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In South Asian and Sub-Saharan African nations, climate change offers numerous hurdles to growth and development. These regions are susceptible to climate change due to their vast population reliance on agriculture, high demand for natural resources, and comparatively limited strategies for coping. Reduced food grain yields, crop losses, feed scarcity, lack of potable water for livestock during the summer, forceful animal migrations, and severe losses in the poultry and fishery industries have all been documented, posing a threat to the lives of the rural poor. As global food security and agricultural productivity become increasingly vulnerable, the focus has shifted towards adopting climate-smart agricultural practices and techniques. The present study discussed the need to identify and prioritize regionally evolving climate-smart farming practices and the enabling environment required for CSA uptake. The popular CSA practices in South Asia and Sub-Saharan Africa are crop rotation, cultivation of drought/flood-tolerant crops, legume intercropping, changing planting dates, rainwater harvesting, agroforestry, micro-irrigation technologies, minimum tillage, and integrated crop-livestock farming. A solid institutional structure, policy environment, infrastructure, agricultural insurance, climate information services, and gender and social inclusion provide the required enabling environment to alleviate farmer issues, lower CSA adoption obstacles, and improve operational sustainability. Highlights of the study are: This study examines how climate-smart farming practices are evolving in South Asia and SubSaharan Africa. We used a systematic approach to categorize and characterize agricultural adaptation alternatives to climate change. Our specific goals are to gain knowledge of the CSA adoption-enabling environments and the climate-smart agriculture practices employed in South Asia and Sub-Saharan Africa

An improved understanding of the sanitation enabling environment and status of market development (“sanitation economy”) is crucial not only for advancing national and global sanitation goals, but also for attracting the financing necessary to drive meaningful progress in low- and middle-income countries (LMICs). This need is particularly pressing as the sanitation sector faces a significant funding gap that must be bridged to meet the growing demands for sanitation services, infrastructure, and innovation. This paper reviews frameworks that assess the sanitation economy in LMICs with the aim of informing the development of more impactful future frameworks and the wider application of existing frameworks. Frameworks were identified through internet search and interviews with representatives of international sanitation sector organisations and universities. Thirty-nine frameworks were identified that have been or are currently being used in sanitation. Frameworks are diverse in the structure they adopt, their focus areas, the number of indicators, the number of countries covered, the frequency with which they have been applied, their reliance on primary versus secondary data sources, and their uptake and impact. Overall, use of the frameworks has been piecemeal and sporadic in LMICs. Only few frameworks have been picked up and applied by another organisation, although the results of some frameworks are widely used and cited. To ensure future efforts to measure and monitor the sanitation economy are evidence-based and make the best use of limited resources, frameworks currently in use should be independently evaluated and there should be greater collaboration and adoption of common frameworks.

Following the hype that has been given to culture and creativity as triggers and enhancers of local economic performance in the last 20 years, this work originally contributes to the literature with the objective of assessing the impact of cultural and creative cities (CCCs) on the economic output of their regions. In this sense, the cultural and creative character of cities is considered a strategic strength and opportunity that can spillover, favoring the economic system of the entire regions in which the cities are located. Through an innovative methodology that exploits a regional production function estimated by a panel fixed effects model, the effect of cities’ cultural vibrancy and creative economy on the output of their regions is econometrically explored. The data source is the Cultural and Creative Cities Monitor (CCCM) provided by the JRC, which also allows the investigation of the possible role played by the enabling environment in catalyzing the action of cultural vibrancy and creative economy. The results are thoroughly examined: especially through cultural vibrancy, CCCs strategically support the output of their region. This is particularly the case when local context conditions—such as human capital and education, openness, tolerance and trust, and quality of governance—catalyze their effect. Overall, CCCs contribute to feeding a long-term self-supporting system, interpreted according to a holistic conception that includes economic, social, cultural, and environmental domains.

Diabetic retinopathy (DR), a major microvascular complication of diabetes, has a significant impact on the world's health systems. Globally, the number of people with DR will grow from 126.6 million in 2010 to 191.0 million by 2030, and we estimate that the number with vision-threatening diabetic retinopathy (VTDR) will increase from 37.3 million to 56.3 million, if prompt action is not taken. Despite growing evidence documenting the effectiveness of routine DR screening and early treatment, DR frequently leads to poor visual functioning and represents the leading cause of blindness in working-age populations. DR has been neglected in health-care research and planning in many low-income countries, where access to trained eye-care professionals and tertiary eye-care services may be inadequate. Demand for, as well as, supply of services may be a problem. Rates of compliance with diabetes medications and annual eye examinations may be low, the reasons for which are multifactorial. Innovative and comprehensive approaches are needed to reduce the risk of vision loss by prompt diagnosis and early treatment of VTDR.

Accountability, a cornerstone of contemporary education policy, is increasingly characterized by external monitoring and an emphasis on outcomes or results. Largely absent in discussions of accountability are the voices of stakeholders who work, learn, and teach in schools and other educational institutions. This article highlights the critical importance of structured democratic voice. This process involves enabling diverse education stakeholders to make use of organized opportunities to articulate their views, especially in discussions of planning and evaluation, in ways that their concerns are heard and valued. Using illustrative examples at the regional, national, and local level, this article discusses how structured democratic voice can help re-imagine approaches to accountability while strengthening the enabling environment, increasing trust in the system, and improving policy ownership. Notwithstanding the challenges of building local capacity and sustaining political commitment, this article highlights the important consequences of implementing a process of structured democratic voice: in particular, sustaining educational reforms over time and meeting ambitious collective goals in education.

Background South Africa faces a high burden of malnutrition, including undernutrition, overweight, obesity, and diet-related non-communicable diseases. This coexistence and interaction of multiple forms of malnutrition within individuals and communities across the life-course is referred to as the double burden of malnutrition (DBM) and has complex, interrelated causes that need to be concurrently addressed. This qualitative study explored the drivers and potential leverage points of the DBM at individual, household, community, and (local) policy level in the Cape Town Metropolitan region. Methods From November 2023 to April 2024, 35 in-depth, semi-structured interviews were conducted with community health workers (CHWs) and CHW coordinators, researchers, civil society representatives, and government employees. Interviews were conducted in isiXhosa or English, and transcribed and translated into English where necessary. Coding and analysis drew from grounded theory and complex systems thinking. Results Across the individual, household, community, and local policy level, four central drivers of the DBM emerged: financial constraints, other resource constraints, food and nutrition literacy, and food quality of informal food business. At the individual and household level (micro-level), two additional barriers were identified: abuse of alcohol and other drugs and a lack of individual accountability. At the community and local policy level (meso-level), additional challenges included the power of the formal food industry, political inertia, and a siloed government approach. Leverage points at the micro-level included government social support programs and food gardens. At the meso-level, leverage points included an emphasis on the first 1000 days of life, food sensitive urban planning, strengthening networks, and adopting a systems response. Conclusions This study revealed drivers of the DBM at the micro- and meso-level in Cape Town, as well as potential leverage points. By understanding the lived realities of those experiencing and working with the DBM, researchers can better understand the interconnected drivers and how these drivers manifest in everyday life. Local solutions to address the complex issue of the DBM require multi-sectoral stakeholder perspectives.

The impact of chronic diseases on people’s daily lives and the exponential number of people affected is a major public health issue. The consequences on individuals and their families is significant, particularly in terms of quality of life. In the literature, this phenomenon is well described in terms of care policy and cost. Although there is a link between a supportive environment and empowerment, there is little literature describing a supportive environment and the daily lives of people living with cardiovascular disease. The objectives of this study are to identify the strategies people use to develop an enabling environment. It will be a qualitative ethnographic study that will address both human behavior and the notion of culture in a broad sense. In the context of this study, an orientation towards critical ethnography will be considered for its particular interest in vulnerable people and in the power relations that may exist in the socio-cultural system. Data will be collected directly in people’s homes through observations and interviews with 10 people with cardiovascular disease. For each person, the data collection will take place over three days and will represent approximately 210 h of observation. This protocol was registered in the Research Register on 30 June 2021 and its number is 6933. This study will explore strategies for developing an enabling environment for people living with heart disease and eventually provide recommendations for nursing practices in terms of support.

Adolescents 360 (A360) was a 4.5-year project working directly with young people to increase demand for, and voluntary uptake of, modern contraception among adolescent girls aged 15 to 19 years. A360 utilized human centered design (HCD) to create four adolescent sexual and reproductive health (ASRH) interventions across three countries - Smart Start in Ethiopia, Kuwa Mjanja in Tanzania, Matasa Matan Arewa (MMA) in northern Nigeria, and 9ja Girls in southern Nigeria. A360’s interventions tap into girls’ aspirations and position contraception as a tool that can support them in pursuing their life goals. As A360 transitioned from its first program phase into its follow-on in 2020, the project examined what it had accomplished, where it had failed, and what it had learned in the process, with the goal of contributing to the global evidence base and building on these lessons in its follow-on program. A360 draws out five key lessons in this publication. These lessons speak to 1) the value of A360’s aspirational program components and the need to meaningfully support girls to pursue their life goals holistically; 2) the necessity of taking a consistent and rigorous approach to improving the enabling environment for contraceptive use to promote transformative change; 3) the need to find program and measurement approaches that respond to girls’ unique patterns of sexual activity, and support contraceptive continuation ; 4) the usefulness of continuous program improvement during implementation to maintain a user-centered focus and create a culture of curiosity and innovation; and 5) the tension between designing for users and beginning with program sustainability in mind from the outset. A360 continues to grow in its understanding of what it takes to support sustained, transformative, holistic change for adolescent girls and commits to openness and transparency regarding successes and failures during its next project phase.

Participatory approaches are an important component of institutional frameworks for the governance of water resources and services. Studies on public participation in water management provide evidence for the outcomes of public participation and insights into the types of methods and the contexts under which participation can be meaningful. However, participatory processes are complex, and there is no single method by which to interpret, approach and implement them. This paper explores elements from the theory and practice of participation, applied to the management of water resources and water and sanitation services. Based on an in-depth literature review, we analyze the forms of participation in water and sanitation, their outcomes, as well as the contextual factors and procedural elements of participatory processes that affect their success. Contextual factors are those that are largely outside of the control of agencies or participants (e.g., demographics, history, and culture) or those that can only be influenced by management and institutional decisions in the mid- and long-term (e.g., the legal and institutional framework); while procedural elements are those over which agencies and participants have considerable control when designing and executing participatory efforts (e.g., representativeness and inclusivity, access to information, and opportunity to influence). We propose a framework that interrelates and integrates both contextual factors and procedural elements of participation. It, includes three additional aspects that are influenced by, and in turn influence, the context and the process: existing capacities for implementation of meaningful participatory processes, the resources that are allocated to them, and attitudes towards participatory processes. The framework helps conceptualize what we call the enabling environment for active, free, and meaningful participation in the delivery of water and sanitation services. By breaking down the complexities of participation, the framework supports practitioners and decision-makers to better design and implement participatory processes in water resources and water and sanitation services.

Sustainable urban transitions promise high mitigation and adaptation potential to address the effects of anthropogenic climate change. The two coastal megacities studied in this paper, Shanghai and Istanbul, have the potential for low-carbon urban transitions that can destabilize existing regimes. The destabilization is brought about by the disruptive business model innovations of the sharing economy in Shanghai’s mobility sector and by the energy-efficient practices developed alongside the intensification of the building sector through the process of urban renewal in Istanbul. However, the emergence of such urban transitions through the actions of agents relies on the existence of enabling environments for regime destabilization. In a comparative case study of Shanghai and Istanbul, we assess the challenges of realizing regime destabilization opportunities through an enabling environment framework. We find that without adequate enabling environments for regime destabilization, urban transitions to sustainability may fail to achieve effective low-carbon action and make progress towards meeting the sustainable development goals. We also show that while deliberate and collective efforts are underway from multiple agents within and beyond the two megacities, the environments for regime destabilization in the building and transport sectors considered remain insufficient primarily due to conflicting priorities among key agents in the underlying urban systems.