Diffusion of electronic water payment innovations in urban Ghana. Evidence from Tema Metropolis

Recent advances in mobile technologies, especially in the utility payment space, are having an increasingly profound impact on our daily lives and offer advantageous services in the utility sectors. This paper examines the prevalence and patterns of customer uptake of an electronic water payment (EWP) system and its implications for water delivery in the Tema Metropolitan Area, Ghana. Data for the study comprised a survey of 250 utility customers and the review of a 12-month water use and customer payment database from a water supply company. Results indicate that although customers were aware of EWP’s existence, overall uptake was very low. EWP awareness and intention to use EWP were not significantly associated with customers’ gender,phone/mobile money ownership,educational status, and water usage. However, age, employment status, income, and means of receiving monthly bills were found to be statistically different in relation to the awareness of EWP. These findings offer several implications for water service and utility providers to market mobile payment solutions and to increase the consumer uptake of these services and payment options

‘It doesn’t happen how you think, it is very complex!’ Reconciling stakeholder priorities, evidence, and processes for zoonoses prioritisation in India

BackgroundWhy do some zoonotic diseases receive priority from health policy decision-makers and planners whereas others receive little attention? By leveraging Shiffman and Smith’s political prioritisation framework, our paper advances a political economy of disease prioritisation focusing on four key components: the strength of the actors involved in the prioritisation, the power of the ideas they use to portray the issue, the political contexts in which they operate, and the characteristics of the issue itself (e.g., overall burdens, severity, cost-effective interventions). These components afford a nuanced characterisation of how zoonotic diseases are prioritised for intervention and highlight the associated knowledge gaps affecting prioritisation outcomes. We apply this framework to the case of zoonoses management in India, specifically to identify the factors that shape disease prioritisation decision-making and outcomes.MethodsWe conducted 26 semi-structured interviews with national, state and district level health policymakers, disease managers and technical experts involved in disease surveillance and control in India.ResultsOur results show pluralistic interpretation of risks, exemplified by a disconnect between state and district level actors on priority diseases. The main factors identified as shaping prioritisation outcomes were related to the nature of the zoonoses problem (the complexity of the zoonotic disease, insufficient awareness and lack of evidence on disease burdens and impacts) as well as political, social, cultural and institutional environments (isolated departmental priorities, limited institutional authority, opaque funding mechanisms), and challenges in organisation leadership for cross-sectoral engagement.ConclusionThe findings highlight a compartmentalised regulatory system for zoonoses where political, social, cultural, and media factors can influence disease management and prioritisation. A major policy window is the institutionalisation of One Health to increase the political priority for strengthening cross-sectoral engagement to address several challenges, including the creation of effective institutions to reconcile stakeholder priorities and prioritisation processes

What is the state of the art on traditional medicine interventions for zoonotic diseases in the Indian subcontinent? A scoping review of the peer-reviewed evidence base

•Background: Traditional medicine (TM) interventions are plausible therapeutic alternatives to conventional medical interventions against emerging and endemic zoonotic diseases, particularly in low-and middle-income countries that may lack resources and infrastructure. Despite the growing popularity in the usage of TM interventions, their clinical safety and effectiveness are still contested within conventional healthcare in many countries. •Methods: We conducted a scoping review of the peer-reviewed literature that synthesises and maps the evidence on TM interventions for the treatment and prevention of zoonoses on the Indian subcontinent. The region, a global hotspot of biodiversity and emerging infections, is characterised by high prevalence of TM use. Based on the scientific literature (mostly case study research, n=l06 studies), our review (1) maps the scope of the literature, (2) synthesises the evidence on the application of TM interventions for zoonoses, and (3) critically reflects on the state of TM and identifies areas for future research focus. •Results: The evidence synthesis confirmed widespread usage of TM interventions for zoonoses on the subcontinent, with the majority of research reported from India (n=99 studies, 93.4%), followed by Pakistan (n=3 studies, 2.8%), Bangladesh (n=2 studies, 1.9%), and Sri Lanka (n=1, 0.9%). Most of the reviewed studies reported on ethno-medicinal uses of plant species, primarily for treating dengue (n=20 studies), tuberculosis (n=18 studies), Escherichia coli infection (n=16 studies), lymphatic filariasis and cholera (n=9 apiece). However, the evidence on the safety and effectiveness of these reported TM interventions is limited, indicating that these data are rarely collected and/or shared within the peer-reviewed literature. •Conclusion: This review thus highlights that, whilst TMs are already being used and could offer more widely accessible interventions against emerging and endemic zoonoses and ectoparasites, there is an urgent need for rigorous clinical testing and validation of the safety and effectiveness of these interventions

‘None of my ancestors ever discussed this disease before!’ How disease information shapes adaptive capacity of marginalised rural populations in India

Smallholder farmer and tribal communities are often characterised as marginalised and highly vulnerable to emerging zoonotic diseases due to their relatively poor access to healthcare, worse-off health outcomes, proximity to sources of disease risks, and their social and livelihood organisation. Yet, access to relevant and timely disease information that could strengthen their adaptive capacity remain challenging and poorly characterised in the empirical literature. This paper addresses this gap by exploring the role of disease information in shaping the adaptive capacity of smallholder farmer and tribal groups to Kyasanur Forest Disease (KFD), a tick-borne viral haemorrhagic fever. We carried out household surveys (n = 229) and in-depth interviews (n = 25) in two affected districts–Shimoga and Wayanad–in the Western Ghats region. Our findings suggest that, despite the generally limited awareness about KFD, access to disease information improved households’ propensity to implement adaptation strategies relative to households that had no access to it. Of the variety of adaptation strategies implemented, vaccination, avoiding forest visits, wearing of protective clothing and footwear, application of dimethyl phthalate (DMP) oil and income diversification were identified by respondents as important adaptive measures during the outbreak seasons. Even so, we identified significant differences between individuals in exposure to disease information and its contribution to substantive adaptive action. Households reported several barriers to implement adaptation strategies including, lack of disease information, low efficacy of existing vaccine, distrust, religio-cultural sentiments, and livelihood concerns. We also found that informal information sharing presented a promising avenue from a health extension perspective albeit with trade-offs with potential distortion of the messages through misinformation and/or reporting bias. Altogether, our findings stress the importance of contextualising disease information and implementing interventions in a participatory way that sufficiently addresses the social determinants of health in order to bolster households’ adaptive capacity to KFD and other neglected endemic zoonoses

Co-production of knowledge as part of a OneHealth approach to better control zoonotic diseases

There is increased global and national attention on the need for effective strategies to control zoonotic diseases. Quick, effective action is, however, hampered by poor evidence-bases and limited coordination between stakeholders from relevant sectors such as public and animal health, wildlife and forestry sectors at different scales, who may not usually work together. The OneHealth approach recognises the value of cross-sectoral evaluation of human, animal and environmental health questions in an integrated, holistic and transdisciplinary manner to reduce disease impacts and/or mitigate risks. Co-production of knowledge is also widely advocated to improve the quality and acceptability of decision-making across sectors and may be particularly important when it comes to zoonoses. This paper brings together OneHealth and knowledge co-production and reflects on lessons learned for future OneHealth co-production processes by describing a process implemented to understand spill-over and identify disease control and mitigation strategies for a zoonotic disease in Southern India (Kyasanur Forest Disease). The co-production process aimed to develop a joint decision-support tool with stakeholders, and we complemented our approach with a simple retrospective theory of change on researcher expectations of the system-level outcomes of the co-production process. Our results highlight that while co-production in OneHealth is a difficult and resource intensive process, requiring regular iterative adjustments and flexibility, the beneficial outcomes justify its adoption. A key future aim should be to improve and evaluate the degree of inter-sectoral collaboration required to achieve the aims of OneHealth. We conclude by providing guidelines based on our experience to help funders and decision-makers support future co-production processes

Building on “traditional” land dispute resolution mechanisms in rural Ghana: adaptive or anachronistic?

Despite the ongoing land administration reforms being implemented across sub-Saharan Africa (SSA), including Ghana, as a viable pathway to achieve tenure security and greater efficiency in land administration, the subject of land dispute resolution has received relatively less attention. Whereas customary tenure institutions play a central role in land administration (controlling ~80% of all land in Ghana), they remain at the fringes of the formal land dispute adjudicatory process. Recognising the pivotal role of traditional institutions as development agents and potential vehicles for promoting good land governance, recent discourses on land tenure have geared toward mainstreaming traditional land dispute institutions into the architecture of the formal judicial process via alternative dispute resolution pathways. Yet, little is known, at least empirically, as to the operations of traditional dispute resolution institutions in the contemporary context. This study therefore explores the importance of traditional dispute resolution institutions in the management of land-related disputes in southcentral and western Ghana, drawing on data collated from 380 farming households operating 746 plots. The results show that contrary to the conventional thinking that traditional institutions are anachronistic and not fit for purpose, they remain strong and a preferred forum for land dispute resolution (proving resilient and adaptable), given the changing socio-economic and tenurial conditions. Yet, these forums have differing implications for different actors within the customary spheres accessing them. The results highlight practical ways for incorporating traditional dispute resolution in the overall land governance setup in Ghana and elsewhere in sub-Saharan Africa. This has implications for redesigning context-specific and appropriate land-use policy interventions that address local land dispute resolution

Windows of opportunity or windows of exclusion? Changing dynamics of tenurial relations in rural Ghana

Central to contemporary debates on land tenure in sub-Saharan Africa are questions concerning appropriate pathways to successfully harmonize customary and statutory land tenure arrangements to address normative goals of improving access to land and security of tenure for the poor and marginalized. These are particularly prevalent in the face of increasing commodification and individualisation of land rights. Developing appropriate land policies requires a detailed understanding of existing tenurial dynamics. This paper draws on a mixture of qualitative methods and a household survey among 380 farmers from 19 villages in the Kakum and Ankasa areas of southcentral and western Ghana, to explore the mechanisms of land access, control and ownership arrangements, focusing on key differentiations around gender, age and ethnicity. The results articulate how transformations in land tenure have shifted patterns of accessing land in favour of wealthier individuals to the relative disadvantage of women, young people and poor people regardless of ethnicity. The analysis further indicates that the ‘self-transformation’ or dynamism of local customary tenure arrangements is inadequate for addressing issues of challenges in access to and control of land, particularly by the vulnerable social groups. This is evidenced by some traditional authorities and local powerful elites capitalizing on the ‘new opportunities’ afforded by the emergent tenurial relations to advance their individual interests at the expense of the vulnerable groups. Overall, the study highlights how on-going changes in customary tenure arrangements towards individualisation are far more complex and socially embedded than is often assumed. The paper underscores the need for land policy reforms to shift away from static approaches geared towards promoting efficiency or merely lauding customary tenure arrangements towards more flexible approaches that accommodate the complexity of contemporary changes to land tenure arrangements

Questioning the link between tenure security and sustainable land management in cocoa landscapes in Ghana

Sustainable land management (SLM) is increasingly recognized as viable pathway to accelerate poverty reduction and achieving sustainable development, particularly in the global South. Despite efforts to promote SLM practices, their adoption has been extremely limited with debates revolving around the role of land tenure in farmer’s decision-making. Drawing on a tripartite conception of tenure security, we distinguish between three categories of tenure security: 1) legal security; 2) contextual/ defacto security, and 3) perceived tenure security to examine factors affecting smallholders’ investment in SLM in Ghana. The paper draws on 380 surveys covering 796 plots and a series of key informant interview to investigate how land tenure shapes farmers’ investment decisions regarding SLM adoption at the plot level. The findings of the study demonstrate that different types of SLM investments (including soil improvements, on-farm tree planting and conservation of naturally-occurring tree species) were undertaken by farmers, even those who perceived their tenure rights as insecure. However, the results demonstrate that different components of tenure security influence adoption of SLM practices in ways which are not consistent across the different components of tenure security or specific SLM practices. Furthermore, the relationship between tenure security and SLM investments is also mediated by other important non-tenurial factors (including access to credit, modernised agricultural inputs and targeted extension service support). The findings suggest that land tenure policies will deliver a range of outcomes (both positive and negative) pertaining to land conservation investments. This means thinking more deeply about priorities with respect to SLM interventions, particularly in emerging contexts like Ghana and SSA generally. Overall, these findings are important for redesigning context- specific and appropriate land-use policy interventions that address barriers to SLM adoption

Utility of decision tools for assessing plant health risks from management strategies in natural environments.

Publication status: PublishedFunder: Forest ResearchFunder: NatureScot; doi: http://dx.doi.org/10.13039/100014610Funder: Cumbria WoodlandsFunder: Scottish ForestryFunder: Centre for Ecology and Hydrology; doi: http://dx.doi.org/10.13039/501100011027Funder: Royal Botanic Garden EdinburghFunder: Plant Health Cente ‐ Scotland's Centre of ExpertiseFunder: The Scottish Forestry TrustIncreased imports of plants and timber through global trade networks provide frequent opportunities for the introduction of novel plant pathogens that can cross-over from commercial to natural environments, threatening native species and ecosystem functioning. Prevention or management of such outbreaks relies on a diversity of cross-sectoral stakeholders acting along the invasion pathway. Yet, guidelines are often only produced for a small number of stakeholders, missing opportunities to consider ways to control outbreaks in other parts of the pathway. We used the infection of common juniper with the invasive pathogen Phytophthora austrocedri as a case study to explore the utility of decision tools for managing outbreaks of plant pathogens in the wider environment. We invited stakeholders who manage or monitor juniper populations or supply plants or management advice to participate in a survey exploring their awareness of, and ability to use, an existing decision tree produced by a coalition of statutory agencies augmented with new distribution maps designed by the authors. Awareness of the decision tree was low across all stakeholder groups including those planting juniper for restoration purposes. Stakeholders requested that decision tools contain greater detail about environmental conditions that increase host vulnerability to the pathogen, and clearer examples of when management practices implicated in pathogen introduction or spread should not be adopted. The results demonstrate the need to set clear objectives for the purpose of decision tools and to frame and co-produce them with many different stakeholders, including overlooked groups, such as growers and advisory agents, to improve management of pathogens in the wider environment

‘It doesn’t happen how you think, it is very complex!’ Reconciling stakeholder priorities, evidence, and processes for zoonoses prioritisation in India

International audienceBackground: Why do some zoonotic diseases receive priority from health policy decision-makers and planners whereas others receive little attention? By leveraging Shiffman and Smith's political prioritisation framework, our paper advances a political economy of disease prioritisation focusing on four key components: the strength of the actors involved in the prioritisation, the power of the ideas they use to portray the issue, the political contexts in which they operate, and the characteristics of the issue itself (e.g., overall burdens, severity, costeffective interventions). These components afford a nuanced characterisation of how zoonotic diseases are prioritised for intervention and highlight the associated knowledge gaps affecting prioritisation outcomes. We apply this framework to the case of zoonoses management in India, specifically to identify the factors that shape disease prioritisation decision-making and outcomes. Methods: We conducted 26 semi-structured interviews with national, state and district level health policymakers, disease managers and technical experts involved in disease surveillance and control in India. Results: Our results show pluralistic interpretation of risks, exemplified by a disconnect between state and district level actors on priority diseases. The main factors identified as shaping prioritisation outcomes were related to the nature of the zoonoses problem (the complexity of the zoonotic disease, insufficient awareness and lack of evidence on disease burdens and impacts) as well as political, social, cultural and institutional environments (isolated departmental priorities, limited institutional authority, opaque funding mechanisms), and challenges in organisation leadership for cross-sectoral engagement. Conclusion: The findings highlight a compartmentalised regulatory system for zoonoses where political, social, cultural, and media factors can influence disease management and prioritisation. A major policy window is the institutionalisation of One Health to increase the political priority for strengthening cross-sectoral engagement to address several challenges, including the creation of effective institutions to reconcile stakeholder priorities and prioritisation processes