Urban Reproductive Health Initiative – New website

October 30, 2009 · 4 comments

mleThe Measurement, Learning & Evaluation (MLE) Project for the Urban Reproductive Health Initiative (URHI) is pleased to announce the launch of its website: www.urbanreproductivehealth.org. Through a rigorous evaluation study design, the MLE project will identify approaches that increase contraceptive prevalence rates in rapidly growing cities in India, Nigeria, Kenya, and Senegal.

The MLE project serves as the technical resource for local efforts to monitor and evaluate URHI programs in these countries and documents evidence-based best practices for health services that target the urban poor. Through the website and other dissemination events, the MLE project plans to share promising approaches with policy makers, program managers, and researchers globally and build local capacity to undertake rigorous measurement and evaluation of population, family planning, and integrated reproductive health activities targeting vulnerable urban populations.

To receive the MLE quarterly e-newsletter, please register at: http://www.cpc.unc.edu/urbanreproductivehealth/registration.

PRB Online – Does Climate Change Threaten Our Cities?

October 30, 2009 · 0 comments

Join the PRB Discuss Online – “Does Climate Change Threaten Our Cities?”

When: Friday, Oct. 30, 2009, 1 – 2 p.m.

Who: Mark Montgomery, professor, Stony Brook University; and senior associate, Population Council’s Poverty, Gender, and Youth Program

Where: Go to http://discuss.prb.org. You may submit questions in advance and during the discussion. A full transcript of the questions and answers will be posted after the discussion.

The cities and towns of developing countries are projected to absorb at least 2.5 billion additional people by 2050. At the same time, these areas will experience global climate change likely to bring floods, droughts, food insecurity, and loss of livelihoods. These converging trends pose mounting health risks for people living in urban areas in developing countries, especially for the poorest residents. Where are the greatest health risks and what can be done to manage them?

Join Mark Montgomery as he answers your questions about urban growth, health, and climate change. He studies the implications of global climate change on urban areas of developing countries, particularly in sub-Saharan Africa.

Mark Montgomery is a professor of economics at Stony Brook University, New York, and a senior associate with the Population Council’s Poverty, Gender, and Youth Program. His current research interests include the links between poverty and demographic behavior in the cities of developing countries; measuring poverty and poverty dynamics; and the implications of climate change for the urban areas of developing countries. As co-chair of the U.S. National Academy of Sciences Panel on Urban Population Dynamics, he co-edited the panel’s report, Cities Transformed: Demographic Change and Its Implications in the Developing World. He is the author of the recent PRB Population Bulletin “Urban Poverty and Health in Developing Countries.”

Population Reference Bureau

www.prb.

Oct. 23 update from the International Conference on Urban Health, Nairobi

October 23, 2009 · 1 comment

As the 8th International Conference on Urban Health draws to a close, delegates are reminded of the commitment they have made in the Nairobi Statement on Urbanization and Health.

The first of its kind to be held in Africa the conference did draw from the challenges that urbanization brings to countries in the south. Making the statement the delegates acknowledged the fact that urbanization is a reality facing all countries and that between now and 2050, 3 billion people will settle primarily in cities a fact that needs planning and action now.

When the conference began, delegates took a tour of some of the slums that are in Nairobi and witnessed for themselves the fact that majority of urban residents are living in informal settlements where they lack proper housing, water, sanitation, garbage disposal, security, schooling and health services.

The statement adds that if well managed, cities can be engines of development for national economies and centers of positive sociopolitical transformation. The conference has also noted that countries that fail to plan for increasing urbanization place themselves and their citizens’ health, economic, and security risk. Countries that fail to plan for increasing urbanization place themselves and their citizens at serious health, economic and security risk.

The health of slum dwellers is typically well below that in other urban and rural areas, even when stratified by poverty level. These inequities are also observed in other critical development indicators like schooling and affect the health of the entire city.

Settlements without legal status and services can become focal points for social tensions, conflict and illicit economic activity as was witnessed in Kenya during the post election violence.

Owing to the above challenges the participants especially the urban champions who are mainly drawn from local governments committed themselves to give effective, transparent, accountable and proactive governance that is broadly inclusive as a critical factor in the growth of healthy cities.

The first day of the conference demonstrated what this particular commitment was all about. For the first time, communities spoke of solutions for issues like, water and sanitation; waste management; security, health services among others. Residents of Kibera, Korogocho,Viwandani and Mathare (some of the informal settlements from Kenya’s capital, Nairobi) showcased projects that offer solutions to the ever challenging problems of urbanization like; health insurance, HIV/AIDs, Sustainable Livelihoods, Security and Peace initiatives, Water, Sanitation and Hygiene, Disabilities and Alcohol and Drug Abuse.

The conference closes with acknowledging that solutions to urbanization should be developed within a framework that is intersectoral where governments work effectively in partnership with the public, organizations of civil society and the business community.

To echo Kenya’s Assistant Minister for Nairobi Metropolitan Mrs Elizabeth Ongoro, ‘governments need to create people-centred solutions’. This means that donor agencies and governments must include urban concerns in their strategies as adapted to country circumstances. A point that was emphasized by Darren Walker, the Vice President of the Rockefeller Foundation Initiative. “We need to bridge policy and practice as well as find out how we can break from the old ways of thinking to be able to move away from the grave challenges of infrastructure and housing.”

Interventions and programs to improve the functioning of urban areas and cities should be designed with equity consciousness to ensure that the most vulnerable urban dwellers have input to and benefit from the programs.

As the meeting closes what is urgent is the development of effective strategies that create incentives to health to address the challenges of slum settlements to ensure they are places where human needs are met , and people can live decent lives.

No malaria in Nairobi say experts – presentation at ICUH conference, Nairobi

October 22, 2009 · 0 comments

There is no malaria in Nairobi, say experts – City residents may have been taking expensive malaria drugs for years when the disease is negligible, if not non-existent, in Nairobi.

Research carried out in 2008 by reputable organisations indicates there is no malaria in the city. The firms that conducted the study include the Kenya Medical Research Institute, the UK’s Oxford and Southampton universities, London School of Tropical Medicine and the African Population and Health Research Centre in Nairobi.

Despite evidence that there could be no malaria in Nairobi, patients especially children with fever were treated for the disease and with the wrong drugs in most instances, says the study, which was prepared for an international conference on health.

Some 983 people in Korogocho, Nairobi were tested and only three indicated they could be having the parasite. Further testing, however, found them to be negative.

“Microscopic examination showed zero prevalence,” says the study titled Malaria Infection in an Urban Informal Settlement in Nairobi: A myth or reality.

Of the group, 170 had run a fever in the last 14 days with more than half being treated for malaria with drugs that are not recommended by the government.

“Only four cases were treated using the recommended first-line treatment,” says the study. The findings contradict the perception of a rising incidence of malaria in Nairobi attributed to warm climate that is more habitable for mosquitoes that carry the disease.

If the findings are validated, malaria may be one problem less to worry about for people in Nairobi. However a more emerging and potent threat will be outlined at the conference on Thursday.

Mr J. O. Ogendo of Maseno University says the biggest danger to city residents, after muggers and robbers, are road accidents targeting pedestrians and cyclists. The researcher recommends that city planners consider pedestrian-friendly policies for Nairobi.

Source – The Nation

Youth fear stigma of buying condoms – presentation at ICUH, Nairobi

October 22, 2009 · 0 comments

The youth are engaging in unprotected sex because of the stigma and embarrassment associated with buying condoms, a research has revealed.

Religion was also used by young people aged between 15 and 35 as a reason for not using condoms. The study showed that the group had a strong desire to show love, trust and commitment to their partners but shunned protecting themselves from sexually transmitted infections.

The research was carried out by Dr Gwendolyn Morgan and is being exhibited at the urban health conference in Nairobi. It sampled unmarried people. The global health conference has drawn participants from over 40 countries to address challenges facing the urban population.

The research carried out by a local non-governmental organisation says that persons in steady relationships opt not to use condoms because their partners may suspect them of unfaithfulness.

However, older age and a higher level of education and good negotiation skills are among the reasons that prompted young men to consistently use protection.

Behaviour change

Experience and a sexual debut at an earlier age than the average female youth also highly contributed to consistent condom use. The findings support another research done by I Choose Life – Africa, a behaviour change programme in institutions of higher learning on the impact of peer education in such institutions.

The study carried out at Maseno and Kenyatta University in 2007 indicated that 69.5 per cent say they could say “no” to sex without a condom and 76.3 per cent of the respondents agreed that using a condom “shows they care about themselves and their partner”.

Ms Michelle Hassan, an ICL project officer attributed the high incidence of unprotected sex to peer pressure especially amongst university students.

Curiosity and exploration also featured as one of the excuses the youth gave for risky sexual activity. “The most common reason for the sexually active students not using a condom was that they trusted their partner,” Ms Hassan added.

Source – The Nation

Gates Foundation funding for urban health in India, Kenya, Nigeria and Senegal

October 21, 2009 · 0 comments

NAIROBI, Kenya, Oct 21- The Bill and Melinda Gates Foundation is now partnering with the government to help Kenya improve reproductive health services among its urban poor.

Speaking during the 8th International Conference on Urban Health on Wednesday, Senior Programme Officer Monica Kerrigan said the foundation had dedicated itself towards improving reproductive health care among the urban poor in Kenya.

“The foundation is committed to serving the needs of mothers and children and we are launching the urban health initiative in Kenya, Nigeria, Senegal and Uttar Pradesh in India to improve maternal and new born health services in the urban slum,” she said.

Ms Kerrigan stated that the foundation would work with government, stakeholders, donors and the private sector to assist poor women and children access cheap quality health care.

“We should never turn them away because of financial constraints. We should instead empower them so that they know where to take their children for vaccinations and where to get good medical care,” she explained.

She added that the urban poor had many needs that were not being met by the government and donors saying that the foundation would come in to sort this out through research.

“At the foundation we feel like we have an opportunity to really begin to build robust, evidence-based initiatives to help providers and communities better meet the needs of the urban poor,” she held.

Ms Kerrigan added that it was important for the urban poor to be involved in reproductive health programmes.

“This way we will find out what their needs are and how to best serve them especially in the areas of family planning, maternal and new born survival,” she noted.

She also challenged the government to provide quality family planning services to the urban poor in order to develop a vibrant economy.

“One of the most empowering things for women and men is to identify how many children they want to have and when they want to have them. Family planning will help not only meet their own needs but also educate the children that they have. By helping them have the quality families they want, they can also have a quality community and quality life,” she said.

Ms Kerrigan explained that the foundation would capitalise on the advantages of working in the urban areas and that it would also harness the private sector to activate demand in order to better serve the population.

“We are also interested in advocacy. How can we best work with civil society organisations to allow them the opportunity to monitor and be watch dogs to the urban poor so that they are offered the best services everyday?” she posed.

The Foundation was established by Microsoft founder Bill Gates and his wife Melinda with the primary goals of enhancing healthcare and reduce extreme poverty globally.

Source – Capital News

Summary of Day 2 – International Conference on Urban Health, Nairobi

October 21, 2009 · 0 comments

Day two round up – http://www.icuh2009.org

Mayors and local government leaders met on day two of the conference at the urban champions forum looking at the best practices within cities that can make a difference in urban health.

Four council leaders from different countries in Africa have expressed their satisfaction that despite various challenges, there is evidence of development as far as housing and primary healthcare for slum dwellers is concerned.

During a group discussion at the 8th International Conference on Urban Health in Nairobi, council leaders from the City of Johannesburg in South Africa, the City of Banjul in Gambia, City of Windhoek in Namibia, and the City of Abuja in Nigeria articulated some development aspects in their various towns, despite the myriad challenges.

“We are in the process of formalising all our towns in South Africa,” said Bengeza Mthombeni, a Member of the Mayoral Committee, responsible for health in Johannesburg said.

“By this, I mean that we are in the process of eradicating all the informal settlements in South Africa, in a project projected to be through by the year 2014,” he said.

Mthombeni has responsibilities to ensure that a world class primary health services are delivered all over Johannesburg, and overseeing a service which has won a number of prizes in the health sector.

He said that South Africa has ensured that all the slum dwellers have access to primary healthcare free of charge, and that there are mobile clinics provided by the government specifically to serve informal settlements.

“We are in the process of numbering all the streets within all the informal settlements. This will make it easy for one to describe where he or she is when calling for services such as ambulance in case of emergency, fire brigade among others,” said Mthombeni.

In Gambia, His Worship Mayor Samba Faal of the Banjul City said that the government has taken charge of the city, and is buying idle properties left in dilapidated conditions by the city residents, to manage them, and return to the rightful owners when they need them.

“Our economy is dependent on tourism, which includes travelling out and into the country, due to our country’s proximity to the western countries. Several residents find it easy to travel abroad and live there for several years, leaving their properties at home without proper management,” said Mayor Faal.

He added, “The government is now managing the sewage system and solid waste disposal, in a project aimed at reducing diseases that would arise from such.”

So far, the Gambian president Sheikh Professor Alhaji Dr Yahya Jammeh has made a commitment to fix the city drainage system that has been ineffective for several years.

However, the most impressive step to development can be witnessed in the City of Windhoek in Namibia. This is one of the rarest places in Africa where the government has developed a water banking system.

“We save up to 90 per cent of all the rain water. And after it is treated, it becomes very handy for the city dwellers as they pump it up for domestic and industrial use,” said His Warship Mayor Matheus Shikongo of the Windhoek City.

He added, “Waste management is excellent. From the airport, to the doorsteps even within the informal settlements, you cannot see a piece of paper.”

He disclosed that the country leadership has made city dwellers believe that the country belongs to them. “We do not force anybody to conserve the environment. Everyone understands that it is their responsibility to do so,” he said.

And according to Bernard Mbogoh, a Public Health Officer in the ministry of Public Health and Sanitation in Kenya, the country has implemented several projects to better housing and ensure availability of primary healthcare especially for the low income earners.

“The government provides funding to every constituency, known as the Constituency Development Fund (CDF). Through this, communities identify projects of their priority, of which they are later funded to implement,” said Mbogoh.

Through CDF, communities especially within informal settlement areas have been able to put up health centres, school laboratories, toilets among several other projects that they feel are positive for them.

“We also have an initiative to clean the Nairobi River, which has been in a sorrow state for decades. And this is definitely a positive step towards the city development,” Added Mbogoh.

So far, the government of Kenya is in the process of constructing decent houses for slum dwellers, in an effort to formalise the city.

However, all the council leaders identified a few challenges which are common in nearly all the African countries. They included rural urban migration, leading to the upsurge in population pressure within urban areas, provision of affordable primary healthcare to the poor, waste management, decent housing among others.

Delegates will take a break on day two 20th October which is Kenyatta Day and resume on Wednesday 21st with the scientific part of the conference.

India – Hospitals encouraged to adopt slums

October 19, 2009 · 0 comments

GHMC to urge hospitals to adopt slums

HYDERABAD: With a spurt in vector and water-borne diseases in the city, the Greater Hyderabad Municipal Corporation (GHMC) is planning to rope in private hospitals to curb infections.

Corporate hospitals would be asked to adopt slums in their nearby areas. In those areas, hospitals would have to conduct regular health camps, awareness programmes and provide medical care to the needy.

As many vector and water-borne diseases can be tackled in the initial stages with precautions and drugs, the corporate hospitals would have to identify cases and take steps immediately when there is an outbreak of dengue, malaria, jaundice and cholera.

Over 110 dengue and 185 malaria cases were reported in the city in the last one month. Water-borne diseases like cholera and air-borne infections like mumps and measles have also been reported in the city.

Until now, medical camps were conducted only when there was an outbreak or an emergency. For instance, medical camps were conducted in Bholakpur when water pollution was reported in May last. Now, hospitals by using their machinery would have to conduct health camps periodically and treat people.

“The GHMC has written letters to corporate hospitals to adopt slums. A meeting is being planned with the hospital managements,” GHMC additional commissioner (health and sanitation) S K Aleem Basha told TOI.

There are 1,448 slums in the Greater Hyderabad area and of them 370 slums are non notified ones. Though various infrastructure development works like roads, schools and housing schemes were taken up in the last few years, improvement of health conditions has taken a backseat.

“The process of identifying slums where diseases were reported or are vulnerable has begun,” GHMC additional commissioner (urban community development) K Shiva Parvathi said.

Some hospitals are now and then holding camps in some areas as part of their social responsibility programmes. But now, the hospitals would have to concentrate only on some pockets and adopt them.

Source – Times of India

8th International Conference on Urban Health, Day One Update

October 19, 2009 · 0 comments

The 8th International Conference on Urban Health in Nairobi, Kenya, Oct. 18-23, 2009

Conference website – http://www.icuh2009.org

Day One’s Round up, Oct. 19, 2009

The 8th International Conference on Urban Health kicked off today in Nairobi, Kenya, hearing first hand from the community that has been affected by rapid growth of cities- those that live in Informal settlements.

Unlike other previous conferences on Urban Health the Nairobi one focuses more on the challenges that urbanization posses to the health of residents in Africa and Asia. For the first time, communities spoke of solutions for issues like, water and sanitation; waste management; security, health services among others.

Speaking at the Community Voices Forum, Hon Elizabeth Ongoro, Assistant Minister, Nairobi Metropolitan Development was quick to note that the discussions could not have come at a better time than this ‘since her ministry needs the solutions to achieve Kenya’s vision 2030. “As the government seeks to listen to the voices of the people, this forum is very welcome so that we can continue implementing people-centred solutions”

The day saw residents of Kibera, Korogocho Viwandani and Mathare ( some of the informal settlements from Kenya’s capital, Nairobi) showcase projects that offer solutions to the ever challenging problems of urbanization like; health insurance, HIV/AIDs, Sustainable Livelihoods, Security and Peace initiatives, Water, Sanitation and Hygiene, Disabilities and Alcohol and Drug Abuse.

Earlier in the day journalists went through a briefing that highlighted why the meeting was held in Africa for the first time as well as the unique challenges that Africa and Asia face by virtue of having fast growing cities.

The ICUH president Dr. Jean-Christophe Fotso, the ISUH founding president David Vlahov together with David Kinyua the communications and advocacy officer of the National Coordinating Agency on Population and Development were on hand to explain the different themes that the conference will be addressing.

The African continent is urbanizing very fast and at a time when local economies are not performing well, the result is that many Africans moving to urban areas are unable to find employment and they end up living in deplorable conditions in slums, where they don’t enjoy the services that an urban setting is supposed to provide. Day one did provide the beginning of a discussion by hearing from the community and Day two- Monday 19th’s session will be hearing the voices of representatives of local governments from 40 different cities around the world on how they are handling the challenges of their growing cities.

Dubbed as the Urban Health Champions is an entry point to an engagement with policy makers and forging of partnerships that will help make the Nairobi Urban Health Statement at the end of the week.

YEMEN: Dengue cases on the rise in Taiz city

October 16, 2009 · 0 comments

SANAA, 16 October 2009 (IRIN) – Hundreds of people in Taiz city, 250km south of the Yemeni capital, Sanaa, have dengue fever and local hospitals are taking in new cases on a daily basis, according to health officials.

“Since the new outbreak in September, at least 350 cases have been confirmed and a further 1,000 are suspected,” Mohammed Mahmoud, manager of the government’s National Malaria Control Programme (NMCP) in Taiz, told IRIN.

He said the number of infections had increased due to the widespread use of uncovered water tanks, particularly in the city’s slums. “Swamps and open sewers contribute much to the reproduction of the vector, known as Aedes [mosquito] that transmits the fever,” Mahmoud said.

Many cases go undiagnosed and are not properly treated as most of those infected do not go to hospital for screening, said Huwaida al-Shathili, a professor at Taiz university’s faculty of medicine. Al-Shathili said the number of dengue-infected cases may be many times more than those registered by NMCP, as symptoms can be difficult to detect.

Doctors say Taiz (population 500,000) has a fertile environment for mosquito breeding. “In Taiz, dengue isn’t an epidemic… it is a recurring disease in the governorate where stagnant water and pollution are commonplace… The disease appears every two or three years,” al-Shathili noted. “Last year, more than 300 cases were detected.”

Epidemiology

According to the World Health Organization (WHO), dengue is transmitted by the bite of an Aedes mosquito infected with any one of the four dengue viruses. It occurs in tropical and sub-tropical areas. Symptoms appear 3-14 days after a bite from an infected mosquito.

Common dengue symptoms include high fever, vomiting, headache, acute pain in the joints and skin rash, according to Murshid Hassan, a senior health official in the governorate. “Infected cases must have access to immediate treatment under the supervision of physicians,” Hassan said. A WHO factsheet states: “There is no specific treatment for dengue, but appropriate medical care frequently saves the lives of patients with the more serious dengue haemorrhagic fever.”

Spraying campaigns were undertaken in some parts of the city in September but results have been poor due to a lack of funding, according to Mahmoud.

“We proposed two massive spraying campaigns to cover all 94,000 houses in the city at a cost of YR 38 million [US$190,000],” he said, adding that the Health Ministry had provided insufficient funding.

Source – http://www.irinnews.org/Report.aspx?ReportId=86616

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