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Many developing countries are at a crucial juncture in road transport electrification with electric mobility because they have limited economic capacity to implement government policy support and financial mechanisms that have spurred the capital-intensive electric mobility growth in developed countries. Attracting private sector investments remains a viable option for developing countries. While investors have identified opportunities to invest in developing countries, it remains to be seen which countries to prioritise, considering the complexities involved in investment decision-making despite the availability of myriad investment appraisal tools. This paper contributes to this academic and policy debate. With a power and transport sector coupling viewpoint, we explain the interaction of the power and transport sectors in the context of decarbonisation and digitalisation to identify developing countries that could be considered for private sector investment in electric mobility. Then, we apply our framework to case studies of the Philippines, Argentina, Romania, and Poland. We argue that countries with wholesale power markets and wholesale and retail power markets could attract electric mobility investment. We offer policy recommendations to stakeholders interested in electric mobility investment issues in developing countries.

BackgroundAfrican, Caribbean, and Black (Black) communities in Canada are disproportionately affected by the HIV epidemic. Pre-exposure prophylaxis (PrEP) is a highly effective option for the prevention of HIV. However, the use of PrEP for HIV prevention among eligible Black clients in Canada remains far below the thresholds necessary to achieve the goal of zero new HIV infections. In a recent study in Toronto, PrEP-eligible Black clients were found to have decisional conflict and unmet decisional needs, which affected the quality of their decision-making process regarding the initiation and adherence to PrEP. There is evidence that decision support tools (DSTs) can improve the quality of a decision, the quality of the decision-making process, the implementation or continuation of the chosen option, and the appropriate use of health services. Despite these benefits, there is currently no DST for PrEP-eligible Black clients being asked to consider PrEP for HIV prevention. ObjectiveOur study aimed to develop a DST to improve PrEP decision-making for Black clients and to evaluate the tool’s acceptability and usability. MethodsWe developed and evaluated the PrEP DST for Black patients using the 7-step process outlined in the Ottawa Decision Support Group Guideline for the development and evaluation of DST. To facilitate the implementation of the Ottawa Decision Support Group guideline, we assembled a multidisciplinary team of primary health care providers, researchers, community members with lived experiences, and digital content designers to serve as the steering committee. First, we assessed patients’ and primary health care providers’ views on decisional support needs, after which we determined the content, design, and distribution plan for the DST. Subsequently, we conducted evidence synthesis, reviews, and appraisal before developing the PrEP DST prototype. The final tool was reviewed by steering committee members for completeness before acceptability and usability testing with potential Black clients and PrEP providers. ResultsThe web-based DST yielded 27 pages divided into 6 distinct sections. The six sections include (1) an introduction of the DST, (2) clarify your decision, (3) knowledge, (4) a value clarification exercise, (5) support system, and (6) next steps. Both Black clients and PrEP providers reported ease of task performance, general satisfaction, and usefulness of the tool to support decision-making for Black clients. Feedback on usability centered on the need to add a user guide to increase usability. All feedback was incorporated into the final tool. ConclusionsA PrEP DST for Black clients developed using a systematic process and a multidisciplinary steering committee was acceptable and usable by both Black clients and PrEP providers. Further study (eg, randomized controlled trials) may be needed to evaluate the efficacy of the PrEP DST.

The future of food production in Nigeria where smallholding agriculture is prevalent is threatened by climate change. Despite the threats, Nigeria has no specific plan or policy to combat it. Therefore, understanding how smallholder farmers adjust to the changing climate and the factors that influence their adaptation choices will facilitate developing a policy to tackle climate change. This study therefore evaluates climate change adaptation techniques among smallholder rice farmers in Kebbi state, Nigeria. The study employs a simple random sampling technique to select 345 respondents. The data was analysed using multivariate probit and ordered probit regression.The findings revealed that marital status, literacy, farm size, farming experience, major occupation, extension visits, amount of credit, and access to climate information influenced adaptation strategy choice. Furthermore, marital status, literacy, household size, farm size, extension visits, and access to climate information are crucial drivers of adoption intensity. This study concludes that smallholder rice farmers in the study area adopt several practices to cope with climate change, however, farmers’ intensity of adoption is low. This study recommends that stakeholders in the food systems in the study area should consider literacy, farm size, extension service, credits, and climate information in designing viable policies toward combating the vagaries of climate.

Automated vehicles (AV) can increase safety, reduce congestion, and provide environmental benefits to the urban transport system. Nonetheless, AV’s governance in the urban transport system is challenging. This paper proposes a novel interdisciplinary methodology and contributes to the governance debate from the ‘policy’ and ‘polity’ dimensions. We attempt to draw insight from the Norwegian cultural context and a willingness to use AV survey in Oslo, Norway. We then attempt to provide insight into the workable governance approach for AV deployment in the Oslo region, Norway. Our result suggests that less than half of the people in the Oslo region are willing to use AV. Based on our analytical insight, we argue that a workable governance approach for AV that will allay fears of privacy loss while making people feel safe and secure, manage uncertainty, pessimism about technological innovation, and embrace time-honoured Norwegian traditions should be considered to support the deployment of AV in Norway.

The probability that the beneficiary would default on future payments poses a great risk to extending agricultural credit. Also, previous research on farmers' repayment of agricultural credit emphasized that a high default rate is a growing concern, thereby becoming a tall order for financial institutions to lend to farmers. Similarly, past studies accentuate an increasing focus on socio-economic characteristics as factors that explain the repayment rate. The nexus between repayment rates and credit rationing has not been well analyzed. The effect of credit rationing on repayment rate was therefore investigated. The study, therefore, investigates the causal effects of credit rationing on loan repayment performance using a structured questionnaire to elicit information from selected 240 respondents via a three-stage method of sampling technique, and the instrumental variable Tobit technique to analyze the effect of credit rationing on repayment performance. The result showed that the majority (70.83%) of the respondents are males, the mean age was 51 years with an average education year of 12.65. The result of instrumental variable Tobit regression confirmed the endogeneity of rationing rate (Wald test of exogeneity = Wald Chi2 (1) = 67.26; Prob > chi2 = 0.000) at a 1% level of statistical significance. The result with a Log-likelihood function (265.62459) revealed that the ration rate, among others, with coefficients of 0.4335, was a crucial factor in ascertaining the rate of repayment at various significant levels of the arable crop farmers in the research area. The key finding is that credit rationing did have a significantly positive influence on agricultural credit repayment. The research concluded that the significance of credit rationing in influencing the likelihood of repayment rate, points to the vital significance of adequacy in rationing borrowers.

IntroductionAgricultural insurance is crucial to reducing financial exposures and vulnerabilities, and managing the production risks of poultry farmers while also reducing hunger levels. Unfortunately, it has not been effective in developing countries, like Nigeria.MethodsThis study examined the outcome of agricultural insurance use on poultry egg output and efficiency in Oyo State, Nigeria. The multistage sampling technique was adopted to select 120 and 152 insured and uninsured poultry egg farmers, respectively. The data gathered, using a well-designed questionnaire, was analyzed by descriptive statistics, a logistic regression model, and a Stochastic Production Frontier.Results and DiscussionResults showed that the majority (about 74% and 77%) of uninsured and insured poultry egg farmers, respectively, were small-scale farmers who operated on low capital investment, making it difficult to take insurance policy. Educational level, farming size, access to credit facilities, previous mortality rate, sales challenges, and net farm income were significant variables affecting the level of use of insurance. The result of the stochastic production frontier showed that the use of insurance is not statistically significant to the poultry egg farmers’ production inefficiency. This study highlights the importance of formulating policies that promote private sector involvement, ensure prompt indemnity payment, and encourage uninsured farmers to adopt insurance policies, ultimately aiding affected farmers, improving production scale, and mitigating farm risks.

The claim that religion has any bearing on a country’s growth is still up for discussion. Nigeria is not exempt from the widespread underdevelopment that is currently sweeping through the African continent. Religious leaders and their followers’ personal interests affect the contributions that religion should have made to the nation’s growth and development. Religion itself is being misused for nefarious and selfish ends. The decline in the country educational, social, political, and economic conditions coupled with problem of insecurity is proof of this. The nation is witnessing high level of insecurity, kidnapping, banditry, and corruption in public sectors is getting worse. This paper aims to identify reasons why religious values are being relegated, and why religion is not doing much to counter some of the menaces retarding development. It was discovered that religious leaders and adherents had contributed negatively to the development of the nation by placing personal interest above religious values through desire for power and love for money. Karl Marx’s theory on religion is applicable to this research considering the practise of religion in our society. The article suggests, among others, that religion must play the social role of helping to conserve the national values that can guarantee virtues of national development as against private gain.

Alemnew Wale,1 Legese Chelkeba,2 Yohannes Wobie,3 Abinet Abebe3 1Clinical Midwifery, Department of Midwifery, College of Medicine and Health Science, MizanTepi University, Mizan, Ethiopia; 2Clinical Pharmacy, School of Pharmacy, Institute of Health, Addis Ababa University, Addis Ababa, Ethiopia; 3Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, MizanTepi University, Mizan, EthiopiaCorrespondence: Alemnew Wale; Yohannes Wobie Email walealemnew@gmail.com; yohanneswobie@gmail.comIntroduction: Neonatal sepsis is the gravest problem in neonates, ending in significant morbidity and mortality. World wide 6.9 million neonates were spotted with potentially severe bacterial infections needing treatment and 2.6 million of them occurred in sub-Saharan Africa (SSA). Sepsis is the leading cause of neonatal mortality and is perhaps answerable for about 30– 50% of the total neonatal deaths per year in emerging countries.Objective: This study aims to assess the treatment outcome and associated factors of neonatal sepsis at Mizan Tepi University Teaching Hospital, South West Ethiopia.Methods: A hospital-based prospective observational study was done at Mizan Tepi University Teaching Hospital (MTUTH) from May to November 2019 among neonates admitted with sepsis. Data were entered to Epi-data 4.2 and analyzed by SPSS version 21. Bivariate and multivariate Cox regression was used to identify the relationship between dependent and independent variables. All neonates ≤ 28 days who were admitted to MTUTH at the neonatal intensive care unit (NICU) and neonates diagnosed with sepsis by the attending physician either clinically or laboratory-confirmed included in the study.Results: Of the 211 neonatal sepsis patients, 110 (52.1%) were females, 161 (76.3%) were admitted with late-onset sepsis, 16 (7.6%) were very low birth weight, and 156 (73.9%) were term. About 143 (67.8%) had a good outcome and 68 (32.2%) had a poor outcome. Very low birth weight [P = 0.006, AHR = 1.692, 95% CI: (1.245, 4.36)], age of neonate being less than 4 days at admission [P = 0.001, AHR = 9.67, 95% CI: (2.24, 41.70)], maternal infection [P = 0.032, AHR = 3.186, 95% CI: (1.32, 30.68)], and prolonged length of hospital stay [(P = 0.017, AHR = 12.29, 95% CI: (1.55, 96.31), were significantly associated to mortality.Conclusion: The mortality rate of neonatal sepsis was found to be high. Age of neonate < 4 days, birth weight of the neonate < 1500 gm, and prolonged length of hospital stay were identified as independently associated factors of increased risk of mortality.Keywords: neonate, sepsis, treatment outcome, Mizan, Ethiopia 2021

Desalegn Girma,1 Zinie Abita,2 Alemnew Wale,1 Semahagn Tilahun1 1Mizan-Tepi University, College of Health Science, Department of Midwifery, Mizan-Teferi, Ethiopia; 2Mizan-Tepi University, College of Health Science, School of Public Health, Department of Reproductive Health, Mizan-Teferi, EthiopiaCorrespondence: Desalegn Girma Tel +251933704490Email desegir@gmail.comBackground: The PedsQLTM 4.0 generic core scales (GCS) assess the generic health by integrating with disease-specific PedsQLTM 3.0 diabetes module (DM). The PedsQLTM 3.0 DM measures the health-related quality of life (HrQoL) specific to diabetes. Even though there is no translation to Ethiopian Amharic, the instruments had translated to different languages and validated. The study is aimed to assess the validity and reliability of the Amharic version of the PedsQLTM 4.0 GCS and the PedsQLTM 3.0 DM in children and adolescents with diabetes.Methods: PedsQLTM 4.0 GCS and the PedsQLTM 3.0 DM were administered on 193 children and adolescents with diabetes and their parents. The validity was examined by the exploratory factor analysis, multitrait/multi-item scaling analysis, and multitrait-multimethod and monotrait-multimethod analysis. Cronbach’s alpha coefficient checked the reliability.Results: Cronbach’s alpha coefficient for the total PedsQLTM 4.0 GCS (α child self-report= 0.96; α parent proxy report= 0.95) and for total PedsQLTM 3.0 DM (α child self-report= 0.96; α parent proxy report=0.93) were acceptable at individual patient-level analysis. The monotrait-multimethod correlations were higher than multitrait-multimethod correlations. In multitrait/multi-item scale analysis, both total PedsQLTM 4.0 GCS and PedsQLTM 3.0 DM had an excellent item convergent and discriminatory validity success rate.Conclusion: The Amharic versions of the PedsQLTM 4.0 GCS and the PedsQLTM 3.0 DM were valid and reliable instruments to measure the HrQoL of children and adolescents with diabetes.Keywords: quality of life, PedsQL™ 3.0 DM, PedsQLTM 4.0 GCS, validation, reliability

Aychew Kassie,1 Alemnew Wale,2 Worke Yismaw3 1Department of Nursing, College of Medicine and Health Science, Mizan-Tepi University, Mizan Teferi, Ethiopia; 2Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan Teferi, Ethiopia; 3Department of Nursing, College of Medicine and Health Science, Mettu University, Mettu, EthiopiaCorrespondence: Aychew Kassie Tel +251922460461Email aychewkassie055@gmail.comBackground: In low-and middle-income countries, it is challenging to provide basic health-care services even before the COVID-19 pandemic outbreak. The purpose of this study was to evaluate the early indirect impact of COVID-19 on the utilization of reproductive, maternal, and newborn health services at government health facilities in South West Ethiopia, and its consequences.Methods: A comparative cross-sectional study was employed. The collected data were entered into Microsoft excel 2010 and then exported to SPSS 25 and R3.5.0 software for analysis. Independent sample t-test and two-sample test of proportion were computed, and the results were presented in text, tables, and graphs. P-value < 0.05 was considered statistically significant.Results: This study showed that there was a significant reduction in mean utilization of antenatal care (943.25 visits vs 694.75 visits), health facility birth (808.75 births vs 619 births), family planning (4744.5 visits vs 3991.25 visits), and newborn immunization (739.5 given vs 528.5 given) between March–June 2019 and March–June 2020. However, there were significant increases in proportion of teenage pregnancy (7.5% vs 13.1%), teenage abortion care user (21.3% vs 28.5%), institutional stillbirth (14% vs 21.8%) and neonatal death (33.1% vs 46.2%) during the same period.Conclusion and Recommendation: This study showed that utilization of reproductive, maternal, and newborn health-care services was affected by the pandemic with deterioration of maternal and perinatal outcomes. An increase in the proportion of teenage pregnancy who seeks abortion care and the rising cesarean section rate with no improvement in perinatal outcome is a great concern that needs further investigation. Further research is also needed to explore the main reason for an increase in teenage pregnancy, abortion care users, stillbirth, and neonatal death during COVID-19.Keywords: COVID-19, impact, utilization, outcome, maternal and child health, Ethiopia

Alesha Wale,1 Mark Ireland,2 Rowan Yemm,1 Sarah Hiom,3 Alison Jones,3 John Paul Spark,3 Mark Francis,4 Karen May,5 Louise Allen,5 Steve Ridd,6 Efi Mantzourani1,7 1School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, Wales, UK; 2Community Pharmacy Wales, Cardiff, Wales, UK; 3St. Mary’s Pharmaceutical Unit, Cardiff, Wales, UK; 4Swansea Bay University Health Board, Swansea, Wales, UK; 5Cardiff and Vale University Health Board, Swansea, Wales, UK; 6Mayberry Pharmacy, Cardiff, Wales, UK; 7NHS Wales Informatics Service, Cardiff, Wales, UKCorrespondence: Efi Mantzourani Email MantzouraniE1@cardiff.ac.ukObjective: Community pharmacy staff are responsible for obtaining and supplying unlicensed “special” medicines to patients in primary care. Less well-defined parameters for safe and effective use of unlicensed compared to licensed medicines, along with issues around maintaining consistency between care settings or among manufacturers, have been associated with increased risks. This study aimed to explore the views and experiences of community pharmacy staff on accessing and supplying unlicensed “special” medicines to patients in Wales and the perceived impact of challenges faced on patient care.Methods: A qualitative, phenomenological approach was employed, involving semi-structured interviews with pharmacists and pharmacy technicians working at one small chain of community pharmacies in Wales. The interview schedule focused on the personal experiences and perceptions of the participants on the processes involved in accessing and supplying unlicensed “special” medicines from a community pharmacy. Interviews were audio-recorded and transcribed verbatim.Results: A total of six participants completed the interview. Three main themes were constructed from inductive thematic analysis of the transcribed interviews: requirement for additional patient responsibilities; influences on the confidence felt by pharmacy staff when accessing and supplying unlicensed “special” medicines; and continuity of supply.Conclusion: This study gives a preliminary insight into the views and experiences of community pharmacy staff in Wales when accessing and supplying unlicensed “special” medicines. Further research is required to see if these views and experiences are representative of community pharmacy staff across the country.Keywords: unlicensed medicines, “special” medicines, specials, community pharmacy, transfer of care, medicines supply, transmural care, off-label, compounding

Objectives: This study examined factors contributing to decision conflict and the decision support needs of PrEP-eligible Black patients. Methods: The Ottawa Decision Support Framework (ODSF) was used to guide the development of a key informant guide used for qualitative data collection. Black patients assessed by healthcare providers as meeting the basic criteria for starting PrEP were recruited through the St. Michael's Hospital Academic Family Health Team and clinical and community agencies in Toronto. Participants were interviewed by trained research staff. Qualitative content analysis was guided by the ODSF, and analysis was done using the Nvivo. Results: Four women and twenty-five men (both heterosexual and men who have sex with men) were interviewed. Participants reported having difficulty in decision making regarding adoption of PrEP. The main reasons for decision-conflict regading PrEP adoption were: lack of adequate information about PrEP, concerns about the side effects of PrEP, inability to ascertain the benefits or risk of taking PrEP, provider's lack of adequate time for interaction during clinical consultation, and perceived pressure from healthcare provider. Participants identified detailed information about PrEP, and being able to clarify how their personal values align with the benefits and drawbacks of PrEP as their decision support needs. Conclusion: Many PrEP-eligible Black patients who are prescribed PrEP have decision conflict which often causes delay in decision making and sometimes rejection of PrEP. Healthcare providers should offer decision support to Black patients who are being asked to consider PrEP for HIV prevention.

The challenges of identifying and eliminating racial disparities regarding the exposure, transmission, prevention, and treatment of communicable diseases within the healthcare system have been a mounting concern since the COVID-19 pandemic began. The African, Caribbean, and Black (ACB) populations in Canada represent a fast-expanding and underprivileged community, which have been previously found to have higher susceptibility to communicable diseases and lower sensitivity to intervention measures. Currently, there is insufficient evidence to adequately identify racial patterns in the prevalence and healthcare utilization among the ACB population within the context of the ongoing pandemic. Our proposed study will explore the association between the social determinants of health (SDH) and COVID-19 health outcomes in ACB populations in high-income countries (UK, US, Australia). We will explore the literary evidence through a systematic review (SR) of COVID-19 literature covering the period between December 2019 and October 2020. The objectives include investigating the effect of SDH on the ACB populations’ risk to COVID-19 health outcomes, including COVID-19 infection incidence, severity of disease, hospitalization, mortality and barriers to the treatment and management of COVID-19 for Black people in Canada. In addition, this project aims to investigate the effect of COVID-19 on ACB communities in Ontario by examining the challenges that front-line healthcare workers and administrators have during this pandemic as it pertains to service provisions to ACB communities. A systematic review of original and review studies will be conducted based on the publications on eleven databases (MEDLINE, Web of Science, Cochrane Library, CINAHL, NHS EDD, Global Health, PsychInfo, PubMed, Scopus, Proquest, and Taylor and Francis Online Journals) published between December 2019 to October 2020. Primary outcomes will include the rate of COVID-19 infection. The systematic review will include a meta-analysis of available quantitative data, as well as a narrative synthesis of qualitative studies. This systematic review will be among the first to report racial disparities in COVID-19 infection among the ACB population in Canada. Through synthesizing population data regarding the risk factors on various levels, the findings from this systematic review will provide recommendations for future research and evidence for clinical practitioners and social workers. Overall, a better understanding of the nature and consequences of racial disparities during the pandemic will provide policy directions for effective interventions and resilience-building in the post-pandemic era.

COVID-19 has rapidly spread across the globe and was declared a pandemic by the World Health Organization (WHO). The COVID-19 infection continues to spread across Africa. In Africa, mobile phone applications have been used for the surveillance and reporting of infectious diseases such as malaria, measles, polio, and other notifiable diseases as mandated by the WHO. A good example is the early warning alert and response system. We developed an eight-question triage tool using the Nigerian Centre for Disease Control surveillance case definitions for new coronavirus disease. Based on the assessed risk level we offered advice and guidance on the next steps. A user-administered tool such as this is vital to COVID19 control. It is also significant in relieving the burden on health systems, providing information on national health guidelines for prevention and control, fostering the participation of citizens, and giving them the next steps, pandemic control efforts become more effective.

Solving the hydra-headed economic, technical and institutional electrification challenges in the Nigeria Power sector requires innovative insights that decentralized offgrid reverse auction with solar power plus storage offers. However, running a successful auction requires a meticulous design with in-depth understanding of the environment and data access to provide insight on what capacity to procure, locations, costs and regulatory governance.Combining GIS, energy system optimization and market/regulation design expertise, we contribute to bridging this knowledge gap for the Nigeria Power sector. We identified the most populated consumer clusters without electricity access, made load demand projections and determined the techno-economically optimized PV plus battery storage sizes to achieve high quality power supply with some demand side management. Furthermore, we analysed the land requirements/availability to achieve a shortlist of 233 clusters with 7.2 million people that require 3280 MW solar PV for the proposed auction. Finally, we discussed the pathway to adapt our design to the existing market/regulatory framework. Keywords: Nigeria Power Sector, Reverse auction, Geographical information System (GIS), Market design, Energy Policy