The geographies of food banks in the meantime

The authors gratefully acknowledge the support given by the British Academy for this research (grant no. SG131950). The ‘Emergency Food Provision in the UK’ research includes: over eighteen months of ethnographic research in a Trussell Trust Foodbank; a national survey of the Trussell Trust Network and Independent food banks (and other food aid providers); and in-depth interviews with food bank managers, volunteers and service-users in London, Bristol, Leicestershire, South Wales, Devon, and Cornwall

Impact of Primary Care Benefits on Healthcare Utilisation and Estimated Out-of-pocket Expenses in Urban, Rural and Remote Settings in the Philippines

Background This study aimed to determine the effects of primary care interventions on healthcare utilisation and estimated out-of-pocket (OOP) expenses in selected urban, rural and remote settings in the Philippines. Methodology Context-specific measures relating to expanding healthcare provider networks, augmenting the health human workforce and subsidising transportation costs were implemented to strengthen primary care systems. In this study, two key outcomes were monitored: (1) monthly healthcare utilisation measured by the total number of outpatient consultations per site and (2) change in OOP expenses from baseline to endline within a 1 year study period. Results All sites had a positive trend in monthly outpatient consultations in healthcare utilisation over 1 year. The remote site had the steepest increase in outpatient consultations, with a 401% increase compared with the baseline during the peak of consultations at month 7. The urban site had a 62% increase in outpatient consultations from baseline to month 6, while the rural site had a 251% increase from baseline to month 11, which corresponded to the peak month in terms of the number of outpatient consultations. The rural site had the largest decrease in estimated OOP expenses (50.3% reduction, 95% CI -88 to -13), followed by the remote site (33.2% reduction, 95% CI -67,+1) and the urban site (16.0% reduction, 95% CI -65,+33). Conclusion The rural site showed a significant reduction in estimated OOP expenses and an increase in healthcare utilisation. The remote site had the steepest increase in utilisation, but the reduction in estimated OOP expenses was not statistically significant. The urban site experienced the lowest increase in utilisation, and the smallest reduction in estimated OOP expenses, which was also not statistically significant. Implementing primary care benefits will necessitate contextualised approaches to avoid the inadvertent aggravation of inequities in healthcare

Weird exoskeletons: propositional politics and the making of home in underground Bucharest

The article explores the politics of life underground in Bucharest, Romania. It focuses on a tunnel passing under Bucharest's central train station, where a community of drug users and so‐called ‘homeless’ have made a long‐standing home, using a space that many others considered uninhabitable. Relying on extensive ethnographic observations and interviews undertaken within the tunnels, the article traces and illustrates the socio‐material entanglements characterizing life underground. It frames this assemblage of bodies, veins, syringes, substances and various relationships of power and affect, as a ‘propositional politics’ of home and life at the margins. Such a politics speaks of drug addiction and extreme marginalization, but also of a sense of belonging, reciprocal trust and care. In tracing such a politics, the article does not aim to romanticize the status of home in the underground or to treat it as the marginal antithesis of normative homeliness, but to reveal the ways in which an affirmative, self‐grounding politics of home emerges from the immanence of tunnel life within the fabric of the city. As such, the article contributes to debates around homing practices in conditions of uninhabitability and proposes a radical approach to the politics of life at the margins in the contemporary urban

An Optimization Model for Technology Adoption of Marginalized Smallholders: Theoretical Support for Matching Technological and Institutional Innovations

The rural poor are often marginalized and restricted from access to markets, public services and information, mainly due to poor connections to transport and communication infrastructure. Despite these unfavorable conditions, agricultural technology investments are believed to unleash unused human and natural capital potentials and alleviate poverty by productivity growth in agriculture. Based on the concept of marginality we develop a theoretical model which shows that these expectations for productivity growth are conditional on human and natural capital stocks and transaction costs. Our model categorizes the rural farm households below the poverty line into four segments according to labor and land endowments. Policy recommendations for segment and location specific investments are provided. Theoretical findings indicate that adjusting rural infrastructure and institutions to reduce transaction costs is a more preferable investment strategy than adjusting agricultural technologies to marginalized production conditions

Methodological Review and Revision of the Global Hunger Index

The Global Hunger Index (GHI) is a multidimensional measure of hunger that considers three dimensions: (1) inadequate dietary energy supply, (2) child undernutrition, and (3) child mortality. The initial version of the index included the following three, equally weighted, non-standardized (i.e. unscaled) indicators that are expressed in percent: the proportion of the population that is calorie deficient (FAO's prevalence of undernourishment); the prevalence of underweight in children under five; and the under-five mortality rate. Several decisions regarding the original formulation of the GHI are reconsidered in light of recent discussions in the nutrition community and suggestions by other researchers, namely the choice of the prevalence of child underweight for the child undernutrition dimension, the use of the under-five mortality rate from all causes for the child mortality dimension, and the decision not to standardize the component indicators prior to aggregation. Based on an exploration of the literature, data availability and comparability across countries, and correlation analyses with indicators of micronutrient deficiencies, the index is revised as follows: (1) The child underweight indicator is replaced with child stunting and child wasting; (2) The weight of one third for the child undernutrition dimension is shared equally between the two new indicators; and (3) The component indicators of the index are standardized prior to aggregation, using fixed thresholds set above the maximum values observed in the data set. The under-five mortality rate from all causes is retained, because estimating under-five mortality attributable to nutritional deficiencies would be very costly and make the production of the GHI dependent on statistics about cause-specific mortality rates by country and year that are published irregularly, while the expected benefits are limited

Food and Nutrition Security Indicators: A Review

In this paper, we review existing food and nutrition security indicators, discuss some of their advantages and disadvantages, and finally classify them and describe their relationships and overlaps. In order to achieve this, the paper makes reference to the existing definitions of food and nutrition security (FNS), in particular as they have been agreed upon and implemented in the FoodSecure project (www.foodsecure.eu). The main existing conceptual frameworks of FNS predating the present paper are also used as guidelines and briefly discussed. Finally, we make recommendations in terms of the most appropriate FNS indicators to quantify the impacts of various shocks and interventions on food and nutrition security outcomes