Infant and child feeding index reflects feeding practices, nutritional status of urban slum children

December 9, 2014 · 0 comments

Infant and child feeding index reflects feeding practices, nutritional status of urban slum children. BMC Pediatr. 2014; 14(1): 290.Published online Nov 30, 2014.

Authors: Neha Lohia and Shobha A Udipi

Background - Infant and child feeding index (ICFI) an age-specific index, can be used to assess child feeding practices. We used the ICFI to assess feeding practices for urban slum children and the association between ICFI and child nutritional status.

Methods - 446 children aged 6 to 24 months from urban slums of Mumbai, India were studied. We used the 24-hour diet recall to study dietary diversity and a food frequency questionnaire for consumption of food groups during the preceding week. ICFI was computed using five components, namely, breastfeeding, use of bottle, dietary diversity score (DDS), food group frequency score (FGFS) and feeding frequency scores (FFS). Weight, height and Mid-Upper Arm Circumference (MUAC) were measured, and z scores were calculated. Association between ICFI scores and nutritional status was examined.

Results - The mean total ICFI score for all was 5.9 ± 1.9. Among the five components, FGFS and FFS differed between children <12 months of age and >12 months and by breast feeding status. In contrast, there were no differences vis-à-vis dietary diversity scores (DDS), breast feeding, and use of bottle. Non-breastfed children had significantly higher DDS scores than did breastfed children. The mean feeding frequency score (FFS) for children <12 months of age was slightly but not significantly lower than scores for children >12 months of age. Mother’s age and child’s age were significant determinants of ICFI. Multivariate analysis indicated that ICFI was significantly associated with Length-for-Age z scores (LAZ) and BMI-for-Age z scores (BAZ). Sensitivity of ICFI was lower than its specificity.

Conclusions - The results of the present study confirmed that the ICFI can be used to collect information on key components of young child feeding practices and be incorporated into public-health programmes. Further, it could be used to determine the influence of complementary feeding practices on nutritional status of children.

A Simple Microbiological Tool to Evaluate the Effect of Environmental Health Interventions on Hand Contamination

December 9, 2014 · 0 comments

A Simple Microbiological Tool to Evaluate the Effect of Environmental Health Interventions on Hand Contamination. Int J Environ Res Public Health. Nov 2014; 11(11): 11846–11859.

Authors: Carol Devamani, Guy Norman and Wolf-Peter Schmidt

The effects of interventions such as sanitation or hand hygiene on hand contamination are difficult to evaluate. We explored the ability of a simple microbiological test to: (1) detect recontamination after handwashing; (2) reflect risk factors for microbial contamination and (3) be applicable to large populations. The study was done in rural Andhra Pradesh, India, and Maputo, Mozambique. Participants placed all 10 fingertips on a chromogenic agar that stains Enterococcus spp. and E. coli spp. Outcomes were the number of colonies and the number of fingertips with colonies. In the recontamination study, participants were randomised to handwashing with soap and no handwashing, and tested at 30 min intervals afterwards. In two cross sectional studies, risk factors for hand contamination were explored. Recontamination of hands after washing with soap was fast, with baseline levels reached after 1 h. Child care was associated with higher Enterococcus spp. counts, whereas agricultural activities increased E. coli spp. counts. Food preparation was associated with higher counts for both organisms. In Maputo, counts were not strongly associated with water access, latrine type, education or diarrhoea. The method seems unsuitable for the evaluation of handwashing promotion. It may reflect immediately preceding risk practices but not household-level risk factors.

Place and Child Health: The Interaction of Population Density and Sanitation in Developing Countries

December 9, 2014 · 0 comments

Place and Child Health: The Interaction of Population Density and Sanitation in Developing Countries, 2014. World Bank.

Authors: Payal Hathi, Sabrina Haque, Lovey Pant, Diane Coffey Dean Spears

This paper assesses whether the importance of dense settlement for child mortality and child height is moderated by exposure to local sanitation behavior. Is open defecation, without a toilet or latrine, worse for infant mortality and child height where population density is greater? Is poor sanitation an important mechanism by which population density influences health outcomes? The paper uses newly assembled data sets to present two complementary analyses, which represent different points in a trade-off between external and internal validity. The first analysis concentrates on external validity by studying infant mortality and child height in a large, international child-level data set of 172 Demographic and Health Surveys, matched to census population density data for 1,800 subnational regions. The second analysis concentrates on internal validityby studying child height in Bangladeshi districts, witha new data set constructed with Geographic Information System techniques, and controls for fixed effects at a high level of geographic resolution. The paper finds a statistically robust and quantitatively comparable interaction between sanitation and population density with both approaches:open defecation externalities are more important for child health outcomes where people live more closely together.

WHO – The Urban Health Index:A Handbook for its Calculation and Use

December 9, 2014 · 0 comments

The Urban Health Index:A Handbook for its Calculation and Use, 2014. Prepared for:World Health Organization Centre for Health Development Kobe, Japan

Authors: Georgia State University, Atlanta, USA

The Urban Health Index (UHI) is a single metric that can be used to measure and map the disparities in health determinants and outcomes in urban areas. This Handbook is primarily intended for those who want to calculate the UHI for a particular geographic area of interest.What is the Urban Health Index?The UHI provides a flexible approach to selection, amalgamation, and presentation of health data. Its purpose is to furnish visual, graphical, and statistical insight into various health indicators and, health determinants within particular geographic boundaries and health disparities with a focus on capturing intra-urban health disparities. The UHI may be used by public health workers, evaluators, statisticians, program managers, academic researchers, and decision makers to examine the current status of urban areas, to assess change and the effect of program interventions, and to plan for urban improvements.

WASHplus Weekly – World Habitat Day: Focus on Slums

November 25, 2014 · 1 comment

WASHplus Weekly | Issue 164 | Oct 3, 2014 | World Habitat Day: Focus on Slums

The first Monday in each October is World Habitat Day. This year the theme is Voices from Slums. This issue of the weekly contains news of upcoming urban events, urban innovation awards, recent urban WASH studies, and other reports and resources on issues faced by the urban poor.

EVENTS

World Habitat Day: Voices from Slums, October 6, 2014 - Link
Each year World Habitat Day takes on a new theme chosen by the United Nations based on current issues relevant to the habitat agenda. The themes are selected to bring attention to UN-Habitat’s mandate to promote sustainable development policies that ensure adequate shelter for all. This year’s theme, Voices from Slums, is intended to give voice to slum dwellers for improving quality of living conditions in existing slums. This is the UN’s official website for the event.

International Conference on Urban Health, March 9-12, 2015, Bangladesh - Link
The International Society for Urban Health is an association of researchers, scholars, professionals, community members, and workers and activists from various disciplines, roles, and areas of the world whose work is directly related to the health effects of urban environments and urbanization. The International Conference on Urban Health provides an international forum for information exchange among urban health stakeholders. The theme for the 2015 conference is Urban Health for a Sustainable Future: The Post 2015 Agenda.

URBAN HEALTH STUDIES

USAID/WASHplus Urban Health Updates - Link
Urban Health Updates contains more than 800 peer-review articles and “gray” literature reports on health issues faced by the urban poor.

Urban Health: It’s Time to Get Moving! Global Health Science & Practice, May 2014. V Barbiero. Link
Policy makers must commit to a long-term action plan that addresses the triple burden of health issues faced by growing urban populations. A comprehensive global urban health strategy is in order; one similar to the global approach to HIV/AIDS, polio eradication, and malaria. The strategy should build on the urban experience, both positive and negative, from all regions of the globe and provide a clear vision and programmatic guidance.

Trends in Childhood Mortality in Kenya: The Urban Advantage Has Seemingly Been Wiped Out. Health Place, Sept 2014. E Kimani-Murage. Link
The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums.

Vulnerability to Food Insecurity in Urban Slums: Experiences from Nairobi, Kenya.Journal of Urban Health, Aug 2014. E W Kimani-Murage. Link
The study found a high prevalence of food insecurity in Nairobi slums; 85 percent of the households were food insecure, with 50 percent being severely food insecure. Factors associated with food security include level of income, source of livelihood, household size, dependence ratio, illness, perceived insecurity, and slum of residence.

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Towards systemic change in urban sanitation

November 25, 2014 · 0 comments

Towards systemic change in urban sanitation, 2014.

Authors: Galli, G., Nothomb, C., and Baetings, E. IRC.

Failing systems, caused by fragmented, disorganised and uncoordinated government leadership, coupled with the ineffective application of already-scarce resources, mark the state of urban sanitation in most low-and middle-income countries. The two most critical results are that it impacts very negatively on the health and wellbeing of the urban poor and on all aspects of the intended or desired sustainability of sanitation systems.

Against this background, this working paper outlines a ‘whole-system approach’ to urban sanitation by shifting the focus from building infrastructure or a project-driven implementation approach to providing and maintaining equitable and environmentally friendly services, championed and supported by the government and with sufficient resources allocated to ensure sustainability.

This working paper proposes a step-by-step approach to unravel and tackle the very complex circumstances surrounding the need to provide sanitation in urban areas, particularly in densely populated areas and to the less affluent sectors of society.

Gender variations in access, choice to use and cleaning of shared latrines; experiences from Kampala Slums, Uganda

November 25, 2014 · 0 comments

Gender variations in access, choice to use and cleaning of shared latrines; experiences from Kampala Slums, Uganda. BMC Public Health 2014, 14:1180

Authors: Japheth Kwiringira, Peter Atekyereza, Charles Niwagaba and Isabel Günther

Background - Sanitation is one of the most intimate issues that affect women, especially in slums of developing countries. There are few studies that have paid attention to the gender variations in access, choice to use and cleaning of shared latrines in slums.

Methods - This paper draws on qualitative data from a cross sectional study conducted between 2012 and 2013 in six slums of Kampala City, Uganda. The study involved both women and men. Data were collected from 12 Focus Group Discussions (FGDs), 15 Key informant interviews; community transects and photographs of shared latrines.

Results - Location of a shared latrine facility, distance, filthy, narrow and irregular paths; the time when a facility is visited (day or night), privacy and steep inclines were gender ‘filters’ to accessing shared latrines. A full latrine pit was more likely to inhibit access to and choice of a facility for women than men. Results indicate that the available coping mechanisms turned out to be gendered, with fewer options available for women than men. On the whole, women sought for privacy, easy reach, self-respect and esteem, cleanliness and privacy than men. While men like women also wanted clean facilities for use; they (men) were not keen on cleaning these facilities. The cleaning of shared latrines was seen by both women and men as a role for women.

Conclusion - The presence of sanitation facilities as the first step in the access, choice, use, and cleaning by both women and men has distinct motivations and limitations along gender lines. The study confirms that the use and cleaning of latrines is regulated by gender in daily living. Using a latrine for women was much more than relieving oneself: it involved security, intimacy and and health concerns.

 

 

Sanitation can eliminate slums in less than a generation

November 25, 2014 · 0 comments

Sanitation can eliminate slums in less than a generation. Source: Thomson Reuters Foundation – Thu, 6 Nov 2014

Author: Magda Mis

Investing in water and sanitation could eradicate urban poverty and eliminate slums in less than a generation, said a study published on Thursday.

Almost 1 billion people, most of them in South Asia and Africa, live in slums without access to basic services like clean water and improved toilets.

Providing water and sanitation to those impoverished areas is necessary to drive economic development and can be done within decades, a study by international charity Water Aid said.

“Sanitation doesn’t come once prosperity comes – it is a driver of prosperity,” Barbara Frost, chief executive of Water Aid told the Thomson Reuters Foundation on the sidelines of a water summit in London.

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Ebola in urban slums: the elephant in the room

November 25, 2014 · 0 comments

Ebola in urban slums: the elephant in the room. The Lancet Global Health, Early Online Publication, 30 October 2014

Authors: Robert E Snyder, Mariel A Marlow, Lee W Riley

A host of factors has been cited as causes of the current Ebola virus disease (EVD) epidemic in west Africa: local cultural practices, poverty, inadequate health infrastructure, and the region’s recent strife-filled history. These factors alone, however, cannot completely explain the epidemic’s uncontrolled nature. There is an “elephant in the room” in the international discourse concerning this epidemic: urban informal human settlements or slums.

The UN defines slums as settlements with inadequate access to safe water, sanitation, and other infrastructure; poor structural housing quality; overcrowding; and insecure residential status.1 These conditions are the perfect breeding ground for EVD. Previously reported outbreaks of EVD occurred in rural and geographically isolated communities.2—6 The presumed introduction of the virus to the slums of Kenema and Freetown in Sierra Leone has undoubtedly augmented its spread.7 Sierra Leone is urbanising at a rate of 3% each year, and in 2005 more than 97% of its urban population lived in slums.8

The West Point slum in Monrovia, Liberia, has been a flashpoint for that country’s epidemic. The community’s poor health infrastructure, lack of health education, and inadequate government-enforced quarantine have all contributed to the disease’s spread. WHO has reported that the bodies of West Point EVD victims were being thrown into an adjacent river in a desperate attempt to stem the disease and deal with the overwhelming death toll.9 This inhumane situation is another simple means for the disease’s transmission to new areas.

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Oliver Cumming – Does Improving Sanitation Benefit Health? (podcast)

November 3, 2014 · 0 comments

In this podcast, Oliver Cumming, Policy & Research Manager at SHARE, discusses whether improving sanitation benefits health and explains how a sanitation campaign in India has led to a rethink about future interventions. This podcast was first published on 23/10/14 by LSHTM.

 

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