Measles Outbreak Investigation in Aneded District, Northwest Ethiopia: A Case-Control Study.

BACKGROUND: Between 2000 and 2018, global measles deaths decreased by 73%, but the disease remains prevalent in many developing countries, especially in Africa and Asia. Although Ethiopia was attempting to eliminate the measles, it still ranks fourth in the world in terms of the number of cases. The aim of the investigation was to describe the outbreak and identify its determinants in the Aneded district. METHODS: Between March 3, 2020, and April 2, 2020, the 89 patients and 178 controls participated in a case-control study. Data were gathered by means of in-person interviews with household leaders. The attack and case fatality rates were determined. In multivariable logistic regression analysis, variables having a p-value of less than 0.05 were considered statistically significant cut-off points. RESULTS: An investigation was conducted on a total of 89 measles cases, with 3 deaths and 178 controls. In total, there were 1.65 attacks per 1000 people, or 3.4% of the case fatality rate. There were 155 days of outbreak duration. The disease was significantly associated with being female [adjusted odds ratios (AOR) = 2.66; 95% confidence interval (CI) = 1.38-5.11], under 5 years old [AOR = 7.24; 95% CI = 2.58-20.31], positive in attitude [AOR = 0.22; 95% CI = 0.11-0.42], and having a contact history [AOR = 3.19; 95% CI = 1.67-6.10]. CONCLUSION: The measles outbreak, with its higher attack and case fatality rate, has been influenced by factors like household attitudes, age, sex, contact and travel history and needs to be reduced through early detection, active surveillance, and fostering favorable attitudes towards disease prevention and control.

Predicting the pulse of urban water demand: a machine learning approach to deciphering meteorological influences.

OBJECTIVE: This study delves into the impact of urban meteorological elements-specifically, air temperature, relative humidity, and atmospheric pressure-on water consumption in Kamyaran city. Data on urban water consumption, temperature (in Celsius), air pressure (in hectopascals), and relative humidity (in percent) were used for the statistical period 2017-2023. Various models, including the correlation coefficient, generalized additive models (GAM), generalized linear models (GLM), and support vector machines (SVM), were employed to scrutinize the data. RESULTS: Water consumption increases due to the influence of relative humidity and air pressure when the temperature variable is controlled. Under specific air temperature conditions, elevated air pressure coupled with high relative humidity intensifies the response of water consumption to variations in these elements. Water consumption exhibits heightened sensitivity to high relative humidity and air pressure compared to low levels of these factors. During winter, when a western low-pressure air mass arrives and disrupts normal conditions, causing a decrease in pressure and temperature, urban water consumption also diminishes. The output from the models employed in this study holds significance for enhancing the prediction and management of water resource consumption.

Heterogeneous Trajectories in Post-Disaster Drug Use Across Different Race/Ethnicity and Income Strata: Focus on Natural Hazards During COVID-19.

During the COVID-19 pandemic, climate-related natural hazards, such as wildfires, storms/hurricanes, and others (e.g., earthquakes, tornadoes), further disrupted the normal functioning of US residents. The co-occurrence of natural disasters and COVID-19 created unprecedentedly elevated levels of stress, especially to the racial/ethnic minorities and lower-income households. This study examines how natural disasters related to recreational drug use during COVID-19 and whether the relation is heterogeneous across different subgroups categorized by race/ethnicity and household income. This study used the data from the biweekly online surveys of the Understanding America Study (UAS) and analyzed the drug use behaviors of 966 US adults between April 29 and December 31, 2020. This study found that middle-income adults (household income ranging from $50,000 to $149,999), serving as the reference group, generally exhibited a significant reduction in drug consumption during or after disaster events. However, compared to the middle-income group, White and Black adults with household income lower than $50,000 showed 142% and 88% more frequent drug use when experiencing storms/hurricanes. This disparity widened in the following weeks. Additionally, lower-income Hispanics showed 74% more frequent drug use compared to the middle-income group in the weeks following wildfire incidents. The study's findings shed light on the risk of drug misuse during the co-occurrence of climate and public health crises, emphasizing the disproportionate risk among lower-income racial/ethnic minorities amid the pandemic and natural disasters.

Changes in mixed ethnicity households and neighbourhood transitions in England and Wales.

Conventional explanations of neighbourhood ethnic transitions consider what drives differential growth in ethnic group populations without regard to household composition. We enrich these nonhousehold approaches by using consistent Census data on neighbourhoods and households for England and Wales for 2001, 2011 and 2021 to analyse connections between mixed-ethnicity households and neighbourhood ethnic diversity. We employ a neighbourhood typology of ethnic diversity that identifies neighbourhoods as either low- or moderate-diversity, or high-diversity, where no single ethnic group is in the majority. We focus particularly on White-majority and highly diverse neighbourhoods given the dominance of the former in residential spaces in England and Wales, and because they are the principal source of transitions to highly diverse neighbourhoods. Mixed-ethnicity households have become an increasingly important feature of the ethnic diversification of England and Wales; by 2021, almost 15% of multiperson households were mixed, a growth from 12% in 2011 and 9% in 2001. We find that higher levels of neighbourhood ethnic diversity are associated with higher shares of mixed-ethnicity households. In high-diversity neighbourhoods, for example, around 30% of multiperson households (nearly a quarter of a million households) were ethnically mixed in 2021. Levels of household mixing in moderate-diversity White neighbourhoods were considerably higher than in low-diversity White neighbourhoods. The same is found for diversifying neighbourhoods. Neighbourhoods that become more ethnically diverse were typically home to higher rates of mixed-ethnicity households. Stably moderately diverse White neighbourhoods also had a higher proportion of mixed households. Studies of neighbourhood transition that focus on individuals in neighbourhoods may be missing important processes operating in the intimate spaces of the home. Including this intermediate scale of analysis adds to our understanding of neighbourhood ethnic mixing and processes of integration.

Factors Associated with Participation in Community Supported Agriculture (CSA) among Low-Income Households: A Scoping Review.

Households with limited financial resources often struggle with inadequate access to healthy, affordable food. Community supported agriculture (CSA) has the potential to improve access to fresh fruits and vegetables, yet low-income households seldom participate due to cost and other barriers. Cost-offset (or subsidized) CSA reduces financial barriers, yet engagement varies widely among those who enroll. This scoping review explored factors associated with CSA participation among low-income households in the United States. Eighteen articles met the inclusion criteria, quantitative and qualitative data were extracted, the evidence was synthesized, and themes were developed. The findings suggested that women may be more likely than men to enroll in CSA. A lack of familiarity with CSA may hinder enrollment, whereas more education and self-efficacy for food preparation may facilitate participation. In terms of share contents, high-quality produce, a variety of items, more fruit, a choice of share contents, and a choice of share sizes may facilitate participation. In terms of CSA operations, a low price, good value, acceptance of Supplemental Nutrition Assistance Program (SNAP) benefits, close pick-up locations on existing travel routes, delivery of shares, clear communication, fostering a sense of belonging and trust, and educational support may support participation. Together these findings support 13 recommendations for cost-offset CSA implementation to engage low-income households.

Assessing greywater characteristics in the sahel region and perception of the local population on its reuse in agriculture.

Research on greywater reuse in water stressed areas is in full swing. However, the perception of greywater reuse is one of the least researched areas in West Africa, particularly in Sahelian countries. This study aimed to fills a significant gap in the existing literature, which has largely ignored the specific socio-demographic contexts of developing countries in the Sahelian regions. The study involved in-depth interviews with 240 rural households and the collection of 40 greywater samples in four locations for laboratory analysis. The survey focused on greywater management and household perceptions of greywater reuse in agriculture. The analyses focused on determining the physico-chemical and microbiological parameters of greywater collected from households. The results showed that over 80 % of households discharged greywater into the natural environment without prior treatment. The majority of respondents were aware that poor greywater management poses a health risk. The results also showed an association between locality, gender, education level and perceptions of poor grey water management. Respondents were willing to accept the reuse of greywater in agriculture, to consume irrigated vegetables and to install a greywater treatment system. The quality analysis showed that the greywater was not in compliance with the legal discharge limits. This study highlights that in order to promote sustainable greywater management practices within households, it is important to design effective greywater treatment systems that meet the needs of the target population. Awareness campaigns, education and training programmes on wastewater management could also be established.

Spatial variations and determinants of receiving cash and food from the productive safety net program among households in Ethiopia: spatial clustering and multilevel analyses.

Background: There is a global struggle with food insecurity and undernutrition among women, and Ethiopia has been particularly impacted by these issues. To address this challenge, Ethiopia has implemented a cash and food safety net program over many years. However, there is limited information available regarding the program's factors and spatial distributions, with no recent national evidence from Ethiopia. Consequently, the objective of this study is to investigate the spatial clustering and determinants of the Productive Safety Net Program (PSNP) in Ethiopia. Method: This study utilized data from the Ethiopian Demographic and Health Survey. The sample included 8,570 weighted households. Given the hierarchical nature of the data, a multilevel logistic regression model was employed to identify factors influencing the outcome variable. Geographical clusters of individuals receiving assistance from the PSNP were examined using SaTScan software and the Bernoulli model, along with the Kulldorff methods. The nationwide distribution of the program beneficiaries was visualized using ArcGIS version 10.8. Variables were considered statistically significant if their p-value was <0.05. Results: The overall coverage of the PSNP was 13.54% [95% confidence interval (CI): 12.84-14.29] among households in Ethiopia. The study revealed that people from richer households adjusted odds ratio [AOR = 0.46 (95% CI: (0.33, 0.64))], those from the richest households [AOR = 0.26 (95% CI:(0.17,0.41))], and those with educated household heads [AOR = 0.45 (95% CI:(0.28, 0.71))] have a lower likelihood of utilizing the PSNP compared to their counterparts. Conversely, a unit increase in household heads' age [AOR = 1.02 (95% CI:(1.01, 1.02))] and family size [AOR = 1.05 (95% CI:1.021.10)] showed a higher likelihood of joining the PSNP, respectively. Household heads who have joined community health insurance [AOR = 3.21 (95% CI:(2.58, 4.01))] had significantly higher odds of being included in the PSNP than their counterparts. Heads who belong to a community with a high poverty level [AOR = 2.68 (95% CI:(1.51, 4.79))] and community health insurance [AOR = 2.49 (95% CI:(1.51, 4.11))] showed more inclination to utilize the PSNP compared to their counterparts. Conclusion: PSNP was judged to have a low implementation status based on the findings gathered regarding it. We found factors such as age, sex, region, wealth, education, family size, regions, and health insurance to be statistically significant. Therefore, encouraging women empowerment, community-based awareness creation, and coordination with regional states is advisable.

Absenteeism and Health Behavior Trends Associated With Acute Respiratory Illness Before and During the COVID-19 Pandemic in a Community Household Cohort, King County, Washington.

Introduction: Longitudinal data on how acute respiratory illness (ARI) affects behavior, namely school or work participation, and nonpharmaceutical intervention (NPI) usage before and during the COVID-19 pandemic is limited. The authors assessed how ARIs and specific symptoms affected school, work, and health-related behaviors over time. Methods: From November 2019 to June 2021, participating households with children in King County, Washington, were remotely monitored for ARI symptoms weekly. Following ARIs, participants reported illness-related effects on school, work, and NPI use. Using logistic regression with generalized estimating equations, the authors examined associations between symptoms and behaviors. Results: Of 1,861 participants, 581 (31%) from 293 households reported 884 ARIs and completed one-week follow-up surveys. Compared with the prepandemic period, during the period of the pandemic pre-COVID-19 vaccine, ARI-related school (56% vs 10%, p<0.001) absenteeism decreased and masking increased (3% vs 28%, p<0.001). After vaccine authorization in December 2020, more ARIs resulted in masking (3% vs 48%, p<0.001), avoiding contact with non-household members (26% vs 58%, p<0.001), and staying home (37% vs 69%, p<0.001) compared with the prepandemic period. Constitutional symptoms such as fever were associated with work disruptions (OR=1.91; 95% CI=1.06, 3.43), staying home (OR=1.55; 95% CI=1.06, 2.27), and decreased contact with non-household members (OR=1.58; 95% CI=1.05, 2.36). Conclusions: This remote household study permitted uninterrupted tracking of behavioral changes in families with children before and during the COVID-19 pandemic, identifying increased use of some NPIs when ill but no additional illness-associated work or school disruptions.

High prevalence of SARS-CoV-2 antibodies and low prevalence of SARS-CoV-2 RNA in cats recently exposed to human cases.

BACKGROUND: The primary objective of this cross-sectional study, conducted in Québec and Bristish Columbia (Canada) between February 2021 and January 2022, was to measure the prevalence of viral RNA in oronasal and rectal swabs and serum antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) amongst cats living in households with at least one confirmed human case. Secondary objectives included a description of potential risk factors for the presence of SARS-CoV-2 antibodies and an estimation of the association between the presence of viral RNA in swabs as well as SARS-CoV-2 antibodies and clinical signs. Oronasal and rectal swabs and sera were collected from 55 cats from 40 households at most 15 days after a human case confirmation, and at up to two follow-up visits. A RT-qPCR assay and an ELISA were used to detect SARS-CoV-2 RNA in swabs and serum SARS-CoV-2 IgG antibodies, respectively. Prevalence and 95% Bayesian credibility intervals (BCI) were calculated, and associations were evaluated using prevalence ratio and 95% BCI obtained from Bayesian mixed log-binomial models. RESULTS: Nine (0.16; 95% BCI = 0.08-0.28) and 38 (0.69; 95% BCI = 0.56-0.80) cats had at least one positive RT-qPCR and at least one positive serological test result, respectively. No risk factor was associated with the prevalence of SARS-CoV-2 serum antibodies. The prevalence of clinical signs suggestive of COVID-19 in cats, mainly sneezing, was 2.12 (95% BCI = 1.03-3.98) times higher amongst cats with detectable viral RNA compared to those without. CONCLUSIONS: We showed that cats develop antibodies to SARS-CoV-2 when exposed to recent human cases, but detection of viral RNA on swabs is rare, even when sampling occurs soon after confirmation of a human case. Moreover, cats with detectable levels of virus showed clinical signs more often than cats without signs, which can be useful for the management of such cases.

Rural households' resilience to the adverse impacts of climate variability and food insecurity in the North-eastern highlands of Ethiopia.

Climate variability and food insecurity shocks frequently affect the livelihood of rural households. Therefore, understanding the fundamentals of resilience is essential for enhancing the capabilities of vulnerable households. The objective of this study was to analyze rural households' resilience to the adverse impacts of climate variability and food insecurity in the North-eastern highlands of Ethiopia. Based on a cross-sectional survey, both probability and non-probability sampling procedures were employed to select sample respondents, key informants and focus group discussants. Principal Component Analysis (PCA), one-way ANOVA and linear regression modeling were used to analyze the data. The results indicated that perceptions of climatic variability, agricultural assets, adaptive capacity and income and food access are the four resilience dimensions with the largest contribution to households' resilience. Likewise, social capital and access to basic services were the next positive contributors. However, agricultural technology adoption and social safety nets were insignificant contributors. Moreover, households living in the Meher livelihood zone/LHZ/were highly resilient followed by ABB and Meher-belg. On the other hand, respondents in the SWS, CHV and Belg LHZs were less resilient. Male-headed households, household heads with formal education and married households were found to be more resilient than their counterparts. The study found that 50.4 % of the respondents were non-resilient and 45.5 % were highly resilient. In conclusion, the adverse impacts of climate-related hazards associated with the existing food insecurity have deteriorated the resilience capacity of rural households by which they became highly vulnerable and could be easily exposed to shocks. The study suggested that unless well-planned intervention is implemented many households might quickly lose their resilience status to worse even by a very little shock. Moreover, enhancing capability aspects should be the primary goal of any interventions aimed at increasing households' resilience in drought-prone areas in general and the study area in particular.

Awareness and use of improved livestock feed technologies among agro-pastoral households in the West African Sahel.

Seasonal scarcity of quality feed continues to be a bottleneck for agro-pastoralists and is the most important limitation to livestock production in agro-pastoral systems in the West African Sahel. In this regard, diverse promising technologies to increase the production and availability of quality feed have been introduced. Despite the introduction of various feed technologies in the region, the adoption rate by smallholder farmers is very low. The objective of this study was to identify factors affecting the likelihood of using improved livestock feed technologies among agro-pastoral households in two regions of Niger. A logit model was employed using data collected from randomly selected 218 agro-pastoral households between February and April 2023. The study revealed low awareness and use of improved livestock feed technologies among agro-pastoral households. The findings suggested the positive impact of education level, membership of farmer groups and ownership of small ruminant on enhancing the probability of using improved livestock feed technologies. Households' geographical area was one of the determinant factors in using improved livestock feed technologies. The use of improved livestock feed technologies was also influenced by family size. The study provides guidance to inform strategies by the decision-makers to enhance the utilization of improved livestock feed technologies among agro-pastoral households in the West African Sahel. Suggested strategies may in turn alleviate the current problem of low productivity of livestock, contribute to improving household food security and nutrition among agro-pastoral communities.

Unraveling diarrheal disease knowledge, understanding, and management practices among climate change vulnerable coastal communities in Ghana.

Introduction: Diarrheal disease is a global public health concern, particularly in low-income countries. In Ghana, widespread issues like inadequate sanitation, unsafe drinking water, malnutrition, and poor hygiene practices contribute to the high incidence of diarrhea. Climate change exacerbates these challenges by increasing the frequency and severity of conditions that spread diarrheal diseases. This study explores households' knowledge, understanding, and management practices for diarrhea in climate change-vulnerable coastal communities. Methods: The study is set in Ghana's central (Mumford, Opetekwei) and eastern (Anyako, Anyanui-Atiteti) coastlines. Using a cross-sectional study design, a structured questionnaire was administered to randomly sampled households (n = 419) to collect quantitative data. The study collected qualitative data from focus group discussions (n = 8), with groups separated into men and women, key informant interviews, and observations of food, water, and sanitation conditions across the studied communities. Results and discussion: The study found significant variations between the studied communities and socio-demographic variables except for the respondents' gender. Multivariate regression analyses identified significant associations between socio-demographic variables (especially gender and educational status) and perceptions of diarrhea causes. The most used first management action against diarrhea is 'over-the-counter drugs', followed by home-made traditional remedies. Significant differences were observed in the usage of management practices across the studied communities. Trust, affordability, and availability were identified as the main factors influencing households' use of approved pharmaceutical drugs and traditional herbal remedies for managing behavior, with significant differences being observed across communities. The study recommends a multi-sectoral approach, including improved access to regularly flowing, safe water and sanitation facilities, education on preventing diarrhea, and adequate healthcare services. Community-based interventions such as promoting good hygiene practices at homes and community settings such as schools, lorry parks, funeral grounds, and recreational areas can also effectively reduce the burden of diarrhea.

Improving urban waste management: A comprehensive study on household waste generation and spatial patterns in the Grand Guayaquil Metropolitan Area.

This study tackles the growing global concern about municipal waste management, particularly in cities like the Grand Guayaquil Metropolitan Area (GGA). Through realistic field studies on in situ household waste generation and geographic information system (GIS) tools, this work offers a framework to predict the quantities and types of recyclable household waste for any metropolitan area in Latin America. Over 4 weeks, students collected, sorted and weighed recyclable waste types, including plastic, paper, metal, glass and fabric, from 776 sampled household of the GGA. ArcGIS survey tool identified household locations and allowed to survey different socio-demographic features. With the help of ArcGIS interpolation method, the total household waste generation for GGA was predicted, and the classification of the different types of recyclable waste was also spatially distributed for the study area. The report identified notable trends in plastic waste, specifically polyethylene terephthalate waste's steady prevalence and 42% growth rate, emphasizing the importance of enhanced recycling techniques. Spatial density maps showed a heterogeneous waste distribution across the GGA, emphasizing locations with higher waste output. This study demonstrates that improving recyclable waste collection can be accomplished with a moderately cheap expenditure by collaborating with academia to overcome knowledge gaps. This strategy provides opportunities to mitigate the environmental impacts of poor waste management.

Heavy metal concentrations in drinking water sources in two mining districts in Ghana.

- In Ghana, mining of minerals at small-scale and large-scale is widespread across many districts, leading to significant heavy metal pollution in the environment. In this study, the concentrations of iron (Fe), manganese (Mn), arsenic (As), and mercury (Hg) in the different drinking water samples collected from households, institutions, water points and surface water in two mining districts namely the Wassa East and Asutifi North were analyzed. The water types collected included boreholes, wells, piped water into yards, public standpipes, rainwater, sachet water, and surface water. The results indicated that the levels of Fe and Mn were higher than As and Hg in all the drinking water samples. The levels of As and Hg in drinking water from households and institutions were higher in the Wassa East district compared to the Asutifi North district. However, the metal levels at water points were similar in both districts. In surface water, Fe levels were higher in the Wassa East district compared to the Asutifi North district with median values of 1243 µg/L and 860 µg/L for the Wassa East and Asutifi North districts, respectively. In contrast, the Mn levels were higher in the Asutifi North district than the Wassa East district with median values of 9.5 µg/L and 90 µg/L for Wassa East and Asutifi North districts, respectively. All the metals (Mn, As, and Hg) studied except Fe were within the recommended WHO level. The Heavy Metal Pollution Index (HPI) values for the different water types in households, institutions and water points were all below the critical limit of 100. The Water Quality Index (WQI) indicates that the boreholes, piped water into yards, and public standpipes in both districts were classified as excellent or good, making them suitable for drinking. However, the wells and surface water in both districts were classified as very poor and unfit for drinking, respectively.

Evaluating the Association of the Increase in the WIC Cash Value Benefit on the Diversity of MyPlate Fruits and Vegetables Redeemed and Consumed By Children in Low-Income Households.

Background: Fruits and vegetables (FV) are a critical source of nutrients, yet children in the United States are not meeting the Dietary Guidelines for Americans (DGA). The monthly FV cash value benefit (CVB) included in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)'s food package to support child FV intake (FVI) received a substantial increase for economic relief during the COVID-19 pandemic. Objectives: To evaluate how an expansion of the monthly WIC CVB to purchase FV for WIC children ages 1-4 y is associated with diversity in FV redeemed, and how changes in redeemed FV are related to FVI. Methods: Caregivers representing 1463 WIC-participating children recruited from Los Angeles County, California, completed surveys during the CVB augmentation (T1: CVB = $9/mo; T2 = $35/mo; T3 = $24/mo). Redeemed price look-up codes (PLUs), corresponding to a food item, were assigned to its corresponding MyPlate FV group. Multivariable generalized estimating equation regression models assessed changes in amount and diversity of FV redemption across MyPlate groups and associations between changes in FV diversity and changes in FVI. Results: Slightly over half of all households were food insecure (55%), half of the children were female (52%), and most were Hispanic (78%). Compared with T1, significant increases in the number of PLUs and dollars redeemed were observed in most MyPlate FV groups. From T1 to T2, significant increases in diversity scores were observed for total fruit (ß: 1.6 pts; 95% confidence interval [CI]: 1.4, 1.7), total vegetable (ß: 3.6 pts; 95%CI: 3.4, 3.9), and total FV (ß:7.8 pts; 95%CI: 7.4, 8.2). Similarly, increases in diversity score were observed at T3 compared with T1. Changes in FV diversity redeemed were not associated with changes in FVI. Conclusions: During the CVB augmentation, WIC participants redeemed a greater amount and variety of FV according to DGA MyPlate recommendations, supporting its permanent increase.

New Evidence From Census 2020 on the Residential Segregation of Same-Sex Households: A Research Note.

The 2020 decennial census provides new insights into the demography of same-sex households and can shed light on ongoing debates in urban and gayborhood studies. Although the U.S. Census gives a vast undercount of the LGBTQ population, it is still the largest source of nationally representative data on same-sex households and is accessible over three time points (2000, 2010, 2020). In this research note, we use 2020 census data to examine the residential patterns of same-sex households down to the neighborhood level. By employing the index of dissimilarity, we present results for the 100 largest U.S. cities and 100 largest metropolitan areas that demonstrate moderate yet persistent segregation. In a continuation of prior trends, male same-sex households remain more segregated from different-sex households than do female same-sex households. We find moderate levels of within-group segregation by gender and marital status-representing new demographic trends. Finally, metropolitan areas have a higher dissimilarity index than cities, revealing greater levels of segregation when factoring in suburban areas. We discuss these trends in light of debates regarding the spatial organization of sexuality in residential contexts and outline future avenues for research utilizing recently released 2020 census data.

The role of social capital in the impact of multiple shocks on households' coping strategies in underdeveloped rural areas.

Social capital has long been recognized as a facilitator of socio-economic development. However, the role of social capital in enhancing resilience to multiple shocks in rural China remains insufficiently explored. This study focus on the resilience of households that have recently get rid of poverty and reside in underdeveloped rural areas of China. Unlike previous studies, the article incorporates multiple shocks, social capital, and households' coping strategies into a research framework at the micro level. This study systematically analyses the multiple shocks experienced by households, their coping strategies, and further explores the mediating role of social capital. Utilizing two waves of a rural household panel survey data collected in six underdeveloped counties in 2015 and 2018 in China, we present four key findings. Currently, households primarily contend with drought, illness of family members, and the high costs of agricultural inputs as the main shocks. Their predominant coping strategy is reducing consumption. Importantly, social capital exhibits a mediating effect, accounting for 9.8% of the impact of multiple shocks on households' coping strategies. Notably, natural disasters significantly diminish the informal functions of social capital. While social capital exerts a full mediating effect in non-agricultural households, this effect is not observed among others. This study contributes to a better understanding of the dynamics and specificities of social capital in vulnerable rural areas. Additionally, the findings provide policymakers with practical insights regarding differentiated and preemptive risk governance approaches.

Spatial distribution and geographical heterogeneity factors associated with households' enrollment level in community-based health insurance.

Background: Healthcare service utilization is unequal among different subpopulations in low-income countries. For healthcare access and utilization of healthcare services with partial or full support, households are recommended to be enrolled in a community-based health insurance system (CBHIS). However, many households in low-income countries incur catastrophic health expenditure. This study aimed to assess the spatial distribution and factors associated with households' enrollment level in CBHIS in Ethiopia. Methods: A cross-sectional study design with two-stage sampling techniques was used. The 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) data were used. STATA 15 software and Microsoft Office Excel were used for data management. ArcMap 10.7 and SaTScan 9.5 software were used for geographically weighted regression analysis and mapping the results. A multilevel fixed-effect regression was used to assess the association of variables. A variable with a p < 0.05 was considered significant with a 95% confidence interval. Results: Nearly three out of 10 (28.6%) households were enrolled in a CBHIS. The spatial distribution of households' enrollment in the health insurance system was not random, and households in the Amhara and Tigray regions had good enrollment in community-based health insurance. A total of 126 significant clusters were detected, and households in the primary clusters were more likely to be enrolled in CBHIS. Primary education (AOR: 1.21, 95% CI: 1.05, 1.31), age of the head of the household >35 years (AOR: 2.47, 95% CI: 2.04, 3.02), poor wealth status (AOR: 0.31, 95% CI: 0.21, 1.31), media exposure (AOR: 1.35, 95% CI: 1.02, 2.27), and residing in Afar (AOR: 0.01, 95% CI: 0.003, 0.03), Gambela (AOR: 0.03, 95% CI: 0.01, 0.08), Harari (AOR: 0.06, 95% CI: 0.02, 0.18), and Dire Dawa (AOR: 0.02, 95% CI: 0.01, 0.06) regions were significant factors for households' enrollment in CBHIS. The secondary education status of household heads, poor wealth status, and media exposure had stationary significant positive and negative effects on the enrollment of households in CBHIS across the geographical areas of the country. Conclusion: The majority of households did not enroll in the CBHIS. Effective CBHIS frameworks and packages are required to improve the households' enrollment level. Financial support and subsidizing the premiums are also critical to enhancing households' enrollment in CBHIS.

Prevalence and determinants of multiple chronic conditions (MCC) among young adults in Indian households: an analysis of NFHS-5.

BACKGROUND: Multiple chronic conditions (MCC) are defined as the presence of two or more chronic conditions, that significantly impact health status, functional capacity, quality of life, and overall healthcare management. Despite the significant evidence on chronic disease burden, the co-existence of MCC within a household in low- and middle-income countries (LMICs) is less studied. This study therefore estimates the prevalence of MCC and its determinants among adults in the Indian households. METHODS: Data used in this study were drawn from the fifth round of the National Family Health Survey (NFHS) conducted in 2019-21. Data sets of men (15-54 years) and women (15-49 years) were used for the study. The total sample size of adults for this analysis was N = 239,848. The outcome variable of this study was multiple chronic conditions (MCC) in adults which included a total of nine chronic conditions (hypertension, diabetes, chronic respiratory diseases, chronic kidney disorders, cancer, thyroid disorders, obesity, and heart diseases, consuming alcohol, chewing tobacco, and smoking) documented in NFHS-5. Descriptive statistics and binary logistic regression analysis were used to quantify the results. RESULTS: A prevalence of 5.5% of MCC in adults emerged from our study. Logistic regression analysis identified that younger age, males (AOR 0.36 (0.33-0.39)), urban areas (AOR 1.11 (1.02-1.17)) as the place of residence, and participants representing SC (AOR 0.89 (0.81-0.97)), and ST (AOR 1.30 (1.17-1.45)), had a higher risk of MCC irrespective of level of education, type of occupation, marital status, or wealth index, and states from any category of social progress. CONCLUSION: A 5% prevalence of MCC specifically obesity, substance use, and hypertension calls for integrated efforts aiming at behavior change, and regulatory efforts to prevent further increase of MCC among young adults in India.

An analysis of the vulnerability of informal and formal households to disaster risks in the Rand West City region.

This study aimed to compare how vulnerable informal and formal households are to disaster risks in Bekkersdal mining area in the Rand West City municipality, using a mixed method. A qualitative approach was used to construct a situational analysis of the community, while a questionnaire was used to collect descriptive data. Findings showed both household types (formal and informal) experienced disaster-related risks as their coping resources are limited. Disaster risks such as mining-related incidents (dust, earth tremors and windstorms) are more significant in the informal areas than in formal areas because of their geographical locations. The latter are located in high density areas, with limited access to basic services. Resulting in among others, construction of illegal informal areas and use of illegal electricity connections. These disaster incidents occur against the backdrop of an already vulnerable dolomitic environment that tends to form sinkholes. Thus, the negative impact of mining is the highest disaster risk factor in the area, yet households seem tolerant and distant as they perceive mining as a job opportunity. The study recommended the municipality to include disaster risks in their integrated development plans to ensure that sustainable mining practices are in place to minimise the negative effects in the area. The rehabilitation of mines, measures to prevent informal construction or illegal occupation, and educational awareness on mitigation and adaptation measures are necessary. Contribution: The study adds to the body of knowledge by revising some old techniques of addressing disaster risk measures, especially in surrounding mining communities.