Semi-urban Setting Research Articles

Complementary feeding and food handling practices among caregivers in a semi-urban setting in Northern Uganda

Background: Complementary feeding practices influence the nutritional status and health of children, especially in developing countries where sub-optimal infant feeding practices are the major cause of childhood undernutrition, morbidity, and mortality. This study sought to characterize the adequacy of complimentary feeding and food handling practices among caregivers of children aged 6-23 months in a semi-urban setting. Methods: Exploratory cross-sectional study was conducted in Adyel division, Lira district in Northern Uganda among 127 child-caregiver pairs randomly selected from three villages. Caregivers were interviewed about their child-feeding practices, complementary foods used, and common practices in handling and preparation of foods used as complementary feeds. Results: Overall, children’s feeding patterns met the recommended dietary intake when assessed using the child feeding index (CFI) whereby children aged 6-8, 9-11, and 12-23 months scored 8.03, 9.17, and 7.59, respectively. However, most children were complemented with foods from the household meals and dietary diversity was limited by frequent use of food leftover from the previous meals. Conclusions: Inappropriate meal patterns and food handling practices identified are likely to compromise child nutrition and health. Nutrition education is needed to improve the caregivers’ child-feeding and food handling practices within their socio-economic and cultural context. Keywords: Complementary feeding practices; food handling; diet quality; food safety; children; Uganda.

Prevalence and factors associated with short birth interval in the semi-rural community of Kaya, Burkina Faso: results of a community-based survey

BackgroundA short birth interval adversely affects the health of mothers and children. This study aimed to measure the prevalence of short birth intervals and identify their associated factors in a semi-urban setting in Burkina Faso.MethodsWe conducted a cross-sectional study in which data were collected in households between May and October 2022. The dependent variable was the short birth interval (SBI), defined by the World Health Organization as the time between two live births. We performed a multilevel mixed-effects Poisson regression with robust variance to determine the factors associated with the SBI by reporting adjusted prevalence ratios (aPR) with a 95% confidence interval (CI).ResultsA total of 5544 birth intervals were recorded from 4067 women. A short birth interval was found in 1503 cases out of 5544, i.e., a frequency of 27.1%. The prevalence of short birth interval (time between two live births less than 33 months) was higher in never users of modern contraceptive users (aPR = 1.24; 95% CI [1.14–1.34] vs. previous users), in younger ages with aPR of 4.21 (95% CI [3.30–5.37]), 2.47 (95% CI [1.96–3.11]), and 1.45 (95% CI [1.16–1.81]), respectively for under 18, 18–24 years old, and 25–34 years old, compared to 35 and over. Childbirths occurring before the implementation of the maternal and infant free health care policy (aPR = 2.13; 95% CI [1.98–2.30]) and also before the free family planning policy (aPR = 1.53; 95% CI [1.28–1.81]) were more likely to have SBI. Women with low socio-economic positions were also more likely to have SBI.ConclusionThis study found a high SBI in Burkina Faso (more than one woman out of four). Our results have programmatic implications, as some factors, such as contraceptive practice and socioeconomic status, are modifiable. These factors need particular attention to lengthen birth intervals and, in turn, improve mother–child couple health by reducing short birth interval consequences.

Temporal changes in the size resolved fractions of bacterial aerosols in urban and semi-urban residences

Despite the significant amount of time spent in the domestic environment, culture-independent size distribution data of bioaerosols are largely missing. This study investigated the temporal changes in size-resolved bacterial aerosols in urban and semi-urban residential settings. Overall, airborne bacterial taxa identified in both sites were dispersed across particles of various sizes. qPCR analysis showed that outdoors bacteria dominated particles > 8 μm, whilst indoor bacterial loadings were greater with 1–2 μm (winter) and 2–4 μm (summer) ranges. Indoor and outdoor aerosols harboured distinct bacterial communities due to the dominance of human-associated taxa (Staphylococcus, Micrococcus, Corynebacterium) in indoor air. The aerosol microbiome exhibited significant temporal variation, with Actinobacteria, Gammaproteobacteria and Bacilli predominant indoors, whereas Actinobacteria, Alphaproteobacteria and Gammaproteobacteria were the most abundant taxa outdoors. The variation between the two residences was mostly driven by particles < 2 μm, whereas differences between indoors and outdoors were mostly influenced by particles > 2 μm. Source-tracking analysis estimated that household surfaces accounted for the greatest source proportion of bacteria, surpassing that of outdoor air, which varied due to natural ventilation throughout the year. Our findings provide new insights into the factors governing the aerosol microbiome in residential environments which are crucial for exposure assessment.

Supporting small firms in a fragile context: Comparing matching and cash grants in Burkina Faso

We used a randomized controlled trial to compare matching grants earmarked for technical training and consulting services with more flexible cash grants and with a control group. The experiment was implemented in a semi-urban and rural fragile setting where subsidizing innovative activities might be particularly important. Firms were selected on the basis of a business plan competition. After two years, beneficiaries of cash grants showed higher survival rates, improved business practices, a higher degree of formalization, and more activities for innovation relative to recipients of matching grants and the control group, but we saw no effects on profits, sales, and employment. Across all outcomes, beneficiaries of cash grants performed better than beneficiaries of matching grants, for them the treatment effects are smaller and often insignificant, though implementation costs were higher. Recipients of cash grants also increased their capital stock more and were more resilient to the COVID-19 crisis.

Utilisation of Children's Emergency Services in a Semi-urban Nigerian Tertiary Health Facility

Background: Children's emergency services are still evolving in Nigeria. The description of the attributes of children attending Children Emergency Services in Nigeria is yet to be extensively studied in recent times. This can guide resource allocation and help develop health policies that advance children's emergency care. Objective: To review the profile of children patronising children’s emergency services in a tertiary health institution in a semi-urban setting in Nigeria. Methods: The study was a descriptive, cross-sectional survey among seventy-five caregiver-child pairs attending the children's emergency room of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Results: The mean age of the parents was 39.76±9.21 years and 33.47±8.11 years for the fathers and mothers, respectively. About two-thirds (65.4%) of the children were aged five years and below with male preponderance (69.3%). The highest educational level reported was secondary among 53.3% of the fathers and 42.7% of the mothers. Sixty-eight per cent (68%) of the children came on self-referral. Fever was the most common presenting complaint (72.0%) and paracetamol was the most commonly used medication as home remedy (21.3%). Conclusion: Most children utilising emergency services arrived at the facility on self-referral. There is a need for increased advocacy to ensure that the referral systems effectively function in referring patients to tertiary facilities from either primary health or secondary facilities.

Characterizing Profiles of Alternative Food Source Utilization Among New Food Bank Users in Urban, Semi-Urban, and Rural Settings in Quebec (Canada)

ABSTRACT This study aimed to characterize alternative food source (AFS) utilization profiles among newly registered food bank (FB) users in urban, semi-urban, and rural settings. A cross-sectional analysis was conducted on the baseline data of the Pathways Study, a cohort of newly registered FB-users in Québec (2018–2020). Participants aged between 18–63 responsible for household food acquisition (n = 990) were included. Latent class analysis was used to classify FB-users into three latent AFS utilization profiles: FB-Exclusive-users, FB-Fruit/Vegetable-Market-users, and Multiple-AFS-users. The socio-demographic factors related to AFS utilization profiles vary across settings. These differences should be considered to improve AFS access.

Burden of tobacco-related cancers in urban, semi-urban and rural setting of Nepal: Findings from population-based cancer registries 2019.

Nepal is one of the high prevalent countries for tobacco use in Southeast Asia regions. Tobacco related cancer share the major burden since a decade, however, population-based estimates is still lacking. This study provides results from population-based cancer registries on tobacco-related cancer (TRCs) burden in Nepal. The data were collected by population-based cancer registry conducted in nine districts by Nepal Health Research Council. The districts were categorized in urban, semi-urban and rural regions on the basis of geographical locations and facilities available in the regions. Analysis was done to identify tobacco-associated cancer incidence, mortality and patterns along with cumulative risk of having cancer before the age of 75 years. Tobacco-related cancer was 35.3% in men and 17.3% in women. We found that every one in 36 men and one in 65 women developed tobacco-related cancer before age 75 in Nepal. Cancer of lung, mouth, esophagus and larynx were among the five most common tobacco-related cancers in both men and women. The incidence of tobacco-associated cancers was higher in urban region with age adjusted rate 33.6 and 17.0 per 100,000 population for men and women respectively compared to semi-urban and rural regions. Tobacco-associated cancer mortality was significantly higher compared to incidence. The prevalence of tobacco-related cancer found high in Nepal despite of enforcement of tobacco control policy and strategies including WHO framework convention on tobacco control. Concerned authorities should focus towards monitoring of implemented tobacco control policy and strategies.

CORRELATION ANALYSIS OF NORMAL AND JAUNDICE-RELATED BIRTHS: A COMPARATIVE STUDY IN GENERAL HOSPITAL AGBOR (SEMI-URBAN) AND FEDERAL MEDICAL CENTER ASABA (URBAN), 2013-2022

CORRELATION ANALYSIS OF NORMAL AND JAUNDICE-RELATED BIRTHS: A COMPARATIVE STUDY IN GENERAL HOSPITAL AGBOR (SEMI-URBAN) AND FEDERAL MEDICAL CENTER ASABA (URBAN), 2013-2022

Understanding of cervical cancer, acceptability of HPV self-collection, and prevalence of HPV in a semi-urban setting in Bangladesh.

Human Papillomavirus (HPV) self-sampling has been implemented successfully as an alternative to traditional forms of cervical cancer screening in low-resource settings. Through Bangladesh's current national cervical cancer screening program, only about 10% of the at-risk population is reached. Thus, Bangladesh is an ideal setting to consider HPV self-sampling to improve cervical cancer prevention efforts. However, the feasibility and acceptability of HPV self-sampling has not been evaluated in Bangladesh. We aimed to understand levels of HPV and cervical cancer knowledge and to evaluate the feasibility and acceptability of HPV self-sampling for cervical cancer screening in a semi-urban Bangladeshi community. Participants were recruited from a local clinic; 164 women completed a cross-sectional questionnaire about attitudes towards screening, and cervical cancer and HPV risk factor knowledge, and provided self-collected cervical samples for high-risk HPV testing. Of the participants, 4.3% tested positive for high-risk HPV and were referred for appropriate follow-up care. Nearly all participants had heard of cervical cancer, though specific knowledge was quite low. Self-sampling for high-risk HPV testing had high rates of acceptability, high rates of convenience, and very little discomfort and embarrassment reported in this study population, making implementing HPV self-sampling as a form of cervical cancer screening in Bangladesh appear feasible.

Exploring Experiences of Visually Impaired Youths in Tertiary Education

Several conventions worldwide have recognized impartial access to formal and high-quality education as a core human right for all youths, regardless of their disability. The study aims to explore the perception of visually impaired university students (VIs) in Nepal and determine their strengths and challenges to make recommendations for policy making and practice. Face-to-face and focus group interviews were conducted with 10 non-probability samplings: purposive and snowball VIs selected from various semi-urban settings. The interview content was transcribed, translated and a descriptive thematic analysis was done. Findings revealed that the majority of participants relied on their sighted peers in academics and other everyday activities, and that they received limited incentives from the government. They also faced significant challenges during their higher education including inaccessible supportive programs, unfavorable physical and instructional environments, inflexibility in coursework and examination, financial crises, inadequate learning resources and limited support. It is recommended that educators take part in disability-specific training programs, VIs have access to adequate academic resources and receive necessary assistance to improve instruction in inclusive settings.

The intergenerational reinforcement of Spanish in Galicia (Spain)

This article presents a case study on family language policies (FLP) in Galicia (official bilingual community of Spain), based on the analysis of semi-structured interviews with three Spanish-speaking parents who live with their partners and children in urban or semi-urban settings where Spanish is the dominant language. The results indicate a FLP model that reinforces the position of this language in the family, in interaction with the environment, since the informants attribute their children’s learning of Galician exclusively to school, even though they see it as insufficient to incorporate this minority language into their everyday linguistic repertoire, both now and in the future. The assumption of this result is revealed to be rooted in the ideologies about languages, since Galician has little or no economic or even symbolic value for these parents and continues to be strongly associated with the rural world, with the elderly or with no education, reproducing a persistent diglossic culture in Galician society. This language micropolicy is interpreted as a mirror of the laissez-faire attitude that has characterised language policies at the macro level in Galicia, as well as a reflection of its shortcomings in achieving true prestige for Galician.

Multimorbidity and acute infectious diseases in urban and semi-urban settings in Peru: A mixed-methods study.

The co-occurrence of chronic diseases and acute infectious events exacerbates disability and diminishes quality of life, yet research in Low- and Middle-Income countries is scarce. We aimed to investigate the relationship between infectious events and multimorbidity in resource-constrained settings. We conducted a sequential mixed-method study in Lima and Tumbes, Peru, with participants having multimorbidity from the CRONICAS Cohort Study. They completed a questionnaire on the occurrence, treatment, and health-seeking behaviour related to acute infectious events. Qualitative interviews explored the perceptions and links between multimorbidity and acute infectious events for a subgroup of participants. Among individuals with multimorbidity, low awareness of chronic conditions and poor medication adherence. The cumulative incidence for respiratory and gastrointestinal infections, the most reported acute conditions, was 2.0 [95%CI: 1.8-2.2] and 1.6 [1.2-1.9] events per person per year, respectively. Individuals with cancer (6.4 [1.6-11.2] events per person per year) or gastrointestinal reflux (7.2 [4.4-10.1] events per person per year) reported higher cumulative incidence of infectious events than others, such as those with cardiovascular and metabolic conditions (5.2 [4.6-5.8] events per person per year). Those with three or more chronic conditions had a slightly higher cumulative incidence compared with individuals with two conditions (5.7 [4.4-7.0] vs 5.0 [4.4-5.6] events per person per year). Around 40% of individuals with multimorbidity sought healthcare assistance, while others chose drugstores or didn't seek help. Our qualitative analysis showed diverse perceptions among participants regarding the connections between chronic and acute conditions. Those who recognized a connection emphasized the challenges in managing these interactions. Our study advances understanding of multimorbidity challenges in resource-limited settings, highlighting the impact of acute infections on patients' existing multimorbidity burden.

Healthcare Workers' Experiences and Challenges in Managing Gender-Based Violence Among HIV-Positive Women Living in Southern, Tanzania: A Qualitative Study.

Healthcare workers (HCW) play an important role in managing women living with HIV (WLHIV) with gender-based violence (GBV) experience, but little is known about their experience in screening and managing GBV among WLHIV. This study explored the perceptions and experience of the HCWs on screening and managing GBV cases among WLHIV. We performed a descriptive phenomenological qualitative study to elicit the views and experience of HCW on GBV screening and management for WLHIV. The study was conducted in the semi-urban setting in Morogoro Region, Tanzania. Ten in-depth interviews (IDIs) were administered to HCW selected purposefully based on their roles at an HIV care and treatment center. Data were transcribed using patterns matching study aim and then merged into relevant themes for analysis and interpretation. NVIVO software version 12 was used for data coding and analysis. We found that HCW experienced multiple challenges in GBV screening and management, including limited capacity for GBV screening and management; inadequate training on assessment and handling GBV cases, limited resources (time, GBV guidelines and screening tools), inadequate GBV referral and monitoring systems; referral forms for GBV survivors to social support centers and follow-up mechanisms to trace survivors, mental aspects; HCWs' fear of being stressed by listening to women's' GBV traumatic experiences, HCWs' fear of causing problems to the women's families and HCW biased notions on women disclosure of GBV; the believes that women will not report their GBV experiences. We identified context-specific challenges preventing HCW to deliver optimal services of GBV to WLHIV, stressing the necessity to strengthen HCW capacity and resources for GBV services and to integrate psychosocial services into HIV care. Policy and programs should be developed to support GBV screening and management for WLHIV.

Pregnancy outcomes amongst booked parturients in a semi-urban secondary healthcare setting in Southern Nigeria

Pregnancy outcomes amongst booked parturients in a semi-urban secondary healthcare setting in Southern Nigeria

Critical Interconnectedness of Awareness, Waste Management and Infrastructure in Environmental Discourse and Practice

Awareness, waste management (WM) and infrastructure are closely linked issues of environmental sustainability. Perception levels shape household activities which have to do with waste generation, waste collection, waste disposal, and waste recycling. Urban, sub-urban and rural infrastructure in turn impacts WM. Botswana’s laudable vision 2036 to transform into a knowledge-based economy has implications for knowledge and for the gaseous, liquid, and solid environment. The objective of this study is to examine a few environmental issues that are germane to having a knowledge-based economy in the twenty-first century. The methodology is qualitative; hence data collection is through the desktop modality to source relevant orthographic and pictorial information from academic journals, books, pictures, and newspapers, etc. The issues are examined from the viewpoints of selected frameworks of environmental education, specifically those of behavioural change, personal change and social change. The procedure is also comparative between Botswana and other cross border urban, semi-urban, and rural geographic settings and experiences in Southern Africa (Durban, Cape Town), East and Central Africa (Rwanda, Uganda, Tanzania), and West Africa (Lagos State, Ogun State, Osun State). The study found that an adequate level of awareness, the formulation and implementation of an effective WM policy, and the provision of basic infrastructure, are important requirements to drive a knowledge-based economy.

Developing a Standardized Questionnaire for Measuring Older Adult's Health and Well-Being in Kenya.

Policy and program interventions for older adults 60 years or older in Africa have consistently been undermined by a lack of vital data as they are usually excluded from nationally representative population surveys. The Health and Wellbeing of Older Persons in Kenya (HWOPs-1) study developed a standardized assessment questionnaire that can be used for periodic data generation. This study presents how the questionnaire was developed and examines its internal consistency and psychometric properties of the health module. The development and validation of the HWOPs-1 questionnaire was a 3-step process. Step 1 was a review of 19 panel studies and 2 national level surveys followed by a wide consultation with key experts and stakeholders on aging. The 3rd step was validation of the questionnaire with a cross-section of a representative sample to test its applicability and adaptability in a mix of rural and semi-urban settings. The internal consistency and psychometric properties of the 3 subscales: functionality, disability, and quality of life were assessed using Cronbach's (α) alpha and exploratory factor analysis, respectively. Three subscales of functionality, disability, and quality of life showed high internal consistency with α = 0.94, 0.97, and 0.87, respectively. There were also consistent factor loadings above 0.3 across all the factors. Gender differences across the 3 scales from the results of t test were observed. Finally, weak but statistically significant correlations between the measures of well-being and risk factors for noncommunicable diseases were also observed from the analyses. The indicators assessed have been used in settings outside Africa to measure health and well-being of older adults are adaptable and reliable enabling comparability across space and across studies. The questionnaire provides a framework for examining disease and disability burden and their determinants among older adults in Kenya or similar settings.

Loan Eligibility Prediction: An Analysis of Feature Relationships and Regional Variations in Urban, Rural, and Semi-Urban Settings

In the complex realm of banking and financial systems, the process of extending loans involves navigating through multifaceted criteria that reflect an individual's creditworthiness. As modern global economies evolve, they present distinct financial behaviors across urban, rural, and semi-urban geographies. This dynamic landscape prompts an essential inquiry: Are the determinants for loan approval consistent irrespective of these varying settings? Our research, set against the backdrop of this question, harnesses the power of machine learning to delve deep into this enigma.Utilizing a comprehensive dataset acquired from Kaggle[1], we embark on a rigorous journey of data preprocessing. This phase involves meticulous efforts like rectifying null values and sophisticated encoding techniques to prepare the data for machine learning models. Subsequent stages see the employment of multiple algorithms, including decision trees, random forests, logistic regression, XGBoost, among others, each rigorously trained and critically evaluated for their predictive capabilities. Of these, the Logistic Regression algorithm stood out, boasting an impressive accuracy of 83.78%.However, the essence of this research transcends mere algorithmic performance. The heart of our findings elucidates the subtle yet significant variations in factors dictating loan approvals across urban, rural, and semi-urban datasets. This nuanced understanding underscores a vital recommendation for financial institutions: the imperative to customize and refine their loan eligibility parameters in harmony with these regional intricacies, ensuring a more holistic and informed lending approach.

Heterogeneity of Mycobacterium tuberculosis Strains Circulating in Panama's Western Region.

Tuberculosis remains a challenge in both rural and urban areas. Although a majority of countries display a higher burden in urban areas compared with rural areas, Panama continues to report the highest mortality rate in Central America. Urban areas, such as Panama City, report a high tuberculosis burden, whereas Panama's western region, including the provinces of Chiriquí, Bocas del Toro (both semiurban) and Ngäbe-Bugle (rural), show a lower burden. We aimed to identify highly transmitted Mycobacterium tuberculosis strains within rural and semiurban settings of Panama's western region during a 3-year period (2017, 2019, 2021). We randomly selected 87 M. tuberculosis isolates from a biobank from Panama's western region and analyzed them using allele-specific oligonucleotide polymerase chain reaction and 24-mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR). Our results show only 11.7% (10/85) of M. tuberculosis strains identified as prevalent A-Beijing, B-Haarlem, or C-LAM Strains. We found a low prevalence of A, B, and C M. tuberculosis strains in both rural and semirural settings compared with isolates collected from the Eastern Colon Province. MIRU-VNTR genotyping revealed a high degree of diversity with no clusters with single loci variation of ≥ 2 loci. These results support the notion that tuberculosis prevalence in the rural and semiurban western region of Panama are not due to previously described highly transmitted strains but is influenced instead by other health determinants, including poor health system access and a lack of systematic transmission chain monitoring. For remote rural and semiurban settings, we recommend allocating resources to reinforce efforts to prevent tuberculosis spread.

E-biking within a transitioning transport system: the quest for flexible mobility

Over the last few years, electrically assisted cycling, e-biking, has increased substantially worldwide. Replacing car driving for individual journeys, especially commuting, is highlighted as important to mitigate climate change, improve public health, and reduce congestion and other unwanted consequences connected to the car. Car driving, however, is still the overwhelmingly dominant mode of personal transport globally and the ‘system of automobility’ permeates the whole of society. Flexibility and autonomy are considered the main reasons for the car’s dominance (Urry 2004). By analysing interviews and diaries kept by e-bikers, collected in semi-urban and urban settings in Sweden, this article aims to contribute to knowledge about emerging micromobility practices such as e-biking in relation to a transport system where flexibility is the norm. The results show that e-biking encompasses elements that give the practice potential to both recruit and retain practitioners. By successfully combining elements of conventional cycling and car driving, it offers reliability, convenience, and flexibility. E-biking facilitates transforming a dull commute into leisure as the rider can enjoy the sensuous and reflective aspects of the journey. At the same time, through that squeezing of time, it does not challenge prevailing structures but rather maintains the time-space of automobility.

CUSTOMER PERCEPTION: SPECIAL REFERENCE TO “OLA” ELECTRIC VEHICLE

Electric vehicles have rapidly gained prominence in the automotive industry, and Ola, a prominent player in the ride-sharing sector, has ventured into the electric vehicle market. The rapid rise of electric vehicles (EVs) in the automotive industry has spurred Ola, a leading ride-sharing company, to enter the electric vehicle market. This study investigates customer perceptions of Olas electric vehicles in Nelamangala, a semi-urban town near Bengaluru, Karnataka, India, within the context of an industry undergoing a sustainability transformation. The research aims to uncover factors shaping customer perception, adoption, and expectations regarding Olas EVs, focusing on attitudes, preferences, and concerns of residents. By addressing research gaps specific to semi-urban regions and the Indian market, this study provides valuable insights into the barriers and facilitators of EV adoption, ultimately benefiting Olas strategy refinement and informing policymakers and urban planners in promoting sustainable transportation options. The study seeks to bridge the knowledge gap in a burgeoning field of electric mobility and its adoption, particularly in semi-urban settings. KEYWORDS: Customer perceptions, Sustainability, Semi-urban, Adoption.