Reviewing mHealth in developing countries: A stakeholder perspective

Infrastructural deficiencies, limited access to medicare, and shortage of health care workers are just a few of the barriers to health care in developing countries. As a consequence, the burden of disease and its impact on the livelihoods and the economic productivity of people are staggering. mHealth has been extolled as one possible solution to overcoming these challenges, yet discussion of mHealth systems is often limited to specific tasks and user groups. To address this, we adopt a stakeholder perspective and analyze existing research on the mHealth process in developing countries. Specifically, we focus on three key stakeholder groups, i.e. healthcare workers, patients, and system developers. We perform an in-depth analysis of 60 peer-reviewed studies to determine the extent to which different mHealth stakeholder interactions are researched, and to identify high-level themes emerging within these interactions. This analysis illustrates two key gaps in existing mHealth research. First, while interactions involving healthcare workers and/or patients have received significant attention, relatively little research has looked at the role of patient-to-patient interactions. Second, the interactions between system developers and the other stakeholder groups are strikingly under-represented. We conclude by calling for more mHealth research that explicitly addresses these stakeholder interactions.

Governmentality and exclusion in post-disaster spaces : conducting the conduct of the survivors of Typhoon Sendong in Cagayan de Oro, Philippines

Lorsque les aléas naturels se déroulent en catastrophes, les réponses des religieux, de l’Etat, et d’autres acteurs puissants dans une société révèlent à la fois les relations complexes entre ces parties et leur pouvoir dans la production des espaces auxquelles les survivants accèdent. La réponse en cas de catastrophe comprend la création d’espaces post-catastrophes, tels que des centres d’évacuation, des logements de transition et des sites de réinstallation permanente, qui ciblent spécifiquement un sous-ensemble particulier de survivants, et visent à les aider à survivre, à faire face, et à se remettre de la catastrophe. Les acteurs puissants dans une société dirigent les processus de secours, de récupération et de reconstruction sont des acteurs puissants qui cherchent à problématiser et à rendre un problème technique dans des termes qu’ils sont idéalement placés pour aborder à travers une variété d'interventions. Ce projet de recherche vise à répondre à la question: où les survivants d'une catastrophe reconstruisent-ils leurs vies et leurs moyens de subsistance? Il enquête sur un cas spécifique de la migration environnementale dans laquelle des dizaines de milliers d'habitants ont été déplacés de façon permanente et temporaire de leurs résidences habituelles après le typhon Sendong à Cagayan de Oro, Philippines en 2011. La recherche est basée sur des entretiens avec les acteurs puissants et les survivants, des vidéos participatives réalisées par des survivants pauvres urbains, et des activités de cartographie. L’étude se fonde sur la théorie féministe, les études de migration, les études dans la gouvernementalité, la recherche sur les changements de l’environnement planétaire, et les études régionales afin de situer les diverses expériences de la migration dans un contexte géographique et historique. Cette thèse propose une topographie critique dans laquelle les processus et les pratiques de production d’espaces post-catastrophe sont exposés. Parce que l’espace est nécessairement malléable, fluide, et relationnelle en raison de l'évolution constante des activités, des conflits, et des expériences qui se déroulent dans le paysage, une analyse de l'espace doit être formulée en termes de relations sociales qui se produisent dans et au-delà de ses frontières poreuses. En conséquence, cette étude explore comment les relations sociales entre les survivants et les acteurs puissants sont liées à l’exclusion, la gouvernementalité, la mobilité, et la production des espaces, des lieux et des territoires. Il constate que, si les trajectoires de migration de la plupart des survivants ont été confinés à l'intérieur des limites de la ville, les expériences de ces survivants et leur utilisation des espaces urbains sont très différentes. Ces différences peuvent être expliquées par des structures politiques, économiques, et sociales, et par les différences religieuses, économiques, et de genre. En outre, il fait valoir que les espaces post-catastrophe doivent être considérés comme des «espaces d’exclusion» où les fiduciaires exercent une rationalité gouvernementale. C’est-à-dire, les espaces post-catastrophe prétendument inclusives servent à marginaliser davantage les populations vulnérables. Ces espaces offrent aussi des occasions pour les acteurs puissants dans la société philippine d'effectuer des interventions gouvernementales dans lesquelles certaines personnes et les paysages sont simplifiées, rendues lisibles, et améliorés.

Ecuadorian migration and family strategies of social mobility: dialectic relation between emotional and financial capital

This text deals with transnational strategies of social mobility in Ecuadorian migrant households in Spain. We apply the capital accumulation model (Moser, 2009) for this purpose. The main target of this article is, beyond thinking in terms of capital stock and accumulation, the analysis in depth of the dynamics of the different types of capital, that is to say, how they interact with each other in the framework of the social mobility strategies of the migrants and their families. We are bringing into light the way some households adopt investing decisions in capitals that don't translate into any addition or earnings in all cases, on the contrary, concentrating all their efforts on the accumulation of a certain asset they may, in some cases, lead to a loss of another. We will concentrate our analysis primarily on the dynamics between the physical and financial capital and the social and emotional capital, showing the tensions produced between these two types of assets. At the same time, we will highlight how migrants negotiate their family strategies of social mobility in the transnational area. Our study is based in empirical material obtained from qualitative fieldwork (in-depth interviews) with families of migrants in the urban district of Turubamba Bajo -(south of Quito) and in Madrid. A series of households were selected where interviews were carried out in the country of origin as well as in the context of immigration, with different family members, analysing the transnational social and economic strategies of families of migrant members. Family members of migrants established in Spain were interviewed in Quito, as well as key informants in the district (school teachers, nursery members of the staff, etc.). The research was framed within the projects "Impact of migration on the development: gender and transnationalism", Ministry of Science and Innovation (SEJ2007/63179) (Laura Oso, dir. 2007-2010),"Gender, transnationalism and intergenerational strategies of social mobility", Ministry of Economy and Competitiveness (FEM2011/26210) (Laura Oso, dir. 201-1-2015) and “Gender, Crossed Mobilities and Transnational Dynamics”, Ministry of Economy and Competitiveness (FEM2015-67164).

Late-career international migration and reproductive work. A comparison between Peruvian and Ukrainian women in the Southern Europe

Research on the relationship between reproductive work and women´s life trajectories including the experience of labour migration has mainly focused on the case of relatively young mothers who leave behind, or later re-join, their children. While it is true that most women migrate at a younger age, there are a significant number of cases of men and women who move abroad for labour purposes at a more advanced stage, undertaking a late-career migration. This is still an under-estimated and under-researched sub-field that uncovers a varied range of issues, including the global organization of reproductive work and the employment of migrant women as domestic workers late in their lives. By pooling the findings of two qualitative studies, this article focuses on Peruvian and Ukrainian women who seek employment in Spain and Italy when they are well into their forties, or older. A commonality the two groups of women share is that, independently of their level of education and professional experience, more often than not they end up as domestic and care workers. The article initially discusses the reasons for late-career female migration, taking into consideration the structural and personal determinants that have affected Peruvian and Ukrainian women’s careers in their countries of origin and settlement. After this, the focus is set on the characteristics of domestic employment at later life, on the impact on their current lives, including the transnational family organization, and on future labour and retirement prospects. Apart from an evaluation of objective working and living conditions, we discuss women’s personal impressions of being domestic workers in the context of their occupational experiences and family commitments. In this regard, women report varying levels of personal and professional satisfaction, as well as different patterns of continuity-discontinuity in their work and family lives, and of optimism towards the future. Divergences could be, to some extent, explained by the effect of migrants´ transnational social practices and policies of states.

Herd management and livestock productivity in the Altai region of Western Mongolia

This thesis analyses the influence of qualitative and quantitative herbage production on seasonal rangelands, and of herd and pasture use strategies on feed intake, body mass development and reproductive performance of sheep and goats in the Altai mountain region of Bulgan county (soum) in Khovd province (aimag). This westernmost county of Mongolia is characterized by a very poor road network and thus very difficult access to regional and national markets. The thesis explores in this localized context the current rural development, the economic settings and political measures that affect the traditional extensive livestock husbandry system and its importance for rural livelihoods. Livestock management practices still follow the traditional transhumant mode, fully relying on natural pasture. This renders animal feeding very vulnerable to the highly variable climatic conditions which is one of many reasons for gradually declining quantity and quality of pasture vegetation. Small ruminants, and especially goats, are the main important species securing economic viability of their owners’ livelihood, and they are well adapted to the harsh continental climate and the present low input management practices. It is likely that small ruminants will keep their vital role for the rural community in the future, since the weak local infrastructure and slow market developments currently do not allow many income diversification options. Since the profitability of a single animal is low, animal numbers tend to increase, whereas herd management does not change. Possibilities to improve the current livestock management and thus herders’ livelihoods in an environmentally, economically and socially sustainable manner are simulated through bio-economic modelling and the implications are discussed at the regional and national scale. To increase the welfare of the local population, a substantial infrastructural and market development is needed, which needs to be accompanied by suitable pasture management schemes and policies

Opportunities and constraints of transhumant small ruminant production in the Chinese Altay Mountains

This PhD thesis focuses on current livelihoods of agro-pastoral livestock keepers, their animal nutrition, herd and rangeland management strategies. It thereby aims to contribute to sustainable rangeland management, livestock production and household income in Qinghe county of the Chinese Altay Mountain region, located in Xinjiang Uyghur Autonomous Region, PR China. In its first part the study characterizes the socio-economic situation and agricultural practices of agro-pastoralists through structured household interviews. The second part provides insights into the grazing behaviour and feed intake of small ruminants on seasonal pastures in this region, and into the quantitative and qualitative biomass offer on natural rangelands. The third part analyses the reproductive performance and annual growth of the local sheep and goat herds, and, by modelling improved feeding and culling strategies, tests herd management options that potentially improve the monetary output per female herd animal without increasing the pressure onto natural rangelands. Taken together, the results of the study suggest that, despite an increase and intensification of cropping and vegetable gardening in the region of Qinghe, livestock rearing is still the major livelihood strategy both in terms of prevalence and relative importance. However, livestock keeping is challenged by low biomass production on rangelands, due to the combined impact of high climate variability and highly localized grazing pressure on the seasonal pastures. Though government regulations try to tackle the latter aspect, their implementation is sometimes difficult. Alternatives to strict regulation of grazing periods and animal numbers on seasonal pastures are, in the case of goats, more rigorous culling strategies and, in the case of sheep and goats, strategic supplementation of the animals in the winter and spring season. However, for the latter strategy to become economically viable, an improvement of live animal and meat marketing options and an investment in local meat processing facilities that add value to the carcasses is needed. As the regional cities grow rapidly, the potential market to absorb diverse and good quality meat products is there, along with the road network connecting Qinghe county to the regional capital. Such governmental measures will not only create new job opportunities in the region but also benefit the cash income of pastoralists in this westernmost region of China.

Bridging Perspectives

People’s ability to change their social and economic circumstances may be constrained by various forms of social, cultural and political domination. Thus to consider a social actor’s particular lifeworld in which the research is embedded assists in the understanding of how and why different trajectories of change occur or are hindered and how those changes fundamentally affect livelihood opportunities and constraints. In seeking to fulfill this condition this thesis adopted an actor-oriented approach to the study of rural livelihoods. A comprehensive livelihoods study requires grasping how social reality is being historically constituted. That means to understand how the interaction of modes of production and symbolical reproduction produces the socio-space. Research is here integrated to action through the facilitation of farmer groups. The overall aim of the groups was to prompt agency, as essential conditions to build more resilient livelihoods. The smallholder farmers in the Mabalane District of Mozambique are located in a remote semi-arid area. Their livelihoods customarily depend at least as much on livestock as on (mostly) rain-fed food crops. Increased climate variability exerts pressure on the already vulnerable production system. An extensive 10-month duration of participant observation divided into 3 periods of fieldwork structured the situated multi-method approach that drew on a set of interview categories. The actor-oriented appraisal of livelihoods worked in building a mutually shared definition of the situation. This reflection process was taken up by the facilitation of the farmer groups, one in Mabomo and one in Mungazi, which used an inquiry iteratively combining individual interviews and facilitated group meetings. Integration of action and reflection was fundamental for group constitution as spaces for communicative action. They needed to be self-organized and to achieve understanding intersubjectively, as well as to base action on cooperation and coordination. Results from this approach focus on how learning as collaboratively generated was enabled, or at times hindered, in (a) selecting meaningful options to test; (b) in developing mechanisms for group functioning; and (c) in learning from steering the testing of options. The study of livelihoods looked at how the different assets composing livelihoods are intertwined and how the increased severity of dry spells is contributing to escalated food insecurity. The reorganization of the social space, as households moved from scattered homesteads to form settlements, further exerts pressure on the already scarce natural resource-based livelihoods. Moreover, this process disrupted a normative base substantiating the way that the use of resources is governed. Hence, actual livelihood strategies and response mechanisms turn to diversification through income-generating activities that further increase pressure on the resource-base in a rather unsustainable way. These response mechanisms are, for example, the increase in small-livestock keeping, which has easier conversion to cash, and charcoal production. The latter results in ever more precarious living and working conditions. In the majority of the cases such responses are short-term and reduce future opportunities in a downward spiral of continuously decreasing assets. Thus, by indicating the failure of institutions in the mediation of smallholders’ adaptive capabilities, the livelihood assessment in Mabomo and Mungazi sheds light on the complex underlying structure of present day social vulnerability, linking the macro-context to the actual situation. To assist in breaking this state of “subordination”, shaped by historical processes, weak institutions and food insecurity, the chosen approach to facilitation of farmer groups puts farmer knowledge at the center of an evolving process of intersubjective co-construction of knowledge towards emancipation.

Mesurer la résilience des ménages ruraux sénégalais : Une approche en termes de trajectoires et seuils de moyens d’existence

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Mesurer la résilience des ménages ruraux sénégalais : Une approche en termes de trajectoires et seuils de moyens d’existence

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Changing times, changing stories: generational differences in climate change perspectives from four remote indigenous communities in Subarctic Alaska

Indigenous Arctic and Subarctic communities currently are facing a myriad of social and environmental changes. In response to these changes, studies concerning indigenous knowledge (IK) and climate change vulnerability, resiliency, and adaptation have increased dramatically in recent years. Risks to lives and livelihoods are often the focus of adaptation research; however, the cultural dimensions of climate change are equally important because cultural dimensions inform perceptions of risk. Furthermore, many Arctic and Subarctic IK climate change studies document observations of change and knowledge of the elders and older generations in a community, but few include the perspectives of the younger population. These observations by elders and older generations form a historical baseline record of weather and climate observations in these regions. However, many indigenous Arctic and Subarctic communities are composed of primarily younger residents. We focused on the differences in the cultural dimensions of climate change found between young adults and elders. We outlined the findings from interviews conducted in four indigenous communities in Subarctic Alaska. The findings revealed that (1) intergenerational observations of change were common among interview participants in all four communities, (2) older generations observed more overall change than younger generations interviewed by us, and (3) how change was perceived varied between generations. We defined “observations” as the specific examples of environmental and weather change that were described, whereas “perceptions” referred to the manner in which these observations of change were understood and contextualized by the interview participants. Understanding the differences in generational observations and perceptions of change are key issues in the development of climate change adaptation strategies.

Assessing the resilience of a real-world social-ecological system: lessons from a multidisciplinary evaluation of a South African pastoral system

In the past decades, social-ecological systems (SESs) worldwide have undergone dramatic transformations with often detrimental consequences for livelihoods. Although resilience thinking offers promising conceptual frameworks to understand SES transformations, empirical resilience assessments of real-world SESs are still rare because SES complexity requires integrating knowledge, theories, and approaches from different disciplines. Taking up this challenge, we empirically assess the resilience of a South African pastoral SES to drought using various methods from natural and social sciences. In the ecological subsystem, we analyze rangelands’ ability to buffer drought effects on forage provision, using soil and vegetation indicators. In the social subsystem, we assess households’ and communities’ capacities to mitigate drought effects, applying agronomic and institutional indicators and benchmarking against practices and institutions in traditional pastoral SESs. Our results indicate that a decoupling of livelihoods from livestock-generated income was initiated by government interventions in the 1930s. In the post-apartheid phase, minimum-input strategies of herd management were adopted, leading to a recovery of rangeland vegetation due to unintentionally reduced stocking densities. Because current livelihood security is mainly based on external monetary resources (pensions, child grants, and disability grants), household resilience to drought is higher than in historical phases. Our study is one of the first to use a truly multidisciplinary resilience assessment. Conflicting results from partial assessments underline that measuring narrow indicator sets may impede a deeper understanding of SES transformations. The results also imply that the resilience of contemporary, open SESs cannot be explained by an inward-looking approach because essential connections and drivers at other scales have become relevant in the globalized world. Our study thus has helped to identify pitfalls in empirical resilience assessment and to improve the conceptualization of SES dynamics.

Insufficient Evidence of Jatropha curcas L. Invasiveness: Experimental Observations in Burkina Faso, West Africa

Biofuel plants such as Jatropha curcas L. have potential to support the livelihoods of rural communities and contribute to sustainable rural development in Africa, if risks and uncertainties are minimized. Yet, recent papers have warned of the risk of biological invasions in such tropical regions as a consequence of the introduction of exotic biofuel crops. We investigated the seed dispersal risk and invasiveness potential of both J. curcas monoculture plantations and live fences into adjacent cultivated and uncultivated land use systems in Sissili province, Burkina Faso. Invasiveness potential was assessed through (i) detecting evidence of natural regeneration in perimeters around J. curcas plantations and live fences, (ii) assessing seed dispersal mechanisms, and (iii) assessing seedling establishment potential through in situ direct seed sowing. Spontaneous regeneration around the plantation perimeters of the three sites was very low. Individual seedling density around J. curcas live fences was less than 0.01 m⁻² in all sites. Seventy percent of the seedlings were found close to the live fence and most of them derived from the same year (96 %), which indicates low seed-bank longevity and seedling survival. J. curcas can be dispersed by small mammals and arthropods, particularly rodents and ants. In some sites, such as in Onliassan, high secondary seed dispersal by animals (up to 98 %) was recorded. There were highly significant differences in germination rates between seeds at the soil surface (11 %) and those buried artificially at 1–2-cm depth (64 %). In conclusion, we failed to find convincing evidence of the spreading of J. curcas or any significant impact on the surrounding environment.

Climate Change or Urbanization? Impacts on a Traditional Coffee Production System in East Africa over the Last 80 Years

Global environmental changes (GEC) such as climate change (CC) and climate variability have serious impacts in the tropics, particularly in Africa. These are compounded by changes in land use/land cover, which in turn are driven mainly by economic and population growth, and urbanization. These factors create a feedback loop, which affects ecosystems and particularly ecosystem services, for example plant-insect interactions, and by consequence agricultural productivity. We studied effects of GEC at a local level, using a traditional coffee production area in greater Nairobi, Kenya. We chose coffee, the most valuable agricultural commodity worldwide, as it generates income for 100 million people, mainly in the developing world. Using the coffee berry borer, the most serious biotic threat to global coffee production, we show how environmental changes and different production systems (shaded and sun-grown coffee) can affect the crop. We combined detailed entomological assessments with historic climate records (from 1929-2011), and spatial and demographic data, to assess GEC's impact on coffee at a local scale. Additionally, we tested the utility of an adaptation strategy that is simple and easy to implement. Our results show that while interactions between CC and migration/urbanization, with its resultant landscape modifications, create a feedback loop whereby agroecosystems such as coffee are adversely affected, bio-diverse shaded coffee proved far more resilient and productive than coffee grown in monoculture, and was significantly less harmed by its insect pest. Thus, a relatively simple strategy such as shading coffee can tremendously improve resilience of agro-ecosystems, providing small-scale farmers in Africa with an easily implemented tool to safeguard their livelihoods in a changing climate.

Some Like It Hot: The Influence and Implications of Climate Change on Coffee Berry Borer (Hypothenemus hampei) and Coffee Production in East Africa

The negative effects of climate change are already evident for many of the 25 million coffee farmers across the tropics and the 90 billion dollar (US) coffee industry. The coffee berry borer (Hypothenemus hampei), the most important pest of coffee worldwide, has already benefited from the temperature rise in East Africa: increased damage to coffee crops and expansion in its distribution range have been reported. In order to anticipate threats and prioritize management actions for H. hampei we present here, maps on future distributions of H. hampei in coffee producing areas of East Africa. Using the CLIMEX model we relate present-day insect distributions to current climate and then project the fitted climatic envelopes under future scenarios A2A and B2B (for HADCM3 model). In both scenarios, the situation with H. hampei is forecasted to worsen in the current Coffea arabica producing areas of Ethiopia, the Ugandan part of the Lake Victoria and Mt. Elgon regions, Mt. Kenya and the Kenyan side of Mt. Elgon, and most of Rwanda and Burundi. The calculated hypothetical number of generations per year of H. hampei is predicted to increase in all C. arabica-producing areas from five to ten. These outcomes will have serious implications for C. arabica production and livelihoods in East Africa. We suggest that the best way to adapt to a rise of temperatures in coffee plantations could be via the introduction of shade trees in sun grown plantations. The aims of this study are to fill knowledge gaps existing in the coffee industry, and to draft an outline for the development of an adaptation strategy package for climate change on coffee production. An abstract in Spanish is provided as Abstract S1.

Improving income and livelihood of poor farming household in Bangladesh through adoption of improved aquaculture technologies and varieties

Fish are an important part of Bangladeshi culture and diet. Bangladesh ranks among the top five freshwater fish producers in the world. Fish are abundant in the thousands of rivers, ponds, lakes and seasonal floodplains across the country. They are a major source of protein for people living near these water bodies. In Bangladesh, many households depend on fish farming for their livelihood. By growing fish in homestead ponds, households have a consistent supply of nutritious fish and can sell the surplus for an income. The USAID-funded Cereal Systems Initiative for South Asia in Bangladesh (CSISA-BD) aimed to increase the income of farming households through increased productivity of aquaculture systems. Key activities of the project included developing and disseminating appropriate improved agricultural technology and quality fish seeds to improve livelihoods, food security and nutrition.