Influence of forest management systems on natural resource use and provision of ecosystem services in Tanzania.

Social, religious and economic facets of rural livelihoods in Sub-Saharan Africa are heavily dependent on natural resources, but improper resource management, drought, and social instability frequently lead to their unsustainable exploitation. In rural Tanzania, natural resources are often governed locally by informal systems of traditional resource management (TRM), defined as cultural practices developed within the context of social and religious institutions over hundreds of years. However, following independence from colonial rule, centralized governments began to exercise jurisdictional control over natural resources. Following decades of mismanagement that resulted in lost ecosystem services, communities demanded change. To improve resource protection and participation in management among stakeholders, the Tanzanian government began to decentralize management programs in the early 2000s. We investigated these two differing management approaches (traditional and decentralized government) in Sonjo communities, to examine local perceptions of resource governance, management influences on forest use, and their consequences for forest and water resources. While 97% of households understood the regulations governing traditionally-managed forests, this was true for only 39% of households for government-managed forests, leading to differences in forest use. Traditional management practices resulted in improved forest condition and surface water quality. This research provides an essential case study demonstrating the importance of TRM in shaping decision frameworks for natural resource planning and management.

Evaluating rapid participatory rural appraisal as an assessment of ethnoecological knowledge and local biodiversity patterns.

There is a pressing need to find both locally and globally relevant tools to measure and compare biodiversity patterns. Traditional ecological knowledge (TEK) is important to biodiversity monitoring, but has a contested role in preliminary biodiversity assessments. We examined rapid participatory rural appraisal (rPRA) (a tool commonly used for local needs assessments) as an alternative to surveys of vascular plants conducted by people with local knowledge. We used rPRA to determine the local-knowledge consensus on the average richness, diversity, and height of local grasses and trees in three habitats surrounding Boumba, Niger, bordering Park-W. We then conducted our own vascular plant surveys to collect information on plant richness, abundance, and structure. Using a qualitative ranking, we compared TEK-based assessments of diversity patterns with our survey-based assessments. The TEK-based assessments matched survey-based assessments on measures of height and density for grasses and trees and tree richness. The two assessments correlated poorly on herb richness and Simpson's D value for both trees and grasses. Plant life form and gender of the participant affected the way diversity patterns were described, which highlights the usefulness of TEK in explaining local realities and indicates limitations of using TEK as a large-scale assessment tool. Our results demonstrate that rPRA can serve to combine local-knowledge inquiry with scientific study at a cost lower than vascular plant surveys and demonstrates a useful blunt tool for preliminary biodiversity assessment.

Resilience in post-Katrina New Orleans, Louisiana: a preliminary study.

BACKGROUND: Much scholarly and practitioner attention to the impact of Hurricane Katrina on the city of New Orleans, Louisiana has focused on the failures of government disaster prevention and management at all levels, often overlooking the human strength and resourcefulness observed in individuals and groups among the worst-affected communities. OBJECTIVES: This preliminary study sought to investigate human resilience in the city of New Orleans, State of Louisiana, eighteen months after Hurricane Katrina struck the Mississippi delta region. METHODS: The Sense of Coherence scale, short form (SOC-13) was administered to a sample of 41 residents of Lower Ninth Ward and adjacent Wards who had been displaced by Hurricane Katrina but were either living in or visiting their home area during March 2007. Study participants were recruited through the local branch of the Association of Community Organizations for Reform Now (ACORN), a nation-wide grassroots organization whose mission is to promote the housing rights of low and moderate-income individuals and families across the USA and in several other countries. RESULTS: Those who had returned to their homes had significantly higher SOC scores compared to those who were still displaced (p<0.001). Among the latter, those who were members of ACORN scored significantly higher than non-members (p<0.005), and their SOC-13 scores were not significantly different from the scores of study participants who had returned home (including both members and non-members of ACORN). CONCLUSIONS: The findings of this preliminary study concur with previous reports in the literature on the deleterious impact of displacement on individual and collective resilience to disasters. Relevant insight gleaned from the qualitative data gathered during the course of administering the SOC-13 scale compensate for the limitations of the small sample size as they draw attention to the importance of the study participants' sources of social support. Possible avenues for further research are outlined.

Resilience research and policy/practice discourse in health, social, behavioral, and environmental sciences over the last ten years.

BACKGROUND: Resilience research has gained increased scientific interest and political currency over the last ten years. OBJECTIVE: To set this volume in the wider context of scholarly debate conducted in previous special theme issue and/or special section publications of refereed journals on resilience and related concepts (1998-2008). METHOD: Peer reviewed journals of health, social, behavioral, and environmental sciences were searched systematically for articles on resilience and/or related themes published as a set. Non-English language publications were included, while those involving non-human subjects were excluded. RESULTS: A total of fifteen journal special issues and/or special sections (including a debate and a roundtable discussion) on resilience and/or related themes were retrieved and examined with the aim of teasing out salient points of direct relevance to African social policy and health care systems. Viewed chronologically, this series of public discussions and debates charts a progressive paradigm shift from the pathogenic perspectives on risk and vulnerability to a clear turn of attention to health-centered approaches to building resilience to disasters and preventing vulnerability to disease, social dysfunction, human and environmental resource depletion. CONCLUSION: Resilience is a dynamic and multi-dimensional process of adaptation to adverse and/or turbulent changes in human, institutional, and ecological systems across scales, and thus requires a composite, multi-faceted Resilience Index (RI), in order to be meaningfully gauged. Collaborative links between interdisciplinary research institutions, policy makers and practitioners involved in promoting sustainable social and health care systems are called for, particularly in Africa.

Use of 'sense of coherence (SOC)' scale to measure resilience in Eritrea: interrogating both the data and the scale.

An adapted 'sense of coherence' scale short form (SOC-13) was administered in nine languages of Eritrea with a total of 265 participants (162 women and 103 men) in order to assess 'resilience' in quantitative terms. Statistical analysis yielded significant differences in SOC scores between the displaced and non-displaced: mean=54.84 (SD=6.48) in internally displaced person (IDP) camps, compared with mean=48.94 (SD=11.99) in urban and rural settlements (t=3.831, p<0.001). Post-hoc tests revealed that the main difference is between IDP camp dwellers and urban (non-displaced) residents. Those in rural but traditionally mobile (pastoralist or transhumant) communities scored more or less the same as the urban non-displaced - i.e. significantly higher than those in IDP camps (p<0.05). Analysis of variance showed that displacement has a significantly negative effect on women compared with men (RR=0.262, p<0.001). Repeating the analysis for the three groups confirmed that urban and pastoralist/transhumant groups are similar, while women in IDP camps are lower scoring (RR=0.268, p<0.001), Hamboka women being worst affected due to their experience of serial displacement. These findings are interpreted and discussed in the light of qualitative information gleaned from the study participants' interrogation of the content of the SOC scale; and in the wider context of historical, socio-political and cultural characteristics of Eritrea. The study's implications for humanitarian and public health policy are considered.

Social capital and mental health: an interdisciplinary review of primary evidence.

An interdisciplinary interrogation of primary evidence linking social capital and mental health sought to establish: (1) 'quality of evidence' (assessed in terms of study design, methods used to address stated questions, rigor of data analysis, and logic and clarity of interpretation of results), and (2) applicability of the evidence to public health policy and practice with respect to mental health. It is found that social capital, a complex and compound construct, can be both an asset and a liability with respect to mental health of those in receipt of and those providing services and other interventions. The most meaningful assessment of social capital or components thereof may examine individual access to rather than possession of social capital, a property of groups, and therefore an ecological variable. Theoretical advances in research on social capital serve to identify mainly two types of social capital: bonding (between individuals in a group) and bridging (between groups). Each type of social capital has cognitive and/or structural component(s) and may operate at micro and/or macro level(s). Effective mental health policy and service provision may build or strengthen bridging social capital and benefit from both bonding and bridging social capital where either or both exist. Established indicators of social capital are amenable to quantitative and qualitative assessment, preferably in tandem. However studies that employ combined research design are rare or non-existent. Interdisciplinary multi-method investigations and analyses are called for in order to unravel mechanisms whereby social capital and mental health might be meaningfully associated.

Postnatal salivary cortisol and sense of coherence (SOC) in Eritrean mothers.

This pilot study explores possible physiological correlates of maternal sense of coherence (SOC) by looking at salivary cortisol levels in Eritrean mothers during the immediate pre- and postnatal period. Samples of pre- and postnatal resting whole saliva were obtained from 19 mothers and from 31 controls in Ghinda. Radioimmunoassay results revealed no differences between prenatal and control concentrations of salivary cortisol, but postnatal levels were significantly lower (P < 0.014). Mothers who delivered in hospital had significantly higher SOC scores compared to those who opted for home birth (P < 0.045). This difference was particularly pronounced in the comprehensibility subscale of the SOC scores (P < 0.037). Moreover, mothers with higher comprehensibility scores showed significantly lower postnatal cortisol levels (P < 0.017). No associations were found between cortisol and age or parity. The implications of these findings for maternity health service policy and practice in Eritrea are considered.

Promotion of handwashing as a measure of quality of care and prevention of hospital-acquired infections in Eritrea: the Keren study.

UNLABELLED: A complex interplay of cognitive, socio-economic and technical factors may determine hand-washing practice among hospital-based health workers, particularly doctors, regardless of the location of the country or hospital they work in. OBJECTIVES: To assess quality of care with respect to handwashing practice as a routine measure of infection prevention in Keren hospital, a provincial referral hospital, second largest in Eritrea; with a view to putting in place quality standards and effective means of monitoring and evaluation. DESIGN: Qualitative study with a participatory and iterative/dynamic design. METHODS: Semi-structured interviews and focus group discussions were held with 34 members of the hospital staff; and a total of 30 patients in the medical, surgical and obstetric wards were interviewed. Direct observation of handwashing practice and facilities were also employed. RESULTS: Although only 30% of health workers routinely washed their hands between patient contact, the study revealed genuine interest in training and the need to reward good practice in order to motivate health workers. Educational intervention and technical training resulted in significant improvements in health workers' compliance with hospital infection prevention standards. Patient satisfaction with health workers' hygiene practices also improved significantly. CONCLUSION: Hospital-based health workers' handwashing practice needs to improve globally. There is no room for complacency, however, in Eritrea (as indeed in other African countries) where public health services need to keep patients' welfare at heart; particularly with respect to women in childbirth, as mothers continue to bear the lion's share of post-war rebuilding of lives, livelihoods, and the country as a whole.

Prolonged displacement may compromise resilience in Eritrean mothers.

OBJECTIVE: to assess the impact of prolonged displacement on the resilience of Eritrean mothers. METHODS: an adapted SOC scale (short form) was administered. Complementary qualitative data were gathered from study participants' spontaneous reactions to and commentaries on the SOC scale. RESULTS: Displaced women's SOC scores were significantly less than those of the non-displaced: Mean = 54.84; SD = 6.48 in internally displaced person (IDP) camps, compared to non-displaced urban and rural/pastoralist: Mean = 48. 94, SD = 11.99; t = 3.831, p < .001. Post hoc tests revealed that the main difference is between IDP camp dwellers and urban (non-displaced). Rural but traditionally mobile (pastoralist or transhumant) communities scored more or less the same as the urban non-displaced--i.e., significantly higher than those in IDP camps (p < 0.05). Analysis of variance confirmed that gender is critical: displacement has significantly negative effects on women compared to men: RR = .262, p < .001. SOC scores of urban and pastoralist/transhumant groups were similar, while women in IDP camps were lower scoring--RR = .268, p < .001. CONCLUSIONS: The implications of these findings for health policy are critical. It is incumbent on the international health institutions including the World Health Organization and regional as well as local players to address the plight of internally displaced women, their families and communities in Eritrea and other places of dire conditions such as, for example Darfur in the Sudan.

Morinda revisited: changes in nutritional well-being and gender differences after 30 years of rapid economic growth in rural Punjab, India.

A follow-up study of malnutrition and its determinants among children 6 to 24 months of age was carried out in rural areas of Punjab State in India 30 years after the original study, and following a period of rapid economic growth. The original 1971 study had found a high prevalence of mortality and malnutrition and the worst gender difference in nutritional status ever recorded in an Indian study. The 2001 follow-up study found dramatic reductions in child mortality, child malnutrition, gender-based imbalances in child well-being and care, and family size, the result of participatory economic growth coupled with broad-based educational, health, and family-planning services. Despite overall improvements in caloric intake, however, 40% of lower-class children in 2001 were still consuming less than 50% of their caloric allowance. With minimal gender-based abortion and significantly reduced neglect and mortality offemale children, gender balance among children in this area of rural Punjab improved markedly over the 30-year period.

Mental well-being in settings of 'complex emergency': an overview.

The mental state of people affected by war and other disasters has been a subject of special interest to academic researchers and practitioners in humanitarian assistance and public health for over two decades. The last decade in particular has seen a rise in the number of papers published in scholarly journals around the Post-Traumatic Stress Disorder (PTSD) debate. Anthropologists have rarely engaged in this debate. Nevertheless, some of the most illuminating contributions have come from socio-medical anthropology (Last, 2000). This volume brings together a wide range of disciplines in the human sciences to address some of the key questions that bear upon the mental health and well-being of populations affected by war and displacement, with contributions from applied biosocial and medical anthropology (Almedom; Lewando-Hundt et al.); applied psychology/public health and social psychiatry (Carballo et al.; Snider et al.; Fullilove et al.); social work (Ahearn & Noble); and political sciences (Pupavac). The four themes that run through this set of papers (outlined below) remain topical areas of contention in contemporary humanitarianism. Scholars and practitioners in the biosocial sciences may wish to engage in the empirical study of human (if not humanitarian) responses to disaster focusing on questions as yet unanswered.

Factors that mitigate war-induced anxiety and mental distress.

The effects of war-induced anxiety and mental distress on individuals and groups can either be mitigated or exacerbated by 'humanitarian action'. This paper focuses on two key factors that protect the mental well-being of war-affected populations: organized displacement or assisted relocation; and coordinated humanitarian aid operations that are responsive to local needs. Qualitative data from two internally displaced person (IDP) camps in Eritrea are presented. Analysis of these data serves to substantiate and refine a working hypothesis: that social support of the right type, provided at the right time and level, can mitigate the worst effects of war and displacement on victims/survivors. An integrated model of psychosocial transition is suggested. The implications of this approach for humanitarian policy and practice are discussed in the wider context of current debates and lamentations of the 'humanitarian idea'.

Maternal psychosocial well-being in Eritrea: application of participatory methods and tools of investigation and analysis in complex emergency settings.

OBJECTIVE: To establish the context in which maternal psychosocial well-being is understood in war-affected settings in Eritrea. METHOD: Pretested and validated participatory methods and tools of investigation and analysis were employed to allow participants to engage in processes of qualitative data collection, on-site analysis, and interpretation. FINDINGS: Maternal psychosocial well-being in Eritrea is maintained primarily by traditional systems of social support that are mostly outside the domain of statutory primary care. Traditional birth attendants provide a vital link between the two. Formal training and regular supplies of sterile delivery kits appear to be worthwhile options for health policy and practice in the face of the post-conflict challenges of ruined infrastructure and an overstretched and/or ill-mannered workforce in the maternity health service. CONCLUSION: Methodological advances in health research and the dearth of data on maternal psychosocial well-being in complex emergency settings call for scholars and practitioners to collaborate in creative searches for sound evidence on which to base maternity, mental health and social care policy and practice. Participatory methods facilitate the meaningful engagement of key stakeholders and enhance data quality, reliability and usability.