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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Aitziber Egusquiza; Mikel Zubiaga; Alessandra Gandini; Claudia De Luca; +1 Authors

    This paper presents the result of the analysis of the data gathered from 20 Role Models (RM) case studies regarding their successful heritage-led rural regeneration models. For the study and comparison of the narratives of these Role Models two tools were used: the Community Capitals Framework, which studied the transference of capitals in each process and the identification of six Systemic Innovation Areas that allow this capital transference. A multilevel repository of best practices has been developed allowing the identification of common features, mechanisms for mobilisation of capitals and required resources that will facilitate the replication in other rural areas. The results of this work support the acknowledgement of the contribution of culture, together with cultural and natural heritage, to economic growth, social inclusion and environmental sustainability in rural areas reinforcing the role of culture as the fourth pillar of sustainable development. This research was funded by H2020, grant number 776465.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Sustainability; ZENO...arrow_drop_down
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Sustainability; ZENO...arrow_drop_down
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Simo Sarkki; Cristina Dalla Torre; Jasmiini Fransala; Ivana Živojinović; +11 Authors

    Social innovations can tackle various challenges related to gender equity in rural areas, especially when such innovations are initiated and developed by women themselves. We examine cases located in rural areas of Canada, Italy, Lebanon, Morocco, and Serbia, where women are marginalized by gender roles, patriarchal values, male dominated economy and policy, and lack of opportunities for education and employment. Our objective is to analyze five case studies on how women-led social innovation processes can tackle gender equity related challenges manifested at the levels of everyday practice, institutions, and cognitive frames. The analyses are based on interviews, workshops, literature screening, and are examined via the qualitative abductive method. Results summarize challenges that rural women are facing, explore social innovation initiatives as promising solutions, and analyze their implications on gender equity in the five case studies. Based on our results we propose a new concept: reconstructive social innovation cycle. It refers to is defined as cyclical innovation processes that engage women via civil society initiatives. These initiatives reconstruct the existing state of affairs, by questioning marginalizing and discriminative practices, institutions, and cognitive frames that are often perceived as normal. The new concept helps with to assessing the implications that women-led social innovations have for gender equity. The authors are grateful to the European Commission for financial support to the project on Social Innovation in Marginalised Rural Areas (SIMRA) provided from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement No 677622. Contribution of the author from the James Hutton Institute to this study was also partly funded by the Rural & Environment Science & Analytical Services Division of the Scottish Government through its Strategic Research Programme (2016–2021). The Nunavut/Canada case study was supported by Nordforsk Nordic Centre of Excellence: Resource Extraction and Sustainable Arctic Communities (REXSAC: project number 76938).

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    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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    Repositori Obert UdL
    Article . 2021
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Sustainability; Arch...arrow_drop_down
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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      Repositori Obert UdL
      Article . 2021
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Lilla Bonanno; Margherita Russo; Alessia Bramanti; Rocco Salvatore Calabrò; +1 Authors

    Abstract Rationale: Multiple sclerosis (MS) is an inflammatory demyelinating disease of central nervous system and it is associated with an impaired motor function status. The efficacy of rehabilitation in promoting functional recovery and increasing quality of life in MS patients has been demonstrated. Patient concerns: A 47-year-old woman was diagnosed with relapsing-remitting multiple sclerosis (RRMS) in November 2014 because of left upper limb hypoesthesia and weakness with difficulty in hand manipulation skills (there was a 1-point Expanded Disability Status Scale (EDSS) progression, i.e., 2.5 vs 1.5). Magnetic resonance image (MRI) showed a new frontal right cortical high-signal-intensity lesion. Diagnosis: Neurological and MRI examination were suggestive of MS diagnosis. Interventions: Patient was treated with robotic rehabilitation and evaluated by a Glove Analyzer for fMRI system (GAF). Functional MRI (fMRI) was acquired before and at the end of rehabilitative treatment performed with robotic device (Armeo-power). Outcomes: At the end of the rehabilitation program, most of the behavioral parameters, GAF and fMRI evaluation, showed a significative improvement. Moreover, fMRI showed a significantly increased functional activation within the sensory-motor network in the active, motor task. Lessons: Our findings suggest a possible restorative effect of robotics on brain networks. Moreover, we may argue that GAF may be a valuable tool in assessing functional recovery after upper limb rehabilitation, especially of associated to fMRI examination.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Medicinearrow_drop_down
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    Article . 2019 . Peer-reviewed
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    image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Medicinearrow_drop_down
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      Article . 2019 . Peer-reviewed
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      image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
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    Authors: Benjamin Palafox; Martin McKee; Dina Balabanova; Khalid F. AlHabib; +40 Authors

    Background Effective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household’s ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study. Methods A cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples. Results Overall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden). Conclusion Inequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level. 14 p.

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    image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
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    Authors: Biritwum, Richard B.; Mensah, George; Minicuci, Nadia; Yawson, Alfred E.; +3 Authors

    Background: Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub- Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. Methods: The World Health Organization’s Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18-49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. Results: The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of drinking water, with the lowest at 29.6% in the Volta region. The overall rate of access to improved sanitation was just 14.9%. The findings show significant regional differences, with the three Northern Regions having worse education, income, and sanitation levels, compared to Southern and Central Regions of the country. Conclusion: Household characteristics and intra-household dynamics have been shown to influence health and health-seeking behaviors across a number of contexts and countries, and play a fundamental role in the well-being of older Ghanaians. SAGE Ghana is part of a multi-country study using standardized questionnaires and tested methodologies to provide household level data required to inform policy on the growing population of older adults in Ghana. With the good response rates and measures instituted to assure quality of data, this article demonstrates the high quality data and research methods of SAGE. Keywords: SAGE; Ghana; ageing; household characteristics (Published: 11 June 2013) Citation: Glob Health Action 2013, 6 : 20096 - http://dx.doi.org/10.3402/gha.v6i0.20096 This paper is part of the thematic cluster Improving health and living conditions for elderly populations - more papers from this cluster can be found here .

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    Authors: Turan, Janet M; Hatcher, Abigail M.; Odero, Merab; Onono, Maricianah; +4 Authors

    Objective. Pregnant women are especially vulnerable to adverse outcomes related to HIV infection and gender-based violence (GBV). We aimed at developing a program for prevention and mitigation of the effects of GBV among pregnant women at an antenatal clinic in rural Kenya.Methods. Based on formative research with pregnant women, male partners, and service providers, we developed a GBV program including comprehensive clinic training, risk assessments in the clinic, referrals supported by community volunteers, and community mobilization. To evaluate the program, we analyzed data from risk assessment forms and conducted focus groups (n=2groups) and in-depth interviews (n=25) with healthcare workers and community members.Results. A total of 134 pregnant women were assessed during a 5-month period: 49 (37%) reported violence and of those 53% accepted referrals to local support resources. Qualitative findings suggested that the program was acceptable and feasible, as it aided pregnant women in accessing GBV services and raised awareness of GBV. Community collaboration was crucial in this low-resource setting.Conclusion. Integrating GBV programs into rural antenatal clinics has potential to contribute to both primary and secondary GBV prevention. Following further evaluation, this model may be deemed applicable for rural communities in Kenya and elsewhere in East Africa.

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    Authors: Paola Minoia;

    This article analyses some problems emerging in aid practices aimed to support civil society in developing countries. First, it reports the debate emerged in critical development studies regarding non-state actors, and particularly nongovernmental organizations, which have progressively substituted public institutions in service provision and in representative forums, often as a consequence of external pressures made by international donors. Secondly, it analyses the European aid programme named “Non-State Actors and Local Authorities in Development”, whose aim is to fight poverty and increase governance through actions empowering local organisations. More specifically, it evaluates the programme’s coherence and effectiveness in five visited countries (Georgia, Occupied Palestinian Territory, Zimbabwe, Rwanda and Cameroon) and, particularly, in two projects based in Rwanda. These two case studies show very different results as far as local involvement. Interviews, field visits and analyses of project reports reveal the diverse nature of the various organizations that compose the non-state actors, and their different capacity to express local agency. External donors need to redefine their aid relations in a way to effectively empower the most vulnerable groups. Peer reviewed

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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Aitziber Egusquiza; Mikel Zubiaga; Alessandra Gandini; Claudia De Luca; +1 Authors

    This paper presents the result of the analysis of the data gathered from 20 Role Models (RM) case studies regarding their successful heritage-led rural regeneration models. For the study and comparison of the narratives of these Role Models two tools were used: the Community Capitals Framework, which studied the transference of capitals in each process and the identification of six Systemic Innovation Areas that allow this capital transference. A multilevel repository of best practices has been developed allowing the identification of common features, mechanisms for mobilisation of capitals and required resources that will facilitate the replication in other rural areas. The results of this work support the acknowledgement of the contribution of culture, together with cultural and natural heritage, to economic growth, social inclusion and environmental sustainability in rural areas reinforcing the role of culture as the fourth pillar of sustainable development. This research was funded by H2020, grant number 776465.

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    Authors: Simo Sarkki; Cristina Dalla Torre; Jasmiini Fransala; Ivana Živojinović; +11 Authors

    Social innovations can tackle various challenges related to gender equity in rural areas, especially when such innovations are initiated and developed by women themselves. We examine cases located in rural areas of Canada, Italy, Lebanon, Morocco, and Serbia, where women are marginalized by gender roles, patriarchal values, male dominated economy and policy, and lack of opportunities for education and employment. Our objective is to analyze five case studies on how women-led social innovation processes can tackle gender equity related challenges manifested at the levels of everyday practice, institutions, and cognitive frames. The analyses are based on interviews, workshops, literature screening, and are examined via the qualitative abductive method. Results summarize challenges that rural women are facing, explore social innovation initiatives as promising solutions, and analyze their implications on gender equity in the five case studies. Based on our results we propose a new concept: reconstructive social innovation cycle. It refers to is defined as cyclical innovation processes that engage women via civil society initiatives. These initiatives reconstruct the existing state of affairs, by questioning marginalizing and discriminative practices, institutions, and cognitive frames that are often perceived as normal. The new concept helps with to assessing the implications that women-led social innovations have for gender equity. The authors are grateful to the European Commission for financial support to the project on Social Innovation in Marginalised Rural Areas (SIMRA) provided from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement No 677622. Contribution of the author from the James Hutton Institute to this study was also partly funded by the Rural & Environment Science & Analytical Services Division of the Scottish Government through its Strategic Research Programme (2016–2021). The Nunavut/Canada case study was supported by Nordforsk Nordic Centre of Excellence: Resource Extraction and Sustainable Arctic Communities (REXSAC: project number 76938).

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    Article . 2021
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    Authors: Lilla Bonanno; Margherita Russo; Alessia Bramanti; Rocco Salvatore Calabrò; +1 Authors

    Abstract Rationale: Multiple sclerosis (MS) is an inflammatory demyelinating disease of central nervous system and it is associated with an impaired motor function status. The efficacy of rehabilitation in promoting functional recovery and increasing quality of life in MS patients has been demonstrated. Patient concerns: A 47-year-old woman was diagnosed with relapsing-remitting multiple sclerosis (RRMS) in November 2014 because of left upper limb hypoesthesia and weakness with difficulty in hand manipulation skills (there was a 1-point Expanded Disability Status Scale (EDSS) progression, i.e., 2.5 vs 1.5). Magnetic resonance image (MRI) showed a new frontal right cortical high-signal-intensity lesion. Diagnosis: Neurological and MRI examination were suggestive of MS diagnosis. Interventions: Patient was treated with robotic rehabilitation and evaluated by a Glove Analyzer for fMRI system (GAF). Functional MRI (fMRI) was acquired before and at the end of rehabilitative treatment performed with robotic device (Armeo-power). Outcomes: At the end of the rehabilitation program, most of the behavioral parameters, GAF and fMRI evaluation, showed a significative improvement. Moreover, fMRI showed a significantly increased functional activation within the sensory-motor network in the active, motor task. Lessons: Our findings suggest a possible restorative effect of robotics on brain networks. Moreover, we may argue that GAF may be a valuable tool in assessing functional recovery after upper limb rehabilitation, especially of associated to fMRI examination.

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    Authors: Benjamin Palafox; Martin McKee; Dina Balabanova; Khalid F. AlHabib; +40 Authors

    Background Effective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household’s ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study. Methods A cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples. Results Overall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden). Conclusion Inequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level. 14 p.

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    Authors: Biritwum, Richard B.; Mensah, George; Minicuci, Nadia; Yawson, Alfred E.; +3 Authors

    Background: Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub- Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. Methods: The World Health Organization’s Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18-49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. Results: The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of drinking water, with the lowest at 29.6% in the Volta region. The overall rate of access to improved sanitation was just 14.9%. The findings show significant regional differences, with the three Northern Regions having worse education, income, and sanitation levels, compared to Southern and Central Regions of the country. Conclusion: Household characteristics and intra-household dynamics have been shown to influence health and health-seeking behaviors across a number of contexts and countries, and play a fundamental role in the well-being of older Ghanaians. SAGE Ghana is part of a multi-country study using standardized questionnaires and tested methodologies to provide household level data required to inform policy on the growing population of older adults in Ghana. With the good response rates and measures instituted to assure quality of data, this article demonstrates the high quality data and research methods of SAGE. Keywords: SAGE; Ghana; ageing; household characteristics (Published: 11 June 2013) Citation: Glob Health Action 2013, 6 : 20096 - http://dx.doi.org/10.3402/gha.v6i0.20096 This paper is part of the thematic cluster Improving health and living conditions for elderly populations - more papers from this cluster can be found here .

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    Global Health Action
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    https://doi.org/10.3402/gha.v6...
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    Authors: Turan, Janet M; Hatcher, Abigail M.; Odero, Merab; Onono, Maricianah; +4 Authors

    Objective. Pregnant women are especially vulnerable to adverse outcomes related to HIV infection and gender-based violence (GBV). We aimed at developing a program for prevention and mitigation of the effects of GBV among pregnant women at an antenatal clinic in rural Kenya.Methods. Based on formative research with pregnant women, male partners, and service providers, we developed a GBV program including comprehensive clinic training, risk assessments in the clinic, referrals supported by community volunteers, and community mobilization. To evaluate the program, we analyzed data from risk assessment forms and conducted focus groups (n=2groups) and in-depth interviews (n=25) with healthcare workers and community members.Results. A total of 134 pregnant women were assessed during a 5-month period: 49 (37%) reported violence and of those 53% accepted referrals to local support resources. Qualitative findings suggested that the program was acceptable and feasible, as it aided pregnant women in accessing GBV services and raised awareness of GBV. Community collaboration was crucial in this low-resource setting.Conclusion. Integrating GBV programs into rural antenatal clinics has potential to contribute to both primary and secondary GBV prevention. Following further evaluation, this model may be deemed applicable for rural communities in Kenya and elsewhere in East Africa.

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    Authors: Paola Minoia;

    This article analyses some problems emerging in aid practices aimed to support civil society in developing countries. First, it reports the debate emerged in critical development studies regarding non-state actors, and particularly nongovernmental organizations, which have progressively substituted public institutions in service provision and in representative forums, often as a consequence of external pressures made by international donors. Secondly, it analyses the European aid programme named “Non-State Actors and Local Authorities in Development”, whose aim is to fight poverty and increase governance through actions empowering local organisations. More specifically, it evaluates the programme’s coherence and effectiveness in five visited countries (Georgia, Occupied Palestinian Territory, Zimbabwe, Rwanda and Cameroon) and, particularly, in two projects based in Rwanda. These two case studies show very different results as far as local involvement. Interviews, field visits and analyses of project reports reveal the diverse nature of the various organizations that compose the non-state actors, and their different capacity to express local agency. External donors need to redefine their aid relations in a way to effectively empower the most vulnerable groups. Peer reviewed

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