This study examines the impact of cash crop cultivation on household income and migration decisions,using survey data collected from low-income regions in China.Given farmers decide themselves whether to cultivate cas...This study examines the impact of cash crop cultivation on household income and migration decisions,using survey data collected from low-income regions in China.Given farmers decide themselves whether to cultivate cash crops,an endogenous treatment regression model that accounts for potential selection bias issue is used to analyze the data.The empirical results show that cash crop cultivation exerts a positive and statistically significant impact on household income,but it does not affect household migration decisions significantly.The disaggregated analyses reveal that cash crop cultivation significantly increases farm income but decreases off-farm income.展开更多
Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. ...Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.展开更多
Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centr...Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centre region of Cameroon was the most affected in the country and being at the frontline of the fight against this illness, we conducted this study in order to determine the epidemiological and clinical characteristics as well as the outcome of children who contracted the measles and were hospitalized at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Methodology: We conducted a cross-sectional descriptive and prospective study for one year from October 2022 to November 2023 corresponding to the duration of the outbreak. We included all children admitted in the pediatric unit for measles and its complications during this period. Results: In total, 60 children were enrolled. Their caregivers were mostly their mothers who had a mean age of 34.71 ± 9.55 years living in significant precarious conditions for the majority. The median age of children was 16 months (09 - 30 months). Twenty six percent of children (16) were less than 9 months. Girls were predominant (55%). Most children were not up to date with their routine EPI vaccination (80%) and most did not receive the measles and Rubella vaccine (76.67%). Clinical manifestations, included fever, conjunctivitis, and cough. Skin rash and catarrh (98.33% and 86.67% respectively) are the case definition signs of measles. The outcome was unfavorable for 4 children. One had a neurological disorder: coma and three presented with pneumonia and severe respiratory distress (6.67%). Conclusion: Measles is still being a reality and claiming lives in our context, emphasis should be made on immunization coverage and if possible, advocacies should be formulated to decrease the age of measles vaccine administration.展开更多
Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing ...Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.展开更多
Introduction:Chronic diseases are becoming more prevalent worldwide.The effects of chronic illnesses are disastrous not only for the diagnosed person but also for their entire family.This study explores chronic disea...Introduction:Chronic diseases are becoming more prevalent worldwide.The effects of chronic illnesses are disastrous not only for the diagnosed person but also for their entire family.This study explores chronic diseases’social and economic impact on low-income families.The study aims to determine the economic and social implications of various chronic diseases and the loss of income due to these conditions among low-income individuals in Southern Punjab,Pakistan.Methodology:A sample of 424 patients was selected from different areas of Southern Punjab.Data were collected using a questionnaire that included questions about economic status,self-reported health status,social status,management strategies,and health insurance,among other factors.Results:The mean monthly income of the respondents was found to be 57,097.6 Pakistani rupee(PKR),and the mean monthly expenses for treatment were 8,256.1 PKR.The loss of income was calculated at 15%.Additionally,62%of patients spent more than 10%of their monthly income on managing their disease.Approximately 85%of the respondents reported that chronic diseases affected their social life.Furthermore,80%of patients lacked health insurance.Conclusion:Chronic diseases impose significant economic and social burdens on patients and their families in Southern Punjab.To reduce the burden of chronic diseases,the government should enhance healthcare services in this region and provide health insurance to low-income families.展开更多
In this paper,a theoretical model is developed on the basis of systems theory,which structures the livelihood system of low-income households in a European country characterized by a semi-peripheral economy.Based on t...In this paper,a theoretical model is developed on the basis of systems theory,which structures the livelihood system of low-income households in a European country characterized by a semi-peripheral economy.Based on the proposed model,the complex system of network connections and formal and informal financial transactions,which households use in their daily lives to cover their expenses,becomes graspable.The proposed theoretical model is analyzed through simulations based on agent-based modelling(ABM)centred on empirical network data.Through the simulations,the author explores the mechanisms of the market and asks what formal and informal credit transactions determine its operation,how these factors shape the local social structure and how resilient the market is to crises.The results show that this dynamic,complex risk-sharing system has an inherent logic and it can mitigate the small liquidity shocks but it is not resistant to bigger financial shocks or overconsumptions.展开更多
Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-co...Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-course utility model, we examine the association amongst income and overweight. The data used for this study are from the China Health and Nutrition Survey(CHNS). Estimations are conducted for overweight initiation, cessation, and participation mirroring a decision to begin and a past decision to not terminate. Our findings propose that body weight and the likelihood of overweight commencement rise with additional income but at a diminishing degree, representing a concave relation;while the likelihood of overweight discontinuance declines with additional income but at an accelerating degree, suggesting a convex relation.We presume that, as opposed to developed countries, low-income people are less inclined to be overweight in China, a country in transition. This could be explained by an income constraint for unhealthy foodstuff. Nevertheless, it will switch when income surpasses the critical threshold of the concave or inverted U-shape curve indicating that low-income people appear to receive not as much utility from future health. Specifically, this adjustment seems to occur earlier for females and inhabitants of urban areas.展开更多
Hypertension has been a major risk factor for cardiovascular disease[1].Hypertension overall prevalence in adults is 30%–45%,becoming>60%in people aged above 60 years[2],with a worldwide agestandardised prevalence...Hypertension has been a major risk factor for cardiovascular disease[1].Hypertension overall prevalence in adults is 30%–45%,becoming>60%in people aged above 60 years[2],with a worldwide agestandardised prevalence of 20 and 24%in women and men,respectively[3].展开更多
Focusing on the peculiarities of urban construction resulting from specific mountain terrains, the purpose of this study is to find out a suitable method based on a Spatial Network Comprehensive Model(SNCM) to reasona...Focusing on the peculiarities of urban construction resulting from specific mountain terrains, the purpose of this study is to find out a suitable method based on a Spatial Network Comprehensive Model(SNCM) to reasonably plan and distribute primary schools in low-income mountain cities. The construction principles and advantages of the SNCM method are proposed and the method tested in Wanyuan city of Qinba Mountain area(Southwest China) to verify its feasibility and optimization. Taking account of the mountain terrain and its influence on user behavior, we used the SNCM method to build a comprehensive model which integrates the road slope and the walking speed of pupils into the basic spatial model. The model is used to calculate a reasonable layout of the primary schools and to validate the rationale. The results show that the SNCM method can be effectively applied in low-income mountainous cities. It can not only improve the accessibility and service efficiency of primary schools using as little capital-investment as possible, but also help the city grow in an intensive and efficient way.展开更多
There have been many studies on the nutrition and the growth status of children from rural and remote western regions of China, whereas researches on children from urban low-income families are scarce. This study aime...There have been many studies on the nutrition and the growth status of children from rural and remote western regions of China, whereas researches on children from urban low-income families are scarce. This study aimed to investigate the growth and nutritional status of children under five years of age from urban low-income families in China. There were 169 children aged 25–60 months recruited from Xiangtan and Jilin, two cities with a population of 2.81 million and 4.26 million respectively, in China in this cluster cross-sectional study. Data were collected on demographic and socioeconomic characteristics, the feeding practices and the incidence of anemia and diarrhea. The results showed that the prevalence of low birth weight and macrosomia was 7.1% and 9.5% for the two cities, respectively, which was higher than that for other cities in China(1.5% and 5.9%). Of all the sampled children, 14.6% and 8.2% suffered anemia and diarrhea, respectively. Multivariate analysis showed that legumes or nuts fed in a 24-h recall increased the risk of anemia(OR=4.9). Children whose caregivers began to introduce complementary foods relatively late would have high diarrhea prevalence(OR=1.4). In conclusion, the prevalence of anemia and diarrhea in under-five children from urban low-income families in China is relatively high. The growth and nutritional status of these children is greatly affected by feeding practices. A series of measures should be taken by relevant government departments to improve the health of these children.展开更多
BACKGROUND Colorectal cancer(CRC)remains a relevant public health problem.Current research suggests that racial,economic and geographic disparities impact access.Despite the expansion of Medicaid eligibility as a key ...BACKGROUND Colorectal cancer(CRC)remains a relevant public health problem.Current research suggests that racial,economic and geographic disparities impact access.Despite the expansion of Medicaid eligibility as a key component of the Affordable Care Act(ACA),there is a dearth of information on the utilization of newly gained access to CRC screening by low-income individuals.This study investigates the impact of the ACA’s Medicaid expansion on utilization of the various CRC screening modalities by low-income participants.Our working hypothesis is that Medicaid expansion will increase access and utilization of CRC screening by low-income participants.AIM To investigate the impact of the Affordable Care Act and in particular the effect of Medicaid expansion on access and utilization of CRC screening modalities by Medicaid state expansion status across the United States.METHODS This was a quasi-experimental study design using data from the Behavioral Risk Factor Surveillance System,a large health system survey for participants across the United States and with over 2.8 million responses.The period of the study was from 2011 to 2016 which was dichotomized as pre-ACA Medicaid expansion(2011-2013)and post-ACA Medicaid expansion(2014-2016).The change in utilization of access to CRC screening strategies between the expansion periods were analyzed as the dependent variables.Secondary analyses included stratification of the access by ethnicity/race,income,and education status.RESULTS A greater increase in utilization of access to CRC screening was observed in Medicaid expansion states than in nonexpansion states[+2.9%;95%confidence interval(95%CI):2.12,3.69].Low-income participants showed a+4.02%(95%CI:2.96,5.07)change between the expansion periods compared with higher income groups+3.19%(1.70,4.67).Non-Hispanic Whites and Hispanics[+3.01%(95%CI:2.16,3.85)vs+5.51%(95%CI:2.81,8.20)]showed a statistically significant increase in utilization of access but not in Non-Hispanic Blacks,or Multiracial.There was an increase in utilization across all educational levels.This was significant among those who reported having a high school graduate degree or more+4.26%(95%CI:3.16,5.35)compared to some high school or less+1.59%(95%CI:-1.37,4.55).CONCLUSION Medicaid expansion under the Affordable Care Act led to an overall increase in self-reported use of CRC screening tests by adults aged 50-64 years in the United States.This finding was consistent across all low-income populations,but not all races or levels of education.展开更多
This paper explores how to use container buildings to resolve the housing problem of migrant workers in the context of urbanization, and ascertains the characteristics of the container housing and public space through...This paper explores how to use container buildings to resolve the housing problem of migrant workers in the context of urbanization, and ascertains the characteristics of the container housing and public space through the analysis of excellent examples of the container recycling project at home and abroad. In terms of the material, economic benefits, environmental protection and industrialization, those characteristics are summarized as follows.(1) Being sturdy, corrosion-resisting, waterproof and insulated, building materials are able to resist bad weather.(2) Their economic results lie in the short constructive cycle so that the cost of reinforced concrete per unit area reduces 20% on year-on-year basis.(3) Their environmental protection rests with the recyclability of materials, less construction waste and less noise in the construction process.(4) Their industrialization is embedded in their modular design and standardized specifications as well as the flexibility and replaceability.展开更多
Low-rise apartments for low-income residents have been built in Surabaya in recent years. They have four stories and many rooms, and the dwellers are all small traders. Because these projects are built with funds from...Low-rise apartments for low-income residents have been built in Surabaya in recent years. They have four stories and many rooms, and the dwellers are all small traders. Because these projects are built with funds from the government, the buildings are designed to consider the cost of construction, without consideration of embodied energy material. As a result, the buildings are not optimal in terms of embodied energy and construction cost. At present, because there are both concerns over global warning and a worldwide energy crisis, the embodied energy in a building is a very important concept for building design, because it can determine usage of energy in relation to natural sources, especially fossil fuels. This is part of the sustainable design concept. This paper describes research regarding: differences in embodied energy and construction cost between different wall materials, including brick, corn block and lightweight concrete in low rise apartments; the optimal relationship between embodied energy and building cost; and which factors determine these differences. The findings of this research show that lightweight concrete is the best material for the building walls; apartments for low-income in Surabaya still do not represent optimal construction design; and that sustainable buildings are cheaper than those that do not use this concept.展开更多
Multi-storey housing for low income society is a concept of redevelopment from many alternatives of housing development for slum in Jakarta. However, redevelopment directly or indirectly leads to displacement of low-i...Multi-storey housing for low income society is a concept of redevelopment from many alternatives of housing development for slum in Jakarta. However, redevelopment directly or indirectly leads to displacement of low-income residents. The new residents would be of a higher socio-economic status than the previous occupants. For controlling this phenomenon, a study about the influence of displacement to the successful of sustainable multi-storey housing development for low-income society has been done with descriptive method, observation and literature study. The result of this study give knowledge that displacement always happened when the quality of building and environment is increase, the location of multi-storey housing is near city center and commercial area. Low income society voluntary displaced their units to middle or high income society, because they are not affordable for paying operational and maintenance costs. The government has to make regulations for controlling displacement on multi-storey housing for low-income society and for the successful of sustainable multi-storey housing development in urban area.展开更多
This paper attempts to investigate the negative effects of the spread of COVID-19 on low-income families in Egypt.Coronavirus spread is measured by"Coronavirus cases"and"Coronavirus deaths"on a dai...This paper attempts to investigate the negative effects of the spread of COVID-19 on low-income families in Egypt.Coronavirus spread is measured by"Coronavirus cases"and"Coronavirus deaths"on a daily basis.Besides,it is measured by both"new Coronavirus cases"and"new deaths from Coronavirus",in relation to the population of Egypt.The Egyptian government is taking some measures to reduce the negative effects of COVID-19,including increasing personal exemptions by amending some provisions of the Egyptian Income Tax Law promulgated by Law No.91 of 2005 to protect low-income families.Of the negative effects of COVID-19,it is one of the most important tax policies to achieve social justice in distributing the tax burden,according to income levels,in a manner that achieves justice and equality.We find that Personal exemptions did not succeed in achieving tax justice by easing the tax burden on the low-income people in society.展开更多
This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descr...This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descriptive and inferential statistics were used to analyze collected data and significance at p < 0.05 accepted. Corn fufu with huckleberry was the most frequently consumed meal with little or no animal-source protein. Protein and B group vitamins intake of respondents in both communities were below the FAO/WHO recommended values while energy, iron, and vitamins A and C were in excess for most age groups. Adolescents 10 - 19 years and adults 20 years and above failed to meet at least 85% of RNI for calcium.展开更多
Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors inclu...Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.展开更多
With the completion of the strategic vision of building a moderately prosperous society in an all-round way in 2020,China’s economic development has entered a new normal.The concept of innovative,coordinated,green,op...With the completion of the strategic vision of building a moderately prosperous society in an all-round way in 2020,China’s economic development has entered a new normal.The concept of innovative,coordinated,green,open and shared development will lead China’s economic progress and development.However,the development of urban and rural areas and regions in China is still not coordinated,and the sudden COVID-19 outbreak has caused a serious impact on urban low-income groups.Due to the characteristics of poor employment stability,low income and single source,as well as greater family pressure of urban low-income groups,the author focuses on the influencing factors of their feelings of happiness.This paper assumes that the satisfaction degree of residents’needs is positively correlated with residents’feelings of happiness.Based on Maslow’s hierarchy of needs theory,this paper analyzes the factors that may affect the happiness of urban low-income groups in five levels,and explores the special needs and difficulties of urban low-income groups in the context of the epidemic.So as to find ways to improve the happiness of urban low-income people to provide reference.展开更多
Specialized households serve as the primary units within specialized villages in China,and their capacity to withstand risks and external influences significantly shapes the future trajectory of specialized villages a...Specialized households serve as the primary units within specialized villages in China,and their capacity to withstand risks and external influences significantly shapes the future trajectory of specialized villages and the overall vitality of the rural economy.In this study,we established a measurement indicator system based on the definition of specialized households’resilience,elucidating the logical connection between specialized households’resilience and rural industrial development in China.The musical instrument industry in Lankao County,Henan Province of China,was employed as a case;survey data,the entropy method,and an obstacle diagnosis model were used to examine how instrument production specialized households responded to the challenges posed by Corona Virus Disease 2019(COVID-19)and the tightening of national environmental protection policies,yielding the following key findings:1)there exists substantial variation in the comprehensive resilience levels among different specialized households;2)the ability to learn and adapt is the most significant contributor to the overall resilience level of specialized households;3)technological proficiency and access to skilled talent emerge as pivotal factors influencing specialized households’resilience;4)the positioning of specialized households within the industrial supply chain and the stability of their income have a direct bearing on their resilience level.The influence of specialized households’resilience on industrial development primarily manifests in the following ways:stronger resilience correlates with increased stability in production and sales,fostering a more proactive approach to future actions.However,heightened exposure to the external macroeconomic environment can lead to a higher rate of export reduction.To enhance the development resilience of entities like specialized households and family farms,and to invigorate rural economic development,escalating investments in rural science and technology and prioritizing the training of technical talent become imperative.展开更多
基金Supported by the Humanities and Social Science Research Fund of the Ministry of Education of China(19YJC790063)the Natural Science Foundation of Fujian,China(2017J05112)the Social Science Foundation of Fujian,China(FJ2017C076).
文摘This study examines the impact of cash crop cultivation on household income and migration decisions,using survey data collected from low-income regions in China.Given farmers decide themselves whether to cultivate cash crops,an endogenous treatment regression model that accounts for potential selection bias issue is used to analyze the data.The empirical results show that cash crop cultivation exerts a positive and statistically significant impact on household income,but it does not affect household migration decisions significantly.The disaggregated analyses reveal that cash crop cultivation significantly increases farm income but decreases off-farm income.
文摘Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.
文摘Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centre region of Cameroon was the most affected in the country and being at the frontline of the fight against this illness, we conducted this study in order to determine the epidemiological and clinical characteristics as well as the outcome of children who contracted the measles and were hospitalized at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Methodology: We conducted a cross-sectional descriptive and prospective study for one year from October 2022 to November 2023 corresponding to the duration of the outbreak. We included all children admitted in the pediatric unit for measles and its complications during this period. Results: In total, 60 children were enrolled. Their caregivers were mostly their mothers who had a mean age of 34.71 ± 9.55 years living in significant precarious conditions for the majority. The median age of children was 16 months (09 - 30 months). Twenty six percent of children (16) were less than 9 months. Girls were predominant (55%). Most children were not up to date with their routine EPI vaccination (80%) and most did not receive the measles and Rubella vaccine (76.67%). Clinical manifestations, included fever, conjunctivitis, and cough. Skin rash and catarrh (98.33% and 86.67% respectively) are the case definition signs of measles. The outcome was unfavorable for 4 children. One had a neurological disorder: coma and three presented with pneumonia and severe respiratory distress (6.67%). Conclusion: Measles is still being a reality and claiming lives in our context, emphasis should be made on immunization coverage and if possible, advocacies should be formulated to decrease the age of measles vaccine administration.
文摘Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.
文摘Introduction:Chronic diseases are becoming more prevalent worldwide.The effects of chronic illnesses are disastrous not only for the diagnosed person but also for their entire family.This study explores chronic diseases’social and economic impact on low-income families.The study aims to determine the economic and social implications of various chronic diseases and the loss of income due to these conditions among low-income individuals in Southern Punjab,Pakistan.Methodology:A sample of 424 patients was selected from different areas of Southern Punjab.Data were collected using a questionnaire that included questions about economic status,self-reported health status,social status,management strategies,and health insurance,among other factors.Results:The mean monthly income of the respondents was found to be 57,097.6 Pakistani rupee(PKR),and the mean monthly expenses for treatment were 8,256.1 PKR.The loss of income was calculated at 15%.Additionally,62%of patients spent more than 10%of their monthly income on managing their disease.Approximately 85%of the respondents reported that chronic diseases affected their social life.Furthermore,80%of patients lacked health insurance.Conclusion:Chronic diseases impose significant economic and social burdens on patients and their families in Southern Punjab.To reduce the burden of chronic diseases,the government should enhance healthcare services in this region and provide health insurance to low-income families.
基金supported by the Hungarian National Research Fund,in the framework of the research project“Moralities of dependent relations in the era of financialisation”under Grant No.K-143543。
文摘In this paper,a theoretical model is developed on the basis of systems theory,which structures the livelihood system of low-income households in a European country characterized by a semi-peripheral economy.Based on the proposed model,the complex system of network connections and formal and informal financial transactions,which households use in their daily lives to cover their expenses,becomes graspable.The proposed theoretical model is analyzed through simulations based on agent-based modelling(ABM)centred on empirical network data.Through the simulations,the author explores the mechanisms of the market and asks what formal and informal credit transactions determine its operation,how these factors shape the local social structure and how resilient the market is to crises.The results show that this dynamic,complex risk-sharing system has an inherent logic and it can mitigate the small liquidity shocks but it is not resistant to bigger financial shocks or overconsumptions.
基金the National Institute of Nutrition and Food Safety, China Center for Disease Control and Prevention, Carolina Population Center (5 R24 HD050924)the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, R24 HD050924, and R01HD38700)+2 种基金the Fogarty International Center, NIH for financial support for the CHNS data collection and analysis files from 1989 to 2011 and future surveysthe China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009financial support from the China Scholarship Council for conducting this research
文摘Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-course utility model, we examine the association amongst income and overweight. The data used for this study are from the China Health and Nutrition Survey(CHNS). Estimations are conducted for overweight initiation, cessation, and participation mirroring a decision to begin and a past decision to not terminate. Our findings propose that body weight and the likelihood of overweight commencement rise with additional income but at a diminishing degree, representing a concave relation;while the likelihood of overweight discontinuance declines with additional income but at an accelerating degree, suggesting a convex relation.We presume that, as opposed to developed countries, low-income people are less inclined to be overweight in China, a country in transition. This could be explained by an income constraint for unhealthy foodstuff. Nevertheless, it will switch when income surpasses the critical threshold of the concave or inverted U-shape curve indicating that low-income people appear to receive not as much utility from future health. Specifically, this adjustment seems to occur earlier for females and inhabitants of urban areas.
基金supported by the Natural Science Foundation of Inner Mongolia in China[2016MS0828].
文摘Hypertension has been a major risk factor for cardiovascular disease[1].Hypertension overall prevalence in adults is 30%–45%,becoming>60%in people aged above 60 years[2],with a worldwide agestandardised prevalence of 20 and 24%in women and men,respectively[3].
基金funded by the National Social Science Foundation of Chongqing (Grants No. 2016YBJJ031)
文摘Focusing on the peculiarities of urban construction resulting from specific mountain terrains, the purpose of this study is to find out a suitable method based on a Spatial Network Comprehensive Model(SNCM) to reasonably plan and distribute primary schools in low-income mountain cities. The construction principles and advantages of the SNCM method are proposed and the method tested in Wanyuan city of Qinba Mountain area(Southwest China) to verify its feasibility and optimization. Taking account of the mountain terrain and its influence on user behavior, we used the SNCM method to build a comprehensive model which integrates the road slope and the walking speed of pupils into the basic spatial model. The model is used to calculate a reasonable layout of the primary schools and to validate the rationale. The results show that the SNCM method can be effectively applied in low-income mountainous cities. It can not only improve the accessibility and service efficiency of primary schools using as little capital-investment as possible, but also help the city grow in an intensive and efficient way.
基金supported by the project“Survey on the Nutritional Status of Children from Urban Low-income Families in China”funded by Center for Monitoring and Verification of Low-income Families of Chinese Ministry of Civil Affairs,the Humanity and Social Science Project of Chinese Ministry of Education(No.10YJC630215)the Fundamental Research Funds for the Central Universities(No.HUST 2014 TS055)
文摘There have been many studies on the nutrition and the growth status of children from rural and remote western regions of China, whereas researches on children from urban low-income families are scarce. This study aimed to investigate the growth and nutritional status of children under five years of age from urban low-income families in China. There were 169 children aged 25–60 months recruited from Xiangtan and Jilin, two cities with a population of 2.81 million and 4.26 million respectively, in China in this cluster cross-sectional study. Data were collected on demographic and socioeconomic characteristics, the feeding practices and the incidence of anemia and diarrhea. The results showed that the prevalence of low birth weight and macrosomia was 7.1% and 9.5% for the two cities, respectively, which was higher than that for other cities in China(1.5% and 5.9%). Of all the sampled children, 14.6% and 8.2% suffered anemia and diarrhea, respectively. Multivariate analysis showed that legumes or nuts fed in a 24-h recall increased the risk of anemia(OR=4.9). Children whose caregivers began to introduce complementary foods relatively late would have high diarrhea prevalence(OR=1.4). In conclusion, the prevalence of anemia and diarrhea in under-five children from urban low-income families in China is relatively high. The growth and nutritional status of these children is greatly affected by feeding practices. A series of measures should be taken by relevant government departments to improve the health of these children.
文摘BACKGROUND Colorectal cancer(CRC)remains a relevant public health problem.Current research suggests that racial,economic and geographic disparities impact access.Despite the expansion of Medicaid eligibility as a key component of the Affordable Care Act(ACA),there is a dearth of information on the utilization of newly gained access to CRC screening by low-income individuals.This study investigates the impact of the ACA’s Medicaid expansion on utilization of the various CRC screening modalities by low-income participants.Our working hypothesis is that Medicaid expansion will increase access and utilization of CRC screening by low-income participants.AIM To investigate the impact of the Affordable Care Act and in particular the effect of Medicaid expansion on access and utilization of CRC screening modalities by Medicaid state expansion status across the United States.METHODS This was a quasi-experimental study design using data from the Behavioral Risk Factor Surveillance System,a large health system survey for participants across the United States and with over 2.8 million responses.The period of the study was from 2011 to 2016 which was dichotomized as pre-ACA Medicaid expansion(2011-2013)and post-ACA Medicaid expansion(2014-2016).The change in utilization of access to CRC screening strategies between the expansion periods were analyzed as the dependent variables.Secondary analyses included stratification of the access by ethnicity/race,income,and education status.RESULTS A greater increase in utilization of access to CRC screening was observed in Medicaid expansion states than in nonexpansion states[+2.9%;95%confidence interval(95%CI):2.12,3.69].Low-income participants showed a+4.02%(95%CI:2.96,5.07)change between the expansion periods compared with higher income groups+3.19%(1.70,4.67).Non-Hispanic Whites and Hispanics[+3.01%(95%CI:2.16,3.85)vs+5.51%(95%CI:2.81,8.20)]showed a statistically significant increase in utilization of access but not in Non-Hispanic Blacks,or Multiracial.There was an increase in utilization across all educational levels.This was significant among those who reported having a high school graduate degree or more+4.26%(95%CI:3.16,5.35)compared to some high school or less+1.59%(95%CI:-1.37,4.55).CONCLUSION Medicaid expansion under the Affordable Care Act led to an overall increase in self-reported use of CRC screening tests by adults aged 50-64 years in the United States.This finding was consistent across all low-income populations,but not all races or levels of education.
文摘This paper explores how to use container buildings to resolve the housing problem of migrant workers in the context of urbanization, and ascertains the characteristics of the container housing and public space through the analysis of excellent examples of the container recycling project at home and abroad. In terms of the material, economic benefits, environmental protection and industrialization, those characteristics are summarized as follows.(1) Being sturdy, corrosion-resisting, waterproof and insulated, building materials are able to resist bad weather.(2) Their economic results lie in the short constructive cycle so that the cost of reinforced concrete per unit area reduces 20% on year-on-year basis.(3) Their environmental protection rests with the recyclability of materials, less construction waste and less noise in the construction process.(4) Their industrialization is embedded in their modular design and standardized specifications as well as the flexibility and replaceability.
文摘Low-rise apartments for low-income residents have been built in Surabaya in recent years. They have four stories and many rooms, and the dwellers are all small traders. Because these projects are built with funds from the government, the buildings are designed to consider the cost of construction, without consideration of embodied energy material. As a result, the buildings are not optimal in terms of embodied energy and construction cost. At present, because there are both concerns over global warning and a worldwide energy crisis, the embodied energy in a building is a very important concept for building design, because it can determine usage of energy in relation to natural sources, especially fossil fuels. This is part of the sustainable design concept. This paper describes research regarding: differences in embodied energy and construction cost between different wall materials, including brick, corn block and lightweight concrete in low rise apartments; the optimal relationship between embodied energy and building cost; and which factors determine these differences. The findings of this research show that lightweight concrete is the best material for the building walls; apartments for low-income in Surabaya still do not represent optimal construction design; and that sustainable buildings are cheaper than those that do not use this concept.
文摘Multi-storey housing for low income society is a concept of redevelopment from many alternatives of housing development for slum in Jakarta. However, redevelopment directly or indirectly leads to displacement of low-income residents. The new residents would be of a higher socio-economic status than the previous occupants. For controlling this phenomenon, a study about the influence of displacement to the successful of sustainable multi-storey housing development for low-income society has been done with descriptive method, observation and literature study. The result of this study give knowledge that displacement always happened when the quality of building and environment is increase, the location of multi-storey housing is near city center and commercial area. Low income society voluntary displaced their units to middle or high income society, because they are not affordable for paying operational and maintenance costs. The government has to make regulations for controlling displacement on multi-storey housing for low-income society and for the successful of sustainable multi-storey housing development in urban area.
文摘This paper attempts to investigate the negative effects of the spread of COVID-19 on low-income families in Egypt.Coronavirus spread is measured by"Coronavirus cases"and"Coronavirus deaths"on a daily basis.Besides,it is measured by both"new Coronavirus cases"and"new deaths from Coronavirus",in relation to the population of Egypt.The Egyptian government is taking some measures to reduce the negative effects of COVID-19,including increasing personal exemptions by amending some provisions of the Egyptian Income Tax Law promulgated by Law No.91 of 2005 to protect low-income families.Of the negative effects of COVID-19,it is one of the most important tax policies to achieve social justice in distributing the tax burden,according to income levels,in a manner that achieves justice and equality.We find that Personal exemptions did not succeed in achieving tax justice by easing the tax burden on the low-income people in society.
文摘This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descriptive and inferential statistics were used to analyze collected data and significance at p < 0.05 accepted. Corn fufu with huckleberry was the most frequently consumed meal with little or no animal-source protein. Protein and B group vitamins intake of respondents in both communities were below the FAO/WHO recommended values while energy, iron, and vitamins A and C were in excess for most age groups. Adolescents 10 - 19 years and adults 20 years and above failed to meet at least 85% of RNI for calcium.
文摘Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.
文摘With the completion of the strategic vision of building a moderately prosperous society in an all-round way in 2020,China’s economic development has entered a new normal.The concept of innovative,coordinated,green,open and shared development will lead China’s economic progress and development.However,the development of urban and rural areas and regions in China is still not coordinated,and the sudden COVID-19 outbreak has caused a serious impact on urban low-income groups.Due to the characteristics of poor employment stability,low income and single source,as well as greater family pressure of urban low-income groups,the author focuses on the influencing factors of their feelings of happiness.This paper assumes that the satisfaction degree of residents’needs is positively correlated with residents’feelings of happiness.Based on Maslow’s hierarchy of needs theory,this paper analyzes the factors that may affect the happiness of urban low-income groups in five levels,and explores the special needs and difficulties of urban low-income groups in the context of the epidemic.So as to find ways to improve the happiness of urban low-income people to provide reference.
基金Under the auspices of the China Social Science(No.21BJY218)National Natural Science Foundation of China(No.41801113)Newcomer funding from Institute of Geographic Sciences and Natural Resources Research,Chinese Academy of Sciences(No.E0V00100)。
文摘Specialized households serve as the primary units within specialized villages in China,and their capacity to withstand risks and external influences significantly shapes the future trajectory of specialized villages and the overall vitality of the rural economy.In this study,we established a measurement indicator system based on the definition of specialized households’resilience,elucidating the logical connection between specialized households’resilience and rural industrial development in China.The musical instrument industry in Lankao County,Henan Province of China,was employed as a case;survey data,the entropy method,and an obstacle diagnosis model were used to examine how instrument production specialized households responded to the challenges posed by Corona Virus Disease 2019(COVID-19)and the tightening of national environmental protection policies,yielding the following key findings:1)there exists substantial variation in the comprehensive resilience levels among different specialized households;2)the ability to learn and adapt is the most significant contributor to the overall resilience level of specialized households;3)technological proficiency and access to skilled talent emerge as pivotal factors influencing specialized households’resilience;4)the positioning of specialized households within the industrial supply chain and the stability of their income have a direct bearing on their resilience level.The influence of specialized households’resilience on industrial development primarily manifests in the following ways:stronger resilience correlates with increased stability in production and sales,fostering a more proactive approach to future actions.However,heightened exposure to the external macroeconomic environment can lead to a higher rate of export reduction.To enhance the development resilience of entities like specialized households and family farms,and to invigorate rural economic development,escalating investments in rural science and technology and prioritizing the training of technical talent become imperative.