The rising salinity of land and water is an important, but understudied, climate change-sensitive trend that can exert devastating impacts on food security. This mixed methods investigation combines salinity testing with qualitative research methods to explore these impacts in one of the most salinity-affected regions in the world—the Ganges River Delta. Data collection in 2015 and 2016 undertaken in Bangladesh’s southwest coastal region and Dhaka consisted of 83 in-depth household and stakeholder interviews, six community focus groups, and salinity testing of 27 soil and 45 surface and groundwater samples. Results show that household food production is a multifaceted cornerstone of rural livelihood in the southwest coastal region, and virtually every component of it—from rice plantation and homestead gardening to livestock cultivation and aquaculture—is being negatively affected by salinity. Although households have attempted multiple strategies for adapting food production, effective adaptation remains elusive. At the community level, improved irrigation and floodplain management, as well as restrictions on saltwater aquaculture to abate salinity, are viewed as promising interventions. However, the potential of such measures remains unrealized on a broad scale, as they require a level of external resources and regulation not yet provided by the NGO and government sectors. This study elucidates issues of accessibility, equity, and governance surrounding agricultural interventions for climate change-related salinity adaptation, and its findings can help inform the community of organizations that will increasingly need to grapple with salinity in order to guarantee food security in the context of environmental change.
Healthcare workers play an important role in responding to the needs of the millions of children and adolescents who experience sexual abuse around the globe. A supportive child and adolescent-centered initial response is crucial for the physical and emotional wellbeing of survivors. In 2017, the World Health Organization (WHO) published clinical guidelines for responding to child and adolescent sexual abuse. The review described in this paper informed the development of good practice statements on how best to deliver health care to survivors. This review examined the values and preferences of children and adolescents who were sexually abused, and of their caregivers and healthcare workers, regarding: 1) initial response to children and adolescents who have been sexually abused; and 2) obtaining medical history, conducting physical examination, and documenting examination findings. Searches were conducted in Scopus, Pubmed, and the WHO's Global Index Medicus (1 January, 1995-15 July 2016). All articles in English that indicated preferences of survivors, caregivers and/or healthcare workers in ensuring empathetic and trauma-informed care were included. Sixty-two articles were included and analyzed thematically. Key findings included the importance of providing care to survivors in a manner that respects the child or adolescent's autonomy and wishes, ensures privacy and confidentiality, and makes services and facilities appropriate and welcoming. Findings indicate how evidence-based recommendations can be delivered in a child or adolescent-centred and trauma-informed manner.
1 January 2013 in International Journal for Equity in Health
Research suggests that literacy plays a key role in mediating the relationship between formal education and care-seeking among women in developing countries. However, little research has examined literacy’s role independently from formal education. This differentiation is important, as literacy programs and formal schooling entail distinct intervention designs and resources, and may target different groups. To assess the relationship between literacy and healthcare-seeking among Nepali women of low educational attainment, we analyzed data from the 2011 Nepal Demographic and Health Survey (DHS).