Urban Water Supply Challenges in Dhaka: Potential for Residential Water Conservation Using Water Efficient Fixtures, 2012.
Asanga Gunawansa, et al.
Population and economic growth are increasing the demand for water, while climate change, pollution and over extraction of groundwater are decreasing the world’s supply of fresh water. While technological and management reforms can increase supply, sustainable development calls for water conservation. This paper explores the potential of residential water conservation in Dhaka using water efficient fixtures. Primary data collected from 60 households in Dhaka reflects that on average households spend 1.15 percent of their monthly expenditures on water bills with a median of Tk. 350/month (USD 4.40/month).
A typical household of 4-6 people living consumes about 2000 litres/day. Water conservation is a neglected concept in Dhaka, and despite the wide availability of efficient fixtures in the market, very few households have installed them. Under this scenario, more accurate pricing through 100 percent metering, implementation of regulations and greater awareness are necessary to promote domestic water conservation using water efficient fixtures.
What are the effects of different models of delivery for improving maternal and infant health outcomes for poor people in urban areas in low income and lower middle income countries? 2012.
Coast, Ernestina and McDaid, et al. Department for International Development, London.
Our analyses form a convincing case that there is a need for high-quality evidence on maternal and infant interventions that specifically target the urban poor. The existing evidence base is minuscule compared to the rapidly growing and large urban poor population. Much of the existing evidence is of poor quality, with little emphasis on baselines and follow-up studies, and almost no qualitative (how? why?) evidence to complement the limited quantitative (what?) data. This small evidence base is out of step with the growing interest in urban poor people and the size of this population. Interventions supported by the review are already present in existing WHO guidelines. However, there is a need for research that specifically addresses the effectiveness of different models of service delivery, including how sub-populations (e.g., urban poor) are targeted. Although the evidence base appears limited, there are in fact a number of ways in which it might be strengthened in the short term. We suggest one way of strengthening the evidence base on the cost-effectiveness of different strategies to promote better access and use of maternal and infant health services.
Global burden of cholera, WHO Bulletin, Jan 2012.
Anna Lena Lopez, et al.
Objective – To estimate the global burden of cholera using population-based incidence data and reports.
Methods – Countries with a recent history of cholera were classified as endemic or non-endemic, depending on whether they had reported cholera cases in at least three of the five most recent years. The percentages of the population in each country that lacked access to improved sanitation were used to compute the populations at risk for cholera, and incidence rates from published studies were applied to groups of countries to estimate the annual number of cholera cases in endemic countries. The estimates of cholera cases in non-endemic countries were based on the average numbers of cases reported from 2000 to 2008. Literature-based estimates of cholera case-fatality rates (CFRs) were used to compute the variance-weighted average cholera CFRs for estimating the number of cholera deaths.
Findings – About 1.4 billion people are at risk for cholera in endemic countries. An estimated 2.8 million cholera cases occur annually in such countries (uncertainty range: 1.4–4.2) and an estimated 87 000 cholera cases occur in non-endemic countries. The incidence is estimated to be greatest in children less than 5 years of age. Every year about 91 000 people (uncertainty range: 28 000 to 142 000) die of cholera in endemic countries and 2500 people die of the disease in non-endemic countries.
Conclusion – The global burden of cholera, as determined through a systematic review with clearly stated assumptions, is high. The findings of this study provide a contemporary basis for planning public health interventions to control cholera.
Willingness to Pay and Inclusive Tariff Designs for Improved Water Supply Services in Khulna, Bangladesh, 2012.
Herath Gunatilake and Masayuki Tachiiri. Asian Development Bank.
The study investigates willingness to pay for water supply services in Khulna, using a contingent valuation method. Since the large connection cost is regarded as one of the major obstacles to expand the piped network among the poor, the model explicitly incorporates the connection cost in addition to monthly charge. The study shows that both willingness to pay the monthly charge and willingness to pay the connection cost are higher for richer households.
Policy simulation shows that poor households are less likely to be connected under flat rate tariff, and introduction of volumetric tariff will increase the coverage of poor households. The large connection cost is found to be a critical bottleneck to expanding the coverage for the poor.
Reducing the connection charge by installment payment, or by including the connection under a capital investment project, will significantly improve the inclusion of the poor in the proposed water supply scheme.
Water 2012, 4(1), 123-134; doi:10.3390/w4010123
Improving Water Supply Systems for Domestic Uses in Urban Togo: The Case of a Suburb in Lomé
Laurent Ahiablame * , Bernard Engel and Taisha Venort. Department of Agricultural and Biological Engineering, Purdue University, 225 S. University Street, West Lafayette, IN 47907, USA
The rapid urbanization facing developing countries is increasing pressure on public institutions to provide adequate supplies of clean water to populations. In most developing countries, the general public is not involved in strategies and policies regarding enhancement, conservation, and management of water supply systems. To assist governments and decision makers in providing potable water to meet the increasing demand due to the rapid urbanization, this study sought to characterize existing water supply systems and obtain public opinion for identifying a community water supply system model for households in a residential neighborhood in Lomé, Togo.
Existing water supply systems in the study area consist of bucket-drawn water wells, mini water tower systems, rainwater harvesting, and public piped water. Daily domestic water consumption in the study area compared well with findings on water uses per capita from Sub-Saharan Africa, but was well below daily water usage in developed nations. Based on the surveys, participants thought highly of a large scale community water tower and expressed interest in maintaining it. Even though people rely on water sources deemed convenient for drinking, they also reported limited confidence in the quality of these sources.
OIDA International Journal of Sustainable Development, Vol. 2, No. 12, pp. 67-76, 2012
Factors Influencing the Performance of Delivery Centers in Urban Slums of Bangladesh: A Qualitative Study
Morsheda Ban; Hashima E. Nasreen. BRAC
Averting the devastating majority of maternal mortality, BRAC initiated an intervention named Manoshi in 2007; maternal, neonatal and child health program for the urban poor of Dhaka city. It established delivery centers (DC) to provide clean and safe delivery services by community health workers (CHW) as well as referring maternal and neonatal complications to equipped hospital.
The study aimed to measure the performance of DCs and explore the factors related to its performance. Data was collected using qualitative methods during December 2009 – January 2010 from six DCs in the slums of Dhaka city. Findings revealed that the DCs at Magbazar and Kamrangir Char performed ‘well’ due to availability of CHWs, their emotional support and caring attitude, regular antenatal care (ANC) visits, convenient location, cleanliness and free services of the DCs.
The DCs at Madertek and Shyampur performed ‘average’ and Ramna and Kotwali DCs performed poor. Poor performance was largely due to lack of CHWs, less motivation, frequent dropout due to low remuneration, and recurrent slum demolition. The reasons for women not attending DCs were fear of being referred to the hospital which might compel them to have a caesarean delivery, lack of comprehensive services at DCs including doctor-assisted normal deliveries, medicines, and emergency case management. Neonatal mortality rate in poor performed DCs found to be high. The respondents recommended that instead of referring women for minor complications, DCs should be competent of providing supervised skilled service package with basic treatment during childbirth, tetanus toxoid during ANC and child immunizations during postnatal care.
Given the existing scenario, the program needs to pay attention to the ‘poor’ performed DCs with developing alternative strategies to enhance collaboration with existing health facilities and emphasizing community mobilization on ANC, safe delivery and strengthen appropriate referral for obstetric and neonatal complications.
Ecohealth. 2012 Feb 7.
Quantification of Diarrhea Risk Related to Wastewater Contact in Thailand.
Ferrer A, Nguyen-Viet H, Zinsstag J. Department Epidemiology and Public Health, Swiss Tropical and Public Health (Swiss TPH), Basel, Switzerland.
Wastewater reuse contributes to closing the nutrient recycling loop as a sustainable way of managing water resources. Bangkok has over a thousand man-made drainage and irrigation canals for such purposes. Its use for agricultural and recreational purposes has a long tradition in rural and peri-urban areas. However, the continuation of these practices is increasingly questioned since potential health risks are an issue if such practices are not appropriately managed. The microbial and chemical quality of canal water has considerably deteriorated over the last decade, mainly because of discharged, untreated domestic and industrial wastewater.
It is important to understand the health risks of wastewater reuse and identify risky behaviors from the most highly exposed actors promote the safe use of wastewater. This study assessed diarrhea infection risks caused by the use of and contact with wastewater in Klong Luang municipality, a peri-urban setting in Northern Bangkok, using quantitative microbial risk assessment.
Wastewater samples were collected from canals, sewers at household level, and vegetables grown in the canals for consumption. Samples were also collected from irrigation water from the agricultural fields. Two protozoa, Giardia lamblia and Entamoeba histolytica, were quantified and analyzed by real-time PCR, exposure assessment was conducted, and finally, the risk of infection due to contact with wastewater in different scenarios was calculated.
The results showed that canal water and vegetables were heavily contaminated with G. lamblia and E. histolytica. Infection risk was high in tested scenarios and largely exceeded the acceptable risk given by WHO guidelines.
BMC Public Health 2012, 12:84 doi:10.1186/1471-2458-12-84
Causes of neonatal and maternal deaths in Dhaka slums: Implications for service delivery
Fatema Khatun, et al.
Background – Bangladesh has about 5.7 million people living in urban slums that are characterized by adverse living conditions, poor access to healthcare services and health outcomes. In an attempt to ensure safe maternal, neonatal and child health services in the slums BRAC started a programme, MANOSHI, in 2007. This paper reports the causes of maternal and neonatal deaths in slums and discusses the implications of those deaths for Maternal Neonatal and Child Health service delivery.
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Community and institutional responses to the challenges facing poor urban people in Khulna, Bangladesh in an era of climate change, 2012.
Manoj Roy, University of Manchester
Poor urban people in Bangladesh are already experiencing numerous climate-related problems because of their multiple forms of vulnerability and multiple sources of deprivation. Their problems differ greatly, both within and across settlements and cities, and so do the practices by which they are trying to tackle them. Various factors – physical, tenure-related, socio-political and institutional – contribute to this great variety of problems and practices. In this paper, we focus on Khulna City to identify the challenges facing Khulna’s poor people, understand the practices they are developing, and examine the role that institutions are playing in supporting/constraining these practices. Khulna is third largest city of Bangladesh, located in the southwest region, where the consequences of climate change are expected to be particularly severe.
In order to capture the main features of Khulna’s diverse low-income settlements, we examined two of the most common forms of settlement – a public (Rupsha Ghat) and a private (Bagmara) settlement. A quantitative mini-survey was followed by detailed qualitative interviews and participatory exercises. In many ways Khulna’s poor are responding well to their problems, such as through adjusting their livelihoods and reducing risks through individual and collective actions, and built environment changes and adaptation. People have more opportunities for advancement in public than private settlements, in terms of both developing more effective practices and having comparatively fewer constraints.
However, several factors are constraining what they can achieve, such as geography and settings, lack of socio-political platform, ineffective support from public institutions, aid and NGO dependency, and limits to their own agency and structures. The paper concludes by arguing that improving the formal and informal processes of urban governance is central to strengthening the capacity of people in low-income settlements to cope with both existing problems and the intensified problems created by climate change.
The effect of Behavior Change Communication (BCC) interventions on maternal neonatal and child health (MNCH) knowledge in urban slums of Bangladesh [Manoshi-WP17, 2012]
by icddr,b, BRAC
This cross-sectional study was conducted to capture maternal, neonatal and child health (MNCH) related knowledge and practices among the participants of Manoshi program and to explore the association between exposure to different Behavior Change Communication (BCC) approaches and changes in MNCH knowledge. This study also explored the acceptability of BCC materials among urban slum women, their families, and the community members as well as documented the behavior change interventions currently being used by the Manoshi program. Both quantitative and qualitative methods were applied to address the objectives of the study.
