A thesis submitted to the Faculty of Arts in fulfilment of the requirements for the Degree of Masters in Social Work in the Department of Social Work at the University of Zululand, South Africa, 2013 / The study “An Investigation of Factors Surrounding Food Insecurity in KwaMthethwa”examines the factors responsible for food insecurity with specific reference to the rural people of KwaMthethwa. The investigation found that many factors coalesce to worsen the problem of food insecurity in the area under study. Mainly but not exclusively, factors that were found to worsen food insecurity in the KwaMthethwa area were: inadequate land supply, unemployment exacerbated by lack of marketable work skills, cultural practices and beliefs that tend to marginalize women away from the profitable work force, the HIV- AIDS epidemic which leaves many children without parents and the colonial mentality of white farm employers who see black labour as an exploitable commodity. In KwaMthethwa area the population group most severely affected by food insecurity was women and children. It was found that the situation of food insecurity could be improved by increasing productive infrastructure such as roads, telecommunication links, clinics, schools and properly equipped libraries.

Thesis (Ph. D.)--University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. "December 2006" Vita. Includes bibliographical references.

Although abortion has been decriminalized in Canada since 1988 and is covered as a medically necessary service through territorial health insurance schemes, anecdotal evidence suggests women in Canada’s north face significant barriers to accessing care. With a population of fewer than 34,000 spread across an area that is larger than California, geographic remoteness impacts health care access and quality in Yukon Territory. This qualitative study aimed to explore the dynamics shaping access to abortion care in the Yukon, provide an opportunity for women to share their experiences, and identify possible avenues for improving service delivery. In 2015-2016, the study team conducted 16 in-depth interviews with women and 11 key informant interviews. We used an iterative analytic approach allowing for the identification of emerging codes and themes. Our findings reveal that women face a number of barriers when accessing abortion services in Yukon. Specifically, a physician referral is required, as are several pre-procedure appointments, with no one central location to obtain these services. Women expressed concerns of privacy, overcoming logistical constraints, lengthy wait times, and lack of follow-up supports. Challenges were further amplified for women residing outside of Whitehorse, the sole location to obtain abortion services in the territory. Facilitating efforts to create a more transparent and streamlined service would ease the process for women seeking care and appears warranted. The recent registration of mifepristone could serve to alleviate certain barriers, presuming that the approved regimen is affordable, evidence-based, and available at more service delivery points. Bien que l'avortement a été décriminalisé au Canada depuis 1988 et est couvert en tant que service médicalement essentiel par le biais des régimes d'assurance-santé territoriales, des évidences non confirmées suggèrent que les femmes vivant au Nord du Canada font face à des obstacles importants quant à l'accès aux soins. Avec une population de moins de 34,000 habitants répartit sur un territoire d’une superficie supérieure à celle de la Californie, les effets de l’éloignement géographique sur l'accès et la qualité des soins de santé dans le territoire du Yukon sont considérables. Cette étude qualitative visait à explorer la dynamique qui façonne l'accès aux services d'avortement au Yukon, fournir une occasion pour ces femmes de partager leurs expériences et d'identifier les alternatives possibles pour améliorer la prestation de ces services. En 2016-2016, l’equipe de recherche a effectué 16 entrevues avec des femmes et 11 entrevues avec des informateurs/acteurs clés, et avons utilisé une approche analytique itérative permettant l'identification d’une codification et des thèmes émergents. Nos résultats démontrent que les femmes font face à un certain nombre d'obstacles lors de l'accès aux services d'avortement au Yukon. En effet, une recommandation médicale est requise, de même que plusieurs rendez-vous pré-procédure et un manque de services centralisés. Les atteintes à la vie privée, les contraintes logistiques, les longs temps d’attente et le manque de suivi sont des contraintes exprimées par nos participantes. Ces défis sont encore plus important pour les femmes habitant à l'extérieur de Whitehorse qui est le seul endroit pour obtenir des services d'avortement sur le territoire. Promouvoir les efforts visant à créer des services plus transparents et simplifiés faciliteraient le processus pour les femmes qui requiert des soins et semblent nécessaires. La récente introduction de la mifépristone pourrait alléger certains obstacles, en supposant que le médicament adopté est abordable, fondé sur des preuves scientifiques, et disponible à plusieurs points de services.

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Health-related disparities remain a persistent, serious problem across the nation's more than 60 million rural residents. Rural Populations and Health provides an overview of the critical issues surrounding rural health and offers a strong theoretical and evidence-based rationale for rectifying rural health disparities in the United States. This edited collection includes a comprehensive examination of myriad issues in rural health and rural health care services, as well as a road map for reducing disparities, building capacity and collaboration, and applying prevention research in rural areas. This textbook offers a review of rural health systems in Colorado, Kentucky, Alabama, and Iowa, and features contributions from key leaders in rural public health throughout the United States.

El turismo basado en la comunidad viene creciendo de manera sostenida y permite que el turista aprenda las costumbres y tradiciones de poblaciones rurales. Asimismo, se da la oportunidad a las poblaciones rurales de ser los protagonistas de organizar las actividades turísticas para lograr un beneficio propio. Sin embargo, este tema no está siendo correctamente abordado en la literatura ya que existe escasa información sobre los perjuicios de esta actividad. Por ende, el objetivo de este estudio es analizar los beneficios y perjuicios que perciben las poblaciones que habitan en lugares donde se practica el turismo basado en la comunidad. Este estudio se desarrolló usando la metodología de revisión literaria bajo el enfoque integrador, el cual permitió sintetizar la información recolectada con el fin de hallar vacíos sobre el tema. Es así que se descubre que el turismo basado en la comunidad genera más beneficios que perjuicios, entonces se recomienda realizar futuros estudios cualitativos a profundidad de las dificultades que enfrentan las poblaciones en dicho escenario. Asimismo, se recomienda una intervención de los actores pertinentes del Estado para capacitar a los pobladores y que se desarrolle la actividad turística de una manera más sostenible. / Community-based tourism has been growing steadily and allows tourists to learn about the customs and traditions of rural populations. It also gives rural populations the opportunity to be the protagonists in organizing tourism activities for their own benefit. However, this issue is not being properly addressed in the literature, as there is little information on the detrimental effects of this activity. Therefore, the objective of this study is to analyze the benefits and detriments perceived by the populations living in places where community-based tourism is practiced. This study was developed using the literature review methodology under the integrative approach, which allowed synthesizing the information collected in order to find gaps on the subject. It is thus discovered that community-based tourism generates more benefits than detriments, so it is recommended that future in-depth qualitative studies be conducted on the difficulties faced by the populations in this scenario. It is also recommended that the relevant state actors intervene to train local people and develop tourism activities in a more sustainable manner. / Trabajo de investigación

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported facing many barriers including trust in local physicians, access, availability, cost, and quality of healthcare. These issues often impede women’s access to preventative care and place burdens on their health and an already strained healthcare system.

Background: Numerous epidemiological studies have demonstrated a possible correlation between high temperature and mortality in different settings. Most of these studies have focused on urban settings in industrialized countries, concluding that urban populations are more vulnerable to heat effects than rural populations. This has mainly been attributed to the urban heat island (UHI) effect, a phenomenon which explains the elevated temperatures in urban areas. Others have contradicted this finding and concluded that rural residents are more vulnerable. For this study, we test the hypothesis that rural populations and sub-populations are also vulnerable to heat mortality. Method: A comprehensive literature search was conducted using PubMed, Web of Science and Google Scholar to identify peer-reviewed studies investigating heat mortality in rural settings. Using keywords and a set of rigorous inclusion and exclusion criteria, ten studies were selected. Meta-analysis was then performed using the Comprehensive MetaAnalysis V3.exe software. Results and discussion: The pooled relative risk (RR) was 1.191 (95% confidence interval: 1.130-1.251). Although rural populations may not be exposed to as high temperatures as urban populations, they remain vulnerable to heat effects. Conclusion: There is evidence of heat vulnerability in rural populations and subpopulations. Heat vulnerability is not only determined by heat exposure, but also by sensitivity and adaptive capacity. Rural populations and sub-populations may be vulnerable to heat mortality due to low adaptive capacity. Further studies are needed to assess risk factors that predispose rural populations and sub-populations to heat mortality in order to develop effective public health interventions.

Despite recent advances in the global electrification rates, increasing from 76% in 1990 to 85% in 2012, the United Nations goal of universal access to electricity by 2030 is still far from achieved, with an estimated 1.1 billion people still without access to electricity. Over half of these live in Sub-Saharan Africa, with a majority in rural areas and extreme poverty. Major challenges are inert with the current electrification path of centralized grid extension, leaving these people without power in decades to come. Microgrids, a decentralized power system consisting of solar power generation, energy storage and distribution technology, has been hailed as the only option to provide life improving and productivity inducing power for rural communities in Africa. However, despite recent hype and development in the sector, the diffusion of microgrids is still incremental due to a lack of viable large-scale operation, required for profitability. This is explained by targeting customers in remote rural areas with low ability to pay, and the task of delivering expensive technology and complex operations needed to manage and operate the grids. No industry blueprint or research on how to operate microgrids at scale or profitably exists. This thesis explores one blueprint, with the promise to increase profitability and allow for a more sustainable scaling. Local Capacity building is a decentralized approach by developing capacity directly in the local communities, through recruiting, skills development and training of people to be employed to operate and manage their local microgrids. The results consist of a framework outlining what local capacity building is, through research propositions that define the key components capturing the complete system of local capacity building is for scaling a microgrid business, along with the challenges and opportunities associated with scaling a business using local capacity building. It has been developed iteratively by application of an action research approach conducted on a small-scale Zambian Microgrid company facing radical growth. The researcher was immersed in the context, at the heart of this change, and in a participatory and interventionist fashion turning every stone to explore what local capacity building is, resulting in a robust study anchored in the field. Because of the contextually embedded nature of the data, this also means that the results are local. It is up to the reader to assess the applicability of the results in another context. The extensive results span multiple areas of the business, capturing the complexity of local capacity building, and contribute to knowledge on a holistic level on what local capacity building is. This blueprint was deemed viable to further develop in the small-scale Zambian microgrid company, specifically because of its potential to lower operating expenses and offer a more sustainable way to scale, and in extension diffuse microgrids in Africa. / Trots en positiv utveckling i tillgång till el globalt, ökandes från 76% år 1990, till 85% år 2012, så är Förenta Nationernas mål om universell tillgång till el till år 2030, långt ifrån att bli uppfyllt. 1.1 miljarder människor estimeras vara utan tillgång till el globalt, där över hälften av dessa bor i Sub-Saharanska Afrika, med majoriteten levandes på landsbygden och i extrem fattigdom. Stora utmaningar finns med innevarande elektrifierings strategin, som handlar om centraliserad elproduktion och distribution genom ett centralt elnät, detta kommer att lämna dessa människor utan el under lång tid framöver. Mikronät, ett decentraliserat energisystem, som kan producera och distribuera el, har lyfts fram som det bästa alternativet för att försörja livsförbättrande och produktivitetsökande elektricitet för samhällen på landsbygden i Afrika. Dock, trots nylig hype och utveckling i mikronät sektorn, så är spridningen av mikronät fortfarande inkrementell, beroende av en brist på genomförbarheten av att driva mikronät verksamheten i stor skala, vilket krävs för lönsamhet. Detta förklaras av den fundamentala utmaningen i att inrikta sig mot kunder i avlägsna områden, med en låg förmåga att betala, kombinerat med leveransen av dyr teknologi, och de komplex operativa strukturerna som krävs. Det finns ingen forskning eller blåkopia i industrin som visar hur man skulle kunna bedriva mikronäts verksamhets i stor skala, eller på ett lönsamt vis. Denna forskning undersöker en möjlig sådan blåkopia, med löftet att öka lönsamheten och möjliggöra en mer hållbar spridning. Utveckling av lokal kapacitet, är ett decentraliserat tillvägagångssätt för att utveckla kapacitet direkt i dessa avlägsna samhällen, genom rekrytering, färdighetsutveckling och utbildning av människor för att bli anställda för att sköta deras lokala mikronät. Resultaten i studien består av ett ramverk som visar vad utveckling av lokal kapacitet innebär, genom forskningsförslag som definierar vilka nyckelkomponenter som krävs för att skala upp en mikronäts verksamhet, tillsammans med utmaningar och möjligheter för att göra detta. Ramverket har utvecklats iterativt genom applicering av Action Research, utförd i ett småskaligt mikronät företag i Zambia som står inför en radikal expansion. Forskaren var fördjupad i företagskontexten, i hjärtat av förändringen, och på ett ingripande och deltagande sätt vänt på varenda sten för att utforska vad utveckling av lokal kapacitet är. Detta resulterade i en robust studie, förankrad i verkligheten. På grund av den kontextuellt inbäddade naturen av datan, så betyder detta även att resultaten är lokala. Det är upp till läsaren att bedöma till vilken grad resultaten kan appliceras i en annan kontext. De omfattande resultaten spänner över många olika områden i företaget, och lyckas fånga komplexiteten i vad utveckling av lokal kapacitet är. Blåkopian som utvecklades, bedömdes värdefull att utveckla vidare i företaget där studien gjorde, specifikt för dess potential att minska de operativa kostnaderna och erbjuda ett mer hållbart sätt att skala verksamheten, och i förlängningen, erbjuda ett mer hållbart sätt att sprida tillgång till el i Afrika.