Language ideologies and Schooled Education in Rural Tanzania : The Case of Karagwe

In this article I argue that language policies for education have effects on pupils’ educational possibilities. With the case of Karagwe district in Tanzania I have found that the case of “Swahili only” in primary school education favours the small minority of the children that live in a context where Swahili is used. This leads to inequality in pupils’ chances in education and to a low level of achievement of academic content in schools. This also promote the developing and use of safety strategies among teachers and pupils that hide failure and prevent pupils’ learning.

Effectiveness of artemether-lumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania : an open label prospective study

Background: Home-management of malaria (HMM) strategy improves early access of anti-malarial medicines to high-risk groups in remote areas of sub-Saharan Africa. However, limited data are available on the effectiveness of using artemisinin-based combination therapy (ACT) within the HMM strategy. The aim of this study was to assess the effectiveness of artemether-lumefantrine (AL), presently the most favoured ACT in Africa, in under-five children with uncomplicated Plasmodium falciparum malaria in Tanzania, when provided by community health workers (CHWs) and administered unsupervised by parents or guardians at home. Methods: An open label, single arm prospective study was conducted in two rural villages with high malaria transmission in Kibaha District, Tanzania. Children presenting to CHWs with uncomplicated fever and a positive rapid malaria diagnostic test (RDT) were provisionally enrolled and provided AL for unsupervised treatment at home. Patients with microscopy confirmed P. falciparum parasitaemia were definitely enrolled and reviewed weekly by the CHWs during 42 days. Primary outcome measure was PCR corrected parasitological cure rate by day 42, as estimated by Kaplan-Meier survival analysis. This trial is registered with ClinicalTrials.gov, number NCT00454961. Results: A total of 244 febrile children were enrolled between March-August 2007. Two patients were lost to follow up on day 14, and one patient withdrew consent on day 21. Some 141/241 (58.5%) patients had recurrent infection during follow-up, of whom 14 had recrudescence. The PCR corrected cure rate by day 42 was 93.0% (95% CI 88.3%-95.9%). The median lumefantrine concentration was statistically significantly lower in patients with recrudescence (97 ng/mL [IQR 0-234]; n = 10) compared with reinfections (205 ng/mL [114-390]; n = 92), or no parasite reappearance (217 [121-374] ng/mL; n = 70; p <= 0.046). Conclusions: Provision of AL by CHWs for unsupervised malaria treatment at home was highly effective, which provides evidence base for scaling-up implementation of HMM with AL in Tanzania.

Distance measure and the p-median problem in rural areas

The p-median model is used to locate P facilities to serve a geographically distributed population. Conventionally, it is assumed that the population patronize the nearest facility and that the distance between the resident and the facility may be measured by the Euclidean distance. Carling, Han, and Håkansson (2012) compared two network distances with the Euclidean in a rural region witha sparse, heterogeneous network and a non-symmetric distribution of thepopulation. For a coarse network and P small, they found, in contrast to the literature, the Euclidean distance to be problematic. In this paper we extend their work by use of a refined network and study systematically the case when P is of varying size (2-100 facilities). We find that the network distance give as gooda solution as the travel-time network. The Euclidean distance gives solutions some 2-7 per cent worse than the network distances, and the solutions deteriorate with increasing P. Our conclusions extend to intra-urban location problems.

Maternal health care professionals perspective on the provision and use of antenatal and delivery care : a qualitative descriptive study in rural Vietnam

Background. High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. Method. The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result. Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Conclusion. Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.

Portals for microenterprises in rural area : two cases

Research has shown that microenterprises have ability to survive and grow with the support of portals that include eCcommerce. However, almost no research has demonstrated how it’s done and what support microenterprises want. Results of our study shows that the portals have to be improved to support the use of advanced ICT applications, make it usable to use, and give more time for core business for the participating microenterprises. We have seen that portals have to solve problem with the technical solution and the process of payment. The network building activities in the portals do not happen in such extent that we have expected based on previous research. If portals will get businesses to grow in microenterprises, we propose that in addition to providing access to advanced ICT applications need to climbs one step higher in the DTI ladder and create more of eCommerce to increase sales in a greater market. We also propose that portals which support cooperation between microenterprises in rural areas from different branches have the best chances to succeed in the future.

How does the use of different road networks effect the optimal location of facilities in rural areas?

The p-median problem is often used to locate P service facilities in a geographically distributed population. Important for the performance of such a model is the distance measure. Distance measure can vary if the accuracy of the road network varies. The rst aim in this study is to analyze how the optimal location solutions vary, using the p-median model, when the road network is alternated. It is hard to nd an exact optimal solution for p-median problems. Therefore, in this study two heuristic solutions are applied, simulating annealing and a classic heuristic. The secondary aim is to compare the optimal location solutions using dierent algorithms for large p-median problem. The investigation is conducted by the means of a case study in a rural region with an asymmetrically distributed population, Dalecarlia. The study shows that the use of more accurate road networks gives better solutions for optimal location, regardless what algorithm that is used and regardless how many service facilities that is optimized for. It is also shown that the simulated annealing algorithm not just is much faster than the classic heuristic used here, but also in most cases gives better location solutions.

Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care

Background: Smokers with chronic obstructive pulmonary disease (COPD) have high nicotine dependence making it difficult to quit smoking. Motivational interviewing (MI) is a method that is used in stimulating motivation and behavioral changes. Objective: To describe smoking cessation communication between patients and registered nurses trained in MI in COPD nurse-led clinics in Swedish primary health care. Methods: A prospective observational study with structured quantitative content analyses of the communication between six nurses with basic education in MI and 13 patients in non-smoking consultations. Results: Only to a small extent did nurses’ evoke patients’ reasons for change, stimulate collaboration, and support patients’ autonomy. Nurses provided information, asked closed questions, and made simple reflections. Patients’ communicationwasmainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation. Conclusion: The nurses did not adhere to the principles of MI in smoking cessation, and the patients focused to a limited extent on how to quit smoking. Practice implications: To make patients more active, the nurses need more education and continuous training in motivational communication.

Negotiating collective and individual agency : a qualitative study of young women's reproductive health in rural India

The societal changes in India and the available variety of reproductive health services call for evidence to inform health systems how to satisfy young women's reproductive health needs. Inspired by Foucault's power idiom and Bandura's agency framework, we explore young women's opportunities to practice reproductive agency in the context of collective social expectations. We carried out in-depth interviews with 19 young women in rural Rajasthan. Our findings highlight how changes in notions of agency across generations enable young women's reproductive intentions and desires, and call for effective means of reproductive control. However, the taboo around sex without the intention to reproduce made contraceptive use unfeasible. Instead, abortions were the preferred method for reproductive control. In conclusion, safe abortion is key, along with the need to address the taboo around sex to enable use of "modern" contraception. This approach could prevent unintended pregnancies and expand young women's agency.

Study of the innovation management process in the development of a discontinuous product case: Motorola RAZR V3

This study will collaborate by bringing some detailed analysis and findings on a special case study of a discontinuous product development process, trying to answer how the discontinuous product development process takes place and the main factors that influence this process. Additionally, it tried to explore some explanations for the difficulties generally faced by the companies to sustain innovation. The case is about the Motorola cell phone RAZR V3, launched in 2004. RAZR V3 was noted by industry experts as game-changing feat of design and engineering, selling more than 110 million units by end of 2008 and recognized as one of the fastest selling products in the industry. The study uses a single case methodology, which is appropriate given the access to a phenomenon that happened inside corporate dominium and it is not easily accessed for academic studies, besides being a rare case of success in the cellular phone industry. In order to magnify the understanding of the phenomenon, the exploration was extended to contrast the RAZR development process and the standard product development process in Motorola. Additionally, it was integrated a longitudinal reflection of the company product development evolution until the next breakthrough product hitting the cellular phone industry. The result of the analysis shows that discontinuous products do not fit well traditional product development process (in this case, stage-gate). This result reinforces the results obtained on previous studies of discontinuous product development conducted by other authors. Therefore, it is clear that the dynamics of discontinuous product development are different from the continuous product development, requiring different treatment to succeed. Moreover, this study highlighted the importance of the management influence in all the phases of the process as one of the most important factors, suggesting a key component to be carefully observed in future researches. Some other findings of the study that were considered very important for a discontinuous product development process: have champions (who believe and protect the project) and not only one champion; create a right atmosphere to make flow the creative process; question paradigms to create discontinuous products; simple guiding light to focus the team; company culture that accepts and knows how to deal with risks; and undoubtedly, have a company strategy that understands the different dynamics of continuous and discontinuous product development processes and treat them accordingly.

Lighting and violent crimes: evaluating the effect of an electrification policy in rural Brazil on violent crime reduction

This paper estimates the effect of lighting on violent crime reduction. We explore an electrification program (LUZ PARA TODOS or Light for All - LPT) adopted by the federal government to expand electrification to rural areas in all Brazilian municipalities in the 2000s as an exogenous source of variation in electrification expansion. Our instrumental variable results show a reduction in homicide rates (approximately five homicides per 100,000 inhabitants) on rural roads/urban streets when a municipality moved from no access to full coverage of electricity between 2000 and 2010. These findings are even more significant in the northern and northeastern regions of Brazil, where rates of electrification are lower than those of the rest of the country and, thus, where the program is concentrated. In the north (northeast), the number of violent deaths on the streets per 100,000 inhabitants decreased by 48.12 (13.43). This moved a municipality at the 99th percentile (75th) to the median (zero) of the crime distribution of municipalities. Finally, we do not find effects on violent deaths in households and at other locations. Because we use an IV strategy by exploring the LPT program eligibility criteria, we can interpret the results as the estimated impact of the program on those experiencing an increase in electricity coverage due to their program eligibility. Thus, the results represent local average treatment effects of lighting on homicides.