Measuring poverty and vulnerability in microfinance

This dissertation explores how to best measure poverty and vulnerability to poverty in microfinance clients in rural areas and provides the results of the test for Angkor Mikroheranhvatho (Kampuchea) (AMK), a microfinance institution operating in rural Cambodia. The objective is to find the best measuring tool available and to adapt it to the rural Cambodian context. Thus, the first section of this dissertation discusses the theoretical framework for rural finance, microfinance, poverty and vulnerability to poverty and the second section explores the Cambodian context and its poverty profile. In the third section, two complementary but distinct poverty measuring tools are applied: a multidimensional relative poverty tool based on Principal Component Analysis (AMK-PCA Wellbeing Score) and a one-dimensional absolute poverty tool based on Daily Food Expenditure per capita. Both tools are based on food security. The analysis shows AMK’s extensive poverty outreach, and the comparison of the outputs from both tools further confirm the reliability of results.The main conclusion of this dissertation is that it is not possible to create a single poverty assessment tool that provides simultaneously absolute and multidimensional results. What is possible is to apply two tools, as part of a combined research effort within the context of rural Cambodia, so that poverty and vulnerability can be assessed regularly as a multidimensional concept while adding a monetary tool that allows for easier comparisons at the national level

Evaluation of potential antiviral properties of tualang honey against in vitro chikungunya virus infection in vero cells

Chikungunya is a mosquito-borne viral disease transmitted to human by CHIKV which has affected many countries around the world. CHIKV is transmitted mainly by two species of Aedes mosquitoes, Aedes albopictus and Aedes aegypti, and causes typically acute illness with incapacitating arthralgia, fever and rashes. Currently, there is no antiviral or licensed vaccine commercially available. In this study, we explored the in vitro antiviral activity of the Tualang honey against CHIKV in Vero cells. The potential anti-CHIKV property of Tualang honey was determined in different assays including virucidal, pre-treatment, post-treatment, anti- entry and anti-adsorption, using the non-toxic concentrations of Tualang honey at different incubation hours. The viral inhibitory effect was confirmed by plaque assay after morphological changes of Vero cells were observed. The results showed that Tualang honey was not toxic to Vero cells at concentration between 20 mg/mL to 5 mg/mL. This study demonstrated that Tualang honey exhibited significant antiviral activity against CHIKV. The virucidal activity of Tualang honey against different amounts of CHIKV was observed by the significant inhibition noticed in the viral titre. Remarkably, the pre-treatment of Tualang honey on Vero cells for 12 and 24 hours before infection gave the highest inhibitory effect on CHIKV especially at 48 hours post infection, with about 90% inhibition of viral titres was observed (P < 0.05). Surprisingly, during post-treatment assay, CHIKV replication was significantly inhibited in Vero cells following post-exposure to Tualang honey for 8 hours. The post-treatment of cells with Tualang honey displayed the biggest reduction of viral titre effect when compared with the other assays with percentage of inhibition 98% (P < 0.05). However, Tualang honey did not significantly inhibit infection of Vero cells by CHIKV during the anti-adsorption and anti-entry assay with percentage of inhibition surpassed 33 to 80%. Overall, the results from the current study suggest that Tualang honey can be explored as an alternative anti-CHIKV agent. Future study is warranted to elucidate Tualang honey mechanism of action and whether similar effects could be demonstrated in vivo

Can the poor enhance poverty reduction? rural and urban perspectives on water resources, poverty & participatory development in the Tonle Sap Region and Phnom Penh, Cambodia

In recent years, Cambodia has seen a significant economic growth. However, this development has not reached the poorest dwellers, resulting in escalating inequality. The Tonle Sap Region is one of the poorest regions in the country. The livelihoods of the region's poor are greatly dependent on water resources. The livelihoods are thus vulnerable to possible changes in water resources associated with the current development plans. By contrast, Phnom Penh, which is the main destination for the region's migrants when searching for a better level of living, is struggling with increasing poverty, informality and inequality. Participatory development is considered crucial when aiming at equal poverty reduction. Consequently, this study analyzes the strategies used by the poor to participate in decision-making and to enhance poverty reduction in urban and rural areas of Cambodia. Furthermore, the study analyzes the role of water resources and migration in the country's poverty reduction. The study focuses especially on grass root level observations. Hence, the participatory studies and expert interviews undertaken serve as a major source of information for the research. This study identifies various strategies used by the poor for participating and enhancing poverty reduction. Many of these, however, are rather narrow, project-based and fragile, and thus have only limited impacts on general poverty reduction and empowerment in the study regions. To conclude, poverty reduction is hindered by the lack of competent authorities and sound policies to address poverty, inequality and informality as well as mistrust and weaknesses within the communities. Improving the possibilities of the poor to enhance poverty reduction calls for several changes at both the community and decision-making level

La contribution de la géographie et de l’anthropologie dans l’analyse et la compréhension des inégalités socio-territoriales du paludisme au Cambodge

Le programme interdisciplinaire « Sociétés, Résistances, Malaria » (SOREMA : 2012-2015) sur le paludisme et la résistance au traitement de première ligne au Cambodge et au Vietnam réunit une quinzaine de chercheurs provenant des sciences de la santé, des sciences environnementales et des sciences humaines. Le cadre de cette recherche intégrée fait part des interventions publiques et des inégalités de santé dans les écosystèmes naturels et sociaux recomposés de la sous-région du Mékong. La vocation est de produire une synthèse originale susceptible de rendre compte le plus finement possible de la complexité sociale, environnementale et biologique, associée au paludisme. La géographie est partie prenante mais, à l’instar des autres disciplines conviées, on n’attend pas d’elle une contribution isolée. L’interdisciplinarité implique non pas la juxtaposition mais l’articulation effective et une synergie entre les savoirs produits à partir de différents angles d’approche d’une même réalité complexe. Un effort d’élargissement des idées hors de la discipline d’origine est attendu pour chacun des participants. L’interpénétration des connaissances constitue la pierre d’angle de l’ambition du projet traitant d’un problème hybride. Le présent article reprend une étape de la mise en application de ces grandes lignes. Il vise à montrer l’apport mais aussi les limites de l’approche géographique dans le cas précis du projet qui nous intéresse. Ce que nous désignons par ‘limites’ n’est pas propre à la géographie mais reste inhérent à tout montage disciplinaire soliloque. Après avoir retracé quelques traits saillants retenus par la géographie quand elle aborde les notions de dépistage dans un environnement donné, on se concentre sur la mise en perspective anthropologique qui, avec ses propres méthodes d’investigation complémentaires, offre une vision complémentaire de la réalité sociale.The interdisciplinary research program « Societies, Resistances, Malaria» (SOREMA 2012-2015) on malaria and resistance to the first line treatment in Cambodia and Vietnam, brings together fifteen researchers coming from health, environmental and human sciences. The frame of this integrated research analyses public interventions and inequality of health in the natural and social ecosystems in the Mekong sub-region. Its goal is to produce an original synthesis showing as precisely as possible the social, environmental and biological complexity linked to malaria to understand the process leading to disease persistence and drug-resistant strains emergence even diffusion. Geography is part of the process, but like the other concerned disciplines, an isolated contribution is not expected from her. Interdisciplinarity is not just a matter of juxtaposition, but a real articulation and synergy between knowledge issued from various angles and approaches of the same complex reality. An effort to broaden their ideas out of their discipline of origin is awaited from the contributors. The interpenetration of various types of knowledge constitutes the keystone of the ambition of this project dealing with a hybrid problem. This article is one step of this particular process. It aims at showing the contribution as well as the borders of the geographical approach, in the case of this particular research project. ‘Borders’ are not specific to the geographical field but remain inherent to this kind of interdisciplinary work. After having retraced some geographical salient features dealing with the concept of malaria morbidity in a given environment, we focus on an anthropological perspective which, with its own methods of investigation, comes to enrich the understanding of social reality of the malaria

Impacts of the Interest Rate Ceiling on Microfinance Sector in Cambodia: Evidence from a Household Survey

This paper examines the effects of the imposition of an interest rate ceiling in the microfinance sector in Cambodia in 2017, based on a household survey undertaken in 2019. Evidence indicates that the average interest rate was reduced after the imposition of the ceiling. Although this reduction is partially offset by the increase of the average loan assessment and processing fee, the average effective interest rate (i.e., credit cost) declined. The results also show the increase in the average loan size from formal sources at a relatively small level and the increase in the percentage of loans from informal sources by a few percentage points. Moreover, we find that relatively low-income households face a higher probability of being rejected for loans and a higher debt service ratio is positively associated with a larger loan amount. This implies the possibility of the increase of the debt burden occurring among relatively small borrowers, given that an increase of the average loan size at relatively small loan levels is observed. The evidence supporting the important role of financial literacy in reducing household debt burden is also confirmed

Chikungunya Virus

The chikungunya virus (CHIKV) is an RNA virus that is transmitted to humans by Aedes mosquitos commonly found in tropical and subtropical countries. In humans, CHIKV causes an infection with symptoms strikingly like those of the dengue virus and Zika disease, both of which are also transmitted to humans by the same genus of mosquitos. This book delves into the history of the disease and the molecular characterization of the virus. It sheds light on modern diagnosis tools that allow unambiguous identification of CHIKV infection. In addition, this book addresses the epidemiology of chikungunya fever, the distribution and spread of the disease, and the promising approaches under consideration for preventing and treating the disease

An economic analysis of the market for malaria treatment in Cambodia

In developing countries, malaria treatment is often inadequate, notably in retail shops where the majority of people seek care. Shopkeepers are the last link in a chain of wholesalers who have an influence on treatment availability, price and quality. Evidence on competition in retail and wholesale markets is scarce, partly due to the methodological challenges of studying healthcare markets in poor countries. The thesis investigates how market structure, provider conduct, customer demand and regulation affect malaria treatment outcomes in Cambodia. In addition the thesis contributes to the development of methods for studying private drug markets. Cross-sectional surveys and semi-structured interviews of representative samples of antimalarial retailers and wholesalers were conducted to collect data on provider practices and perceptions. The contribution of different empirical methods for identifying and sampling wholesalers and measuring sales volumes was also assessed. Private commercial providers supplied the majority of antimalarial drugs, reflecting the relative proximity, long opening hours, reliable drug stock and friendliness of private retailers. Retail and wholesale competition increased accessibility to malaria treatment but did not lead to optimal supply of affordable quality treatment. Several market failures were evident: intense product differentiation, high concentration, and imperfect consumer information on treatment quality. These provided opportunities for higher mark-ups, although not in all market segments. With high market heterogeneity, higher retail mark-ups did not necessarily translate into higher consumer prices, highlighting the influence of distribution chain structure and wholesaler's price setting decisions. Government failures were also frequent, with poor public sector treatment accessibility and ineffective regulation'. Recommendations include widening distribution networks for artemisinin combination therapy and rapid diagnostic tests; improving product stock reliability; decreasing wholesale and retail product prices; intensifying providers' training; diffusing information to consumers on what constitutes appropriate management of malaria fever; and strengthening regulation and the potential to extend its supportive role

A Model for a Chikungunya Outbreak in a Rural Cambodian Setting: Implications for Disease Control in Uninfected Areas

International audienceFollowing almost 30 years of relative silence, chikungunya fever reemerged in Kenya in 2004. It subsequently spread to the islands of the Indian Ocean, reaching Southeast Asia in 2006. The virus was first detected in Cambodia in 2011 and a large outbreak occurred in the village of Trapeang Roka Kampong Speu Province in March 2012, in which 44% of the villagers had a recent infection biologically confirmed. The epidemic curve was constructed from the number of biologically-confirmed CHIKV cases per day determined from the date of fever onset, which was self-reported during a data collection campaign conducted in the village after the outbreak. All individuals participating in the campaign had infections confirmed by laboratory analysis, allowing for the identification of asymptomatic cases and those with an unreported date of fever onset. We develop a stochastic model explicitly including such cases, all of whom do not appear on the epidemic curve. We estimate the basic reproduction number of the outbreak to be 6.46 (95% C.I. [6.24, 6.78]). We show that this estimate is particularly sensitive to changes in the biting rate and mosquito longevity. Our model also indicates that the infection was more widespread within the population on the reported epidemic start date. We show that the exclusion of asymptomatic cases and cases with undocumented onset dates can lead to an underestimation of the reproduction number which, in turn, could negatively impact control strategies implemented by public health authorities. We highlight the need for properly documenting newly emerging pathogens in immunologically naive populations and the importance of identifying the route of disease introduction