A Formative Assessment of the Vulnerability Context of Three Indigenous Communities in Rural Ecuador for Improved Intervention Design

Nearly 20 % of the current world population are small-scale producers living in rural areas who rely on agriculture and related activities to support their families (IFAD, 2016; World Bank, 2008). Despite the almost 76 billion USD of official development assistance committed to agriculture improvement projects and associated activities over the past decade, many of the intended beneficiaries remain poor and struggle to meet their basic needs. The lack of success in addressing rural poverty highlights the need for quality research focused on understanding what type of intervention/s could help rural communities sustainably improve their livelihood security. The goal of this dissertation is to conduct a formative participatory assessment of the contextual facilitators and barriers to livelihood security in Guangaje Centro, Tingo Pucará, and Curinge, three rural indigenous communities in the Andes of Ecuador. Using mixed methods, the dissertation examines a range of factors, including economic and natural resource trends and the impact of seasonality on income and food availability, that are believed to be contributing to the diminished resiliency and increased livelihood vulnerability of the three study communities. Study findings indicate that soil degradation linked to land overuse and erosion have led to decreasing agriculture production and economic hardship. Current planting and harvesting cycles suggest the likelihood of close to 10 months of food insecurity and increased climatic variability has exacerbated already existing periods of seasonal hunger. These issues are compounded by the fact that households have limited human, physical, and financial assets, which limits their resiliency during times of stress or shock. This challenging dynamic is believed to have negatively impacted the health of young children and their mothers and forced many community members to migrate to cities in search of work. The cultural changes associated with migration have led many participants to feel that they are losing their identity as indigenous people. Based on these findings, the author determined that an intervention centered on addressing the challenges of land overuse/soil fertility and increased climate variability through agroecology, improved water retention, and crop storage is likely to be acceptable, appropriate and feasible in the current context and positively impact the long-term resiliency of the study communities

Fish and complementary feeding practices for young children: Qualitative research findings from coastal Kenya

This study examines barriers to fish consumption during the complementary feeding period in two coastal counties of Kenya with high rates of child malnutrition. Study findings indicate that young child fish consumption is impacted by factors related to accessibility, food preferences, and caregiver’s knowledge and beliefs about fish during the complementary feeding period. These factors are influenced by prominent community figures such as elder women and health workers, whose own beliefs and understandings are impacted by underlying cultural norms, potentially limiting fish consumption. To our knowledge, this is the first study conducted in the coastal region of Kenya to focus on understanding fish consumption attitudes and beliefs during the complementary feeding phase. Our findings represent a critical first step towards the creation of more effective policies and interventions to address the significant nutritional disparities that exist in the study population

Samaki Salama - Promoting healthy child growth and sustainable fisheries in coastal Kenya: A study protocol

Background: One in five young children globally suffer the consequences of stunted growth and development and millions experience deficiencies in zinc, iron, iodine, vitamins A and B12, nutrients found bioavailable in fish foods. Small-scale fisheries have the potential to generate income and augment fish consumption while being environmentally sustainable if appropriately managed. However, those engaged in small-scale fisheries are often marginalized, poor, and malnourished. The Samaki Salama project seeks to better understand and address these challenges through a three-arm, longitudinal matched cluster study which evaluates the impact of an integrated nutrition social marketing and modified fishing trap intervention. Methods: here will be 400 small-scale fisher households enrolled from Kilifi County, Kenya and residing in communities matched on location (rural), livelihoods, and child nutritional status. The sample will include mothers and other caregivers, children 6–60 months, and fishers in the family. Applying a cluster design, the matched communities will be divided into three groups: (1) control (n = 200); (2) multi-component nutrition social marketing intervention to fishers, mothers, and health workers (n = 100); and (3) multi-component nutrition social marketing intervention plus modified fishing traps and training (n = 100). Primary outcomes include child growth, fish food intakes, and fisheries yield of mature fish. Secondary outcomes are diet diversity, child diarrheal morbidity, and fisheries revenue. A process evaluation will be used to monitor and ensure fidelity of intervention delivery. Discussion: This study builds on a growing body of literature illustrating the effectiveness of nutrition focused social marketing campaigns to promote active engagement of participants, high compliance to the intervention, and sustained behavior change. The second intervention element of modified fishing traps that allow immature fish to escape enables participants to act on the messaging they receive and promotes sustainable fishing through increased harvest efficiency and reduced catch of immature fish. The integrated approach of the Samaki Salama intervention provides an example of how to leverage multiple disciplines to address key challenges to human and environmental health and illustrates a pathway for scaling study innovations to other small-scale fisheries systems

Getting Ahead of the Game: Experiential Learning for Groundwater Governance in Ethiopia

Groundwater management is highly complex, with many users sharing the same resource often with limited understanding of their interconnectedness. Behavioral experiments (games) that simulate real-life common-pool resource use have shown promise as an experiential learning tool for improving resource governance. This study pilots an experiential learning intervention in Ethiopia using a groundwater game to help raise awareness of groundwater over-extraction and improve understanding of the importance of collective action in governance. In the Meki River catchment in Ethiopia, small-scale irrigation is expanding, but overextraction and competition over groundwater have not yet reached alarming levels. The groundwater game, adapted from India and including the addition of a rule-making round, was played in 15 villages with 30 groups. The game was accompanied by subsequent community-wide debriefing in each village to reflect on the experience and lessons learned, which stimulated discussions about groundwater governance. We surveyed participants to capture individual mental models regarding groundwater use and management, as well as any immediate learning effects. Focus group discussions in each village prior to the intervention and again six months after the intervention assessed possible lasting effects. The findings indicate cognitive, normative and relational learning, including increased understanding of groundwater dynamics (such as the joint effect of diverse water uses and users), the importance of collective action in resource management, and the benefits of communication. We find gendered differences in decision-making about resource extraction in the game and development of group-level resource management, confirming the need for gender-responsive approach to sustainable groundwater management interventions. We discuss community-wide learning and institution-building, and considerations for future intervention designs. We recommend embedding experiential learning, facilitated by local extension officers and other practitioners, in intervention packages that include both technical assistance on water-conserving technologies and groundwater management approaches and support in building communities’ institutional capacity

A systematic review of reviews: Recruitment and retention of rural family physicians

The recruitment and retention of family physicians in rural and remote communities has been the topic of many reviews; however, a lack of consensus among them with regard to which factors are most influential makes it difficult for setting priorities. We performed a systematic review of reviews which helped to establish an overall conclusion and provided a set of fundamental influential factors, regardless of the consistency or generalisability of the findings across reviews. This review also identified the knowledge gaps and areas of priority for future research. Methods: A literature search was conducted to find the review articles discussing the factors of recruitment or retention of rural family physicians. Results were screened by two independent reviewers. The number of times that each factor was mentioned in the literature was counted and ordered in terms of frequency. Results: The literature search identified 84 systematic reviews. Fourteen met the inclusion criteria, from which 158 specific factors were identified and summarised into 11 categories: personal, health, family, training, practice, work, professional, pay, community, regional and system/legislation. The three categories referenced most often were training, personal and practice. The specific individual factors mentioned most often in the literature were 'medical school characteristics', 'longitudinal rural training' and 'raised in a small town'. Conclusion: The three most often cited categories resemble three distinct phases of a family physician's life: pre-medical school, medical school and post-medical school. To increase the number of physicians who choose to work in rural practice, strategies must encompass and promote continuity across all three of these phases. The results of this systematic review will allow for the identification of areas of priority that require further attention to develop appropriate strategies to improve the number of family physicians working in rural and remote locations

Getting ahead of the game: Experiential learning for groundwater governance in Ethiopia

The goal of this study is to assess the potential of game-based experiential learning in raising awareness and stimulating discussions about groundwater resource systems, the social dilemma in groundwater management, and the need for institutional arrangements (rules) governing this shared resource, as well as whether such awareness and community discussions lead to actual change in groundwater governance in Ethiopia. Groundwater management is highly complex, with many users sharing the same resource often without realizing their interconnectedness. Behavioral experiments (games) that simulate real-life common-pool resource use have shown promise as an experiential learning tool for improving resource governance. This study pilots an experiential learning intervention in Ethiopia using a groundwater gameto help raise awareness of groundwater over-extraction and improve understanding of the importance of collective action in governance. The Meki River catchment in rural Ethiopia is a unique context where small-scale irrigation is expanding, but overextraction and competition over groundwater have not yet reached alarming levels. The groundwater game, adapted from Meinzen-Dick et al. (2016 and 2018), was played in 15 villages, accompanied by community-wide debriefing discussions in each village after the game to reflect on the process and lessons learned, and to stimulate discussions around groundwater governance. We carried out participant surveys to capture individual mental models regarding groundwater use and management, as well as any immediate learning effects. Focus group discussions were held in each village prior to the intervention to establish a baseline and again six months after the intervention to assess possible lasting effects. The findings indicate cognitive, normative and relational learning, including increased understanding of groundwater dynamics (such as the joint effect of diverse water uses and users), the importance of collective action in resource management, and the benefits of communication. We find gendered differences in decision-making about resource extraction in the game and evolvement of group-level resource management across no-communication, communication, and rule-making rounds of the game. We discuss community-wide learning and institutions-building, and considerations for future intervention designs. We recommend embedding experiential learning, facilitated by local extension officers or other community engagement practitioners, in intervention packages that include both technical assistance on water-conserving technologies and management approaches and support in building communities’ institutional capacity

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The Power of Microenterprise: An Analysis of the Economic and Social Impact of a Weaving Collective in Rural Nicaragua

This paper explores the potential economic and social impacts of a weaving microenterprise located in a small rural Nicaraguan village. First, I examine the determinants of a female head of household’s decision to join the weaving collective. Based on the decisions to join the weaving collective or not, I test if joining the collective impacts key economic indicators and levels of female empowerment. Over 840,000,000 women, 12 percent of the world population, live in extreme poverty on less than a dollar a day . Understanding the factors that contribute to a female head of household becoming involved in the development of a microenterprise has implications for the design of female targeted development programs. The ability to quantify the benefits of microenterprise will assist policy makers in allocating scarce resources for microenterprise development, and justifying microenterprise development to funders. With the continued growth of female targeted development initiatives particularly in regards to conditional cash transfer and microfinance initiatives, there is a need for a better understanding of the benefits of microenterprise development, to be able to present it as a viable alternative to these other initiatives. To justify additional funding for the development of more female targeted microenterprise initiative there is a need for more rigorous impact evaluations, linking them to improved family well-being and female empowerment. The weaving microenterprise initiative has yet to have a significant overall impact on the economic indicators so I cannot claim that it has had a positive impact on the economic well-being of the women and households that are participating in the weaving project. One of the main limitations of this analysis is the very small number of observations. More rigorous analysis over a longer period of time with a larger dataset is likely to generate evidence to strengthen microenterprise development and provide support for microenterprise projects that have already taken place. Even though the weaving project has not had clear short term economic impacts, in developing a specific skill and a new type of knowledge, the weavers have begun to believe in themselves as actual business women, to be creative and innovative and to involve their families in that process. This impact is evidenced by the relative statistical significance of the empowerment variable. The weaving enterprise is building a sustainable framework that will hopefully continue to propel the women, their families, and the communit

Gender gaps in agricultural growth and development: Opportunities for improving gender-responsive programming

In addition to identifying gender gaps and other challenges and opportunities for entrepreneurship in agricultural growth and development, this brief focuses on potential for improvement in the key areas of (1) seed systems, (2) finance and market access, and (3) production and value chains. While gender norms and challenges are inherently context-specific, the underlying intention of this evidence brief is to provide an overview of research findings from low- and middle-income countries, to address key questions and challenges that can be generalized across contexts, and to offer suggestions of promising approaches and best practices.Non-PRIFPRI1; GCAN; CRP7; 1 Fostering Climate-Resilient and Sustainable Food Supply; Feed the Future InitiativeEPTDCGIAR Research Program on Climate Change, Agriculture and Food Security (CCAFS

Aquatic Animal Foods for Nutrition Security and Child Health

Background: Aquatic animal source foods (AASF) can provide vital nutrients and bioactive factors essential for human health, yet disparities in consumption patterns prevail globally. Limited evidence exists for the implications of AASF access on child health outcomes. Objective: This study aimed to examine global AASF intakes longitudinally in association with critical nutrient intakes and childhood stunting and anemia. Methods: The analysis draws from compiled longitudinal country data (1993-2013) based on a constructed conceptual framework encompassing social and ecological factors that influence fish consumption and human health. Longitudinal generalized linear models were used to estimate the association of apparent AASF intake on country-level nutrient availability (docosahexaenoic acid [DHA], choline, vitamin B12, iron, and zinc) and prevalence of undernourishment, child stunting, and child anemia. Results: Across 175 countries, the median per capita daily apparent intake of all AASF was 37.87 g, with marginally significant differences observed between countries with low (46.65 g) versus high child mortality (23.50 g). The combined category of all AASF was significantly associated with increased total apparent intakes of DHA, choline, and vitamin B12 and reduced child stunting. Finfish (pelagic and demersal) and crustaceans inversely correlated with child stunting, while apparent intakes of mollusks and crustaceans were associated with reduced child anemia. Conclusions: This study uniquely showed that AASF were associated with improved child health outcomes and the critical nutrients necessary for growth, development, and maintaining health throughout the life course. Policies should ensure increased access to AASF across food systems and within sustainable healthy diets globally