Major Settlement Research Articles

Understanding the presence of Cannabis across the Holocene in Central India

Pollen records from sediment cores do not allow understanding of past human use of Cannabis because Cannabis may also grow naturally or increase incidentally in the presence of human settlements. This was particularly true in Asia, where Cannabis was not used as hemp as often as it was in Europe; hemp retting makes it easy to identify Cannabis use as it causes characteristically high increases in Cannabis fossil pollen in strata where it was used. In this study, we evaluate the evidence for Cannabis cultivation and use in Central India, where Cannabis fossil pollen occur in sediment cores from ~ 12.2 ka (1 ka= 1000y ago). While the public perception is that Cannabis has a long history of use in South Asia, textual sources suggest significant increases in Cannabis use ~1-2 ka. To disentangle Cannabis presence due to natural dispersal and due to use, we develop a new approach. Artemisia grows alongside Cannabis and disperses in similar conditions, whether naturally or due to increase in human settlements. We investigate when Cannabis increased in the paleo-record independent of Artemisia and find that Cannabis increased ~ 2.5 ka in areas close to major early historic settlements, where Cannabis displays characteristic patterns of cultivation. Cannabis does not display these patterns away from the early historic settlements. These dates are similar to findings of Cannabis use as hemp in the Himalayas (2.5 ka) and as a drug in China (2.7 ka), but pre-date the proliferation of Cannabis presence in textual sources. Overall, Cannabis pollen presence in pre-historic India (<2.5 ka), although common, is likely to be because of natural dispersal of Cannabis.

원삼국~백제 한성기 취락의 저장 양상 변화

In the process of state formation, storage methods can change according to political, economic, and social transformations. This study aims to identify such changes in storage methods, storage amounts, and stored crops by comparing and analyzing various types of archaeological evidence, such as crop remains, pottery, storage pits, and above-ground structures from sites of the central region of the Korean Peninsula dating the Proto-Three Kingdoms to Baekje’s Hanseong period. The results of the analysis revealed that, in the Gyeonggi region, the tendency to store crops indoors was weakened by the Hanseong period. However, in major settlements, this tendency persisted, and the use of external storage facilities increased, with rice becom-ing a significant crop for external storage. In the Yeongseo region, the change in indoor storage methods was not as distinct as in the Gyeonggi region, but there was a noticeable change in external storage patterns. Overall, the use of deep storage pits increased, new storage crops were added, and the use of external storage facilities increased somewhat in the Namhan River basin. Analyzing the reasons for these changes based on contemporary contexts, it was found that both the Gyeonggi and Yeongseo regions were influenced by changes in agricultural production methods. In the case of the Gyeonggi region, the in-creased complexity of society, such as the intensification of social stratification and the dif-ferentiation of site functions, also influenced storage strategies.

Temporal dynamics of land use land cover (LULC) changes and assessment of environmental and climatic parameters using remote sensing and GIS: A case study in Limboti Reservoir, Loha Taluka, Maharashtra, India

In this study, multispectral satellite data from Landsat 4-5 TM and Landsat 8 OLI/TIRS was used to analyse Land Use Land Cover (LULC) change detection and to retrieve environmental parameters. The LULC change detection was done between 2007 and 2021. This study used the supervised classification-maximum likelihood approach in ArcGIS 10.3 software to detect LULC in Loha Taluka, Maharashtra. The taluka was classified into four major LULC classes, viz. water, vegetation, settlement and barren-land. Changes in LULC directly or indirectly will also induce a change in the environmental parameters. Environmental parameters (water surface temperature, chlorophyll-a concentration and total suspended solids) were analysed for Limboti Reservoir. Data were predicted for next two years (2022 and 2023) using multiplicative seasonal decomposition and Holt-Winter’s multiplicative method and trends of each parameter were analysed using Mann-Kendall trend method. For both years, vegetative land was the most extensive LC in Loha Taluka, accounting for more than 60% of the total land area. However, throughout these years, urbanisation was rampant and vegetative land was converted to settlement. In these years, open water resources such as reservoirs, lakes and rivers covered a very small percentage of the total area, which is a serious threat to the ecosystem. As a result, proper water body management is essential; otherwise, these resources will be destroyed and will no longer be able to contribute to the area’s socioeconomic growth. Keywords: Change detection, Chlorophyll content, Land use land cover, Water quality, Water surface temperature

Posh Anthroponyms in Northern Bulgaria

This study focuses on the most recent trends in the name-giving process among the Bulgarians, citizens of the Northern part of the country, specifically the major settlements in the area including Pleven, Veliko Tarnovo, Ruse, and Varna, over a ten-year research period (2008 – 2018).

Physicochemical Analysis of Surface Water in Rohri Canal from Sukkur Barrage to Mehrabpur

The purpose of this study was to assess the effect of domestic and industrial waste discharge on the surface water quality of Rohri Canal in the stretch of the canal from Sukkur Barrage to Mehrabpur town. Eight sampling points were selected along the canal focusing on canal locations near major settlements. The parameters studied were temperature, pH, turbidity, hardness, alkalinity, total dissolved solids and suspended solids, chlorides, biochemical oxygen demand (BOD), chemical oxygen demand (COD) and E-coli. The average value of BOD and COD at the sampling stations were recorded as 212 mg/L and 423 mg/L respectively, which exceed the permissible surface water limits for drinking and irrigation purposes. The results indicate significantly higher value of BOD in sampling locations where there are major settlements and there is a continuous inflow of untreated sewage into the canal. The pH values at all the sampling sites were found within the drinking and irrigation water quality standards whereas the TDS values at only sampling stations (3 and 4) exceeded these limits. The turbidity values of the samples ranged from 237 to 821 NTU, exceeding the WHO drinking water quality standards for this parameter. The values of the water quality parameters including hardness (range 146 to 300 mg/L), chlorides (range 36 to 103 mg/L) and alkalinity (range 120 to 230 mg/L) were found well below the limits of WHO drinking water quality standards. The turbidity values of the samples ranged from 237 to 821 NTU and exceeded the WHO drinking water quality standards for this parameter. At all the sampling sites located near major settlements low levels of dissolved oxygen and the presence of E.coli were recorded. The results revealed that the continuous inflowing of untreated or un-treated sewage and industrial effluents into the canal has changed its physicochemical and biological characteristics, which make it unfit for human consumption and can have long-term irrevocable ecological threats if left unmanaged

Analyzing coastal erosion and sedimentation using Sentinel-1 SAR change detection: An application on the Volta Delta, Ghana

Ghana's coastline has been facing erosion and sedimentation phenomena for several decades, resulting in a serious threat to life and property considering that major urban settlements are located on the coast. In this region, there has been a lack of emphasis on comprehensive, large-scale investigations into coastal changes: prior research has predominantly centered on site-specific assessments. These studies have revealed alarming erosion rates, with reports indicating that nearly ten meters are lost annually. The use of high-resolution remotely sensed data can be a consistent support in regions where physical or economic obstacles interfere with collecting in situ information. In particular, the use of continuous all-weather SAR data may facilitate the evaluation of erosion and sedimentation phenomena in coastal areas. In this paper, we apply SAR data over a time period between 2017 and 2021. Sentinel-1 data are pre-processed using the Google Earth Engine platform, and a dedicated algorithm is then applied to identify and quantify erosion and sedimentation processes. Optical images are used as a reference for detecting the location of two areas where consistent sedimentation and erosion phenomena occurred in the considered four years. The results demonstrate that SAR backscattering variations over time offer a reliable method for monitoring coastal changes. This approach enables the identification of the type of phenomena occurring - sedimentation or erosion -, and allows for the quantification of their intensity and dimensions over time. The method can be worldwide applied once the appropriate thresholds are evaluated and help in predictive studies and environmental planning.

Physical Modeling of a Soft Soil Improved with Stone Columns

Abstract This paper reports on an experimental study conducted on a soft cohesive soil improved with stone columns. The load–deformation behavior of the soil specimen has been captured by varying the number of columns, foundation shape, and stones’ particle gradation. A uniform soil bed has been prepared under controlled density and moisture conditions inside a cubic steel tank and stone columns have been installed. Keeping the vertical compressive load, length, and diameter of stone columns constant, five different stone sizes of uniform gradations having average particle sizes ranging between 1.5 and 11 mm have been examined. Load tests are performed using square- and circular-shaped footing plates, and the physical models have been subsequently simulated using the finite element method. The analysis of results revealed that the foundation shape has insignificant effect on current small-scale model testing, but it may be significant at magnified scale. With the increase in particle size, a better reduction in settlement could be achieved, thus implying better improvement. Observed results indicated settlement of a single column is governed by both punching and bulging of column, whereas in a group, the major settlement takes place because of punching into the soil. Nevertheless, this study provides verified and comprehensive frameworks for both physical and numerical model testing of different soils improved with stone columns that would directly benefit practitioners to optimize a site-specific soil improvement program involving the use of stone columns.

Re-thinking Chalcolithic landscapes in southeast Iberia: the case of the Middle Antas river (Almeria, Spain)

Our understanding of Chalcolithic settlements in southern Iberia (c. 3200–2200 bce) has changed dramatically in recent decades. Instead of clearly bounded and dense settlements, archaeology is establishing a range of site types, some sparsely settled, some quite large. Such varied settlement typology is now understood as being part of a thriving period of development, which included monumental tombs, high-quality craft organisation and highly dynamic exchange networks. This article presents recent work around the River Antas in Almeria, Spain, which has revealed a complex settlement network along the river for the period in question. This new evidence challenges our understanding of prehistoric habitation in the area and poses new questions about major settlement pattern changes in the prehistory of the region.

Small villages and their sanitary infrastructure—an unnoticed influence on water quantity and a threat to water quality in headwater catchments

In rural catchments, villages often feature their own, separate urban water infrastructure, including combined sewer overflows (CSOs) or wastewater treatment plants (WWTPs). These point sources affect the water quantity and quality of the receiving low order streams. However, the extent of this impact is rarely monitored. We installed discharge and water quality measurements at the outlet of two small, neighbouring headwater catchments, one that includes a village, a WWTP, and two CSOs, while the other is predominantly influenced by agricultural activities. We also deployed electrical conductivity (EC) loggers at the CSOs to accurately detect discharge times. Discharge from the WWTP and CSOs led to higher peak flows and runoff coefficients during events. Less dilution of EC and increasing ammonium-N (NH4 − N) and ortho-phosphorus (oPO4 − P) concentrations indicate a significant contribution of poorly treated wastewater from the WWTP. During CSO events, water volumes and nutrient loads were clearly elevated, although concentrations were diluted, except for nitrite-N (NO2 − N) and particulate phosphorus (PP). Baseflow nitrate-N (NO3 − N) concentrations were diluted by the WWTP effluent, which led to considerably lower concentrations compared to the more agriculturally influenced stream. Concentrations of oPO4 − P, NH4 − N, and NO2 − N, which are most likely to originate from the WWTP, vary throughout the year but are always elevated. Our study shows the major and variable impact rural settlements can have on stream hydrology and water quality. Point sources should be monitored more closely to better understand the interaction of natural catchment responses and effects caused by sanitary infrastructure.

A combined approach to reconstructing livestock management in Iron Age north-eastern Iberia: estimating the season of death and palaeodiet using cementochronology and dental micro- and mesowear analyses

Two major settlements were established in the Empordà region (north-eastern Iberian Peninsula) in the Iron Age (6th-2nd centuries BC), 15 km from each other: the Greek colony of Empúries and the Iberian city of Ullastret. This coexistence of two different ethnic entities in the same region – and the same environment – presents an opportunity to shed light on the variability of livestock practices in these settlements, as well as their relationship with the environment. For this purpose, in addition to traditional zooarchaeological approaches, we reconstructed the animal palaeodiet and seasonality of death using three different proxies: dental meso- and microwear analyses, and cementum analysis. The results of the study, conducted on caprine and bovine teeth from both sites, support the hypothesis proposed in previous works, namely that the environment was exploited differently depending on livestock species. Caprinae (sheep and goats) were fed in marginal areas and less suitable areas for agriculture while, in contrast, cattle grazed on rich grassland and/or in wetland areas. The combination of cementochronology and dental microwear suggests a lower consumption of grasses in summer for Caprinae and cattle. Seasonality results show that Caprinae were mainly slaughtered during spring and summer.

The Initial Upper Paleolithic of the Altai: New radiocarbon determinations for the Kara-Bom site

The Initial Upper Paleolithic (IUP) is one of the most important phases in the recent period of the evolution of humans. During a narrow period in the first half of Marine Isotope Stage 3 laminar industries, accompanied by developed symbolism and specific blade technology, emerged over a vast area, replacing different variants of the Middle Paleolithic. In western Eurasia, the earliest appearance of IUP technology is seen at the Boker Tachtit site, dated ca. 50 ka cal BP. The earliest evidence of IUP industries in the Balkans and Central Europe, linked to the spread of Homo sapiens, has been dated to around 48 ka cal BP. A key area of IUP dispersals are the mountains and piedmont of southern Siberia and eastern Central Asia. One of the reference assemblages here is Kara-Bom, an open-air site in the Siberian Altai. Three major settlement phases are distinguished in the sediment sequence. In this paper, we present the results of new radiocarbon determinations and Bayesian models. We find that the latest phase of the IUP, Upper Paleolithic 1 (‘UP1’) is bracketed between 43 and 35 ka cal BP (at 95.4% probability). The earliest IUP phase, ‘UP2’, begins to accumulate from ca. 49 ka cal BP and ends by ca. 45 ka cal BP. The Middle Paleolithic ‘MP2’ assemblages all fall prior to 50 ka cal BP. We can detect a spatial distribution of dates from the geographic core of the IUP beyond the Altai where it appears around 47–45 ka cal BP. The current distribution of dates suggests a west–east dispersal of the IUP technocomplex along the mountain belts of Central Asia and South Siberia.

Distribution of Heavy Metals in Water and Bottom Sediments in the Basin of Lake Gusinoe (Russia): Ecological Risk Assessment

Fresh water scarcity is considered a significant component, and potentially one of the most critical, of global climate change. With the rapid development of industry, there is an increasing risk of freshwater contamination by heavy metals (HMs). The danger of HM pollution is also attributed to their accumulation, which can subsequently become a source of secondary pollution in aquatic environments. In the Lake Gusinoe basin, located in Russia, concentrations of HMs were measured in both water and bottom sediments within the lake area, as well as in inflowing and outflowing watercourses. Ecological risk indices were also calculated for the Gusinoe basin. Our results showed that the average concentrations of Fe, Zn, Cr, Ni, Cd, and Pb in the water did not exceed the maximum allowable concentrations (MACs) set by Russian national standards and WHO standards, while the concentrations of Mn and Cu exceeded the corresponding MACs during winter, spring, and autumn possibly due to decomposition of aquatic vegetation and influx from groundwater sources. The average concentrations of the investigated HMs in the BSs did not exceed the background values. The water hazard index indicated a low risk for all samples in the lake water area. For all BS samples, the geoaccumulation index (Igeo) and the Pollution Load Index (PLI) indicated low pollution levels, while the values of the Enrichment Factor (EF) and the Contamination Factor (CF) indicated moderate pollution in the central part of the lake. The Ecological Risk Factor (Er) for Cu in BSs at points near major settlements and in the Tel River indicated moderate pollution. The Potential Ecological Risk Index (RI) in all investigated BS samples indicated a low risk of contamination.

Perceptions underlying road safety behaviours of drivers in urban Ghana – a health-belief and planned behaviour perspective

PurposeThe study aims to examine social-psychological beliefs and personality traits and their linkage with driver predispositions and road safety behaviour grounded on notions derived from an integration of the health belief model (HBM) and the theory of planned behaviour (TPB) in social marketing.Design/methodology/approachThe study used a cross-sectional survey to gather data from 587 licenced drivers in 3 major urban settlements in Ghana. The theoretical model was tested by using covariance-based structural equation modelling.FindingsThe study finds that the effects of perceived benefits, perceived behavioural control, social norms and cues to action on road safety behaviour are direct; the effects of perceived susceptibility, severity and barriers on road safety behaviour are fully mediated by driver attitude towards safe driving. Some of these effects were moderated by conscientiousness and neuroticism.Practical implicationsThe findings offer empirical grounds for the development of evidence-based social marketing interventions that leverage efficacy-centred messages, social influence through community-based approaches, informational cues with consistent education and are tailored to the personality traits of drivers with the aim of inducing wilful on-road safety behaviour towards achieving sustainable road safety culture.Originality/valueThis study extends the integrative applicability of the HBM and TPB in understanding road safety behaviour and establishes attitude as a vital facilitator, and personality traits as moderators of the belief-preventive behaviour linkage within a developing country context. It contributes towards the use of theory-based outcomes to enhance the efficacy of social marketing road safety campaigns.

Population-Level Risk Factors Related to Measles Case Fatality: A Conceptual Framework Based on Expert Consultation and Literature Review.

A better understanding of population-level factors related to measles case fatality is needed to estimate measles mortality burden and impact of interventions such as vaccination. This study aimed to develop a conceptual framework of mechanisms associated with measles case fatality ratios (CFRs) and assess the scope of evidence available for related indicators. Using expert consultation, we developed a conceptual framework of mechanisms associated with measles CFR and identified population-level indicators potentially associated with each mechanism. We conducted a literature review by searching PubMed on 31 October 2021 to determine the scope of evidence for the expert-identified indicators. Studies were included if they contained evidence of an association between an indicator and CFR and were excluded if they were from non-human studies or reported non-original data. Included studies were assessed for study quality. Expert consultation identified five mechanisms in a conceptual framework of factors related to measles CFR. We identified 3772 studies for review and found 49 studies showing at least one significant association with CFR for 15 indicators (average household size, educational attainment, first- and second-dose coverage of measles-containing vaccine, human immunodeficiency virus prevalence, level of health care available, stunting prevalence, surrounding conflict, travel time to major city or settlement, travel time to nearest health care facility, under-five mortality rate, underweight prevalence, vitamin A deficiency prevalence, vitamin A treatment, and general malnutrition) and only non-significant associations for five indicators (antibiotic use for measles-related pneumonia, malaria prevalence, percent living in urban settings, pneumococcal conjugate vaccination coverage, vitamin A supplementation). Our study used expert consultation and a literature review to provide additional insights and a summary of the available evidence of these underlying mechanisms and indicators that could inform future measles CFR estimations.

Mapping spatial patterning of Bronze Age towers in Oman according to water flow accumulation

AbstractWater played an undeniably significant role in the origins of complex societies across the Near East, but political complexity in regions like Southeast Arabia diverges dramatically from the more well‐known histories of Egypt, the Levant and Mesopotamia. Through quantitative analysis, this paper investigates spatial associations between water availability and Umm an‐Nar towers in Adh Dhahirah Governorate of Oman. We hypothesise that ancient Umm an‐Nar people targeted high water flow accumulation areas for major settlements with towers. Our results lead us to reject the null hypothesis of no spatial association between tower settlements and water and help clarify the role of water in the rise of complex polities.

Drivers of household antibiotic use in urban informal settlements in Northern Ghana: Implications for antimicrobial resistance control.

Urban informal settlements have been described as the epicenters of frequent antibiotic misuse, which has local and global consequences on the goals of antimicrobial stewardship. The aim of this study was to assess the relationship between knowledge, attitude, and practices of antibiotic use among households in urban informal settlements in the Tamale metropolis of Ghana. This study was a prospective cross-sectional survey of the two major informal settlements in the Tamale metropolis, namely Dungu-Asawaba and Moshie Zongo. In all, 660 households were randomly selected for this study. Households with an adult and at least a child under 5 years old were randomly chosen. An adult with knowledge of household healthcare practices was selected to respond to a structured questionnaire. In all, 291 (44.1%) of the 660 households reported taking at least one type of antibiotic within the last month before the study and 30.9% (204/660) had used antibiotics without a prescription. Information on which antibiotics to use was obtained mostly from friends/family members 50 (24.5%) and were commonly purchased from a medical store or a pharmacy 84 (41.2%), saved up from a previously used antibiotic 46 (22.5%), a friend/family members 38 (18.6%), and drug hawkers 30 (14.7%). Amoxicillin 95 (26.0%) was the most frequently used antibiotic and the commonest indication for antibiotics use was diarrhea 136 (37.9%). Female respondents (odds ratio [OR] = 3.07; 95% confidence interval [CI] = 2.199-4.301; p < 0.0001), larger households (OR = 2.02; 95% CI = 1.337-3.117; p = 0.0011) and those with highermonthly household income (OR = 3.39; 95% CI = 1.945-5.816; p < 0.0001) were more likely to have good knowledge of appropriate antibiotic use and antibiotic resistance. Furthermore, bad attitudes influenced participants' use of antibiotics without prescription (OR = 2.41; 95% CI = 0.432-4.05; p = 0.0009). This study exposes the drivers of inappropriate use of antibiotics at the household level, particularly in urban informal settlements. Policy interventions aimed at controlling the indiscriminate use of antibiotics in such settlements could improve the responsible use of antibiotics. Keywords: antibiotic resistance, informal settlements, Tamale, Ghana.

Economic Empowerment and Collaboration of Urban Slum Arrangement: Review the Kotaku Program in Kendari City

Purpose: Evaluating the slum handling program, slum typology, and factors that are challenges (gaps) for socio-economic empowerment in participatory handling of slums. Theoretical framework: Focus on several theories and concepts about slum settlements, criteria for slum houses, typologies, and empowerment. The subject matter is built from the results of research gaps, phenomena, and empiricism so as to give rise to research positions and novelty. Design/methodology/approach: This research uses a qualitative approach. Involved 38 key informants, and 53,066 households observed in determining the typology (non-informants). Data were obtained through in-depth interviews, observation, and FGD. Data credibility with data source triangulation techniques. Findings: Finding a gap between program objectives and the decline in slum settlements, where the implementation program is running well but the area of slum settlements has actually increased. The majority of settlements (typology) are in the category of "heavy slums and light slums". There are five targets for program empowerment, only one namely collaboration is considered good, while others (institutional aspects, human resources, business development, and environmental development) are not good. Research, Practical &amp; Social implications: Reviewing the criteria for poor households, and techniques for determining areas (slums). Next is the Central Government through the relevant ministries to review the database of budget allocations and other processes for determining the amount of funding allocations so as to avoid data manipulation to obtain additional allocations of funds to the regions. Originality/value: Disclosure is factual with a qualitative approach to participation.

VETTONIA PROJECT: A VIRTUAL ENVIRONMENT FOR THE EDUCATIONAL DISSEMINATION OF THE IRON AGE

Abstract. The VETTONIA project aims to disseminate the rich heritage from the Iron Age of the western Iberian Peninsula and the archaeological investigations carried out on this topic in recent years. The project utilizes new technologies such as virtual tours, 3D models, and impressions to create interactive and stimulating ways to access the results of the most recent archaeological research. Using these resources, lectures and seminars are being given in various forums with diverse types of audiences to present the virtual tours and the rest of the dissemination initiatives. In addition, the project presents its different initiatives during the annual archaeological interventions developed in the oppidum of Ulaca (Solosancho, Ávila, Spain), with good reception by the attending public. The VETTONIA project represents a pioneering dissemination experience that takes advantage of the educational opportunities offered by new technologies. In the future, tools such as virtual tours to archaeological sites may prove essential in classroom teaching at different levels and could promote sustainable tourism in fragile natural environments such as those that constitute the major settlements of the Late Iron Age (ca. 400–50 BC).

The location of a railway station and its impact on urban planning in colonial Lahore 1846–1947

ABSTRACT In the nineteenth century, the impact of railways on urbanization was significant, despite initial predictions that its role would be limited to transportation. The presence of a railway station had impacted the urban fabric of Lahore during the colonial rule. It was the first purpose-built building by the British and it started the new era of urban expansion. Eventually, railway development turned out to be the fourth major settlement of Lahore. The objective of this paper is to highlight the contribution of railways in shaping the form and growth of Lahore. The methodology employed for this study consisted of collecting both primary and secondary data, followed by a comparative analysis of the urban context of pre-colonial Lahore and its development post the introduction of railways in the city.

Is the neglected tropical disease mass drug administration campaign approach an effective strategy to deliver universal health coverage? A case study of the Liberia neglected tropical disease programme.

Access to affordable, quality healthcare is the key element of universal health coverage (UHC). This study examines the effectiveness of the neglected tropical disease (NTD) mass drug administration (MDA) campaign approach as a means to deliver UHC, using the example of the Liberia national programme. We first mapped the location of 3195 communities from the 2019 national MDA treatment data reporting record of Liberia. The association between coverage for onchocerciasis and lymphatic filariasis treatment achieved in these communities was then explored using a binomial geo-additive model. This model employed three key determinants for community 'remoteness': population density and the modelled travel time of communities to their supporting health facility and to their nearest major settlement. Maps produced highlight a small number of clusters of low treatment coverage in Liberia. Statistical analysis suggests there is a complex relationship between treatment coverage and geographic location. We accept the MDA campaign approach is a valid mechanism to reach geographically marginal communities and, as such, has the potential to deliver UHC. We recognise there are specific limitations requiring further study.