Perinatal mortality and maternal health in rural China

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

Good Morning, America! The explosive U.S. awakening to the need for adaptation

Since the early years of the 21st century, and in particular since 2007, the U.S. has been awakening rapidly to the fact that climate change is underway and that even if stringent efforts are undertaken to mitigate greenhouse gas emissions, adaptation to the unavoidable impacts from the existing commitment to climate change is still needed and needs to be begun now. This report provides an historical overview of the public, political, and scientific concern with adaptation in the United States. It begins by briefly distinguishing ongoing, historical adaptation to environmental circumstances from deliberate adaptation to human‐induced climate change. It then describes the shift from the early concerns with climate change and adaptation to the more recent awakening to the need for a comprehensive approach to managing the risks from climate change. Ranging from the treatment of the topic in the news media to the drafting of bills in Congress, to state and local government activities with considerable engagement of NGOs, scientists and consultants, it is apparent that adaptation has finally, and explosively, emerged on the political agenda as a legitimate and needed subject for debate. At the same time, the current policy rush is not underlain by widespread public engagement and mobilization nor does it rest on a solid research foundation. Funding for vulnerability and adaptation research, establishing adequate decision support institutions, as well as the building of the necessary capacity in science, the consulting world, and in government agencies, lags far behind the need. (PDF contains 42 pages)

Various types of canoe fishery in Ikot Abasi

Ikot Abasi, one of the six maritime local government areas in the Cross River State has a longstanding reputation as a fishing centre in Nigeria. Here various types of fishery are practiced. A description is given of 5 definitive areas, the criteria of which are either on the type of gear used, for example hook fishery or on the type of fish species landed e.g. Bonga. For a period of 12 months some detailed observations were registered on how they operate in 4 coastal fishing ports of Uta Ewa, Okoroeta, Iko and Kampa all on Atlantic coastline of Opobo

Artisanal canoe fishing industry of the Rivers State: its economic viability and investment potentials

Consequent upon the present national call in Nigeria for all to go back to agriculture including fishing, most retrenched workers and unemployed youths from the riverine areas are taking up fishing as a legitimate and gainful livelihood. To sustain this tempo and attract more investment, the economic viability of such projects must be known. This study is an attempt to document the profitability and investment potential of artisanal canoe fishing. Socio-economic information including catches, operational cost and returns were obtained through a personal interview questionnaire survey of 240 randomly selected artisanal canoe fishermen from Bonny, Brass and Degema Local Government Areas (LGA) of the State and analyzed. With an investment cost of about 8,135, 8,490 and 6,571 and operation cost of 750, 776 and 627, the analysis showed an average monthly gross income of 1,869, 3,221 and 1,775 for the three local government areas respectively. A benefit-cost-ratio of 1:8, net present value of 400, 603 and internal rate of return greater than 50% were obtained. Since capital invested in fisheries is not tied up for long before benefits start flowing, coupled with the high IRR, it is concluded that artisanal canoe fishing would be an economically viable venture if well managed

Integrating cultural, economic and environmental requirements for fish production in Borno State

The study examines the integration of cultural, economic and environmental requirements for fish production in Borno State, Nigeria. A reconnaissance survey was conducted transferring some selected Local Government Areas. 60 questionnaires were administered in the six Local Governments representing Southern Borno State with Biu and Shani, central Borno with Konduga & Jere and Northern Borno with Gubia and Kukawa respectively. There is no cultural constraint to fish production but about 63% prefers to invest in other farming activities than in fish farming. 33% are not aware that fish can be cultured apart from getting it from the wild. 35% have the impression that fish farming ventures can be handled by government only. The economic earnings for fish production are high especially in some parts of Northern Borno, but the Local market potentials throughout the state are great. Nigeria has suitable soil for ponds apart from few locations at the central and Northern Borno that are made by sandy soil. Numerous perennial and seasonal rivers, streams, lakes, pools and flood plains adequate for fish culture especially in Southern Borno exist. The mean annual rainfall can result in some water storage in ponds. In areas where the annual precipitation is less than 550mm, exist few flow boreholes with potentials for fish production. The temperature regime may support growth and survival of fish even during the hottest months of the year (March, April and May). With the understanding and manipulation of these requirements, fish production in Nigeria can be greatly enhanced

Preliminary report of fishing at the Alawariwa beels, Ogun State, Nigeria

The Alawariwa beels located in the flood plains of the Ogun River, off Ibafo in Owode/Obafemi Local Government Area of Ogun State number 16 with an approximate total surface area of 28.0 hectares. The beels are conveniently exploited between January and April annually when the dry season and riverine contraction make this possible. The daily landing showed that the fish enclosure is truly a natural fisheries reserve as well as a medium of biodiversity. Fish catch per unit effort is reasonable especially for the more abundant fish species. The beel is sufficiently productive and worthy of the fishing efforts of the fishing efforts of eight fishers undertaking the daily assignment. Beel fishing is therefore economically advisable for fishers having access to such valuable communal or individual natural wetland resources

A survey of fisherfolk involved in artisanal fisheries in some selected areas of Ikorodu in Lagos State

The study focused on men and women involved in artisanal fisheries in some selected areas of Ikorodu Local government in Lagos State. The random sampling technique was used to select 50 fishermen each at Ibeshe and Baiyeku sites. The results revealed that majority of the fishermen were male, christian, semi-illiterate, and married. Data were collected on capital sources, labour used, income, gear techniques and type of fish caught. Analysis showed that the highest sources of capital were from personal savings (50%). Majority of labour used were hired labour, 44% at Ibeshe and 50% at Baiyeku. Highest monthly income ranged between N10, 000 - N25, 000 at both sites. Planks were mostly used at both sites for fishing boats as well as means of transport (Ibeshe 68%, Baiyeku 72%). Common fishing gear was the gill net, The fishes caught were found to be of various tyupes. Ethalmalosa fimbriata constituted the highest fish species caught by weight and number at both sites (50%). However, the problems of capital source were most peculiar coupled with high cost of fishing materials and labour scarcity

Uma cidade partida: Itacaré e os dilemas da desterritorialização pelo turismo

Este trabalho iniciou-se a partir das inquietações que surgiram por ocasião da primeira visita ao município de Itacaré, no litoral sul da Bahia, onde trabalhamos com alfabetização de jovens e adultos, em função das muitas vozes que se fizeram ouvir. Itacaré, rica em belezas naturais, com praias, rios e cachoeiras lindíssimas, vem sofrendo, segundo a população nativa da região, muitas transformações em nome do progresso e da globalização, via processo de turistificação. Precisamente, nos últimos cinco anos as mudanças são tantas, com a chegada dos turistas das mais variadas regiões, que moradores já se percebem desterritorializados, bem como já se torna visível por intermédio das vozes ouvidas, que o processo de desconstrução de identidades é uma realidade inconteste. Desta forma, tentando entender o processo de desterritorialização que se generaliza, como também o de desconstrução de identidades, nos propusemos a entender as especificidades deste município permeadas pelos desdobramentos do turismo e suas consequências, desvelando as memórias coletivas e as representações sociais, através das histórias da população local que apontam, de certa forma, a usurpação daquilo que, segundo eles, são os seus maiores bens: a dignidade e o respeito aos filhos da terra, pois que boa parcela da população local está perdendo o seu espaço na medida em que as preocupações do poder público local se solidificam nos privilégios aos estrangeiros. Buscou-se o Serviço Social como o lugar da discussão na medida em que neste vislumbramos de forma mais adensada a preocupação com políticas sociais que deem conta de grande parcela da população excluída ou incluída perversamente.

A transinstitucionalização no caso do fechamento da Casa de Saúde Dr. Eiras- Paracambi: uma questão paradoxal

O presente estudo teve por objetivo analisar o processo de fechamento da Casa de Saúde Dr. Eiras- Paracambi, uma clínica psiquiátrica privada que esteve em processo de fechamento por 12 anos e que efetivamente foi fechada em março de 2012. Este processo envolveu a gestão estadual de saúde mental, o município de Paracambi, os municípios que tinham pacientes internados, o Ministério Público Federal e Estadual e a Área Técnica de Saúde Mental do Ministério da Saúde. A pesquisa pretendeu analisar as respostas políticas que o município do Rio de Janeiro, que apresentava o maior número de internações, articulou para seus munícipes que se encontravam internados nesta instituição, focando na transinstitucionalização, ou seja, na transferência dos pacientes da Casa de Saúde Dr. Eiras-Paracambi para outras instituições de internações psiquiátricas ou clínicas. Procurou-se entender por que essa resposta foi pensada e como foi realizada por este município e compreender, a partir dos profissionais, como foi feita a passagem dos pacientes da Casa de Saúde Dr. Eiras-Paracambi para outra instituição e quais são as perspectivas para a continuidade do acompanhamento dos casos transinstitucionalizados. A pesquisa se dividiu em duas fases, em ambas foram realizadas entrevistas semi-estruturadas. A primeira fase partiu do recolhimento das falas de gestores, numa visada mais geral do processo, inclusive investigando a participação de outros municípios. A segunda fase, por sua vez, priorizou a experiência dos profissionais, que trabalham ou trabalharam mais diretamente com os pacientes transferidos no município do Rio de Janeiro. As instituições escolhidas para a segunda fase foram o Instituto Municipal Nise da Silveira e o Centro de Atenção Psicossocial Torquato Neto. Constatamos que além de diferentes sentidos para desinstitucionalização (desospitalização; desassistência;desconstrução; novas institucionalidades e intencionalidade do tratamento), podemos falar em vários tipos de transinstitucionalização: para hospital ou outro estabelecimento asilar; para estabelecimento privado ou público; para estabelecimento psiquiátrico ou clínico. O tema da transinstitucionalização foi abordado como um paradoxo, superando a dicotomia problema- solução.

Meso-scale transboundary units for the management of coral reefs in the South China Sea area

Local communities and local government units are recognized as the primary stakeholders and participants in the management of coral reef resources and the primary beneficiaries of small-scale fishing activities in the nearshore areas of the coastal zone. The issues relating to the management of the coastal zone are multi-faceted and some issues are largely intertwined with national policy and development goals. Thus, national governments have jurisdiction over these nearshore coastal resources to harmonize policies, monitor resource use and provide incentives for sustainable use. However, the natural boundaries of these reef resources, the processes that support reef ecosystems, and the local or national affiliation of the people who benefit from them may transcend the boundaries of the local and national management units. Therefore, efforts to arrest the decline in fish catch and loss of biodiversity for reefs require management interventions and assessment activities to be carried out at varying scales. In Southeast Asia, some aspects of reef and reef resources management — particularly in deciding the allocation of catch among competing fisheries, development of sustainable harvest strategies, use of broodstock for restocking or stock enhancement programs, protection of nursery and spawning areas, designation of systems of marine protected areas, and the identification of representative, adequate and comprehensive areas for biodiversity conservation in the region — may require the definition of larger management units. At the regional level, multi-country initiatives will need to define units for the transboundary management of resources. The use of large marine ecosystems (LMEs) to identify and manage fisheries resources may be a starting point; however, given the relatively sedentary nature of coral reef-dwelling and reef-associated organisms compared with other pelagic and demersal species, meso-scale transboundary units within the LMEs have to be defined. This paper provides suggestions for transboundary management units for coral reef and reef-associated resources in Southeast Asia based on information from genetic structures of model organisms in the region. In addition, specific reef areas are identified, which may be important beyond their national boundaries, as potential sources of recruits.

Quilombo Santana: seus conflitos e o processo de desterritorialização da comunidade quilombola, município de Quatis - RJ

O Quilombo Santana está localizado na zona rural do distrito de Ribeirão de São Joaquim, município de Quatis, estado do Rio de Janeiro (médio vale do Rio paraíba do Sul). Atualmente o quilombo é composto por 21 famílias, sendo 17 auto reconhecidas, de acordo com as normas estabelecidas pela Fundação Cultural Palmares e titulado, pela mesma instituição, desde 14 de julho do 2000. No entanto, até a presente data, não houve a desapropriação das fazendas que estão no território quilombola, como prevê o artigo 216 da Constituição Federal Brasileira de 1988, que se encontra nucleado e impossibilitado de realizar suas práticas tradicionais, bem como sua subsistência. O objetivo do presente trabalho é compreender de que maneira a inação do poder público e a posse das terras circunvizinhas ao território do Quilombo Santana influenciou o processo de desterritorialização da comunidade, sob uma perspectiva holística, contemplando a visão de todas as partes envolvidas no conflito territorial. As consequências desta desterritorialização para o quilombo e para a sociedade quatiense também foram consideradas a fim de se destacar a importância da manutenção da identidade santanense e seus conhecimentos tradicionais.

Sístoles e diástoles no financiamento da saúde em Minas Gerais:período pós-Constituição de 1989

Esta tese tem como objeto o estudo do financiamento da saúde pública no Estado de Minas Gerais, no período compreendido entra a promulgação da Constituição mineira, em 21 de setembro de 1989, e o ano de 2005. Seu texto analisa também o financiamento da saúde pública no federalismo trino, em Minas Gerais, e, diferentes momentos de vinculação constitucional: na vigência do ordenamento constitucional determinado pelo 1 do art. 158 da Constituição estadual de 19989 e na vigência da Emenda n 29, de 13 de setembro de 2000, da Constituição da República. A presente tese constrói a série histórica de 1989 a 2005, com os valores do gasto em saúde pelo Estado de Minas Gerais, a partir dos Balanços Gerais do Estado. Através desses dados, comprova-se que a aplicação de recursos em ações e serviços públicos de saúde não se elevou com a vigência da EC-29, ao contrário, constatamos uma diminuição do aporte realizado em 2005 quando comparado ao valor aplicado em 1995 (15,62%). A construção da série histórica de gastos municipais em saúde total despendido pelo conjunto dos 853 municípios mineiros no período 1996-2005, demonstra que Minas Gerais no período analisado o aporte dos governos locais e, na média anual expressa em real de 2005 (13,22%), menor no quinquênio 2000-2005 do que no quadriênio 1996-1999 que antecede a vigência da EC-29. Este estudo pioneiro, já que o Siops disponibiliza dados municipais até o primeiro semestre de 2003, recomenda a necessidade de verificação em outros estados, pois em Minas Gerais a EC-29 se revela ferramenta incapaz de garantir maiores aportes ao financiamento das ações e serviços públicos de saúde. Verificamos, também que, nos últimos quatro anos, há coerência entre as quatro leis que formam o arcabouço do planejamento orçamentário (PMDI, PPAG, LDOs, LOAs) e os respectivos Balanços Gerais do Estado, mas o Fundo Estadual de Saúde FES não é a unidade orçamentária que realiza a maior parte dos gastos na função saúde.

The impacts of El Nino on Philippine fisheries

The El Nino phenomenon is an "anomalous climatic condition in the tropical Pacific region which occurs every two to seven years and affects the global climate". There is a greater increase in the water surface temperature of the eastern tropical and central tropical Pacific during an El Nino episode relative to that of the western tropical Pacific. The phenomenon causes fluctuations in rainfall, resulting in drought in some areas and heavy rainfall in others. During the El Nino of 1990-1992, the damage caused by the drought in the Philippines was estimated to be P4.1 billion (PhP24 = US$1). While the damage to agriculture is well documented, the impact on fisheries has not been considered. The impacts of the El Nino episode of 1997-1998 were assessed in the Philippines by the filed personnel of the Department of Agriculture and representatives of the private sector in the 15 regions of the country. Data on the losses caused by the phenomenon were obtained from interviews, surveys and reports of local government units and provincial agricultural offices for the period October 1997-June 1998. The effects of El Nino on aquaculture, marine fisheries and inland fisheries were determined.

Community-based marine protected areas in the Bohol (Mindanao) Sea, Philippines

This paper discusses the status, direction and management issues in the marine protected areas (MPAs) of the Bohol (Mindanao) Sea, Philippines. The MPAs in the study area have increased through the years. Many of them were established and managed by the local government units (LGUs) in collaboration with national government agencies (NGAs), academic institutions, people’s and non-governmental organizations (NGOs). Several management issues and problems were cited by the MPA managers such as insuffi cient funds and facilities, lack of support from NGAs/NGOs and lack of education among the people. Nevertheless, lessons for sustainability can be learned from the experience of some wellmanaged MPAs in the Bohol Sea. These include strong support from the political leadership, community participation and networking among the concerned sectors. Although the best practices are being followed in a number of MPAs in the Bohol Sea, success is still fragmented. The MPAs are currently managed independently although there are ongoing initiatives to network their efforts. However, it can be observed that, as a management tool, MPAs are gaining popularity and support, not only among the fisherfolk but also among local communities and LGUs in the Bohol Sea area.

The effects of aquaculture on farm household economy: a case study in Omon District, Cantho Province, Vietnam

A study of the farming systems in the Mekong River Delta (Vietnam) indicate that fish culture brings to the household a higher level of net farm income and family labor use. In general, adoption of fish culture is strongly affected by: (1) decline of wildfish; (2) location of the farm; (3) farm size per person and available water bodies within the farm; (4) income of farm, excluding income from fish; (5) guidance from agricultural extension workers; (6) policies of local government on the development of agriculture including aquaculture.