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Communal Intimacy and the Violence of Politics explores the notoriously brutal Philippine war on drugs from below. Steffen Bo Jensen and Karl Hapal examine how the war on drugs folded itself into communal and intimate spheres in one Manila neighborhood, Bagong Silang. Police killings have been regular occurrences since the birth of Bagong Silang. Communal Intimacy and the Violence of Politics shows that although the drug war was introduced from the outside, it fit into and perpetuated already existing gendered and generational structures. In Bagong Silang, the war on drugs implicated local structures of authority, including a justice system that had always been deeply integrated into communal relations. The ways in which the war on drugs transformed these intimate relations between the state and its citizens, and between neighbors, may turn out to be the most lasting impact of Duterte's infamously violent policies.

The urbanization of Latin America has also lead to the urbanization of its poor. Today about half of the region’s poor live in cities. Yet the phenomenon of urban poverty is not one that is well studied or well understood and policy makers across Latin America are increasingly interested in policy advice on how to design programs and policies to tackle poverty. Urban Poor in Latin America argues that the causes of poverty, the nature of deprivation, and the policy levers to fight poverty are to a large extent site-specific. As such, the book looks at strategies to assist the urban poor in making the most of the opportunities offered by cities (deeper labor markets, better amenities and services, greater freedom, and possibly less discrimination) while helping them cope with the negative externalities (high cost of housing and difficulty of obtaining shelter; risks to physical safety associated with pollution and environmental contamination, but also crime and violence; other congestion costs, more isolation and possibly less social capital).

Background In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana. Methods This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15–59 years for men and 15–49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria. Results Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment. Conclusions The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty.

Diabetes is estimated to affect between 3.3% and 8.3% of adults in Ghana, and prevalence is expected to rise. The lack of cost-effective diabetes prevention programmes designed specifically for the Ghanaian population warrants urgent attention. The Contextual Awareness, Response and Evaluation (CARE): Diabetes Project in Ghana is a mixed methods study that aims to understand diabetes in the Ga Mashie area of Accra, identify opportunities for community-based intervention and inform future diabetes prevention and control strategies. This paper presents the study design for the quantitative survey within the CARE project. This survey will take place in the densely populated Ga Mashie area of Accra, Ghana. A household survey will be conducted using simple random sampling to select households from 80 enumeration areas identified in the 2021 Ghana Population and Housing Census. Trained enumerators will interview and collect data from permanent residents aged ≥ 25 years. Pregnant women and those who have given birth in the last six months will be excluded. Data analysis will use a combination of descriptive and inferential statistics, and all analyses will account for the cluster sampling design. Analyses will describe the prevalence of diabetes, other morbidities, and associated risk factors and identify the relationship between diabetes and physical, social, and behavioural parameters. This survey will generate evidence on drivers and consequences of diabetes and facilitate efforts to prevent and control diabetes and other NCDs in urban Ghana, with relevance for other low-income communities.

Building caring communities is fundamental to achieving a community-based approach to mental health. Understanding how communities perceive mental illness provides critical insight into fostering mental health awareness and care. We explored the perceptions of mental illness among members of two urban poor communities in Accra, Ghana. Qualitative data were collected from 77 participants through key informant interviews, focus group discussions, and situated conversations. Using theory-driven thematic analysis based on social representations theory, findings revealed cognitive-emotional representations of mental illness. The communities demonstrated high awareness of the multilevel factors contributing to mental illness risk and experiences, drawing on five sources of knowledge: embodied, common sense, medical, cultural, and religious. Mental illness representations informed the classification and legitimization of mental illness based on the severity of conditions and the identity of sufferers. These findings provide valuable insights for planning community mental health interventions that address both social and institutional care needs.

The relationship between social innovation venture and poor communities has received little attention from studies in the area of social innovation. In order to clarify this relationship, our study seeks to answer: What strategies would help to bring social innovation ventures closer to poor communities? We developed an empirical and qualitative research in a social innovation venture and two poor beneficiary communities in Brazil. The results indicate that the proximity between those agents was based on five main items: (a) reputation of the social venture; (b) appropriate prices according to the community’s reality; (c) close relations with the community; (d) structure proximity; and (e) winning the community leadership’s trust. Thus, our study contributes to the literature by exploring the beneficiary communities and their relationship with social innovation ventures. In addition, we suggest the use of the term “social innovation venture” to designate a wide range of types of organizations willing to generate social innovation in the practical field.

Purpose The purpose of this paper is to study triadic market relations between an international aid agency (IAA), local ventures and the poor communities where they are embedded in order to shift the poverty alleviation discussion to account for the perceptions held by each category of actor, especially those of poor communities. Poverty alleviation is a key commitment of the United Nations, and market-driven approaches are increasingly advocated as a means to reduce poverty, particularly among IAAs. One such strategy is to connect ventures in poor communities with international markets. However, research shows that such approaches have mixed success. Design/methodology/approach The authors conducted a comparative case study of three ventures embedded in urban and rural poor communities receiving support from an IAA. The authors then analyzed the data to determine the mechanisms that led to discrepancies in the perceptions of poverty alleviation held by each actor involved. Findings This study suggests three such mechanisms: ‘decoupling markets from poverty’, wherein aiding ventures may paradoxically lead to decoupling them from poor communities; ‘overburden stress’, in which ventures cannot fulfil a poverty alleviation role through their market activities because the expectation to do so overburdens the venture; and ‘value divergence’, in which the actors involved evaluate the impact of these approaches differently. Originality/value The authors propose that a key aspect of enabling effective poverty alleviation through market-driven approaches in terms of substantial, long-term contributions is to monitor and support the relations between the actors involved – including the poor communities themselves – and explore how each perceives the efficacy of the approach. Propósito El objetivo de nuestro estudio es integrar las percepciones de tres actores: los organismos internacionales, los emprendimientos en comunidades pobres y las propias comunidades pobres, con el fin de cambiar la discusión sobre la reducción de la pobreza hacia las percepciones de los diferentes actores involucrados en las relaciones de mercado, en particular las de las comunidades pobres. La reducción de la pobreza es un compromiso clave de las Naciones Unidas, y en la actualidad se promueven enfoques de mercado como un medio para reducir la pobreza, especialmente entre los organismos internacionales. Una estrategia consiste en conectar emprendimientos en comunidades pobres con mercados internacionales. Sin embargo, investigaciones previas muestran que estos enfoques de mercado tienen un éxito variado en ciertas ocasiones y en otras no. Metodología Realizamos un estudio de casos comparativo de tres emprendimientos en comunidades pobres urbanas y rurales que reciben apoyo de un organismo internacional. Luego, analizamos nuestros datos para determinar qué mecanismos condujeron a discrepancias en las percepciones de cada actor involucrado con respecto a la reducción de la pobreza. Resultados Nuestro estudio identifica tres mecanismos que explican las discrepancias en las percepciones de los actores involucrados con respecto a los enfoques de mercado para la reducción de la pobreza: ‘desvinculación de los mercados de la pobreza’, en donde el apoyo a los emprendimientos puede llevar paradójicamente a separarlos de las comunidades pobres; ‘estrés de sobrecarga’ que captura situaciones en las que los emprendimientos no pueden cumplir su función de reducción de la pobreza a través de sus actividades en el mercado debido a que la expectativa de hacerlo, aunque implícita, sobrecarga al emprendimiento; y ‘divergencia de valores’ que muestra que los actores involucrados a menudo evalúan de manera diferente el impacto de los enfoques de mercado en la pobreza. Originalidad Proponemos que un aspecto clave de la reducción efectiva de la pobreza a través de enfoques de mercado que hagan contribuciones sustanciales y a largo plazo es monitorear las relaciones y la eficacia percibida entre todos los actores involucrados en estos enfoques, incluyendo a las propias comunidades pobres. Propósito El objetivo de nosso estudo é integrar as percepções de três atores: os organismos internacionais, os empreendimentos em comunidades pobres e as próprias comunidades pobres, com o objetivo de mudar a discussão sobre a redução da pobreza para as percepções dos diferentes atores envolvidos nas relações de mercado, particularmente as das comunidades pobres. A redução da pobreza é um compromisso chave das nações unidas, e atualmente abordagens de mercado são promovidas como um meio para reduzir a pobreza, especialmente entre os organismos internacionais. Uma estratégia consiste em conectar empreendimentos em comunidades pobres com mercados internacionais. No entanto, pesquisas anteriores mostram que essas abordagens de mercado têm sucesso variado em algumas ocasiões e em outras não. Metodologia Realizamos um estudo de casos comparativo de três empreendimentos em comunidades pobres urbanas e rurais que recebem apoio de um organismo internacional. Em seguida, analisamos nossos dados para determinar quais mecanismos levaram a discrepâncias nas percepções de cada ator envolvido em relação à redução da pobreza. Resultados Nosso estudo identifica três mecanismos que explicam as discrepâncias nas percepções dos atores envolvidos em relação às abordagens de mercado para a redução da pobreza: ‘desvinculação dos mercados da pobreza’, onde o apoio aos empreendimentos pode paradoxalmente separá-los das comunidades pobres; ‘estresse de sobrecarga’ que captura situações em que os empreendimentos não podem cumprir sua função de redução da pobreza por meio de suas atividades no mercado devido à expectativa de fazê-lo, mesmo que implicitamente, sobrecarregando o empreendimento; e ‘divergência de valores’ que mostra que os atores envolvidos frequentemente avaliam de maneira diferente o impacto das abordagens de mercado na pobreza. Originalidade Propomos que um aspecto-chave da redução efetiva da pobreza por meio de abordagens de mercado que façam contribuições substanciais e a longo prazo é monitorar as relações e a eficácia percebida entre todos os atores envolvidos nessas abordagens, incluindo as próprias comunidades pobres.

Schizophrenia is a severe and disabling condition that presents a dire health equity challenge. Our initial 6-month trial (previously reported) using mobile texting and lay health supporters, called LEAN, significantly improved medication adherence from 0.48 to 0.61 (adjusted mean 0.11, 95% CI 0.03 to 0.20, P=.007) for adults with schizophrenia living in a resource-poor village in rural China. We explored the effectiveness of our texting program in improving participants' medication adherence, functioning, and symptoms in an extended implementation of the intervention after its initial phase. In an approximated stepped-wedge wait-list design randomized controlled trial, 277 community-dwelling villagers with schizophrenia were assigned 1:1 in phase 1 into intervention and wait-list control groups. The intervention group received (1) lay health supporters (medication or care supervisors), (2) e-platform (mobile-texting reminders and education message) access, (3) a token gift for positive behavioral changes, and (4) integration with the existing government community-mental health program (the 686 Program) while the wait-listed control group initially only received the 686 Program. Subsequently (in the extended period), both groups received the LEAN intervention plus the 686 Program. The primary outcome was antipsychotic medication adherence (percentage of dosages taken over the past month assessed by unannounced home-based pill counts). The secondary outcomes were symptoms measured during visits to 686 Program psychiatrists using the Clinical Global Impression scale for schizophrenia and functioning measured by trained student assessors using the World Health Organization Disability Assessment Schedule 2.0. Other outcomes included data routinely collected in the 686 Program system (refill records, rehospitalization due to schizophrenia, death for any reason, suicide, wandering, and violent behaviors). We used intention-to-treat analysis and missing data were imputed. A generalized estimating equation model was used to assess program effects on antipsychotics medication adherence, symptoms, and functioning. Antipsychotics medication adherence improved from 0.48 in the control period to 0.58 in the extended intervention period (adjusted mean difference 0.11, 95% CI 0.04 to 0.19; P=.004). We also noted an improvement in symptoms (adjusted mean difference -0.26, 95% CI -0.50 to -0.02; P=.04; Cohen d effect size 0.20) and a reduction in rehospitalization (0.37, 95% CI 0.18 to 0.76; P=.007; number-needed-to-treat 8.05, 95% CI 4.61 to 21.41). There was no improvement in functioning (adjusted mean difference 0.02, 95% CI -0.01 to 0.06; P=.18; Cohen d effect size 0.04). In an extended implementation, our intervention featuring mobile texting messages and lay health workers in a resource-poor community setting was more effective than the 686 Program alone in improving medication adherence, improving symptoms, and reducing rehospitalization. Chinese Clinical Trial Registry; ChiCTR-ICR-15006053 https://tinyurl.com/y5hk8vng.

In this case study I explored the dilemmas of three early childhood care and education (ECCE) teachers in a poor community in the Cape Flats of Cape Town, South Africa during COVID-19, and how they used these dilemmas to transform their teaching. Purposive sampling was used to select the participants and data was collected through a semi-structured interview and thematically analyzed. Ethical clearance was secured from the Cape Peninsula University of Technology. Mezirow’s transformative learning theory was used as an analytical framework for the study. In particular, Mezirow’s concept of disorienting dilemmas was used to engage with the dilemmas the ECCE teachers were confronted with during the pandemic. Further, his concept of perspective transformations was used to analyze how the ECCE teachers engaged with these dilemmas to transform their teaching. Findings show that while ECCE teachers’ faced disorienting dilemmas of digital inequity and of children’s interactive play, they also adopted alternative roles and actions as they engaged in dialogue and shared negotiations, ensuring that the functioning of the ECCE centre would continue in solidarity with the children and parents. These findings have important implications for how local government provide financial and digital support for poor communities during times of crisis.

Social protection is one way to reduce the adverse effects of stunting on the urban poor. This study aimed to analyze the impact of social protection on stunting prevention in urban poor communities. The design of this study was a cross-sectional study, and the study location was in Makassar, the Capital City South Sulawesi Province of Indonesia, which has poor urban settlements. The sample size was 180 people from impoverished families in economically disadvantaged areas of Makassar City located in 12 specific locations. Stunting was presented by height-for-age Z-score (HAZ), based on the 2006 median WHO reference population. The study revealed that a significant proportion of individuals with stunted growth had a documented background of malnutrition, with a staggering 81.4% requiring immediate access to food aid. Moreover, an overwhelming 72.9% lacked social security assistance, while 73.1% reported a lack of access to affordable rice, further exacerbating their circumstances. Therefore, social protection is very much needed by the urban poor to prevent stunting.