Bed net use and associated factors in a rice farming community in Central Kenya

<p>Abstract</p> <p>Background</p> <p>Use of insecticide-treated nets (ITNs) continues to offer potential strategy for malaria prevention in endemic areas. However their effectiveness, sustainability and massive scale up remain a factor of socio-economic and cultural variables of the local community which are indispensable during design and implementation stages.</p> <p>Methods</p> <p>An ethnographic household survey was conducted in four study villages which were purposefully selected to represent socio-economic and geographical diversity. In total, 400 households were randomly selected from the four study villages. Quantitative and qualitative information of the respondents were collected by use of semi-structured questionnaires and focus group discussions.</p> <p>Results</p> <p>Malaria was reported the most frequently occurring disease in the area (93%) and its aetiology was attributed to other non-biomedical causes like stagnant water (16%), and long rains (13%). Factors which significantly caused variation in bed net use were occupant relationship to household head (χ²= 105.705; df 14; P = 0.000), Age (χ²= 74.483; df 14; P = 0.000), village (χ²= 150.325; df 6; P = 0.000), occupation (χ²= 7.955; df 3; P = 0.047), gender (χ²= 4.254; df 1; P = 0.039) and education levels of the household head or spouse (χ²= 33.622; df 6; P = 0.000). The same variables determined access and conditions of bed nets at household level. Protection against mosquito bite (95%) was the main reason cited for using bed nets in most households while protection against malaria came second (54%). Colour, shape and affordability were some of the key potential factors which determined choice, use and acceptance of bed nets in the study area.</p> <p>Conclusion</p> <p>The study highlights potential social and economic variables important for effective and sustainable implementation of bed nets-related programmes in Sub-Saharan Africa.</p

Malaria vector control practices in an irrigated rice agro-ecosystem in central Kenya and implications for malaria control

<p>Abstract</p> <p>Background</p> <p>Malaria transmission in most agricultural ecosystems is complex and hence the need for developing a holistic malaria control strategy with adequate consideration of socio-economic factors driving transmission at community level. A cross-sectional household survey was conducted in an irrigated ecosystem with the aim of investigating vector control practices applied and factors affecting their application both at household and community level.</p> <p>Methods</p> <p>Four villages representing the socio-economic, demographic and geographical diversity within the study area were purposefully selected. A total of 400 households were randomly sampled from the four study villages. Both semi-structured questionnaires and focus group discussions were used to gather both qualitative and quantitative data.</p> <p>Results</p> <p>The results showed that malaria was perceived to be a major public health problem in the area and the role of the vector <it>Anopheles </it>mosquitoes in malaria transmission was generally recognized. More than 80% of respondents were aware of the major breeding sites of the vector. Reported personal protection methods applied to prevent mosquito bites included; use of treated bed nets (57%), untreated bed nets (35%), insecticide coils (21%), traditional methods such as burning of cow dung (8%), insecticide sprays (6%), and use of skin repellents (2%). However, 39% of respondents could not apply some of the known vector control methods due to unaffordability (50.5%), side effects (19.9%), perceived lack of effectiveness (16%), and lack of time to apply (2.6%). Lack of time was the main reason (56.3%) reported for non-application of environmental management practices, such as draining of stagnant water (77%) and clearing of vegetations along water canals (67%).</p> <p>Conclusion</p> <p>The study provides relevant information necessary for the management, prevention and control of malaria in irrigated agro-ecosystems, where vectors of malaria are abundant and disease transmission is stable.</p

A Disruptive Innovation Approach to Design a Business Model for a Startup DigitalHealthcare Platform.

Date: 27/05/2021 Level: Bachelor thesis in Business Administration, 15 cr Institution: School of Business, Society and Engineering, Mälardalen University Authors: Hekmat Bsirini, Moe Gamil Hashem, and Hasitha Gayathri Jayasinghe                    (93/04/22)        ( 90\08\23 )                 ( 86/11/04 ) Title: A Disruptive Innovation Approach to Design a Business Model for a Startup DigitalHealthcare Platform. Tutor: Leanne Johnstone Keywords: disruptive innovation - healthcare - business model - digitalization - business modelinnovation. Research question: How should a disruptive innovation be successfully integrated into the business model of a digital healthcare platform startup, in terms of its value proposition? Purpose: Understanding the importance of innovative business models for new entrants to the healthcare sector, in terms of the marketing-related elements (namely, customer relationships, segments, and channels) which affect the whole process as the means to implement strategic aims. Method: This study used an action research approach. Data was generated by three integrative methods; a discussion with five board members of the case company, a secondary data review, and a questionnaire survey with potential customers. Conclusion: The model developed in this study identifies the implications of the disruptive innovation approach for a startup digital healthcare platform. It points out, identifying a customer segment that has been away from digital healthcare platforms due to certain inefficiencies in current platforms and designing the business model elements to cater to their needs eventually leads to the domination of the startup in the market

Effect of chlorination of drinking-water on water quality and childhood diarrhoea in a village in Pakistan.

To evaluate the importance of public-domain transmission of pathogens in drinking-water, an intervention study was carried out by chlorinating the public water-supply system in a village in Pakistan. The water quality improved and reached a geometric mean of 3 Escherichia coli per 100 mL at the last standpipe of the water-supply system. Drinking-water source used and the occurrence of diarrhoea were monitored on a weekly basis over a six-month period among 144 children aged less than five years in the village. In this group, the children using chlorinated water from the water-supply scheme had a higher risk of diarrhoea than children using groundwater sources, controlled for confounding by season and availability of a toilet and a water-storage facility. The incidence of diarrhoea in the village (7.3 episodes per 10(3) person-days) was not statistically different from that in a neighbouring village where most children used water from a non-chlorinated water-supply system with very poor water quality. In this study area, under non-epidemic conditions, the reduction of faecal bacteria in the public drinking-water supply by chlorination does not seem to be a priority intervention to reduce childhood diarrhoea. However, the study was of limited size and cannot provide conclusive evidence

Poverty impacts of agricultural water management technologies in Ethiopia

Farmers in rural Ethiopia live in a shock-prone environment. The major source of shock is the persistent variation in the amount and distribution of rainfall. The dependence on unreliable rainfall increases farmers’ vulnerability to shocks while also constraining farmers’ decisions to use yield-enhancing modern inputs exacerbating household’s vulnerability to poverty and food insecurity. As a response, the government of Ethiopia has embarked on massive investment in low cost agricultural water management technologies (AWMTs). Despite these huge investments, their impact remains hardly understood. The main focus of this paper was to explore whether access to selected AWMTs, such as deep and shallow wells, ponds, river diversions and small dams, has led to significant reduction in poverty, and if they did to identify which technologies have higher impacts. In measuring impact we followed different approaches: mean separation tests, propensity score matching and poverty analysis. The study used a unique dataset from a representative sample of 1517 households from 29 Kebeles in four regions of Ethiopia. Findings indicated that the estimated average treatment effect was significant and amounted to USD 82/ household. Moreover, there was 22% less poverty among users of AWMTs compared to non-users. The poverty impact of AWMT was also found to differ by technology type. Accordingly, deep wells, river diversions and micro dams have led to 50, 32 and 25 percent reduction in poverty levels compared to the reference, i.e. rain fed system. Finally, our study identified the most important determinants of poverty on the basis of which we made the policy recommendations: i) build assets; ii) human resource development; and iii) improve the functioning of labor markets and access to markets (input or output markets) for enhanced impact of AWMT on poverty

Poverty impacts of agricultural water management technologies in Ethiopia

Farmers in rural Ethiopia live in a shock-prone environment. The major source of shock is the persistent variation in the amount and distribution of rainfall. The dependence on unreliable rainfall increases farmers’ vulnerability to shocks while also constraining farmers’ decisions to use yield-enhancing modern inputs exacerbating household’s vulnerability to poverty and food insecurity. As a response, the government of Ethiopia has embarked on massive investment in low cost agricultural water management technologies (AWMTs). Despite these huge investments, their impact remains hardly understood. The main focus of this paper was to explore whether access to selected AWMTs, such as deep and shallow wells, ponds, river diversions and small dams, has led to significant reduction in poverty, and if they did to identify which technologies have higher impacts. In measuring impact we followed different approaches: mean separation tests, propensity score matching and poverty analysis. The study used a unique dataset from a representative sample of 1517 households from 29 Kebeles in four regions of Ethiopia. Findings indicated that the estimated average treatment effect was significant and amounted to USD 82/ household. Moreover, there was 22% less poverty among users of AWMTs compared to non-users. The poverty impact of AWMT was also found to differ by technology type. Accordingly, deep wells, river diversions and micro dams have led to 50, 32 and 25 percent reduction in poverty levels compared to the reference, i.e. rain fed system. Finally, our study identified the most important determinants of poverty on the basis of which we made the policy recommendations: i) build assets; ii) human resource development; and iii) improve the functioning of labor markets and access to markets (input or output markets) for enhanced impact of AWMT on poverty

Agricultural water management and poverty in Ethiopia

The main focus of this article is to explore whether access to selected agricultural water management (AWM) technologies has led to significant reduction in poverty and, if they did so, to identify which technologies had higher impacts. In measuring impact we estimated the average treatment effect for the treated on crop income and measured the differences in consumption expenditures per adult equivalent of those with access and without access using matched data. The estimated average treatment effect was significant and amounted to USD 82 per season. Moreover, there was 24 less poverty incidence among users of AWM technologies compared to nonusers. All technologies were found to have significant poverty reducing impacts with micro dams, deep wells, river diversions, and ponds leading to 37%, 26%, 11%, and 9% reduction in poverty incidence compared to rainfed system. Finally, our study identified the most important correlates of poverty on the basis this we made the policy recommendations to build assets (AWM technologies, livestock, etc); to enhance human resource development and improve the functioning of labor markets for enhanced impact of AWM technologies on poverty

Malaria and land use : a spatial and temporal risk analysis in Southern Sri Lanka

Malaria in Sri Lanka is unstable and epidemic, with large spatial and temporal differences in transmission dynamics. The disease is of great public-health significance and, hence, identification of underlying risk factors is important to target the limited resources for most cost-effective control of the disease. Health-seeking behavior in Sri Lanka is primarily in government-based facilities, with malaria-incidence rates reported in a systematic manner. Recently, the International Water Management Institute launched a project of malaria risk mapping in Sri Lanka to investigate whether this tool could be utilized for epidemic forecasting . We present the first results of the study for the Uda Walawe region in southern Sri Lanka. Data on aggregate malaria-incidence rates, land- and water-use patterns, socioeconomic features and malaria-control interventions were collected and put into a geographical information system. Malaria cases were mapped at the smallest administrative level, namely the Grama Niladhari Division. Relative risks for different variables were calculated employing multivariate analyses. Areas of high malaria risk were characterized by a) more than average rainfall , b) a large forest coverage, c) chena (slash-and-burn) cultivation, d) the presence of abandoned tanks, and e) a poor socioeconomic status. The risk of malaria in irrigated rice cultivation areas was lower than in other areas. People performing irrigated agriculture generally have higher socioeconomic, nutritional and health indicators, live in better constructed houses, and use preventive measures more frequently, and these might explain their lower malaria risk. However, ecological idiosyncrasies in malaria vector density or species composition might also account for this difference. Our findings call for malaria-control strategies that are readily adapted to different ecological and epidemiological settings. Malaria risk maps are a convenient tool for discussion with control personnel and for assisting them in targeted and cost-effective interventions

Domestic transmission routes of pathogens: the problem of in-house contamination of drinking water during storage in developing countries.

Even if drinking water of poor rural communities is obtained from a 'safe' source, it can become contaminated during storage in the house. To investigate the relative importance of this domestic domain contamination, a 5-week intervention study was conducted. Sixty-seven households in Punjab, Pakistan, were provided with new water storage containers (pitchers): 33 received a traditional wide-necked pitcher normally used in the area and the remaining 34 households received a narrow-necked water storage pitcher, preventing direct hand contact with the water. Results showed that the domestic domain contamination with indicator bacteria is important only when the water source is relatively clean, i.e. contains less than 100 Escherichia coli per 100 ml of water. When the number of E. coli in the water source is above this value, interventions to prevent the domestic contamination would have a minor impact on water quality compared with public domain interventions. Although the bacteriological water quality improved, elimination of direct hand contact with the stored water inside the household could not prevent the occasional occurrence of extreme pollution of the drinking water at its source. This shows that extreme contamination values that are often thought to originate within the domestic domain have to be attributed to the public domain transmission, i.e. filling and washing of the water pitchers. This finding has implications for interventions that aim at the elimination of these extreme contaminations