Socio-cultural perceptions that influence the choice of where to give birth among women in pastoralist communities of Afar region, Ethiopia:A qualitative study using the health belief model

Background: Facility-based delivery care provided by skilled birth attendants is globally considered to be crucial in reducing maternal mortality and morbidity. Although home deliveries are discouraged in Ethiopia due to an associated higher risk of maternal mortality or morbidity, the majority of women in the Afar region continue to deliver at home. Numerous barriers contribute to the low utilization of health facility delivery and skilled birth attendance services in the Afar region. Objective: Investigate the perceptions and decision-making processes of pastoralist women from Afar regarding home and institutional childbirth using the health belief model. Methods: A qualitative study was conducted to examine the socio-cultural perceptions that influence the decisionmaking of Afar women who utilize institutional delivery services and those who deliver at home. A total of 13 women aged 17 to 45 who gave birth within the past four years before the data collection period were selected, based on a purposive selection strategy, and took part in in-depth interviews. Atlas.ti 7 software was used for deductive content analysis. Upcoming themes were assigned to pre-determined constructs of the health belief model. Results: The main barriers to the demand, access and use of facility-based delivery were lack of awareness regarding the risks of childbirth; lack of support from social networks; the strong impact of husbands' opinions; difficulties associated with discussing reproductive health issues; the reliance on traditional birth attendants; lifestyle factors; cultural needs; and distrust in skilled birth attendants and health facilities. The factors that motivated women to use delivery services provided by skilled birth attendants were associated with strong communal and kinship support; antenatal care visits; high awareness of pregnancy-related risks; the influence of previous negative birth experiences; and the belief that facility-based delivery brings faster recovery from birthrelated wounds. Conclusions: The data give in-depth insights into a range of socio-cultural factors that prevent or facilitate the choice of institutional delivery. Based on our findings, recommendations to increase the uptake of institutional delivery services should focus on community and family involvement, as well as on individual factors. Similarly, effective integration of traditional birth attendants should be encouraged to advise mothers to utilize reproductive, maternal and neonatal health services, and arrange a timely referral of women to emergency obstetric care. Furthermore, making facility-based care more culturally attractive to the needs of pastoralist women should be addressed in future interventions

Application of the urban exposome framework using drinking water and quality of life indicators: a proof-of-concept study in Limassol, Cyprus

Background Cities face rapid changes leading to increasing inequalities and emerging public health issues that require cost-effective interventions. The urban exposome concept refers to the continuous monitoring of urban environmental and health indicators using the city and smaller intra-city areas as measurement units in an interdisciplinary approach that combines qualitative and quantitative methods from social sciences, to epidemiology and exposure assessment. Methods In this proof of concept study, drinking water and quality of life indicators were described as part of the development of the urban exposome of Limassol (Cyprus) and were combined with agnostic environment-wide association analysis. This study was conducted as a two-part project with a qualitative part assessing the perceptions of city stakeholders, and quantitative part using a cross-sectional study design (an urban population study). We mapped the water quality parameters and participants’ opinions on city life (i.e., neighborhood life, health care, and green space access) using quarters (small administrative areas) as the reference unit of the city. In an exploratory, agnostic, environment-wide association study analysis, we used all variables (questionnaire responses and water quality metrics) to describe correlations between them. Results Overall, urban drinking-water quality using conventional indicators of chemical (disinfection byproducts-trihalomethanes (THM)) and microbial (coliforms, E. coli, and Enterococci) quality did not raise particular concerns. The general health and chronic health status of the urban participants were significantly (false discovery rate corrected p-value < 0.1) associated with different health conditions such as hypertension and asthma, as well as having financial issues in access to dental care. Additionally, correlations between THM exposures and participant behavioral characteristics (e.g., household cleaning, drinking water habits) were documented. Conclusion This proof-of-concept study showed the potential of using integrative approaches to develop urban exposomic profiles and identifying within-city differences in environmental and health indicators. The characterization of the urban exposome of Limassol will be expanded via the inclusion of biomonitoring tools and untargeted metabolomics

Sustopia or Cosmopolis? A Critical Reflection on the Sustainable City

A broader perspective on the role of cities and their relation to their inhabitants and the planet is essential to effectively answer urgent sustainability questions that emerge in and beyond cities. This essay provides a critical reflection on the notion of the sustainable city. The central question discussed is: how can the ideal of a sustainable city be best conceptualised? Through exploring historic and contemporary theories on the urban-nature-people relationship and analysing some current sustainable city projects with the help of Cultural Theory, it is argued that creating a sustainable city paradoxically means parting with Sustopia. Sustopia often turns into Dystopia when a single perspective on constructing a sustainable city becomes dominant. In order to assist the process of meaningfully conceptualising the sustainable city, the notion of Cosmopolis is re-explored. This notion of a city embraces creativity, critical practice, adaptation, and it places urban development and planning in a context of multiple spatial and temporal scales

Wilding or worrying? Place meaning in a rewilding landscape

Public acceptance of 'place change' is an issue of increasing significance in the UK as post-Brexit policy changes push more landowners to provide ecosystem services. This research looks into the existing conservation project of Knepp Wildland to contribute to understanding the effects of place change on 'place meaning' for the local community. Place meaning looks beyond specific attitudes, to engage in the emotive subjective experience of places for people. The results were collected by means of a qualitative questionnaire distributed through purposive sampling online community groups and finding other contacts through snowballing. Theoretical thematic analysis was conducted using Jacobs and Buijs' (2011) place meaning categories: beauty, functionality, attachment, biodiversity and risk, with two additional categories: emotions-in-place and temporality. The main finding is that in the case of transitioning from an agricultural to a rewilding landscape, place change affects place meaning by triggering renegotiation of place meaning for people themselves and their relationship to the landscape. This can also be understood as causing a change in cultured naturalness, which reflects a community's local identity and way of life, over time. This renegotiation of place meaning included an increasing sense of ecological loss, changing view of visible stewardship, and increasing appreciation of wildlife. Influences on how place change affected place meaning were perceptions on access, wilderness, and belonging. The results also indicate that over time the place meaning derived from Knepp Estate's rewilding landscape is predominantly positive, particularly evident from the emotions-in-place expressed

BIMBY’s first steps: a pilot study on the contribution of residential front-yards in Phoenix and Maastricht to biodiversity, ecosystem services and urban sustainability

Large parts of urban space around the world exist of small-scale plots such as domestic gardens. These small-scale urban spaces carry potential for enhancing biodiversity, sustainability and ecosystem services in and beyond cities. However, domestic gardening and residential garden designs are often guided by aesthetics and ease more than by the aim to create habitat and biological diversity. Yard-management decisions impact socio-ecological systems in various ways, for example through irrigation patterns, fertilization or the use of pesticides or through the choice for exotic species that may become invasive over time. Yard-management decisions can also positively influence the presence of pollinators, improve soil quality or even foster small scale 'Wildlife Habitats' that can function as ecological stepping stones to the wider environment. In this paper a pilot assessment is presented of the contribution of residential front-yards in Phoenix (Arizona) and Maastricht (The Netherlands) to biodiversity, ecosystem services and sustainability by applying the BIMBY (Biodiversity in My (Back) Yard) framework

Wilding or worrying? Place meaning in a rewilding landscape

Public acceptance of 'place change' is an issue of increasing significance in the UK as post-Brexit policy changes push more landowners to provide ecosystem services. This research looks into the existing conservation project of Knepp Wildland to contribute to understanding the effects of place change on 'place meaning' for the local community. Place meaning looks beyond specific attitudes, to engage in the emotive subjective experience of places for people. The results were collected by means of a qualitative questionnaire distributed through purposive sampling online community groups and finding other contacts through snowballing. Theoretical thematic analysis was conducted using Jacobs and Buijs' (2011) place meaning categories: beauty, functionality, attachment, biodiversity and risk, with two additional categories: emotions-in-place and temporality. The main finding is that in the case of transitioning from an agricultural to a rewilding landscape, place change affects place meaning by triggering renegotiation of place meaning for people themselves and their relationship to the landscape. This can also be understood as causing a change in cultured naturalness, which reflects a community's local identity and way of life, over time. This renegotiation of place meaning included an increasing sense of ecological loss, changing view of visible stewardship, and increasing appreciation of wildlife. Influences on how place change affected place meaning were perceptions on access, wilderness, and belonging. The results also indicate that over time the place meaning derived from Knepp Estate's rewilding landscape is predominantly positive, particularly evident from the emotions-in-place expressed

Noah’s Ark or World Wild Web? Cultural Perspectives in Global Scenario Studies and Their Function for Biodiversity Conservation in a Changing World

In this paper, we review the Intergovernmental Panel on Climate Change and the Millennium Ecosystem Assessment Scenarios and their assumptions on biodiversity conservation, using a framework based on the cultural theory (CT) perspectives. We explored an adaptation of the CT typology and the significance of some underrepresented worldviews for discussions on conservation in a changing world. The evaluation of the assumptions on biodiversity conservation in the scenario studies and storylines adds to our understanding of the socio-cultural dimensions of biodiversity loss in a changing world. It contributes to an understanding of the worldviews underlying the complex debates on biodiversity conservation and sustainable development. Making such assumptions and world views explicit will help policymakers and conservationists discuss the diversity of conservation strategies in the face of uncertainty.global scenario studies; cultural perspectives; biodiversity conservation; ecosystem services