A systematic review of community-based interventions for emerging zoonotic diseases in Southeast Asia

Background Southeast Asia has been at the epicentre of recent epidemics of emerging and re-emerging zoonotic diseases. Community-based surveillance and control interventions have been heavily promoted but the most effective interventions have not been identified. Objectives This review evaluated evidence for the effectiveness of community-based surveillance interventions at monitoring and identifying emerging infectious disease; the effectiveness of community-based control interventions at reducing rates of emerging infectious disease; and contextual factors that influence intervention effectiveness. Inclusion criteria Participants Communities in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. Types of intervention(s) Non-pharmaceutical, non-vaccine, and community-based surveillance or prevention and control interventions targeting rabies, Nipah virus , dengue, SARS or avian influenza. Types of outcomes Primary outcomes: measures: of infection or disease; secondary outcomes: measures of intervention function. Types of studies Original quantitative studies published in English. Search strategy Databases searched (1980 to 2011): PubMed, CINAHL, ProQuest, EBSCOhost, Web of Science, Science Direct, Cochrane database of systematic reviews, WHOLIS, British Development Library, LILACS, World Bank (East Asia), Asian Development Bank. Methodological quality Two independent reviewers critically appraised studies using standard Joanna Briggs Institute instruments. Disagreements were resolved through discussion. Data extraction A customised tool was used to extract quantitative data on intervention(s), populations, study methods, and primary and secondary outcomes; and qualitative contextual information or narrative evidence about interventions. Data synthesis Data was synthesised in a narrative summary with the aid of tables. Meta-analysis was used to statistically pool quantitative results. Results Fifty-seven studies were included. Vector control interventions using copepods, environmental cleanup and education are effective and sustainable at reducing dengue in rural and urban communities, whilst insecticide spraying is effective in urban outbreak situations. Community-based surveillance interventions can effectively identify avian influenza in backyard flocks, but have not been broadly applied. Outbreak control interventions for Nipah virus and SARS are effective but may not be suitable for ongoing control. Canine vaccination and education is more acceptable than culling, but still fails to reach coverage levels required to effectively control rabies. Contextual factors were identified that influence community engagement with, and ultimately effectiveness of, interventions. Conclusion Despite investment in community-based disease control and surveillance in Southeast Asia, published evidence evaluating interventions is limited in quantity and quality. Nonetheless this review identified a number of effective interventions, and several contextual factors influencing effectiveness. Identification of the best programs will require comparative evidence of effectiveness acceptability, cost-effectiveness and sustainability.

Evaluation of a community-based intervention to promote physical activity in youth : lessons from active winners

Purpose To test the effects of a community-based physical activity intervention designed to increase physical activity and to conduct an extensive process evaluation of the intervention. Design Quasi-experimental. Setting Two rural communities in South Carolina. One community received the intervention, and the other served as the comparison. Subjects Public school students who were in fifth grade at the start of the study (558 at baseline) were eligible to participate. A total of 436 students participated over the course of the study. Intervention The intervention included after-school and summer physical activity programs and home, school, and community components designed to increase physical activity in youth. The intervention took place over an 18-month period. Measures. Students reported after-school physical activity at three data collection points (prior to, during, and following the intervention) using the Previous Day Physical Activity Recall (PDPAR). They also completed a questionnaire designed to measure hypothesized psychosocial and environmental determinants of physical activity behavior The process evaluation used meeting records, documentation of program activities, interviews, focus groups, and heart rate monitoring to evaluate the planning and implementation of the intervention. Results There were no significant differences in the physical activity variables and few significant differences in the psychosocial variables between the intervention and comparison groups. The process evaluation indicated that the after-school and summer physical activity component of the intervention was implemented as planned, but because of resource and time limitations, the home, school, and community components were not implemented as planned. Conclusions The intervention did not have a significant effect on physical activity in the target population of children in the intervention community. This outcome is similar to that reported in other studies of community-based physical activity intervention.

Systematic Review Protocol : "Are community-based interventions effective in identifying and responding to emerging zoonotic infectious diseases?"

Review question/objective The objective of this review is to identify the effectiveness of surveillance systems and community-based interventions in identifying and responding to emerging and re-emerging zoonotic infections in Southeast Asia (SE Asia). More specifically the research questions are: 1. What is the effectiveness of community-based surveillance interventions designed to identify emerging zoonotic infectious diseases? 2. What is the effectiveness of non-pharmaceutical community-based interventions designed to prevent transmission of emerging zoonotic infectious diseases? 3. How do factors related to the emergence and management of emerging zoonotic infectious diseases impact the effectiveness of interventions designed to identify and respond to them?

Prevalence of Chlamydia trachomatis infection in Samoan women aged 18 to 29 and assessment of possible risk factors: a community-based study

Background Knowledge about genital Chlamydia trachomatis (CT) infections in the Pacific is limited. In this study we investigated CT infection in Samoan women. Methods We recruited women having unprotected sex aged 18 to 29 years from 41 Samoan villages. They completed a questionnaire and provided a urine sample for CT testing by PCR. Associations between CT infection and possible risk factors were explored using logistic regression. Results Altogether, 239 women were recruited; 86 (36.0%; weighted estimate of prevalence: 41.9%; 95% CI: 33.4–50.5%) were positive for CT infection. A higher proportion of women aged 18 to 24 were positive (54/145; 37.2%) than those aged 25 to 29 (32/94; 34.0%; p=0.20). Being single (OR 1.92; 95% CI: 1.02–3.63) and having two or more lifetime sexual partners (OR 3.02; 95% CI: 1.19–7.67) were associated with CT infection; 27.6% of those with one lifetime partner were positive. Participants who had a previous pregnancy were less likely to be positive (OR 0.49; 95% CI: 0.27–0.87). Primiparous and multiparous women were less likely to be positive than nulliparous women (OR 0.54; 95% CI: 0.30–0.99 and OR 0.46; 95% CI: 0.24–0.89, respectively). Conclusions The prevalence of CT infection in these Samoan women is very high. Further studies, including investigating the prevalence of CT infection in men, and strategies for sustainable control are needed.

Community-based social marketing: Effects on social norms

Purpose This research investigates whether application of a community-based social marketing principle, namely increasing the visibility of a target behaviour in the community, can change social norms surrounding the behaviour. Design/methodology/approach A repeated measures quasi-experimental design was employed to evaluate the Victorian Health Promotion Foundation’s Walk to School 2013 programme, which increases the visibility of walking to and from school through programme participation to promote active transportation for primary school children. The target population for the survey were caregivers of primary school children aged between 5-12 years old. The final sample size across the three online surveys administered was 102 respondents. Findings The results suggest that the programme increased caregivers’ perceptions that children in their community walked to and from school and that walking to and from school is socially acceptable. Originality/value The study contributes to addressing the recent call for research examining the relationship between community-based social marketing principles and programme outcomes. Further, the results provide insight for enhancing the social norms approach, which has traditionally relied on changing social norms exclusively through media campaigns.

Development of a Gulf community based natural resource monitoring program.

Development of a Gulf community based natural resource monitoring program, with sawfish as an initial focus.

Spatial and temporal variability in midge (Nematocera) assemblages in shallow Finnish lakes (60−70 °N) : community-based modelling of past environmental change

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.

Nature-based entrepreneurship in private forests – The preconditions for the sustainable co-operation between private forest owners and entrepreneurs

Nature-based tourism is one of the fastest growing tourism sectors at the moment. It is also the form of tourism that often benefits the economy of rural areas. In addition to state owned forests, nature-based tourism is in many countries situated in private forests, which are not owned by entrepreneurs themselves. Therefore, the ownership issues and property rights form central challenges for the business activities. The maintenance of good relationships between private forest owners and entrepreneurs, as well as combining their interests, becomes vital. These relationships are typically exceptionally asymmetrical, granting the forest owner unilateral rights regulating the business activities in their forests. Despite this, the co-operation is typically very informal and the existing economic compensation models do not necessarily cover all the forest owners’ costs. The ownership issues bring their own characteristics to the relationship. Therefore, we argue that different aspects of ownership, especially psychological ones, have to be more critically examined and taken into consideration in order to build truly successful relations between these parties. This is crucial for sustaining the business activities. The core of psychological ownership is the sense of possession. Psychological ownership can be defined as a state, in which individuals perceive the target of ownership, the object or idea, as “theirs”. The concept of psychological ownership has so far been mainly used in the context of professional organizations. In this research, it has been used to explain the relationships between private forest owners and nature-based entrepreneurs. The aim of this study is to provide new information concerning the effect of psychological ownership on the collaboration and to highlight the good practices. To address the complexity of the phenomenon, qualitative case study methods were adopted to understand the role of ownership at the level of subjective experience. The empirical data was based on 27 in-depth interviews with private forest owners and nature-based tourism entrepreneurs. The data was analysed by using the methods of qualitative analysis to construct different typologies to describe the essence of successful collaboration. As a result of the study, the special characteristics and the practical level expressions of the psychological ownership in the privately owned forest context were analysed. Four different strategies to perceive these ownership characteristics in co-operation relationships were found. By taking the psychological ownership into consideration via these strategies, the nature-based entrepreneurs aim to balance the co-operation relationship and minimise the risks in long term activities based on privately owned forests.

Community-based Ecotourism as a Sustainable Development Option in the Taita Hills, Kenya

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.

Community-based Natural Resource Management: Issues and Cases from South Asia

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.

Symposium on participatory approaches to reservoir fisheries management: issues, challenges and policies. Dambulla, Sri Lanka, 04-06 Oct. 2004. Session I: Community-based fisheries management: experience in other countries

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).

Symposium on participatory approaches to reservoir fisheries management: issues, challenges and policies. Dambulla, Sri Lanka, 04-06 Oct. 2004 Session I. Community-based fisheries management; experience in other countries: presentation on STREAM Vietnam’s experience

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.)