The COVID-19 outbreak and its economic, social and financial fallouts have generated a renewed interest in finding adequate policies and means to strengthen economic resilience to future shocks, particularly in developing countries. The latter are usually disproportionately affected by adverse shocks (compared to developed countries) and lack the adequate resources to weather these shocks. Strengthening economic resilience is now at the heart of the policy discussion both at the national and international levels. The present paper aims to contribute to this debate by investigating the effect of productive capacities on economic resilience in a panel dataset of 118 developing countries over the period 2000-2018. It constructs a regression-based economic resilience indicator, and makes use of the indicator of productive capacities recently developed by the UNCTAD. Results are quite interesting, including from a policy perspective. The development of productive capacities is associated with greater economic resilience. This is particularly the case for countries with greater trade openness, greater capital account openness, and those that promote a stable macroeconomic environment. Interestingly, development aid appears to matter for the effect of productive capacities on economic resilience. On the one hand, the magnitude of the positive economic resilience effect of productive capacities increases as countries receive higher Aid for Trade (AfT) flows. On the other hand, NonAfT flows (i.e., other development aid flows that AfT flows) hinder the possible positive contribution of productive capacities to economic resilience. These findings have important policy implications that are discussed in the paper.

Antibiotic resistance is a major public health issue that requires a multifaceted approach. One potential source of antibiotic-resistant bacteria is wastewater in developing countries, which often lacks proper treatment infrastructure and can release high levels of antibiotics and antibiotic-resistant bacteria into the environment. This review article summarizes current knowledge on strategies to combat antibiotic resistance in wastewater in developing countries. Our review highlights the importance of improving wastewater treatment infrastructure to effectively remove antibiotics and antibiotic-resistant bacteria, implementing measures to reduce the release of antibiotics into the environment, and monitoring and surveillance to track the presence and spread of antibiotic-resistant bacteria in wastewater. We also discuss the potential challenges and barriers to implementing these strategies and the need for further research to determine their effectiveness in real-world settings. Overall, this review highlights the need for a comprehensive approach to address antibiotic resistance in wastewater in developing countries and underscores the importance of addressing this issue to protect public health.

The COVID-19 pandemic, like previous major crises, such as the 2008 financial crisis, has had a severe negative impact on international trade flows. International institutions are now exploring ways to help their member states recover from the health crisis, and foster the resilience of their economies to future crises. As far as trade is concerned, institutions that deal primarily with trade matters are making effort to help their member states foster the resilience of their trade performance to future shocks. In this context, the World Trade Organization (WTO), which is the only international organization that deals with the global rules of trade between nations, has organized a series of events since the onset of the COVID-19 pandemic. It has now planned to hold in September 2021 the 2021 WTO Public Forum whose theme is "Trade Beyond COVID-19: Building Resilience". The present paper aims to contribute to this debate by examining the effect of development aid, i.e., the so-called official development aid, in particular its Aid for Trade (AfT) component, on export resilience. The resilience of exports refers to the capacity of countries' aggregate exports to resist to shocks, whether environmental or external shocks. The core argument of the analysis is that development aid would affect export resilience through its effect on productive capacities. The analysis covers 93 developing countries over the period 2002-2018. The findings indicate that total development aid flows, including both AfT flows and NonAfT flows exert a positive effect on export resilience. Among AfT components, AfT for productive capacities appears to exert a higher positive effect on export resilience than AfT for economic infrastructure and AfT for trade policy and regulation. In addition, development aid (whatever the aid variable considered) exerts the highest positive effect on export resilience in countries (such as Least developed countries - LDCs) that have the lowest level of productive capacities. These findings highlight the need for donor-countries to supply higher development aid flows, in particular AfT flows to countries such as LDCs that have low levels of productive capacities.

The paper examines the impact of INGOs on the democratization of developing countries. Following the ‘end of history,’ the INGOs multiplied globally, and the number of aids to developing countries was given through them in billions of dollars in the past three decades. It is envisaged that with the increase in their population, the developing countries will be better off with a standard form of living that is attributable to standard democratization. However, despite the billions of dollars spent, the citizens of the developing countries are still worse in poverty, poor leadership, and corruption. On the contrary, some countries, including Nigeria, are threatening legislation that will curtail the INGOs, sighting their opacity and lack of tangible results as reasons. The research used Nigeria as a case study to analyze the methods, approaches, and the capacity of these INGOs and how they affect the democratization of their host countries. Through a review of existing records, non-participatory observations, and reviews of conference proceedings. The paper analyzed the parallel gaps that exist by arguing that, taking a broad, multi-disciplinary method from the various works of literature studied will provide essential conceptual and practical insights that can inform current debates.

This review paper is intended to exhibit the interplays between environmental change and rapid population growth in developing countries. In the course of discussion, the impacts of rapidly population growing on the environment have been discussed, and evidence, from various parts of the world have been traced. Studies on the impacts of population pressure on environment have been critically reviewed. It is revealed that all across the developing countries, farm size is shrinking as farmers continue to subdivide holdings among their children. In countries such as Malawi, Rwanda, Ethiopia, Haiti, Nepal and Bangladesh, population growth rates are high, and the non-farm sector is still in its early stages of development. Demographic pressure, land scarcity, and land fragmentation drive greater rural vulnerability and poverty, marked by decreased food security, inadequate response to such natural disasters such as drought or pest infestations, weakened resilience to shocks, and poor health. It is not just the supply of food, fodder, and fuel wood but the resource base itself and the lives that depend upon it are being affected. The evidences pinpoints that man through his non-sustainable production and consumption patterns, is placed at the heart of environmental changes. However, contradictory view, and practices are also in place that the population growth has positive impacts environmental restoration and improvements, while other evidences show insignificant effect of population on the environment. This contradicting scenario puts scholars in argument, and still need further research. Hence, it would be a blind generalization to draw conclusion from this relationship alone, rather, another factor that acts beyond population pressure must also be considered to justify the impact of population on environmental changes.

Natural rivers in urban areas bear significant potential to provide ecosystem services for the surrounding inhabitants. However, surface sealing by houses and street networks, urban drainage, disposal of waste and wastewater resulting from advancing urbanization usually lead to the deterioration of urban rivers and their riparian areas. This ultimately damages their ability to provide ecosystem services. This paper presents an innovative methodology for a rapid and low-cost assessment of the ecological status of urban rivers and riparian areas in developing countries under data scarce conditions. The methodology uses a combination of field data and freely available high-resolution satellite images to assess three ecological status categories: river hydromorphology, water quality, and riparian land cover. The focus here is on the assessment of proxies for biophysical structures and processes representing ecological functioning that enable urban rivers and riparian areas to provide ecosystem services. These proxies represent a combination of remote sensing land cover- and field-based indicators. Finally, the three ecological status categories are combined to quantify the potential of different river sections to provide regulating ecosystem services. The development and application of the methodology is demonstrated and visualized for each 100 m section of the Pochote River in the City of León, Nicaragua. This spatially distributed information of the ecosystem service potential of individual sections of the urban river and riparian areas can serve as important information for decision making regarding the protection, future use, and city development of these areas, as well as the targeted and tailor-made development of nature-based solutions such as green infrastructure.

Aim of this study is to gather information regarding the sustainability development goals from the public as well as the organizations of Pakistan. A sample of 500 respondents each from five main cities including employs and general public is selected for their opinion regarding sustainability development goal. The level of awareness as well as level of commitment towards the fulfilment of Sustainable Development Goals varies across the cities of Pakistan due to difference in literacy level. The commitment to achieve Sustainable Development Goals of the organizations across the selected cities varies according to the nature of the business, volume and the membership with the United Nations. This study provides the policy makers with the ground level data regarding the awareness and commitment of Pakistan based organizations and public towards SDGs fulfilment. A glance towards the attitudes of the people towards the subject matter could also be seen through this study. This a comprehensive study conducted at federal and provincial level of Pakistan which has yielded ground realities towards the implementation of SDGs. The results could be used for policy making and planning at national level and also serve as bench mark for other countries.

The governance of public sector infrastructure projects became an important topic of interest in the project, programme and portfolio management literature during the last decade. Today, it is becoming a central focus for policymakers seeking to ensure success in selecting, designing and implementing government-sponsored programme of multi-projects. Due to the multiple underlying risks and complexities, the governance of infrastructure programme constitutes a critical element in strategic planning in developing countries. This paper has analyzed infrastructure development programme and revealed shortcomings in the areas of appraisal, decision-making, quality assurance and stakeholder management. Approaches to remedy these shortcomings have been proposed.

Despite the success of recent efforts to increase access to improved water, sanitation, and hygiene (WASH) globally, approximately one-third of schools around the world still lack adequate WASH services. A lack of WASH in schools can lead to the spread of preventable disease and increase school absences, especially among women. Inadequate financing and budgeting has been named as a key barrier for integrating successful and sustainable WASH programs into school settings. For this reason, the purpose of this review is to describe the current knowledge around the costs of WASH components as well as financing models that could be applied to WASH in schools. Results show a lack of information around WASH costing, particularly around software elements as well as there is a lack of data overall for WASH in school settings as compared to community WASH. This review also identifies several key considerations when designing WASH budgets or selecting financing mechanisms. Findings may be used to advise future WASH in school programs.

The paper attempts to explore the relationship between federalism and rural development. Federalism is a division of power, responsibility and accountability to bring the administrative and political power closer to the ground and essentially to increase the good governance. On the other hand, rural development is a complex and multidimensional issue- especially much demanding for least developed and developing countries. A descriptive and qualitative approach was carried out to study the complex relationship between rural development and federalism. Similarly, a SWOT analysis was carried out to have a better understanding of the relationship. The study found that there is significant potentiality for accelerated development of rural landscape in federalism if carefully executed. However, on the other hand, federalism may pose several risks on rural development and may restrict the development pace if not executed with appropriate care and understanding. Therefore, the study concludes that cooperation and coordination among the federal structures are crucial for better development of the rural economy.

Plastic waste management has become a major problem in the present times, and many countries are struggling to deal with it. The situation has become a crisis in developing nations due to a lack of proper waste management, resources, technology, and political will. The extensive usage of foam-based packaging materials such as Styrofoam as a secondary packaging material has led to environmental pollution both in land and water, in developing countries. It is important to address this problem using a sustainable approach such as biomimetic manufacturing. One such solution that is present in developed nations is mycelium-based packaging, wherein the agricultural and industrial-based cellulose waste is converted into a biocomposite with the help of a fungi root network. Such a process has the potential to convert biomass into useful products but also has an indirect effect on pollution reduction by eliminating stubble burning in nations like India. In this review, we examine the details of the manufacturing process, properties, advantages, and limitations of such composite materials. A comparison of the present status of such materials produced in the market by some of the companies across the world is presented. Finally, the challenges involved with such materials and the future directions are discussed.

One of the main drivers behind the urbanization process is attributed to economic fundamentals of urban growth, which boost migration from rural to urban context. This migration can be studied geographically, with increasing rates of population as the main component in developing countries, over Asia and Africa, specifically. Research has been focusing in creating models and adaptative schemes to manage and plan cities to promote sustainable development for housing large quantities of population and preserve a long-term living environment. The approach from a smart city perspective, adjusted to the rapid urbanization condition can be helpful to deal urban issues by convergence and interaction between urban agents and information technology. At academia, few works have addressed the role of Smart Cities to face the challenge of rapid urbanization. The aim of this study is to research and analyze if strategies with smart city vision can lessen environmental impacts at cases with rapid urbanization, and how can we leverage technology to promote environmental sustainability at rapid urbanization phenomena occurring at developing countries using RIAM environmental assessment method in the case of Beijing, China'.

A reliable and affordable energy supply is a fundamental prerequisite for reducing poverty, promoting investment, and boosting economic growth in the developing world. Among the different challenges that developing countries face, chronic energy crises are harrowing. The crises result from the unsatisfactory state of the central grid, a misguided energy mix, and ill-informed policies, among other things. The possibility of solving energy crises through a variety of alternative solutions is worth exploring. This review discusses two paths of energy development side by side: a traditional “hard” path of energy development (i.e., central grid extension powered by fossil fuels and nuclear energy expansion) and a relatively recent “soft” path of energy development, which is based on energy conservation and the deployment of renewable energy resources. This paper focuses on one central axis of the discussion: centralization vs. decentralization. This discussion, in turn, has technological, economic/business, and political dimensions. Finally, the paper discusses the significance of the debate from meeting the developing world’s energy demands. The paper intends not to prefer one or another path of energy development, nor it gives recommendations on diffusing or adopting those development paths. Instead, it explores the literature’s central arguments that might help frame the questions for further research. While this debate could be used to ask interesting questions that might help solve the energy crisis in the developing world, the discussion informs countries to advance policies specific to their circumstances under the umbrella of a sound and thoughtful energy productivity policy framework.

The production of vaccines of biological origin presents a tremendous challenge for researchers. In this context, animal cell cultures are an excellent alternative for the isolation and production of biologicals against several viruses since they have an affinity with viruses and a great capacity for their replicability. Different variables have been studied to know the system's ideal parameters, allowing it to obtain profitable and competitive products. Consequently, this work focuses its efforts on evaluating an alternative for producing an anti-influenza biological from MDCK cells using SuperPro Designer v8.0 software. The process uses the DMEN culture medium supplemented with nutrients as raw material for cell development; the MDCK cells were obtained from a potential scale-up with a final working volume of 500 L, four days of residence time, inoculum volume of 10%, and continuous working mode with up to a total of 7400 h/Yr of work. The scheme has the necessary equipment for the vaccine's production, infection, and manufacture with yields of up to 416,698 units/h. In addition, it was estimated to be economically viable to produce recombinant vaccines with competitive prices of up to 0.31 USD/unit.

Small Island States (SIDS) are among the nations most exposed to climate change (CC) and are characterised by a high degree of vulnerability. Their special nature means there is a need for more studies focused on the limits to CC adaptation on such fragile nations, particularly in respect of their problems and constraints. This paper addressed a perceived need for research into the limitations of adaptation on SIDS, focusing on the many restrictions which are unique to them. The main research question raised by this study was that how and to what extent the challenges by human activities (e.g., agriculture and tourism) posed to coastlines of SIDS could be addressed. This paper identified and described the adaptation limits they have, by using a review of the literature and an analysis of case studies from a sample of five SIDS in the Caribbean and Pacific regions (Barbados, Trinidad and Tobago, Cook Islands, Fiji, Solomon Islands, and Tonga). The findings of this research showed that an adaptable SIDS is characterised by awareness of various values, appreciation and understanding of a diversity of impacts and vulnerabilities, and acceptance of certain losses through change. The implications of this paper are two-fold. It explains why island nations continue to suffer from the impacts of CC, and suggest some of the means via which adequate policies may support SIDS in their efforts to cope with the threats associated with a changing climate. This study concluded that, despite the technological and ecological limits (hard limits) affecting natural systems, adaptation to CC is not only limited by such complex forces, but also by societal factors (soft limits) that could potentially be overcome by more adequate adaptation strategies.

The tumor suppressor protein p53 is considered a guardian of genome integrity, regulating the induction of apoptosis and cell cycle arrest in response to irradiation to block the transmission of teratogenic mutations to progeny cells. We examined the function of p53 in highly radiosensitive tissues, the developing brain and mature testis, using a small fish model, medaka (Oryzias latipes). Medaka offer advantages as a vertebrate model system, as the transparency and small size of the embryos enables clear detection of apoptotic cells in the developing brain. In addition, the simple architecture of medaka testes enables more precise identification of the differentiating spermatogenic stages compared with mammals. We found that in irradiated p53-deficient embryonic brain, diminished induction of apoptosis facilitated tissue regeneration earlier compared to irradiated wild-type embryos, which remained structural abnormalities in the retina at hatching. Moreover, the prominent delay in apoptotic induction in irradiated p53-deficient testes could induce transient mis-differentiation during spermatogenesis, such as the formation of ovum-like cells (testis-ova). However, all testis-ova cells were eliminated via p53-independent apoptosis, and spermatogenesis was completely restored within 1 month after irradiation. Collectively, these data indicate that p53 is not indispensable for the restoration of irradiation-induced damaged tissues.

This study presents a novel approach for the early detection of developing thunderstorms. To date, methods for the detection of developing thunderstorms usually rely on accurate atmospheric motion vectors (AMVs) for the estimation of cooling rate of convective clouds, which corresponds to the updraft strength of the cloud objects. In this study we present a method for the estimation of the updraft strength that does not rely on AMVs. The updraft strength is derived directly from the satellite observations in the SEVIRI water vapor channels. For this purpose the absolute value of the vector product of two vectors derived from the observed radiances emitted by the water vapor channels in 2 subsequent satellite images is calculated. The x and y components of the vectors consists of the temporal change of the spatial brightness temperature gradients in x- and y-direction, the z component consists of the temporal variation of the brightness temperature at pixel level. The absolute value of the vector product is referred to as normalized updraft strength (NUS). The performance of the method has been investigated for 2 summer periods in 2016 and 2017 by validation with lightning data. Values of the Critical Success Index (CSI) of about 66 % for the 2016 period and 62 % for the 2017 period demonstrate the good performance of the method. The POD values for the experiments with the highest CSI values are 90.3 for 2016 period and 87.6 for the 2017 period, respectively The corresponding FAR values are 28.2% (2016) and 32.5 % (2017), respectively. In summary, the method has the potential to reduce the forecast lead time significantly, and can be quite useful in regions without a well maintained radar network.

Academic publishing appears to be the most important key of the academic functions (academic research, excellence in teaching and learning and community services). Selecting the right journal to publish research results is a challenge to academics. Yet, there is inadequate knowledge about a model specifically directed at the topic of the journal selection process with a mathematical certainty. The objectives of this research are: to identify the main factors that an author or researchers consider when selecting an academic journal for submitting a manuscript, and, to develop a mathematical algorithm of journal selection that provide the best journal choice with a mathematical certainty based on difficulty of each factor. Quantitative research through questionnaires has been applied as an appropriate instrument base to address the researcher’s identification of the factors that should be considered when selecting a journal. Questionnaire developed and emailed to academics in 31 public and private universities in the developing countries. Academics reported that the most important publication difficulty factors were publishing in reputable journals, and publishing in a journal that has an impact factor. However, the most least publication difficulty factors were found to be: number of issues per year and if the journal is an open access. The proposed mathematical algorithm of journal’s publication difficulty factors was developed and tested.

This study evaluated the impact of didactic videos and service user testimonial videos on mental illness stigma among medical students. Two randomized controlled trials were conducted in Nepal. Study 1 examined stigma reduction for depression. Study 2 examined depression and psychosis. Participants were Nepali medical students (Study 1:n=94, Study 2:¬n=213) randomized to three conditions: a didactic video based on the mental health Gap Action Programme (mhGAP), a service user video about living with mental illness, or a control condition with no videos. In Study 1, videos only addressed depression. In Study 2, videos addressed depression and psychosis. In Study 1, both didactic and service user videos reduced stigma compared to the control (F2,91=6.37, p=0.003). In Study 2 (depression and psychosis), there were no differences among the three arms (F2,210=2.07, p=0.13). When comparing Study 1 and 2, there was greater stigma reduction in the service user video arm with only depression versus service user videos with depression and psychosis (t(31)=-3.04, p=0.005). In summary, didactic and service user videos were associated with decreased stigma when content addressed only depression. However, no stigma reduction was seen when including depression and psychosis. This calls for different strategies based on types of mental illnesses. ClinicalTrials.gov identifier: NCT03231761

This paper investigates empirically the effect of export diversification (i.e., both export product diversification and services export diversification) on financial openness, using a sample of 119 countries (including both developed and developing countries) over the period 1985-2014. Based on the Blundell and Bond's two-step system Generalized Methods of Moments, the analysis has revealed that both export product diversification and services export diversification influence positively financial openness. However, this outcome hides differentiated effects across countries in the full sample. Specially, countries with a very high real per capita income experience a positive effect of export concentration on financial openness, while for countries with a relatively lower per capita income, it is rather export diversification that drives positively financial openness. Interestingly, the effect of export diversification on financial openness depends on the size of external shocks that affect domestic economies, as well as countries' economic growth performance. Overall, these findings add to the empirical literature on the effect of international trade on financial openness by showing that both export product diversification and services export diversification matter for financial openness.

Rapid increase in digital data coupled with advances in deep learning algorithms is opening unprecedented opportunities for incorporating multiple data sources for modeling spatial dynamics of human infectious diseases. We used Convolutional Neural Networks (CNN) in conjunction with satellite imagery-based urban housing and socio-economic data to predict disease density in a developing country setting. We explored both single (uni) and multiple input (multimodality) network architectures for this purpose. We achieved maximum test set accuracy of 81.6 per cent using a single input CNN model built with one convolutional layer and trained using housing image data. However, this fairly good performance was biased in favor of specific disease density classes due to an unbalanced data set despite our use of methods to address the problem. These results suggest CNN are promising for modeling spatial dynamics of human infectious diseases, especially in a developing country setting. Urban housing signals extracted from satellite imagery seem suitable for this purpose, under the same context.

High maternal mortality in the developing countries, particularly in Nigeria, poses serious challenge to achieving the maternal mortality target of the Sustainable Development Goals (SDGs) in the countries. Hence, there is need for multifaceted approach to curtailing the scourge. Women being the victims of maternal mortality, this study finds the effect of their household decision making power in reducing maternal mortality. The study used data from the 2013 Nigeria Health and Demographic Survey (NDHS) and logistic regression model to explore the relationship between women household decision making power and maternal mortality in Nigeria. The finding shows that women who decide and participate in household decision on own health, major purchases and visit to family and relatives were 35% (OR = 0.65, 95% CI: 0.52, 0.83), 27% (OR = 0.73, 95% CI: 0.57, 0.92), and 37% (OR = 0.63, 95% CI: 0.50, 0.80) less likely to experience maternal mortality, respectively, compared to those whose husbands alone decide. Women household decision making power is therefore instrumental to reducing maternal mortality. It is thus important for policy makers, particularly in Nigeria, to pay more attention to social and cultural factors that surround women household decision making ability for speedy reduction in maternal deaths.

Introduction: In rural communities in regions with limited resources the provision of clean water remains challenging. Fecal contamination of water is very common and results in a high incidence of diarrhea, subsequent acute kidney injury and mortality particularly in the very young and old. Membrane filtration is a practical solution to this problem and recent innovation allows membrane filtration using recycled hemodialyzers. We, Easy Water for Everyone, have quantified the systematic effect on health outcomes. Material and Methods: Between 02/2018 and 12/2018, 4 communities in rural Ghana (in the Greater-Accra region) were each provided with a high-volume membrane filtration devices (NUF 500; NuFiltration using recycled hemodialyzers). Health data from montly household surveys and chart review in local healthcare facilities were collected with approval from Ghana Health Services. Specifically, data was collected on gastrointestinal disease, acute kidney injury and therapeutic interventions. Incidence rates for a five-months period before and after implementation of the device were calculated and compared to rates during the same months from 4 neighboring communities that were not yet provided with the device. Results: Acceptance of the devices and the purified water in the studied villages was good and self-reported data of 1130 villagers over 10 months from 9 studied communities in rural Ghana (11% younger than 5 years and 14 % older than 65 years) were included in this analysis. The overall monthly incidence rate of diarrhea showed a decline following the implementation of the device in the 4 study villages from a mean of 0.18 to 0.05 cases per person-month for a reduction in rates by 72% (rate ratio = 0.27). By contrast, the control group of 4 villages in the same region showed no decline in mean rates during the same months as the study period with mean rates changing not significantly from 0.11 to 0.08 cases per person-month. Discussion: Provision of a hemodialyzer membrane filtration device markedly improves health outcomes as measured by diarrhea incidence within rural communities. While our data awaits confirmation in a larger population and further statistical analyses accounting for village characteristics, seasonality and subject demographics, the obvious decline in incidence rates supports widespread use of hemodialyzer membrane filtration devices, particularly in rural regions. Rollout of the device in further sites will likely increase our understanding in terms of risk and other preventive factors modifying the incidence of diarrhea and subsequent acute kidney injury.

UN 2030 Sustainable Development Goal 6 presents difficulties for small island developing states such as the Kingdom of Tonga, which relies on rainwater and groundwater lenses for freshwater supply. Planning and managing water resources to supply demands in dispersed small islands under variable climate and frequent extreme events is challenging. Tensions between water planning using top-down versus bottom-up processes have long been recognized. Tonga’s overarching national planning instrument is the Tonga Strategic Development Framework, 2015-2025 (TSDFII). This identifies desired national outcomes and is used to direct and resource Ministries and address international and regional commitments. Water supply was a low priority in the three-month consultations that led to TSDFII. Community Development Plans (CDPs), developed by rural villages throughout Tonga’s five Island Groups over nine years, involved participation from 80% of each village population who ranked local priorities. Analysis of priorities in 117 available village CDPs reveals improvements to village water supply was the highest overall priority in all five Island Groups and ranked within the top three priorities by 76% of all villages, with women, youth and men returning figures of 83%, 66% and 80% respectively. The mismatch between top-down and bottom-up priorities appears to result from an urban/rural divide.

Water resources, especially safe, potable water, are limited for many Haitians. In areas where shallow groundwater is available, many household water needs such as laundry, bathing, and cooking are supplied by hand-dug wells. In order to better understand the water quality and prevalence of these household wells, 35 hand-dug wells were surveyed and sampled near the Hôpital Albert Schweitzer (HAS) in Deschapelles, Haiti. Water samples were collected and tested for fecal coliform and E. coli using the IDEXX Colilert-18 method. Of the samples collected, 89 percent were determined unsafe to use as a drinking water source based on the World Health Organization standard of 1.0 colony-forming unit (cfu) Escherichia Coli (E. coli) per 100 mL. 66 percent of the wells exceeded recreational/body contact standards for the state of Michigan (130 cfu/100 mL). Some of these wells were deemed suitable for conversion to a new well type called In-Situ Filtration (ISF) wells. ISF wells are installed with an internal sand filter pack, PVC casing, pump, and cap which seals the well from surface contamination and provides additional water treatment as water is pumped. Previous ISF installations have reduced E. coli to safe drinking water levels within 90 days.

In developing countries, noise exposure and its negative health effects have been little explored. The present study aimed to assess the noise exposure situation in adults living in informal settings in the Western Cape Province, South Africa. We conducted continuous one-week outdoor noise measurements at 134 homes in four different areas. These data were used to develop a land use regression (LUR) model to predict A-weighted day-evening-night equivalent sound level (Lden) from geographic information system (GIS) variables. Mean noise exposure during day (6:00-18:00) was 60.0 A-weighted decibels (dB(A)) (interquartile range 56.9-62.9 dB(A)), during night (22:00-6:00) 52.9 dB(A) (49.3-55.8 dB(A)) and average Lden was 63.0 dB(A) (60.1-66.5 dB(A)). Main predictors of the LUR model were related to road traffic and household density. Model performance was low (adjusted R²=0.130) suggesting that other influences than represented in the geographic predictors are relevant for noise exposure. This is one of the few studies on the noise exposure situation in low- and middle-income countries. It demonstrates that noise exposure levels are high in these settings.

Amongst the advantages of using Worldwide Interoperability Microwave Access (WiMAX) technology at the last-mile level as access technology include an extensive range of 50 km Line of Sight (LOS), 5 to 15 km Non-Line of Sight and few infrastructure installations compared to other wireless broadband access technologies. Despite positive investments in ICT fibre infrastructure by developing countries, including Botswana, servicing end-users is subjected to high prices and service disparities. The alternative, the Wi-Fi hotspot initiative by the Botswana government, falls short as a solution for last-mile connectivity and access. This study used OPNET simulation Modeller 14,5 to investigate whether Botswana’s national broadband project could adopt WiMAX IEEE 802.16e as an access technology. Therefore, using the simulation method, this paper evaluates the WiMAX IEEE 802.16e/m over three subscriber locations in Botswana. The results obtained indicate that the deployment of the WiMAX IEEE 802.16e standard can solve most of the deployment issues and access at the last-mile level. Although the findings suggest that WiMAX IEEE 802.16e is more suitable for high-density areas, it could also solve rural areas’ infrastructure development challenges and provide the required high-speed connectivity access. However, unlike the Wi-Fi initiative, which requires more infrastructure deployment and less on institutional and regulatory frameworks, the deployment of WiMAX IEEE802.16e requires institutional and regulatory standards.

Background Increasingly, healthcare organizations are using technology for the efficient management of data. The aim of this study was to compare the data quality of digital records with the quality of the corresponding paper-based records by using data quality assessment framework. Methodology We conducted a desk review of paper-based and digital records over the study duration from April 2016 to July 2016 at six enrolled TB clinics. We input all data fields of the patient treatment (TB01) card into a spreadsheet-based template to undertake a field-to-field comparison of the shared fields between TB01 and digital data. Findings A total of 117 TB01 cards were prepared at six enrolled sites, whereas just 50% of the records (n=59; 59 out of 117 TB01 cards) were digitized. There were 1,239 comparable data fields, out of which 65% (n=803) were correctly matched between paper based and digital records. However, 35% of the data fields (n=436) had anomalies, either in paper-based records or in digital records. 1.9 data quality issues were calculated per digital patient record, whereas it was 2.1 issues per record for paper-based record. Based on the analysis of valid data quality issues, it was found that there were more data quality issues in paper-based records (n=123) than in digital records (n=110). Conclusion There were fewer data quality issues in digital records as compared to the corresponding paper-based records. Greater use of mobile data capture and continued use of the data quality assessment framework can deliver more meaningful information for decision making.

Over the last three decades, special economic zones (SEZs) have given new impetus to the ever-growing export-oriented industrialization in developing countries. Where various economies have benefited from SEZs, many zones have ended up becoming enclaves with trifling advantage. The SEZs in Pakistan have experienced the same fate and failed to contribute to exports, employment and creating linkages with the domestic economy. Recently under China Pakistan Economic Corridor (CPEC), SEZs are proposed to be set up in Pakistan; with a hope to fuel the stuttering economy. However, it is pertinent to first understand the local context and device policies considering stakeholders' perspectives. This study aims to identify the factors for the successful implementation of SEZs derived from the regional context of Pakistan. In-depth interviews are conducted from most relevant stakeholders, who have been involved in the development of SEZs. The results pointed towards the removal of political influence over zones and government taking the lead role in deciding the types of industry to be invited in these zones. Each zone should have a clear vision of development based on its regional advantage. The zone promotions should be based on competitiveness rather than fiscal incentives. Joint ventures and PPP to be encouraged inside the zones for sustainable operations.

This service improvement project was carried out at LEKMA Hospital, Ghana. Ghana has high levels of antimicrobial resistance (AMR). There is an urgent need to introduce models of care that optimize antibiotic prescribing. Methods Delayed / back-up prescribing is a strategy that could reduce antibiotic use in suspected upper respiratory tract infections. Four different models of delayed / back-up prescribing [no prescription; post-dated prescription (given to patient); post-dated prescription (forwarded to pharmacy); and follow-up appointment for reassessment after 3 days] were implemented in discussion between clinician and patient. Patients were contacted 10 days after their appointment to record compliance, check on their wellbeing, and rate their experience. Results Over a 3-month period (12/2019-02/2020), 142 patients were eligible for delayed / back-up prescribing. The most common clinical diagnoses were sore throat (102/140, 73%), common cold (22/140, 16%) and sinusitis (10/140, 7%). In total, 12 (9%) patients remained symptomatic at day 10, and only one individual in the entire cohort took antibiotics. Most patients (95%) rated their experience as good or very good. Conclusions Delayed / back-up prescribing models can lead to substantial reduction in antibiotic consumption amongst outpatient department patients with suspected upper respiratory tract infections. Delayed / back-up prescribing can be implemented safely in low and middle-income countries.

Sanitation, water supply and their governance remain major challenges in many Pacific Island Countries. National sustainable development strategies (NSDSs) are promoted throughout the Pacific as overarching improved governance instruments to identify priorities, plan solutions and fulfill commitments to sustainable development. Their relevance to local village-level development priorities is uncertain. The Kingdom of Tonga provides opportunities to compare both. Tonga’s Strategic Development Frameworks (TSDFI 2011-2014 and TSDFII 2015-2025) were developed to focus government and its agencies on national outcomes. From 2007 to 2016, 136 villages throughout Tonga’s five Island Divisions (IDs) formulated Community Development Plans (CDPs) involving separately 80% of women, youth and men in each village. Censuses in 2006 and 2016 show linked improvements in water supply and sanitation systems but reveal IDs with continuing challenges. Sanitation and water are prominent in TSDFI but absent from the current TSDFII. In contrast, CDPs show in one ID, 53% of villages ranked sanitation as a priority with marked differences between IDs and between women, youth and men. CDPs’ sanitation priorities in IDs mostly correspond to sanitation and water metrics in the Censuses, but some reflect impacts of natural disasters. Explanations for differences in sanitation priorities between national and local development plans, as well as suggestions for improving NSDS processes in island countries, are advanced.

The SARS-CoV-2 virus that causes the COVID-19 disease has wreaked havoc on the world community in terms of every imaginable parameter. The research output on COVID-19 has been nothing short of phenomenal, especially in the medical and biomedical sciences, where the search for a potential vaccine is being conducted in earnest. Much of the advanced research has been distributed in the leading medical journals, including the Journal of the American Medical Association (JAMA), where the latest research is distributed on a daily basis. The purpose of this paper is to provide some perspectives on 44 interesting and highly topical research papers that have been published in JAMA, at the time of writing, within the past two weeks. The diverse topics include public health, general medicine, internal medicine, oncology, paediatrics, geriatrics, and biostatistics.