Urban health indicators and indices—current status. BMC Public Health (2015) 15:494.
Authors: Richard Rothenberg, Christine Stauber, et al.
Over the past 30 years, facilitated by high speed computing and electronics, considerable investment has been made in the collection and analysis of urban health indicators, environmental indicators, and methods for their amalgamation. Much of this work has been characterized by a perceived need for a standard set of indicators. We used publication databases (e.g. Medline) and web searches to identify compilations of health indicators and health metrics. We found 14 long-term large-area compilations of health indicators and determinants and seven compilations of environmental health indicators, comprising hundreds of metrics. Despite the plethora of indicators, these compilations have striking similarities in the domains from which the indicators are drawn—an unappreciated concordance among the major collections.
Research with these databases and other sources has produced a small number of composite indices, and a number of methods for the amalgamation of indicators and the demonstration of disparities. These indices have been primarily used for large-area (nation, region, state) comparisons, with both developing and developed countries, often for purposes of ranking. Small area indices have been less explored, in part perhaps because of the vagaries of data availability, and because idiosyncratic local conditions require flexible approaches as opposed to a fixed format. One result has been advances in the ability to compare large areas, but with a concomitant deficiency in tools for public health workers to assess the status of local health and health disparities. Large area assessments are important, but the need for small area action requires a greater focus on local information and analysis, emphasizing method over prespecified content.
Developing Microfinance for Sanitation in Tanzania, 2015.
Authors: Sophie Trémolet, Goufrane Mansour, George Muruka
This report presents the findings of a one-year action-research project on sanitation microfinance in Tanzania funded by SHARE. The project took place between December 2013 and January 2015. The project was the culmination of a broader research initiative which investigated how financing for sanitation can be mobilised via the use of microfinance in order to support sustainable access to improved sanitation facilities and/or services. This report describes the activities carried out under the action-research and extracts emerging lessons on the potential for developing sanitation microfinance through capacity building and networking.
How does urban health relate to the sustainable development agenda? African Population and Health Research Centre blog, June 24, 2015.
The inclusion of Sustainable Development Goal 11 in the post-2015 agenda—to make cities and human settlements inclusive, safe, resilient and sustainable—is both a challenge and an opportunity for public health, said a panel of experts at last month’s International Conference on Urban Health in Dhaka. Unabated urbanisation is having a radical effect on urban health, especially because it is widening the divide between the rich and the poor. Among the points that were raised, the panelists emphasised a growing need for multi-sectoral approaches and innovative solutions to delivery of care like public-private partnerships.
Entrepreneurial ecosystems: strengthening the WASH sector in Kenya, May 2015. WSUP.
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The WASH ecosystem in Kenya is still in its infancy, and remains much less developed than other impact sectors in the country. Nonetheless, there has been significant activity in the sector: over 200 water companies are listed in Kenya’s major business directory (Yellow.co.ke), with services ranging from bottling and supply to provision of water purification and treatment equipment; over 50 sanitation companies offer services ranging from sewerage disposal to provision of sanitary goods (e.g. sanitary pads), wares and fittings (e.g. toilets and sinks). Significantly, the sector is yet to produce success stories of brands built and sold on, and solutions taken to full market penetration.
Managing the Emerging Waste Crisis in Developing Countries’ Large Cities, 2015. IDS.
Rising prosperity around the globe is both welcome and, in many countries, long overdue. However, it brings with it a number of undesirable consequences, such as an increased demand for raw materials, which puts pressure on limited natural resources, and the generation of waste, due to dominant linear economic models of ‘make-use-throw’. The circular economy model proposes a move towards the complete elimination of waste by bringing resources embedded in products back into the production process through repair, re-use and recycling. This Policy Briefing identifies some of the key challenges and opportunities for transitioning waste management into resource management, which engages both the formal and informal sector and provides livelihoods for the urban poor.
Cooking up a storm: Community-led mapping and advocacy with food vendors in Nairobi’s informal settlements, June 2015. IIED.
Authors: Sohel Ahmed, Edwin Simiyu, Grace Githiri, Alice Sverdlik, Shadrack Mbaka
Food security is rarely prioritised in African cities, and food vendors are similarly ignored or stigmatised, despite providing a range of affordable, accessible meals. Furthermore, past research and urban policies usually overlook food hawkers selling inside informal settlements. Based on participatory research in Nairobi, this pap
Balloon-mapping and other novel mapping techniques were combined with focus group discussions to explore vendors’ practices, challenges, and opportunities for promoting food safety. Our detailed maps, vivid narratives, and community-led strategies may cook up a storm that can create safer foods and more secure livelihoods, with benefits extending across African informal settlements.
Developing Microfinance for Sanitation in Tanzania, June 2015. SHARE.
This report presents the findings of a one-year action-research project on sanitation microfinance in Tanzania funded by SHARE. The project took place between December 2013 and January 2015. The project was the culmination of a broader research initiative which investigated how financing for sanitation can be mobilised via the use of microfinance in order to support sustainable access to improved sanitation facilities and/or services. This report describes the activities carried out under the action-research and extracts emerging lessons on the potential for developing sanitation microfinance through capacity building and networking.
Editorial: Is it possible to reach low-income urban dwellers with good-quality sanitation? Environment & Urbanization, April 2015.
Authors: David Satterthwaite, Diana Mitlin, Sheridan Bartlett
All urban dwellers need safe, quick, easy access to clean toilets, day and night – without fear, without a long walk, without a long wait in line, and without the need to plan ahead or to spend more than they can easily afford. They should be able to count on privacy, cleanliness and the means to wash anus and hands quickly and conveniently, which is difficult if there is no water piped on the premises.(1) These toilets need to serve everyone – girls and boys, women and men of all ages and conditions.
Women who are menstruating should have not only a way to wash but a place to put their waste safely and privately. People with impaired mobility should not have to add toilets to the list of challenges they face.(2) Small children should be able to meet their needs without someone having to pick up and dispose of their waste or accompany them to a distant facility. Older children should be able to count on sufficient well-maintained toilets at school. And all toilets need to function so that toilet wastes do not end up contaminating anyone’s food, water or hands.
Catastrophic health expenditure and its determinants in Kenya slum communities. Journal for Equity in Health (2015) 14:46.
Authors: Steven Buigut, Remare Ettarh and Djesika D Amendah
Background: In Kenya, where 60 to 80% of the urban residents live in informal settlements (frequently referred to as slums), out-of-pocket (OOP) payments account for more than a third of national health expenditures. However, little is known on the extent to which these OOP payments are associated with personal or household financial catastrophe in the slums. This paper seeks to examine the incidence and determinants of catastrophic health expenditure among urban slum communities in Kenya.
Methods: We use a unique dataset on informal settlement residents in Kenya and various approaches that relate households OOP payments for healthcare to total expenditures adjusted for subsistence, or income. We classified households whose OOP was in excess of a predefined threshold as facing catastrophic health expenditures (CHE), and identified the determinants of CHE using multivariate logistic regression analysis.
Results: The results indicate that the proportion of households facing CHE varies widely between 1.52% and 28.38% depending on the method and the threshold used. A core set of variables were found to be key determinants of CHE. The number of working adults in a household and membership in a social safety net appear to reduce the risk of catastrophic expenditure. Conversely, seeking care in a public or private hospital increases the risk of CHE.
Conclusion: This study suggests that a substantial proportion of residents of informal settlements in Kenya face CHE and would likely forgo health care they need but cannot afford. Mechanisms that pool risk and cost (insurance) are needed to protect slum residents from CHE and improve equity in health care access and payment.
Riding the Growth Bubble in an Increasingly Urban World. USAID Impact Blog, May 2015. by Charles Setchell, Senior Shelter, Settlements, and Hazard Mitigation Advisor with USAID’s Office of U.S. Foreign Disaster Assistance.
An excerpt - In the past, most plans to manage urban growth and reduce poverty were aspirational–or even inspirational–but almost never operational in terms of actually helping urban communities affected by disasters and crises. Acknowledging this and looking forward, we must focus on creating resilient living conditions in urban areas that are capable of withstanding the subsequent shocks of a disaster.
