Regulatory Officials Research Articles

Development, Evaluation, and Initial Findings of New York State Department of Health Community Drug Checking Pilot Programs.

The illicit drug landscape in the United States is dynamic, featuring a risky and erratic drug supply. Drug checking programs (DCP) have been successfully implemented and studied extensively in Canada and Europe but are scarce in the United States. Integrating DCP at harm reduction programs provides an opportunity to engage people at the point-of-care and deliver a combination of harm reduction services, access to healthcare services, and linkages to treatment. The New York State Department of Health (NYSDOH) developed and supports operation of 8 pilot community DCP sites throughout the state. The DCP were trained to utilize Fourier-transform infrared spectroscopy (FTIR) technology to deliver real-time results to participants. The NYSDOH community DCP pilot began development in 2022. Partnerships were formed across multiple domains including other DCP, universities, forensic laboratories, syringe service and harm reduction programs, and legal and regulatory offices within the NYSDOH. The first pilot sites began operating in mid-2023 and program expansion is on-going. Evaluation staff were extensively engaged in development and implementation phases. Qualitative evaluation focused on barriers, facilitators, and lessons learned from program staff and technicians. Quantitative evidence was gathered to assess the reach of the DCP and accuracy of results attained by drug checking technicians during their training periods. Drug checking results helped characterize the illicit drug supply. Development and implementation of DCP in NYS was facilitated by strong partnerships across sectors including public health and harm reduction. DCP may involve diverse partners who do not regularly collaborate, and health departments are positioned to build relationships and convene partners for program implementation. Evaluation findings highlight the importance of facilitating on-going training and technical assistance to DCP for quality assurance. The initial successes and lessons learned from the NYSDOH DCP demonstrate state public health departments' ability to successfully deploy this innovative harm reduction strategy.

Drug Dispensation by ‘Signature Pharmacists’ in South Asia

The phenomenon of ‘signature pharmacists’ in South Asia has allowed allopathic prescription medication to be dispensed without the necessary medical knowledge, specifically of drug interactions, dosages and side effects. This practice, in which qualified pharmacists delegate their professional inputs to often unqualified and unsupervised sales staff, persists due to complicity among pharmacists, other healthcare professionals and regulatory officials. The article discusses the extent of this significant risk to public health in South Asia and argues that pharmacy enforcement and education standards should be reformed to address these huge challenges to ensure consumer protection and the general public’s welfare. While the advice is that regulatory authorities should intensify their supervision and inspection efforts to ensure registered pharmacists actively participate in regular pharmacy operations, the article also identifies predicaments related to corruption that are difficult to tackle.

Navigating illegal land use in the quest for a just energy transition

Illegal land use inhibits available land for renewable resource development and hinders a just energy transition, posing a significant challenge to sustainability. This article utilizes the TOE (Technology, Organization, Environment) framework to examine the impact of under-regulation on illegal land use in China. By employing a multidisciplinary approach, the study navigates the complexities of unscrupulous land practices and uncovers their socio-economic and environmental implications. Findings from panel data analysis covering the period of 1999 to 2009 reveal several key insights. Firstly, inadequate technology hampers regulators' ability to detect illegal activities, leading to an increase in the area of illegal land use. Secondly, a high turnover rate of regulatory officers is linked to lower levels of punishment for illegal land use, thereby contributing to an expansion of illegal land use. Thirdly, a permissive government-business environment hinders the effective enforcement of the land approval system, thereby restraining the prevention of illegal land use. Through case studies and policy analyses, the research aims to reveal the challenges and obstacles arising from illegal land use in transitioning to a cleaner energy future. The findings contribute to a nuanced understanding of the obstacles posed by illegal land use, offering insights to policymakers, industry stakeholders, and advocates in navigating towards a more equitable and sustainable energy landscape.

The Effects of Regulatory Office Closures on Bank Behavior

AbstractWe investigate if the decentralized structure of regulatory office networks influences supervisory outcomes and bank behavior. Following the closure of an office, banks previously supervised by that office increase their lending and risk‐taking. As a result, affected banks have larger loan losses and higher failure rates during the 2008–09 financial crisis. Analysis of the channels suggests that proximate supervisors enforce timelier provisioning practices, restrict large cash payouts, and provide advice that increases a bank's risk‐adjusted returns. Overall, our findings imply that geographical proximity reduces informational frictions in supervisory monitoring and leads to more stable banks.

Deconcentrating regulation in low- and middle-income country health systems: a proposed ambidextrous solution to problems with professional regulation for doctors and nurses in Kenya and Uganda

BackgroundRegulation can improve professional practice and patient care, but is often weakly implemented and enforced in health systems in low- and middle-income countries (LMICs). Taking a de-centred and frontline perspective, we examine national regulatory actors’ and health professionals’ views and experiences of health professional regulation in Kenya and Uganda and discuss how it might be improved in LMICs more generally.MethodsWe conducted large-scale research on professional regulation for doctors and nurses (including midwives) in Uganda and Kenya during 2019–2021. We interviewed 29 national regulatory stakeholders and 47 subnational regulatory actors, doctors, and nurses. We then ran a national survey of Kenyan and Ugandan doctors and nurses, which received 3466 responses. We thematically analysed qualitative data, conducted an exploratory factor analysis of survey data, and validated findings in four focus group discussions.ResultsKenyan and Ugandan regulators were generally perceived as resource-constrained, remote, and out of touch with health professionals. This resulted in weak regulation that did little to prevent malpractice and inadequate professional education and training. However, interviewees were positive about online licencing and regulation where they had relationships with accessible regulators. Building on these positive findings, we propose an ambidextrous approach to improving regulation in LMIC health systems, which we term deconcentrating regulation. This involves developing online licencing and streamlining regulatory administration to make efficiency savings, freeing regulatory resources. These resources should then be used to develop connected subnational regulatory offices, enhance relations between regulators and health professionals, and address problems at local level.ConclusionProfessional regulation for doctors and nurses in Kenya and Uganda is generally perceived as weak. Yet these professionals are more positive about online licencing and regulation where they have relationships with regulators. Building on these positive findings, we propose deconcentrating regulation as a solution to regulatory problems in LMICs. However, we note resource, cultural and political barriers to its effective implementation.

Effects of Urban Fertilizer Ordinances on Water Quality

Originating from environmental or humans sources, too much nitrogen (N) and/or phosphorus (P) in water bodies can degrade water quality. In an attempt to reduce the contribution of human sources of N and P to local waters, urban fertilizer ordinances have been adopted in at least 35 counties in Florida and 97 additional Florida municipalities. Despite this work, the efficacy of fertilizer ordinances are debated by end users. The purpose of this publication is to summarize a peer-reviewed, scientific article that investigated impacts of fertilizer on long-term water quality trends in Florida lakes (Smidt et al. 2022) and is intended to be used by UF/IFAS Extension faculty and/or regulatory officials considering adopting or modifying an urban fertilizer ordinance. We encourage green industry professionals and concerned community members to share the effectiveness of fertilizer ordinances.

Voices of Change: Stakeholders' Roles in the Fight Against Substance Abuse in Mogadishu, Somalia.

This study explores the roles, challenges, and collaborative efforts of key stakeholders engaged in addressing substance abuse. Using a qualitative narrative approach, the study examined stakeholder roles in tackling substance abuse in Mogadishu, Somalia. Purposive sampling was utilised to select all available community stakeholders actively addressing substance abuse. Semi-structured interviews were conducted to collect data, allowing participants the freedom to share their experiences openly. Thematic analysis was employed to identify patterns, commonalities, and diversities in the stakeholders' roles. The study focused on a population of five key stakeholders, including the Somali police force, a National Medicines Regulatory Authority officer, two social workers, and a representative from the Ministry of Endowments & Religious Affairs. The research reveals a significant prevalence of psychoactive substances in Mogadishu, with emerging trends like the misuse of pregabalin driven by accessibility and affordability. Emphasising collaborative efforts, the study highlights the importance of effective communication and coordination among stakeholders to provide comprehensive support for individuals with substance abuse issues. Despite these challenges, such as limited resources, evolving drug trends, and addiction complexity, ongoing efforts and adaptation are crucial. Additionally, the research elucidates the established link between substance abuse and criminal behaviour, emphasising the potential consequences of drug addiction on financial desperation, violent acts, drug trafficking, and other criminal behaviours. The study reveals widespread substance abuse, necessitating adaptable authorities. Collaborative stakeholder efforts are vital for supporting individuals affected. Challenges demand sustained efforts. The study links substance abuse to crime. Effective resolution requires stakeholder unity, prevention programs, expanded treatment access, and adaptation to the evolving drug landscape while supporting those affected.

The Impact of IoT on the Performance of Vaccine Supply Chain Distribution in the COVID-19 Context

The Government of India has started the distribution of the Covishield and Covaxin vaccines across all the comprising states. In developing states like Bihar, the vaccine supply chain (VSC) is likely to face many challenges due to poor health infrastructure, multidimensional poverty, and poor literacy. Supply chain practitioners are experimenting with available technologies to deal with supply, demand, and behavioral challenges. The present research work seeks to inspect the potential impact of Internet of Things (IoT) on the performance of the VSC. This study draws literature on the impact of IoT on product management, demand management, supply management, social behavior, and government rules and regulations to develop and test the conceptual model in Bihar. Consequently, the study administrated a survey and used structural equation modeling to investigate the proposed hypothesis. The analysis illustrates the positive influence of IoT adoption on the performance of the VSC in distributing the COVID vaccine. The finding also shows the positive relationship between product, supply, demand, and social behavior in IoT adoption. Analysis displays that Indian politicians can substantially impact vaccine distribution because they have influence and awareness of their local districts. This research work has a significant theoretical and managerial contribution for government and practitioners, supporting regulatory officials and policymakers in improving vaccine distribution.

Scope and governance of terrestrial sand mining around Accra, Ghana

Sand is a crucial resource for the construction of urban infrastructure and constitutes an integral part of the built environment. In Ghana, terrestrial sand mining on farmlands is widespread in the rural and peri-urban communities adjoining the country's capital, Accra. Despite an estimated mining volume of 765 truckloads per day, corresponding to about 4.55 Mio m3 annually, the governance of sand has received little research attention. To fill this knowledge gap, this paper examines the scope and governance of terrestrial sand mining around Accra. Qualitative data were collected from 30 key informants, including landowners, officials of local government authorities, the Environmental Protection Agency (EPA), the Minerals Commission (MINCOM), sand miners, truck drivers, and staff of real estate companies. Besides, three Focus Group Discussions (FGD) were held with Farmer-Based Organizations (FBOs), complemented by a quantitative and qualitative analysis of the mining process and sand trucking. The results showed that sand mining in the study areas was governed by several regulatory agencies with limited inter-institutional collaboration. Illegal sand mining was widespread in the study areas due to bureaucratic licensing procedures, inadequate collaboration among the regulators, bribery of some regulatory officials by the miners, insufficient monitoring of miners, particularly at night, and landowners' preference for sand mining over farming as a result of prompt monetary gains. The revenues from sand mining accrued to the miners, landowners, and truck drivers who controlled capital or land, while the livelihoods of the majority of the local residents were negatively affected due to the environmental degradation. The findings call for a review of the existing licencing process and collaboration among the regulatory agencies to foster enforcement of the existing laws to ensure sustainable sand mining around Accra.

Identification of Key Factors for the Development of Agricultural Biogas Plants in Poland

Agricultural biogas plants are a renewable source of energy and at the same time enable the disposal of biodegradable waste generated in agriculture and the food industry. In Poland, a program aimed at constructing agricultural biogas plants has been in operation since 2010 with the goal of producing 1.7 billion Nm3 of biogas, which has not been achieved. Factors that could influence the development of this energy source were identified based on a register of agricultural biogas producers from the National Agriculture Support Center and data from the Energy Regulatory Office. These factors are technology, substrates, state energy policy, profitability, population density in the commune and the spatial arrangement of the commune resulting from spatial development plans. A pairwise comparison analysis using the DEMATEL method was conducted for these factors. It allowed us to conclude that they are population density and the lack of local spatial development plans in most rural areas. The situation may be improved by the obligation to develop such plans for the entire area of each commune and by locating biogas plants near livestock farms and agri-food processing plants. The selected DEMATEL method is mature and comprehensively verified. It enables research to be carried out in other contexts, taking into account the correlations between factors. It is a universal method, and after collecting expert opinions, research can be expanded. The obtained results of the analysis will allow for further research by collecting the opinions of experts such as biogas plant users, local communities, local government officials and other stakeholders. In addition, further analysis of key factors will be carried out using the DEMATEL method for several scenarios. The PESTEL method will be used to identify key factors.

ORDER FOR THE CONTINUATION OF ECONOMIC ACTIVITY BY AN ENERGY COMPANY IN THE SOCIAL INTEREST

Article 40 of the Energy Law Act of 10 April 1997 provides for the possibility for the President of the Energy Regulatory Office to order the continuation of economic activity by an energy company despite the expiry of a license. This is a special regulation related to the need to ensure the continuity of supplies and protection of recipients of energy services when required by social interest. Therefore, this regulation provides for an exception to the principle of the freedom to undertake, perform, and terminate economic activity. The purpose of this article is to draw attention to the fact that the necessity to ensure the provision of energy services in a continuous manner means that the state imposes an obligation on energy companies to continue economic activity, at the same time not guaranteeing the entrepreneurs sufficient compensation in the form of appropriate remuneration for continuing the economic activity. Pursuant to the provisions of the Energy Law Act of 10 April 1997, an energy company is only entitled to loss coverage and only in the amount limited to the justified costs of the ordered activity.

Rapid screening and multicomponent quantifications of active components of oral syrup over-the-counter medications by Raman and UV–visible spectroscopy and multivariate regression analysis

Over-the-counter medications (OTCMs) are frequently recommended as a first-line treatment for common ailments, diseases, and illnesses. Oral liquid dosage forms are advantageous for rapid absorption with no dissolution time and are easier for pediatric and geriatric consumers to swallow. The production of these medicines by pharmaceutical industry makes them readily available to the public. Although the US Food and Drug Administration (FDA) provides strict guidelines to drug manufacturers of these products; the risk of counterfeiting is a global issue. This can lead to several adverse effects and health issues. Here, we report a fast screening and quality assurance method using Raman and UV–visible spectroscopy combined with Principal Component Analysis (PCA) and Partial-Least-Square (PLS) regression of commonly used OTCM oral syrups. PLS regressions of UV–visible absorption spectra were used for multicomponent quantifications of the active component (acetaminophen, guaifenesin, dextromethorphan HBr, and phenylephrine HCl) concentrations of OTMCs in flavored (sugar or sugar-free) oral syrups. Raman and UV–visible spectral responses varied based on the type and concentration of the active component analyzed. PCA of the spectral data provided pattern recognition of the oral syrup OTCM. The developed PLS method demonstrated good linearity with an R2 > 0.9784 and high sensitivity with a low detection limit of 0.02 mg/mL for acetaminophen and guaifenesin. Moreover, the simultaneous quantification of concentrations of all active components by the described method yielded good accuracies ranging from 88 to 94%. This study provides an example of the benefits of the combined use of Raman and UV–vis spectral profiling, PCA, and PLS regression for the quality analysis of oral syrups OTCM providing multicomponent quantification of active components with no need for sample extraction. The reported method can be easily adapted and scaled for online detection analysis used in the drug manufacturing industry, both in-situ and field analysis, and for the quality control of syrups OTCM by regulatory agencies and quality control officers.

A genetically-encoded biosensor for direct detection of perfluorooctanoic acid

Determination of per- and polyfluoroalkyl substances (PFAS) in drinking water at the low levels set by regulatory officials has been a major focus for sensor developing researchers. However, it is becoming more apparent that detection of these contaminants in soils, foods and consumer products is relevant and necessary at part per billion and even part per million levels. Here, a fluorescent biosensor for the rapid detection of PFOA was engineered based on human liver fatty acid binding protein (hLFABP). By conjugating circularly permuted green fluorescent protein (cp.GFP) to a split hLFABP construct, the biosensor was able to detect perfluorooctanoic acid PFOA in PBS as well as environmental water samples with LODs of 236 and 330 ppb respectively. Furthermore, E. coli cells cytosolically expressing the protein-based sensor were demonstrated to quickly detect PFOA, demonstrating feasibility of whole-cell sensing. Overall, this work demonstrates a platform technology utilizing a circularly permuted GFP and split hLFABP conjugate as a label-free optical biosensor for PFOA.

Phytosanitary measures and certifications programs implemented in Florida

The geographic and climatic conditions of Florida make the state vulnerable to damaging exotic organisms. This risk is compounded by the intense trade of agricultural products arriving through numerous ports of entry in the state and the tourism industry, with at least 115 million visitors annually. For over 100 years, the Florida Department of Agriculture and Consumer Services' Division of Plant Industry (FDACS-DPI), known as the Florida State Plant Board from 1915-1960, has implemented regulatory programs to protect Florida's diverse agricultural industries from damaging exotic organisms (Tissot et al., 1954). These unwanted organisms include phytoparasitic invertebrates such as arthropods, mollusks, and nematodes, and, also, plant pathogens and invasive plants. Many of these programs have been effective in preventing the establishment of or eradicating severe pests such as the Mediterranean [Ceratitis capitata (Wiedemann)] Oriental [Bactrocera dorsalis (Hendel)] and West Indian [Anastrepha obliqua (Macquart)] fruit flies, boll weevil [Anthonomus grandis Boheman], cotton seed bug [Oxycarenus hyalinipennis (Costa)] and the giant African snail [Lissachatina fulica (Bowdich)], which, at present, is under eradication in central Florida. Florida remains free from some pests through a permanent monitoring system, which, in the case of the fruit flies, is based on traps, baits, and mass release of sterile flies. When eradication is not feasible for a newly introduced pest, the spread of these exotic organisms is limited or controlled by certification programs designed to maintain pest-free propagative plant material and the release of biological control agents. These programs are very costly and require the commitment and dedication of regulatory officials, the support of growers, and public awareness of the risk that damaging exotic pests pose to agriculture and the state's economy.

Engaging Patients and Other Stakeholders in "Designing for Dissemination" of Record Linkage Methods and Tools.

Novel record linkage (RL) methods have the potential to enhance clinical informatics by integrating patient data from multiple sources-including electronic health records, insurance claims, and digital health devices-to inform patient-centered care. Engaging patients and other stakeholders in the use of RL methods in patient-centered outcomes research (PCOR) is a key step in ensuring RL methods are viewed as acceptable, appropriate, and useful. The University of Colorado Record Linkage (CURL) platform empowers the use of RL in PCOR. This study aimed to describe the process of engaging patients and other stakeholders in the design of an RL dissemination package to support the use of RL methods in PCOR. Customer discovery, value proposition design, and user experience methods were used to iteratively develop an RL dissemination package that includes animated explainer videos for patients and an RL research planning workbook for researchers. Patients and other stakeholders (researchers, data managers, and regulatory officials) were engaged in the RL dissemination package design. Patient partners emphasized the importance of conveying how RL methods may benefit patients and the rules researchers must follow to protect the privacy and security of patient data. Other stakeholders described accuracy, flexibility, efficiency, and data security compared with other available RL solutions. Dissemination package communication products reflect the value propositions identified by key stakeholders. As prioritized by patients, the animated explainer videos emphasize the data privacy and security processes and procedures employed when performing research using RL. The RL workbook addresses researchers' and data managers' needs to iteratively design RL projects and provides accompanying resources to alleviate leadership and regulatory officials' concerns about data regulation compliance. Dissemination products to promote adoption and use of CURL include materials to facilitate patient engagement in RL research and investigator step-by-step decision-making materials about the integration of RL methods in PCOR.

Contextual factors influencing the roles of patent medicine vendors in the provision of injectable contraception services in Nigeria

BackgroundPatent medicine vendors (PMVs) play vital roles in the delivery of family planning services in Nigeria and other developing countries. There is a growing recognition of the need to integrate them into the formal health care system as a strategy to increase the contraceptive prevalence rate and achieve universal health coverage. Though promising, the success of this proposition is largely dependent on a critical analysis of the factors which influence their operations. This study was designed to identify the contextual factors influencing the provision of injectable contraceptive services by PMVs and the broader effects of their activities on the health system to inform similar interventions in Nigeria.MethodsThis was a qualitative study guided by the UK Medical Research Council’s Framework for Complex Interventions. Twenty-seven in-depth interviews were conducted among officials of the association of PMVs, health workers, government regulatory officers and programme implementers who participated in a phased 3-year (2015–2018) intervention designed to enhance the capacity of PMVs to deliver injectable contraceptive services. The data were transcribed and analyzed thematically using NVIVO software.ResultsThe contextual factors which had implications on the roles of PMVs were socio-cultural and religious, the failing Nigerian health system coupled with government regulatory policies. Other factors were interprofessional tensions and rivalry between the PMVs and some categories of health care workers and increasing donors’ interest in exploring the potentials of PMVs for expanded healthcare service provision. According to the respondents, the PMVs bridged the Nigerian health system service delivery gaps serving as the first point of contact for injectable contraceptive services and this increased contraceptive uptake in the study sites. A negative effect of their operation is the tendency to exceed their service provision limits, which has spurred a planned tiered PMV accreditation system.ConclusionsThis study has highlighted the contextual factors which define the roles and scope of practice of PMVs involved in injectable contraceptive service provision. Strategies and interventions aimed at expanding the healthcare delivery roles of PMVs must be encompassing to address the broader contextual factors which underpin their capacities and functions.

Comparative simulation of T‐Control® indwelling bladder catheter insertion versus open and closed Foley urinary catheter systems

Luque M. is co-founder and shareholder of Rethink Medical, a company that develops and owns the rights of T-Control®. Serrano M. is the Technical Director, Scientific Manager and Regulatory Officer of Rethink Medical, a company that develops and owns the rights of T-Control®. Molina-Mazón C. S. from Bellvitge University Hospital declares that he has no conflict of interest. Luque L. from Healthcare Living Lab Catalonia declares that she has no conflict of interest. Endrényi S. is co-founder and shareholder of Rethink Medical, a company that develops and owns the rights of T-Control®.

NEED OF INTEGRATION OF COURSE ON MEDICAL DEVICES IN UNDERGRADUATE PHARMACY CURRICULUM

Medical Devices are becoming indispensable part of Indian healthcare sector. Medical Devices are multi-product sector which includes various products such as implants, consumables, IVD reagents. The market of medical devices is growing tremendously but India mainly relies on imports of these devices. Indian Government has announced Promotion of Medical Devices Parks. This will encourage setting of Med Tech Industry in India. But, India has short fall of skilled manpower to work in Med Tech Industries. Pharmacists are the main authority involved in procurement and sale of these medical devices. The current curriculums of B. Pharmacy does not include Medical Devices. A course on Medical Devices should be included in curriculum. Faculty experts in pharmaceutical sciences and regulatory officers are of the view that study of medical devices should be made a mandatory discipline for all pharmacy courses approved by the Pharmacy Council of India (PCI) because, like medicines and other health technologies, these devices are also necessary for patient care. Equipping pharmacist with knowledge will benefit the pharmacist as well as improve patient care. Moreover, this will open a new avenue of jobs for the pharmacist.

Multistate Outbreak of Salmonella Thompson Infections Linked to Seafood Exposure — United States, 2021

In July 2021, the Colorado Department of Public Health and Environment (CDPHE) laboratory identified a cluster of five Salmonella enterica serotype Thompson isolates related to one another within one allele difference, using whole genome multilocus sequence typing (wgMLST). These five isolates, submitted to the public health laboratory as is routine process for confirmatory testing of Salmonella, were highly related to those identified in a 2020 multistate investigation, during which traceback was conducted for sushi-grade tuna and salmon; a common supplier was not identified. The 2021 investigation commenced on August 5, 2021, with five patients living in Colorado, and one each in Missouri, Washington, and Wisconsin. During August-December 2021, CDC, CDPHE, public health and regulatory officials in several states, and the Food and Drug Administration (FDA) conducted epidemiologic, environmental, and laboratory investigations of this multistate outbreak of Salmonella Thompson. Isolates were genetically related to one another and to 2020 isolates within zero to one allele difference. Implicated seafood products were traced to a single seafood distributor, in which the outbreak strain was identified through environmental sampling, and in which inspection identified inadequate sanitization and opportunities for cross-contamination of raw fish. The distributor issued a voluntary recall of 16 seafood items with high potential for contamination and completed remediation actions. This outbreak illustrated the importance of effective cleaning and sanitizing procedures and implementation of controls. When multiple products are recalled during an outbreak investigation, collaboration between public health agencies and implicated facilities can help provide food safety information to restaurants, retailers, and consumers, and to ensure disposal of all recalled products.

Analisis Keberlanjutan Usaha Padi Sawah Di Kecamatan Tugumulyo Kabupaten Musi Rawas Provinsi Sumatera Selatan Analisis

This study aims to determine the sustainability status and sensitive attributes of each dimension in lowland rice cultivation in Tugumulyo District, Musi Rawas Regency, South Sumatra Province. This research was conducted in September - October 2021 in Tugumulyo District, Musi Rawas Regency, South Sumatra Province. Sustainability analysis is carried out using Multi Dimensional Scaling analysis which consists of 5 dimensions, namely ecological, socio-cultural, economic, technological and infrastructure, as well as legal and institutional dimensions. The results showed that the multidimensional sustainability index value of paddy farming in Tugumulyo District was 44.30 with a less sustainable status. Ecological, economic, socio-cultural as well as legal and institutional dimensions have a sustainability status classified as less sustainable. While the dimensions of technology and infrastructure are quite sustainable. Sensitive attributes on the ecological dimension include the suitability of paddy fields, the use of organic fertilizers and biological/biological pesticides. Sensitive attributes on the economic dimension include the incidence of crop failure, labor fees for farming, the availability of labor if needed and the price of pesticides for paddy rice farming. Sensitive attributes on the socio-cultural dimension include water conflicts between farmers or the practice of swift water pools, the level of labor absorption from rice farming, farmers' knowledge of calm lowland rice cultivation techniques and a culture of mutual cooperation in lowland rice cultivation such as cleaning irrigation canals. Sensitive attributes on the technology and infrastructure dimensions include the availability of supporting tools for lowland rice farming, availability of seeds, fertilizers, and pest control drugs for lowland rice diseases, standardization of rice quality and operational control of lowland rice cultivation tools. Sensitive attributes on the legal and institutional dimensions are the availability of microfinance schemes for lowland rice farming, the local government's budget for lowland rice farming and the presence of water regulatory officers.