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Abstract Background Suboptimal glycemic control of type 2 diabetes mellitus (T2DM) which is defined as having HbA1c greater than 7% is a major public health problem in several countries, including the Maldives. The study aimed to estimate the prevalence and determine factors associated with suboptimal glycemic control among T2DM patients. Methods A hospital-based cross-sectional was applied to collect data from T2DM patients who attended public hospitals in the Greater Male’ Region, Maldives where were one of the highest reports of T2DM and suboptimal glycemic control cases in the country between January to March 2023 by a validated questionnaire and anthropometric measurements. Five (5) ml blood specimens were collected to measure the glycated hemoglobin (HbA1c) level. Univariable and multivariable logistic regressions were employed to determine factors associated with suboptimal glycemic control of T2DM at a significant level of α = 0.05. Results A total of 341 participants were recruited for the study: 65.7% were female, 42.5% were aged 40–60 years, and 42.2% were married. The overall prevalence of suboptimal glycemic control was 50.7%. Ten variables were found to be associated with suboptimal glycemic control in multivariable logistic regression. Those aged 40–60 years (AOR = 3.35, 95% CI = 1.78–6.30), being single (AOR = 2.53, 95% CI = 1.21–5.30), preparation of food using more than three tablespoons of cooking oil (AOR = 2.78, 95% CI = 1.46–5.28), preparation of food with more than three tablespoons of sugar (AOR = 2.55, 95% CI = 1.31–4.93), no exercise (AOR = 2.04, 95% CI = 1.15–3.61), DM diagnosed with more than twenty years prior (AOR = 2.59, 95% CI = 1.34–4.99), obese body mass index (BMI) (AOR = 3.82, 95% CI = 1.75–8.32), high total cholesterol (AOR = 2.43, 95% CI = 1.36–4.35), high triglycerides (AOR = 3.43, 95% CI = 1.93–6.11), and high-level stress (AOR = 2.97, 95% CI = 1.48–5.93) were having a greater odds of having suboptimal glycemic control than those who did not have these characteristics. Conclusion A large proportion of T2DM patients in the Greater Male’ Region fail to control their blood glucose. Effective public health interventions should be introduced, especially interventions focused on reducing cooking oil and sugar in daily cooking practices, encouraging regular exercise, and maintaining cholesterol levels, particularly for those diagnosed with diabetes mellitus for more than 20 years prior.

The Maldives commenced its transition to democracy after its first multiparty elections in 2008. This was challenging due to the Maldives being a Muslim nation, its authoritarian legacy of monarchical rule before independence, and by dictatorship after independence. This article analyzes the postindependence rule periods of Ibrahim Nasir and Maumoom Abdul Gayoom, which were akin to one‐man dictatorships. The third autocratic president postindependence, Abdulla Yameen, was an electoral authoritarian as he implemented authoritarian measures in a multi‐party context. I assess if religion provided political legitimacy to these authoritarian leaders or if religion was exploited by leaders to gain political support and civic spaces. Theories of authoritarianism, religious populism, electoral authoritarianism, as well as concepts of the ulema‐state alliance and the rentier state are utilized. In addition to their authoritarian legacy, democratic presidents like Mohamed Nasheed and Mohamed Solih had grappled with politicians' manipulation of religion through political Islam, Islamic nationalism, and fundamentalism to derail democracy by equating it to Westernization. These events resonate with Samuel Huntington's description of the conflict between the West and Islam as a clash of civilizations. Crimes against liberal thinkers by Islamic extremists are an added challenge. There is a real danger of another authoritarian reversal in the Maldives. [ABSTRACT FROM AUTHOR]

Religious sentiments have become a potent tool for political elites, altering national identities and citizenship criteria. This manipulation, driven by majoritarian ideologies, has marginalized religious minorities, leading to discrimination, violence, and legal persecution against them. Hindu, Islamic, and Buddhist nationalisms seem to collectively erode secular democracy in South Asia. Moreover, right‐wing populist leaders, notably Modi in India and the Rajapaksas in Sri Lanka, have merged religious nationalism with authoritarian political orientations posing a challenge to democratic foundations and impacting significantly on the dynamics of state and societal relations. This is the context in which this World Affairs 2024 special issue delves into the relationship(s) between religion, politics, and authoritarianism in the South Asian region. It examines the evolving "religion‐politics" nexus or "complex" to explicate the relationship between religion and authoritarianism, particularly with respect to authoritarian governments mobilizing religion as a readily available resource for popular political mobilization, legitimization, and power consolidation. India's BJP employs Hindutva ideology to marginalize minorities, Bangladesh's regime uses Islam for political legitimacy, and Sri Lanka's Sinhala‐Buddhist nationalism fosters exclusionary policies. By fostering social and cultural polarization, this fusion of authoritarianism with religious nationalism poses a serious challenge to the secular state. The articles in this special issue explore these themes comprehensively, delving into the ideological foundations of political decisions and their consequences for marginalized communities. By shedding light on this multifaceted interplay, the collection offers valuable insights into South Asia's sociopolitical landscape, serving as a vital resource for scholars, policy makers, and global observers seeking to understand the region's complex dynamics. [ABSTRACT FROM AUTHOR]

Objective: the number of women-owned SMEs in the Maldives has increased as a result of the recent popularity of e-commerce and the Covid-19 pandemic. Thus, the purpose of this study was to describe the entrepreneurial experiences of female entrepreneurs in the Maldives in order to gain an understanding of the various stages of entrepreneurial process. Theoretical approach: the conceptual framework of this research was based theoretically on values derived from entrepreneurial theories and the components and features derived from the existing entrepreneurial process models. Method: this study employed a qualitative methodology, with semi-structured interviews conducted with five established female entrepreneurs. Purposive sampling technique was used to select participants. The data collected were analyzed using thematic analysis method. Results: the study's findings revealed that the conception of the entrepreneurial idea, the first stage of the entrepreneurial process, was primarily inspired by the entrepreneur's passion and hobby. In the second stage, it was discovered that no proper business planning had been completed, and the business was initially self-financed. In the third stage, it was discovered that the majority of entrepreneurs launched their businesses through social media and managed day-to-day operations as a small team. When it came to fourth stage, most of female entrepreneurs preferred both image and financial growth, with the majority of them relying on government funds for further business growth. Conclusion: this research will assist policymakers to gain insight into female entrepreneurs' entrepreneurial experiences and, as a result, in developing effective policies and programs to help them expand their business. [ABSTRACT FROM AUTHOR]

Little is known about the relations between principals' effectiveness in specific leadership tasks and student achievement. The purpose of this study is to explore principal task effectiveness, as perceived by principals themselves and their senior management teams (SMTs), and to explore the associations between perceived principal task effectiveness and student achievement. This study employed an exploratory quantitative design using surveys to collect principal and SMT ratings of principal task effectiveness. In addition, grades from secondary school exit examination in Mathematics and English as a Second Language (ESL) were collected from all public secondary schools in the Maldives. An exploratory factor analysis was used to explore principal task dimensions. Hierarchical regressions were used to examine the predictive ability of principal task effectiveness and certain principal characteristics on student achievement. The analysis revealed five leadership task dimensions: School Management, Instructional Management, Teacher Quality, External Relations, and Program Development and Evaluation. The Teacher Quality dimension positively predicted student achievement in ESL. This research highlights the importance of principal task effectiveness and its link to student achievement. The findings have implications for principals' preparation and professional learning. [ABSTRACT FROM AUTHOR]

Three species of the tropical hydrocoral genus Millepora were common and abundant in the Maldives before 1998, characterizing extensive shallow reef areas known as 'Millepora zones'. The 1998 heat wave resulted in mass mortality of all the Millepora species, the characteristic Millepora zones disappeared, and only a few observations of isolated colonies were reported in the years ahead. A recent expedition (January 2024) to the northernmost region of the Maldives (Ihavandhippolhu Atoll) revealed new Millepora zones at 7–13 m depth, suggesting a potential repopulation of a vulnerable genus considered regionally extinct. [ABSTRACT FROM AUTHOR]

There are few impact evaluations of social assistance programmes amongst people with disabilities, despite the increasing popularity of disability-targeted programmes. The Disability Allowance in the Maldives is a non-contributory, non-means-tested and unconditional cash transfer of MVR 2000 (US$130) per month. This study explores the impact of the Disability Allowance on financial well-being using a quasi-experimental study design with difference-in-difference analysis conducted between 2017 and 2019. Overall, this study found a modest impact of the Disability Allowance, mainly in food security. Receipt of the Disability Allowance was attributable to a decrease in the use of negative coping mechanisms in response to food insecurity and an increase in the food proportion of household consumption expenditures. There was a non-significant trend towards reduced poverty headcount and gap, and the likelihood of moderate/severe food insecurity. These findings carry implications for the design of social protection in the Maldives and globally, indicating possible improvements in programme design (e.g., increased amount) and for complementary interventions (e.g., improving access to disability-inclusive livelihood development programmes) to maximise impact. [ABSTRACT FROM AUTHOR]

India and the United States lack the "political warfare" strategy that China has employed in many Belt and Road Initiative (BRI) nations. This article examines the occurrences of political warfare in Sri Lanka and Maldives, the two BRI nations, but focusing the discussion on China's influence in Sri Lanka in five domains. In Sri Lanka, the president has shifted towards a pro-China foreign policy, while in the Maldives, a pro-China regime was installed. Amid the competing environment, despite counter-BRI strategies by India and the West through infrastructure investment, they have not been able to ward off China's expansion through "political warfare". This article also explores why political warfare is integral to the Chinese Communist Party's strategy and the strategic benefits it gains from the strategy. [ABSTRACT FROM AUTHOR]

Female circumcision (FC) affects the lives of millions of girls and women worldwide. This study assessed the demographic and socio-economic factors associated with female circumcision among women aged 15-49 in Maldives. Data for this study were extracted from the 2016-2017 Maldives Demographic and Health Survey, collected from a nationally representative probability sample of 7699 households interviewing women aged 15-49 years. The statistical analysis of this study focused on women aged 15-49 years who have heard about FC, excluding those who have never heard of FC (n = 5943). Analyses of data entailed descriptive statistics (frequencies and percentages) and estimation of logistic regression models to examine the roles that demographic, economic, and social factors play in the occurrence of FC in Maldives. The primary variable of interest (dependent variable) was the occurrence of FC. The factors included women's current age, age circumcised, highest education level, occupation, region, wealth quintile, and women's reported attitudes towards FC. Among all respondents, 17 % of the 5943 women who have heard of female circumcision reported having undergone the procedure. The findings revealed a significant difference in female circumcision by age, education, occupation, and attitudes towards FC. Furthermore, most circumcisions occurred before age 5 and were highest in Malé (capital city) and the island atolls in Maldives's South and North regions. The variables related to opinions were most strongly associated with female circumcision. Women who believed that their religion required FC or that the practice of FC should continue are more likely to be circumcised than women who do not hold this opinion. It was more than double. In addition, cross-tabulations of the opinion variables with age and region have found that the highest proportion of women who held these beliefs was in the age group 25-39 and lived in Malé. Therefore, we recommend further research and encouragement to enact policies and legislation that would eliminate the practice of female circumcision in Maldives. [ABSTRACT FROM AUTHOR]

Blue carbon is fast garnering international interest for its disproportionate contribution to global carbon stocks. However, our understanding of the size of these blue carbon stocks, as well as the provenance of carbon that is stored within them, is still poor. This is especially pertinent for many small-island nations that may have substantial blue carbon ecosystems that are poorly studied. Here, we present a preliminary assessment of blue carbon from three islands in the Maldives. The higher purpose of this research was to assess the feasibility of using blue carbon to help offset carbon emissions associated with Maldivian tourism, the largest Maldivian industry with one of the highest destination-based carbon footprints, globally. We used stable isotope mixing models to identify how habitats contributed to carbon found in sediments, and Loss on Ignition (LoI) to determine carbon content. We found that for the three surveyed islands, seagrasses (Thalassia hemprichii, Thalassodendron ciliatum, Halodule pinofilia, Syringodium isoetifolium, and Cymodocea rotundata) were the main contributors to sediment blue carbon (55 - 72%) while mangroves had the lowest contribution (9 - 44%). Surprisingly, screw pine (Pandanus spp.), a relative of palm trees found across many of these islands, contributed over a quarter of the carbon found in sediments. Organic carbon content ('blue carbon') was 6.8 ± 0.3 SE % and 393 ± 29 tonnes ha-1 for mangrove soils, and 2.5 ± 0.2% and 167 ± 20 tonnes ha-1 for seagrasses, which is slightly higher than global averages. While preliminary, our results highlight the importance of seagrasses as carbon sources in Maldivian blue carbon ecosystems, and the possible role that palms such as screw pines may have in supplementing this. Further research on Maldivian blue carbon ecosystems is needed to: 1) map current ecosystem extent and opportunities for additionality through conservation and restoration; 2) determine carbon sequestration rates; and 3) investigate options and feasibility for tourism-related blue carbon crediting. Overall, the opportunity for blue carbon in the Maldives is promising, but the state of knowledge is very limited. [ABSTRACT FROM AUTHOR]

As the effects of climate change become apparent in line with IPCC projections, the normative aspects of international affairs are being increasingly challenged. The context of rising sea levels, coastal inundation, and salinization in low-lying atoll States points to an unprecedented scenario that beckons revisitations into 'what is natural in international affairs' and 'what turns it into being natural'. Under UNCLOS and a common understanding in international affairs, a State is primarily defined by natural territory. Oppenheim claimed that 'a State without (natural) territory is not possible'. In contrast, Gottmann's instructive approach urges a transition from viewing geographical spaces in a vacuum to understanding the relationship they share with human existence. The article explores the potential of artificial islands such as Hulhumalé in the Maldives as a climate adaptation and human resettlement strategy and their long-term legal identity in international affairs. The article aims to answer two questions: first, what is the role of human inhabitation in the characterisation of geographical spaces as 'natural' in international affairs? and, second, why and how do the definitions around artificial islands need to be revisited amidst contemporary conditions of climate change to offset the normative costs being borne by low-lying atoll States? [ABSTRACT FROM AUTHOR]

The second wave of industrialization at the end of the last century brought the attention of researchers to the effect of more energy usage and its effects on environmental degradation. It was also highlighted in the 2030 agenda for sustainable development goals (2015) that environmental degradation threatens humans' well-being unless countries use environment-friendly production processes. The present study has used the Malmquist- Luenberger Index (MLI) to estimate the environmental efficiency of the Asia-Pacific (APAC) region for the period 1990 to 2019. The estimated results showed that the environmental efficiency of APAC countries declined by 0.36%, on average, in the studied period. The results also highlighted that the Republic of Korea has the highest total factor productivity (TFP) output growth rate in the APAC region. In contrast, Lao People's DR and the Maldives have the lowest TFP. Conditional, unconditional, and Club convergence tests are also tested for the APAC region. The results also suggested that convergence in environmental efficiency is conditional on trade openness, industrial growth, and energy prices. Some policies are also suggested for the APAC region at the end of the study. [ABSTRACT FROM AUTHOR]

The Maldives face the threat of tsunamis from a multitude of sources. However, the limited availability of critical data, such as bathymetry (a recurrent problem for many island nations), has meant that the impact of these threats has not been studied at an island scale. Conducting studies of tsunami propagation at the island scale but across multiple atolls is also a challenging task due to the large domain and high resolution required for modelling. Here we use a high-resolution bathymetry dataset of the Maldives archipelago, as well as corresponding high numerical model resolution, to carry out a scenario-based tsunami hazard assessment for the entire Maldives archipelago to investigate the potential impact of plausible far-field tsunamis across the Indian Ocean at the nearshore island scales across the atolls. The results indicate that the bathymetry of the atolls, which are characterized by very steep boundaries offshore, is extremely efficient in absorbing and redirecting incoming tsunami waves. Results also highlight the importance that local effects have in modulating tsunami amplitude nearshore, including the location of the atoll in question, the location of a given island within the atoll, and the distance of that island to the reef, as well as a variety of other factors. We also find that the refraction and diffraction of tsunami waves within individual atolls contribute to the maximum tsunami amplitude patterns observed across the islands in the atolls. The findings from this study contribute to a better understanding of tsunamis across complex atoll systems and will help decision and policy makers in the Maldives assess the potential impact of tsunamis across individual islands. An online tool is provided which presents users with a simple interface, allowing the wider community to browse the simulation results presented here and assess the potential impact of tsunamis at the local scale. [ABSTRACT FROM AUTHOR]

The Maldives Archipelago (Indian Ocean), composed of two rows of atolls that enclose an inner sea, offers an excellent study site to explore the forcings of carbonate production at platforms. Glacial–interglacial sea-level changes have been claimed to be the main factor controlling the carbonate platform factories; however, climatic factors may also have an impact. In this work we used geochemical compositional records, obtained by X-ray fluorescence (XRF) core-scanning from the International Ocean Discovery Program (IODP) Site U1467 in the Maldives Inner Sea, to analyze the orbitally driven fluctuations on the carbonate production and export from the neritic environment into the Maldives Inner Sea over the last 1.3 million years. High Sr aragonite-rich carbonates (HSAC) from neritic settings were deposited in the Maldives Inner Sea during sea-level highstand intervals, increasing the Sr/Ca values. In contrast, low Sr/Ca values are observed coincident with sea-level lowstand periods, suggesting that large areas of the atolls were exposed or unable to grow, and therefore, there was a demise in the carbonate production and sediment export to the Maldives Inner Sea. However, comparison of the Sr/Ca values and the sea-level reconstructions for different interglacial periods before and after the mid-Brunhes event (MBE, ∼ 430 ka) indicates that sea level is not the only factor controlling the production of HSAC during sea-level highstands. The study of monsoon and primary productivity proxies (Fe -normalized, Fe/K , and Br -normalized records) from the same site suggests that the intensity of the summer monsoon and the Indian Ocean dipole probably modulated the carbonate production at the atolls. Moreover, Marine Isotope Stage 11 stands out as a period with high sea level and extraordinary carbonate production in the Maldives platform. This outstanding carbonate production in the Maldives atolls (and in other low-latitude carbonate platforms) probably contributed to the mid-Brunhes dissolution event through a strong shelf-to-basin fractionation of carbonate deposition. [ABSTRACT FROM AUTHOR]

In 2019, Indonesia and the other countries in the WHO South-East Asia Region adopted the goal of measles and rubella elimination by 2023. This report describes Indonesia's progress during 2013-2022. Coverage with a first dose of measles-containing vaccine (MCV) decreased from 87% to 84%, and coverage with a second MCV dose decreased from 76% to 67%. After rubella vaccine was introduced in 2017, coverage with the first dose of rubella-containing vaccine increased by 5 times, from 15% in 2017 to 84% in 2022. During 2013-2021, the annual reported measles incidence decreased by 95%, from 33.2 to 1.4 cases per million population, and the reported rubella incidence decreased by 89%, from 9.3 to 1.0 cases per million population. A large upsurge in measles and rubella cases occurred in 2022, however, with a reported measles incidence of 29 cases per million population and a reported rubella incidence of 3 per million, due primarily to the disruption in immunization services by the coronavirus disease 2019 (COVID-19) pandemic. In 2022, >26 million children (an estimated 73% of the target population) received a combined measles- and rubella-containing vaccine (measles and rubella CV) during supplementary immunization activities in 32 provinces. Although progress has been made towards measles and rubella elimination in Indonesia, continued and urgent efforts are necessary to restore routine immunization services and to close gaps in order to accelerate progress towards elimination. En 2019, l'Indonesie et les autres pays de la Region OMS de l'Asie du Sud-Est ont adopte l'objectif d'eliminer la rougeole et la rubeole d'ici a 2023. Le present rapport decrit les progres realises par l'Indonesie sur la periode 2013-2022. La couverture par la premiere dose de vaccin a valence rougeole (MCV) a baisse, passant de 87% a 84%, de meme que la couverture par la deuxieme dose de MCV, qui est passee de 76% a 67%. Apres l'introduction du vaccin contre la rubeole en 2017, la couverture par la premiere dose du vaccin a valence rubeole a ete multipliee par 5, passant de 15% en 2017 a 84% en 2022. Entre 2013 et 2021, d'apres les donnees qui ont ete communiquees, l'incidence annuelle de la rougeole a diminue de 95%, passant de 33,2 a 1,4 cas par million d'habitants, et l'incidence de la rubeole a baisse de 89%, passant de 9,3 a 1,0 cas par million d'habitants. Une forte recrudescence de cas de rougeole et de rubeole s'est toutefois produite en 2022, oU l'incidence de la rougeole etait de 29 cas par million d'habitants et l'incidence de rubeole de 3 cas par million d'habitants, principalement en raison de la perturbation des services de vaccination par la pandemie de maladie a coronavirus 2019 (COVID-19). En 2022, >26 millions d'enfants (environ 73% de la population cible) ont recu le vaccin combine antirougeoleux-antirubeoleux (MRCV) lors des activites de vaccination supplementaire menees dans 32 provinces. Bien que des progres vers l'elimination de la rougeole et de la rubeole aient ete accomplis en Indonesie, il est urgent de retablir les services de vaccination systematique et de combler les lacunes afin de parvenir plus rapidement a l'elimination de ces maladies., Introduction Indonesia's immunization programme currently targets a birth cohort of over 4.4 million children annually. In 1982, a first dose of measles-containing vaccine (MCV1) was introduced into the routine immunization [...]

This article focuses on one of the largest infrastructure projects in the Maldives, the Sinamale' ('China-Maldives Friendship') Bridge. The bridge affords a range of meanings, shaped to various degrees by both its global entanglements with China's Belt and Road Initiative (BRI) and local political contestation within the Maldives. Linking the national capital to its international airport and spanning across the three islands, the Sinamale' bridge quickly became the site of a diverse range of social and cultural experiences and interpretations--including encounters with the supernatural. The bridge has thus inadvertently become a space in which local experiences of modernity are elaborated by individuals through complex engagements with diverse elements of local cosmology, and symbolic expressions of locality and trespass that complicate any neat linear narratives of modernizing development and 'progress.' Keywords: Indian Ocean--China--infrastructure--identity--sense of place-- haunting, Ghostly matters are part of the 'something more' because haunting is one of the most important places where meaning--comprehension--and force intersect. (Gordon 1997, 194) Beyond its publicly expressed intentions to [...]