Participatory action research for conservation and development: Experiences from the Amazon

Research that features participation and action orientation, such as participatory action research (PAR), is especially valuable in contexts where there is rapid change, high social inequality, and great uncertainty about the future, which drives stakeholder demands for information to support their goals. The Amazon offers such a context, for it is a region where diverse stakeholders engage in contestation over environmental governance to address issues such as climate change to achieve conservation and sustainable development. Stakeholder mobilization has changed the terms by which research is conducted, from the definition of priority topics to the application of findings. Due to stakeholder mobilization, more and more research in the Amazon is now necessarily participatory, for stakeholders routinely issue demands about how the research will be conducted and for what purpose. In this paper, we provide an overview of several experiences of implementing methods such as PAR by different teams or networks, focusing on the complementary contributions of outside researchers and local stakeholders. The heart of the paper reports on three broad types of experiences focusing on conservation and development in the Amazon: (1) participatory data collection for co-production of knowledge for environmental governance, (2) inclusive environmental monitoring systems, and (3) innovative models of knowledge exchange to facilitate collective action. Within each type, we report multiple experiences with distinct approaches to participation and action in research. These experiences constitute models that can be replicated in other places for broader impact to support conservation and developmen

Participatory Action Research for Conservation and Development: Experiences from the Amazon

Research that features participation and action orientation, such as participatory action research (PAR), is especially valuable in contexts where there is rapid change, high social inequality, and great uncertainty about the future, which drives stakeholder demands for information to support their goals. The Amazon offers such a context, for it is a region where diverse stakeholders engage in contestation over environmental governance to address issues such as climate change to achieve conservation and sustainable development. Stakeholder mobilization has changed the terms by which research is conducted, from the definition of priority topics to the application of findings. Due to stakeholder mobilization, more and more research in the Amazon is now necessarily participatory, for stakeholders routinely issue demands about how the research will be conducted and for what purpose. In this paper, we provide an overview of several experiences of implementing methods such as PAR by different teams or networks, focusing on the complementary contributions of outside researchers and local stakeholders. The heart of the paper reports on three broad types of experiences focusing on conservation and development in the Amazon: (1) participatory data collection for co-production of knowledge for environmental governance, (2) inclusive environmental monitoring systems, and (3) innovative models of knowledge exchange to facilitate collective action. Within each type, we report multiple experiences with distinct approaches to participation and action in research. These experiences constitute models that can be replicated in other places for broader impact to support conservation and development

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially