- D. Iskander, K. Brickell, N. Natarajan, and 8 more authors2023
Small-scale credit is exalted in mainstream development thinking as a key means of supporting women and their families in dealing with daily, ongoing, and often slow-onset climate disasters. Facing growing crises of agricultural productivity from droughts and floods, and taking primary responsibility for the nutritional wellbeing of their households, women are targeted as credit borrowers globally. Credit provisioning therefore speaks to the push for ’resilience’ against climate disasters that is central to Sustainable Development Goal (SDG) 13, ’Take urgent action to combat climate change and its impacts’, and which has serious implications for SDG 5 ’Achieve gender equality and empower all women and girls’ that prioritises the valuing and recognition of women’s unpaid care and domestic work. How do we ensure, then, that ’climate resilience’ does not come at the cost of women’s emotional and bodily depletion through processes of household nutrition provisioning? This is the key concern motivating the project which asks: (1) In what ways is credit, as a form of climate resilience, shaping nutritional provisioning? (2) How are the dynamics of nutrition provisioning and credit-taking in a changing climate being experienced and visualised? (3) What are the gender and social reproductive dynamics of the climate-credit-nutrition nexus? (4) What lessons can be learned to deliver improved and more equitable credit provisioning and nutritional outcomes to households and communities affected by slow-onset climate disasters? The project is set within the political economy contexts of Cambodia and Tamil Nadu, India.
- Physical activity, time use, and food intakes of rural households in Ghana, India, and Nepal 2017-2018G. Zanello, C. Srinivasan, F. Picchioni, and 4 more authors2019
This research developed a methodological protocol that allows the triangulation of accelerometer data with time use and food intakes in rural settings of low- and middle-income countries (LMICs). Household and individual surveys were administrated to 120 individuals in rural Ghana (Upper West Region), India (Telangana State) and Nepal (Province #3). The data collection spanned from June 2017 to November 2018 and participants were invited to wear a medical-graded accelerometer device (ActiGraph GT3X+) throughout the day for four full non-consecutive weeks across an agricultural season. Raw accelerometer data has been archived at one-second interval. Daily individual questionnaires collected information on time use and food intake. Datasets can be used as stand-alone, yet richer analysis can be done linking the various sources of information. Such set of data opens potential new avenues to accurately measure energy expenditure in rural livelihood, thereby complementing an important part of human health and nutrition research in LMICs.
- Antibiotics and activity spaces: rural health behaviour survey in Northern Thailand and Southern Laos 2017-2018M. J. Haenssgen, A. Proochista, H. F. L. Wertheim, and 7 more authors2019
Antimicrobial resistance (AMR) is a global health threat that endangers the achievement of the Sustainable Development Goals, especially Goal 3 on ’Good Health and Well-Being’; Leading UK and global strategy papers aiming at improving people’s antibiotic usage to fight and prevent AMR thereby focus exclusively on awareness-raising campaigns, but this narrow approach suffers from conceptual, methodological, and empirical weaknesses. In response, our study intends to improve the understanding of patients’ antibiotic-related health behaviour to inspire more targeted and unconventional interventions in low- and middle-income countries (LMICs). Speaking to the themes of "awareness and engagement" and "informal markets and access to antibiotics" we will investigate three research questions: (1) What are the manifestations and determinants of problematic antibiotic use in patients’ healthcare-seeking pathways? (2) Will people’s exposure to a behavioural health systems intervention diffuse or dissipate within a network of competing healthcare practices? (3) Which proxy indicators facilitate the detection of problematic antibiotic behaviours across and within communities? Our interdisciplinary approach frames behaviour within a shared activity space. By drawing on theories and tools from public health, medical anthropology, sociology, and development economics, and by focusing on vulnerable rural dwellers in the DAC countries Thailand and Laos, we will be able to generate innovative and unprecedentedly detailed open-access survey data on antibiotic-related behaviour and its social, economic, and spatial determinants. We aim to maximise complementarities with other ongoing projects in the region that (1) implement biomarker testing and education campaigns in clinical settings, (2) generate mixed-method evidence on cross-cultural patterns of antibiotic use, and (3) engage with the general public to improve global health awareness. We will apply a rigorous three-stage stratified cluster random sampling design to produce district-level representative survey data of the antibiotic use of 2,400 villagers; and we will carry out social network censuses in four communities with a total of 2,400 villagers. Using satellite imagery and digital data collection tools, we can realise these sample sizes at 75percent of the cost of conventional survey approaches. Pursuant to our research questions, we will generate novel insights into the nature and variability of Thai and Lao antibiotic usage and health behaviours using the following methods: We will (1) use event sequence analysis and multilevel regression to investigate the impact of technology and digital media as well as economic, social, and spatial characteristics of patients on adverse antibiotic usage, (2) apply social network analysis to understand how knowledge and practice diffuse from clinical interventions into village communities, and (3) use latent class analysis to detect problematic conditions for antibiotic use through easy-to-collect proxy indicators. Under the umbrella of the Oxford Tropical Network-an inspiring and enabling research environment-this project will be made possible through collaboration across world-leading researchers and groups in health behaviour research (KEMRI Wellcome Trust Research Programme; Kenya), health economics and public engagement (Mahidol Oxford Tropical Medicine Research Unit in Thailand; LOMWRU in Laos), evidence-based antibiotic policy (Oxford University Clinical Research Unit; Viet Nam), social network analysis (CABDyN Complexity Centre; Oxford), development economics (Technology and Management Centre for Development; Oxford), and global health training (Centre for Tropical Medicine and Global Health; Oxford). ODA relevance follows from our partnerships, capacity building activities, and research interest in vulnerable groups in LMICs.