Engagement in agriculture protects against food insecurity and malnutrition in peri-urban Nepal

BACKGROUND: Urbanization is occurring rapidly in many low- and middle-income countries, which may affect households’ livelihoods, diet, and food security and nutritional outcomes. OBJECTIVE: The main objective of our study was to explore whether agricultural activity amongst a peri-urban population in Nepal was associated with better or worse food household security, household and maternal dietary diversity, and nutritional outcomes for children and women. METHODS: A cross-sectional survey administered to 344 mother-child pairs in Bhaktapur district, Nepal, including data on household agricultural practices, livestock ownership, food security, dietary diversity and expenditures, anthropometric measurements of children (aged 5–6 years old), maternal body mass index (BMI), and maternal anemia. Multivariable adjusted and unadjusted odds ratios (AOR and OR respectively) were calculated using logistic regression. RESULTS: Our findings suggest that in this sample, cultivation of land was associated with a lower odds of child stunting (AOR 0.55, 95% CI 0.33,0.93) and household food insecurity (AOR 0.33, 95% CI 0.18, 0.63), but not low (or high) maternal BMI or anemia. Livestock ownership (mostly chickens) was associated with lower of food insecurity (AOR 0.34, 95% CI 0.16, 0.73) but not with nutrition outcomes. Women in farming households were significantly more likely to eat green leafy vegetables than women in non-farming households, and children living in households that grew vegetables had a lower odds of stunting than children in households that cultivated land but did not grow vegetables (AOR 0.49, 95% CI 0.25, 0.98). CONCLUSIONS: Our study suggests that households involved in cultivation of land in peri-urban Bhaktapur had lower odds of children's stunting and of food insecurity than non-cultivating households – and that vegetable consumption is higher among those households. Given Nepal's rapid urbanization rate, more attention is needed to the potential role of peri-urban agriculture in shaping diets and nutrition.Funding was provided by the USAID Feed the Future Security Innovation Lab for Nutrition - Asia [award number AIDOAA-l-10-00005] through a sub-contract to the Harvard T.H. Chan School of Public Health and the Johns Hopkins Bloomberg School of Public Health from the Friedman School of Nutrition Science and Policy, Tufts University; and by the GC Rieber Foundation.https://academic.oup.com/cdn/advance-article/doi/10.1093/cdn/nzy078/5154906Accepted manuscrip

Changing housing policies and housing provision in Jos, Nigeria

Nigeria's housing problems have persisted regardless of changes in policy, strategies, actions and instruments. This study examines housing policy changes and factors that influence housing supply outcomes at the local level. The study reviews the state of housing provision in the national context. The focus is then turned to the city of Jos in north-central Nigeria, where institutional arrangements for the provision of housing are critically examined. Primary data was obtained through interviews with industry role players (government officers and house builders) and the views of people were sampled through a questionnaire survey. This data was then combined with secondary source material to examine financial mechanisms, subsidy provision and local-level organisational frameworks for partnership. The findings suggest that a shift from a state-led to an enabling approach for housing did stimulate the activities of private house-builders and primary mortgage institutions. However, their activities are not spread across the regions of Nigeria. The issue of equitable allocation of public housing across the regions of Nigeria by the federal agencies has not been addressed by the enabling policy framework. Further, the idea of decentralisation of housing provision was introduced but did not result in the formulation of strategies by the local authorities in Jos. The national housing policy itself appears to be ambiguous and difficult to implement by the authorities in Jos. The ambiguities arose because there is a lack of policy enforcement mechanism, political commitment, and a poor local organisation and coordination framework. These failures create uncertainties and risks for private house builders that partnered the government to access finance and subsidies for the provision of low-income housing in Jos. Also, there is limited participation of households due to lack of awareness on public policies. On the basis of the study's findings, some policy recommendations are made

Responsibility to Be Enthusiastic? Public Servants and the Public Face of “Promiscuous Partisanship”

Contemporary public service leaders are no longer the anonymous mandarins of Westminster folklore. Whether giving public speeches to outside organizations or communicating directly with the media, senior public servants are emerging from anonymity to become public actors in their own right. This article undertakes a comparative study across four Westminster jurisdictions-Australia, Canada, New Zealand, and the United Kingdom-to examine the formal rules and guidelines that apply to public servants when making public statements in their official capacity. Drawing on the late Peter Aucoin's notion of "promiscuous partisanship," the article argues that public servants are expected to demonstrate a new level of enthusiasm when explaining or justifying government policy to the public. This has implications for the extent to which nonpartisanship can continue to effectively function within Westminster systems.Griffith Business School, School of Government and International RelationsNo Full Tex

Preparing for disaster: a comparative analysis of education for critical infrastructure collapse

This article explores policy approaches to educating populations for potential critical infrastructure collapse in five different countries: the UK, the US, Germany, Japan and New Zealand. ‘Critical infrastructure’ is not always easy to define, and indeed is defined slightly differently across countries – it includes entities vital to life, such as utilities (water, energy), transportation systems and communications, and may also include social and cultural infrastructure. The article is a mapping exercise of different approaches to critical infrastructure protection and preparedness education by the five countries. The exercise facilitates a comparison of the countries and enables us to identify distinctive characteristics of each country’s approach. We argue that contrary to what most scholars of security have argued, these national approaches diverge greatly, suggesting that they are shaped more by internal politics and culture than by global approaches

Integrative policy development for healthier people and ecosystems : a European case analysis

There is growing evidence of the inter‐relationships between ecosystems and public health. This creates opportunities for the development of cross‐sectoral policies and interventions that provide dual benefits to public health and to the natural environment. These benefits are increasingly articulated in strategy documents at national and regional level, yet implementation of integrative policies on the ground remains limited and fragmented. Here, we use a workshop approach to identify some features of this evidence–implementation gap based on policy and practice within a number of western European countries. The driving forces behind some recent moves towards more integrative policy development and implementation show important differences between countries, reflecting the non‐linear and complex nature of the policy‐making process. We use these case studies to illustrate some of the key barriers to greater integrative policy development identified in the policy analysis literature. Specific barriers we identify include: institutional barriers; differing time perspectives in public health and ecosystem management; contrasting historical development of public health and natural environment disciplinary policy agendas; an incomplete evidence base relating investment in the natural environment to benefits for public health; a lack of appropriate outcome measures including benefit–cost trade‐offs; and finally a lack of integrative policy frameworks across the health and natural environment sectors. We also identify opportunities for greater policy integration and examples of good practice from different countries. However, we note there is no single mechanism that will deliver integrative policy for healthier people and ecosystems in all countries and situations. National governments, national public agencies, local governments, research institutions, and professional bodies all share a responsibility to identify and seize opportunities for influencing policy change, whether incremental or abrupt, to ensure that ecosystems and the health of society are managed so that the interests of future generations, as well as present generations, can be protected

"Monkey see, monkey do" : peers’ behaviors predict preschoolers’ physical activity and dietary intake in childcare centers

Abstract : Preschoolers observe and imitate the behaviors of those who are similar to them. Therefore, peers may be important role models for preschoolers’ dietary intake and physical activity in childcare centers. This study examined whether peers’ behaviors predict change in preschoolers’ dietary intake and physical activity in childcare centers over 9 months. A total of 238 preschoolers (3 to 5 years old) from 23 childcare centers in two Canadian provinces provided data at the beginning (October 2013 and 2014) and the end (June 2014 and 2015) of a 9-month period for this longitudinal study. Dietary intake was collected at lunch using weighed plate waste and digital photography on two consecutive weekdays. Physical activity was assessed using accelerometers over five days. Multilevel linear regressions were used to estimate the influence of peers’ behaviors on preschoolers’ change in dietary intake and physical activity over 9 months. Results showed that preschoolers whose dietary intake or physical activity level deviated the most from those of their peers at the beginning of the year demonstrated greater change in their intakes and activity levels over 9 months (all p values<0.05), which enabled them to become more similar to their peers. This study suggests that preschoolers’ dietary intake and physical activity may be influenced by the behaviors of their peers in childcare centers. Since peers could play an important role in promoting healthy eating behaviors and physical activity in childcare centers, future studies should test interventions based on positive role modeling by children

Retail sector distribution chains for malaria treatment in the developing world: a review of the literature

BACKGROUND: In many low-income countries, the retail sector plays an important role in the treatment of malaria and is increasingly being considered as a channel for improving medicine availability. Retailers are the last link in a distribution chain and their supply sources are likely to have an important influence on the availability, quality and price of malaria treatment. This article presents the findings of a systematic literature review on the retail sector distribution chain for malaria treatment in low and middle-income countries. METHODS: Publication databases were searched using key terms relevant to the distribution chain serving all types of anti-malarial retailers. Organizations involved in malaria treatment and distribution chain related activities were contacted to identify unpublished studies. RESULTS: A total of 32 references distributed across 12 developing countries were identified. The distribution chain had a pyramid shape with numerous suppliers at the bottom and fewer at the top. The chain supplying rural and less-formal outlets was made of more levels than that serving urban and more formal outlets. Wholesale markets tended to be relatively concentrated, especially at the top of the chain where few importers accounted for most of the anti-malarial volumes sold. Wholesale price mark-ups varied across chain levels, ranging from 27% to 99% at the top of the chain, 8% at intermediate level (one study only) and 2% to 67% at the level supplying retailers directly. Retail mark-ups tended to be higher, and varied across outlet types, ranging from 3% to 566% in pharmacies, 29% to 669% in drug shops and 100% to 233% in general shops. Information on pricing determinants was very limited. CONCLUSIONS: Evidence on the distribution chain for retail sector malaria treatment was mainly descriptive and lacked representative data on a national scale. These are important limitations in the advent of the Affordable Medicine Facility for Malaria, which aims to increase consumer access to artemisinin-based combination therapy (ACT), through a subsidy introduced at the top of the distribution chain. This review calls for rigorous distribution chain analysis, notably on the factors that influence ACT availability and prices in order to contribute to efforts towards improved access to effective malaria treatment

Ruled by records: The expropriation of land and the misappropriation of lists in Islamabad

In this article, I investigate the ongoing battle between villagers on the outskirts of Islamabad, Pakistan, and the state development agency attempting to expropriate their land. This battle has been waged through the medium of documents, particularly lists, which villagers and colluding officials have used to defraud the Pakistani government of the equivalent of millions of dollars. Through this case study, I develop an approach to contemporary state governance as material practice, showing how government discourse is shaped by the material forms it takes and highlighting the issue of reference and predication (or how words relate to things). [ governance, documents, state, semiotics, technology, materiality, South Asia, Pakistan ]Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75363/1/j.1548-1425.2008.00095.x.pd

Human resources requirements for highly active antiretroviral therapy scale-up in Malawi

<p>Abstract</p> <p>Background</p> <p>Twelve percent of the adult population in Malawi is estimated to be HIV infected. About 15% to 20% of these are in need of life saving antiretroviral therapy. The country has a public sector-led antiretroviral treatment program both in the private and public health sectors. Estimation of the clinical human resources needs is required to inform the planning and distribution of health professionals.</p> <p>Methods</p> <p>We obtained data on the total number of patients on highly active antiretroviral treatment program from the Malawi National AIDS Commission and Ministry of Health, HIV Unit, and the number of registered health professionals from the relevant regulatory bodies. We also estimated number of health professionals required to deliver highly active antiretroviral therapy (HAART) using estimates of human resources from the literature. We also obtained data from the Ministry of Health on the actual number of nurses, clinical officers and medical doctors providing services in HAART clinics. We then made comparisons between the human resources situation on the ground and the theoretical estimates based on explicit assumptions.</p> <p>Results</p> <p>There were 610 clinicians (396 clinical officers and 214 physicians), 44 pharmacists and 98 pharmacy technicians and 7264 nurses registered in Malawi. At the end of March 2007 there were 85 clinical officer and physician full-time equivalents (FTEs) and 91 nurse FTEs providing HAART to 95,674 patients. The human resources used for the delivery of HAART comprised 13.9% of all clinical officers and physicians and 1.1% of all nurses. Using the estimated numbers of health professionals from the literature required 15.7–31.4% of all physicians and clinical officers, 66.5–199.3% of all pharmacists and pharmacy technicians and 2.6 to 9.2% of all the available nurses. To provide HAART to all the 170,000 HIV infected persons estimated as clinically eligible would require 4.7% to 16.4% of the total number of nurses, 118.1% to 354.2% of all the available pharmacists and pharmacy technicians and 27.9% to 55.7% of all clinical officers and physicians. The actual number of health professionals working in the delivery of HAART in the clinics represented 44% to 88.8% (for clinical officers and medical doctors) and 13.6% and 47.6% (for nurses), of what would have been needed based on the literature estimation.</p> <p>Conclusion</p> <p>HAART provision is a labour intensive exercise. Although these data are insufficient to determine whether HAART scale-up has resulted in the weakening or strengthening of the health systems in Malawi, the human resources requirements for HAART scale-up are significant. Malawi is using far less human resources than would be estimated based on the literature from other settings. The impact of HAART scale-up on the overall delivery of health services should be assessed.</p