Search Results (167)

This paper examines the impacts of climate-related hazards on water, sanitation, and hygiene (WASH) access and practices in rural Cambodia using a Vulnerability–Exposure–Adaptive Capacity (VEAC) framework. Drawing on survey data with 423 households and 96 local authorities across five climate-vulnerable provinces in rural Cambodia, the study integrates household experiences with perspectives from village, commune, and district authorities responsible for local WASH planning and service delivery. The analysis distinguishes exposure to floods and droughts from underlying socio-economic and environmental vulnerabilities in WASH access and use, and from the social, economic, and geographic determinants shaping adaptive capacity. The findings show that while exposure to climate hazards is geographically patterned, similar levels of exposure do not produce uniform WASH outcomes. Flood impacts on hygiene, sanitation, and health are mediated by village environmental conditions and household economic status, while drought impacts and responses reflect broader locational factors alongside income insecurity and social marginalisation, including disability, older age, and female-headed households. Although awareness of climate risks and adaptative WASH options is relatively high, uptake of adaptation measures remains uneven. Adaptive capacity is constrained less by knowledge deficits than by structural and economic barriers, resulting in short-term coping rather than sustained adaptation. Overall, the study demonstrates that climate-related WASH vulnerability is shaped more by socio-economic vulnerability and mismatches in adaptive capacity across household and authority scales than by hazard exposure alone. Full article

This study explores the lived experiences of pregnant women in rural Nepal navigating maternal healthcare amidst intersecting structural barriers. Using the Social Determinants of Health framework and intersectionality, we examine how geographic isolation, inadequate infrastructure, and economic hardship compound risks to timely and safe maternal care. Twenty in-depth interviews were conducted at a district hospital in the eastern region of Koshi Province, Nepal. Four major themes were identified through inductive thematic analysis. These are: geographic vulnerability and transport challenges; gaps in rural maternal health provision; accommodation and institutional support deficits; and economic vulnerability and hidden costs of care. Findings reveal that poor road conditions, unreliable transport, and limited diagnostic services force women to undertake long, costly journeys, often requiring temporary relocation without institutional accommodation support. Despite policies such as the Safe Motherhood Programme, implementation gaps persist, leaving women to bear significant financial and emotional burdens. These experiences underscore systemic inequities in resource distribution and highlight the compounded disadvantage faced by women from rural and marginalised communities. To ensure equitable maternal healthcare, this study advocates for the decentralisation of health services and the implementation of inclusive financial protection policies tailored to the needs of women from rural and marginalised communities. To promote equitable maternal healthcare, we recommend strengthening rural health infrastructure, implementing maternity waiting homes, and expanding financial protection schemes tailored to vulnerable populations. This research offers critical insights for policymakers to address maternal health inequalities and advance Nepal’s progress toward Universal Health Coverage and Sustainable Development Goal 3 (Ensure healthy lives and promote well-being for all at all ages). Full article

In South Africa, both economic and social entrepreneurship have become a game-changing strategy for tackling enduring socioeconomic issues, including inequality, unemployment, and poverty. In contrast to conventional business models that put profit maximisation first, social entrepreneurship combines entrepreneurial tactics with social goals to develop long-lasting solutions for underserved populations. This study examines how social entrepreneurship can be used to address socioeconomic problems in South Africa, highlighting how it can promote inclusive growth and help achieve both national and international development objectives. The study illustrates how social companies use innovation and community participation models to overcome structural impediments such as youth unemployment, healthcare disparities, and limited access to education. It is based on a thorough evaluation of academic literature. The results show that social entrepreneurship fosters social cohesiveness and resilience in marginalised areas in addition to creating job and income opportunities. However, issues including weak finance, insufficient policy frameworks, and a dearth of capacity-building programmes make it difficult for social enterprises to grow and survive. In order to strengthen the social enterprise sector, the study’s conclusion suggests creating supportive ecosystems through impact investments, policy reforms, and educational initiatives. South Africa can expedite its efforts to reduce inequality and achieve sustained socioeconomic transformation by presenting social entrepreneurship as a strategic development tool. Full article

The smart city concept has become a dominant framework for contemporary urban governance, largely driven by advances in digital technologies and data-driven decision-making. However, the prevailing technocratic orientation of smart city development risks marginalising the sociopolitical dimensions of urban governance, particularly citizen and stakeholder participation. Although smart governance frameworks increasingly recognise participation as a normative principle, limited empirical attention has been paid to the participation motivators that drive engagement among different urban stakeholder groups. This study addresses this gap by analysing the key motivators influencing stakeholder participation in urban development within a smart city context. Building on established behavioural and participation theories, the article develops an Urban Participation Motivator Model comprising four core motivators: social pressure, emotional trigger, rational motivation, and reward for participation. The model is empirically tested using quantitative survey data from 620 respondents representing four stakeholder groups in Riga, Latvia: municipal residents, municipal employees, municipal politicians, and real estate developers. Data are analysed using descriptive statistics and non-parametric methods, including the Kruskal–Wallis test. The results reveal statistically significant differences in the perceived importance of participation motivators across stakeholder groups. Emotional triggers and social pressure emerge as the most influential motivators overall, while rational motivation is particularly salient for professional stakeholders. Reward for participation plays a weaker but differentiated role, being most relevant for municipal employees. These findings highlight the need for differentiated motivator-sensitive urban communication and participation strategies to enhance inclusiveness, democratic legitimacy, and long-term engagement in smart city development. Full article

Background: Australia’s increasingly multicultural landscape has seen a rise in culturally and linguistically diverse populations, many of whom face subtle and systemic forms of discrimination known as “new racism”. Objective: Underpinned by a person-centred and holistic framework, which recognises individuals as experts in their own lived experiences and emphasises strength-based, culturally situated understandings of well-being, this paper reports on a study that explores how culturally and racially marginalised diverse people in Australia cope with the mental health impacts of new racism. Design: A qualitative descriptive approach was employed in this study. Participants: Thirty participants from ten culturally and linguistically diverse communities participated in eight focus groups, providing rich insights into their lived experiences. Methods: Data were collected through semi-structured focus-group interviews conducted between March and June 2025. Data were analysed using Braun and Clarke’ method of thematic analysis. Results: Thematic analysis revealed four key coping strategies: (1) acceptance of immutable identity traits to foster resilience, (2) emotional ventilation within culturally safe spaces, (3) self-growth and empowerment through reflection and adaptive practices, and (4) assertive responses to racism when necessary. While some participants reported psychological distress, many demonstrated resilience and resourcefulness, challenging deficit-based assumptions often found in the existing literature. Findings underscore the importance of culturally responsive mental healthcare, including peer support, emotional safe spaces, and strength-based interventions. Conclusions: This study offers a holistic understanding of how culturally and racially marginalised people cope with new racism and its mental health impacts. The findings highlight the critical need for person-centred, culturally responsive, and equity-focused mental health support, providing actionable guidance for nursing practice and policy development. Full article

Unmitigated communion (UC), the prioritisation of others’ needs over one’s own well-being, is a critical lens for understanding the mental health of female migrants. This qualitative study explores how UC intersects with constructions of strength and vulnerability within this population, particularly amid challenges such as adaptation, discrimination, and gendered roles. Using a feminist participatory methodology, the study was co-produced with 10 migrant women and three professionals. Semi-structured interviews were conducted with 18 female migrants from 13 countries, representing diverse languages, cultures, and lengths of stay in the UK. Data were thematically analysed using the Engaging Marginalised Communities by Building Relationships and Knowledge (EMBaRK) framework, which centres lived experience and equitable collaboration. Through this analytic process, three key themes were generated: (1) perceived strength and resilience shaped by societal pressures and internalised self-reliance; (2) gender roles and self-sacrifice, including traditional caregiving expectations and neglect of personal health; and (3) isolation and reluctance to seek support, marked by concealed mental health struggles and stigma. Participants’ narratives revealed shared tensions between resilience and vulnerability. The findings highlight the central role of unmitigated communion in shaping migrant women’s mental health and underscore the need for gender-responsive, culturally informed interventions that support women to balance caregiving with self-care. Full article

Blue tourism has become a central pillar of blue economy strategies, yet the governance foundations required to support this expansion remain weakly theorised in tourism management research. This study reframes blue tourism as a governance regime shaped by institutional capacity, platform power, and social legitimacy. Drawing on a systematic review and critical interpretive synthesis of 562 peer-reviewed journal articles, the paper examines how blue tourism has been conceptualised and managed across the literature. Bibliometric and qualitative analyses reveal a persistent imbalance: while demonstrating strong engagement with environmental management and destination optimisation, the literature marginalises governance capacity, distributive outcomes, and community consent. Furthermore, there is epistemic asymmetry between regions that dominate theoretical influence and those experiencing the most acute coastal tourism pressures. The study advances a governance-centred framework that helps destination managers, DMOs, and regulators anticipate legitimacy risks and align blue tourism development with institutional capacity under intensifying climate and capital pressures. Full article

Background/Objectives: New models of care are needed to address the barriers people who use substances (PWUS) and/or experience homelessness face when accessing primary healthcare. This study reports findings from the evaluation of a six-month pilot of a mobile health clinic (MHC) co-delivered by primary healthcare, local government, and lived-experience recovery organisations in the North East of England, UK. Methods: Pragmatic mixed-methods process evaluation with data sources including a patient survey, overt observations, qualitative interviews, and routine patient data. Qualitative data were analysed using inductive and deductive thematic analysis; quantitative data were analysed descriptively. RE-AIM framework dimensions were applied to inform interpretation. Results: N = 164 patients accessed the bus between 1 April and 31 October 2025, with survey data indicating that most patients were PWUS (n = 96, 84%), with experience of homelessness (n = 67, 61%) and/or lived in the most deprived neighbourhoods, with complex physical and mental health needs (Reach). Patients expressed satisfaction with the service, valuing the compassionate and comprehensive support provided. There was qualitative evidence of further re-engagement with statutory healthcare following attendance on the bus (Effectiveness). Local organisations were mostly keen to be involved in the pilot, with participation benefiting from existing local relationships and infrastructure (Adoption). The flexible yet consistent approach of those involved in service delivery was viewed as positive. There was some uncertainty around the functions of the bus and the role of some delivery staff (Implementation). Limited funding was perceived as a barrier to sustaining the bus, alongside lack of capacity within local organisations (Maintenance). Conclusions: The study highlighted the positive impact that an MHC can have on this marginalised population and provides further evidence for the need for clinical care that provides relational support and attends to the social determinants of health. The study indicates the potential for interdisciplinary working to improve access to healthcare for PWUS, and underlines that delivering healthcare at a neighbourhood level is reliant on strong community networks. Wider system change is still needed to further support the population. Full article

Background: People navigating pregnancy face significant emotional vulnerability, with emotional support serving as a crucial protective factor for perinatal wellbeing. While there is emerging scholarship on how AI is used as a diagnostic tool during pregnancies, early evidence suggests that people are increasingly turning to generative AI platforms for everyday emotional support during pregnancy. Yet, scholarly understanding of this phenomenon remains limited. Objective: This scoping review maps the existing literature on AI and emotional support during pregnancy, identifies critical research gaps, and establishes scaffolding for future research. Methods: Based on a thematic synthesis of a selected body of research, we reviewed literature examining AI applications in perinatal emotional support, distinguishing everyday emotional support from clinical mental health interventions. Results: The analysis revealed a nascent field dominated by clinical diagnostics and purpose-built chatbots. Critical gaps include absence of research on organic use of generative AI platforms, imbalanced representation of the perinatal continuum, and a focus on diagnosable conditions rather than everyday emotional needs. The evidence suggests women are co-constructing emotional support scaffolding through AI, something previously unavailable with existing technology. Conclusions: The findings indicate that AI may enable an entirely new domain of wellbeing support at unprecedented scale. Equity-oriented future research is needed to understand how people—particularly from marginalised communities—are using AI for everyday emotional support, ensuring this emerging domain develops responsively rather than reproduce existing inequities. Full article

Background/Objectives: British trans and gender-expansive individuals face stigma and consistently experience lengthy waits for gender-enhancing interventions. Researchers are using a range of qualitative methodologies to give this marginalised community a voice. In this study the focus is on the lived experiences of British transgender men seeking medical intervention around their gender identity. The aim was to explore how psychological well-being for this group of transmen was both threatened and supported. Methods: Online semi-structured interviews using auto-photography were conducted with eleven transmen aged between 18 and 68 years. Both verbal and visual data were analysed together using interpretive phenomenological analysis. Analysis: Three themes focus on challenges and supportive strategies utilised by participants both before their decision to transition and after. All participants expressed significant mental health difficulties before commencing their transition, typically originating from childhood and continuing until they gained access to gender-affirming medical care. Their transition journeys damaged their well-being through resistance and rejection from families and communities, and difficulties navigating healthcare systems. A series of resources which significantly enhanced well-being were also reported. Unconditional acceptance and belonging found within and beyond the trans community, connecting with nature and ultimately progressing with gender-affirming healthcare were key elements in protecting and promoting well-being. Conclusions: The toll on the well-being of trans and other gender-expansive individuals is considerable and recent changes in UK law have exacerbated the hostile environment faced by TGE individuals. Community-based allyship and access to affirmative professional psychological support at all stages is vital. Full article

Background: Street sex workers (SSWs) experience some of the highest levels of health inequality in the UK, yet face persistent barriers to accessing NHS healthcare. These barriers are shaped by structural disadvantage, stigma, and the complex realities of their lives. Despite significant health needs, engagement with services remains low, and existing models of care often fail to accommodate the lived experiences of this population. Aims: This study explores how SSWs access, experience, and navigate NHS healthcare. It aims to understand the barriers and enablers of access, identify areas for improvement, and offer recommendations to inform the development of more inclusive service provision. Methods: An ethnographic approach was undertaken within a South Yorkshire charitable organisation. Data collection involved participant observation and an arts-based scrapbook intended to facilitate trauma-informed, flexible engagement. Thematic analysis was used to analyse the data, organised around a dynamic, processual approach using the candidacy framework. Findings: Barriers to care were present across all stages of healthcare engagement, including minimisation of health needs, administrative exclusion, lack of continuity, and stigma from professionals. Participants frequently described systems as inaccessible. Key enablers included supportive organisational staff and consistent, trusted relationships with specific providers. Areas for Improvement and Recommendations: Findings highlight the need to simplify registration processes, provide in-person options, and reduce reliance on digital communication. Greater continuity of care and gender-sensitive, trauma-informed approaches were consistently requested. Services should not be evaluated solely by uptake but by how well they accommodate marginalised users. Healthcare settings that prioritise safety, trust, and consistency were shown to improve engagement. SWs spoke of the work of accessing care, which for many was too hard to gain. Conclusions: SSWs are not disengaged from healthcare but are routinely excluded by systems that fail to meet their needs. Service redesign must begin from the realities of those who are most marginalised, through co-production, to reduce health inequity and build meaningful access. Full article

This article explores the reclamation of Khoisan identities in South Africa as a multifaceted process of cultural, spatial, and political resurgence. Framed within the country’s constitutional vision of a “Nation of Nations,” the research examines how Khoisan communities—historically marginalised and classified under apartheid as “Coloured”—are reasserting their Indigenous heritage through acts of cultural revival and place-based activism. Centred on Cape Town, the ancestral homeland and symbolic epicentre of both colonial encounter and Indigenous resurgence, the article theoretically investigates how creativity, heritage, and activism intersect in processes of reimagining, renaming, and retaking of place. Drawing on theories of visual sovereignty and re-placement, it analyses how visual and performative practices—ranging from protest art and language revitalisation to heritage occupations—function as decolonial acts that reclaim both the image and meaning of place. The article situates the Khoisan revival within broader global movements of Indigenous self-representation and argues that reclaiming place constitutes a living form of sovereignty, restoring relational networks between people, land, and identity. Ultimately, it demonstrates that contemporary Khoisan activism transforms visibility into agency, using culture and creativity as tools to rewrite belonging and to decolonise South Africa’s cultural landscape. Full article

The continued marginalisation of Indigenous knowledges and practices in environmental education sustains curricula and pedagogies grounded in Western worldviews. This exclusion reinforces limited or deficit-oriented perceptions of Indigenous cultures, environments, and epistemologies. Therefore, this study draws on the theory of critical consciousness to examine the need for Indigenous peoples and educators to become critically aware of the forces shaping their educational experiences and to use this awareness to transform their lives and teaching practices for a sustainable future. To illustrate how this transformation might occur, a qualitative study was conducted with ten Nigerian secondary school teachers who engaged with the design and implementation of a decolonisation model for environmental education. Findings show that seven participants successfully adopted the model, and several demonstrated notable shifts in their perspectives during the process. The study offers two key contributions: a conceptual framework for understanding decolonisation in environmental education and a practical decolonisation model for teachers. These contributions have broader relevance for educational reform and environmental education in countries with similar contexts to Nigeria and in marginalised communities in the Global North, where learners are often alienated from their local realities in favour of globalist perspectives. Full article

Refugees and asylum seekers (RASs) are among the most marginalised, vulnerable, and economically disadvantaged groups worldwide. As a result, many government and non-government organizations, including migrant-led community organizations (MLCOs), support RASs to improve their lives in their host countries. However, there is a lack of research on the role and challenges of MLCOs supporting RASs. Therefore, informed by the concepts of grassroots humanitarianism and ethnic capital, and based on data collected through focus group discussions, this article explores the rationale, activities, and challenges of Eritrean MLCOs in England. The findings indicate that MLCOs help fill some gaps left by government agencies by providing RASs with strong advocacy and support systems to protect their rights and meet their needs. Although volunteers with limited funding run these organizations, they utilise ethnic capital to provide knowledge, raise awareness, and deliver culturally sensitive services to RASs in their own language. This article advances understanding of MLCOs’ work and improves their services to better meet the needs of RASs. It also contributes to knowledge by highlighting MLCOs’ role as sites of learning and education. Full article

Sierra Leone’s water sector faces a “paradox of scarcity in abundance”: despite plentiful natural water resources, access to safe, reliable, and affordable supply remains limited, particularly for vulnerable populations. This paper investigates the governance dynamics and stakeholder relationships that underpin these challenges, drawing on a mixed-methods approach combining desktop research, surveys, and 37 semi-structured interviews. Using stakeholder and social network analysis, the study identifies key actors and their roles, interests, influence, and interdependencies, while also examining systemic barriers across social, technical, economic, environmental, and political dimensions. The findings reveal a highly fragmented governance landscape, characterised by overlapping mandates, donor dependency, weak enforcement, and the marginalisation of community voices. Although recent reforms—including new regulatory institutions, donor-funded infrastructure projects, and community-based initiatives—represent progress, they remain largely piecemeal, reactive, and insufficient to address entrenched structural deficiencies. The paper concludes that Sierra Leone’s water crisis is less a problem of resource scarcity than one of governance. Achieving sustainable water security requires integrated, system-wide reforms that strengthen institutional capacity, enhance coordination, enforce accountability, and embed inclusive stakeholder participation. Full article