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- Genre: Doctoral Dissertation
Description
Climate change impacts are evident throughout the world, particularly in the low lying coastal areas. The multidimensional nature and cross-scale impacts of climate change require a concerted effort from different organizations operating at multiple levels of governance. The efficiency and effectiveness of the adaptation actions of these organizations rely on the problem framings, network structure, and power dynamics of the organizations and the challenges they encounter. Nevertheless, knowledge on how organizations within multi-level governance arrangements frame vulnerability, how the adaptation governance structure shapes their roles, how power dynamics affect the governance process, and how barriers emerge in adaptation governance as a result of multi-level interactions is limited. In this dissertation research, a multilevel governance perspective has been adopted to address these knowledge gaps through a case study of flood risk management in coastal Bangladesh. Key-informant interviews, systematic literature review, spatial multi-criteria decision analysis, social network analysis (SNA), and content analysis techniques have been used to collect and analyze data. This research finds that the organizations involved in adaptation governance generally have aligned framings of vulnerability, irrespective of the level at which they are operated, thus facilitating adaptation decision-making. However, this alignment raises concerns of a neglect of socio-economic aspects of vulnerability, potentially undermining adaptation initiatives. This study further finds that the adaptation governance process is elite-pluralistic in nature, but has a coexistence of top-down and bottom-up processes in different phases of adaptation actions. The analysis of power dynamics discloses the dominance of a few national level organizations in the adaptation governance process in Bangladesh. Lastly, four mechanisms have been found that can explain how organizational culture, practices, and preferences dictate the emergence of barriers in the adaptation governance process. This dissertation research overall advances our understanding on the significance of multilevel governance approach in climate change adaptation governance.
ContributorsIshtiaque, Asif (Author) / Chhetri, Netra (Thesis advisor) / Eakin, Hallie (Thesis advisor) / Myint, Soe W (Committee member) / Arizona State University (Publisher)
Created2019
Description
While women in higher income countries can expect to survive a diagnosis of breast cancer, women in lower- and middle-income countries such as Bangladesh have mortality rates near 50%, suggesting that there are significant barriers to care seeking for breast problems. Given limited literature on barriers to care among native, rural South Asian populations, this study thus sought to understand 1) the impacts of breast problems on women and their families, including the extent of abuse among women with breast problems, and 2) the barriers and facilitators of care for women with breast problems in rural Bangladesh.
Sixty-three study participants (43 women and 20 men) were interviewed about their experiences. Interviewers elicited barriers to care, facilitators of care, and questions about the attitudes and behaviors of family and community members were in structured interviews.
The study found that breast problems and their treatment put significant resource and emotional strains on the family. Furthermore, over a third of women in this study reported abuse of some kind, with emotional abuse, neglect, and abandonment being the most frequently reported.
The study reinforced barriers to care identified in the literature for South Asian populations, but only a quarter of participants reported stigma of any kind. Lack of knowledge about breast cancer and inability to pay for care were the most frequently reported barriers, followed by access to care and fear of treatment. Facilitators of care among women who received a biopsy point to the importance of support by the husband and husband’s family, as well as the ability to identify economic support for and knowledge about care.
This study contributes to the understanding of two overarching themes: structural violence and the value of women, as well as how these themes influence poor outcomes for women with breast cancer in rural Bangladesh. Suggestions for future studies and short and long-term interventions to address study findings are offered.
Sixty-three study participants (43 women and 20 men) were interviewed about their experiences. Interviewers elicited barriers to care, facilitators of care, and questions about the attitudes and behaviors of family and community members were in structured interviews.
The study found that breast problems and their treatment put significant resource and emotional strains on the family. Furthermore, over a third of women in this study reported abuse of some kind, with emotional abuse, neglect, and abandonment being the most frequently reported.
The study reinforced barriers to care identified in the literature for South Asian populations, but only a quarter of participants reported stigma of any kind. Lack of knowledge about breast cancer and inability to pay for care were the most frequently reported barriers, followed by access to care and fear of treatment. Facilitators of care among women who received a biopsy point to the importance of support by the husband and husband’s family, as well as the ability to identify economic support for and knowledge about care.
This study contributes to the understanding of two overarching themes: structural violence and the value of women, as well as how these themes influence poor outcomes for women with breast cancer in rural Bangladesh. Suggestions for future studies and short and long-term interventions to address study findings are offered.
ContributorsSteiness, Heather Lynn Story (Author) / Hruschka, Daniel J (Thesis advisor) / Wutich, Amber (Committee member) / Ginsburg, Ophira (Committee member) / Arizona State University (Publisher)
Created2016