Underdeveloped Areas Research Articles

Digital Transformation of English Language Teaching (ELT) at Junior High School Level: A Case Study in Remote Area of West Kalimantan

The development of technology runs very rapidly in this day and age. Indonesian are no exception to the worldwide trend toward greater reliance on digital technologies. And the Sambas community as residents of border areas tend to enter underdeveloped areas in various aspects of life, including in the field of education, especially in English language learning. The weak use of English communication for students living at the border further complicates opportunities to enter the workforce. As a border area with a high intensity of interaction and communication with other countries, it demands mastering English from an early age. The border area should get special attention from the government because the border area is a strategic area from the point of defense and security of a country and as an attraction for trade and tourism. Learning using digital means must absolutely be mastered by teachers as a means of improving English learning in the area. Based on the explanation above, this research reveals the problem that exists in digital English language teaching (ELT) at the junior high school level in border areas. Case study research, which is used in this study, is a qualitative method that aims to reveal issues that are otherwise unseen and to convey stories of problem-solving or situations based on data collected in the field

Analysis of demand and influencing factors for smart senior care among older adults in underdeveloped regions of western China: a case study of Lanzhou

IntroductionWith the rapid development of artificial intelligence and Internet-of-Things technology, internal support systems among families are gradually weakening, which can no longer satisfy the current demands of older adults. In this context, smart senior care has become a new development direction. However, existing studies on the demand for smart senior care are primarily concentrated in economically developed provinces and mega-cities in eastern China; their research results or conclusions may not apply to underdeveloped areas in the Western region. Therefore, our study selects Lanzhou as a representative city in an underdeveloped western region to investigate the demand of older adults for smart senior care and analyze the influencing factors.MethodsThis cross-sectional study included 4,815 older adults from Lanzhou, China. A structured questionnaire was designed to investigate the demands of the older adults for smart senior care and analyze thie influencing factors. The Chi-square test was used for single factor analysis of each variable. The logistic regression model included the statistically significant variables to analyze factors influencing older adults’ demand for smart senior care. A significance level of p < 0.05 was considered statistically significant.ResultsAmong the surveyed older adults, 1,625 (33.75%) expressed a demand for smart senior care. The finding indicated that participants’ age, level of education, marital status, monthly income, number of children, type of endowment insurance, and knowledge of smart senior care were significantly associated with their demands for smart senior care (p < 0.05). Notably, medical care emerged as the smart senior care service with the highest demand rate (79.45%).ConclusionIn Lanzhou, older adults show a low level of knowledge but a high demand for smart senior care. Their demand is influenced by personal, family, health conditions, senior care security, and other factors. To advance smart senior care, government departments should accelerate the improvement of the laws and regulations on smart senior care while vigorously enhancing the service’s publicity to raise knowledge about it. Additionally, the service contents for smart senior care should be expanded to meet the diversified demands of older adults.

ANALISIS PEMBIASAAN NILAI - NILAI AKHLAKUL KARIMAH SEBAGAI UPAYA PEMBANGUNAN KARAKTER PADA ANAK USIA DINI DI DAERAH TERDEPAN, TERLUAR DAN TERTINGGAL (3T) KABUPATEN ROTE NDAO

The phenomenon of a character crisis resulting in moral decline in the nation's generation should be overcome through the role of education as an effort to familiarize oneself with moral values. Schools and teachers have an important role in forming children's morals apart from family and parents in educating them, especially during the learning process. Facilitating the akhlakul karimah (noble character) needs of children in underdeveloped, outermost and frontier areas is an important and urgent challenge. This research uses a qualitative descriptive research approach. The aim of this research is to collect as much factual data as possible on the subject naturally in implementing the practice of akhlakul karimah values as an effort to build character in early childhood in frontier, outermost and disadvantaged areas (3T). Efforts to facilitate children's moral and moral needs are often not a top priority. Nevertheless, the importance of character and morality formation in children should not be ignored. To overcome this challenge, a collaborative approach between various parties, inclusive education that integrates moral values in educational programs, parent training, use of technology, community strengthening, and social skills development programs can be an effective solution.

The digitalization of Chinese fisheries and its configuration path to empower fishery sustainable development

The green and sustainable development of fisheries is a crucial way to safeguard the environment, guarantee food security, and promote social and economic development. In the rapidly evolving era of digitalization, how to fully leverage the advantages of digitalization to motivate fishery sustainable development has become a worthy research question. Based on combing the development stage and characteristics of Chinese fishery digitalization, this paper selects six fishery digitalization factors from the perspective of configuration based on the technology-organization-environment (TOE) theoretical framework, and uses the panel fuzzy-set qualitative comparative analysis (fsQCA) method to explore the configurational path of how digitalization empowered the sustainable development of fisheries in China from 2011 to 2021. This paper found that: (1) Fishery digitalization can significantly enhance the level of fishery sustainable development, but individual elements of fishery digitalization are not necessary conditions for realizing a high degree of fishery sustainable development. However, strengthening digitalization talent support plays a more universal role. (2) Four types of fishery digital ecology can generate a high level of fishery sustainable development, demonstrating the multiple paths and complex mechanisms of fishery digitalization empowering fishery sustainable development. (3) In underdeveloped areas such as Jilin, Hunan, and Qinghai, the empowering effect of digitalization on the sustainable development of fisheries is relatively limited. The research findings open the "black box" of how digitalization empowers the sustainable development of fisheries, providing theoretical reference for various types of provinces to utilize digitalization to drive the sustainable development of fisheries.

Perceptual Evaluation of Street Quality in Underdeveloped Ethnic Areas: A Random Forest Method Combined with Human–Machine Confrontation Framework Provides Insights for Improved Urban Planning—A Case Study of Lhasa City

Perceptual Evaluation of Street Quality in Underdeveloped Ethnic Areas: A Random Forest Method Combined with Human–Machine Confrontation Framework Provides Insights for Improved Urban Planning—A Case Study of Lhasa City

Measures for preventing norovirus outbreaks on campus in economically underdeveloped areas and countries: evidence from rural areas in Western China.

The outbreak of norovirus represents a significant public health emergency within densely populated, impoverished, and underdeveloped areas and countries. Our objective is to conduct an epidemiology study of a norovirus outbreak that occurred in a kindergarten located in rural western China. We aim to raise awareness and garner increased attention towards the prevention and control of norovirus, particularly in economically underdeveloped regions. Retrospective on-site epidemiological investigation results, including data on school layout, case symptoms, onset time, disposal methods and sample testing results, questionnaire surveys, and case-control study were conducted in a kindergarten to analyze the underlying causes of the norovirus outbreak. A total of 15 cases were identified, with an attack rate of 44.12% (15/34). Among them, 10 cases were diagnosed through laboratory tests, and 5 cases were diagnosed clinically. Vomiting (100%, 15/15) and diarrhea (93.33%, 14/15) were the most common symptoms in the outbreak. Case control study revealed that cases who had close contact (<1 m) with the patient's vomitus (OR = 5.500) and those who had close contact with similar patients (OR = 8.000) had significantly higher ORs compared to the control participants. The current study demonstrated that improper handling of vomitus is positively associated with norovirus outbreak. The absence of standardized disinfection protocols heightens the risk of norovirus outbreaks. To our knowledge, this study represents the first investigation into a norovirus outbreak in rural areas of western China. We aspire that amidst rapid economic development, a greater emphasis will be placed on the prevention and control of infectious diseases in economically underdeveloped areas and countries.

SPATIAL ANALYSIS OF REGIONAL DEVELOPMENT OF NGEMPLAK DISTRICT 2013-2023

Development policies influence the rate of regional development. Population growth and the affordability of areas to urban centers determine development policies. Urban areas that have experienced rapid development will gradually influence the surrounding peri-urban areas. The expansion of urban areas leads to suburban areas, starting from the expansion of residential areas. This research aims to determine regional development and regional development priorities in Ngemplak District. This research is qualitative research with comparative and spatial analysis. The results of this research are 1) the level of regional development in Ngemplak District is categorized into 3, namely developed, medium and underdeveloped areas. Villages in the advanced category include Sawahan Village, Ngesrep Village, Pandeyan Village, Kismoyoso Village, Donohudan Village and Gagaksipat Village. Those included in the medium category are Dibal Village, Manggung Village and Sobokerto Village, and those included in the underdeveloped villages are Sindon Village, Ngargorejo Village and Giriroto Village. 2) There are 3 development priorities, namely priority 1 for underdeveloped villages, priority II for medium level villages and priority III for advanced villages.

A Field in Transition: A Scoping Review and Thematic Network Map of Qualitative Health Research in Liver Transplantation

BACKGROUNDIn liver transplantation, qualitative methodologies can offer important insights from a range of perspectives into the meaning and impact of health experiences. This review aims to characterize the existing qualitative research in liver transplantation to understand how this work has evolved over time, its contribution to understanding clinical issues, and to conceptualize under-developed areas for future research. METHODSStudies from MEDLINE, Embase, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, and Web of Science were searched from database inception to January 2024. All English language studies focused on a liver transplant population with qualitative methodological components were included. Using VOSviewer network mapping software we constructed a visualization of the thematic networks within included studies. RESULTSOur initial search yielded 9092 studies from which 229 were included in the final review. Data extraction revealed significant increases in the publication of qualitative studies since 2015, predominantly utilizing interviews and focus groups. The thematic network map we constructed placed “social support” as a dominant and central concept across many different studies, with related themes tending to cluster within four domains of research: Care of the Organ & Patienthood; Identity, Embodiment, Adjustment; Relational & Ethical Issues; Existential Themes. Medicalized subject such as “self-management” were less well-networked with identity-related, ethical, and existential topics. DISCUSSIONThere is a growing body of rich qualitative research in liver transplantation. Future research would benefit from more longitudinal approaches as well as increased attention to the interrelation between “clinical” issues (adherence, quality of life) and ethical, relational, and existential ones.

Determination of Growth Centers in Regional Development in Wonogiri Regency

Abstract One of the reasons for the social inequality that occurs in various regions is the difference in the pace of the economy and the uneven development across regions. In general, the problems that exist in areas experiencing inequality are high unemployment rates, lack of community facilities and infrastructure, and even inequality in the quality of natural resources and human resources. This problem causes underdeveloped areas to experience poverty. For this reason, it is necessary to determine distributed growth centers in Wonogiri Regency to minimize the gaps that occur. The aim of this research is to determine which sub-districts are suitable as locations for growth centers in Wonogiri Regency. The analysis used is scalogram analysis and gravity model analysis. Scalogram analysis is used to analyze the location of growth centers in terms of the number of facilities and infrastructure available, while gravity model analysis is used to analyze the determination of the hinterland of each growth center. The results of the analysis show that of the 25 sub-districts in Wonogiri Regency, 5 sub-districts have been identified as centers of growth, namely Wonogiri Sub-district, Jatisrono Sub-district, Baturetno Sub-district, Purwantoro Sub-district and Pracimantoro Sub-district.

Analysis of the Problems in the Application of Educational Technology in Underdeveloped Areas

In underdeveloped areas, the teaching environment of educational technology has been initially established, which has laid a solid foundation for further enhancing teaching efficiency and improving teaching quality. But only when it is used effectively and reasonably can its function be maximized. If educational technology is turned into a stunt, it is undoubtedly a waste of the country's precious educational resources. Based on this idea, this paper discusses how to better promote the development of applied technology from the current teaching practice of primary and secondary schools in underdeveloped areas.

Research on the Intervention of Social Organizations in the Governance of Service Poverty for Rural Empty-nest Elderly: A Case Study of County S in Jiangxi Province

There are multiple dimensions of deficiencies in elderly care services for rural empty-nest elderly in China, necessitating the intervention of social organizations. Social organizations possess various advantages in participating in rural elderly care services, reflecting their importance and necessity in the governance of service poverty from the perspectives of governance concepts, governance subjects, and governance mechanisms. Combining the theory of collaborative governance and based on service cases of a social work agency in County S, Jiangxi Province, this study explores the collaborative mechanisms and governance effectiveness of the government, social organizations, villages, and social forces in the governance of service poverty for empty-nest elderly. It summarizes shortcomings, proposes countermeasures, and improves the multi-subject collaborative governance model for rural empty-nest elderly care services, which consists of government leadership, social organizations as operating entities, villages, volunteers, and other forces, aiming to promote the experience of the case to other underdeveloped areas.

The Spatial Pattern of Polluting Enterprises and the Effects of Local Regulation in the Guanzhong Plain Urban Agglomeration

In the context of actively undertaking the transfer of domestic and foreign industries in the central and western regions of China, local regulatory behaviors influence the spatial distribution of polluting enterprises (PEs). This study examined the Guanzhong Plain urban agglomeration (GPUA), the largest urban agglomeration in the northwest region of China and one of the main regions that undertakes industrial transfer, using kernel density estimation and geographically and temporally weighted regression to explore the spatial pattern characteristics and evolution of PEs and reveal the effects of local regulatory behaviors, including environmental regulation (ER) and local protection (LP). The results indicate that (1) The distribution of the PEs tended towards energy and mineral resources and agglomerated along the development axes, aligning with the strategic positioning of the major function-oriented zones. Agglomerated areas gradually concentrate in key development zones. Major agricultural production zones exit high-density areas, and those adjacent to high-density areas often become secondary agglomeration core areas. Key ecological functional zones do not form high-density areas. (2) Both ER and LP have a positive impact on the distribution of PEs, and the dominant influence shifts from ER to LP. Counties with strict ER have increased the tendency of PEs to exhibit a certain layout due to better pollution treatment facilities and more mature pollution control technologies. The “pollution haven effect” has not yet formed within the GPUA. (3) The role of LP was more prominent in key development zones and major agricultural production zones, whereas the role of ER was more evident in key ecological functional zones. (4) RE and LP have mutually reinforcing effects on the distribution of PEs; the “innovation compensation effect” gradually manifests, but an increase in ER leads to a decrease in regional industrial clustering. This study provides a reference value for understanding the impact of government regulation on the distribution of PEs in underdeveloped areas.

Peran E-Commerce dalam Meningkatkan Akses Pasar bagi Produk UMKM Lokal di Kota Serang

The development of MSMEs (Micro, Small, and Medium Enterprises) in Indonesia has been quite rapid, especially with the occurrence of the Covid-19 pandemic worldwide, which has dampened economies globally. Several studies have also found that MSMEs and cooperatives play a crucial role in driving local economic growth by creating new job opportunities, especially in underdeveloped areas. With the presence of MSMEs and support for digitalization through the utilization of e-commerce platforms, this becomes one of the essential strategies for MSME players in Indonesia, particularly in Serang City, to market and promote their products widely. The research method employed is a case study based on previous research on the impact of MSMEs that have adopted e-commerce. The research results indicate that the implementation of e-commerce has a significant positive influence on the growth of MSMEs in Serang City.

How Does Foreign Capital Impact Urban Green Development? Evidence from Central China

Background: Foreign capital, a significant component of the contemporary export-oriented economy, helps to solve ecological and environmental issues and encourages the green transformation of urban development techniques. This study develops an assessment framework for urban green development using panel data from 80 cities in Central China between 2007 and 2022. Simultaneously, the impact of foreign capital on urban green development was tested through the mechanism of green technological innovation using the panel mediating effect model, and the impact of economic development level on the impact of foreign capital on the same was tested using the threshold effect model. The primary research findings are as follows: (1) Foreign capital has greatly enhanced urban green development in Central China; (2) Green technology innovation acts as a major mediating variable in the process by which foreign capital influences urban green development; (3) Economic development has a single threshold effect on foreign capital influencing urban green development. This article suggests that the government focus more on the prudent use of foreign capital in light of the findings above. The study's findings offer an empirical foundation for more effectively encouraging urban green development as well as some theoretical direction for the long-term growth of human society in underdeveloped nations or areas. Objective: The objective of this study is to explore the key factors affecting urban green development in Central China, including the direct impact of foreign capital, the mediating effect of green technology innovation and the threshold effect of economic development, with the aim of improving urban green development in Central China. Theoretical Framework: This study mainly refers to Sustainable Development Theory and Schumpeterian Innovation Theory. Because urban green development belongs to the category of sustainable development, and the mediating analysis in this article is consistent with Schumpeterian Innovation Theory. Method: The entropy method is used to measure the degree of urban green development. Baseline regression is used to analyze the direct impact of foreign capital on urban green development. The mediating model is used to analyze the mediating role of green technology innovation in the impact of foreign capital on urban green development. The threshold model is used to analyze the threshold effect of economic development on foreign capital in affecting urban green development. Results and Discussion: The results confirmed the hypothesis. First, foreign capital has a positive impact on urban green development. Second, green technology innovation plays a mediating role in the process of foreign capital affecting urban green development. Third, economic development plays a single threshold effect in the process of green technology innovation affecting urban green development.However, this study still has certain limitations. Because there are certain differences between official statistics and reality, and the indicators selected in this article are limited, they cannot fully reflect the actual results. Research Implications: The practical and theoretical implications of this research are discussed, providing new ideas for urban green development in Central China from the perspective of foreign capital. And the role of green technology innovation and economic development cannot be ignored. This is not only in line with the world theme of green and sustainable development, but also conducive to accelerating the internationalization process of Central China. And this research also provides theoretical support for green development in developing countries or regions. Originality/Value: This study contributes to the literature by being based on official data from the National Bureau of Statistics of China and using a series of recognized empirical methods to study Central China's urban green development and key influencing factors. The value of this article is that it not only enriches the research on urban green development in Central China. It also provides a reference for green development and international development in other developing regions in China and other developing countries or regions around the world.

Construction of a Biogas Digester Using Gas and Temperature Sensor

The construction of a biogas digester is the main emphasis of this project. Biogas is a mixture of gases created during the anaerobic decomposition of organic material, including food waste, animal waste, sewage, and waste from farms and plants. One of the major causes is environmental degradation, which has emerged to be the greatest threat to the health of the environment and the economy of the underdeveloped areas. But with the discovery and application of biogas which is a gaseous fuel obtained from biomass by the process of anaerobic digestion, most problems are resolved. The project’s aim is to create a biogas digester that leverages animal manure to generate biogas for usage at Covenant University. The digester selected for construction is a barrel drum digester for the production of biogas using cow dung. The cow dung was tested for a total of 14 days, during which the days of gas production and digestion were observed, and the biogas was then tested with the gas and temperature sensor and was confirmed to detect gas and temperature.

Research On the Impact and Mechanism of Digital Inclusive Finance on Regional Carbon Emissions

Digital inclusive finance will be a crucial engine to support high-quality and sustainable economic development and achieve carbon emission reduction in the context of achieving carbon peak and carbon neutrality goals. Based on China's provincial panel data from 2011 to 2020, this essay focuses on the impact and heterogeneity of digital inclusive finance on regional carbon emissions. It explores the role of digital inclusive finance in promoting green carbon reduction through industrial structure upgrading and energy utilization efficiency. The results show a significant negative connection between digital inclusive finance and regional carbon emissions, manifesting that digital inclusive finance has made a difference in reducing emissions. Digital inclusive finance can achieve the effect of carbon emission reduction by upgrading industrial structure and improving energy utilization efficiency. The inhibitory effect of digital inclusive finance on carbon emissions shows a strong carbon emission reduction effect in the eastern and western regions. Compared to underdeveloped areas in financial development, the inhibitory effect of digital inclusive finance on regional carbon emissions is more obvious.

Development of an artificial intelligence-based multimodal model for assisting in the diagnosis of necrotizing enterocolitis in newborns: a retrospective study.

The purpose of this study is to develop a multimodal model based on artificial intelligence to assist clinical doctors in the early diagnosis of necrotizing enterocolitis in newborns. This study is a retrospective study that collected the initial laboratory test results and abdominal x-ray image data of newborns (non-NEC, NEC) admitted to our hospital from January 2022 to January 2024.A multimodal model was developed to differentiate multimodal data, trained on the training dataset, and evaluated on the validation dataset. The interpretability was enhanced by incorporating the Gradient-weighted Class Activation Mapping (GradCAM) analysis to analyze the attention mechanism of the multimodal model, and finally compared and evaluated with clinical doctors on external datasets. The dataset constructed in this study included 11,016 laboratory examination data from 408 children and 408 image data. When applied to the validation dataset, the area under the curve was 0.91, and the accuracy was 0.94. The GradCAM analysis shows that the model's attention is focused on the fixed dilatation of the intestinal folds, intestinal wall edema, interintestinal gas, and portal venous gas. External validation demonstrated that the multimodal model had comparable accuracy to pediatric doctors with ten years of clinical experience in identification. The multimodal model we developed can assist doctors in early and accurate diagnosis of NEC, providing a new approach for assisting diagnosis in underdeveloped medical areas.

Literature Review: The Relationship Between Technology Development, the Digital Era, and HRD In Indonesia's Underdeveloped Regions

This study aimed to find the relationship between technology development and human resource development in underdeveloped areas, especially in Indonesia. The effect of technological development in the digital era is really good, but there are fewer facilities in underdeveloped areas. This was a literature review study. The sources for this literature review were indexed journals and proceedings on Google Scholars from 2019 onwards. There was only one journal before 2019, which was in 2017. With low human resources and minimal access to the internet, human resources in remote areas are threatened with being left behind in facing the changing times brought by the digital era. This research was limited to a general overview of remote areas and their impacts on existing conditions in the digital era. This research can contribute to policy building by the government by giving some views about the condition of the digital era and its impact on human resource development. This research also showed the importance of human resource development in underdeveloped areas. This research can also be a reference for future research on human resource development, the digital era, and the underdeveloped regions in Indonesia. Keywords: human resource development, digital era, change, underdeveloped area, facility

Flexible fiber composite functional materials based on Fe-MOFs nanozyme catalytic activity for efficient point-of-use water disinfection

Ensuring clean water sources is crucial for human health and safety. However, in underdeveloped areas and emergency situations, low-energy, convenient water disinfection technologies remain a significant challenge. Herein, a series of Fe-MIL-101@flexible fiber composites were designed and synthesized by in-situ cross-linking growth of Fe-MIL-101 metal–organic framework nanozymes on carboxymethyl cellulose (filter paper, cotton, gauze), as a class of point-of-use (POU) water disinfection modules with antibacterial efficacy, portability and biosecurity. The results show that the preparation method of water disinfection material is universal, and the most convenient Fe-MIL-101@composite carboxymethyl filter paper (Fe-MIL-101@CMFP) is outstanding. The combination of Fe-MIL-101 nanozyme with carboxymethyl filter paper (CMFP) is highly stable, even after 200 mechanical or manual frictions, the MOF particles does not fall off, and its flexibility, mechanical properties and filtration efficiency remain unchanged. Furthermore, Fe-MIL-101@CMFP exhibits remarkable simulated activity of peroxidase and oxidase, generating reactive oxygen species (ROS, •OH and O2•-), which effectively eliminate bacteria. Notably, Fe-MIL-101@CMFP filters have excellent bactericidal capability (about 99%), are equally effective on field water, and have no biosafety concerns. Such Fe-MIL-101@flexible fiber composite material, as a portable POU water disinfection and sterilization functional modules, is expected to solve the problem of distributed water disinfection as well as change the way of obtaining safe drinking water in underdeveloped areas and emergency situations.

The Relationship Between the Number of Chronic Diseases and Health-Related Quality of Life Among Middle-Aged and Older Adults in Rural Areas of Yunnan Province, China: moderating Effect of Health Lifestyle.

With population aging, individuals in underdeveloped areas may experience a higher prevalence of chronic non-communicable diseases (NCDs), a lower level of health-related quality of life (HRQoL), and distinct lifestyles. However, this triadic association remains inadequately studied, particularly regarding the role of health lifestyle. This study aims to examine the relationship between the number of NCDs and HRQoL, while considering the moderating effect of health lifestyle among middle-aged and older adults residing in resource-limited areas. This cross-sectional study was conducted in Yunnan Province from July to December 2022. Participants completed a self-report questionnaire related to socio-demographic information, NCDs conditions, health lifestyle status, and HRQoL, which was assessed using the EuroQol five-dimension five-level (EQ-5D-5L) scale. Hierarchical regression and simple slope tests were used to examine the moderating effect of health lifestyle. Out of the total 2704 participants, 57.91% presented at least one NCD. The mean scores for health lifestyle and health utility value were 11.109 and 0.944 respectively. The number of NCDs was negatively associated with health utility value, while positively correlated with the health lifestyle score (P<0.001). The results of hierarchical regression indicated that health lifestyle exerted a negative moderating effect on the relationship between the number of NCDs and HRQoL (β=0.006, P<0.001), which was also observed for specific health-related behaviors such as sleep duration (β=0.013, P<0.001), physical examination attendance (β=0.006, P<0.05) and physical activity (β=0.013, P<0.001). These findings highlight the crucial role of a healthy lifestyle in attenuating the association between the number of NCDs and HRQoL. Recognizing the potential modulating influence of a healthy lifestyle in this relationship could be pivotal for developing effective interventions for this population, even within resource-constrained rural settings.