14 resultados para community-based organizations
em Helda - Digital Repository of University of Helsinki
Resumo:
Multi- and intralake datasets of fossil midge assemblages in surface sediments of small shallow lakes in Finland were studied to determine the most important environmental factors explaining trends in midge distribution and abundance. The aim was to develop palaeoenvironmental calibration models for the most important environmental variables for the purpose of reconstructing past environmental conditions. The developed models were applied to three high-resolution fossil midge stratigraphies from southern and eastern Finland to interpret environmental variability over the past 2000 years, with special focus on the Medieval Climate Anomaly (MCA), the Little Ice Age (LIA) and recent anthropogenic changes. The midge-based results were compared with physical properties of the sediment, historical evidence and environmental reconstructions based on diatoms (Bacillariophyta), cladocerans (Crustacea: Cladocera) and tree rings. The results showed that the most important environmental factor controlling midge distribution and abundance along a latitudinal gradient in Finland was the mean July air temperature (TJul). However, when the dataset was environmentally screened to include only pristine lakes, water depth at the sampling site became more important. Furthermore, when the dataset was geographically scaled to southern Finland, hypolimnetic oxygen conditions became the dominant environmental factor. The results from an intralake dataset from eastern Finland showed that the most important environmental factors controlling midge distribution within a lake basin were river contribution, water depth and submerged vegetation patterns. In addition, the results of the intralake dataset showed that the fossil midge assemblages represent fauna that lived in close proximity to the sampling sites, thus enabling the exploration of within-lake gradients in midge assemblages. Importantly, this within-lake heterogeneity in midge assemblages may have effects on midge-based temperature estimations, because samples taken from the deepest point of a lake basin may infer considerably colder temperatures than expected, as shown by the present test results. Therefore, it is suggested here that the samples in fossil midge studies involving shallow boreal lakes should be taken from the sublittoral, where the assemblages are most representative of the whole lake fauna. Transfer functions between midge assemblages and the environmental forcing factors that were significantly related with the assemblages, including mean air TJul, water depth, hypolimnetic oxygen, stream flow and distance to littoral vegetation, were developed using weighted averaging (WA) and weighted averaging-partial least squares (WA-PLS) techniques, which outperformed all the other tested numerical approaches. Application of the models in downcore studies showed mostly consistent trends. Based on the present results, which agreed with previous studies and historical evidence, the Medieval Climate Anomaly between ca. 800 and 1300 AD in eastern Finland was characterized by warm temperature conditions and dry summers, but probably humid winters. The Little Ice Age (LIA) prevailed in southern Finland from ca. 1550 to 1850 AD, with the coldest conditions occurring at ca. 1700 AD, whereas in eastern Finland the cold conditions prevailed over a longer time period, from ca. 1300 until 1900 AD. The recent climatic warming was clearly represented in all of the temperature reconstructions. In the terms of long-term climatology, the present results provide support for the concept that the North Atlantic Oscillation (NAO) index has a positive correlation with winter precipitation and annual temperature and a negative correlation with summer precipitation in eastern Finland. In general, the results indicate a relatively warm climate with dry summers but snowy winters during the MCA and a cool climate with rainy summers and dry winters during the LIA. The results of the present reconstructions and the forthcoming applications of the models can be used in assessments of long-term environmental dynamics to refine the understanding of past environmental reference conditions and natural variability required by environmental scientists, ecologists and policy makers to make decisions concerning the presently occurring global, regional and local changes. The developed midge-based models for temperature, hypolimnetic oxygen, water depth, littoral vegetation shift and stream flow, presented in this thesis, are open for scientific use on request.
Resumo:
This study aims at identifying the existing and potential resources, as well as recognizing the hinderances, for community-based ecotourism development in the Taita Hills in south-eastern Kenya. The indigenous mountain rain forests on the hills are rich in biodiversity, but severely degraded because of encroachment caused by the dynamics of increased population, socio-politics and economics. The research problems are based on the hypothesis that there is no tourism in the Taita Hills generating income for the local economy and high population density combined with poverty creates a need for alternative employment opportunities as well as for sustainable ways of forest resource management. The data for this study was gathered during two field trips in Kenya, in January-February 2004 and 2005, as a part of the Taita Project within the Department of Geography at the University of Helsinki. The qualitative methods used consist of RRA and PRA techniques, in-depth interviews, a structured questionnaire and literature analysis as well as attendance on excursions and a workshop with conservation experts and officials. Four case areas in the Taita Hills are studied. The study concludes that alternative livelihoods are needed among the Taita Hills´ rural population and community-based ecotourism is seen as a way of bringing financial benefits for households as well as reviving the fading cultural traditions and indigenous knowledge about forest use. The governmental policies, district level development plans and some NGOs support ecotourism development. The Forest Act 2005 forms base for local participation in forest management. The unique natural features, the welcoming Taita-culture and the location in the coastal tourism circle favour Taita Hills. However, this kind of development has its risks, such as too rapid change of sorest usage level and the exposure of communities to an ecotourism treadmill process. The costbenefit ration of marketing for hard ecotourists is generally low and the tourism infrastructure needs upgrading in the Taita Hills. More tight collaboration is important between the different level stakeholders working for conservation and development. Community-based ecotourism in Taita Hills, when carefully planned and managed, could be one opportunity for Kenya to diversify its tourism product supply and for forestadjacent communities to gain tangible benefits on a sustainable basis from forests.
Resumo:
Varhaislapsuuden karies ja sen ehkäisy kehittyvän terveydenhuollon maassa Varhaislapsuuden karies on merkittävä kansanterveysongelma varsinkin lapsirikkaissa maissa ja väestöissä. Karieksen hoitaminen vie paljon voimavaroja ja aiheuttaa mittavia taloudellisia seuraamuksia. Karies voi ilmaantua lapselle jo vauvaikäisenä, pian ensimmäisten maitohampaiden puhjettua suuhun. Alle 3-vuotiaiden karieksesta on kuitenkin niukasti tilastotietoja. Maailman terveysjärjestökin suosittaa tietojen keräämistä vasta 3-vuotiaiden ikäryhmästä. Heistä kariesta sairastaa Suomessa 16 %, Yhdysvalloissa 25 %, Englannissa 30 %, Iranissa 46 % ja Saudi-Arabiassa 61 %. Tämä väitöstutkimus selvitti karieksen esiintymistä ja sen vaaratekijöitä 1─3-vuotiailla Teheranissa. Lisäksi tutkimus arvioi perusterveydenhuoltoon sisällytetyn karieksen ehkäisyn tuloksellisuutta. Tutkimuskohteiksi arvottiin Teheranista 18 neuvolaa. Jokaisessa oltiin 4 päivää, jolloin kaikkia rokotuksiin tulleita 1─3-vuotiaita äiteineen pyydettiin osallistumaan tutkimukseen. Kahta lukuun ottamatta kaikki äidit suostuivat, ja aineistoon tuli kaikkiaan 504 lasta äiteineen. Kaikki 1-vuotiaat, 242 lasta äiteineen, valittiin karieksen ehkäisykokeiluun. Sitä varten neuvolat jaettiin kolmeen ryhmään, joista kaksi (A ja B) oli koeryhmiä ja yksi (C) oli vertailuryhmä. Tutkimus alkoi äidin haastattelulla. Siinä selvitettiin perheen koulutus- ja tulotaso sekä lapsen ruokinnasta imetyksen kesto, yösyötöt ja päiväaikaan nautitut makeat. Vielä kysyttiin lapsen ja äidin suuhygieniatavoista ja äidin kokemuksista lapsen suun puhdistamisessa. Sitten hammaslääkäri tutki lapsen suun ja kirjasi karieksen ja hammasplakin esiintymät. Suun tutkimuksen jälkeen äiti ja lapsi siirtyivät rokotushuoneeseen. Koeryhmissä (A ja B) äidit saivat terveydenhoitajalta suunterveyttä koskevan esitteen ja kehotuksen lukea se huolellisesti. Lisäksi ryhmässä A terveydenhoitaja kertoi suun ja hampaiden terveydenhoidosta saman esitteen avulla, ja neuvolan henkilökunta muistutti suunhoidon tärkeydestä puhelimitse kahdesti seuraavan puolen vuoden kuluessa. Vertailuryhmässä äideille ei annettu suunhoidon ohjeita. Kaikissa ryhmissä äitejä muistutettiin seuraavan rokotuskerran ajankohdasta, muttei mainittu tulevaa toista hammastarkastusta. Varhaislapsuuden kariesta sairasti ikäryhmästä riippuen 3─26 % tutkituista 1─3-vuotiaista, ja 65─76 %:lla oli hammasplakkia. Äideistä 68 % harjasi hampaansa päivittäin ja 39 % puhdisti lapsensa suun päivittäin. Mitä useammin äiti harjasi omat hampaansa, sitä paremmin hän huolehti lapsen suun puhtaudesta. Rintaruokinta oli yleistä eikä lisännyt kariesvaaraa. Yöllä pullomaitoa saavilla karies oli 5 kertaa yleisempää kuin muilla. Neuvolassa saatu ohjeistus ehkäisi selvästi karieksen syntyä puolen vuoden kokeessa.
Resumo:
Is oral health becoming a part of the global health culture? Oral health seems to turn out to be part of the global health culture, according to the findings of a thesis-research, Institute of Dentistry, University of Helsinki. The thesis is entitled as “Preadolescents and Their Mothers as Oral Health-Promoting Actors: Non-biologic Determinants of Oral Health among Turkish and Finnish Preadolescents.” The research was supervised by Prof.Murtomaa and led by Dr.A.Basak Cinar. It was conducted as a cross-sectional study of 611 Turkish and 223 Finnish school preadolescents in Istanbul and Helsinki, from the fourth, fifth, and sixth grades, aged 10 to 12, based on self-administered and pre-tested health behavior questionnaires for them and their mothers as well as the youth’s oral health records. Clinically assessed dental status (DMFT) and self-reported oral health of Turkish preadolescents was significantly poorer than the Finns`. A similar association occurred for well-being measures (height and weight, self-esteem), but not for school performance. Turkish preadolescents were more dentally anxious and reported lower mean values of toothbrushing self-efficacy and dietary self-efficacy than did Finns. The Turks less frequently reported recommended oral health behaviors (twice daily or more toothbrushing, sweet consumption on 2 days or less/week, decreased between-meal sweet consumption) than did the Finns. Turkish mothers reported less frequently dental health as being above average and recommended oral health behaviors as well as regular dental visits. Their mean values for dental anxiety was higher and self-efficacy on implementation of twice-daily toothbrushing were lower than those of the Finnish. Despite these differences between the Turks and Finns, the associations found in common for all preadolescents, regardless of cultural differences and different oral health care systems, assessed for the first time in a holistic framework, were as follows: There seems to be interrelation between oral health and general-well being (body height-weight measures, school performance, and self-esteem) among preadolescents: • The body height was an explanatory factor for dental health, underlining the possible common life-course factors for dental health and general well-being. • Better school performance, high levels of self-esteem and self-efficacy were interrelated and they contributed to good oral health. • Good school performance was a common predictor for twice-daily toothbrushing. Self-efficacy and maternal modelling have significant role for maintenance and improvement of both oral- and general health- related behaviors. In addition, there is need for integration of self-efficacy based approaches to promote better oral health. • All preadolescents with high levels of self-efficacy were more likely to report more frequent twice-daily toothbrushing and less frequent sweet consumption. • All preadolescents were likely to imitate toothbrushing and sweet consumption behaviors of their mothers. • High levels of self-efficacy contributed to low dental anxiety in various patterns in both groups. As a conclusion: • Many health-detrimental behaviors arise from the school age years and are unlikely to change later. Schools have powerful influences on children’s development and well-being. Therefore, oral health promotion in schools should be integrated into general health promotion, school curricula, and other activities. • Health promotion messages should be reinforced in schools, enabling children and their families to develop lifelong sustainable positive health-related skills (self-esteem, self-efficacy) and behaviors. • Placing more emphasis on behavioral sciences, preventive approaches, and community-based education during undergraduate studies should encourage social responsibility and health-promoting roles among dentists. Attempts to increase general well-being and to reduce oral health inequalities among preadolescents will remain unsuccessful if the individual factors, as well as maternal and societal influences, are not considered by psycho-social holistic approaches.
Resumo:
The aim of the study was to examine the effects of a smoking prevention program and smoking from early adolescence to early adulthood by using longitudinal data. In addition, predictors of smoking, smoking cessation, and associations of smoking with socio-economic factors and other health behaviours were assessed. The data was gathered in connection with the North Karelia Youth Project follow-up study during 15 years. A two-year cardiovascular disease risk factor prevention program was carried out among students from grades seven to nine in four schools in North Karelia. Two schools were selected from Kuopio province for the control schools. The North Karelia Project, a community-based cardiovascular disease prevention program, was implemented in the same area. At the baseline in 1978 the subjects were 13-year-olds (n=903) and in the following surveys 15-, 16-, 17-, 21- and 28-year-olds. The parents of the subjects were studied twice, in 1978 and 1980. A two-year intervention based on social influence approach prevented the onset of smoking for several years. The continuity of smoking from adolescence to adulthood was strong: most adolescent smokers were still smoking in adulthood. Moreover, approximately half of the 28-year-old smokers had started smoking after the age of 15. Previous smoking status and smoking by friends were the most important predictors of smoking. One third of all adolescent smokers had stopped smoking before the age of 28, averaging at 2.3 % annual decline. The socioeconomic status of the subject and, especially, education were strongly related to smoking, the lower socioeconomic groups smoking the most. Parental socioeconomic status and intergenerational social mobility were not significantly related to the smoking of the subject in adolescence or adulthood. Smoking was associated positively with the use of alcohol and negatively with physical activity from adolescence to adulthood. The results support the feasibility of a school-based social influence program with a community-based program in smoking prevention among adolescents. Strong continuity of smoking from adolescence to adulthood supports the importance of preventing the onset of smoking in adolescence. It would be useful to continue prevention programs also after the comprehensive school, since so many young start smoking after that. It would likewise be important to develop cessation programs tailor-made for adolescents and young adults. Additionally, the results support the importance of using methods based on social influence in smoking prevention and cessation programs, targeting especially such risk groups as those with low socioeconomic status as well as those with other unhealthy behaviours.
Resumo:
The purpose of the present study was to increase understanding of the interaction of rural people and, specifically, women with the environment in a dry area in Sudan. The study that included both nomadic pastoralists and farmers aimed at answering two main research questions, namely: What kinds of roles have the local people, and the women in particular, had in land degradation in the study area and what kinds of issues would a gender-sensitive, forestry-related environmental rehabilitation intervention need to consider there? The study adopted the definition of land degradation as proposed by the United Nations Convention to Combat Desertification (UNCCD), which describes land degradation as reduction or loss the biological or economic productivity and complexity of land in arid, semi-arid and dry sub-humid areas. The Convention perceives desertification as land degradation. The dry study area in Sudan, South of the Sahara, has been the subject of land degradation or desertification discussions since the 1970s, and other studies have been also conducted to assess the degradation in the area. Nevertheless, the exact occurrence, scale and local significance of land degradation in the area is still unclear. This study explored how the rural population whose livelihood depended on the area, perceived environmental changes occurring there and compared their conceptions with other sources of information of the area such as research reports. The main fieldwork methods included interviews with open-ended questions and observation of people and the environment. The theoretical framework conceptualised the rural population as land users whose choices of environmental activities are affected by multiple factors in the social and biophysical contexts in which they live. It was emphasised that these factors have their own specific characteristics in different contexts, simultaneously recognising that there are also factors that generally affect environmental practices in various areas such as the land users' environmental literacy (conceptions of the environment), gender and livelihood needs. The people studied described that environmental changes, such as reduced vegetation cover and cropland production, had complicated the maintenance of their livelihoods in the study area. Some degraded sites were also identified through observations during the fieldwork. Whether a large-scale reduction of cropland productivity had occurred in the farmers' croplands remained, however, unclear. The study found that the environmental impact of the rural women's activities varied and was normally limited. The women's most significant environmental impact resulted from their cutting of trees, which was likely to contribute, at least in some places, to land degradation, affecting the environment together with climate and livestock. However, when a wider perspective is taken, it becomes questionable whether the women have really played roles in land degradation, since gender, poverty and the need to maintain livelihood had caused them to conduct environmentally harmful activities. The women have had, however, no power to change the causes of their activities. The findings further suggested that an inadequate availability of food was the most critical problem in the study area. Therefore, an environmental programme in the area was suggested to include technical measures to increase the productivity of croplands, opportunities for income generation and readiness to co-operate with other programmes to improve the local people's abilities to maintain their livelihoods. In order to protect the environment and alleviate the women's work burden, the introduction of fuel-saving stoves was also suggested. Furthermore, it was suggested that increased planting of trees on homesteads would be supported by an easy availability of tree seedlings. Planting trees on common property land was, however, perceived as extremely demanding in the study area, due to scarcity of such land. In addition, it became apparent that the local land users, and women in particular, needed to allocate their labour to maintain the immediate livelihood of their families and were not motivated to allocate their labour solely for environmental rehabilitation. Nonetheless, from the point of view of the existing social structures, women's active participation in a community-based environmental programme would be rather natural, particularly among the farmer women who had already formed a women's group and participated in communal decision making. Forming of a women group or groups was suggested to further support both the farmer women's and pastoral women's active participation within an environmental programme and their general empowerment. An Environmental programme would need to acknowledge that improving rural people's well-being and maintaining their livelihood in the study area requires development and co-operation with various sectors in Sudan.
Resumo:
In Tanzania, indigenous forests can still be found whose existence is based on the management systems of precolonial society. This study covers material from over 900 forests. There are similar types of forests elsewhere in Africa, and similar forests can also be found in indigenous cultures on every continent. In this study they are called traditionally protected forests (TPFs). They have a high level of endemism and a rich biodiversity. The field study was carried out during the years 1997-2003 using participatory methods. An active debate is going on concerning the capacity of local communities to manage their environment. The role of indigenous people and their institutions in the development of the physical environment is a central issue in the debate. This study discusses the opportunities that the local people have had to decide on how to conserve, maintain, utilise, and manage their environment during different political periods. The study explains what kinds of changes have taken place in these forests and institutions in northeastern Tanzania among the matrilinear Zigua and patrilinear Gweno ethnic groups. About 2% of the land area of the communities was still protected by the precolonial structures. The communities have established their protection systems for different reasons, not only because of their beliefs but also because of different secular and clearly environmentally motivated reasons. There are different TPF types. Less than half of them are directly related to spirituality, and more than half are not. In earlier research elsewhere, it has been commonly understood that spiritual reasons played the main role in the protection of these environments. This study is also part of the postcolonial geographical discussion on the precolonial landscape and environmental management which was started by Carl Sauer. In the Zigua case study villages, only two out of five first comer clans have performed rain rituals in the past 30 years. Many of the most respected sacred sites do not have a ritual maker or even a person who knows how to perform rituals any longer. The same is happening with male initiation rites. In all case study villages there have been illegal cuts in the TPFs, but variations can be seen between the communities. The number of those who neither respect indigenous regulations nor accept indigenous penalties is growing. Positive developments have also taken place. Nowadays, the Forest Act of 2002 is in effect, which works as a cornerstone of community-based land ownership and also allows elders to protect TPFs, and by-laws are created with the support of different projects. Moreover, during the field study it was found that many young people are ignorant about their village's TPF sites, but interested in learning about their history and values.
Resumo:
Tämän pro gradu-tutkielman tarkoitus on tutkia, miten reilun kaupan banaania tuottavan El Guabon pienten banaaninviljelijöiden järjestön Asoguabon reilun turismin projekti on rakennettu. Projektin muotoutumista tutkitaan tässä työssä kahdesta eri näkökulmasta: siitä, miksi ja miten Asoguabo on monipuolistanut viljelystä turismiin, sekä siitä, millainen kuva projektista on rakennettu markkinoinnin kautta ja miten reilun kaupan mainonnasta tuttuja ilmiöitä on hyödynnetty reilun turismin rakentamisessa. Tutkielman teoreettisena taustana on maaseudun muutoksia tarkasteleva uuden ruraliteetin käsite. Turismi on viime vuosikymmenten aikana muuttunut, ja matkailijat etsivät yhä enemmän aitoja ja autenttisia matkailukokemuksia. Samanaikaisesti turismia on tuotteistettu korostamalla sen tiettyjä, kestävän kehityksen mukaisia piirteitä, ja erityisesti kehittyvissä maissa turismia markkinoidaan usein vaihtoehtoisena, yhteisöpohjaisena tai ekoturismina. Reilu turismi on uutena käsitteenä tullut mukaan tähän laajaan kirjoon, ja tämä tutkielma käsitteleekin Asoguabon projektia nimenomaan reilun turismin näkökulmasta. Tämä tutkielma on tapaustutkimus Asoguabon turismiprojektista, ja pohjautuu kuukauden pituiseen kenttätyöhön Ecuadorissa tammikussa 2010 sekä kirjoittajan aiempiin kokemuksiin Asoguabosta. Aineisto koostuu 21 puoli-strukturoidusta laadullisesta haastattelusta kuudentoista informantin kanssa, joista suurin osa oli hyvin läheisesti tekemisissä projektin kanssa. Tämän lisäksi aineistonkeruussa on käytetty havainnointia sekä projektin markkinointimateriaalien sisällönanalyysia. Tutkielma osoittaa reilun turismin projektin sisältävän monia haasteita ennen kuin se voi saavuttaa tavoitteensa tuottaa lisätuloja Asoguabon toimintaan. Tutkimushetkellä projekti hyödytti suoraan pääasiassa muutamia järjestön viljelijöitä, lähinnä niitä, jotka toimivat projektissa oppaina. Nämä oppaat hyötyvät projektista saamalla pieniä lisätuloja, kasvattamalla sosiaalista pääomaansa, sekä saamalla mahdollisuuden oppia muun muassa osallistumalla kursseille. Tutkimuksen keskeiset tulokset osoittavat myös, kuinka vuorovaikutus-ongelmat projektin eri toimijoiden välillä vaikeuttavat tiedonkulkua ja täten reilun turismin toimintaa. Nämä ongelmat myös lisäävät epätietoisuutta Asoguabon muiden viljelijöiden parissa. Lisäksi tutkimus osoittaa, kuinka reilun turismin projektin mainonnassa käytetään osittain samoja keinoja kuin reilun kaupan tuotteiden mainonnassa, joskin tuottajia on kuvattu mainosmateriaaleissa yllättävän vähän ja pääosassa ovat usein eurooppalaiset turistit.
Resumo:
The driving force behind this study is the gap between the reality of the firms engaged in project business and the available studies covering project management and business process development. Previous studies show that project-based organizations were ‘immature’ in terms of the project-management ‘maturity model’, as few firms were found to be optimizing processes. Even within those, very little attention was paid to combine inter-organizational and intra-organizational perspectives. In this study an effort is made to elaborate some thoughts and views on project management, which interrelate firms’ external and internal activities. In line with the integration, the dissertation uses an approach to the management of project-business interdependencies in the networks of actors, activities and resources. Firstly, the study develops an understanding for inter-organizational perspectives by exploring the complementarities of process activities in the basic development of project business. It presents a framework that is elaborated on the basis of the reciprocal interactions of activities within and outside the organization—thus providing a coherent basis for continuous business-process improvement. In addition, the study presents new tools that can be used to develop project-business processes in each of its functional areas. The research demonstrates how project-business activities can be optimized using the right resources at the right time with the right actors and the right actions. The selected five articles included in this dissertation explain the basic framework for the development of project business. Each paper covers various aspects of inter-organizational and intra-organizational perspectives for project management. The study develops a valuable and procedural model for business-process improvement using the Delphi method that can be used not only in academia but also as a guide for practitioners that takes them through a series of well-defined steps when making informed, consistent and efficient changes to their business processes.
Resumo:
Background and context Since the economic reforms of 1978, China has been acclaimed as a remarkable economy, achieving 9% annual growth per head for more than 25 years. However, China's health sector has not fared well. The population health gains slowed down and health disparities increased. In the field of health and health care, significant progress in maternal care has been achieved. However, there still remain important disparities between the urban and rural areas and among the rural areas in terms of economic development. The excess female infant deaths and the rapidly increasing sex ratio at birth in the last decade aroused serious concerns among policy makers and scholars. Decentralization of the government administration and health sector reform impacts maternal care. Many studies using census data have been conducted to explore the determinants of a high sex ratio at birth, but no agreement has been so far reached on the possible contributing factors. No study using family planning system data has been conducted to explore perinatal mortality and sex ratio at birth and only few studies have examined the impact of the decentralization of government and health sector reforms on the provision and organization of maternal care in rural China. Objectives The general objective of this study was to investigate the state of perinatal health and maternal care and their determinants in rural China under the historic context of major socioeconomic reforms and the one child family planning policy. The specific objectives of the study included: 1) to study pregnancy outcomes and perinatal health and their correlates in a rural Chinese county; 2) to examine the issue of sex ratio at birth and its determinants in a rural Chinese county; 3) to explore the patterns of provision, utilization, and content of maternal care in a rural Chinese county; 4) to investigate the changes in the use of maternal care in China from 1991 to 2003. Materials and Methods This study is based on a project for evaluating the prenatal care programme in Dingyuan county in 1999-2003, Anhui province, China and a nationwide household health survey to describe the changes in maternal care utilization. The approaches used included a retrospective cohort study, cross sectional interview surveys, informant interviews, observations and the use of statistical data. The data sources included the following: 1) A cohort of pregnant women followed from pregnancy up to 7 days after birth in 20 townships in the study county, collecting information on pregnancy outcomes using family planning records; 2) A questionnaire interview survey given to women who gave birth between 2001 and 2003; 3) Various statistical and informant surveys data collected from the study county; 4) Three national household health interview survey data sets (1993-2003) were utilized, and reanalyzed to described the changes in maternity care utilization. Relative risks (RR) and their confidence intervals (CI) were calculated for comparison between parity, approval status, infant sex and township groups. The chi-square test was used to analyse the disparity of use of maternal care between and within urban and rural areas and its trend across the years in China. Logistic regression was used to analyse the factors associated with hospital delivery in rural areas. Results There were 3697 pregnancies in the study cohort, resulting in 3092 live births in a total population of 299463 in the 20 study townships during 1999-2000. The average age at pregnancy in the cohort was 25.9 years. Of the women, 61% were childless, 38% already had one child and 0.3% had two children before the current pregnancy. About 90% of approved pregnancies ended in a live birth while 73% of the unapproved ones were aborted. The perinatal mortality rate was 69 per thousand births. If the 30 induced abortions in which the gestational age was more than 28 weeks had been counted as perinatal deaths, the perinatal mortality rate would have been as high as 78 per thousand. The perinatal mortality rate was negatively associated with the wealth of the township. Approximately two thirds of the perinatal deaths occurred in the early neonatal period. Both the still birth rate and the early neonatal death rate increased with parity. The risk of a stillbirth in a second pregnancy was almost four times that for a first pregnancy, while the risk of early neonatal deaths doubled. The early neonatal mortality rate was twice as high for female as for male infants. The sex difference in the early neonatal mortality rate was mainly attributable to mortality in second births. The male early neonatal mortality rate was not affected by parity, while the female early neonatal mortality rate increased dramatically with parity: it was about six times higher for second births than for first births. About 82% early neonatal deaths happened within 24 hours after birth, and during that time, girls were almost three times more likely to die than boys. The death rate of females on the day of birth increased much more sharply with parity than that of males. The total sex ratio at birth of 3697 registered pregnancies was 152 males to 100 females, with 118 and 287 in first and second pregnancies, respectively. Among unapproved pregnancies, there were almost 5 live-born boys for each girl. Most prenatal and delivery care was to be taken care of in township hospitals. At the village level, there were small private clinics. There was no limitation period for the provision of prenatal and postnatal care by private practitioners. They were not permitted to provide delivery care by the county health bureau, but as some 12% of all births occurred either at home or at private clinics; some village health workers might have been involved. The county level hospitals served as the referral centers for the township hospitals in the county. However, there was no formal regulation or guideline on how the referral system should work. Whether or not a woman was referred to a higher level hospital depended on the individual midwife's professional judgment and on the clients' compliance. The county health bureau had little power over township hospitals, because township hospitals had in the decentralization process become directly accountable to the township government. In the township and county hospitals only 10-20% of the recurrent costs were funded by local government (the township hospital was funded by the township government and the county hospital was funded by the county government) and the hospitals collected user fees to balance their budgets. Also the staff salaries depended on fee incomes by the hospital. The hospitals could define the user charges themselves. Prenatal care consultations were however free in most township hospitals. None of the midwives made postnatal home visits, because of low profit of these services. The three national household health survey data showed that the proportion of women receiving their first prenatal visit within 12 weeks increased greatly from the early to middle 1990s in all areas except for large cities. The increase was much larger in the rural areas, reducing the urban-rural difference from more than 4 times to about 1.4 times. The proportion of women that received antenatal care visits meeting the Ministry of Health s standard (at least 5 times) in the rural areas increased sharply from 12% in 1991-1993 to 36% in 2001-2003. In rural areas, the proportion increase was much faster in less developed areas than in developed areas. The hospital delivery rate increased slightly from 90% to 94% in urban areas while the proportion increased from 27% to 69% in rural areas. The fastest change was found to be in type 4 rural areas, where the utilization even quadrupled. The overall difference between rural and urban areas was substantially narrowed over the period. Multiple logistic regression analysis shows that time periods, residency in rural or urban areas, income levels, age group, education levels, delivery history, occupation, health insurance and distance from the nearest health care facilities were significantly associated with hospital delivery rates. Conclusions 1. Perinatal mortality in this study was much higher than that for urban areas as well as any reported rate from specific studies in rural areas of China. Previous studies in which calculations of infant mortality were not based on epidemiological surveys have been shown to underestimate the rates by more than 50%. 2. Routine statistics collected by the Chinese family planning system proved to be a reliable data source for studying perinatal health, including still births, neonatal deaths, sex ratio at birth and among newborns. National Household Health Survey data proved to be a useful and reliable data source for studying population health and health services. Prior to this research there were few studies in these areas available to international audiences. 3.Though perinatal mortality rate was negatively associated with the level of township economic development, the excess female early neonatal mortality rate contributed much more to high perinatal mortality rate than economic factors. This was likely a result of the role of the family planning policy and the traditional preferences for sons, which leads to lethal neglect of female newborns and high perinatal mortality. 4. The selective abortions of female foetuses were likely to contribute most to the high sex ratio at birth. The underreporting of female births seemed to have played a secondary role. The higher early neonatal mortality rate in second-born as compared to first-born children, particularly in females, may indicate that neglect or poorer care of female newborn infants also contributes to the high sex ratio at birth or among newborns. Existing family planning policy proved not to effectively control the steadily increased birth sex ratio. 5. The rural-urban gap in service utilization was on average significantly narrowed in terms of maternal healthcare in China from 1991 to 2003. This demonstrates that significant achievements in reducing inequities can be made through a combination of socio-economic development and targeted investments in improving health services, including infrastructure, staff capacities, and subsidies to reduce the costs of service utilization for the poorest. However, the huge gap which persisted among cities of different size and within different types of rural areas indicated the need for further efforts to support the poorest areas. 6. Hospital delivery care in the study county was better accepted by women because most of women think delivery care was very important while prenatal and postnatal care were not. Hospital delivery care was more systematically provided and promoted than prenatal and postnatal care by township hospital in the study area. The reliance of hospital staff income on user fees gave the hospitals an incentive to put more emphasis on revenue generating activities such as delivery care instead of prenatal and postnatal care, since delivery care generated much profits than prenatal and postnatal care . Recommendations 1. It is essential for the central government to re-assess and modify existing family planning policies. In order to keep national sex balance, the existing practice of one couple one child in urban areas and at-least-one-son a couple in rural areas should be gradually changed to a two-children-a-couple policy throughout the country. The government should establish a favourable social security policy for couples, especially for rural couples who have only daughters, with particular emphasis on their pension and medical care insurance, combined with an educational campaign for equal rights for boys and girls in society. 2. There is currently no routine vital-statistics registration system in rural China. Using the findings of this study, the central government could set up a routine vital-statistics registration system using family planning routine work records, which could be used by policy makers and researchers. 3. It is possible for the central and provincial government to invest more in the less developed and poor rural areas to increase the access of pregnant women in these areas to maternal care services. Central government together with local government should gradually provide free maternal care including prenatal and postnatal as well as delivery care to the women in poor and less developed rural areas. 4. Future research could be done to explore if county and the township level health care sector and the family planning system could be merged to increase the effectiveness and efficiency of maternal and child care. 5. Future research could be done to explore the relative contribution of maternal care, economic development and family planning policy on perinatal and child health using prospective cohort studies and community based randomized trials. Key words: perinatal health, perinatal mortality, stillbirth, neonatal death, sex selective abortion, sex ratio at birth, family planning, son preference, maternal care, prenatal care, postnatal care, equity, China
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Tämän pro gradu-tutkielman tarkoitus on tutkia, miten reilun kaupan banaania tuottavan El Guabon pienten banaaninviljelijöiden järjestön Asoguabon reilun turismin projekti on rakennettu. Projektin muotoutumista tutkitaan tässä työssä kahdesta eri näkökulmasta: siitä, miksi ja miten Asoguabo on monipuolistanut viljelystä turismiin, sekä siitä, millainen kuva projektista on rakennettu markkinoinnin kautta ja miten reilun kaupan mainonnasta tuttuja ilmiöitä on hyödynnetty reilun turismin rakentamisessa. Tutkielman teoreettisena taustana on maaseudun muutoksia tarkasteleva uuden ruraliteetin käsite. Turismi on viime vuosikymmenten aikana muuttunut, ja matkailijat etsivät yhä enemmän aitoja ja autenttisia matkailukokemuksia. Samanaikaisesti turismia on tuotteistettu korostamalla sen tiettyjä, kestävän kehityksen mukaisia piirteitä, ja erityisesti kehittyvissä maissa turismia markkinoidaan usein vaihtoehtoisena, yhteisöpohjaisena tai ekoturismina. Reilu turismi on uutena käsitteenä tullut mukaan tähän laajaan kirjoon, ja tämä tutkielma käsitteleekin Asoguabon projektia nimenomaan reilun turismin näkökulmasta. Tämä tutkielma on tapaustutkimus Asoguabon turismiprojektista, ja pohjautuu kuukauden pituiseen kenttätyöhön Ecuadorissa tammikussa 2010 sekä kirjoittajan aiempiin kokemuksiin Asoguabosta. Aineisto koostuu 21 puoli-strukturoidusta laadullisesta haastattelusta kuudentoista informantin kanssa, joista suurin osa oli hyvin läheisesti tekemisissä projektin kanssa. Tämän lisäksi aineistonkeruussa on käytetty havainnointia sekä projektin markkinointimateriaalien sisällönanalyysia. Tutkielma osoittaa reilun turismin projektin sisältävän monia haasteita ennen kuin se voi saavuttaa tavoitteensa tuottaa lisätuloja Asoguabon toimintaan. Tutkimushetkellä projekti hyödytti suoraan pääasiassa muutamia järjestön viljelijöitä, lähinnä niitä, jotka toimivat projektissa oppaina. Nämä oppaat hyötyvät projektista saamalla pieniä lisätuloja, kasvattamalla sosiaalista pääomaansa, sekä saamalla mahdollisuuden oppia muun muassa osallistumalla kursseille. Tutkimuksen keskeiset tulokset osoittavat myös, kuinka vuorovaikutus-ongelmat projektin eri toimijoiden välillä vaikeuttavat tiedonkulkua ja täten reilun turismin toimintaa. Nämä ongelmat myös lisäävät epätietoisuutta Asoguabon muiden viljelijöiden parissa. Lisäksi tutkimus osoittaa, kuinka reilun turismin projektin mainonnassa käytetään osittain samoja keinoja kuin reilun kaupan tuotteiden mainonnassa, joskin tuottajia on kuvattu mainosmateriaaleissa yllättävän vähän ja pääosassa ovat usein eurooppalaiset turistit.
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The aim of this masters thesis was to examine subjective wellbeing and personal happiness. Empirical study of happiness is part of broader wellbeing reseach and is based on an idea that the best experts of personal wellbeing are the individuals themselves. In addition to perceptions of personal happiness, the aim was also to acquire knowledge about personal values and components personal happiness is based on. In this study, moving into certain community and the charesteristics of neigbourhood contributing happiness, were defined to represent these values. The object was, through comparative casestudy, to obtain knowledge about subjective wellbeing of the inviduals in two different residental areas inside metropolitan area of Helsinki. In comparative case study the intention usually is that the examined units represent spesific "cases" from something broader and therefore the results can be somehow generalized. Consequently the chosen cases in this study were selected due to their image of "urban village" and thus the juxtapositioning was constructed between secluded post-suburban village and more heterogeneous urban village better attached to excisting urban structure. The researh questins were formed as follows: Are there any differencies between the areas regarding the components personal happines is based on? Are there any differencies between the areas regarding the level of residents subjective wellbeing? Based on the residents assesments, what are the most important charesteristics of neigbourhood contributing personal happiness? The data used in order to gain aswers to these questions was obtained from internet-based survey questionnaire. Based on the data residents of post-suburban village Sundsberg seem to share highly family oriented set of values and actualizing these values is ensured with high income, wealth and secure work situation. Insteadt in Kumpula the components of happiness seem place more towards learning and personal developement, interesting leisure and hobbies and specially having an influence regarding communal decisions. Conserning subjective wellbeing of residents there can be seen some differencies as well. Personal life is experienced a bit more happier in Sundsberg than in Kumpula. People are more satified with their personal health and job satisfaction in Sundsberg and additionally feelings of loneliness, inadequancy and frustration are bit more common in Kumpula. Regarding the charesteristics of neigbourhood contributing happiness data suggests that key charesteristics of area are peacefulness and safely, good location and connections and proximity of parks and recreational areas. These charesteristics were concidered highly significant in both areas but they were experienced to actualize better in Kumpula. In addition to these components the residents in Kumpula were overall more satisfied with various charecteristics contiburing happiness in their residental area. Besides these attributes mentioned above residents in Kumpula emphasize also some "softer" elements connecting into social, functional and communal side of area. From Sundsberg point of view residental area best contributing happiness is child friendly and safe community based on likeminded people who share the same sosioeconomical situation. The results of this study can be linked back into the society and metropolitan area, which they were chosen from as a cases to be studied. The results can thereby be seen as an example of differentation of conditions of personal happiness between certain population segments. It is possible to detect an spatial dimetion to this process as well and thereby the results suggests that regional segmentation affects between high-ranking residental areas as well. Thereby the results of this reseach contributes to the debate on innovative, diverse and dynamic urban area and as well cohesion of metropolitan area and the society in whole.
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The tourism development nexus in southern Africa involves highly topical issues related to tourism planning, power relations, community participation, and natural resources. Namibia offers a particularly interesting context for the study of these issues due to its colonial legacy, vast tourism potential, recently adopted tourism policy and community-based approaches to tourism and natural resource management. This study is an interdisciplinary endeavour to analyse the role of tourism in Namibia s post-apartheid transformation process by focusing on Namibian tourism policy and local tourism enterprises' policy knowledge. Major attention is paid to how the tourism policy's national development objectives are understood and conceptualised by the representatives of different tourism enterprises and the ways in which they relate to the practical needs of the enterprises. Through such local policy knowledge the study explores various opportunities, challenges and constraints related to the promotion of tourism as a development strategy. The study utilises a political economy approach to tourism and development through three current and interrelated discourses which are relevant in the Namibian context. These are tourism, power and inequality, tourism and sustainable development, and tourism and poverty reduction. The qualitative research material was gathered in Namibia in 2006-2007 and 2008. This material consists of 34 semi-structured interviews in 16 tourism enterprises, including private trophy hunting farms and private lodges, small tour operators and community-based tourism enterprises. In addition, the research material consists of observations in the enterprises, and 37 informal and 23 expert interviews. The findings indicate that in the light of local tourism enterprises the tourism policy objectives appear more complex and ambiguous. Furthermore, they involve multiple meanings and interpretations which reflect the socio-economic stratification of the informants and Namibian society, together with the professional stratification of the tourism enterprises and restrictions on the capacity of tourism to address the development objectives. In the light of such findings it is obvious that aspects of power and inequality affect the tourism development nexus in Namibia. The study concludes that, as in the case of other southern African countries, in order to promote sustainable development and reduce poverty, Namibia should not only target tourism growth but pay attention to who benefits from that growth and how. From a political economy point of view, it is important that prevailing structural challenges are addressed equally in the planning of tourism, development and natural resource management. Such approach would help the Namibian majority to enjoy the benefits of increasing tourism in the country.
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In Taita Hills, south-eastern Kenya, remnants of indigenous mountain rainforests play a crucial role as water towers and socio-cultural sites. They are pressurized due to poverty, shortage of cultivable land and the fading of traditional knowledge. This study examines the traditional ecological knowledge of Taitas and the ways it may be applied within transforming natural resource management regimes. I have analyzed some justifications for and hindrances to ethnodevelopment and participatory forest management in light of recently renewed Kenyan forest policies. Mixed methods were applied by combining an ethnographic approach with participatory GIS. I learned about traditionally protected forests and their ecological and cultural status through a seek out the expert method and with remote sensing data and tools. My informants were: 107 household interviewees, 257 focus group participants, 73 key informants and 87 common informants in participatory mapping. Religious leaders and state officials shared their knowledge for this study. I have gained a better understanding of the traditionally protected forests and sites through examining their ecological characteristics and relation to social dynamics, by evaluating their strengths and hindrances as sites for conservation of cultural and biological diversity. My results show that, these sites are important components of a complex socio-ecological system, which has symbolical status and sacred and mystical elements within it, that contributes to the connectivity of remnant forests in the agroforestry dominated landscape. Altogether, 255 plant species and 220 uses were recognized by the tradition experts, whereas 161 species with 108 beneficial uses were listed by farmers. Out of the traditionally protected forests studied 47 % were on private land and 23% on community land, leaving 9% within state forest reserves. A paradigm shift in conservation is needed; the conservation area approach is not functional for private lands or areas trusted upon communities. The role of traditionally protected forests in community-based forest management is, however, paradoxal, since communal approaches suggests equal participation of people, whereas management of these sites has traditionally been the duty of solely accredited experts in the village. As modernization has gathered pace such experts have become fewer. Sacredness clearly contributes but, it does not equal conservation. Various social, political and economic arrangements further affect the integrity of traditionally protected forests and sites, control of witchcraft being one of them. My results suggest that the Taita have a rich traditional ecological knowledge base, which should be more determinately integrated into the natural resource management planning processes.