Association between indoor air pollution measurements and respiratory health in women and children in Lao PDR

This article presents the results of a study on the association between measured air pollutants and the respiratory health of resident women and children in Lao PDR, one of the least developed countries in Southeast Asia. The study, commissioned by the World Health Organisation, included PM10, CO and NO2 measurements made inside 181 dwellings in nine districts within two provinces in Lao PDR over a 5- month period (12/05–04/06), and respiratory health information (via questionnaires and peak expiratory flow rate (PEFR) measurements) for all residents in the same dwellings. Adjusted odds ratios were calculated separately for each health outcome using binary logistic regression. There was a strong and consistent positive association between NO2 and CO for almost all questionnaire-based health outcomes for both women and children. Women in dwellings with higher measured NO2 had more than triple of the odds of almost all of the health outcomes, and higher concentrations of NO2 and CO were significantly associated with lower PEFR. This study supports a growing literature confirming the role of indoor air pollution in the burden of respiratory disease in developing countries. The results will directly support changes in health and housing policy in Lao PDR.

Pollutant concentrations within households in Lao PDR and association with housing characteristics and occupants' activities

The paper presents the results of a study conducted to investigate indoor air quality within residential dwellings in Lao PDR. Results from PM 10, CO, and NO2 measurements inside 167 dwellings in Lao PDR over a five month period (December 2005-April 2006) are discussed as a function of household characteristics and occupant activities. Extremely high PM10 and NO2 concentrations (12 h mean PM10 concentrations 1275 ± 98 μg m-3 and 1183 ± 99 μg m-3 in Vientiane and Bolikhamxay provinces, respectively; 12 h mean NO2 concentrations 1210 ± 94 μg m-3 and 561 ± 45 μg m-3 in Vientiane and Bolikhamxay, respectively) were measured within the dwellings. Correlations, ANOVA analysis (univariate and multivariate), and linear regression results suggest a substantial contribution from cookingandsmoking.The PM10 concentrations were significantly higher in houses without a chimney compared to houses in which cooking occurred on a stove with a chimney. However, no significant differences in pollutantconcentrations were observed as a function of cooking location. Furthermore, PM10 and NO2 concentrations were higher in houses in which smoking occurred, suggestive of a relationship between increased indoor concentrations and smoking (0.05 < p < 0.10). Resuspension of dust from soil floors was another significant source of PM10 inside the house (634 μg m-3, p < 0.05).

The effect of housing characteristics and occupant activities on the respiratory health of women and children in Lao PDR

The paper presents the results of a study conducted into the relationship between dwelling characteristics and occupant activities with the respiratory health of resident women and children in Lao People’s Democratic Republic (PDR). Lao is one of the least developed countries in south-east Asia with poor life expectancies and mortality rates. The study, commissioned by the World Health Organisation, included questionnaires delivered to residents of 356 dwellings in nine districts in Lao PDR over a five month period (December 2005-April 2006), with the aim of identifying the association between respiratory health and indoor air pollution, in particular exposures related to indoor biomass burning. Adjusted odds ratios were calculated for each health outcome separately using binary logistic regression. After adjusting for age, a wide range of symptoms of respiratory illness in women and children aged 1-4 years were positively associated with a range of indoor exposures related to indoor cooking, including exposure to a fire and location of the cooking place. Among women, “dust always inside the house” and smoking were also identified as strong risk factors for respiratory illness. Other strong risk factors for children, after adjusting for age and gender, included dust and drying clothes inside. This analysis confirms the role of indoor air pollution in the burden of disease among women and children in Lao PDR.

Forage Legumes for supplementing village pigs in Lao PDR

Potential for forage legumes as a feed ingredient for pig nutrition.

Singing from the same hymn sheet? A closer look at the framing of human trafficing by counter-trafficing actors in Lao PDR

As disparities in wealth levels between and within countries become greater many poor people migrate in search of better earning opportunities. Some of this migration is legal but, in many cases, the difficulties involved in securing the necessary documentation mean that would-be migrants resort to illegal methods. This, in turn, makes them vulnerable to human trafficking, a phenomenon that has received growing attention from NGOs, governments and the media in recent years. Despite the attention being given to human trafficking, however, there remains a certain amount of confusion over what exactly it entails though it is generally understood to refer to the transportation and subsequent exploitation of vulnerable people through means of force or deception. The increased attention that has been given to the issue of human trafficking over the last decade has resulted in new discourses emerging which attempt to explain what human trafficking entails, what the root causes of the phenomenon are and how best to tackle the problem. While a certain degree of conceptual clarity has been attained since human trafficking rose to prominence in the 1990s, it could be argued that human trafficking remains a poorly defined concept and that there is frequently confusion concerning the difference between it and related concepts such as people smuggling, migration and prostitution. The thesis examines the ways in which human trafficking has been conceptualised or framed in a specific national context- that of Lao PDR. Attention is given to the task of locating the major frames within which the issue has been situated, as well as considering the diagnoses and prognoses that the various approaches to trafficking suggest. The research considers which particular strands of trafficking discourse have become dominant in Lao PDR and the effect this has had on the kinds of trafficking interventions that have been undertaken in the country. The research is mainly qualitative and consists of an analysis of key texts found in the Lao trafficking discourse.

Assistance in poverty alleviation through improved aquatic resources management in Asia-Pacific: DLF/NACA-STREAM/FAO National Workshop on livelihoods approaches and analysis. Vientiane, Lao PDR, 8-12 Mar. 2004

This is the report of the “DLF/NACA-STREAM/FAO National Workshop on Livelihoods Approaches and Analysis” that was conducted in Vientiane, Lao PDR from 8-12 March 2004. The purpose of the workshop was to develop and document mechanisms for training in livelihoods approaches and analysis, and to build national capacity to conduct livelihoods analysis. The workshop in Vientiane was the first STREAM event in Lao PDR, with colleagues coming to participate from Vientiane and many provinces throughout the country. The workshop in Vientiane was the third in a series, the first of which was held in Iloilo City, Philippines, in November 2003 and the second in Ranchi, India, in February, 2004. Subsequent workshops will take place in other countries in the region, including Myanmar and Yunnan, China. (Pdf contains 59 pages).

Aquaculture in the mountains of the northern Lao PDR and northern Vietnam

This article features the current status of aquaculture in the mountains of the northern Lao PDR and northern Vietnam.

Ritualising residency: territory cults and a sense of place in Southern Lao PDR

Territory cults in southern Lao PDR exemplify the importance of ritual for the production of locality in an era of mobility. Here, the idea of village expressed in ritual incorporates scattered members who have ties of history and affection to village households—a view of residency that is extra-verted, inclusive and traverses space.

Finding a 'safe' place on the risk continuum: a case study of pregnancy and birthing in Lao PDR (Lao People's Democratic Republic)

This paper addresses two questions. Firstly: are the risk regimes faced, and perceived, by pregnant women in rural Lao PDR substantially different from those experienced by pregnant women in western societies? Secondly, if the Lao experiences and perceptions are different, can improvements in maternal health in Lao PDR be achieved without Laotians inheriting the risk regimes of late modernity experienced by many women in western societies? Secondary analysis is undertaken of data collected in 2005 for the evaluation of a pilot maternity waiting home in Bolikhan, Lao PDR. The results suggest significantly different risk perceptions and experiences between Lao and western communities, based on contrasting views of embodiment, identity construction and cosmologies. In the Lao rural communities studied, there is little evidence yet of 'risk society' despite the introduction of western technologies and practices to improve maternal mortality and morbidity. It is argued that 'risk society' can be avoided.

Using the personal wellbeing index in Lao PDR : issues of equivalence

Lao PDR is one of the 50 countries included in the International Wellbeing Group study which uses Cummin's (2001) Personal Wellbeing Index (PWI) to draw cross-national comparisons of subjective wellbeing. Lau, Cummins & McPherson (2005) found a statistically significant difference in PWI scores between Australian & Hong Kong. They ask whether this is a real reflection of lower quality of life in Hong Kong or whether there exists a cultural response bias which predisposes the Hong Kong population to be less willing to admit to high levels of satisfaction in the seven domains of the index. If the difference reflects cultural response bias, what factors contribute to that bias & how common is this phenomenon in the countries of South-east Asia & IndoChina? The paper addresses these questions with particular attention to Lao PDR where responses to the PWI from both urban & rural populations suggest a similar reticence about expressing high levels of satisfaction. The paper explores the sources of resistance to reporting positive subjective wellbeing & what adaptations may be needed to the Index to allow for such bias.

Maternity waiting homes in Southern Lao PDR : the unique 'silk home'

The concept of maternity waiting homes (MWH) has a long history spanning over 100 years. The research reported here was conducted in the Thateng District of Sekong Province in southern Lao People’s Democratic Republic (PDR) to establish whether the MWH concept would be affordable, accessible, and most importantly acceptable, as a strategy to improve maternal outcomes in the remote communities of Thateng with a high proportion of the population from ethnic minority groups. The research suggested that there were major barriers to minority ethnic groups using existing maternal health services (reflected in very low usage of trained birth attendants and hospitals and clinics) in Thateng. Unless MWH are adapted to overcome these potential barriers, such initiatives will suffer the same fate as existing maternal facilities. Consequently, the Lao iteration of the concept, as operationalized in the Silk Homes project in southern Lao PDR is unique in combining maternal and infant health services with opportunities for micro credit and income generating activities and allowing non-harmful traditional practices to co-exist alongside modern medical protocols. These innovative approaches to the MWH concept address the major economic, social and cultural barriers to usage of safe birthing options in remote communities of southern Lao PDR.

Maternal health in Lao PDR : repositioning the goal posts

This paper reviews attempts made in the Lao People's Democratic Republic (PDR) to achieve Millennium Development Goal (MDG) 5: Improve Maternal Health and its two targets: (1) to reduce by three quarters the maternal mortality ratio and (2) to achieve universal access to reproductive health. It will be shown that significant strides have been made in relation to both the targets, especially in the province of Xayaboury where the contraceptive prevalence rate is the highest and maternal mortality is the lowest in the country. That said, it is unlikely that either target will be realised by 2015 for the nation as a whole. Some of the reasons for this are canvassed such as problems with the existing health infrastructure and its personnel, the cost of health care, the demographic profile and cultural expectations of women of childbearing age, geographic barriers, the absence of communication and transport infrastructure and the influence of international donors on how monies are expended. As discussions now begin to set the framework for the post-MDG compact of the international community to address poverty and well-being, it would be valuable to consider the multiplicity of factors which directly impact maternal and infant mortality rates (such as family planning, age at first birth, access to antenatal care and government expenditure on maternal health care) and explain what causes change, over non-contextualised statistics that simply report changes.

Diamond Dialogue method for the evaluation of personal well-being after a maternal health intervention in Lao PDR

This paper follows the genesis of an evolving tool to measure the impact of development interventions on personal well-being in non-literate and non-numerate communities. The Diamond Dialogue was adapted to evaluate the impact on women of the establishment of 17 one stop maternity waiting home/health promotion/income generating centres (Silk Homes) in Southern Lao PDR. The tool elicited data not accessible by research methods which assume literacy and numeracy and revealed that 86% of women who used the Silk Homes experienced substantial improvements in quality of life. The Diamond Dialogue can be modified to assess the outcomes of development interventions in a myriad of contexts.