933 resultados para Community-based medical education


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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.

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Community-based natural resource management (CBNRM) is the joint management of natural resources by a community based on a community strategy, through a participatory mechanism involving all legitimate stakeholders. The approach is community-based in that the communities managing the resources have the legal rights, the local institutions and the economic incentives to take substantial responsibility for sustained use of these resources. This implies that the community plays an active role in the management of natural resources, not because it asserts sole ownership over them, but because it can claim participation in their management and benefits for practical and technical reasons1–4. This approach emerged as the dominant conservation concept in the late 1970s and early 1980s, of the disillusionment with the developmental state. Governments across South and South East Asia, Africa and Latin America have adopted and implemented CBNRM in various ways, viz. through sectoral programmes such as forestry, irrigation or wildlife management, multisectoral programmes such as watershed development and efforts towards political devolution. In India, the principle of decentralization through ‘gram swaraj’ was introduced by Mahatma Gandhi. The 73rd and 74th constitution amendments in 1992 gave impetus to the decentralized planning at panchayat levels through the creation of a statutory three-level local self-government structure5,6. The strength of this book is that it includes chapters by CBNRM advocates based on six seemingly innovative initiatives being implemented by nongovernmental organizations (NGOs) in ecologically vulnerable regions of South Asia: two in the Himalayas (watershed development programme in Lingmutechhu, Bhuthan and Thalisain tehsil, Paudi Grahwal District, Uttarakhand), three in semi-arid parts of western India (watershed development in Hivre Bazar, Maharashtra and Nathugadh village, Gujarat and water-harvesting structures in Gopalapura, Rajasthan) and one in the flood-plains of the Brahmaputra–Jamuna (Char land, Galibanda and Jamalpur districts, Bangladesh). Watersheds in semi-arid regions fall in the low-rainfall region (500–700 mm) and suffer the vagaries of drought 2–3 years in every five-year cycle. In all these locations, the major occupation is agriculture, most of which is rainfed or dry. The other two cases (in Uttarakhand) fall in the Himalayan region (temperate/sub-temperate climate), which has witnessed extensive deforestation in the last century and is now considered as one of the most vulnerable locations in South Asia. Terraced agriculture is being practised in these locations for a long time. The last case (Gono Chetona) falls in the Brahmaputra–Jamuna charlands which are the most ecologically vulnerable regions in the sub-continent with constantly changing landscape. Agriculture and livestock rearing are the main occupations, and there is substantial seasonal emigration for wage labour by the adult males. River erosion and floods force the people to adopt a semi-migratory lifestyle. The book attempts to analyse the potential as well as limitations of NGOdriven CBNRM endeavours across agroclimatic regions of South Asia with emphasis on four intrinsically linked normative concerns, namely sustainability, livelihood enhancement, equity and demographic decentralization in chapters 2–7. Comparative analysis of these case studies done in chapter 8, highlights the issues that require further research while portraying the strengths and limits of NGO-driven CBNRM. In Hivre Bazar, the post-watershed intervention scenario is such that farmers often grow three crops in a year – kharif bajra, rabi jowar and summer vegetable crops. Productivity has increased in the dry lands due to improvement in soil moisture levels. The revival of johads in Gopalpura has led to the proliferation of wheat and increased productivity. In Lingmuteychhu, productivity gains have also arisen, but more due to the introduction of both local and high-yielding, new varieties as opposed to increased water availability. In the case of Gono Chetona, improvements have come due to diversification of agriculture; for example, the promotion of vegetable gardens. CBNRM interventions in most cases have also led to new avenues of employment and income generation. The synthesis shows that CBNRM efforts have made significant contributions to livelihood enhancement and only limited gains in terms of collective action for sustainable and equitable access to benefits and continuing resource use, and in terms of democratic decentralization, contrary to the objectives of the programme. Livelihood benefits include improvements in availability of livelihood support resources (fuelwood, fodder, drinking water), increased productivity (including diversification of cropping pattern) in agriculture and allied activities, and new sources of livelihood. However, NGO-driven CBNRM has not met its goal of providing ‘alternative’ forms of ‘development’ due to impediments of state policy, short-sighted vision of implementers and confrontation with the socio-ecological reality of the region, which almost always are that of fragmented communities (or communities in flux) with unequal dependence and access to land and other natural resources along with great gender imbalances. Appalling, however, is the general absence of recognition of the importance of and the will to explore practical ways to bring about equitable resource transfer or benefit-sharing and the consequent innovations in this respect that are evident in the pioneering community initiatives such as pani panchayat, etc. Pertaining to the gains on the ecological sustainability front, Hivre Bazar and Thalisain initiatives through active participation of villagers have made significant regeneration of the water table within the village, and mechanisms such as ban on number of bore wells, the regulation of cropping pattern, restrictions on felling of trees and free grazing to ensure that in the future, the groundwater is neither over-exploited nor its recharge capability impaired. Nevertheless, the longterm sustainability of the interventions in the case of Ghoga and Gopalpura initiatives as the focus has been mostly on regeneration of resources, and less on regulating the use of regenerated resources. Further, in Lingmuteychhu and Gono Chetona, the interventions are mainly household-based and the focus has been less explicit on ecological components. The studies demonstrate the livelihood benefits to all of the interventions and significant variation in achievements with reference to sustainability, equity and democratic decentralization depending on the level and extent of community participation apart from the vision of implementers, strategy (or nature of intervention shaped by the question of community formation), the centrality of community formation and also the State policy. Case studies show that the influence of State policy is multi-faceted and often contradictory in nature. This necessitates NGOs to engage with the State in a much more purposeful way than in an ‘autonomous space’. Thus the role of NGOs in CBNRM is complementary, wherein they provide innovative experiments that the State can learn. This helps in achieving the goals of CBNRM through democratic decentralization. The book addresses the vital issues related to natural resource management and interests of the community. Key topics discussed throughout the book are still at the centre of the current debate. This compilation consists of well-written chapters based on rigorous synthesis of CBNRM case studies, which will serve as good references for students, researchers and practitioners in the years to come.

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A substantial number of medical students in India have to bear an enormous financial burden for earning a bachelor's degree in medicine referred to as MBBS (bachelor of medicine and bachelor of surgery). This degree program lasts for four and one-half years followed by one year of internship. A postgraduate degree, such as MD, has to be pursued separately on completion of a MBBS. Every medical college in India is part of a hospital where the medical students get clinical exposure during the course of their study. All or at least a number of medical colleges in a given state are affiliated to a university that mainly plays a role of an overseeing authority. The medical colleges usually have no official interaction with other disciplines of education such as science and engineering, perhaps because of their independent location and absence of emphasis on medical research. However, many of the medical colleges are adept in imparting high-quality and sound training in medical practices including diagnostics and treatment. The medical colleges in India are generally of two types, i.e., government owned and private. Since only a limited number of seats are available across India in the former category of colleges, only a small fraction of aspiring candidates can find admission in these colleges after performing competitively in the relevant entrance tests. A major advantage of studying in these colleges is the nominal tuition fees that have to be paid. On the other hand, a large majority of would-be medical graduates have to seek admission in the privately run medical institutes in which the tuition and other related fees can be mind boggling when compared to their public counterparts. Except for candidates of exceptionally affluent background, the only alternative for fulfilling the dream of becoming a doctor is by financing one's study through hefty bank loans that may take years to pay back. It is often heard from patients that they are asked by doctors to undergo a plethora of diagnostic tests for apparently minor illnesses, which may financially benefit those prescribing the tests. The present paper attempts to throw light on the extent of disparity in cost of a medical education between state-funded and privately managed medical colleges in India; the average salary of a new medical graduate, which is often ridiculously low when compared to what is offered in entry-level engineering and business jobs; and the possible repercussions of this apparently unjust economic situation regarding the exploitation of patients.

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This paper advocates strategies, processes and practices that enable: livelihoods approaches rather than resource-based approaches, ‘direct’ institutional and policy development, rather than ‘project demonstrations’, and support for regional, national and local communications. (Pdf contains 12 pages).

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Established in early 2002, STREAM Vietnam has so far attained a number of good experiences and lessons in using participatory approaches for its work. The Country Office has been able to link to a wide range of stakeholders, and is working hard to build close relationships amongst them, so that institutional entities can better support the livelihoods of poor aquatic resources users, and support disadvantaged groups of people to improve their living standards by themselves. Reservoir fisheries and co-management are at early stage in Vietnam, but in certain places and industries co-management has brought about successful results by involving proactive participation of communities. Situated on the same continent and having many similarities, the interaction in agriculture and fisheries sector between Vietnam and Sri Lanka has brought the two countries closer. Being members of the STREAM family, there are great opportunities for exchange of experiences and lessons towards sustainable management of reservoir resources. (PDF has 11 pages.)

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Community Based Resource Management (CBRM) understood as an approach emphasizes a community's capability, responsibility and accountability with regards to managing resources. Based on the recommendations for the Nigerian-German Kainji Lake Fisheries Promotion Project (KLFPP), the Niger and Kebbi States Fisheries Edicts were promulgated in 1997. These edicts, among other things, banned the use of beach seines. Given the conviction of KLFPP, that if communities whose livelihood is linked to the fishery, understand and identify the problems and by consensus agree to the solutions of fisheries problems, they are more likely to adhere to any control measures, specifically the ban on beach seine. In 1999 a first agreement was reached between beach seiners, non-beach seiners and government authorities leading to an almost complete elimination of beach seine on the Lake Kainji. However, despite on going efforts of the Kainji Lake Fisheries Management and Conservation Unit in 2000 and possibly because of certain oversights during and after the first agreement, in May 2001 a significant number of beach seiners was observed. This led to a re-assessment of our approach, which lately culminated into another round of negotiation. The paper presents the latest results on this on-going process

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This paper is aimed at government, non-government organizations, intergovernmental organizations and the general public as they work toward the development of their individual strategies and action plans. It has been recognized that community-based organizations have a particular relevance to the pursuit of sustainable resource management and may well contribute to the foundations of self-sustenance. Women on Lake Victoria, Tanzania presently face great challenges within the fishery. These include the lack of capital, interference by men, theft of fishing gear, time constraints and socio-cultural problems. In recent years, the fish trading and marketing sectors of the fishery, which have traditionally been dominated by women, have seen large incursions by male entrepreneurs. This move has endangered the role of women within the fishery. This paper focuses on the Tweyambe Fishing Enterprise (TFE), a well-known women's group based in Kasheno village in the Muleba District of Kagera Region in northwestern Tanzania. Inhabitants from the Haya ethnic group who make up some 95% of the population of Kagera Region dominate this village. The TFE has a series of initiatives aimed towards ecologically sound self-development

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The freshwater wetlands (beels) of Assam, India, cover an area of 101 232 ha. For the rural poor, the neighboring wetlands are the only source of fish. They depend on them for their daily consumption of fish as well as a source of livelihood. Ecoenergy studies indicate that these wetlands have a fairly high production potential. However, the current regulations and system of management are not conducive to sustainable production from these water bodies. It is resulting in overexploitation and degradation. It is imperative some form of co-management with local communities be established for the beels of Assam.

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During the rainy season in extensive river floodplains and deltaic lowlands, floods render the land unavailable for crop production for several months each year. These waters are considerably underutilized in terms of managed aquatic productivity. This raises the opportunity to enclose parts of these floodwater areas to produce a crop of specifically stocked aquatic organisms aside from the naturally occurring ‘wild’ species that are traditionally fished and are not affected by the culture activity, resulting in more high-quality, nutrient-dense food production and enhanced farm income for all stakeholders, notably the poor. The WorldFish Center and its national partners recently tested the concurrent rice-fish culture in the shallower flooded areas and the alternating rice-fish culture in the deep-flooded areas of Bangladesh and Viet Nam through a community-based management system. Results indicate that community-based fish culture in rice fields can increase fish production by about 600 kg/ha/year in shallow flooded areas and up to 1.5 t/ha/year in deep-flooded areas, without a reduction in the rice yield or wild fish catch.

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There are many similarities, and some differences, between community-based coastal resource management (CBCRM) and co-management. When CBCRM is considered an integral part of co-management, there is a new category of co-management which can be called community-based co-management. Community-based co-management is people-centered, community-oriented, resources-based and partnership-based. The implementation of community-based co-management has four components: resources management, community and economic development, capability building, and institutional support.

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The benefits of decentralizing the management of coastal resources to local governments and resource users have long been recognized, but the best systems for coastal resources management depend on many factors. A number of community-based management and co-management projects were started in the Philippines in the early 1980s. This report describes a comparative assessment of these projects to determine where improvements can be made in the design of future community-based coastal resource management projects. Early and continuing involvement by project beneficiaries is one of the factors that contributes to the success of the project development, implementation, and evaluation.

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Community-based aquaculture founded on the principles of common interest groups working together regardless of sex and age has been an effective tool for implementing scientific aquaculture programs in India. Water bodies that do not interset villagers are targeted for use to avoid communal problems. Farmers who share common interests are identified and organized and a team leader chosen among them. An inventory of resources using the SWOT analysis is made. A participatory approach to identify major problems, socioeconomic and biophysical constraints is used and appropriate interventions are planned. This process is then evaluated and the results of the impact assessment are provided to research/extension /policy planners for setting directions and priorities for further improvement. The potential for expanding community aquaculture for generating self-employment and improving food security of the rural poor as well as improving the environmental conditions of the villages in India can be further tapped.

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The Community-based Coastal Resource Management Project in Orion, Bataan, Philippines was started in 1991. The village level fishers organizations have formed a municipal-wide association called the Samahan at Ugnayan ng Pangisdaan sa Orion (SUGPO). It represents 70% of the small-scale fishers in Orion and has taken on the task of rehabilitating the degraded fishing grounds. The experience in Orion indicates that coastal resource management can be successful if the fishers have ownership of the program and the costs and benefits of the program are distributed equally in a manner acceptable to them.

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This guide was developed to document the process and activities that WorldFish staff have used and adapted as facilitators working with communities interested in marine resource management in Solomon Islands. It draws on the experiences from work conducted with FSPI and MFMR through ACIAR funded projects, with communities that had a primary interest in the management of coral reef fisheries. Since 2011 the process has been trialed and adapted further with communities interested in mangrove ecosystem management (through the MESCAL project). This guide is based on lessons about the process of a community developing, writing and implementing a management plan. This guide does not cover lessons about the outcomes of that management.