Remittances and food security in Bangladesh: an empirical country-level analysis.

OBJECTIVE: To examine the association between remittances and food security in Bangladesh, controlling for other key factors. DESIGN: The secondary data analysis was performed on the most recent (2016) nationally representative Household Income and Expenditure Survey. We used logistic regression models to measure the association between food security of the household and remittances received. The household food security was measured based on expenditure on food items and the energy intake of the household members. The key explanatory variables included the receipt of remittances by the household and household-level socio-economic characteristics. SETTING: Bangladesh. PARTICIPANTS: Totally, 45 977 households across seven divisions of Bangladesh. RESULTS: Findings suggested that remittances have a significant positive effect on food security. Further, the households with female heads were significantly more likely to be food insecure. The wealth status and geographical locations were significantly associated with food security status in Bangladesh. CONCLUSIONS: The findings highlight the importance of considering remittance as one of the key factors, while stakeholders implement nutritional interventions in Bangladesh and other low-income settings. Future research should consider this as an important determinant while further examining food security in such settings.

Climatic factors influence the spread of COVID-19 in Russia.

The study is the first attempt to assess the role of climatic predictors in the rise of COVID-19 intensity in the Russian climatic region. The study used the Random Forest algorithm to understand the underlying associations and monthly scenarios. The results show that temperature seasonality (29.2 ± 0.9%) has the highest contribution for COVID-19 transmission in the humid continental region. In comparison, the diurnal temperature range (26.8 ± 0.4%) and temperature seasonality (14.6 ± 0.8%) had the highest impacts in the sub-arctic region. Our results also show that September and October have favorable climatic conditions for the COVID-19 spread in the sub-arctic and humid continental regions, respectively. From June to August, the high favorable zone for the spread of the disease will shift towards the sub-arctic region from the humid continental region. The study suggests that the government should implement strict measures for these months to prevent the second wave of COVID-19 outbreak in Russia.

Climatic influence on the magnitude of COVID-19 outbreak: a stochastic model-based global analysis.

We investigate the climatic influence on COVID-19 transmission risks in 228 cities globally across three climatic zones. The results, based on the application of a Boosted Regression Tree algorithm method, show that average temperature and average relative humidity explain significant variations in COVID-19 transmission across temperate and subtropical regions, whereas in the tropical region, the average diurnal temperature range and temperature seasonality significantly predict the infection outbreak. The number of positive cases showed a decrease sharply above an average temperature of 10°C in the cities of France, Turkey, the US, the UK, and Germany. Among the tropical countries, COVID-19 in Indian cities is most affected by mean diurnal temperature, and those in Brazil by temperature seasonality. The findings have implications on public health interventions, and contribute to the ongoing scientific and policy discourse on the complex interplay of climatic factors determining the risks of COVID-19 transmission.

Health workforce demography: a framework to improve understanding of the health workforce and support achievement of the Sustainable Development Goals.

The ambition of universal health coverage entails estimation of the number, type and distribution of health workers required to meet the population need for health services. The demography of the population, including anticipated or estimated changes, is a factor in determining the 'universal' needs for health and well-being. Demography is concerned with the size, breakdown, age and gender structure and dynamics of a population. The same science, and its robust methodologies, is equally applicable to the demography of the health workforce itself. For example, a large percentage of the workforce close to retirement will impact availability, a geographically mobile workforce has implications for health coverage, and gender distribution in occupations may have implications for workforce acceptability and equity of opportunity. In a world with an overall shortage of health workers, and the expectation of increasing need as a result of both population growth in the global south and population ageing in the global north, studying and understanding demographic characteristics of the workforce can help with future planning. This paper discusses the dimensions of health worker demography and considers how demographic tools and techniques can be applied to the analysis of the health labour market. A conceptual framework is introduced as a step towards the application of demographic principles and techniques to health workforce analysis and planning exercises as countries work towards universal health coverage, the reduction of inequities and national development targets. Some illustrative data from Nepal and Finland are shown to illustrate the potential of this framework as a simple and effective contribution to health workforce planning.

Catastrophic healthcare expenditure and impoverishment in tropical deltas: evidence from the Mekong Delta region.

BACKGROUND: Universal health coverage implies that people obtain the health services they need without experiencing financial hardship. While the factors contributing to catastrophic health expenditure (CHE) among households are well understood, few studies have examined this relationship in the context of environmentally vulnerable regions, such as tropical deltas. This study aims to examine the disparities in the prevalence of CHE and impoverishment due to out-of-pocket (OOP) healthcare payments in the Mekong Delta in comparison with rest of Vietnam. It also intends to investigate the associations between economic and environmental shocks, CHE and the impoverishment from healthcare payments. METHODS: Using data from the Vietnam Household Living Standards Survey 2012, the prevalence of CHE was estimated from the fraction of healthcare costs in relation to household consumption expenditure. The poverty headcount was estimated using the total household consumption expenditure considering both with and without OOP expenditure for healthcare in comparison with the national poverty-line. Simple and multiple logistic regression models were used to examine the associations between geography, health systems, environmental and demographic variables and OOP healthcare expenditure related CHE, and impoverishment respectively. RESULTS: Both the level of OOP household healthcare expenditure and the proportion of households suffering from impoverishment as the result of such payments were higher in the Mekong Delta region compared to rest of Vietnam. Although the results from the multiple regression analysis showed that households in the Mekong Delta region were significantly less likely to suffer from CHE, they were significantly more likely to be impoverished due to OOP healthcare expenditure. While health insurance membership did not have a significant effect on either outcomes, households that faced an economic or an environmental shock in past 5 years were considerably more likely to suffer from CHE and impoverishment from OOP healthcare payments. CONCLUSIONS: The findings suggest that the financial protection capacity of health insurance schemes in Vietnam should be improved and expanded to reduce impoverishment as the result of OOP healthcare payments, particularly in the Mekong Delta region. Additional investments in disaster preparedness strategies can further help to reduce the financial burden of households in this environmentally vulnerable region.

Causes and consequences of tipping points in river delta social-ecological systems.

The sustainability of social-ecological systems within river deltas globally is in question as rapid development and environmental change trigger "negative" or "positive" tipping points depending on actors' perspectives, e.g. regime shift from abundant sediment deposition to sediment shortage, agricultural sustainability to agricultural collapse or shift from rural to urban land use. Using a systematic review of the literature, we show how cascading effects across anthropogenic, ecological, and geophysical processes have triggered numerous tipping points in the governance, hydrological, and land-use management of the world's river deltas. Crossing tipping points had both positive and negative effects that generally enhanced economic development to the detriment of the environment. Assessment of deltas that featured prominently in the review revealed how outcomes of tipping points can inform the long-term trajectory of deltas towards sustainability or collapse. Management of key drivers at the delta scale can trigger positive tipping points to place social-ecological systems on a pathway towards sustainable development.

Evaluating Research for Development: Innovation to Navigate Complexity.

Large publicly funded programmes of research continue to receive increased investment as interventions aiming to produce impact for the world's poorest and most marginalized populations. At this intersection of research and development, research is expected to contribute to complex processes of societal change. Embracing a co-produced view of impact as emerging along uncertain causal pathways often without predefined outcomes calls for innovation in the use of complexity-aware approaches to evaluation. The papers in this special issue present rich experiences of authors working across sectors and geographies, employing methodological innovation and navigating power as they reconcile tensions. They illustrate the challenges with (i) evaluating performance to meet accountability demands while fostering learning for adaptation; (ii) evaluating prospective theories of change while capturing emergent change; (iii) evaluating internal relational dimensions while measuring external development outcomes; (iv) evaluating across scales: from measuring local level end impact to understanding contributions to systems level change. Taken as a whole, the issue illustrates how the research for development evaluation field is maturing through the experiences of a growing and diverse group of researchers and evaluators as they shift from using narrow accountability instruments to appreciating emergent causal pathways within research for development.

Les grands programmes de recherche financés par des fonds publics continuent de recevoir des investissements accrus en tant qu'interventions visant à produire un impact pour les populations les plus pauvres et les plus marginalisées dans le monde. À cette intersection entre la recherche et le développement, la recherche devrait contribuer aux processus complexes de changement sociétal. Pour adopter une vision coconstruite de l'impact comme phénomène émergeant au fil de liens de causalité incertains, bien souvent sans résultats prédéfinis, il faut innover en utilisant des approches d'évaluation sensibles à la complexité. Les articles de ce numéro spécial présentent de riches expériences d'auteurs travaillant dans différents secteurs et zones géographiques, employant l'innovation méthodologique et le pouvoir de navigation tout en réconciliant les tensions. Ils illustrent les défis lorsqu'il s'agit (i) d'évaluer des performances pour répondre aux exigences de redevabilité tout en favorisant l'apprentissage pour l'adaptation; (ii) d'évaluer les théories prospectives du changement tout en saisissant le changement émergent; (iii) d'évaluer les dimensions relationnelles internes tout en mesurant les résultats de développement externes; (iv) d'évaluer à différentes échelles: de la mesure de l'impact final au niveau local à la compréhension des contributions au changement au niveau des systèmes. Pris dans son ensemble, ce numéro illustre la façon dont l'évaluation de la recherche pour le développement mûrit à travers les expériences d'un groupe toujours plus important et divers de chercheurs et d'évaluateurs qui abandonnent des outils de redevabilité étriqués afin d'apprécier les liens de causalité émergents au sein de la recherche pour le développement.

Evaluating the Contribution of Complex International Research-for-Development Programmes to the Sustainable Development Goals.

While evaluation of research-to-policy projects is a fundamental aspect of measuring the impact of new knowledge, limited studies have examined evaluation methods in such projects, as well as how the evaluation can generate learning to facilitate the progress towards the Sustainable Development Goals (SDGs). This study conducted a systematic literature review and found that the most commonly used methods for SDG contribution evaluation were Analytical Hierarchy Process (40.4%), Fuzzy TOPSIS (13.2%) and ELECTRE and SPADE Methodology (3.5% each). Ranking analysis was undertaken to determine priorities among the six "Big Wins" as defined for the UKRI-GCRF Trade Hub Project, as a case, where the ranking was exercised by the project partners across the globe. Results revealed that "nature and social factors" was better considered in international trade agreements as the priority (36.4%) among others. Moreover, among the four "mechanisms" of the project, "knowledge, networks, and connectivity" was ranked as the top priority (56.9%), followed by "capacity building" (28.5%), "metrics, tools and models" (7.2%), and "improving the knowledge base" (4.6%). Mapping and evaluation revealed that the Big Wins of the Trade Hub contributed to ten out of the 17 SDGs. The most fulfilled goals were SDG 12 (Sustainable Consumption and Production), SDG 15 (Life on Land), and SDG 2 (Zero Hunger) in descending order. Furthermore, interaction analysis of the core SDGs revealed both synergy and tradeoff between different outputs. The research articles reviewed for this paper showed no gold standard framework for assessing international development projects against the SDGs. Further research should develop a tool to capture holistic and synergistic contributions of the target outcomes of projects to sustainable development.

Bien que l'évaluation des projets sur le lien entre recherche et politique soit un aspect fondamental de la mesure de l'impact des nouvelles connaissances, peu d'études ont examiné les méthodes d'évaluation de tels projets, ainsi que la manière dont l'évaluation peut générer un apprentissage pour faciliter la progression vers les objectifs de développement durable (ODD). Cette étude a mené une revue systématique de la littérature et a constaté que les méthodes les plus couramment utilisées pour l'évaluation de la contribution aux ODD étaient le processus d'analyse hiérarchique (40,4%), la méthode TOPSIS floue (13,2%), et les méthodes ELECTRE et SPADE (3,5% chacune). Une analyse par classement a été entreprise pour déterminer les priorités parmi les six « Grands Succès¼ tels que définis pour le projet UKRI-GCRF Trade Hub, par exemple, où le classement a été réalisé par les partenaires du projet à travers le monde. Les résultats ont révélé que les « facteurs naturels et sociaux¼ étaient mieux considérés dans les accords commerciaux internationaux comme la priorité (36,4%), parmi d'autres. De plus, parmi les quatre « mécanismes¼ du projet, « les connaissances, les réseaux et la connectivité¼ ont été classés comme la première priorité (56,9%), suivis du « renforcement des capacités¼ (28,5%), « les mesures, les outils et les modèles¼ (7,2%) et « améliorer la base de connaissances¼ (4,6%). La cartographie et l'évaluation ont révélé que les Grands Succès du projet Trade Hub ont contribué à dix des 17 ODD. La contribution aux objectifs était la plus importante, par ordre décroissant, pour l'ODD 12 (Consommation et production durables), l'ODD 15 (Vie terrestre) et l'ODD 2 (Faim zéro). En outre, l'analyse des interactions des principaux ODD a révélé à la fois une synergie et un compromis entre les différents produits. Les études examinées pour cet article n'ont montré aucun cadre de référence pour évaluer les projets de développement international par rapport aux ODD. Des études supplémentaires devraient être conduites pour développer un outil permettant de mesurer les contributions holistiques et synergiques des résultats cibles des projets au développement durable.

Global food security in the context of COVID-19: A scenario-based exploratory analysis.

This study highlights the major players in the global food balance, potential implications of COVID-19 on global food supply, and SDG-2 (zero hunger). It found that developing countries, fifteen from Africa followed by ten from Latin America, six from Oceania, and four from Asia, are the most vulnerable to changes cereal supply shocks. It concludes that the current pandemic is likely to cause transitory food insecurity across such vulnerable countries. The effects of the pandemic on food security (SDG-2) may persist longer as a combined effect of economic slowdown and increase in poverty, limiting food supply and access beyond 2020.

Food insecurity among senior citizens in high out-migration areas: evidence from Western Nepal.

BACKGROUND: Food insecurity is a critical public health challenge, particularly in low- and middle-income countries such as Nepal. The demographic transition has resulted in a growing population of senior citizens. However, the determinants of food insecurity among Nepali senior citizens remain unknown. This study aims to fill this gap by assessing food insecurity among the older populations in the far-western region, one of the poorest regions of the country. Further, we also aim to assess the potential association between adult children's migration and the food insecurity status of the left behind older parents. METHODS: A community-based cross-sectional study was conducted among 260 randomly selected senior citizens in the Kanchanpur district in far-western Nepal. The short form of the household food security scale, originally developed by the United States Department of Agriculture, was used to measure household food security. Associations were examined by logistic regression. RESULTS: The prevalence of food insecurity in senior citizens' households was 41.1%. Senior citizen households with their adult children's migration (AOR = 0.47, 95% CI: 0.24-0.95) had lower odds of being food insecure whereas households with lower family income (<$100 compared to ≥ $100) had two times higher odds of being food insecure (AOR = 2.26, 95% CI: 1.08-4.76). Also, households owning a cultivable land/farm (AOR = 0.14, 95% CI: 0.05-0.40), primary source of income as service/pension (AOR = 0.26, 95% CI: 0.08-0.89) or business (AOR = 0.15, 95% CI: 0.03-0.59) and participants who received geriatric allowances (AOR = 0.05, 95% CI = 0.01-0.16) had lower odds of being food insecure. CONCLUSION: The prevalence of food insecurity among households with a senior citizen in Kanchanpur district was high and associated with the migration status of adult children, and household socioeconomic status. This calls for a greater policy response focused specifically on households with older adults and the integration of gerontological evidence into the existing food security and nutrition strategies.

Factors associated with newborn care knowledge and practices in the upper Himalayas.

BACKGROUND: Globally, neonatal deaths remain a major public health challenge and account for the majority of deaths occurring among children under five years of age. Despite Nepal's significant achievements in meeting the maternal and child health targets of the Millennium Development Goals, an estimated 23,000 Nepalese children under five years die every year, with three out of five babies dying within the first 28 days of life. This study therefore aimed to examine the level of knowledge and practices of newborn care among Nepalese mothers in the upper Himalayas and the factors associated with these. MATERIALS AND METHODS: A community based cross-sectional study was conducted among 302 randomly selected mothers with children under two years of age in Tripurasundari Municipality of Dolpa district, an upper Himalayan region of Nepal. Mothers were interviewed using semi-structured questionnaires. Mean score for knowledge and Bloom's criteria for practice were considered to categorize newborn care knowledge and practices. Multivariate logistic regression was used to identify factors associated with the newborn care knowledge and practices. RESULTS: In this study, 147 (48.7%) of the mothers were found to have inadequate knowledge of newborn care, while 102 (33.8%) mothers had reported unsatisfactory newborn care practices. Mothers with at least secondary level of formal education were more likely to possess adequate newborn care knowledge compared to mothers who never attended school (AOR 4.93 at 95% CI 1.82-13.33). Mothers whose first pregnancy occurred between the ages of 20-24 years (AOR 3.89 at 95% CI 1.81-8.37) were also more likely to possess adequate newborn care knowledge, compared to mothers with a younger age at first pregnancy. Furthermore, mothers who had completed at least four ANC visits (AOR 2.89 at 95% CI 1.04-7.96), mothers who had completed three PNC visits (AOR 2.79 at 95% CI 1.16-6.72) and mothers who reported that their nearest health facility was less than one hour (30-59 minutes) walking distance (AOR 3.66 at 95% CI 1.43-9.33) had higher odds of having adequate newborn care knowledge. Similarly, mothers whose household monthly income was more than $100 (AOR 4.17 at 95% CI 1.75-9.69), mothers who had completed three PNC visits (AOR 3.27 at 95% CI 1.16-9.20) and mothers with adequate newborn care knowledge (AOR 15.35 at 95% CI 5.82-40.47) were found to be more likely to practice a satisfactory level of newborn care practices in adjusted analysis. CONCLUSION: The study revealed high prevalence of inadequate newborn care and knowledge amongst mothers in upper Himalayan dwellings. Approximately one third of all interviewed mothers practiced suboptimal newborn care. The results indicate an urgent need to increase awareness of neonatal services available to mothers and to prioritize investments by local governments in neonatal health services, in order to improve accessibility and quality of care for mothers and newborns.

Soil salinity, household wealth and food insecurity in tropical deltas: evidence from south-west coast of Bangladesh.

As a creeping process, salinisation represents a significant long-term environmental risk in coastal and deltaic environments. Excess soil salinity may exacerbate existing risks of food insecurity in densely populated tropical deltas, which is likely to have a negative effect on human and ecological sustainability of these regions and beyond. This study focuses on the coastal regions of the Ganges-Brahmaputra delta in Bangladesh, and uses data from the 2010 Household Income and Expenditure Survey and the Soil Resource Development Institute to investigate the effect of soil salinity and wealth on household food security. The outcome variables are two widely used measures of food security: calorie availability and household expenditure on food items. The main explanatory variables tested include indicators of soil salinity and household-level socio-economic characteristics. The results of logistic regression show that in unadjusted models, soil salinisation has a significant negative effect on household food security. However, this impact becomes statistically insignificant when households' wealth is taken into account. The results further suggest that education and remittance flows, but not gender or working status of the household head, are significant predictors of food insecurity in the study area. The findings indicate the need to focus scholarly and policy attention on reducing wealth inequalities in tropical deltas in the context of the global sustainable deltas initiative and the proposed Sustainable Development Goals.

Population dynamics, delta vulnerability and environmental change: comparison of the Mekong, Ganges-Brahmaputra and Amazon delta regions.

Tropical delta regions are at risk of multiple threats including relative sea level rise and human alterations, making them more and more vulnerable to extreme floods, storms, surges, salinity intrusion, and other hazards which could also increase in magnitude and frequency with a changing climate. Given the environmental vulnerability of tropical deltas, understanding the interlinkages between population dynamics and environmental change in these regions is crucial for ensuring efficient policy planning and progress toward social and ecological sustainability. Here, we provide an overview of population trends and dynamics in the Ganges-Brahmaputra, Mekong and Amazon deltas. Using multiple data sources, including census data and Demographic and Health Surveys, a discussion regarding the components of population change is undertaken in the context of environmental factors affecting the demographic landscape of the three delta regions. We find that the demographic trends in all cases are broadly reflective of national trends, although important differences exist within and across the study areas. Moreover, all three delta regions have been experiencing shifts in population structures resulting in aging populations, the latter being most rapid in the Mekong delta. The environmental impacts on the different components of population change are important, and more extensive research is required to effectively quantify the underlying relationships. The paper concludes by discussing selected policy implications in the context of sustainable development of delta regions and beyond.

Agricultural livelihoods in coastal Bangladesh under climate and environmental change--a model framework.

Coastal Bangladesh experiences significant poverty and hazards today and is highly vulnerable to climate and environmental change over the coming decades. Coastal stakeholders are demanding information to assist in the decision making processes, including simulation models to explore how different interventions, under different plausible future socio-economic and environmental scenarios, could alleviate environmental risks and promote development. Many existing simulation models neglect the complex interdependencies between the socio-economic and environmental system of coastal Bangladesh. Here an integrated approach has been proposed to develop a simulation model to support agriculture and poverty-based analysis and decision-making in coastal Bangladesh. In particular, we show how a simulation model of farmer's livelihoods at the household level can be achieved. An extended version of the FAO's CROPWAT agriculture model has been integrated with a downscaled regional demography model to simulate net agriculture profit. This is used together with a household income-expenses balance and a loans logical tree to simulate the evolution of food security indicators and poverty levels. Modelling identifies salinity and temperature stress as limiting factors to crop productivity and fertilisation due to atmospheric carbon dioxide concentrations as a reinforcing factor. The crop simulation results compare well with expected outcomes but also reveal some unexpected behaviours. For example, under current model assumptions, temperature is more important than salinity for crop production. The agriculture-based livelihood and poverty simulations highlight the critical significance of debt through informal and formal loans set at such levels as to persistently undermine the well-being of agriculture-dependent households. Simulations also indicate that progressive approaches to agriculture (i.e. diversification) might not provide the clear economic benefit from the perspective of pricing due to greater susceptibility to climate vagaries. The livelihood and poverty results highlight the importance of the holistic consideration of the human-nature system and the careful selection of poverty indicators. Although the simulation model at this stage contains the minimum elements required to simulate the complexity of farmer livelihood interactions in coastal Bangladesh, the crop and socio-economic findings compare well with expected behaviours. The presented integrated model is the first step to develop a holistic, transferable analytic method and tool for coastal Bangladesh.

The impact of an outpatient heart failure clinic on hospital costs and admissions.

This study of 216 congestive heart failure (CHF) patients at a large teaching hospital in south-central Ontario was undertaken to determine whether the patients managed in an outpatient heart failure clinic used fewer hospital resources (as expressed in number of admissions, complexity of admission, and length of stay (LOS)) than a matched cohort who were not managed in an outpatient clinic. Statistical significance of LOS opportunities could not be demonstrated (owing to sample size), however, the heart failure clinic is making a positive impact on all types of admissions (CHF and non-CHF) in terms of LOS and suggests that management in an outpatient setting for chronic disease states is important for acute care hospitals to consider.