Urbanization and Maternal Health: Perspectives from USAID, 2011.
Anthony Kolb, USAID Urban Health Advisor.
Conclusions
• Signifiant slum variablity
• Slums & poverty not the same
– Wealthy in slum areas
– Poor in non-slum areas
• Lack of services even for non-poor
Recommendations
• Focus on urban poor in DHS analysis
• Focus on urban poor groupings (slums) in program design
Indian J Community Med. 2012 Jan-Mar; 37(1): 50–56. doi: 10.4103/0970-0218.94027
All Slums are Not Equal: Maternal Health Conditions Among Two Urban Slum Dwellers
Zulfia Khan, et al.
Background: Pregnant women inhabiting urban slums are a “high risk” group with limited access to health facilities. Hazardous maternal health practices are rampant in slum areas. Barriers to utilization of health services are well documented. Slums in the same city may differ from one another in their health indicators and service utilization rates. The study examines whether hazardous maternal care practices exist in and whether there are differences in the utilization rates of health services in two different slums.
Materials and Methods: A cross-sectional study was carried out in two urban slums of Aligarh city (Uttar Pradesh, India). House-to-house survey was conducted and 200 mothers having live births in the study period were interviewed. The outcome measures were utilization of antenatal care, natal care, postnatal care, and early infant feeding practices. Rates of hazardous health practices and reasons for these practices were elicited.
Results: Hazardous maternal health practices were common. At least one antenatal visit was accepted by a little more than half the mothers, but delivery was predominantly home based carried out under unsafe conditions. Important barriers to utilization included family tradition, financial constraints, and rude behavior of health personnel in hospitals. Significant differences existed between the two slums.
Conclusion: The fact that barriers to utilization at a local level may differ significantly between slums must be recognized, identified, and addressed in the district level planning for health. Empowerment of slum communities as one of the stakeholders can lend them a stronger voice and help improve access to services.
Eur J Clin Microbiol Infect Dis. 2012 Oct;31(10):2491-6.
Leptospirosis in pregnancy.
Puliyath G, Singh S. Department of Obstetrics and Gynaecology, SUT Academy of Medical Sciences, Trivandrum, 695028, Kerala, India, Email: pgeetha98@yahoo.co.in.
Leptospirosis is a direct zoonotic disease caused by spirochetes belonging to the genus Leptospira. Many animals act as carriers or vectors. Human infection results from accidental contact with carrier animals or environment contaminated with animal urine containing the organism. Epidemics of leptospirosis result from poor sanitation in urban areas and are aggravated following natural calamities. The majority of leptospiral infections are either subclinical or result in very mild illness and patients recover without complications.
In a few cases it may manifest as multiorgan failure where the mortality can go up to 40%. Infection in pregnant women may be grave leading to severe fetal and maternal morbidity and mortality. The presentation may mimic other viral, bacterial, and parasitic infections, acute fatty liver, pregnancy-induced hypertension, and HELLP syndrome. Owing to the unusual presentation, leptospirosis in pregnancy is often misdiagnosed and under-reported. Preventive public education regarding hygiene, personal practices, source reduction, environmental sanitation, early diagnosis, and treatment of the condition are needed to avoid perinatal and maternal mortality.
Corburn J, Cohen AK (2012) Why We Need Urban Health Equity Indicators: Integrating Science, Policy, and Community. PLoS Med 9(8): e1001285. doi:10.1371/journal.pmed.1001285
Summary Points
Health: Urban poor missing out on vital nutrients | Source: Reliefweb| Oct 12, 2012
NAIROBI, 12 October 2012 (IRIN) – In slums around the world, the sight of food vendors along dusty alleys, serving customers as they wave away flies, is common. Many of these consumers do not consider themselves undernourished, but experts say consuming cheap food, cooked and sold under unhygienic conditions, could be affecting the nutrition and health of many urban poor.
“Many of the people living in informal settlements are poor and rely on street food vendors for their consumption… The food is, in most instances, very unhygienic,” Kwadwo Asenso-Okyere, the International Food Policy and Research Institute’s (IFPRI) Eastern and Southern Africa director, told IRIN. “When you get little money in the slums, you either prioritize to buy food or paraffin, and they tend to decide on buying already cooked food.”
Eating cheap, cooked foods is one of the many strategies employed by the urban poor to cope with rising global food prices. Experts say there is a need to create policies to ensure that this segment of the world’s population can access a proper diet.
“Their vulnerability to food price increases means there should be ways to ensure they can access a balanced diet, like promoting urban agriculture and providing them with social protection,” Anne O’Mahoney, the Kenya country director for the global NGO Concern Worldwide, told IRIN.
Kenya’s Plastic Plague: Banning Thin Plastic Bags is Not Enough | Source: Kanyiva Muindi, Research Officer, African Population & Health Research Center | Oct 8, 2012
In 2007, Kenya banned the use of very thin plastic bags (up to 0.06 millimeters thick) commonly used by grocery stores. It was the culmination of a decade long war waged by environmental conservationists, key among them the late Prof. Wangari Maathai. In early 2012, the government went further, banning the manufacture and importation of very thin plastic bags. While this is an encouraging step by the government, the battle must continue if we are to win the war. Just as Rwanda did four years ago, it is time to totally ban all plastic bags in Kenya.
Residents burning plastics in Viwandani slum, Nairobi
A walk in most urban and rural neighborhoods bears witness to the challenges of disposing plastic bags. Despite the plastic bag being king in the packaging industry and replacing the once common brown paper bag, the environmental problems it brings are evidenced by the piles of plastic litter on our roadsides and drainage systems.
According to a 2005 study by the National Environment Management Agency (NEMA), United Nations Environmental Programme (UNEP) and the Kenya Institute for Public Policy Research and Analysis (KIPPRA), about 100 million plastic bags are freely given to consumers in grocery stores every year and very few of these are recycled or reused. This figure excludes plastic bags used by other traders and those directly purchased by households for home use. Unfortunately, most of these plastics are improperly disposed in dumpsites, along the roadside, and in rivers, or burned. The immediate and long-term effects of improper disposal of plastics are mind-numbing and the challenge to fellow Kenyans is: when shall we start thinking about saving our environment? No foreigner shall help us clean our own house – we must do it ourselves. A few years down the line we will be dealing with plastic waste at the magnitude below or worse.
Surviving off rubbish in Kenya’s slums – in pictures | Source: Clar Ni Chonghaile, The Guardian | Sept 18, 2012
Thousands of Nairobi’s slum dwellers risk their lives sifting rubbish on the biggest dump in Kenya. A report from Concern Worldwide and other agencies focuses on an urgent need to close the site, which is a severe health risk to nearby communities and ‘one of the most flagrant violations of human rights in Kenya.’ - Link to Photo Essay
Every day up to 10,000 people sift through the rubbish at Dandora, one of Africa's largest dumps, 8km from the centre of Nairobi. The city's only dump site is the subject of Trash and Tragedy, a report from Concern Worldwide and other agencies highlighting the health hazards it poses to local people
Barefoot army behind NGO’s award-winning research on city slums | Source: Mumbai Mirror | Oct 11, 2012
PUKAR’s team of Barefoot Researchers from the very slums they are helping to improve
Anita Patil-Deshmukh was felicitated by her alma mater, the Harvard School of Public Health, last week as ‘public health innovator of the year’ for her work in a slum on Mumbai’s eastern waterfront.
But to understand the true impact of her work, you’ll have to meet Baliram Boomkar and Shakira Mulla.
Patil-Deshmukh, executive director of research initiative PUKAR (Partners for Urban Knowledge Action and Research), and Mulla and Boomkar, its Barefoot Researchers, are part of a tireless army that makes the organisation’s work possible.
PUKAR works to offer a better standard of living to inhabitants of slums locked within the city’s crevices. Tapping into youth from these communities, it empowers them to spread awareness and collect data that can be collated and then presented to authorities who hold the power to bring about change.
It was innovation in data collection, research and reaching out to the population that won Patil-Deshmukh the award. “Other researchers,” she says, “paratroop into a community. The quality of their information remains superficial. We found that involving locals empowers them. The idea of doing something for themselves is the best motivation.”
“Besides, the information they collect has a granularity which you and I could never land. They can talk to neighbours, gather and reassure them. Thirdly, it creates a wider and more personal reach for follow-up. We can create medical cards and set up appointments, but the Barefoot Researchers can remind the slum-dwellers personally and follow up their visits.”
The advantage that PUKAR gains is small compared to what the Barefoot Researchers reap. The workforce includes people from the immediate surroundings of the slum, and these interactions improve their sense of dignity. “And somehow these children are mainstreamed,” adds Anita.
Boomkar, only 19, has worked with Pukar for three years, while Mulla has been with them for two. Boomkar rattles off the projects he’s worked on: diarrhoea awareness, collecting biometric data, mental health surveys and immunisation.
According to him, tensions about the uncertainty over water, disease and toilets are the main reasons for the rise in mental health issues. Shakira works at Raghuleela Mall in Vashi during the week and Bali is doing his SYBCom from Siddharth College at Fort.
The effects of handling solid waste on the wellbeing of informal and organized recyclers: a review of the literature. International Journal of Occupational and Environmental Health, Volume 18, Number 1, March 2012 , pp. 43-52(10).
Binion, Eric; Gutberlet, Jutta
Previous research has identified health issues in the formal, regulated solid waste collection sector, located primarily in the global North. Conversely, less information is available with regard to the health predicaments of informal, unaffiliated, and organized recyclers operating in regions of the global South. Estimated at 15 million people operating globally, informal recyclers perform a vital public service while working individually or within cooperatives.1 This review assesses, discusses, and compiles the physical and emotional health issues of individuals who are operating in this stigmatized sector.
The study highlights the self-assessed and observed health risks. Findings were coded into a number of reacquiring themes: chemical hazards, infection, musculoskeletal damage, mechanical trauma, emotional vulnerabilities, and environmental contamination. The review showcases the encouraging significance of working as a member in a recycling cooperative as a means of alleviating health issues. The findings suggest the need for further qualitative research with informal recyclers and solid waste policy enforcement with public, commercial, and industrial cooperation in source separation.
Linking the poor to new modalities in service delivery: partnership innovations in solid waste management in Bogotá, Colombia, 2012.
Isabelle Turcotte, et al. International Institute of Social Studies.
Waste picking has become a prominent activity in the urban landscape, bridging the gap between shortfalls in service delivery and personal income generation in virtually all cities of the developing world. Overcoming previous stigmatization and work fragmentation through organization and dialogue, social economy organizations constituted by waste pickers are emerging as valuable actors in the governance framework, partnering at times with the public and private sectors to fulfil public service provision while aiming to improve the livelihoods of the poor and overcome the institutional nature of poverty. Bogota’s Plan Maestro Integral de Residuos Solidos (PMIRS) serves as a case study to explore these new modalities in service delivery, and to delve into the theoretical dimensions and practical implications of fomenting the inclusion of informal waste pickers into integrated solid waste management systems.
