Sustained high incidence of injuries from burns in a densely populated urban slum in Kenya: An emerging public health priority

August 28, 2014 · 0 comments

Sustained high incidence of injuries from burns in a densely populated urban slum in Kenya: An emerging public health priority. Burns, Volume 40, Issue 6, September 2014, Pages 1194–1200.

Authors: Joshua M. Wonga, et al.

Introduction – Ninety-five percent of burn deaths occur in low- and middle-income countries (LMICs); however, longitudinal household-level studies have not been done in urban slum settings, where overcrowding and unsafe cook stoves may increase likelihood of injury.

Methods- Using a prospective, population-based disease surveillance system in the urban slum of Kibera in Kenya, we examined the incidence of household-level burns of all severities from 2006–2011.

Results – Of approximately 28,500 enrolled individuals (6000 households), we identified 3072 burns. The overall incidence was 27.9/1000 person-years-of-observation. Children <5 years old sustained burns at 3.8-fold greater rate compared to (p < 0.001) those ≥5 years old. Females ≥5 years old sustained burns at a rate that was 1.35-fold (p < 0.001) greater than males within the same age distribution. Hospitalizations were uncommon (0.65% of all burns).

Conclusions – The incidence of burns, 10-fold greater than in most published reports from Africa and Asia, suggests that such injuries may contribute more significantly than previously thought to morbidity in LMICs, and may be increased by urbanization. As migration from rural areas into urban slums rapidly increases in many African countries, characterizing and addressing the rising burden of burns is likely to become a public health priority.

WSUP – The urban water supply guide: service delivery options for low-income communities

August 14, 2014 · 0 comments

The urban water supply guide: service delivery options for low-income communities, 2014.

Water and Sanitation for the Urban Poor.

Providing improved water supply to low-income urban communities is a difficult challenge faced by water utilities throughout Africa and Asia. This guide provides an introduction to available options for serving these communities. The guide draws on sector experience in general, and more particularly on WSUP’s extensive experience of implementing urban WASH programmes in sub-Saharan Africa and elsewhere.

This guide is aimed primarily at executive and technical staff in water utilities and related organisations, such as asset-holders and regulators. It will also be useful for WASH professionals working in governments, development agencies, funding agencies or civil society organisations.

Metabolized-water breeding diseases in urban India: Socio-spatiality of water problems and health burden in Ahmedabad

August 14, 2014 · 0 comments

Metabolized-water breeding diseases in urban India: Socio-spatiality of water problems and health burden in Ahmedabad, 2014.

Subramanian, Saravanan V., et al. Center for Development Research, University of Bonn.

The paper brings together urban metabolism, political ecology and anthropological studies to examine how the material flow of water is socially constructed and reconstructed through everyday water problems and its health burden in Ahmedabad city, India. The article geo-references the water problems and occurrence of diseases and through interviews documents the socio-spatial characteristics of water problems and health burden in two case study wards. The paper provides a situated understanding of the everyday practices that exposes the water infrastructure through leakages, reveals the citizens desire for better water quality and struggle to gain access to water using diverse ‚pressure‘ tactics.

It is this social-material construct of infrastructure that gives structure and coherence to urban space, which spatially coincides with the occurrence of diseases. The analysis reveals the socio-political drivers of the water problems, spatial inequity in water access, and identify potential hypothesis of the hotspots of disease emergences. Attempts to bring about a desired change have to be collective and incremental that takes into consideration the diffuse interplay of power by diverse actors in managing the flow of water. The methodology offers a way forward for researchers and development agencies to improve the surveillance and monitoring of water infrastructure and public health. By bringing ‚place-based‘ and ‚people-based‘ approach, the analysis charts out avenues for incorporating the socio-spatiality of the everyday problems within the field of urban metabolism for improving resource use efficiencies in cities of rapidly growing economies.

 

Unintended Pregnancies among Young Women Living in Urban Slums: Evidence from a Prospective Study in Nairobi City, Kenya

August 14, 2014 · 0 comments

Unintended Pregnancies among Young Women Living in Urban Slums: Evidence from a Prospective Study in Nairobi City, Kenya. PLoS One, July 2014.

Donatien Beguy, et al.

Background: Despite the significant proportion of young people residing in slum communities, little attention has beenpaid to the sexual and reproductive health (SRH) challenges they face during their transition to adulthood within this harshenvironment. Little is known about the extent to which living in extreme environments, like slums, impact SRH outcomes,especially during this key developmental period. This paper aims to fill this research gap by examining the levels of andfactors associated with unintended pregnancies among young women aged 15–22 in two informal settlements in Nairobi,Kenya.

Methods: We use data from two waves of a 3-year prospective survey that collected information from adolescents living inthe two slums in 2007–2010. In total, 849 young women aged 15–22 were considered for analysis. We employed Cox andlogistic regression models to investigate factors associated with timing of pregnancy experience and unintended pregnancyamong adolescents who were sexually active by Wave 1 or Wave 2.

Findings: About two thirds of sexually experienced young women (69%) have ever been pregnant by Wave 2. For 41% of adolescents, the pregnancies were unintended, with 26% being mistimed and 15% unwanted. Multivariate analysis shows asignificant association between a set of factors including age at first sex, schooling status, living arrangements and timing ofpregnancy experience. In addition, marital status, schooling status, age at first sex and living arrangements are the only factors that are significantly associated with unintended pregnancy among the young women.

Conclusions: Overall, this study underscores the importance of looking at reproductive outcomes of early sexual initiation, the serious health risks early fertility entail, especially among out-of school girls, and sexual activity in general among young women living in slum settlements. This provides greater impetus for addressing reproductive behaviors among youngwomen living in resource-poor settings such as slums

Shelter from the Storm: Upgrading Housing Infrastructure in Latin American Slums

August 14, 2014 · 0 comments

Shelter from the Storm: Upgrading Housing Infrastructure in Latin American Slums, 2014.

Sebastián Galiani, Paul Gertler, Ryan Cooper, Sebastián Martínez, Adam Ross, Raimundo Undurraga. InterAmerican Development Bank.

This paper provides empirical evidence on the causal effects that upgrading slum dwellings has on the living conditions of the extremely poor. In particular, we study the impact of providing better houses in situ to slum dwellers in El Salvador, Mexico and Uruguay. We experimentally evaluate the impact of a housing project run by the NGO TECHO which provides basic pre-fabricated houses to members of extremely poor population groups in Latin America. The main objective of the program is to improve household well-being. Our findings show that better houses have a positive effect on overall housing conditions and general well-being: treated households are happier with their quality of life. In two countries, we also document improvements in children’s health; in El Salvador, slum dwellers also feel that they are safer. We do not find this result, however, in the other two experimental samples. There are no other noticeable robust effects on the possession of durable goods or in terms of labor outcomes. Our results are robust in terms of both internal and external validity because they are derived from similar experiments in three different Latin American countries.

IIED – Urbanisation Concepts and Trends

August 14, 2014 · 0 comments

Urbanisation Concepts and Trends, 2014.

Authors: Gordon McGranahan, David Satterthwaite. International Institute for Environment and Development.

There is an emerging consensus that urbanisation is critically important to international development, but considerable confusion over what urbanisation actually is, whether it is accelerating or slowing, whether it should be encouraged or discouraged, and more generally what the responses should be. This Working Paper reviews some key conceptual issues and summarises urbanisation trends. It ends with a brief review of urbanisation and sustainable development, concluding that while urbanisation brings serious challenges, attempts to inhibit urbanization through exclusionary policies are likely to be economically, socially and environmentally damaging. Moreover, with the right support urbanisation can become an important element of sustainable development.

 

WSUP – Fecal Sludge Management Services in Lusaka: Moving Up the Excreta Management Services,

August 14, 2014 · 0 comments

Fecal Sludge Management Services in Lusaka: Moving Up the Excreta Management Services, 2014. Water and Sanitation for the Urban Poor.

Despite most residents of African and Asian cities depending on non-sewered sanitation, only a handful of sanitation authorities have addressed the management of faecal sludge from these systems. This Practice Note describes the launch of a faecal sludge management  (FSM) service in the peri-urban area of Kanyama.

2015 International Conference on Urban Health, Dhaka, Bangladesh

July 31, 2014 · 6 comments

March 9-12, 2015 – International Conference on Urban Health, Dhaka, Bangladesh – Urban Health for a Sustainable Future: Post 2015 Agenda

ICUH 2015 will be unique. Why? Because this will be the first ICUH in South Asia, and Bangladesh is very important to the region’s development.

The hosting of the conference in Bangladesh is meaningful at a time in the country’s development with the realization of importance of urban health for sustainable development. The conference will also have significant relevance globally.ICUH 2015 will promote the idea that we need to think of urbanization with its impact on environment, economy and social factors which will benefit all segments of the population. It will aim to address to sustain urbanization in such a way that promotes equality, development and health.

The major objective of the ICUH is to gather scientists, practitioners, policy makers and community organizations across disciplines and geographic boundaries (high and low-income settings), to exchange ideas and advance research and practice that promote the health of individuals who are in urban regions, including those individuals who belong to disadvantaged groups. The conference aims to promote trans disciplinary and collaborative research, policy, and interventions, to foster international discussion of urban health issues, to build networks among individuals engaged in urban health, and to promote the understanding of the impact of urban areas on health and behavior. ICUH 2015 aims to focus on post 2015 development agenda on urban health.

 

Urban Development in Sub-Saharan Africa: Bearer of Goods and Risks

July 31, 2014 · 0 comments

Urban Development in Sub-Saharan Africa: Bearer of Goods and Risks. PLoS Medicine, July 2014.

Authors: Fahad Raza, et al.

Sub-Saharan Africa remains the least urbanized region of the world and more than 60% of the population, 570 million people, still live in rural areas [1]. Over the next few decades Africa will be one of the most rapidly urbanizing regions [2], and with this transition is an expected rise in cardiovascular risk factors and disease (CVD) [3]. Across sub-Saharan Africa, many adults migrate back and forth from rural home communities to more urban areas for work and education; others have moved to urban areas; and in still other cases, rural communities themselves have urbanized.

In this issue of PLOS Medicine, a study by Riha and colleagues is directly concerned with the latter scenario within the context of urbanizing rural Uganda [4]. As the authors aptly note, the crude dichotomy of urban-rural difference obscures the changes occurring within rural regions themselves, as characteristics of urban environments, defined as urbanicity [5], become more prominent. Urbanization is a complex worldwide phenomenon and challenges global populations to re-calibrate a set of far reaching behaviors as the meaning of communities change, networks widen, and globalization influences attitudes and access to new resources. Some of these phenomena are likely to be health promoting, while others expose formerly rural populations to new risks.

Diarrhoea in slum children: observation from a large diarrhoeal disease hospital in Dhaka, Bangladesh.

July 31, 2014 · 0 comments

Diarrhoea in slum children: observation from a large diarrhoeal disease hospital in Dhaka, Bangladesh. Trop Med Int Health, 2014 Jul 18. doi: 10.1111/tmi.12357. |Order information|

Authors: Ferdous F1, Das SK, Ahmed S, Farzana FD, Malek MA, Das J, Latham JR, Faruque AS, Chisti MJ.

1International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh; Department of Clinical Trial and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.

OBJECTIVES: To determine and compare socio-demographic, nutritional and clinical characteristics of children under five with diarrhoea living in slums with those of children who do not live in slums of Dhaka, Bangladesh.

METHODS: From 1993 to 2012, a total of 28 948 under fives children with diarrhoea attended the Dhaka Hospital of icddr,b. Data were extracted from the hospital-based Diarrhoea Disease Surveillance System, which comprised 17 548 under fives children from slum and non-slum areas of the city.

RESULTS: Maternal illiteracy [aOR = 1.57; 95% confidence interval (1.36, 1.81), P-value <0.001], paternal illiteracy [1.37 (1.21, 1.56) <0.001], mother’s employment [1.59 (1.37, 1.85) <0.001], consumption of untreated water [2.73 (2.26, 3.30) <0.001], use of non-sanitary toilets [3.48 (3.09, 3.93) <0.001], 1st wealth quintile background [3.32 (2.88, 3.84) <0.001], presence of fever [1.14 (1.00, 1.29) 0.047], some or severe dehydration [1.21 (1.06, 1.40) 0.007], stunting [1.14 (1.01, 1.29) 0.030] and infection with Vibrio cholerae [1.21 (1.01, 1.45) 0.039] were significantly associated with slum-dwelling children after controlling for co-variates. Measles immunisation [0.52 (0.47, 0.59) P < 0.001] and vitamin A supplementation rates [0.36 (0.31, 0.41) P < 0.001] amongst children 12-59 months were lower for slum dwellers than other children in univarate analysis only.

CONCLUSIONS: Slum-dwelling children are more malnourished, have lower immunisation rates (measles vaccination and vitamin A supplementation) and higher rates of measles, are more susceptible to diarrhoeal illness due to V. cholerae and suffer from severe dehydration more often than children from non-slum areas. Improved health and nutrition strategies should give priority to children living in urban slums.

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