Population-based incidence of typhoid fever in an urban informal settlement and a rural area in Kenya

January 26, 2012 · 0 comments

PLoS One. 2012;7(1):e29119. Epub 2012 Jan 19.

Population-based incidence of typhoid f ever in an urban informal settlement and a rural area in Kenya:  implications for typhoid vaccine use in Africa.

Breiman RF, Cosmas L, Njuguna H, Audi A, Olack B, Ochieng JB, Wamola N, Bigogo GM, Awiti G, Tabu CW, Burke H, Williamson J, Oundo JO, Mintz ED, Feikin DR. Global Disease Detection Division, Kenya Office of the US Centers for Disease Control and Prevention, Nairobi and Kisumu, Kenya.

BACKGROUND: High rates of typhoid fever in children in urban settings in Asia have led to focus on childhood immunization in Asian cities, but not in Africa, where data, mostly from rural areas, have shown low disease incidence. We set out to compare incidence of typhoid fever in a densely populated urban slum and a rural community in Kenya, hypothesizing higher rates in the urban area, given crowding and suboptimal access to safe water, sanitation and hygiene.

METHODS: During 2007-9, we conducted population-based surveillance in Kibera, an urban informal settlement in Nairobi, and in Lwak, a rural area in western Kenya. Participants had free access to study clinics; field workers visited their homes biweekly to collect information about acute illnesses. In clinic, blood cultures were processed from patients with fever or pneumonia. Crude and adjusted incidence rates were calculated.

RESULTS: In the urban site, the overall crude incidence of Salmonella enterica serovar Typhi (S. Typhi) bacteremia was 247 cases per 100,000 person-years of observation (pyo) with highest rates in children 5-9 years old (596 per 100,000 pyo) and 2-4 years old (521 per 100,000 pyo). Crude overall incidence in Lwak was 29 cases per 100,000 pyo with low rates in children 2-4 and 5-9 years old (28 and 18 cases per 100,000 pyo, respectively). Adjusted incidence rates were highest in 2-4 year old urban children (2,243 per 100,000 pyo) which were >15-fold higher than rates in the rural site for the same age group. Nearly 75% of S. Typhi isolates were multi-drug resistant.

CONCLUSIONS: This systematic urban slum and rural comparison showed dramatically higher typhoid incidence among urban children <10 years old with rates similar to those from Asian urban slums. The findings have potential policy implications for use of typhoid vaccines in increasingly urban Africa.

Unhygienic Living Conditions and Health Problems: A Study in Selected Slums of Dhaka City

January 19, 2012 · 0 comments

Unhygienic Living Conditions and Health Problems: A Study in Selected Slums of Dhaka City, 2011.

Tarannum Dana, University of Dhaka – Department of Population Science

In Dhaka significantly the numbers of slums are increasing everyday due to heavy influx of migrants from rural areas. In these slum areas all sorts of services are inadequate and general environmental scenario is hazardous. Data has been collected from field survey, some secondary sources and focused group discussion. The study focuses on the status and practice regarding water, sanitation and hygiene. This paper has also explored that assessment of water resource availability and quality at source point of consumption; problems faced in getting safe drinking water; and knowledge of the features of hygienic latrine; awareness about health.

The study is based on the health problems highlighting factors affecting the health of the population in slums for example due to general environmental condition, water supply system and the sanitation system. The study also focuses on other various reasons associated to poor living condition and their impact on health of the slum population. It is suggested that if conditions are to be improved then the problem of the poor living conditions and the health service needs to be addressed through the application of proper measures and planning by the different sectors of government and private sectors.

Public health researchers to create urban health index

January 19, 2012 · 0 comments

Public health researchers to create urban health index

Janurary 15, 2012

A Georgia State University team–Richard Rothenberg, professor of public health, Christine Stauber, assistant professor of public health; Scott Weaver, data director of the Center of Excellence for Research in Health Disparities; and Dajun Dai, assistant professor of Geosciences–recently received a grant from the Japan-based World Health Organization (WHO) Kobe center to develop an urban health index. This index will track reduction in health disparities and health improvement.

The team has developed a model index using urban United States counties as trial data to compare individuals at the upper and lower ends of the range of health status as well as the slope of change over the population (how quickly the index rises from the lower to upper end). This rise captures the heterogeneity of health care status within the population.

His team has applied to receive additional health data through the National Center for Health Statistics in order study data that are not available for public use. The team expects to receive similar health data from sources in Europe and Japan.

The team hopes that the measurement tool will provide valid distinctions within geographic areas. Because available data may be radically different in different areas, comparison among areas is a greater challenge than comparison within areas. In either case, however, the measure has the potential to help evaluate the effectiveness of health disparity reduction efforts.

[click to continue…]

Bookmark and Share

SHARE-funded project underway to improve urban sanitation in Africa

January 9, 2012 · 0 comments

09 JANUARY 2012

An action research initiative has begun in four African countries to develop and test a community-driven model of tackling sanitation problems in cities. The three-year project seeks to generate findings to assist community organisations as they try to improve sanitation as part of wider efforts to upgrade informal settlements. Nearly 800 million people living in urban areas worldwide currently lack access to sanitation.

The research will be conducted in the cities of Lilongwe in Malawi, Dar es Salaam in Tanzania, Kitwe in Zambia, and Chinhoyi in Zimbabwe, and it will be led by IIED and SDI.
The project aims to:

• Investigate the critical obstacles to city-wide sanitation and explore ways to overcome these
• Develop and test pro-poor city-wide sanitation strategies that can be adapted by federations of community organisations, and supported by public authorities and private providers
• Strengthen SDI’s capacity to support the development of city-wide sanitation strategies across Africa

[click to continue…]

Bookmark and Share

Developing urban waste management in Brazil with waste picker organizations

December 22, 2011 · 0 comments

Environment & Urbanization, October 2011

Developing urban waste management in Brazil with waste picker organizations

Oscar Fergutz, Fundación AVINA, Brazil, oscar.fergutz@avina.net

Sonia Dias, Women in Informal Employment: Globalizing and Organizing (WIEGO), Brazil, sonia.dias@wiego.org; soniamdias2010@gmail.com

Diana Mitlin, International Institute for Environment and Development (IIED), London, Diana.mitlin@iied.org; Diana.mitlin@manchester.ac.uk

In Brazil’s large cities, more than half a million people survive by collecting and selling solid waste. Most face very poor working conditions and have very low incomes as the intermediaries to whom they sell pay low prices. Their activities are even considered illegal in some nations. But the waste pickers save city governments money, contribute to cleaner cities and reduce the volume of waste that has to be dumped (by up to 20 per cent).

After describing the waste pickers and the city and national associations they have created, this paper describes the recycling industry and gives some examples of better methods of recycling. These include waste picker cooperatives that can sell the materials they collect direct to industries and that have partnerships with city governments who provide access to wastes, better prices and facilities to improve working conditions (including transferring the recycling from dumps to recycling centres).

Neglecting the urban poor in Bangladesh

December 22, 2011 · 0 comments

Environment & Urbanization, Oct 2011

Neglecting the urban poor in Bangladesh: research, policy and action in the context of climate change

Nicola Banks, BRAC Uganda, Uganda, nicolabanks@gmail.com

Manoj Roy, University of Manchester, UK, manoj.roy@manchester.ac.uk

David Hulme, University of Manchester, UK, david.hulme@manchester.ac.uk

In Bangladesh, urban poverty is neglected in research, policy and action on poverty reduction. This paper explores the underlying reasons for this relative neglect, which include national identity and image, the political economy of urban poverty and the structuring of knowledge creation. It argues for more comprehensive policy and programmes for the urban poor given Bangladesh’s increasingly urban future and the growing magnitude of urban poverty.

The impact of climate change will accelerate Bangladesh’s ongoing urbanization as well as deepen the scale and severity of urban poverty. The fact that reducing urban poverty will be increasingly important in meeting national goals for poverty reduction means that policy and action must pay more attention to the urban poor. This is contingent upon two factors: first, a better understanding of the scale and nature of urban poverty and vulnerability; and second, the confrontation of powerful interests necessary to secure a national commitment to urban poverty reduction.

Cities can contribute to a healthier and more ecologically sustainable future.

December 20, 2011 · 0 comments

BMJ 2011;343:d7979

Cities can contribute to, rather than threaten, a healthier and more ecologically sustainable future.

by David Satterthwaite, senior fellow at IIED and Diana Mitlin, principal researcher at IIED.

Cities have never enjoyed a good reputation for health. In many African and Asian cities, health problems and life expectancies are still as bad as in 19th century cities in Europe and North America. Yet other cities have some of the world’s highest life expectancies.

Most of the world’s cities are now in Africa, Asia, and Latin America. But in Africa and Asia most governments and aid agencies ignore city problems. They fail to notice how many people now live in cities and how bad conditions are for much of the population—in hundreds of cities, a third or more of the population lives in illegal settlements that lack basic services. But it is increasingly evident that well functioning cities are key to wealthier more resilient economies. Rapid economic growth in Brazil, India, and China has been underpinned by successful cities. Cities attract new investment because of economies of agglomeration, including infrastructure and service provision, a large diverse labour force, and sizeable consumer markets.

[click to continue…]

Bookmark and Share

Child Health Implications of Privatizing the Urban Water Supply in Africa

December 19, 2011 · 0 comments

The Child Health Implications of Privatizing the Urban Water Supply in Africa. October 2011.

Full-text (pdf)

Katrina Kosec, The International Food Policy Research Institute (IFPRI)

Can private sector participation (PSP) in the urban piped water sector improve child health? Allowing the private sector to provide basic infrastructure such as piped water is politically controversial, with some arguing that the private sector is more efficient and will improve access and quality, and others arguing that access and quality will suffer. This paper uses child-level data from 39 African countries during 1986-2010 to shed light on this question. A fixed effects analysis suggests that the introduction of PSP decreases diarrhea among urban-dwelling under-five children by 2.2-2.6 percentage points, or 14-16% of tis mean incidence.

An instrumental variables analysis that exploits variation over time in the share of the world water market controlled by former colonizing countries suggests that the effects are twice as large. The difference between the OLS and the IV results can be explained by the fact that PSP is more likely when the water sector is distressed and causing health problems. PSP in water also leads to higher rates of reliance on piped water as the primary water source, which is a likely channel explaining child health improvements. Importantly, PSP appears to benefit the health of children from the poorest households the most. A placebo analysis reveals that PSP in water does not have a significant effect on respiratory illness (as evidenced by coughing), suggesting that health improvements are driven by changes in the water sector rather than by a correlation of PSP with other health investments.

Sanitation Financing Models for the Urban Poor

December 16, 2011 · 0 comments

Sanitation Financing Models for the Urban Poor, 2011. C Sijbesma. IRC.

This report discusses pro-poor financing models that can facilitate the urban poor’s access to complete sanitation services. The paper catalogues existing financing models and examines each based on an analytical framework that comprises six criteria. It offers a recommendation for mixing financing mechanisms to meet the urban poor’s needs, and recommends developing poor-specific and full-cycle specific plans for sanitation.

Climate Change and Urbanisation: Building Resilience in the Urban Water Sector: Indore, India

December 13, 2011 · 0 comments

Climate Change and Urbanisation: Building Resilience in the Urban Water Sector – A Case Study of Indore, India, 2011.

Pacific Institute

This report is the outcome of research in Indore carried out by the Institute for Social and Environmental Transition (ISET) and the Pacific Institute, supported by TARU, over a period of three years. The purpose of this research was to understand the complex dynamics of the water sector, to investigate the needs of urban water managers and ultimately to suggest strategies and tools that can help these managers meet ever growing needs in the face of climate change and increasing water insecurity.

Over three years, we conducted literature reviews, downscaled climate models for Indore, performed a vulnerability analysis and conducted intensive stakeholder engagement through one-on-one discussions, focus group disscusions (with the formal sector, private providers and households) and Shared Learning Dialogues (where all sectors were brought together). We also conducted a survey of households and private water vendors to understand these two sectors in greater depth. The project team then brought together the research findings to suggest a set of resilience strategies and process tools that could assist managers in better managing and planning future water supply.

The four-step resilience planning process that we conducted in Indore can serve as a model for other communities integrating climate impacts into planning. The steps are (1) scoping to identify emerging problems; (2) synthesis and localised analysis of climate information; (3) vulnerability assessment focusing on the systems, the likely stresses on those systems due to climate and other change processes and the highly differentiated groups that depend on these systems; and (4) identification of potential strategies for building resilience.

← Previous Entries

Next Entries →