Health and Environmental Hazards Posed by Urban Livestock Keeping in Enugu Urban, Nigeria

January 30, 2013 · 0 comments

Health and Environmental Hazards Posed by Urban Livestock Keeping in Enugu Urban, Nigeria: Implication for Climate Change Mitigation, 2012.

A.N. Asadu, et al.

Livestock’s contribution to climate change is now an established fact and closeness of livestock to human beings in urban areas portends many health and environmental implications. The study ascertained farmer’s
perception of health and environmental hazards posed by livestock keeping in Enugu Urban, Nigeria and its implication for climate change mitigation. Seventy five heads of households were freely characterized and data were obtained through interview. Data were analyzed using percentage and mean. Majority of the farmers kept improved chicken under intensive system. All the respondents were aware of health andenvironmental implications of livestock keeping in urban areas, though only few (4.0%) indicated being aware that livestock could cause climate change.

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Squatting Rights: The importance of urban sanitation in India

January 30, 2013 · 1 comment

Squatting Rights: The importance of urban sanitation in India, 2013.

“Growing slum populations and lack of toilets across Indian cities force over 50 million men, women and children to defecate in the open every day. The poor bear the worst consequences of this paucity in the form of ailing children, uneducated girls and unproductive adults, making these populations even more vulnerable, costing India 6.4% of its GDP.”

In a timely report, Dasra, an Indian strategic philanthropy foundation, studied the urban sanitation ecosystem, one of India’s most critical development challenges. In preparing the report, Dasra spoke to 25 experts from across government, corporates, non-profits, academia, social businesses and international development agencies. It also formed an Advisory Committee comprised of individuals from among the 25 experts to guide its research, report framework and recommendations. 

The report was funded by Forbes Marshall, a leader in the area of process efficiency and energy conservation for the process industry. “Rati Forbes, the director of Forbes Marshall is a keen supporter of the sanitation cause. She approached us to undertake a study on the sanitation sector – understand ground realities, challenges, role of stakeholders and top non profits doing significant work in the sector in India so as to direct more funding to one or more of these non profits,” says Pakzan Dastoor, an Advisory Research Associate at Dasra.

Dasra mapped more than 160 non-profits working in the urban sanitation sector and this list was brought down to 50 through a due diligence process, according to Pakzan. These 50 were interviewed over the phone, following which, the Dasra team spent two days with each of the 14 organisations finally selected, met with their senior management teams and visited the communities they worked in.

According to Dasra, non-profits are best placed to deliver impact at scale because of their proximity to the poorest communities and their ability to liaise with key stakeholders such as government and development agencies. It recommends that “philanthropists fund non-profits that are training stakeholders, enabling behaviour change for hygiene education and influencing government as these are the three most scalable and high-impact interventions undertaken to provide access to sanitation in urban India”, according to Pakzan.

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Refugees – the urban challenge

January 10, 2013 · 0 comments

Refugees – the urban challenge | Source: IRIN News, Jan 9, 2013

NOUAKCHOTT/DAKAR, 9 January 2013 (IRIN) – Sequestering refugees in rural camps is no longer the norm: The most recent estimates indicate that almost half of refugees flock to urban areas and just one third to rural camps, according to the UN Refugee Agency (UNHCR). But while agencies are adjusting their approaches, they are still struggling to match their response with their policies.

Photo: Jaspreet Kindra/IRIN A Malian mother and child at M’béra camp in eastern Mauritania

UNHCR has come a long way since 1997 when its refugee response approach implied that responding to refugees in towns and cities was to be avoided. In 2009 it committed to a policy that recognized the right of displaced people to move freely, stressing that its mandate to protect refugees is not affected by their location.

There are upsides to urban support. Refugees are more likely to find work (when permitted to do so by the local authorities) and become self-sufficient in urban settings, say agencies. Because of this, though start-up costs may be higher, these should diminish over the long term. It also makes more sense for a lot of refugees who were in any case displaced from urban settings, said Jeff Crisp, head of policy development and evaluation at UNHCR.

Kellie Leeson, urban refugee strategy focal point at the International Rescue Committee (IRC), told IRIN: “Typically refugees who come to urban centres do so to find jobs – that motivation and ambition should be applauded and should spark the question: how can we take advantage of that to help them survive on their own?”

Dominique Hyde, head of the UN Children’s Fund (UNICEF) in Jordan, said Syrian refugees benefited from being in urban settings: “It’s a positive. If you look at lessons learned from Iraqis in Jordan. Living conditions are more normal, you’re not in a camp setting, your movements are not restricted. Although it is more difficult to access them, they are aware through informal networks of how to access services. Urban settings are better settings for refugees.”

“If you have a camp setting, it’s easier to count people, to provide a school, to provide a health centre. But for refugees, being in their own apartment, and being able to take their own decisions with cash assistance is preferred,” she said.

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The Challenges of the 21st Century City

January 4, 2013 · 0 comments

The Challenges of the 21st Century City, 2012.

Blair A. Ruble, Wilson Center.

In 2008, for the first time in history, more than half of all human beings lived in cities. Cities are growing in population as well as in their geographic footprint at an accelerating pace. Although megacities with populations over 10 million, such as Tokyo, Mexico City, and São Paulo, are widely recognized, most urban growth is taking
place in so-called medium-size cities of between 1 million and 5 million. This reality changes how policymakers in every sphere can pursue their goals.

Uptake of hand washing with soap or soapy water from a large-scale cluster randomized community trial in urban Bangladesh

January 3, 2013 · 0 comments

ICDDRB Health & Science Bulletin, 10(4) Dec 2012

Uptake of hand washing with soap or soapy water from a large-scale cluster randomized community trial in urban Bangladesh (pdf)

Small-scale studies have shown that intensive hand washing promotion reduces disease, but there is little evidence that largescale hand washing promotion programs change behaviour. We deployed a community-based hand washing promotion intervention and used the presence of water and soap or soapy water at hand washing stations as a proxy indicator for hand washing behaviour and found encouraging results. A cluster randomized cholera vaccine trial conducted in a low-income urban area of Dhaka included those who received the vaccine only (Vaccine Only group), those who received the vaccine and a hand washing and water treatment intervention (Vaccine+HWT group), and those who were neither vaccinated nor received the intervention (Control group). Among the Vaccine+HWT group, the presence of water and soap or soapy water at the hand washing place increased from 22% (41/190) at baseline to 60% (102/171) at the 11-month assessment point (p<0.001). We found no significant increase in the presence of water and soap or soapy water among the Control group or the Vaccine Only group during the same period.

Our findings suggest that hand washing behaviour changed following implementation of a large-scale intervention in a low-income urban setting that provided hardware to enable hand washing and encouraged regular hand washing. Further research on health impact of hand washing with soap in this community and the sustainability of using soapy water could help optimize recommendations for improving hand washing practices in other low-income communities.

Knowledge, Attitudes, and Practices Related to Leptospirosis among Urban Slum Residents in Brazil.

January 3, 2013 · 0 comments

Am J Trop Med Hyg. 2012 Dec 26.

Knowledge, Attitudes, and Practices Related to Leptospirosis among Urban Slum Residents in Brazil.

Navegantes de Araújo W, Finkmoore B, Ribeiro GS, Reis RB, Felzemburgh RD, Hagan JE, Reis MG, Ko AI, Costa F.

Gonçalo Moniz Research Center, Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador, Brazil; Field Epidemiology Training Program, Secretariat of Surveillance in Health, Ministry of Health, Brasília, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Brazil; Yale School of Public Health, Yale University, New Haven, Connecticut.

Leptospirosis disproportionately affects residents of urban slums. To understand the knowledge, attitudes, and practices regarding leptospirosis, we conducted a cross-sectional study among residents of an urban slum community in Salvador, Brazil. Of the 257 residents who were interviewed, 225 (90%) were aware of leptospirosis and more than two-thirds of respondents correctly identified the modes of disease transmission and ways to reduce exposure.

However, study participants who performed risk activities such as cleaning open sewers had limited access to protective clothing such as boots (33%) or gloves (35%). Almost all respondents performed at least one activity to prevent household rat infestation, which often included use of an illegal poison. Our findings support the need for interventions targeted at the individual and household levels to reduce risk of leptospirosis until large-scale structural interventions are available to residents of urban slum communities.

Determinants for participation in a public health insurance program among residents of urban slums in Nairobi

December 27, 2012 · 0 comments

Determinants for participation in a public health insurance program among residents of urban slums in Nairobi, Kenya: results from a crosssectional survey. BMC Health Services Research 2012, 12:66

James K Kimani, et al. African Population and Health Research Center.

Background: The government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. This paper examines the determinants associated with participation in the NHIF among residents of urban slums in Nairobi city.

Methods: The study used data from the Nairobi Urban Health and Demographic Surveillance System in two slums in Nairobi city, where a total of about 60,000 individuals living in approximately 23,000 households are under surveillance. Descriptive statistics and multivariate logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with participation in the NHIF program.

Results: Only 10% of the respondents were participating in the NHIF program, while less than 1% (0.8%) had private insurance coverage. The majority of the respondents (89%) did not have any type of insurance coverage. Females were more likely to participate in the NHIF program (OR = 2.4; p < 0.001), while respondents who were formerly in a union (OR = 0.5; p < 0.05) and who were never in a union (OR = 0.6; p < 0.05) were less likely to have public insurance coverage. Respondents working in the formal employment sector (OR = 4.1; p < 0.001) were more likely to be enrolled in the NHIF program compared to those in the informal sector. Membership in microfinance institutions such as savings and credit cooperative organizations (SACCOs) and community-based savings and credit groups were important determinants of access to health insurance.

Conclusions: The proportion of slum residents without any type of insurance is high, which underscores the need for a social health insurance program to ensure equitable access to health care among the poor and vulnerable segments of the population. As the Kenyan government moves toward transforming the NHIF into a universal health program, it is important to harness the unique opportunities offered by both the formal and informal microfinance institutions in improving health care capacity by considering them as viable financing options within a comprehensive national health financing policy framework.

Does living in slums or non-slums influence women’s nutritional status? Evidence from Indian mega-cities

December 27, 2012 · 0 comments

Soc Sci Med. 2013 Jan;77:137-46. doi: 10.1016/j.socscimed.2012.11.017

Does living in slums or non-slums influence women’s nutritional status? Evidence from Indian mega-cities.

Gaur K, Keshri K, Joe W. International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai 400088, Maharashtra, India. Email: gaurk.iips@gmail.com.

This article examines the intra-city distribution of women’s nutritional status across eight Indian mega-cities with a specific focus on slum-non-slum divide. The analysis is based on the National Family Health Survey (2005-06) of India and highlights the dual burden of malnutrition among urban women. The results show that one in every two women in mega-cities is malnourished (either undernourished or overnourished), but a biased, analytical focus on citywide averages conceals the nature of the problem.

Overnutrition among women is notably higher in non-slum areas whereas underweight persists as a key concern among slum dwellers. Cities located in the Central India (Nagpur and Indore) have the highest proportion of underweight women whereas the cities in South India (Chennai and Hyderabad) show a high prevalence of overweight women across both slum and non-slum areas. The intensity of income-related inequalities in underweight outcome is much greater for non-slum areas, whereas inequalities in overweight outcomes are higher among slums.

Furthermore, regression analysis indicates that place of residence as such has no significant impact on women’s nutritional status and that this elementary association is primarily a ramification mediated through other key socioeconomic correlates. Results suggest that, it would be rational to develop a comprehensive urban nutritional plan that focuses on dietary planning and behaviour change to address both type of malnutrition at the same time.

Gates Foundation Backs Scientific Study of Urban Slums

December 21, 2012 · 1 comment

Gates Foundation Backs Scientific Study of Urban Slums | Source: Mediabistro, Dec 19, 2012

The word slum conjures images of the poorest quality housing, most unsanitary conditions, and dangerous–usually illegal–activities. But in developing countries, the word is free of its original, pejorative connatation and simply refers to lower quality or informal housing. Meanwhile, theUnited Nations Human Settlements Programme (UN-HABITAT) has developed a kind of slum-defining checklist that includes: inadequate access to safe water, sanitation, and other infrastrucure; poor structural quality of housing; overcrowding; and insecure residential status. Researchers at the Santa Fe Institute have secured funding from the Bill & Melinda Gates Foundation to undertake a scientific study of a urban slums worldwide. The goal of the project, a collaboration with the nonprofit Slum Dwellers International (SDI), is to uncover some of the underlying principles common to rapid urbanization and the emergence of informal settlements. 

“Part of what we will do is analyze data from 7,000 slum settlements around the world,” says Santa Fe Institute professor Luis Bettencourt, a physicist whose research includes studying urban organization and dynamics, in a statement issued recently. SDI has accumulated census-like data on many of the world’s slums, and researchers will combine and compare it across cultures, levels of socioeconomic development, geography, and time to identify common features of slums and test the data for accuracy. Subsequent stages of the project will examine how the SDI data was collected and find ways to make it most useful to scientists, policymakers, and others interested in urban development. Ultimately, the project will help to shape ongoing data-collection practices and generate new datasets. Added Bettencourt, “In this way, the project will help create standards through which informal communities can collect and use data about themselves and develop economic models to sustain these efforts.“

Healthy Cities Indicators—A Suitable Instrument to Measure Health?

December 20, 2012 · 0 comments

Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2012, Online First

Healthy Cities Indicators—A Suitable Instrument to Measure Health?

Premila Webster and Denise Sanderson

The evidence-base for a health strategy should include information on the determinants of health and how they link together if it is to influence the health of the population. The WHO European Healthy Cities Network developed a set of 53 healthy city indicators (HCIs), to describe the health of its citizens and capture a range of local initiatives addressing the wider dimensions of health. This was the first systematic effort to collect and analyze a range of data from European cities. The analysis provided important insights into the interpretation, availability, and feasibility of collecting data, resulting in the development of a revised set of 32 indicators with improved definitions.

An analysis of the revised indicators showed that this data was more complete and feasible to collect. It provided useful information to cities contributing to developing a description of health and thus helping to identify health problems. It also highlighted issues about the importance of collecting qualitative as well as quantitative data, the number of indicators and the appropriateness of using the indicators to compare different cities. HCIs facilitated the collection of routinely available health data in a systematic manner.

The introduction of HCIs has encouraged cities to adopt a structured process of collecting information on the health of their citizens and build on this information by collecting appropriate local data for developing a city health profile to underpin a city health plan that would set out strategies and interventions to improve health and provide the evidence-base for health plans.

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