Maternity waiting homes in Southern Lao PDR : the unique \u27silk home\u27

The concept of maternity waiting homes (MWH) has a long history spanning over 100 years. The research reported here was conducted in the Thateng District of Sekong Province in southern Lao People&rsquo;s Democratic Republic (PDR) to establish whether the MWH concept would be affordable, accessible, and most importantly acceptable, as a strategy to improve maternal outcomes in the remote communities of Thateng with a high proportion of the population from ethnic minority groups. The research suggested that there were major barriers to minority ethnic groups using existing maternal health services (reflected in very low usage of trained birth attendants and hospitals and clinics) in Thateng. Unless MWH are adapted to overcome these potential barriers, such initiatives will suffer the same fate as existing maternal facilities. Consequently, the Lao iteration of the concept, as operationalized in the Silk Homes project in southern Lao PDR is unique in combining maternal and infant health services with opportunities for micro credit and income generating activities and allowing non-harmful traditional practices to co-exist alongside modern medical protocols. These innovative approaches to the MWH concept address the major economic, social and cultural barriers to usage of safe birthing options in remote communities of southern Lao PDR.<br /

Cultural drivers and health-seeking behaviours that impact on the transmission of pig-associated zoonoses in Lao People's Democratic Republic

Pig rearing is an important income source in the Lao People’s Democratic Republic (PDR), with many smallholder farmers using traditional free-range pig production systems. Despite the potentially significant health risks posed by pig production regarding pig-associated zoonoses, information on the sociocultural drivers of these zoonoses is significantly lacking. This review summarises the existing sociocultural knowledge on eight pig-associated zoonoses suspected to be endemic in Southeast Asia: brucellosis, Q fever (Coxiella burnetii), trichinellosis, hepatitis E virus, leptospirosis, Japanese encephalitis, Streptococcus suis and Taenia solium taeniasis-cysticercosis. It summarises current knowledge on these diseases grouped according to their clinical manifestations in humans to highlight the propensity for underreporting. A literature search was conducted across multiple databases for publications from 1990 to the present day related to the eight pig-associated zoonoses and the risk and impact connected with them, with Lao PDR as a case study. Many of these pig-associated zoonoses have similar presentations and are often diagnosed as clinical syndromes. Misdiagnosis and underreporting are, therefore, substantial and emphasise the need for more robust diagnostics and appropriate surveillance systems. While some reports exist in other countries in the region, information is significantly lacking in Lao PDR with existing information coming mainly from the capital, Vientiane. The disease burden imposed by these zoonoses is not only characterised by morbidity and mortality, but directly impacts on livelihoods through income reduction and production losses, and indirectly through treatment costs and lost work opportunities. Other factors crucial to understanding and controlling these diseases are the influence of ethnicity and culture on food-consumption practices, pig rearing and slaughter practices, hygiene and sanitation, health-seeking behaviours and, therefore, risk factors for disease transmission. Published information on the knowledge, attitudes and beliefs of people regarding pig zoonoses and their risk factors is also extremely limited in Lao PDR and the broader Southeast Asian region. The need for more transdisciplinary research, using a One Health approach, in order to understand the underlining social determinants of health and their impacts on health-seeking behaviours, disease transmission and, ultimately, disease reporting, cannot be more emphasized

Lao PDR case study: Ministry of Public Works and Transport

The Ministry of Public Works and Transport (MPWT) of the Lao People’s Democratic Republic has achieved a great deal of institutional success in the road sector over the past 30 years. The ministry has led the construction and expansion of the road network and, in turn, dramatically improved transport times and access to economic opportunities for Lao households and enterprises. MPWT has generated legitimacy in the eyes of the Lao people for both itself and the Government of the Lao PDR writ large, in particular by improving access to markets and public services across the country and by helping to physically knit the country together. It has slowly expanded its mandate in the road sector and served as a crucial incubator of commercial enterprise in the Lao construction sector. Moreover, the ministry has continued operations through several changes in leadership and demonstrated resilience in the face of crises

Sustainable development in the uplands of Lao PDR

Smallholder farmers resident in marginalized communities in the uplands of Lao People's Democratic Republic (Lao PDR) have been subject to agricultural reforms and policies requiring adaptation of their rural livelihood systems and adoption of new agricultural technologies. Structured interviews with farmers explored their perspectives and experiences when developing economically viable, locally adapted and diversified livelihood and farming system strategies. Agricultural productivity was dependent on cultivatable land and forest biodiversity, while agricultural strategies embedded knowledge, information and ideas to enable farmers to adapt to changing conditions. Political, social, economic and environmental factors have influenced smallholder farmers in their preference and uptake of new technologies and activities. Opportunities to trial new technologies and further support, advice and information from extension officers and projects, combined with market opportunities and access to credit, will enable some farmers to find sustainable production alternatives. Copyright © 2009 John Wiley & Sons, Ltd and ERP Environment.