Fisheries, marine environment, and integrated coastal management policy processes, content and implementation in the BOBLME countries: regional synthesis and country questionnaires

This paper examines policy processes, policy trends and policy implementation with regards to capture fisheries, the marine environment and Integrated Coastal Management (ICM) in BOBLME countries. Individual country information was analyzed to generate a regional synthesis.

Report of the postgraduate certificate course on integrated coastal management, Bangkok, Thailand, 21 January - 1 March, 2013

Student projects included: conservation and protection of critical coral habitats in Phuket; assessing the carrying capacity on conservation and protection strategies; proactive stakeholder strategy to tackle an environmental threat; improving the environmental management through participation and sustainable freshwater management. All of these projects were conducted on Racha Yai Island in Phuket.

Report of the training course on integrated coastal management in the Bay of Bengal, Chonburi, Thailand, 20-24 October, 2014

Participants consisted of 25 middle and junior level personnel from BOBLME countries. Modules included: Integrated Coastal Management (ICM) concept and principles; ICM development and implementation; indicators of good practice; and action planning.

Sustainable development of coastal and marine areas in small island developing states: A basis for integrated coastal management

Agenda 21, the 40-chapter action plan, agreed to by all nations participating in the 1992 Earth Summit represents an ambitious effort to provide policy guidance across the entire spectrum of environment, development, and social issues confronting mankind. In the area of oceans and coasts (Chapter 17 of Agenda 21), the Earth Summit underscored that the management of oceans and coasts should be ‘integrated in content and anticipatory in ambit.’ To assist those responsible for implementing the Earth Summit guidelines on ocean and coastal management, this article first reviews the fundamental shift in paradigm reflected in the Earth Summit agreements as well as the specific recommendations contained in Chapter 17. Next, the article examines the central concept of ‘integrated management,’ noting both its importance and its limits. A general or ‘synthesis’ model of ‘integrated coastal management’ is then presented, addressing such questions as management goals, what is being managed, where, how, and by whom. In a concluding section, methods are proposed whereby the general or ‘synthesis model’ can be tailored to diverse national contexts, involving varying physical, socio-economic, and political conditions.

Building capacity for integrated coastal management in developing countries

The need for building human and institutional capacity has been identified in Agenda 21 of the UNCED conference as well as by a number of international environmental institutions as essential for integrated coastal management (ICM) and sustainable development in developing coastal states. There is a growing need for coastal management practitioners and organizations with expertise in planning and implementation for ICM. The application of strategies for institutional development and building human capacity in coastal management and other fields shows that short-term intensive training efforts and long-term institutional strengthening programs are appropriate to address the issues and needs of ICM. An overview of the experience of the URI/USAID International Coastal Resources Management Program in Sri Lanka, Thailand and Ecuador presents lessons learned for strengthening ICM efforts in developing countries.

A systems view of integrated coastal management

Natural hazards and human activities in the coastal zone are threatening the integrity of the coastal resource system. Conflicts of interest between short term economic benefits and long term ecologic assets should be identified and solved by means of a balanced CZM approach. Systems analysis, supported by mathematical modelling tools are the appropriate instruments to assist the coastal zone manager. The paper presents a general system description of the coastal zone, and focuses on the modelling of the natural subsystem components of this system as a first step towards a model for Integrated Coastal Management (ICM).

A conceptual approach to integrated coastal management

This paper focuses on the concept of Integrated Coastal Management (ICM) putting the theoretical basis of Chapter 17, Agenda 21 (UN Conference on Environment and Development, UNCED), in relation to the theoretical backgrounds on which the development of coastal area programmes have been founded. Reasoning leads us to think that the general system theory is the proper conceptual basis to stimulate ICM and that, in this theoretical context, integration is to be pursued between (i) the claiming of national maritime jurisdictional belts and the protection of the coastal ecosystem, (ii) the coastal system and its external environment, (iii) the decision making systems acting at all levels (international, regional, national and local). Integration, therefore, should be thought of as a political process.

Integrated vector management for malaria control in Uganda: knowledge, perceptions and policy development.

BACKGROUND: Integrated vector management (IVM) is increasingly being recommended as an option for sustainable malaria control. However, many malaria-endemic countries lack a policy framework to guide and promote the approach. The objective of the study was to assess knowledge and perceptions in relation to current malaria vector control policy and IVM in Uganda, and to make recommendations for consideration during future development of a specific IVM policy. METHODS: The study used a structured questionnaire to interview 34 individuals working at technical or policy-making levels in health, environment, agriculture and fisheries sectors. Specific questions on IVM focused on the following key elements of the approach: integration of chemical and non-chemical interventions of vector control; evidence-based decision making; inter-sectoral collaboration; capacity building; legislation; advocacy and community mobilization. RESULTS: All participants were familiar with the term IVM and knew various conventional malaria vector control (MVC) methods. Only 75% thought that Uganda had a MVC policy. Eighty percent (80%) felt there was inter-sectoral collaboration towards IVM, but that it was poor due to financial constraints, difficulties in involving all possible sectors and political differences. The health, environment and agricultural sectors were cited as key areas requiring cooperation in order for IVM to succeed. Sixty-seven percent (67%) of participants responded that communities were actively being involved in MVC, while 48% felt that the use of research results for evidence-based decision making was inadequate or poor. A majority of the participants felt that malaria research in Uganda was rarely used to facilitate policy changes. Suggestions by participants for formulation of specific and effective IVM policy included: revising the MVC policy and IVM-related policies in other sectors into a single, unified IVM policy and, using legislation to enforce IVM in development projects. CONCLUSION: Integrated management of malaria vectors in Uganda remains an underdeveloped component of malaria control policy. Cooperation between the health and other sectors needs strengthening and funding for MVC increased in order to develop and effectively implement an appropriate IVM policy. Continuous engagement of communities by government as well as monitoring and evaluation of vector control programmes will be crucial for sustaining IVM in the country.

Multiple attractors of host-parasitoid models with integrated pest management strategies: eradication, persistence and outbreak

Host-parasitoid models including integrated pest management (IPM) interventions with impulsive effects at both fixed and unfixed times were analyzed with regard to host-eradication, host-parasitoid persistence and host-outbreak solutions. The host-eradication periodic solution with fixed moments is globally stable if the host's intrinsic growth rate is less than the summation of the mean host-killing rate and the mean parasitization rate during the impulsive period. Solutions for all three categories can coexist, with switch-like transitions among their attractors showing that varying dosages and frequencies of insecticide applications and the numbers of parasitoids released are crucial. Periodic solutions also exist for models with unfixed moments for which the maximum amplitude of the host is less than the economic threshold. The dosages and frequencies of IPM interventions for these solutions are much reduced in comparison with the pest-eradication periodic solution. Our results, which are robust to inclusion of stochastic effects and with a wide range of parameter values, confirm that IPM is more effective than any single control tactic.

Intermediate Care: The Role of Medicines Management

Healthcare systems worldwide are facing an unprecedented demographic change as globally, the number of older people will triple to 2 billion by the year 2050. The resulting pressures on acute services have been instrumental in the development of intermediate care (IC) as a new healthcare model, which has its origins in the National Health Service in the UK. IC is an umbrella term for patient services that do not require the resources of a general hospital but are beyond the scope of a traditional primary care team. IC aims to promote timely discharge from hospital, prevent unnecessary hospital admissions and reduce the need for long-term residential care by optimizing functional independence. Various healthcare providers around the world have adopted similar models of care to manage changing healthcare needs. Polypharmacy, along with age-related changes, places older people at an increased risk of adverse drug events, including inappropriate prescribing, which has been shown to be prevalent in this population in other healthcare settings. Medicines management (the practice of maximizing health through optimal use of medicines) of older people has been discussed in the literature in a variety of settings; however, its place within IC is largely unknown. Despite IC being a multidisciplinary healthcare model, there is a lack of evidence to suggest that enhanced pharmaceutical involvement is core to the service provided within IC. This review article highlights the gap in the literature surrounding medicines management within IC and identifies potential solutions aimed at improving patient outcomes in this setting.

“It’s very complicated”: a qualitative study of medicines management in intermediate care facilities in Northern Ireland

Background: Intermediate care (IC) describes a range of services targeted at older people, aimed at preventing unnecessary hospitalisation, promoting faster recovery from illness and maximising independence. Older people are at increased risk of medication-related adverse events, but little is known about the provision of medicines management services in IC facilities. This study aimed to describe the current provision of medicines management services in IC facilities in Northern Ireland (NI) and to explore healthcare workers' (HCWs) and patients' views of, and attitudes towards these services and the IC concept. 

Methods: Semi-structured interviews were conducted, recorded, transcribed verbatim and analysed using a constant comparative approach with HCWs and patients from IC facilities in NI. 

Results: Interviews were conducted with 25 HCWs and 18 patients from 12 IC facilities in NI. Three themes were identified: 'concept and reality', 'setting and supply' and 'responsibility and review'. A mismatch between the concept of IC and the reality was evident. The IC facility setting dictated prescribing responsibilities and the supply of medicines, presenting challenges for HCWs. A lack of a standardised approach to responsibility for the provision of medicines management services including clinical review was identified. Whilst pharmacists were not considered part of the multidisciplinary team, most HCWs recognised a need for their input. Medicines management was not a concern for the majority of IC patients. 

Conclusions: Medicines management services are not integral to IC and medicine-related challenges are frequently encountered. Integration of pharmacists into the multidisciplinary team could potentially improve medicines management in IC.