to transplantation for all.

Outcome of Women’s Reservation in Panchayati Raj Institutions in Bihar

Many studies have highlighted the advantages of female leadership in bolstering investment in public infrastructure aimed at enhancing the well-being of women and children, along with fostering the empowerment of women. Building upon this premise, this study aims to examine how political decentralization and female leadership impact social and demographic indicators related to women's empowerment, thereby contributing to the growing body of research on this topic. The focus of this study is on State of Bihar, which is India's third most populous state with approximately 40 percent of the population lives below the poverty line. By analysing data from various rounds of the National Family Health Survey (NFHS), the study finds that empowering local governance and promoting female leadership have led to enhancements in women and child health outcomes, as well as bolstering women's empowerment at the grassroots level in Bihar.

Food Waste and Loss Management - Causes, Effects and Possible Solutions from A Nigeria Context

Food waste and loss present significant challenges globally, with Nigeria being particularly affected. This study comprehensively analyzes the causes, effects, and potential solutions to food waste within the Nigerian context. Drawing on extensive research and secondary data sources, the study highlights the pervasive nature of food waste, focusing on key sectors such as tomato, onion, and chili production. It identifies critical factors contributing to food waste, including inadequate infrastructure, pests and diseases, transportation constraints, and policy gaps. The socioeconomic impacts of food waste, such as increased food prices, exacerbated poverty, and environmental degradation, underscore the urgency of addressing this issue. However, amidst these challenges lie opportunities for intervention. Nigeria can significantly reduce food waste, enhance food security, and promote economic development by implementing a holistic approach that encompasses infrastructure development, sustainable agricultural practices, and supportive policies. Additionally, individual actions, such as meal planning and supporting local farmers, play a crucial role in mitigating food waste at the grassroots level. Through collaborative efforts involving governments, businesses, civil society, and individuals, Nigeria can pave the way towards a more resilient and sustainable food system, ensuring equitable access to nutritious food while preserving the environment for future generations. The methodology employed in this study entailed data collection primarily from prior research and secondary sources such as published studies, newspapers, articles, and relevant materials. The study’s focal point centered on food waste and loss, with a specific focus on vegetable waste within the Nigerian context.

A “twelve-section ultrasonic screening and diagnosis method” and management system for screening and treating neonatal congenital heart disease at the grassroots level in Tang County, Hebei Province, China

BackgroundTo explore a method for screening and diagnosing neonatal congenital heart disease (CHD) applicable to grassroots level, evaluate the prevalence of CHD, and establish a hierarchical management system for CHD screening and treatment at the grassroots level.MethodsA total of 24,253 newborns born in Tang County between January 2016 and December 2020 were consecutively enrolled and screened by trained primary physicians via the “twelve-section ultrasonic screening and diagnosis method” (referred to as the “twelve-section method”). Specialized staff from the CHD Screening and Diagnosis Center of Hebei Children’s Hospital regularly visited the local area for definite diagnosis of CHD in newborns who screened positive. Newborns with CHD were managed according to the hierarchical management system.ResultsThe centre confirmed that, except for 2 newborns with patent ductus arteriosus missed in the diagnosis of ventricular septal defect combined with severe pulmonary hypertension, newborns with other isolated or concomitant simple CHDs were identified at the grassroots level. The sensitivity, specificity and diagnostic coincidence rate of the twelve-section method for screening complex CHD were 92%, 99.6% and 84%, respectively. A total of 301 children with CHD were identified. The overall CHD prevalence was 12.4‰. According to the hierarchical management system, 113 patients with simple CHD recovered spontaneously during local follow-up, 48 patients continued local follow-up, 106 patients were referred to the centre for surgery (including 17 patients with severe CHD and 89 patients with progressive CHD), 1 patient died without surgery, and 8 patients were lost to follow-up. Eighteen patients with complex CHD were directly referred to the centre for surgery, 3 patients died without surgery, and 4 patients were lost to follow-up. Most patients who received early intervention achieved satisfactory results. The mortality rate of CHD was approximately 28.86 per 100,000 children.ConclusionsThe “twelve-section method” is suitable for screening neonatal CHD at the grassroots level. The establishment of a hierarchical management system for CHD screening and treatment is conducive to the scientific management of CHD, which has important clinical and social significance for early detection, early intervention, reduction in mortality and improvement of the prognosis of complex and severe CHDs.

Enhancing energy conservation in power generation in a coal fired thermal power plant through comprehensive energy audit

Current work presents salient insights from energy audit of a 1050 MW thermal power plant by BEE Certified Energy Auditors. It provides insights into grassroot level data instead of relying only on theoretical calculations, unlike previously published literature.Arresting the air leakages in air-preheater has given total saving of 10.72 million kWh/year, saved 398,978.97 kJ/year, thus saving of 25,322.80 MT of coal/year. Upgradation of insulation resulted in total saving of 6632.208 Million kJ/year, i.e. saving of 510 MT/year of coal. Replacing cooling tower blades material proposed saving of 15,242.4 kWh/year. Installation of Variable Speed Drives for pumps provided saving of 274,836 kWh/year. Replacement of old inefficient pumps with energy efficient pumps has saving potential of 739,632 kWh/year. Pressure reduction in compressors has given saving of 344,794 kWh/year.Thus, in total, this energy audit helped to conserve 12.098 Million kWh & 25,832.80 MT coal/year and consequently, 104,243 tCO2/year. Such savings not only help the plant management/decision makers on the monetary front but also identify the avenues for improvement and channelize the resources such time and investment, prudently. Consequently, it has been established that energy audit is a pragmatic tool to achieve energy conservation at grassroot level.

Trigger mechanism centralized but discursive frame fragmented: China as a case for studying populism at the grassroots level in the social media age

ABSTRACT While most research focuses on top-down populism practiced by political actors in democratic countries, we paid attention to populist phenomena at the grassroots level in an authoritarian context. Specifically, we proposed a perspective of investigating populist discourse embedded in public opinion and adopted a fine-grained discursive frame approach to study Chinese online populism. Using large-scale social media data around trending events and employing cutting-edge computational semantic analysis methods, we discovered that economic anxiety is central to the trigger mechanism of Chinese online populism, and the specific populist discourse is fragmented in terms of ideological resources, cultural toolboxes, and semantic structure. This study not only provides a more comprehensive understanding of contemporary Chinese populism phenomena, but it also contributes to global populism research by providing valuable empirical evidence in authoritarian contexts and broadening the theoretical perspective of studying populism at the grassroots level.

Diversification of Eco-Friendly Batik Craft Products with Export Potential

The Laweyan Surakarta batik industry center has more than 100 developing batik IKMs. The existence of the Laweyan Surakarta batik IKM has contributed greatly to the revival of the batik industry in Surakarta after experiencing a downturn due to the pandemic. However, the presence of batik artisans in the Laweyan area of Surakarta has not been optimally accommodated, coupled with the conditions of the Covid-19 pandemic, leading to an 80% decline in the batik trade. The Indonesian Batik Craftsmen and Entrepreneurs Association (APPBI) is still unable to reach all artisans at the grassroots level. Therefore, batik artisans require guidance to maximize their potential in discovering new innovations related to batik handicraft products. The participatory collaborative approach between craft actors (IKM) and educational institutions is expected to increase the bargaining power of batik artisans. The developed batik craft products are still based on local cultural values and strive to improve product quality by adhering to SNI standards. The participatory collaboration model places artisans as actors and educational institutions as partners. This study aims to develop a diversification model for Laweyan Surakarta batik products through a participatory collaborative approach involving educational institutions and batik craft centers to strengthen export potential. This study employs the development research model from Borg and Gall and Mc Kenny’s development research, which is then modified into 2 steps. The two steps include (1) the preliminary study stage as a need and contents analysis. Keywords: diversification, batik, Laweyan, export potential

Latvia: Political Developments and Data in 2023

AbstractThe elections of the state president by the Latvian Parliament brought about not only a new Cabinet and a new prime minister but also a new coalition and an advancement of the social liberal agenda, including the legal regulation of same‐sex partnership. The new Cabinet continued a strongly supportive Ukraine policy aided by de‐Russification efforts at the grassroots level. The left‐leaning Progressives became part of the governing coalition for the first time, but their impact on government policies remains to be seen.

Implication of Institutional Frameworks Governing Land Tenure Security in Social-Economic Dynamics: Experience from Iringa District in Tanzania

Purpose: The study aimed to examine the implication of institutional frameworks governing land tenure security in socioeconomic dynamics in the Iringa district. The study used the case of the Iringa district to investigate the institutional framework that provides implications for the governance of land tenure security in Tanzania. Methodology: The study employed phenomenography by collecting primary data from 16 key informants selected from village and district levels. Data from key informants were complemented by documentary review with perception considered deductively. Findings: Findings confirmed the existence of two principal institutional frameworks; the Land Act No. 5 of 1999 and the Village Land Act No. 4 of 1999. Nonetheless, bureaucracy, inadequate policy dissemination, and poverty emerged as primary causes of deviations in land policy implementation in the study area. This study concludes that the successful implementation of Tanzania's land policy in the Iringa District Council has significantly facilitated land tenure security through the issuance of a Certificate of Customary Right of Occupancy. Establishing a robust institutional framework and clear land use rules has been central to this success. However, challenges such as complex Certificate of Customary Right of Occupancy acquisition procedures, bureaucracy, inadequate policy dissemination, and prevalent poverty in rural areas have been identified as impediments. Unique Contribution to Theory, Practice and Policy: The study was guided by Institutional Theory which describes the interaction of human beings with existing natural resources, the institution involves the regulation of formal rules from constitutions, status laws, and other legal frameworks controlling the interaction and relationship of human behavior. The study contributed to the theory by establishing the relationship between the organization and enforcement of policy and regulatory framework that governs land tenure. Also, the study recommends expanding the Certificate of Customary Right of Occupancy issuance, strengthening local land administration, simplifying land use regulations, facilitating easier access to Certificate of Customary Right of Occupancy especially for impoverished households, and implementing strategies to reduce bureaucracy and enhancing policy understanding at the grassroots level. These measures aim to enhance land tenure security and support sustainable development in rural communities.

Social Audit: A Key Enabler for Enhancing Outcomes of Social Projects

The focus on sustainable development encompassing dimensions of inclusive and equitable growth is driving the catalytic role of Civil Society Organizations the world over. As these organizations operate at the grass root level, they are able to plan and execute relevant and contextual social projects and programs for bringing about a desirable and positive change in society.A social audit is a procedure used to assess, document, and enhance an organization's behaviour and performance as well as gauge its impact on society.It can be conducted internally or externally and looks at how a certain program, project, or organization is affecting society. To put it briefly, social audits assist businesses in striking a balance between social duty and profits.

Knowledge and Attitude of Homeopathy Doctors Attending the Modern Pharmacology Bridge Course toward Psychiatry – A Cross-sectional Study

Aim: The aim of the study is to assess the knowledge and attitude of homeopathy doctors attending modern pharmacology course toward psychiatry. This is the first ever course approved by the state government of Maharashtra in India for registered homeopathy practitioners. We have considered them as our study group because they work at a grassroots level and are the first level of contact between the individual and the health system. Methodology: One hundred subjects were included in the study. A semi-structured questionnaire was used to assess their knowledge and attitude toward psychiatry. Informed consent was obtained from all the participants. Results: Of the 48 participants included in the study, most belonged to ages 44–53 years, with 83.4% of males. All had completed a degree before 2000 AD with about 50% of the sample having completed a bachelor’s degree. Of these, 74.5% had more than 20 years of homeopathic practice. Based on the Attitudes Toward Psychiatry-30 questionnaire, majority of the sample had a negative attitude toward psychiatry. Conclusion: Most of the traditional homeopathy doctors carry a negative or neutral attitude toward the field of psychiatry and its therapeutic interventions.

LEADER and rural development policy - What's the problem represented to be?

This article problematizes the EU Programme LEADER as a policy to improve opportunities to live and thrive in rural areas. LEADER was initiated in 1991 as a Commission initiative and has, over time, expanded and become an institutionalized public policy in the EU. LEADER is based on a particular development method - the LEADER method - which sets out fundamental principles for conducting development work. The idea is that rural development should start with Local Action Groups at the grassroots level, emphasizing networking and entrepreneurship within a geographic context. Drawing on Bacchi's methodology, What's the problem represented to be, the article aims to examine the LEADER Programme and analyze problem representations and political rationalities. The analysis shows that actors working within LEADER have developed political rationalities that partly constitute obstacles to achieving long-term impacts. It concerns issues related to the bureaucratic framework of LEADER and representations on a fixation on producing added values, an internal logic of project administration, and an emphasis highlighting the role of the individual entrepreneur. The LEADER Programme has not only been institutionalized as part of the EU and member states' administrative systems. Still, it has also created its ideological superstructure consisting of a specific narrative, methodology, language, and common forms of organizing. This gives LEADER advantages but also risks associated with internal closedness that creates subjectification between ‘them and us' and produces lived effects that hinder structural changes promoting rural areas.