Theorizing community health governance for strengthening primary healthcare in LMICs

In recent years, community health governance structures have been established in many low and middle-income countries (LMICs) as part of decentralization policies aimed at strengthening primary healthcare systems. So far, most studies on these local structures either focus on measuring their impact on health outcome or on identifying the factors that affect their performance. In this paper we offer an alternative contribution that draws on a sociological interpretation of community health governance to improve understanding of how the government’s policy vision and instrumentation translate to interactions that take place within local spaces at field level. We study 13 Village Health Sanitation and Nutrition Committees (VHSNCs) in Karnataka, India, from 2016 to 2018 focusing on sanitation, nutrition and hygiene which remain impediments to improving primary healthcare amongst poor and marginalized communities. Three local governance mechanisms of horizontal coordination, demand for accountability and self-help help to explain improvements that have taken place at village level and contribute to the creation of a new theory of community health governance as evolving phenomenon that requires a constant process of learning from the field to strengthen policymaking

Challenges of accountability in resource-poor contexts: lessons about invited spaces from Karnataka’s village health committees

Invited spaces have been discussed by development scholars and policymakers as a new and important means of promoting accountability in primary healthcare. Although numerous experiments have been initiated to establish such spaces in resource-poor contexts, we still have little understanding of how these spaces are used and their effectiveness. Based on our longitudinal study of the Village Health Sanitation and Nutrition Committees (VHSNCs) in Karnataka, we trace changes that have occurred in the frequency and quality of interactions between state, political and civil society committee participants as they come to understand the possibilities afforded to them, work out tactics and develop a set of practices that make them accountable to each other for improving village health. Our findings suggest that strengthening accountability within invited spaces can form an important basis for improving the primary healthcare system with implications for research and policy

Characterization of flow rate and Heat Loss in Heating, Ventilation and Air Conditioning (HVAC) Duct System for Office Building

A building is an assemblage that is firmly attached to the ground and provides the performance of human activities and need to be considered in the daily operation in that building. The improvements in building performance are focused on improving the energy efficiency of buildings. This is approach by designing heating, ventilation and air conditioning (HVAC) duct system due to one of the most utilized energy in maintaining building performance and environment. The objectives of this research is to calculate the air (CFM) supply in office building, to characterize the velocity and head loss in a round and rectangular HVAC ducting system at various duct thickness and to optimize the thickness of the duct in HVAC system according to ASHRAE Standard. The increasing of velocity in duct system shows the increasing of head loss. The round duct design gives the lowest velocity and head loss in HVAC system approximately around 9.35% as compared to rectangular duct at 0.06 inches thickness. Hence, the trends of the head loss and duct thickness has influenced in reducing noise in HVAC duct system in order to select the best design concepts which is round shape design

Digitization to Support Generations of Refugees: How Can IS Research and Researchers Make a Difference?

In recent years, a new refugee crisis has been sweeping the world due to the continuous violence in different places and countries. These developments have caused unexpected challenges on different levels, ranging from individuals (including migrants and refugees and hosting populations) to organizations, countries, and continents (including those fleeing violence and hosting countries of fleeing individuals). Despite the urgency and the potential risks associated with the current refugee situation, relatively little work has been carried out by IS researchers on how to find the intersection between this societal topic and the use of technology to alleviate this crisis. The outcomes of the panel have implications for both academia and practice. We would like to uncover the beneficial use of digital transformation solutions that could help and empower refugees and host communities using the bright side of existing technologies in integrating refugees into society

Pure Cerebellar Ataxia with Homozygous Mutations in the PNPLA6 Gene

Autosomal-recessive cerebellar ataxias (ARCA) are clinically and genetically heterogeneous conditions primarily affecting the cerebellum. Mutations in the PNPLA6 gene have been identified as the cause of hereditary spastic paraplegia and complex forms of ataxia associated with retinal and endocrine manifestations in a field where the genotype-phenotype correlations are rapidly expanding. We identified two cousins from a consanguineous family belonging to a large Zoroastrian (Parsi) family residing in Mumbai, India, who presented with pure cerebellar ataxia without chorioretinal dystrophy or hypogonadotropic hypogonadism. We used a combined approach of clinical characterisation, homozygosity mapping, whole-exome and Sanger sequencing to identify the genetic defect in this family. The phenotype in the family was pure cerebellar ataxia. Homozygosity mapping revealed one large region of shared homozygosity at chromosome 19p13 between affected individuals. Within this region, whole-exome sequencing of the index case identified two novel homozygous missense variants in the PNPLA6 gene at c.3847G>A (p.V1283M) and c.3929A>T (p.D1310V) in exon 32. Both segregated perfectly with the disease in this large family, with only the two affected cousins being homozygous. We identified for the first time PNPLA6 mutations associated with pure cerebellar ataxia in a large autosomal-recessive Parsi kindred. Previous mutations in this gene have been associated with a more complex phenotype but the results here suggest an extension of the associated disease spectrum

A Validity Study of Malay-translated Version of the Modified Caregivers Strain Index Questionnaire (M-CSI-M)

Objectives The diversity of the population of the world suggests a great need for validated cross cultural survey instruments or scales.Health care professionals should have access to reliable sources and valid concepts of interest in their own cultures and languages to provide quality patient care.Therefore, the aims of this study were to translate the Modified Caregiver Strain Index (M-CSI) in the national language of Malaysia.Also to evaluate the validity and reliability of the Malay-translated version of Modified Caregiver Strain Index (M-CSI-M).Methods Instrument was translated forward and rearward through the translation strategy, reconciled by a panel, and verified by the Malaysian Institute of Translation & books as experts of content.After methodological approaches for the translation, adaptation and transcultural validation of Modified Caregiver Strain Index (M-CSI).The latest version of Malaysia was administered to 50 informal care providers of dependent elderly with the Parkinson’s disease, at the Association of Parkinson Malaysia (MPDA) and University Kebangsaan Malaysia (UKM) Medical Centre in May 2017.Results The Malaysians Modified Caregiver Strain Index (M-CSI-M) has a good face validity and content, as well as inner consistency (Cronbach’s alpha 0.75).In conclusion, the M-CSI-M is a reliable tool for the evaluation of caregiving strain levels experienced by informal care providers in Malaysia.M-CSI-M is recommended as a brief and valid measurement that can be used by doctors, counselors, social workers and psychologists to locate the caregiving strain levels of the informal care providers of dependent elderly in Malaysia

Socializing accountability for improving primary healthcare: an action research program in rural Karnataka

The Alma Ata Declaration of 1978 invoked a socialising form of accountability through which communities and health workers participated in and were jointly accountable for primary healthcare. Aside from a few experiments, by the 1990s these ideals were quickly replaced by policy prescriptions based on increasing efficiency in data quality and reporting through the introduction of health information systems. More recently, there has been a revival of interest in community participation as a mechanism for improving the poor status of primary healthcare in developing countries through the constitution of village health committees. This paper documents and reflects on nine years of research on interventions aimed at improving primary healthcare accountability in rural Karnataka. Over this period, our focus has shifted from studying how computerised health information systems can strengthen conventional accountability systems to a period of extended participatory action research aimed at socialising accountability practices at village level. The findings from this study constitute vital knowledge for reforming the primary healthcare sector through different policy measures including the design of appropriate technology-based solutions

Policing the community together: the impact of technology on citizen engagement

Despite broad and often varied underlying definitions, a common theme throughout community and neighbourhood policing strategies establishes the need to target improvements in the relationship and level of engagement between the police and the communities they serve. Community policing approaches have long underpinned a desire to move away from reactive policing models towards those which establish a more proactive philosophy, responsive to the wants and needs of the community. The near ubiquitous proliferation of smartphones and other ICTs (Information and Communication Technologies) means they are often seen as a vector through which initiatives of all kinds can instil a culture of proactive engagement with their respective stakeholder communities. This paper builds upon existing research which suggests that technologies for crime prevention should be designed to support communications and problem-solving rather than used simply as a means to disseminate information, unpacking a number of the core concepts that are considered central to participation and effective engagement; social capital, public participation and social and digital inclusion. Moreover, examples of wider initiatives are comparatively discussed, not just those associated with community policing, which target the engagement of communities through the use of technology, and more specifically mobile applications, before reflecting on the empirical evidence and experiences gleaned through the EU H2020 funded ‘UNITY’ project, a project that sought to establish effective strategies for engagement between police and citizen communities