Geographic Tools for Global Public Health: An Assessment of Available Software

January 10, 2014 · 0 comments

Geographic Tools for Global Public Health: An Assessment of Available Software, 2013. MEASURE Evaluation.

There is a growing list of software options for those wishing to map data. Users in global public health often have little time or money to invest in developing the technical expertise and data required for mapping, and are therefore confronted with capacity and data constraints that can make mapping difficult to implement. This makes the process for selecting the most appropriate software especially challenging.

In this guide, the MEASURE GIS Working Group evaluates the features and ease of use of five commonly used mapping applications: ArcGIS, Quantum GIS (QGIS), Epi Info, Google mapping tools (including Google Maps, Google Earth, and the related MEASURE E2G tool), and DevInfo.

Multi-actor Approaches to Total Sanitation in Africa

December 26, 2013 · 0 comments

Multi-actor Approaches to Total Sanitation in Africa, Policy Brief No. 8, 2013. United Nations University.

Since the 2000s, African cities have witnessed a series of interventions to improve water and sanitation. This policy brief outlines key lessons learned from the intervention experience, drawing on the UNU research project Multi-level Urban Governance for Total Sanitation (2011–2013) under the Education for Sustainable Development in Africa (ESDA) Project. It highlights the importance of multi-actor approaches for promoting: (1) an institutional framework to coordinate civil society organizations, community-based organizations, and the state agencies across levels; (2) policy recognition of water and sanitation as socially embedded infrastructure with gendered dimensions; and (3) the relevance of scientific research and university education to ongoing policy interventions.

Improved Sanitation and Its Impact on Children: An Exploration of Sanergy

December 17, 2013 · 0 comments

Improved Sanitation and Its Impact on Children: An Exploration of Sanergy. Impact Case Study No. 2, 2013.

Esper, H., London, T., and Kanchwala, Y. The William Davidson Institute.

We explore the impacts that Sanergy, a venture providing sanitation facilities and franchising opportunities to the BoP, has on children age eight and under and on pregnant women from the BoP. Sanergy designs and builds 250 USD modular sanitation facilities, called Fresh Life Toilets (FLTs), and sells them to local entrepreneurs for 50,000 Kenyan shillings (KES) or about 588 USD in the Mukuru slum of Nairobi, Kenya. Franchisees receive business management and operations training from Sanergy and earn revenues by charging customers 3-5 KES (0.04-0.06 USD) per use.

We found that Sanergy has the greatest impact on its customers’ children. Sanergy also has substantial impacts on children of franchisees and children in the broader community. The majority of impacts that occur on franchisees’ children are the same as those that occur on customers’ children. In addition, franchisees’ children benefit from the income their parents receive from owning the toilets. However, if parents take out loans to purchase the franchise, their ability to provide for their children may be reduced during the loan repayment period. Franchisees’ children are likely to have greater health benefits from using the toilets, since they are able to use them for free and as often as required, as these are located right outside their homes. Although franchisees’ children will have greater health benefits at an individual level, at an aggregate level, customers’ children will have larger health benefits since the number of franchisees’ children will always be less than the number of customers’ children.

Children living in the community surrounding the FLTs (non-customer children), experience many of the same health benefits as customer’s children as a result of improved cleanliness of the nearby environment. As more people use FLTs, a reduced amount of human waste is found on the ground, resulting in better health outcomes for children. People also begin to have an increased sense of respect for their environment. It is important to note that despite these health benefits, children are still at risk of contracting sanitation-related diseases from exposure to polluted water and other contaminated sources. The impacts we observed on the children of Sanergy’s stakeholders varied within and between the age categories of 0-5 and 6-8 years. We expect that children ages 0-5 receive greater health benefits, as they are more likely to be exposed to contaminants from crawling and playing on the ground and have more vulnerable immune-systems.

Based on the likely outcomes Sanergy has on children across its value chain, we identify opportunities that Sanergy can explore to enhance, deepen, and expand its impacts on children age eight and under and on pregnant women.

Connecting informal settlements to the formal city through household waste collection

December 13, 2013 · 0 comments

Switching Managua on! Connecting informal settlements to the formal city through household waste collection. Environment and Urbanization April 2013.

María José Zapata Campos and Patrik Zapata.

  • Gothenburg Research Institute, University of Gothenburg, Göteborg, Sweden; e-mail: mj.zapata@gri.gu.se
  • School of Public Administration, University of Gothenburg, Göteborg, Sweden; e-mail: patrik.zapata@spa.gu.se

This paper explores the organizing of household solid waste management collection and disposal practices in informal settlements. It is based on a case study of an NGO project that supports Manos Unidas (Joined Hands), an informal waste picker cooperative in Managua, Nicaragua. Using horse carts, these waste pickers collect household solid waste from informal settlements where there was no previous regular, official waste collection.

Unlike many development projects, which try to control people’s agency, the support examined here focused on the residents of illegal neighbourhoods and the waste pickers, who themselves became city constructors and co-producers of basic services such as household waste collection rather than service recipients of aid programmes or municipal governments. By slightly changing the actions of the actors already involved in informal waste handling in the informal settlements, the project succeeded in transforming an agent of pollution into the solution to several interconnected problems, namely illegal dumping by the cart-men and residents, the cart-men’s low and irregular incomes and the lack of household waste collection services.

India – Health of the Urban Poor Program (HUP)

December 13, 2013 · 0 comments

Health of the Urban Poor Program (HUP)

The Population Foundation of India (PFI) is assisting the central government and eight state governments in India, by leading a consortium of technical and implementation partners, in designing and implementing urban health programs, under the USAID-funded Health of the Urban Poor (HUP) program. The PFI-lead consortium works towards strengthening the planning and monitoring systems to deliver innovative models of healthcare, especially maternal, neonatal and child health services (including choices of family planning), while integrating the other determinants of health (nutrition, water, sanitation and hygiene), for the urban poor. These interventions are designed within a larger governance and convergence framework, in partnership with the available private and non-government sector, and supported by effective community engagement at the slum level.

The Health of Urban Poor (HUP) project strives to support, strengthen, and improve Government of India’s comprehensive package of maternal and child health services, and nutrition interventions, including promotion of water supply, sanitation and hygiene services in urban slums. HUP provides technical and capacity -building support to government of India, state governments, local self-governance institutions, line departments, and local civil society organizations to design and implement comprehensive health programs for urban poor in eight states.

The important relationship between landlords and tenants in improving sanitation

December 13, 2013 · 0 comments

The important relationship between landlords and tenants in improving sanitation – the case of Keko Machungwa, 2013.

Stella Stephen, et al.

In the informal settlements of Tanzania, particularly in Dar es Salaam, traditional pit latrines are commonly used for sanitation purposes. Many of these are poorly designed and constructed, and lack the necessary maintenance and formal arrangements for waste disposal. This is the case in Keko Machungwa, which is one of the informal settlements in Miburani ward, located in Temeke municipality. The settlement has a population of 15,644, distributed across 5,180 households.  The relationship between landlords and tenants was highlighted by Keko Machungwa community members as a critical challenge in improving sanitation standards.

This is because they are responsible for the decision-making and investment around the choice and improvement of sanitation solutions, and most houses in Tanzanian informal settlements are owned by landlords. However, despite their responsibility in this area, most landlords do not pay much attention to the improvement and construction of good latrines within the houses they own. The Tanzania Urban Poor Federation (TUPF) and Centre for Community Initiatives) have been exploring ways of improving the relationship between landlords and tenants, with a view to improving sanitation in informal settlements.

Urban Inequalities: The Heart of the Post-2015 Development Agenda

December 13, 2013 · 0 comments

Urban Inequalities: The Heart of the Post-2015 Development Agenda and the Future We Want for All, 2013.

Sheridan Bartlett, Diana Mitlin, David Satterthwaite

Urban inequalities are also masked by standards and definitions that fail to take account of urban realities. National poverty lines often disregard the higher cost of living in most cities and what it means to be tied to a cash economy. These inequalities really matter where every basic need has to be paid for or otherwise negotiated.

Applying global standards for the provision of sanitation and water can also be misleading in densely populated settlements, communicating a level of adequacy that is not warranted. Understanding the causes, nature and extent of urban inequalities is critical, not only because it calls attention to severe and increasing deprivation in many urban areas, but also because of the ramifications of these disparities for economic growth, for peace and security, for the health and well being of all citizens, rich and poor, urban and rural.

 

 

 

 

Reproductive Health Voucher Program and Facility Based Delivery in Informal Settlements in Nairobi

December 3, 2013 · 0 comments

Reproductive Health Voucher Program and Facility Based Delivery in Informal Settlements in Nairobi: A Longitudinal Analysis. PLoS One, Nov 2013.

Djesika D. Amendah, et al.

Introduction – In Kenya, the maternal mortality rate had ranged from 328 to 501 deaths per 100,000 live births over the last three decades. To reduce these rates, the government launched in 2006 a means-tested reproductive health output-based approach (OBA) voucher program that covers costs of antenatal care, a facility-based delivery (FBD) and a postnatal visit in prequalified healthcare facilities. This paper investigated whether women who bought the voucher for their index child and had a FBD were more likely to deliver a subsequent child in a facility compared to those who did not buy vouchers.

Methods and Findings – We used population-based cohort data from two Nairobi slums where the voucher program was piloted. We selected mothers of at least two children born between 2006 and 2012 and divided the mothers into two groups: Index-OBA mothers bought the voucher for the index child (N=352), and non-OBA mothers did not buy the voucher during the study period (N=514). The most complete model indicated that the adjusted odds-ratio of FBD of subsequent child when the index child was born in a facility was 3.89 (p<0.05) and 4.73 (p<0.01) in Group 2.

Discussion and Conclusion – The study indicated that the voucher program improved poor women access to FBD. Furthermore, the FBD of an index child appeared to have a persistent effect, as a subsequent child of the same mother was more likely to be born in a facility as well. While women who purchased the voucher have higher odds of delivering their subsequent child in a facility, those odds were smaller than those of the women who did not buy the voucher. However, women who did not buy the voucher were less likely to deliver in a good healthcare facility, negating their possible benefit of facility-based deliveries. Pathways to improve access to FBD to all near poor women are needed.

Sustainable Service Delivery in an Increasingly Urbanized World

November 25, 2013 · 0 comments

Policy Paper: Sustainable Service Delivery in an Increasingly Urbanized World, 2013. USAID.

This Policy seeks to move away from a development approach oriented around an artificial urban-rural dichotomy. Instead,the Agency believes that development efforts must span a continuum from rural to urban to form an interdependent system. It is the vision of this Policy to support service delivery that attains large-scale benefit to urban residents in a sustainable manner over the long term. This Policy therefore encourages Missions to support programs that will improve governance, encourage accountability, and bolster capacity to manage urban service delivery systems.

The Health of Women and Girls in Urban Areas with a Focus on Kenya and South Africa

November 25, 2013 · 0 comments

The Health of Women and Girls in Urban Areas with a Focus on Kenya and South Africa: A Review, 2013.

Kate Hawkins, Hayley MacGregor and Rose Oronje. Institute of Development Studies.

With respect to the kinds of ‘evidence’ prevalent in the literature, the review revealed a bias towards quantitative biomedical research evidence with a narrow disease focus, which has dominated debates on urban health in developing countries, at the expense of qualitative as well as gender-focused analyses reflecting a broader range of the interconnecting health concerns of women and girls. The knowledge that appears to have dominated debates on urban health in developing countries is largely quantitative, whereas qualitative evidence, including experiential knowledge of poor and marginalised groups that live in informal settlements, has been less prominent.

The bias in the existing body of knowledge on urban health in developing countries has thus to a large extent silenced the voices of the inhabitants of these areas in key decision-making processes. Indeed, it has been argued that relativist scientific knowledge and lay knowledge, although often marginalised in the health sector, are critical in decision-making as they capture contextual issues, which are critical for policy action (Theobald and Nhlema-Simwaka 2008). It has also meant that some important determinants of health have received less attention. Much of the existing evidence does not
provide much insight on how gender inequalities interact with the health disadvantage of living in poor urban settings. Critics have argued that urban health studies often ignore the political and systemic nature of social stratification, instead studying the health impact of decontextualised and isolated characteristics of population groups.

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