Environmental hazards and the health status of women and children in a riverine community in Nigeria: Nikrowa in Edo State

Nikrowa is a riverine village located in Ovia North-East Local Government Area of Edo State. This paper examines the relationship between the environment and the health status of women and children in the village. Data used in this essay were obtained mainly in focus groups from a study of women and health service utilization in Nikrowa. Women in Nikrowa farm, fish, collect water and firewood, and process and prepare food. They also bear many children. Their hard physical labor causes them to suffer continuous body aches and pains. Environment-related illnesses such as malaria, measles, dysentery, and diarrhea are prevalent among children. The geographical isolation of Nikrowa limits access to modern health care facilities, so traditional therapies are used to treat prevailing illnesses. It is suggested that women have access to fertilizers in order to improve soil fertility and agricultural yields. Fuelwood and adequate and safe water supplies should be made readily available to women. Moreover, access roads to rural areas should be improved to facilitate transport to modern health care facilities, and rural primary health care facilities should be helped to provide efficient services by providing trained staff and ensuring regular supplies of drugs.     

村庄次组织的培育与村民自治的成长

村民自治和村庄治理面临的种种困境需要寻求新的组织资源以保证村民自治的价值理念在农村中落实。村庄次组织的发育和成长,不仅不会取代村委会组织,成为村委会功能发挥的障碍,相反,在二者之间建立起民主合作体制,有利于基层群众建立基层政权民主制衡机制,保证村委会更好地发挥作用,推动村委会组织向村民自治精神回归,村民自治的成长空间在这种民主合作中也得以拓展。同时,还有利于更好地为村庄提供公共产品和公共服务,为农民维权提供制度化的渠道和组织化的力量,促进村民利益最大化,实现村庄善治。     

人文湾区建设视角下良溪古村落文化传承与发展研究

《粤港澳大湾区发展规划纲要》提出"共建人文湾区",要保护好非物质文化遗产和弘扬岭南文化,与之对应的湾区古村落及其文化发展机遇空前.良溪千年古村作为中原文化、岭南文化和海洋文化的重要中转站,加强村落文化保护、传承与发展意义重大.通过分析良溪古村落文化保护现状,提出加强规划建设、健全保护机制、"三态结合"保育与活化、数字化...     

Anticipated Engagement in a Village Organization for Aging in Place

Although older adults prefer maintaining residence independently in the community as they grow older it is not always possible due to impairments, isolation, and changing health needs. Villages, an emerging consumer-directed care model providing social engagement and services, support aging in place. To be viable organizations villages must attract and enroll sufficient numbers of members. This study examined factors associated with older adults anticipated engagement as a village member. Using a cross-sectional survey design community residing older adults (N?=?193) identified predisposing, enabling, and need factors associated with anticipated engagement. Participants rated anticipated engagement between “Slightly Unlikely” and “Likely” (Mean?=?2.71, SD?=?1.31). A model including predisposing and enabling factors produced the best overall fit [?2 Log likelihood?=?246.514, χ2(8)?=?20.414, p.?=?.008] correctly classifying 61.1% of cases and explaining 13.4% of the variance according to the Nagelkerke R² statistic. Older adults who engage in preventative health behaviors may be predisposed to joining a village as well as those who are already engaging in supportive acts of neighboring. Villages might consider these factors in designing outreach and service programing. Future research should identify how factors such as income and personal health practices contribute to interest in village membership.     

Community health education for rural women: analysis of a training programme

A regional community health program established in South Orissa, India, is described. It was found that women are the best health workers and educators in rural areas since cultural beliefs are more deeply rooted among them, they look after the sick in the family, they can enter every house where men cannot, and the risk of malpractice and misuse of training is less with women. A cultural obstacle was that sickness among these people is considered a curse of the spirit of their ancestors. The 1st phase of the program is a live-in experience in which the trainees come together for training classes. The causes and treatment of nutritional deficiency diseases, especially malnutrition, early blindness, and anemia are discussed. Posters, charts, and tape recordings proved to keep their attention, as did analogies taken from their daily experience, and communication through song and dance. At the end of 3 weeks the women have to take a test and are then taken back to their villages by the staff of each health center. They have been found to communicate well with their own people, understood the difficulty of changing local beliefs, and did not need formal educational environments in order to communicate. The 2nd phase, after 3-4 months of work experience, is a training course providing them with a chance to share their experiences and gain a deeper understanding of society, teaching about the causes, effects, and treatment of common diseases, with emphasis put on health education, especially food preparation and diet. Also taught were basics of market values, social customs, and causes of poverty. The women again returned to their villages to conduct more in-depth health education. After 4 months, the women return for the 3rd phase in which they were taught home nursing and first aid, discussed social injustices, finances, and other topics. When they returned to their villages they were able to provide the people with medical, family, and personal help. Some went on to become members of the village committees and were given new respect by male members of the village. The 4th phase involved sharing experiences once again and learning organizational skills. Some major obstacles were: 1) using health workers is a part of the total system that does not really meet the needs of the common people, 2) political problems, and 3) institutional problems.     

BANGLADESH The Grameen Bank health programme

In May 1993 the Grameen Bank in Bangladesh - one of the most successful and internationally best-known self-help projects - launched a programme to provide poor people in rural areas with basic health care. The first four medical centres were followed by six more by July 1995. The organization and methods of operation of the Grameen Health Programme are based on the tried and tested self-help principles underlying the loan programme which has been in operation since 1976. The services offered include medical care at reduced fees and free counselling. Target groups are primarily poor women, to whom the programme's women field workers initially give information on simple preventive measures plus advice on avoidance of unwanted pregnancies. This article presents a provisional evaluation based on two primary inquiries conducted in 1994 and 1995. The overall conclusion was that the health programme has still far to go in order to attain the longer-term objective of becoming self-financing. Nevertheless, it demonstrates that decentralized access to health services, and preventive healthcare counselling in particular, can be of real assistance to poor people in rural areas.     

Mark Time: India's March to Universal Health Care Coverage

This article evaluates the efforts underway in India to achieve universal health care coverage and the conditions that fostered its contemporary evolution. It finds that India’s health system is characterized by private provision and financing, horizontal and vertical fragmentation, and weak governance arrangements. The article argues that these defining characteristics, which have solidified over time, account for poor health outcomes and make the system impervious to reforms as they deny the government levers to intervene and shape outcomes in the sector. While the government's recent efforts of increased public funding of national programmes have helped to reduce out of pocket spending, these are unlikely to work in the long run unless the government addresses the sources of the problems. The article argues that building health care governance, strengthening regulatory architecture, and stewardship over the system, in conjunction with increased public spending, are essential if the health care system is to provide affordable care to the entire population.     

Societal factors and the development of self-help groups for the disabled in China: a case study in Beijing

In recent years, self-help groups for the disabled have gradually developed in China because of their significant social welfare function for satisfying the needs of individuals, groups and communities. This article examines the current development of self-help groups for the disabled in Beijing. It focuses on social factors such as legitimacy and relational density. Based on interviews with key members of the selected self-help organization, important factors for the survival and development of self-help groups for the disabled are identified. The policy implications for the promotion of self-help groups for disabled persons are also discussed.     

从熟人社会到弱熟人社会——来自皖西山区村落人际交往关系的社会网络分析

熟人社会”理论虽被广泛应用,但由于一直没有相应的指标来测量,故逐渐被刻板化。本研究使用社会网络分析方法,以皖南山区自然村落的人际交往关系为分析对象,从强弱关系的视角,重新测量发现：自然村落内村民之间的网络依赖于间接连接构成;强交往关系中存在大量孤立的个体,而且整体网络断裂的风险也较高;弱交往关系中基本上不存在孤立的个体,其整体网络断裂的风险较低。在这种情况下,即使自然村落内的村民之间也难以熟知,本研究将这个社会特征概括为弱熟人社会。     

"An Inner Group of Willing People": Volunteering in a Religious Context

In the age of "welfare pluralism", volunteers are attracting increasing attention from academics and policy-makers. This paper focuses on volunteering in the context of religious congregations. It is found to be similar in some ways to that in secular organizations but there are also significant differences including the impact of religious values on motivation, the fact that congregational volunteers are also "members", and the special relationship with clergy. It is concluded that congregational volunteers can be important constituents of the "mixed economy of care"and "civil society". However, long-term care may be provided better by institutions which are less dependent on individual enthusiams.     

Short-term and long-term effects of an outpatient rehabilitation program for patients with musculoskeletal disorders

The objective of the study was to investigate whether intensified rehabilitation efforts in primary health care may produce any short-term or long-term reduction of sick leave. The resources at the health care center were fortified with a coordinator from the local insurance office and a specialist group from the hospital. In one primary health care district, a prospective study was performed among 100 patients with a musculoskeletal disorder, having caused at least 21 consecutive days of full-time sick leave (patients). Serving as a control group were individually matched patients from any other health care center in the surrounding municipality of Kristianstad (controls). The number of sick leave days was assessed during year one (short-term) and year three (long-term) after rehabilitation was initiated. The median number of days with sickness benefits for men in the short-term was lower for patients than for controls (34.5 vs 48.5). No difference was found among women. No differences were found in the long-term between patients and controls, either for men or women. We conclude that rehabilitation in primary health care was made more efficient through collaboration with the local insurance office and the specialists, but the effects were not maintained after the collaboration ended.     

Partnerships, Power and the "New" Politics of Community Participation in British Health Care

Multi–sectoral approaches to health improvement in its broadest sense have entailed an emphasis by the British government upon partnership working in and around community involvement in planning processes. New service planning and delivery organizations in the health service—primary care groups and primary care trusts—thus have to ensure that public and patient involvement strategies reflect a coordinated, if not integrated, multi–sectoral approach to such involvement. But how are these enforced partnership arrangements shaping the approach taken by primary care groups and trusts to the issue of public and patient involvement? More particularly, is the traditional dominance of health service managers and the medical profession in decision–making processes under challenge? This article draws on a study of primary care groups and trusts in three districts in order to gauge perceptions and calculations with regard to partnerships for involvement. Results appear to suggest that health service managers and practitioners continue to exercise considerable influence in comparison to that of patients and citizens. But, if the findings are viewed in the broader contexts of government managerialist strategies of surveillance and accountability and the growth of service–user and advocacy organizations, partnerships may offer significant scope for “lay” challenges to managerial and medical power.     

Evidence of Empowerment in Resident Council Groups: An Examination of Two Leadership Models in Assisted Living

Individuals living in long-term care facilities and the professionals working with them are seeking methods to enhance resident choice and self-direction in personal care and internal community planning. This article presents findings from a study examining the incidence of empowerment opportunities in two resident council groups in assisted living facilities; one group used a resident leadership model and the other used an administrative leadership model by residents' choice. Results indicate that even with health and mental health challenges, residents were able to exercise choice in complicated situations under both leadership models, suggesting that resident council groups are a beneficial empowerment strategy.     

Indigenous Elder Insights About Conventional Care Services in Alaska: Culturally Charged Spaces

Indigenous peoples around the world endure health and social disparities. In the United States, such disparities are typically ameliorated through conventional care services and organizations. Purpose: To examine points of tension that characterize culturally pluralistic care services in the United States, specifically Alaska, within context of Indigenous colonial histories. Design and Methods: The research design is ethnographic and multisited, comprising 12 months of fieldwork across urban, rural and remote village sites in Alaska. A conceptual lens that accounts for culturally diverse social spaces where relations of power are at stake frames research presented here. This work incorporates relational and participatory action research principles with Alaska Native Elders. Ethnographic evidence was collected through multiple methods, including field notes, documents, and interviews, with ethnographic analysis involving atlas.ti. Findings: Alaska Native Elders describe salient points of tension characterizing Alaska’s conventional care services through the following insights: generational curses-—a pain, prejudice on both sides—wounded, and value-systems clash—fighting. Conclusion: This article concludes with discussion about collective anxieties and implications for care services.     

Rehabilitation Initiatives by Disability Self-help Groups: A Comparative Study

As part of its programme of activities for the triennium 1996-98, the ISSA proposed that a comparative country study be conducted on the social relevance of self-help groups and their integration into the rehabilitation process.A pilot study was conducted to assess the situation in five European countries at comparable stages of social development. Increasingly, since the Second World War, people with a chronic illness or a disability in these countries have joined together in self-help groups and organizations in order to overcome their condition together and work for better integration into society. The situation at present is that the self-help movement is no longer seen as an alternative to the regular social security system, as it used to be: instead, both the self-help groups and organizations and the institutions and facilities responsible for rehabilitation are seeking an increase in cooperation.     

城中村已婚流动女性卫生服务需求及政策分析——以昆明市为例

“城中村”是城市化进程中的特殊现象,流动人口多因城中村便宜的住房而聚居于此。笔者调查的城中村社区已婚流动妇女因自身保健知识及居住环境所限,缺乏公共卫生服务的公平性和可及性,严重地影响了流动已婚妇女的健康。本文就更好地实现“城乡统合”、“人人享有卫生保健”提出行政管理的讨论与建议。     

Transnational community enterprises for social welfare in global civil society

Considerable attention has been devoted thus far to transnational economic and political enterprises in globalisation. This article focuses on the phenomenon of social globalisation. Specifically, we call attention to the need for research and development on transnational enterprises to support and maintain individuals and families that are members of transnational communities in the USA and Mexico. The social fallout of transmigration on the health and social wellbeing of sending and receiving communities is enormous and costly, and far beyond the capacity of transmigrants to handle merely through self-help, mutual aid or small voluntary clubs and associations. This article raises questions about whether it is possible, or desirable, for civil society organisations to expand the scope of their vision to include social welfare activities that promote and enhance the health and social wellbeing of host and home communities simultaneously.     

A good death for residents of long-term care: family members speak

Little research has been done on the topic of end-of-life care in long-term care settings to identify important themes regarding end-of-life care structures, processes, and outcomes. This study utilized data gathered in a stratified, random sample of 437 family members of residents who died in 31 nursing homes (NHs) and 199 residential care/ assisted living facilities. Structural components of care including staffing adequacy, training, and consistency as well as facility environment and size were important factors for family members interviewed. "Being there" and manner of care delivery (e.g., staff attitudes/empathy) were major elements in the process of care. These factors were mentioned more than direct care, Hospice, or resident preferences. Family members identified themes of [dying at] home and being comfortable and clean as important outcomes of care. These identified structural components, processes, and outcomes have implications for the role of social workers in these settings despite that social work support is notably absent in these findings.