Responding to Social and Climate Vulnerability in Dar es Salaam, Tanzania

May 5, 2011 · 0 comments

Tomorrow is too Late: Responding to Social and Climate Vulnerability in Dar es Salaam, Tanzania, 2011.

Download full-text (pdf)

David Dodman, Euster Kibona and Linda Kiluma. UN HABITAT. Case study prepared for Cities and Climate Change: Global Report on Human Settlements 2011.

Seventy percent of the population of Dar es Salaam lives in unplanned settlements; and fifty percent of the residents of these informal settlements live on an average income of less than US$1/day. This fact is an important starting point for discussing the city’s vulnerability to climate change, and the strategies for adapting to this. The large number of people living in poor quality housing, frequently on land that is exposed to a variety of hazards, are socially, economically and environmentally vulnerable. The city also has severe shortfalls in its sanitation systems: estimates suggest that approximately 93 per cent of urban residents rely on pit latrines of various types, 5 per cent have access to septic tanks or sewerage, and the remaining 2 per cent have no formal excreta disposal facility. Adaptation responses need to take these issues into account if they are to respond to the threats posed by climate change – and to meet the needs of low-income urban residents.

Discourses of illegality and exclusion: when water access matters.

April 29, 2011 · 0 comments

Glob Public Health. 2011 Apr;6(3)

Discourses of illegality and exclusion: when water access matters.

Mudege NN. African Population and Health Research Center, Shelter Afrique Center, Nairobi, Kenya. netsayi@yahoo.co.uk

This paper examines the politics and the underlying discourses of water provisioning and how residents of Korogocho and Viwandani slum settlements in Nairobi city cope with challenges relating to water access. We use qualitative data from 36 focus group discussions conducted in the two slums to unravel discourses regarding water provisioning in the rapidly growing slum settlements in African cities. Results show that the problems concerning water provisioning within Nairobi slums are less about water scarcity and more about unequal distribution and the marginalisation of slum areas in development plans.

Poor water management, lack of equity-based policies and programmes, and other slum-specific features such as land-tenure systems and insecurity exacerbate water-supply problems within slum areas. It is hard to see how water supply in these communities can improve without the direct and active involvement of the government in infrastructural development and oversight of the water-supply actors. Innovative public-private partnerships in water provision and the harnessing of existing community efforts to improve the water supply would go a long way towards improving the water supply to the rapidly growing urban poor population in Africa.

Green Toilet for India's Slum Dwellers

April 29, 2011 · 0 comments

April 22, 2011 – While other industrial designers merely tweak the appearance of the latest electronic gadget to make minor improvements to trivial point-of-sale appeal, Israel’s Noa Lerner, a Berlin-based industrial engineer, is developing a much more crucial necessity: a mobile public toilet for third world urban slum dwellers.

Lerner was struck by the existence of the problem on a trip to India, finding that even the centers of large cities had no public toilets. It is even worse in slums, where no sewage system exists. 

The design that she created at her company Morph Design, involves a top that resembles the familiar toilet bowl, placed over a removable container covered with a plastic layer with odor-repellant and anti-bacterial substances. A very small amount of water is used to rinse the top bowl.

These nearly waterless green toilets could be emptied like chamber pots, but with a difference. About once a week, these could be rolled (securely closed of course!) to a neighborhood collection facility.

Each of these toilet barrels is sealed and nano-coated in a way that allows them to be used for a week at a time without emptying or cleaning.

Once it’s time to empty, the barrel is brought by an individual or a multi-barrel servce to the local Biogas Plant. Once there, waste is traded for energy in the form of cooking gas, warm water for showers, or electricity. All of these forms of energy are generated by processing the human waste at the Biogas Plant.

Once the contents collected at a neighborhood facility, where the secretions could be farmed to create methane gas through composting, which can then be used as an energy source or fertilizer.

Working with the Indian non-profit: Sulabh, which is already operating various ways of serving the needs of slum dwellers in India, Lerner will create a pilot project to be launched in India’s capital.

ILLUME MAG

Practical Design for the Urban Poor

April 21, 2011 · 0 comments

The "Q Drum," a durable container that can transfer 75 liters of clean water, is one of the design solutions of "Design for the other 90%." Photo by AIDG.

April 20, 2011 – The United Nations will be hosting an exhibition on design solutions to improve the quality of life for the urban poor. Titled, “Design for the Other 90%: CITIES,” the exhibition is by Cooper-Hewitt, the Smithsonian National Design Museum, and it is part of an ongoing series originally started in 2007 to focus the attention of the professional design community to the problems of the other 90 percent of the world’s population. “The majority of the world’s designers focus all their efforts on developing products and services exclusively for the richest 10% of the world’s customers,” says Dr. Paul Polak, the founder of International Development Enterprises, a nonprofit organization that creates income opportunities for poor rural households. “Nothing less than a revolution in design is needed to reach the other 90%.”

The exhibition will explore design solutions to the problems of rapid urbanization in developing countries and the marginalization of the urban poor. “Close to 1 billion people live in informal settlements, and that population is projected to swell to 2 billion people by 2030,” Dexigner’s Levent Ozler says, further emphasizing the rapid growth and concentration of an under-served population in urban areas.

The exhibition will consist of six themes, each one highlighting an important aspect design solutions must follow in order to create useful remedies. Below are the theme areas with short descriptions, as summarized from the press release:

[click to continue…]

Bookmark and Share

Ill-health and poverty: a literature review on health in informal settlements

April 20, 2011 · 0 comments

Environment and Urbanization, April 2011

Ill-health and poverty: a literature review on health in informal settlements

Alice Sverdlik, IIED, 3 Endsleigh Street, London WC1H 0DD, UK,  alice.sverdlik.09@ucl.ac.uk

This paper reviews the literature on health in the informal settlements (and “slums”) that now house a substantial proportion of the urban population in Africa, Asia and Latin America. Although this highlights some important gaps in research, available studies do suggest that urban health inequalities usually begin at birth, are reproduced over a lifetime (often reinforced by undernutrition), and may be recreated through vulnerabilities to climate change and a “double burden” of communicable and non-communicable diseases.

The review begins with a discussion of papers with a life-course perspective on health, poverty and housing, before considering recent literature on chronic poverty and ill-health over time. It then discusses the literature on the cost, quality and access to care among low-income groups, and the under-recognized threat of unintentional injuries. This includes recent literature that discusses where low-income residents may suffer an “urban penalty” rather than benefiting from urban bias — although there are also studies that show the effectiveness of accessible, pro-poor health care.

The concluding section examines emerging risks such as non-communicable diseases and those associated with climate change. It notes how more gender- and age-sensitive strategies can help address the large inequalities in health between those in informal settlements and other urban residents. With greater attention to the multi-faceted needs of low-income communities, governments can create interventions to ensure that urban centres fulfil their enormous potential for health.

Indian cities, sanitation and the state

April 20, 2011 · 0 comments

Environment and Urbanization, April 2011

Indian cities, sanitation and the state: the politics of the failure to provide

Susan E Chaplin, School of Public Health, La Trobe University, Melbourne VIC 3086, Australia, s.chaplin@latrobe.edu.au

The environmental problems confronting Indian cities today have arisen because millions of people have been forced to live in illegal settlements that lack adequate sanitation and other basic urban services. This is the result of two factors. The first is the legacy of the colonial city characterized by inequitable access to sanitation services, a failure to manage urban growth and the proliferation of slums, and the inadequate funding of urban governments. The second is the nature of the post-colonial state, which, instead of being an instrument for socioeconomic change, has been dominated by coalitions of interests accommodated by the use of public funds to provide private goods.

This has enabled the middle class to monopolize what sanitation services the state has provided because the urban poor, despite their political participation, have not been able to exert sufficient pressure to force governments to effectively implement policies designed to improve their living conditions. The consequence is that public health and environmental policies have frequently become exercises in crisis intervention rather than preventive measures that benefit the health and well-being of the whole urban population.

The state of urban health in India

April 20, 2011 · 0 comments

Environment and Urbanization, April 2011

The state of urban health in India; comparing the poorest quartile to the rest of the urban population in selected states and cities

Download Full-text (pdf)

Siddharth Agarwal, Urban Health Resource Centre (UHRC), siddharth@uhrc.in; sids62@yahoo.com

India has the world’s second largest urban population (after China). This paper shows the large disparities within this urban population in health-related indicators. It shows the disparities for child and maternal health, provision for health care and housing conditions between the poorest quartile and the rest of the urban population for India and for several of its most populous states. In the poorest quartile of India’s urban population, only 40 per cent of 12 to 23 month-old children were completely immunized in 2004—2005, 54 per cent of under-five year-olds were stunted, 82 per cent did not have access to piped water at home and 53 per cent were not using a sanitary flush or pit toilet.

The paper also shows the large disparities in eight cities between the poorest population (the population in the city that is within the poorest quartile for India’s urban areas), the population living in settlements classified as “slums” and the non-slum population. It also highlights the poor performance in some health-related indicators for the population that is not part of the poorest quartile in several states — for instance in under-five mortality rates, in the proportion of stunted children and in the proportion of households with no piped water supply to their home.

Rapid Assessment Scorecard to Identify Informal Settlements at Higher Maternal and Child Health Risk in Mumbai

April 18, 2011 · 0 comments

J Urban Health. 2011 Apr 13.

A Rapid Assessment Scorecard to Identify Informal Settlements at Higher Maternal and Child Health Risk in Mumbai.

Osrin D, Das S, Bapat U, Alcock GA, Joshi W, More NS. UCL Centre for International Health and Development, Institute of Child Health, 30 Guilford St, London, WC1N 1EH, UK, d.osrin@ich.ucl.ac.uk.

The communities who live in urban informal settlements are diverse, as are their environmental conditions. Characteristics include inadequate access to safe water and sanitation, poor quality of housing, overcrowding, and insecure residential
status. Interventions to improve health should be equity-driven and target those at higher risk, but it is not clear how to prioritise informal settlements for health action.

In implementing a maternal and child health programme in Mumbai, India, we had conducted a detailed vulnerability assessment which, though important, was time-consuming and may have included collection of redundant information. Subsequent data collection allowed us to examine three issues: whether community environmental characteristics were associated with maternal and newborn healthcare and outcomes; whether it was possible to develop a triage scorecard to rank the health vulnerability of informal settlements based on a few rapidly observable characteristics; and whether the scorecard might be useful for future prioritisation.

The City Initiative for Newborn Health documented births in 48 urban slum areas over 2 years. Information was collected on maternal and newborn care and mortality, and also on household and community environment. We selected three outcomes-less than three antenatal care visits, home delivery, and neonatal mortality-and used logistic regression and classification and regression tree analysis to test their association with rapidly observable environmental characteristics.

We developed a simple triage scorecard and tested its utility as a means of assessing maternal and newborn health risk. In analyses on a sample of 10,754 births, we found associations of health vulnerability with inadequate access to water, toilets, and electricity; non-durable housing; hazardous location; and rental tenancy. A simple scorecard based on these had limited sensitivity and positive predictive value, but relatively high specificity and negative predictive value. The scorecard needs further testing in a range of urban contexts, but we intend to use it to identify informal settlements in particular need of family health interventions in a subsequent program.

Lancet, Feb 2011 – Health care for urban poor falls through the gap

April 18, 2011 · 0 comments

The Lancet, Volume 377, Issue 9766, Pages 627 – 628, 19 February 2011

Health care for urban poor falls through the gap

Priya Shetty

While governments and donors focus on health care for those living in rural poverty in developing countries, the residents of the world’s slums are being neglected, writes Priya Shetty.

The slums of Mumbai and the favelas of Rio de Janeiro are images of urban poverty so extreme that they are indelibly stamped on the identity of those cities. But urban poverty now goes far beyond these notorious icons.

The world is becoming more urbanised overall. 2008 was a demographic turning point—for the first time, according to the UN Population Fund (UNFPA), more people lived in urban areas than in rural ones. Yet these new urbanites, especially in developing countries, are overwhelming cities that were never designed to have so many inhabitants, and therefore simply do not have the infrastructure to cope.

Link to complete article - http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60215-8/fulltext

Determinants of tetanus and sepsis among the last neonatal deaths at household level in a peri-urban area of India

April 6, 2011 · 0 comments

Postgrad Med J. 2011 Apr;87(1026):257-63.

Determinants of tetanus and sepsis among the last neonatal deaths at household level in a peri-urban area of India.

Ghosh R, Sharma AK. Department of Humanities and Social Sciences, Indian Institute of Technology Kanpur, Kanpur 208016, India. rohini.ghosh@gmail.com.

Background – India contributes to one quarter of the total number of newborn deaths in the world. Less explored are the causes of these deaths, and household factors and decision makers for antenatal and postnatal care and their association with neonatal mortality.

Objective – This study estimated neonatal mortality rate due to tetanus and sepsis (TS) and tried to identify the risk factors for TS in a peri-urban area of India characterised by a high level of infant and neonatal mortality rate.

Methods – An intensive cross-sectional study was conducted during January to March 2008. A structured interview schedule was developed, after reviewing major demographic and health studies done in India, to collect data from all women selected in the sample villages, situated at a distance of 3-5 km from a primary health centre.

Results – Of the 894 married women (<50&emsp14;years of age), 109 reported their last pregnancy outcome as neonatal death, and 84 cases of TS were noted. Using forward conditional stepwise logistic regression the risk factors of TS identified were women’s age, socioeconomic score, antenatal care, pregnancy complications, and treatment after delivery during the neonatal period.

Conclusions – Independent of social class there is high prevalence of neonatal mortality. There is a close association between utilisation of health care services during pregnancy, postnatal period and neonatal deaths due to TS. It is argued that there is a need for a two pronged approach to reduce neonatal mortality due to TS: (1) to train traditional birth
attendants, and expand the reach of existing antenatal care and childbirth facilities; and (2) to empower women to increase their awareness to take decisions about seeking proper medical assistance during pregnancy and
childbirth.

PMID: 21296798 [PubMed - in process]

 

← Previous Entries

Next Entries →