The organization of ideological discourse represents strategic, discursive acts committed by populist leaders aimed at foregrounding social conditions that would function in the advancement of various political ends—whether those ends may be the consolidation of power, the undermining of institutional systems of checks and balances, the implementation of exclusionary or injurious policies against disenfranchised constituents, the suspension of civil liberties, or a combination thereof. It is engendered through a three-stage process. In the first stage, surface-level validation by legitimate institutional actors confirms preconceived ideas about a constructed enemy. In the second stage, inflammatory rhetoric is deployed by populist leaders, which scapegoat that constructed enemy. These two stages culminate to create widespread moral panic in society. With moral panic firmly established, in the third stage an environment of fear and paranoia becomes susceptible to the enactment of symbolic and physical violence against the constructed enemy. The essay concludes with some words on the pressing need to deconstruct ideologically motivated discourses related to COVID-19.Using the persecution of Muslims in India that is currently taking place against the backdrop of the COVID-19 global pandemic as an illustrative case, this essay identifies the dynamics of  The events that unfolded in Nazi Germany in the immediate aftermath of vom Roth’s death has, perhaps, never been more timely to revisit than today. The events would come to be popularized as Kristallnacht.Known in English as ‘The Night of the Broken Glass’, Kristallnacht represents the violent acts that transpired in Germany in the late evening of 9 November 1938 and carried over into the early morning hours of the following day. During that night, Jewish owned properties, including synagogues, homes, and businesses were vandalized or seized, dozens of Jews were killed, and countless other Jews were physically assaulted . While Ktheorganization of ideological discourse.Kristallnacht vividly illuminates how the politicization of an unexpected crisis can be mobilized by populist leaders in the service of their underlying ideological agenda. Over eight decades later, such is occurring with the global pandemic of COVID-19. Namely, while worldwide attention has been, almost wholly, focused on immediate concerns on how best to contain the spread of the virus, unscrupulous populist leaders are invoking COVID-19 with ulterior, often malicious, motives. While this phenomenon is manifesting all over the world, perhaps nowhere else is it more evident than in India. Indeed, populist leaders of the reigning Bharatiya Janata Party (BJP) have strategically crafted a set of discourses, shrouded in the veneer of COVID-19 concerns, to promote the party’s longstanding Hindu nationalist—and, concomitantly, anti-Muslim—ideology of Hindutva. In this essay, I label the process through which an unexpected crisis is exploited by populist leaders, The idea of the organization of ideological discourse is informed by readings of hegemony from the works of Antonio In the remainder of this essay, I have two aims. My first aim is to offer some empirical substance to how I am conceiving of the organization of ideological discourse in times of unexpected crisis. On this point, I outline how the BJP has propagated discourses related to COVID-19 with a particular ideological intent—to conjure moral panic among Hindus and, thereby, establish an environment of fear and paranoia necessary to encourage the enactment of symbolic and physical violence against Muslims in India. My second aim is to offer some cautionary words moving forward. On this point, I describe the urgency to deconstruct ideologically motivated discourses related to COVID-19 currently being circulated by populist political leaders around the world.Coming into this year, the reigning BJP, led by Prime Minister Narendra Modi, engaged in concerted efforts to marginalize India’s Muslim population by pursuing its longstanding ideology of Hindutva. Using the most generous of terms, Hindutva is a political ideology for the BJP that “[defines] Indian culture in terms of Hindu values” . In its Many of the BJP’s efforts to advance Hindutva culminated in 2016, when the Lok Sabha—the country’s lower house of parliament—passed the Citizenship Amendment Bill (CAB). The CAB proposed to make illegal immigrants from Afghanistan, Bangladesh, and Pakistan eligible for Indian citizenship so long as they are not Muslim. While members of the BJP purported that the bill was a progressive move in that it sought to protect minorities who had been subjected to persecution in their home countries, its singular exclusion of Muslims—irrespective of the sectarian-based persecution that Muslims may have experienced in their home countries —exposed the bill’s underlying discriminatory project . The tabAt the same time that mass protests were being convened by conscientious citizens across the country to object to the passing of the CAB, COVID-19 spread across the global and, on 11 March 2020, the World Health Organization declared it a global pandemic. India was certainly not immune from the impact of the virus. As confirmed cases of COVID-19 grew exponentially in the country, Modi instituted a draconian-style, countrywide lockdown that took effect on 25 March .Leaders within the BJP seized on the unexpected crisis engendered by the global pandemic by aligning the discourse over COVID-19 with currents of their Hindutva ideology. This politicization of COVID-19 was orchestrated in a three-stage process that singled out Muslims as the carriers and the spreaders of the virus and, in the process, constructed them as the country’s enemy. The first two stages were liminal inasmuch as they enabled one another—one stage would be less tenable without the enactment of the other. The first two stages, functioning in concert, would activate the third stage, which was the precise juncture at which the ideology of Hindutva materialized into myriad violent acts against the constructed enemy.On 31 March, the Delhi Police Crime Branch formally lodged a First Information Report against Maulana Saad Kandhlawi, the great grandson of the Tablighi Jamaat’s founder and the current head of the Nizamuddin Marqaz Mosque—the headquarters of the organization. Saad was accused of violating the Epidemic Diseases Act for not observing the government’s instituted social distancing protocols ;On 2 April, the Ministry of Home Affairs, blacklisted foreigners who were Tablighi members by prohibiting them from engaging in Jamaat activities , and;The Indian government dedicating a specific column in its daily briefings on COVID-19 to the Tablighi Jamaat . Lav AgaThe first stage required surface-level validation by legitimate institutional actors to confirm preconceived ideas about the constructed enemy. In this case, it affixed blame for the virus to India’s Muslim population. This was accomplished when rumors began to circulate that COVID-19 was introduced and spread in India by members of the Islamic group, the Tablighi Jamaat. The rumors acquired wide currency among Hindu nationalists as hashtags like #CoronaJihad, #CrushTablighiSpitters, and #TablighiJamatVirus began to trend on Twitter . These rTaken collectively, these acts—each articulated by a legitimate institutional actor—functioned to validate the rumors on the origin of the virus that had been promulgating in the country.Delhi’s dark underbelly is exploding! Last 3 months have seen an Islamic insurrection of sorts, first in the name of anti-CAA protests from Shaheen Bagh to Jamia, Jaffrabad to Seelampur. And now the illegal gathering of the radical Tablighi Jamaat at the markaz. It needs a fix! .On 4 April, Rajeev Bindal, the Himachal Pradesh BJP chief, asserted that, “the Centre and state governments are leaving no stone unturned in the decisive fight against COVID-19 but some people, including Tablighi Jamaat, members are moving like human bombs to thwart their efforts.” This sentiment was echoed days later when, on 9 April, senior BJP leader and former chief minister of Maharashtra, Devendra Fadnavis, invoked a tried and tested Islamophobic trope by likening Tablighi Jamaat members to “human bombs” , which is presented as a ubiquitous threat to the stability of society as well as to its bona fide citizens . Within Surface-level validation by legitimate institutional actors complemented by incendiary rhetoric from political leaders, paves the way to the third stage: the orchestration of an environment of fear and paranoia that is amenable to the enactment of symbolic and physical violence against the constructed enemy. It is critical to note that at this stage there is an important shift in the discourse. Namely, while the first two stages targeted an easy but definable enemy—members of the Tablighi Jamaat who were linked, however speciously, to the spread of COVID-19—at this stage, the specter of violence was expanded to cover the group’s body politic. To put it another way, it came to encompass all Muslims. Once the pretense of COVID-19 was no longer necessary, Muslims become undifferentiated and the Hindu nationalists’ underlying ideological project of Hindutva would re-emerge more palpably.Stories of violence experienced by Muslims at the hands of Hindus who associated them with the cause of COVID-19 abound. On 5 April, Mehboob Ali, a 22-year-old Muslim man from the village of Harewali was beaten mercilessly by others in his village. The beating was video recorded and posted on social media. During the beating, his assailants can be heard yelling and demanding answers from him: “Tell us your plan! Was your plan to spread corona?” . On the These three illustrative cases are all the outcomes of the third stage of the organization of ideological discourse. The effective appropriation of COVID-19 for political purposes generated a moral panic so intense that merely being Muslim qualified someone to being subjected to communal violence. What is perhaps most alarming, and poignant, is the fact that in all of the cases the Hindu assailants were not strangers to the Muslim victims. The beating experienced by Ali, the stigmatization felt by Muhamud, and the physical and sexual assault encountered by Khan, were committed by their respective neighbors—people whom the victims lived alongside for years. This speaks to the insidiousness with which the organization of ideological discourse functions. The ideological discourse is crafted in such a way that it casts the constructed enemy to be a ubiquitous and an existential threat. The perceived ubiquitous nature of the constructed enemy ensures that fear and paranoia dictate the actions of otherwise peaceful neighbors. Fear and paranoia are evident in hearing demands from ordinary citizens who have turned violent to know the enemy’s “plan to spread corona” or xenophobic calls to “go back to Pakistan.” In sum, once the constructed enemy becomes reified in the minds of citizens, ideologues step back and watch their ideology come to fruition; all too often without having to engage in its direct execution.1 Indeed, today it is an ideology that is materializing into violent acts, and the frequency of such acts risk making them seem increasingly mundane. Worst of all, still, is the fact that Hindutva’s violent acts are being carried out not by a paramilitary force of the BJP but rather by ordinary citizens who have accepted, as truth, fear- and paranoia-arousing propaganda from ideologues. This once again captures the discursive nature of organized ideological discourse.In the period of COVID-19, Hindutva no longer remains a set of racist ideas operating in the imaginations of Hindu nationalists who harbor nostalgic visions of India being a space uncontaminated by Islam. Shielded behind the veil of COVID-19, Hindutva has quickly transitioned from violent ideas to violent acts.Using the persecution of Muslims in India that is currently taking place in the backdrop of the COVID-19 global pandemic as an illustrative case, this essay identifies the dynamics of the organization of ideological discourse by populist leaders in times of unexpected crisis. The organization of ideological discourse is engendered through a three-stage process. In the first stage, surface-level validation by legitimate institutional actors confirms preconceived ideas about a constructed enemy. In the second stage, inflammatory rhetoric is deployed by populist leaders, which scapegoat that constructed enemy. These two stages culminate to create widespread moral panic in society. With moral panic firmly established, in the third stage an environment of fear and paranoia becomes susceptible to the enactment of symbolic and physical violence against the constructed enemy.It bears underscoring that the organization of ideological discourse by populist leaders in times of unexpected crisis is mobilized to yield their underlying political objectives and not, necessarily, to create new ones. Indeed, much akin to how Kristallnacht was not the source of antisemitism in the Nazi ideology, so too did COVID-19 not cause Islamophobia in the BJP’s Hindutva ideology. On the contrary, each of these unexpected crises were exploited by populist leaders to justify, as well as to expedite, the very religious persecution that their ideologies always desired. COVID-19, in the case of the BJP, gave its leaders the license to continue to chart the course, though now only quicker, towards the ideological project that it always possessed—a motherland based on Hindu culture and values (and without Muslims).politically neutral reality of COVID-19, such ideologies have neither encountered meaningful critique nor objection.Given the times in which we are living, it seems apropos to close this essay with some cautionary words related to COVID-19—though these words may have just as much relevance to other unexpected crises that may emerge in the future. At present, much energy has been preoccupied with reorganizing personal and professional lives in the era of social distancing. Most individuals’ social realities have been fundamentally changed; and time and attention, understandably so, have been directed towards acclimating to the changes. Because of COVID-19, we are in the process of creating new ways of living and alternative ways of relating. Even those branches of society that are charged with tackling COVID-19 directly—involving certain members in media, healthcare, academia, industry, state bureaucracy, nongovernmental organizations—have mainly attended to the more technical aspects of the virus, answering important questions like how best to contain it or how to cope with its medical or economic effects. While undoubtedly these were (and remain) important questions, preoccupation with such issues has engendered an inadvertent consequence. It has caused a dangerous form of societal tunnel vision, preventing critical examination on how the very discourses over COVID-19 are being discretely packaged to accomplish problematic ideological aims. COVID-19 has proffered populist leaders around the world with the necessary cover to advance hateful ideologies that often call for violence against constructed enemies. Because this phenomenon has materialized in the shadows of the This essay has illuminated how populist leaders of the BJP have taken full advantage of the current unexpected crisis of COVID-19 to promote their ideology of Hindutva. The anti-Muslim tenor that clandestinely foregrounds Hindutva, when it is cloaked in the concerns over the management of COVID-19, is obfuscated. Of course, it is not only countries in the Global South that are using COVID-19 to achieve political ends; as, for instance, the unsettling crackdown by Viktor Orban, the Prime Minister of Hungary, on basic democratic principles such as a free press and free and open elections has shown. Indeed, populist leaders in the Global South and the Global North adopt a very similar playbook to ascertain and maintain power . For thiThe organization of ideological discourse is part of the intricate machinery invoked by populists to craft social realities that are aligned to their own political and ideological aspirations. Citizens have the responsibility to decipher between truth and false, real and imagined, and fact and fiction . As the


In metal forming, the plastic behavior of metallic alloys is directly related to their formability, and it has been traditionally characterized by simplified models of the flow curves, especially in the analysis by finite element simulation and analytical methods. Tools based on artificial neural networks have shown high potential for predicting the behavior and properties of industrial components. Aluminum alloys are among the most broadly used materials in challenging industries such as aerospace, automotive, or food packaging. In this study, a computer-aided tool is developed to predict two of the most useful mechanical properties of metallic materials to characterize the plastic behavior, yield strength and ultimate tensile strength. These prognostics are based on the alloy chemical composition, tempers, and Brinell hardness. In this study, a material database is employed to train an artificial neural network that is able to make predictions with a confidence greater than  In metal forming, the plastic behavior of metallic alloys is directly related to their formability, that is the material’s ability to undergo plastic deformation. In fact, for the study of forming processes, the plastic behavior of metals is typically implemented in finite element simulation ,2 and otAluminum alloys have one of the lowest densities among structural metals, high resistance to corrosion, high strength (even higher than some steels), and good electrical and thermal conductivity . On the Pure aluminum 1100-O) is a relatively soft material ; however0-O is a Nondestructive approaches to approximate the yield strength (YS) and the ultimate tensile strength (UTS) have been often of interest to engineers  because The methodological approach presented in this paper has the advantage of allowing the yield stress and the ultimate tensile strength to be estimated based on known values  are known . The sysThe Brinell hardness scale, proposed in 1900, is an indentation hardness measurement scale in which the penetration of a spherical ball into the test material is measured . This inThese two scales are based on the measurement of the plastic deformation that occurs on a material when applying a standard load through a standard penetrator ,29. TherThe relationship between the hardness of a material and their tensile properties is so intimate that mathematical expressions have been proposed; however, these equations are not universal . Both thReliable hardness strength relationships allow for quick mechanical property evaluations by means of fast and low-cost hardness testing instead of complicated tensile testing.Contrary to tensile tests, the hardness can be measured non-destructively in situ on fully assembled devices, therefore allowing for structural integrity tests in service.Often, new materials could only be manufactured at a small scale; these materials are not sufficient to accomplish extensive tensile testing, and so, hardness testing is frequently the only option.A good understanding of the correlation between the tensile properties and the hardness of materials is very noteworthy :ReliableEstimation of the tensile properties directly from the results of hardness tests ,38,39,40Estimation of the tensile properties indirectly from a material constant obtained from the results of hardness tests ,14,38.There has been a great interest in trying to find approximations to the tensile properties from the results of the hardness tests. These efforts can be grouped as follow:In this study, a third new method is going to be developed, similar to the first one, but with the particularity that the function that relates the tensile properties with Brinell hardness will be obtained using artificial intelligence and machine learning . This neThis new approach will be compared with the equations that directly estimate the tensile properties from the Brinell hardness test values. The literature is consistent in reflecting a linear relationship between the yield strength and the result of the Brinell hardness test (see Equation ) 13,14,,14,38,40Estimating the UTS from hardness data has been mostly experimental because the phenomenon of tensile instability after which engineering strain increases while engineering stress falls does not take place during indentation . HoweverIn the case of UTS, a linear expression similar to the yield stress approximation is proposed. In this case, the y-intersection coefficient Equation ) 14]:; filtering the data according to the established criteria and eliminating duplicates. Only records containing information on its Brinell hardness (HB), its yield stress (YS), and its ultimate stress (UTS) were considered ,71. EvenOnly alloys whose chemical composition is defined at more than  account .Only 11 chemical elements are considered to define the chemical composition of the alloys : Al, Zn,The methodology only considers 35 different treatments: F , O , H , and T  ,73. All The following considerations and criteria were taken when filtering and organizing the available data :Only recMost of the discarded records were eliminated because the information they contained was imprecise  or incomplete . After conveniently filtering and organizing the 5341 datasheets, seven-hundred thirteen aluminum alloys records were kept.Once the input dataset is prepared (filtered and organized), the neural network is defined: a fully connected multilayer feedforward topology , which cThe topology of a neural network refers to the way in which perceptrons are connected and is a fundamental characteristic in the performance and learning of the network . Each laThis topology is one of the most common because multilayer feedforward neural networks are, potentially, universal approximators , but eveThe number of hidden layers, the activation functions, and the number of neurons per layer are the main parameters of a neural network and must be defined before starting the training , but desThe chosen network topology has more than 200 perceptrons linked by more than 20,000 connections and uses sigmoid-type activation function . This toWhen the input dataset is ready and the neural network model has been correctly defined, it is time to start the training and prediction phase. Each of the two tensile properties that were taken into account in this study will be treated independently: yield strength (YS) and ultimate tensile strength (UTS).The input dataset is randomly split into two subsets, which comprise, respectively, ot occur .The ANN training with the training subset.The prediction of the properties of the testing subset.Results and data storage for further analysis.The ANN executes 10 iterations of training and prediction for each of the two properties. Each of these iterations is fully independent of the others and is subdivided into four main steps:Calculation of the learning rate for each parameter using adaptive moment estimation (ADAM) with  factor) .Early stopping after 20 iterations without significant changes.Training stops when a training error of less than Maximum of 100,000 training epochs to avoid infinite loops.The training is configured as follows :CalculatThe prediction and training process generates a large amount of information that, after a detailed analysis, makes it possible to estimate the performance and capabilities of the methodology.The outcomes of the training and prediction procedures are very stable and converge to similar results although they are randomly initialized. Once the ANN is trained with  network .In this study, the ANN is trained with 570 randomly selected materials from the input dataset, and the remaining 143 are used to test the predictive capabilities of the ANN. Both subsets (training and testing) are randomly built for each of the 10 iterations, and so, they are fully independent.dictions ,35.R2=0.86 , and itsIt is possible to observe that some scattered values appear that are notably far from the general trend. These data cause defects in the results since there is not enough sample for the ANN to correctly learn to predict them. However, it has been decided not to delete any records in order to obtain real metrics about the performance of the method.As can be seen, the averaged error of the yield strength prediction is mstances .R2=0.88 , and itsThere is a multitude of registries that deviate from the general trend. These materials constitute a challenge for the ANN and can cause the performance of the methodology to significantly drop. However, the possibility of eliminating these alloys from the input dataset should not be considered since these properties are not sufficiently aberrant to judge them as outliers.As can be seen, the averaged error of the UTS prediction is The material Al 7010 was selected because the performance of the ANN will be compared with the empirical formulas specifically developed for this alloy in . In thatAl 7010 is a 7000-series aluminum alloy whose main alloying elements are zinc, magnesium, and copper. Tiryakioğlu et al.  develope (∼0.95) .ANN can be employed to predict the YS and the UTS of aluminum alloys based on its hardness, chemical composition, and temper. In this study, the average deviations for both properties are, respectively, The results of a methodology based on artificial intelligence can achieve a similar performance to that obtained through empirical equations. In the example shown in this study, for Al 7010-T6, the resulting difference between both methods was ∼2%.Although the predictive performance of this methodology is slightly lower than that of empirical equations, it provides greater generality since it can make predictions about any aluminum alloy.A multilayer ANN can be trained to make predictions about the mechanical behavior of an in-service industrial component on which a hardness test can be performed.This paper predicts, by means of an ANN, the YS and the UTS of aluminum alloys taking as the input their chemical composition, their tempers, and the results of a hardness test. It is a contribution of great industrial interest as it allows knowing the mechanical behavior based on an almost non-destructive test (hardness test) and parameters specified in standards and scientific databases. In addition to its multiple applications in the selection of the suitability of materials for a specific application and evaluation of their ability to be manufactured by forming processes, this methodology can be an interesting tool to help in the prediction of the possible degradation of properties or the loss of mechanical integrity that could cause failure or breakage. Therefore, the main conclusions of this work are presented as follows:This study shows that it is possible to predict the tensile properties of aluminum alloys using AI based techniques. In the same way, it opens the door to investigate similar solutions applied to other metallic alloys such as steel or, even, to try to apply the same methodology to ceramics.ANNs have proven to be a powerful tool for predicting the tensile properties of highly relevant industrial materials without the need for costly and complicated stress-strain tests. It can be of interest to study whether it is possible to design an artificial intelligence based system capable of predicting these properties using the results of other widespread hardness tests such as Rockwell.Once this working scheme has shown that it can be used to make adequate predictions, other network architectures can be tested to improve the overall performance of the methodology. There is a wide variety of network topologies that meet diverse needs and solve different problems .


Customers’ expectations and satisfaction are critical to ensure a more effective role of the community pharmacists in promoting the safe use of Complementary and Alternative Medicine (CAM). The aim of this study is to examine the perceptions and practices of customers buying their CAM products from pharmacies and explore their satisfaction with CAM-related services offered by the community pharmacists in Lebanon.n = 832). Within the proximity of the pharmacy, subjects were invited to complete a multi-component questionnaire. The latter consisted of four sections related to CAM: general beliefs, perception of pharmacists’ role, practices, satisfaction with services offered by the pharmacists. In addition, the questionnaire included questions about sociodemographic characteristics of participants.A national cross-sectional study was conducted among users of CAM (age > =18 years) who obtained their CAM from community pharmacies in Lebanon  did not agree that the pharmacist is more knowledgeable in this field than other healthcare providers. As for practices, one in two surveyed customers (47%) did not always give feedback to their pharmacists about the outcomes after using CAM, 20% did not often ask the pharmacists about the safe and effective mode of use of the products and 28.1% did not discuss their medical history. For services offered by the pharmacist, the majority of participants reported receiving good education about the CAM product (87.1%), its side effects (87.1%) and mode of use (93.4%), while significant proportions of participants reported that pharmacists were not asking questions about their medical history before dispensing CAM products (22%) nor were they providing information on CAM-drug interactions (30%).The results of this study highlighted important gaps between the perceptions of customers and the services they received from the pharmacists about CAM use. These findings could be used by concerned stakeholders, including public health authorities and educational bodies, to develop evidence-based interventions aimed at promoting the role of pharmacists in ensuring a safe and effective CAM use Lebanon.The online version contains supplementary material available at 10.1186/s12906-021-03256-8. Complementary and alternative medicine (CAM) refers to various therapies that are not considered part of conventional medicine. CAM can be divided into two major areas 1) natural products which are also called dietary supplements including herbs, probiotics, vitamins and minerals, and 2) mind-body therapies such as meditation, yoga, chiropractic, acupuncture and hypnotherapy . Such anIn line with the global trend, the Middle East and North Africa (MENA) region is witnessing a growing market for CAM products –13. In Lvis-à-vis CAM [Among health care professionals, community pharmacists are often considered the first contact point between the patient and the healthcare system, perceived as accessible and trustworthy, and have frequent contact with patients due to prescription dispensing schedules . Ideally-vis CAM .An important factor that could lead to a more effective role of pharmacists in the field of CAM use is a clear understanding of the customers’ needs, expectations and satisfaction with the pharmacists’ services. Pharmacists work within a customer-pharmacists professional framework which is based on trust, understanding and shared decision making , 29. HowA national cross-sectional study was conducted among users of CAM who obtained their CAM from community pharmacies in Lebanon from January to July, 2019. A list of all the community pharmacies and their locations in the different governorates was obtained from the Order of Pharmacists in Lebanon (OPL). Pharmacies were selected from this list using a stratified random sampling technique. The strata were the Lebanese governorates. The number of pharmacies was proportional to the number of pharmacies in each stratum. From each pharmacy, one participant (CAM-user) was invited and recruited in the study. The inclusion criteria were 1) age of 18 years or older, 2) buying CAM products for their own use from the selected pharmacy and 3) conversant in either Arabic or English languages. At the pharmacy, the field researcher approached individuals and asked them whether they have bought a CAM product from the pharmacy. In case they did, the field researcher introduced the study and assured the participants that any information collected would be confidential, strictly used for research purposes and that their answers will not affect the services they are receiving at the pharmacy. Subjects were informed that they are free not to answer any of the questions and to withdraw at any point during the interview. After obtaining a signed written consent, a face-to-face interview was conducted within the proximity to the pharmacy. Each interview lasted 10–15 min and required completion of a multicomponent questionnaire. The field researchers were extensively trained in conducting interviews and administering the questionnaire prior to initiation of data collection. The study protocol was approved by the Institutional Review Board at the Beirut Arab University under the protocol number 2019H-0052-P-R-0342.The questionnaire used for data collection consisted of five main sections. The first section was designed to collect general information about the individuals and included questions on sociodemographic characteristics, CAM use, how the subject was introduced to CAM as well as if using CAM as alternative or complementary to mainstream medicine. In this section, the subject was also asked if he/she suffers from any disease. The second section of the questionnaire included five questions related to the participant’s general beliefs about CAM and its use. The third section of the questionnaire addressed the perception of pharmacists’ role in relation to CAM among study participants. The fourth section included questions on practices of the study participants regarding CAM in the pharmacies. In sections two, three, and four, for each statement, participants marked their degree of agreement on a five-point Likert scale . The last section inquired about the CAM-related services offered by the pharmacists to the subjects and their corresponding satisfaction. The latter was assessed using a Likert rate scale with one representing strongly satisfied and five strongly dissatisfied. The questionnaire was developed by an expert panel consisted of pharmacists, nutritionist, and an epidemiologist, as well as by an extensive review of relevant literature –39. The p-value< 0.2) in the simple regression analyses were entered in the multiple regression model. Statistical significance was set at p < 0.05.The collected data were coded, entered and analyzed using the Statistical Package for Social Sciences (SPSS) software version 25.0 for windows. For the summary of the data, descriptive statistics consisting of frequency and proportions were used. The associations of sociodemographic factors and CAM use characteristics of participants with their beliefs, perceptions and practices towards the role of pharmacists in CAM were examined using simple and multiple linear regressions. For this purpose, using the answers of the participants, overall scores were created for each of the followings: beliefs, perceptions and practices. For the overall belief score, subjects received a score of either 0, 1, 2, 3, 4, or 5 corresponding to the following answers: strongly disagree, disagree, neutral, agree and strongly agree respectively. Scoring was reversed for statements with negative beliefs towards CAM. Therefore, the higher the score, the more positive is the belief with regards to the role of pharmacist in CAM. A similar protocol was used to calculate an overall score for the perception of the pharmacists’ role in relation to CAM. As for practices, the scores of 0, 1, 2, 3, 4, or 5 corresponded to the following answers: always, often, sometimes, rarely and never. In the regression analyses, the scores were considered dependent variables while sociodemographic factors and CAM use characteristics of participants were independent variables. Variables that were significantly associated with the outcome . The main reasons for refusal to participate were lack of time and interest in the study. The distribution of participants in the study is proportional to the distribution of pharmacies in the governorate  strongly disagreed or disagreed that CAM can replace medications for chronic diseases and serious illnesses.Perception of the pharmacist’s role towards CAM among study participants is displayed in Table Table The frequency of services offered by pharmacists with regards to CAM and their corresponding satisfaction among study participants is displayed in Table The analysis of the data was carried out for males and females separately and were compared between the two genders. No significant differences were noted in relation to beliefs, perceptions and practices of customers not their satisfaction between males and females in the study population  in ensuring customers’ safety and wellbeing.Regarding beliefs, the majority of the surveyed customers in this study (84.6%) showed positive beliefs towards the effectiveness of CAM products. Such a positive belief was expected given that the surveyed subjects were identified as users of CAM who bought the CAM product from the pharmacy where they were recruited from. These positive beliefs have been reported in other neighboring countries, such as countries of the Arabian Gulf region, where the positive beliefs towards CAM products were found to be supported by traditional and cultural practices –13, 40. A remarkable finding of this study was the positive perception of the role of pharmacists by CAM consumers. CAM users in Lebanon have high expectations towards the role of pharmacists in CAM. More than 93% of participants perceived that pharmacists should educate them on CAM products’ use and safety coupled with high level of trust (87%) in information from the pharmacists. These findings contrast with previous findings of studies in the region. For instance, the general population in Qatar has a poor understanding of community pharmacists’ role as health care provider . In Kuwathey don’t ask, so I don’t tell” strategy should be avoided by pharmacists when dispensing CAM products [In this study, the aforementioned positive beliefs and perceptions with regards to the role of pharmacists in this study were found not to be in line with the reported practices. More specifically, one in two surveyed customers did not give feedback to their pharmacists about the outcomes after using CAM. Furthermore, one in five participants did not ask the pharmacists about the safe and effective use of the products nor did they discuss their health status and medication taken before taking CAM products. Such a dichotomy between perceptions and practices is rather alarming: When participants were asked in a theoretical way about whether they perceive the pharmacist to have a role in providing education about the use, side effect, and general health issues, their response tended to be positive. However, when they went to get their product from the pharmacy, they did not discuss the health status or share their feedback or even the outcomes after CAM use. Such a dichotomy has been previously reported, even among patients taking prescribed medications from community pharmacies . In thisproducts .In this study, older participants had more positive beliefs, perceptions and practices towards the role of pharmacists in CAM, as compared to younger participants. This finding confirms the results of an earlier study in Lebanon investigating the general public’s perceptions towards the community pharmacist’s role. In this report, patients belonging to the older age category reported a higher perception index compared to their younger counterparts . Such anIn this study, with regards to the CAM services offered by the pharmacists, the findings showed significant variability. On one hand, the majority of participants reported receiving good education of the CAM product, its side effects and mode of use. Such results are in accordance with a previous investigation about the services of weight management among community pharmacists in Lebanon, and which showed a broad range of services that the pharmacists offered to assist their patients in controlling their weight . TogetheDespite the variability in the proportion of customers receiving proper services related to CAM from the pharmacists, the results of this study indicated that the majority of customers were highly satisfied with the received services. These findings highlighted the fact that when the pharmacists offer a service, they are doing it in an effective manner and the customers are highly satisfied. Such a finding represent an opportunity, especially that community pharmacists are often considered the first contact point between patient and the healthcare system, for which patients have easy and recurrent access . FurtherIt is important to note that, in this study, even though participants were recruited from the pharmacies, more than the half of the participants 56.0%) were using CAM as an alternative medicine. This finding is alarming, especially when it is coupled with the fact that 19% of those customers were suffering from chronic diseases. Such a CAM use modality could jeopardize the safety and wellbeing of the patient, more so when the patient does not disclose the use of the CAM to his physician. In fact, previous studies showed very low rate of disclosure from CAM users to healthcare providers for fear of their disapproval, disinterest or inability to help. Such lack of professional supervision may further expose the consumer to various hazardous risks, including drug interactions, adverse reactions or other side effects of the products .0% were .Taken together, the findings of this study further underscored the important role that the pharmacist play/can play in ensuring the safe and efficient use of CAM. According to the literature, the main responsibilities for the pharmacist with regards to CAM: acknowledge that CAM is widely used, know the evidence-based recommendations for the common CAMs used among their patients/customers population, ensure that patients are adhering to the safe use of CAM, document the current use of CAM and report its side effects, contribute to heightening the awareness and education about CAM and lastly to collaborate with other health care professionals to ensure a safe and effective use of CAM . PreviouThe findings of this study ought to be considered in light of a few limitations. First, although every effort was made to obtain a representative sample from all the Lebanese governorates, the representation of the Beqaa governorate was suboptimal. During the data collection, a travel advisory was issued against going to this part of the country as it was deemed unsafe. Future studies are encouraged to find alternative methods  in order to obtain a representative sample of the country including the Beqaa. Second, given that the participants completed the questionnaire during a face-to-face interview with an interviewer, a social desirability bias and an interviewer bias could have affected the findings of this study. That said, all the interviewers in this study were trained on maintaining a neutral attitude and refrain from judgmental hints, hence minimizing any interference with the participants’ responses. Lastly, although the study findings highlighted important issues related to the perspective of CAM users regarding the role of the community pharmacists, the quantitative nature of the study limited an in-depth understanding of the beliefs and the attitude of participants. Future qualitative studies are needed to further explore the aforementioned concepts in further depth and rigor.In conclusion, the findings of this study showed that CAM users in Lebanon have positive perceptions and high expectations with regards to the role of pharmacists in guiding their use of CAM use. However such perceptions were not mirrored by the users practices themselves, of who, a significant proportion did not report side effects nor gave feedback to the pharmacists following the use of their CAM. In addition, the study showed that despite their satisfaction with the CAM related services offered by their pharmacists, the users still did not receive critical services such as information about CAM-drug interaction. These findings provide evidence to concerned stakeholders, including public health authorities, educational bodies, and OPL to reflect on the identified gaps and benefits from the opportunities to promote the role of pharmacists in ensuring a safe and effective CAM use Lebanon.Additional file 1. Role of Pharmacists in Complementary and Alternative Medicine: Users’ Perspectives and Satisfaction.Additional file 2. General beliefs with regards to CAM and CAM use among study participants, by gender. (n = 832)*.Additional file 3. Predictors of general beliefs with regards to CAM and CAM use among study participants*.


The Nairobi pork food system is a growing livestock sub-sector which serves as a source of food and livelihood to its inhabitants. The study aimed to map Nairobi's pork value chains, assess their governance, operational challenges and their impacts on food safety risks and management practices. Qualitative data were collected in seven focus group discussions and 10 key informants' interviews on animal movements and product flows, stakeholders' interactions, perceptions on system governance and challenges, and on their potential impact on food safety management. Quantitative data were obtained to show the importance of flows, business operations and market share. Thematic analysis was conducted to identify themes that provide understanding on the governance, challenges and food safety practices in each profile. The predominant chains identified were [1] The “large integrated company” profile which accounted for 83.6% of pork marketed through abattoirs, and was based on a well-structured supply system, with owned farms (representing 50% of their supply), contract farms and semi-contract farms and [2] Local independent abattoirs, accounting for 16.4%, are privately owned small-scale production, supplied mainly (70%) by small farmers from the immediate neighboring areas. The main challenges associated with governance themes included; (i) Inadequate/lack of enforcement of existing regulation (ii) Negative effect of devolution system of governance (iii) Pig traders' dominance (iii) Lack of association at all system nodes, and (iv) Male dominance across the pig system. The main challenges reported included; (i) Lack of capital to upscale (ii) Poor infrastructure (iii) Pig shortage (iv) Excessive regulation (v) Lack of training (vi) Diseases (v) Lack of knowledge (vi) Unfair competition. Food safety themes were associated with (i) Inadequate slaughter facilities forcing traders/farmers to undertake home slaughter (ii) Lack of knowledge on disease management (iii) Lack of training on hygienic practices in the slaughterhouse and (iv) Lack/insufficient capital to purchase equipment's to ensure proper hygiene e.g., boilers. The study provides insights into the structure of the pork system supplying Nairobi, the governance issues important to the stakeholders, challenges and food safety issues. The framework obtained can be used by policy makers and researchers to investigate and develop pork industry and for food safety and disease control programmes. Recent estimates indicate that the demand for pork and poultry products in East Africa will increase 4-fold by 2030 . In KenyNairobi is one of the rapidly growing cities in Africa with a population of 4.4 million people  and an eThere is a paucity of data on how the Nairobi pork system is organized and operated, with respect to market nodes, governance, challenges, and food safety issues. Such information is crucial to understand the sector, identify growth opportunities, and support national food safety policies and disease control programmes. For this, value chain analysis (VCA) studies are a useful approach to understanding the dynamics of the production system, flow of products and disease transmission impact on different actors' incentive structures and behaviors , 21, whiThe aim of this study was, (i) to map the pork system supplying Nairobi through abattoirs, markets and urban, peri-urban pig keepers and retailers; and (b) to assess the challenges and governance of these chains and their potential influence on disease and food safety risk management.We conducted a cross-sectional study throughout the pork food system in Nairobi city in 2013-2014. For this study, we visited the three major independent pig abattoirs supplying Nairobi: Ndumbuini abattoir in Kiambu county, Lyntano abattoir in Nairobi County and Kabati abattoir in Murang'a County. These abattoirs are named in this study as “Local independent abattoirs” (LIAs) as people in these systems are mostly independent workers and no one group of people or person controls a large process of operations. One large pork processing company was also visited in Nairobi, which integrates most parts part of rearing, sourcing of pigs, slaughter, and distribution of products. In this study it is named as “Integrated company” (IC). This company abattoir and the three LIAs represent the only formal slaughterhouses supplying pork to Nairobi. In addition, three areas of Nairobi were selected for the investigation of farmers and retailers. These were Kibera and Korogocho, two informal urban settlements, and Dagoretti, that could be considered as peri-urban Nairobi. City market, a meat wholesale market, was also visited.For data collection in abattoirs and wholesale pork markets, a formal request was sent to the Ministry of Agriculture and Livestock to seek permission to conduct the study. The Director of Veterinary Services granted permission and gave an introduction to the District Veterinary Officers under whose jurisdiction the abattoirs lay. The District Veterinary Officers provided an authorization letter and introduced researchers to the corresponding chief meat inspectors in charge of abattoirs/markets. These in turn presented the research team to the market/abattoir owners. At each step, the project objectives and methods were explained and permission to conduct the research was obtained. Through an initial discussion with the meat inspectors, abattoir owners or managers, the main types of people involved in the pork value chain associated with these abattoirs were identified. Subsequently, focus groups discussions (FGD) were conducted separately with each type of stakeholder and individual interviews were also organized. The meat inspector and abattoir owners facilitated selection of participants. These were asked to provide a range of different people of the same profession  to maximize the identification and study of all different value chains. The presence of abattoir owners and meat inspectors during interviews and FGDs with other stakeholders was avoided, when possible, to avoid courtesy bias or influence responses.For data collection from pig farmers, an introductory letter from the District Veterinary Officer was presented to the respective Livestock Production Officer in charge of the study area. The Livestock Production Officer is the operative with the most comprehensive knowledge of farmers and their practices. These were then requested to select pig farmers for FGDs and individual interviews in each of the areas. Two FGDs were organized, one in Kibera and one in Dagoretti to assess the differences between informal settlements and peri-urban areas. As with abattoirs, guidance was provided to recruit as much diversity of pig farming practices as possible e.g., small, medium and large-scale farmers; male and female. For the integrated company and city market, interviews with managers of these places were conducted. To assess information on retailers (such as butcheries), we interviewed the public health officers in charge of their inspections in two areas of Nairobi, Dagoretti (peri-urban area) and in Korogocho . All the focus groups and interviews undertaken are summarized in The study was conducted using a mixed method approach. Qualitative data collection was undertaken using interview guides to obtain information on value chain mapping, governance and disease and food safety management. Data collected on value chain mapping included: (i) the process of sourcing the pigs, through understanding the different type of sources animals are bought from, the main geographical areas and type of farms where the pigs came from and the choice rationale for selecting different points of origin; (ii) the methods of transportation of animals; (iii) the methods of slaughtering and carcass processing; (iv) the type of interaction between the different actors and products generated, (v) the distribution of products, including the geographical areas of destination; (vi) the types of farms that exist according to sizes and production methods; and (vii) the sources of inputs such as feeding, watering, and veterinary services. Quantitative data were collected from participants by asking them to estimate proportions of chain flows. When possible, these figures were obtained through consensus and /or by achieving a majority. Such information included output and volume of products distribution to various areas. For this all participants were given time to brainstorm on the different answers to come to a consensus. In addition, data from records from the certificate of transports available at one of the abattoirs visited for the period between November and December of 2014 were consulted. For each certificate data were collected on (i) the origin of the pigs moved, (ii) quantities of pigs moved, (iii) name of the trader, and (iv) movement date. Furthermore, data on abattoirs' activities, infrastructure and equipment were collected through researchers' observation using a checklist.To collect data on value chain governance and challenges, participants were asked to (i) identify the different roles involved in the decision process and the actual performance of the activity; (ii) the type of relationships with other stakeholders in regards to transaction on animals, products and payments; (iii) their views on the power groups in the system and existing associations; (iv) their interaction with government officers and structures; and (v) to indicate gender dominance in their activities.Data on disease control and food safety were collected by observation and completing a pre-prepared checklist. For this, the authors visited the premises of each abattoir during a normal working day. This information was triangulated by asking participants about possible safety challenges they encounter in their workplaces. We also asked farmers to state the main diseases affecting their farm, the source of animal health and production advice, the strategies employed to manage these diseases and the disposal methods for dead pigs.The questions were carefully designed and implemented, to avoid leading answers and/or embarrassing participants. All focus groups and interviews were video and/or voice recorded to obtain all the information given by the respondents and minimize misinterpretation by researchers. Notes were also taken throughout all the discussions and interviews. The result of this work was validated by presenting summaries back to stakeholders.Through listening to the recordings and reading of the notes, all the data from interviews and FGDs were collated into templates, following an approach outlined by Alarcon et al. . A templMapping analysis of the pork system was done by carefully reading the templates to identify all the people involved, the products and places. Any interaction detected was plotted in a flow diagram. Mapping diagrams were constructed for each system segment: livestock keepers, Local independent abattoirs (LIA) and Integrated Company (IC). In the flow diagrams, people and places were represented by boxes and products by circles. Flows were indicated by arrows, and the width of these were used to indicate proportional contribution to the amount of products or animals movements in the system. When proportion of flows were obtained, this was indicated in the diagram. For clarity, only key people involved directly in the movement of pigs and pork products were introduced in the flowchart. Other stakeholders, such as regulators  were left out from the mapping diagram to facilitate the readability of these. The abattoirs were coded for anonymity purposes, as abattoir A, B, C, and IC.Thematic analysis of the data was carried out using Microsoft Excel. For this, all the codes (and associated text) from the templates were entered, and subsequently were used to identify relevant themes that provide an indication or understanding of the governance, challenges and food safety or disease practices for each node in the system.Descriptive analysis of data from the movement permits was done to extract proportions of origin from different sources to the abattoir and to create Lorenz curves that indicate the amount of pig supply covered by each percentage of traders. For this, traders were coded as numbers and sorted according to the quantity moved. A Gini coefficient was then calculated to measure the equality of trade amongst pig traders.Feeding of pigs is done mainly with waste collected from nearby markets  and with swill from restaurants. In Dagoretti, farmers reported that they supplement these feeds with commercial feeds bought from the agrovet shops. Brewers' waste and weeds growing along the roads were additionally mentioned. Free range scavenging of pigs was the most common system in Kibera. The most common water source used was rivers and the surface water the pigs get when scavenging and around households.Finishing pigs were reported to be slaughtered in Dagoretti at an estimated average age of 5 months and with an average of 49 kgs. In Kibera, finishing pigs were slaughtered at 10 months of age, weighing averagely at 98 kgs. The method of selling and distribution of pigs were different in both areas. In Dagoretti, most finishers were sold to brokers or trader who slaughter them in the LIA's. Fewer farmers were reported to periodically supply pigs to the IC in times of shortages. In Kibera, most finisher pigs are sold to butchers, brokers or private individuals (consumers). The pig is either slaughtered behind the butchery (meat shop) or slaughtered in the farm or home (home slaughter) and meat sold to consumers. The selling of the meat is usually advertised via printed brochures pinned at strategic places around the neighborhood.Of the three LIA, the oldest one started in 1952 as a duck slaughterhouse before converting to a pig slaughterhouse. The other two started in 1972 and in 2007. The main characteristics of these abattoirs are shown in The abattoirs have similar operations in the following areas:(i) Supply of pig: This is mainly organized by traders and butchers, and the large majority  is sourced from small-scale pig farms in Nairobi and from nearby counties of Nairobi (Kiambu and Murang'a counties). A small proportion of pigs slaughtered originated from further away counties from western Kenya (rn Kenya . Pigs we(ii) Valuation method of live pigs: Visual live weight estimation was practiced by traders/brokers in all the abattoirs. Some traders reported that pigs from Kiambu country were preferred because of higher meat quality and bigger sizes, compared to pigs from other areas. This allow the traders to sell the carcass at higher prices.(iii) Centrality of traders and butchers: Traders pay the abattoirs for slaughter services and will then transport the carcass to pork butcheries and other traders in the city's markets, where the meat is sold to restaurants or consumers. Another important chain in these system was the one organized by butchers. These are defined as people working in or owning a retail butcher. They purchase the live pigs on the farm, slaughter them in the LIA and bring the carcass to their own butcheries.(iv) Seasonality: In all the abattoirs, the high season for slaughtering was reported to be in the last quarter of the year, associated with school fees payment period at the beginning of the following year, festive and the important tourism season. The first quarter of the year was identified as the low season for sale as farmers start a new cycle of rearing pigs aimed at sales in the last quarter of the year.(v) Legal requirements: Pigs brought to the abattoirs are required to be accompanied by movement permit certificates and “no objection” permits, when coming from a different district.(vi) Live pig transportation: Use of motor vehicles represented the main transport mode in all the three LIAs and are organized and paid for by traders or butchers, who hire or own the vehicles. A pig transporter was reported to move on average 30 pigs per week, and the majority have other business to supplement their income. Trekking of pigs and transport through motorcycle was reported as a minor practice, but with more relative importance for LIA C. Other traders used motorcycles and a smaller proportion of traders transported on foot especially in LIA C.(vii) Distribution of products: This was done mainly through hiring motorcycles, with a few traders owning cars or trucks with a meat box. In abattoir C, those traders buying smaller quantities of meat (7–10 Kgs) reported carrying the meat in gunny bags. The high season for slaughtering was reported to be associated with school fees payment period, festive and tourism season.(viii) Waste disposal: Blood is disposed together with liquid waste into lagoons while solid waste is given or sold to crop farmers to be used as organic fertilizers. The abattoirs are dissimilar in the following areas:(i) Live pigs trading: While in abattoirs A and B, no trading of live pigs was reported in the lairage, in abattoir C, farmers were able to bring pigs in the lairage and sell them to either traders, brokers, butchers or other farmers.(ii) Distribution of offals: Offals are given as payment to the slaughter men in abattoir A and C. Offals from Abattoirs A and C are then sold to specialized traders and roadside vendors operating in Nairobi informal settlements and neighboring counties such as Kirinyaga, Murang'a, and urban informal settlement of Nairobi and Thika, respectively. Offals (the intestines) from abattoir B are also given for free to pig farmers as pig feeds and pet owners in areas around the abattoir.(iii) Removal of fat from the carcass: In abattoir B, the fat layer of the skin is removed and sold separately to specialized traders who sell them to roadside vendors in Nairobi informal settlements. In abattoir A and C, this is sold together with the carcass.(iv) Geographical distribution of products: Although these abattoirs are classified as classes B or C, meaning that their meat distribution should be limited to local areas  comes from other unknown sources. About 55% of the pork in this market is sold to private individuals (consumers), 40% is sold to restaurants in and around the central business district, and the rest is sold to other places or people coming to the market.The IC reported to use four main sources for the supply of pigs. About half of its pig supply at the time of the study originated from their own large farms, composed of three units and with one of the farms having up to 2,000 sows. These farms imported their genetics from European countries. The other supply originates from “contracted farms,” “semi-contracted farmers,” and “non-contracted farmers.” The main breeds brought for slaughter were large white, Landrace and their crosses, and most animals originated within a radius of 70–100 km from the plant. The main source areas were Murang'a, Ngong', Ruai, Dagoretti, and Kikuyu. Transport from the company owned farms and the contracted farms was organized by the company using its own trucks. For semi- contracted farmers, they can either request the company to transport their pigs or they can organize their own transport and get a reimbursement. The non-contracted farmers would organize their transport to the company abattoir plant.Pigs are brought to the abattoir a day before slaughter, to allow them to rest overnight. Characteristics of the abattoir are shown in Governance themes were related to government interaction, producers' relationships and gender differences. In terms of interaction with the government, farmers and key informants complained that conflicting policies and laws exist whereby some city by-laws outlaw farming in the city while some officials still support urban agriculture. This creates confusion and makes farmers perceive themselves as outlaws, despite government employed meat inspectors, who offer services at all the registered slaughterhouses. Furthermore, they also felt that the government was responsible for the current shortfall in capacity of pig slaughterhouses in the area, which has contributed to some people practicing home slaughter. In some instances, particularly in Dagoretti, a meat inspector could be called to inspect carcasses that have been slaughtered at home. In Kibera, chiefs, who are local administrators in charge of lower level of administrative units – location, played a key role in arbitrating disputes involving crop farmers and farmers in instances that the scavenging pigs could stray and destroy farms.In terms of producers' relationships, farmers reported that they did not have an association and that they operate independent of each other. The farmers depended mainly on brokers and traders – with whom they have short term relationships - to buy their pigs and transport them to slaughterhouses. Additionally, the perception of the farmers is that the IC controls the pork market and sets the pricing of pig and pork products. In terms of replacement of animals, the main characteristic considered for determining the best quality trait, is the litter size of the sows. Men were reported to dominate the ownership of farms in Kibera and Dagoretti. Women were responsible for cleaning and taking care of pigs. Some participants mentioned women owning large farms in Dagoretti. Farmers recognized that the image of roaming pigs in waste pits around the city discourages consumption of pork among the people who associate all pigs as being dirty and therefore unfit for consumption.The main challenge of Kibera farmers was the lack of capital and land to enable them to expand their farms. The diminishing land sizes often lead to conflicts with crop farmers when the pigs are unconfined. Access and availability of feed was also an important challenge. Many small-scale farmers in both areas reported a dependency on market waste and on scavenging to feed their pigs, because commercial feed was too expensive for them. It was said that stiff competition among farmers for the collection of market waste exists. Diseases were also reported to be a challenge. Dagorreti farmers pointed out that the main diseases in the area were parasitism, pigs developing red spots (likely to be swine erysipelas) and a disease that caused pigs to die suddenly (likely to be African swine fever – ASF). In Kibera, parasitism was reported as the main disease challenge. In Dagoretti, lack of knowledge and training on pig feeding and on general and health management were reported. Other challenges identified include lack of market access to sell pigs and the theft of live pigs.Government interaction was mainly related to the collection of tax and ante- and post- mortem inspection of animals and carcasses. Traders and butchers opined that multiple licenses were needed to operate and that high taxes levied on them were making them uncompetitive. They attributed these changes to the “devolution system of governance.” The licenses required for them to operate included those issued by the Ministry of Agriculture and Fisheries, the National Environmental Management Authority (NEMA), and the county governments. A government appointed meat inspector offered ante- and post-mortem meat inspection services ensuring that the meat sold to consumers has been passed fit for consumption. Furthermore, meat inspectors offered on the job training to the workers mainly on areas of hygiene. The traders are required to pay the slaughterhouse owner a fee, a government levy as well as pay the workers for slaughtering. The payment to the workers would be by cash while in abattoir B, the worker would be paid using offals.Some of the main challenges reported by traders and brokers were related to higher price of buying live pigs occasioned by increased cost of production, further aggravated by the instability of pig and pork products prices. Apart from the dominant role of the large processing company, prices were said to be affected by high taxation of commercial feeds, which increases the cost of production and discourages its use. Further, the traders and brokers cited the high cost of pig transportation either from farm to slaughterhouse or from farm to farm searching for more pigs. They felt that a live pig market could reduce this cost by creating an exclusive central point to trade on. Diseases such as African swine fever limited the supply of pigs while limited access to artificial insemination limits the capacity to develop and upscale up pig farming enterprises. The continued use of natural breeding leads to reduction of the genetic pool of pigs and subsequently limits production potential of pigs. Traders felt this was one of the causes for the generally low weight of pigs.In addition, traders and brokers attributed the low demand for pork products to the negative cultural perception toward pigs by some tribes and religions living in the city. Also, it was believed that consumers had major food safety concerns fuelled by the images of scavenging pigs in the city waste pits.The abattoir owners also reported challenges related to the high cost of running the abattoir. This was believed to be aggravated by the stiff competition offered by the large processing company, the lack of access to capital to equip the abattoirs to the required standards, and the difficulties associated with bureaucracy involved in upgrading the abattoir from one class to the next, a change that would open new markets. Conflicts with traders and butchers over adherence to official and private standards was also reported as a challenge by abattoir owners. The low supply of pigs being brought for the slaughter at the facility, was attributed to the “prohibitive” taxation regime on the pig feeds in the country. Traders therefore implied that the high cost of feed limits production capacity and act as a barrier to entry for new farmers to enter the system.The meat inspectors reported that ignorance among butchers, traders and other workers was the main challenge to their execution of their mandate. They attributed the ignorance to lack of awareness of official slaughterhouse rules and regulation. Alcoholism among workers was said to contribute to rule breaking. Other challenges, related to the fact that abattoirs start operating at very early hours and the pressure from poor transportation network around the city, which can delay their arrival and, consequently, the slaughtering process. Pressure from the butchers to hasten the inspection processes for them to quickly transport the meat to the retail point was another challenge mentioned. Slaughter on Sundays was said to pose a challenge as to the traders' transport of pigs without any movement permit because government offices are not opened over the weekend.The government provided ante and post-mortem meat inspection service. They were perceived as a critical element in the supply and movement of pigs to the IC. The IC managers reported to be satisfied with status of porcine disease control in the country. The government provides requisite authorization to facilitate transportation of live animals to the slaughter facility i.e., a letter of “No objection” and a “movement permit.” NEMA conducts periodic water testing to ensure quality of water being used in the slaughtering plant and inspect the plant to ensure compliance with the environmental regulations of the country. Further, the government uses the IC slaughtering plant as a demonstration training plant for students in various educational institutions.The IC has three types of suppliers. First, contract farmers who are characterized by having a written agreement with the company to supply a certain number of pigs periodically. To become a contract farmer, it is required to have at least a 5-sow unit (but the average is 10 sows per unit) and to use the company feeds and other inputs, such as company veterinary care and advice. Secondly, semi-contracted farms have a long-term relationship with the company but are run without any written agreement. These farmers provide an important fall back plan in times of pig shortages. The principal requirement of these sets of farmers to bring pigs to the company were for pigs to be free from diseases, to be vaccinated against foot and mouth disease, to be reared in pigpens, fed on commercial feed and demonstrate a high biosecurity level. Finally, the “non-contracted farmers” represented a small or insignificant proportion of the supply. These are farmers or traders who bring pigs to the company without having any prior arrangement and are prominent mainly during certain times of the year when there is an increased demand for pork, or a shortage of animals.Challenges reported by the integrated company were related to the cost of production. This included the costs required to ensure food safety and other legal standards. Yet, IC felt that there was uneven enforcement of regulation among other producers  by the government enforcement agencies. This generates the feeling that IC is more intensively regulated than its competitors, who are not following the rules as stringently as it is done in the IC thus creating an atmosphere of unfair competition from the competitors.An inconsistent supply of pigs by farmers was reported to pose a challenge of planning. During high production peaks non-contracted farmers and semi -contracted farmers bring pigs to the IC. Other challenges included these reported by IC products distributors who mentioned challenges with maintenance of the cold chain due to power outages, refrigerator breakdowns and in other circumstance switching them off to lower the cost of electricity leading to shortening of the shelf life of the products.It was reported that most retailers operate independently, and no association or group was said to exist. Retailers were perceived to have to rely on traders for the supply of live pigs and/or carcasses. To transport carcasses to their respective outlets, the retailers close to the abattoirs pool their transportation needs. Many obtain their pork chiefly from the LIA in Nairobi. Butchers were, however, perceived to dominate the selling of pork in low- and middle-income areas of Nairobi. The high-end market was thought to be served by the large integrated company supplying mainly through supermarkets and high-end restaurants.The pork retailing business was perceived to be dominated by men. It was felt that the pork business is sensitive due to the cultural and superstitions associated with pork, especially with the association of pork with witchcraft by some communities living in Nairobi, and the negative image that the roaming pigs portray around dumpsite in the city.The challenges for retailers were associated with poor infrastructure in terms of physical buildings, availability of portable running water and lack of equipment, such as the cold chain facilities. This is chiefly due to poor access to capital for expansion. The numerous legal requirements and licenses to run a pork butchery were also perceived as an important challenge.The food safety and disease management issues are displayed on Several stakeholders felt that the industry is dominated by the one large processing company followed by pig traders, that they felt was responsible for setting the prices of pork. No major group was reported to operate in LIA, only independent stakeholders. However, the analysis of the certificates of transport in abattoir A for the months of November and December showed that, of the 103 traders that operated in this abattoir, 15% of them were responsible for supplying 50% of the pigs slaughtered . A Gini Traders perceived that consumers of pork did not demand quality, and hence no carcass grading or special cuts were necessary. Visual weight estimation caused cause disagreements between traders and farmers. The traders reported to prefer purchasing live pigs from small and medium farmers due to the perceived lower selling prices. The abattoir ownership, brokerage and trading were reported to be dominated by men, with the exception of the trading of offal, which was predominantly done by women.Parasitism (worms) was reported as the main and commonest disease affecting pigs in both areas. While farmers in Kibera did not mention other diseases, farmers in Dagoretti described clinical signs of diseases that the authors believed to be African Swine Fever and/or Erysipelas. The signs described are reddening of areas around ears and abdomen, loss of appetite, and anorexia. When faced with diseases, farmers in Kibera reported to minimize losses by selling or consuming the pigs, instead of treating the disease (some reported to restrict the pig movements as a treatment option). On the other hand, Dagoretti farmers reported that they look for or pay for professional advice to treat these animals. Disposal of dead animals was done through burying or burning in both area. In Kibera these were used also to feed the dogs. During home slaughter, there is no meat inspector available, although some farmers in Dagoretti reported that inspectors could be invited to homes.In LIA, the lack of equipment and structure for hygiene management at the abattoirs were observed . In termThe lack of a cold chain and the fact that many traders were reported to slaughter the pigs without having a customer order, meant that carcasses were exposed to ambient temperature for long periods of time until a customer for the meat is found. Although most carcasses are sold on the same day, it was reported that some stayed for up to 2 days hanging in the clean area of the abattoir. Overloading of meat boxes was reported to occur frequently, with the consequence that these boxes could only be partially closed, exposing the meat to dust and other possible environmental contaminants. Other themes associated to LIA are shown in The IC governance structure ensures that they control most activities; from slaughter to distribution of processed products; Nevertheless, they reported that due to pig shortages, sometimes they buy pigs from non-contracted farmers, for whom they do not have control on the production process. For contracted farmers, they supply feeds, give health advice and monitor the production process including conducting periodic farm visits. The abattoir operation is fully mechanized and is ISO certified and applies HACCP principles thereby minimizing food safety risks. The cold chain is maintained throughout the process up to transportation of products to various outlets. At the outlets, they reported that they have challenges of ensuring maintenance of the cold chain mainly due to refrigerator breakdown or proprietors switching them off to lower the cost power especially at night. They have been conducting training with these outlets to ensure compliance with the cold chain .At the retail point, houseflies were reported to be a menace especially during the rainy season. The housefly could act as an agent to spread contamination. Many retailing points were reported to lack key infrastructure, such as running water or lack cold storage, with some meat hung for up to 2 days at ambient temperature. Most people working at the butcheries do not have medical certificates, mainly because of the cost associated with their acquisition. The long process involved in enforcing the public health regulations was reported as an impediment to ensuring proper sanitation among retailers see .The results obtained provide a detailed understanding of the flows and process of the Nairobi pork food system. Like all food systems the pork system supplying Nairobi is complex and requires strategic analytical approaches to determine factors and actors to whom interventions should be directed. Several studies have described how this can be achieved , 29–31.These findings highlight the large contrast in the operations between the organized formal sector dominated by the large processing company, and the rest of the sector based on LIA abattoirs or home slaughter. It is important to note that no slaughter slabs were visited in this study. These are believed to be few in number in Nairobi, as opposed to rural areas where they are more prominent . The difMapping results from urban and peri-urban pig producers show that while replacement was similar in both areas, selling of pigs presents some diversity and variation. In Dagoretti, a peri-urban area of Nairobi, most farmers reported to sell their pigs to brokers, traders and butchers who in turn slaughter in the abattoir. The use of abattoirs in this area could however be very much influenced by the proximity of one of the LIAs. In Kibera, farmers practice backyard slaughter more than in Dagoretti. The fact that no meat inspection is conducted in Kibera when conducting backyard slaughtering could represent a risk of exposure of pathogens to abattoir workers and local consumers, and Kibera, in this respect, is likely to be broadly representative of other similar settlements in Nairobi. Differences between urban and peri-urban sites were also observed in terms of pig feed, and their challenges, in terms of quality and lack of training, are similar to what was reported in Western Kenya where scavenging of pigs is predominant , 33. TheIn the LIAs, the key group of people with highest power in the chain were the traders and butchers. They ensure the supply to the abattoirs and provide a market for the farmers, especially small farmers, many of which keep scavenging pigs in informal settlements. As these informal pig keepers are normally unable to supply pigs to the integrated company, these abattoirs represent the most formal channel that these farmers can access, as little or no requirement is needed to supply pigs. For this, the study shows that brokers play an instrumental role of looking for pigs in the farms and either bringing them to the traders or calling the traders to pick them up. Similarly, the importance of these brokers and traders for the development of small-scale producers have been reported in an earlier study conducted in Thika near Nairobi .FurthermThis study identifies several potential food safety issues existing in these LIA, such as the lack of proper equipment ; poor infrastructure, such as lack of cold and detention rooms; important risk practices, such as scalding done manually on the floor, use of untreated water and long distance meat transportation by motorcycle without refrigeration; all coupled with informal pig sourcing and poor traceability. The informal sector therefore requires significant changes and investment in infrastructure and equipment to improve biosecurity and hygiene practices. Yet these may currently be outside the financial capacity of stakeholders given that the chain is based on small pig keepers , low throughput abattoirs and directed to low income consumers. Furthermore, lack of major public and private incentives in the system represents a barrier to generate these changes. The dominant position of traders and butchers suggests that they may be the key stakeholders that could help create the necessary financial incentives for system upgrade. These abattoir system improvements must however be carefully designed to avoid pushing small scale farmers from this semi-regulated chain and forcing them to operate only in slaughter slabs or backyard slaughter. Some food safety risks were related to stakeholders' behaviors and the capacity of government officers to enforce food safety regulations. Indeed, recent research shows that about 8.7% of pigs reaching these abattoirs are positive to cysticercosis which was not detected by meat inspection . This atThe integrated company was identified as the major supplier of pork meat, covering 83% of pork supply through abattoirs, and therefore creating a monopolistic system, especially toward the formal segment. The company is therefore likely to have a critical influence and control on the pig and pork system in Nairobi and Kenya, and in its upgrading capabilities. As mentioned, the study shows that there is a large difference between this IC and the LIAs. The IC has a well-structured and robust supply system, with majority (70%) based on own farms or other farms where written formal contracts are established and in which the company has control on pig feed and veterinary inputs through own inputs. Nonetheless, 50% of supply comes from small farmers (either contract or semi-contract farms), revealing the dependency of the whole pork food system (IC and LIAs) on small-scale producers (5–10 sow unit). These smallholders can be relatively inefficient, as small sizes do not allow for batch management and the benefits of economies of scale, such as access to breeding, markets or reduce labor and other costs. There are considerable market opportunities for pork producers to intensify production and apply modern systems of farm management. The differences between systems are also highly evident with modern slaughterhouse and effective distribution systems. These major differences represent a very important gap in investment, indicating a major barrier to entry to other competitors. However, the fact that the IC has such a large market share and that only three LIAs exists supplying Nairobi (and indeed the rest of Kenya) could also indicate that pork is consumed mainly by high- and middle-income urban consumers and that low-income households use alternative meat products. Indeed, a cross-sectional study of 200 Nairobi low income households revealed that 7.9% of these consumed pork regularly. That study show that reasons for eating pork was mainly because of taste, while reasons for not eating pork were taste, tradition and perception on hygienic standards . The larSeveral limitations were present in this study. Many of the participants interviewed and in focus groups were selected by the livestock production officers and meat inspectors and or abattoir managers. We endeavored to minimize the selection bias by ensuring the participants were as diverse as possible, to achieve heterogeneity and therefore ensure that all chains are identified. Secondly, from a practical and logistical point of view it was not possible to meet all the people involved in the chains, due to the unavailability of some of the people and business time-pressure. This could have led to missing some information or failure to identify some chains. In addition, some data collected represent the perception of key informants or group of people, who might have been reluctant to disclose some of the chains used to avoid problems. However, these challenges were overcome by asking participants to say how other people in the chains operated and by interviewing different key people that have an overall understanding of the markets, such as the meat inspectors, and triangulating the information with them. There is nonetheless an information gap on the amount of pork that is supplied through informal slaughter slabs or backyard slaughter. This gap is mainly due to the fact that there is no consumption data at all available in Nairobi for pork outside of the systems we studied. Further research on pork consumption in the city should be undertaken to understand the extent of pork supply through these other informal systems.In conclusion, this study has provided an understanding of interaction between people working in the abattoirs and markets and urban farmers in Nairobi. It characterized the chains to which the people of Nairobi both contribute and are exposed, as well as illustrating their governance and food safety challenges. The findings have relevance to animal health and farming policy, as well as to food safety policy in sub-Saharan African urban settings similar setting such as Nairobi.The original contributions generated for the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.Ethical approval for this study was obtained from the ILRI Institutional Research Ethics Committee (ILRI IREC) (project reference: ILRI-IREC2014-04/1). ILRI IREC is accredited by the National Commission for Science, Technology and Innovation (NACOSTI) in Kenya. Furthermore, ethical approval form the Royal Veterinary College ethical committee was also obtained (project reference: URN 2013 0084H). The participants provided their written informed consent to participate in this study.MM, DM, PM, JA, and PA collected, analyzed data, and drafted manuscript. PA, EF, MM, JR, and SG were directly involved in developing study design, writing of manuscript, and critically reviewed all manuscript drafts. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.