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Financing of sanitation services in the slums of Kampala and Dar es Salaam

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Health 2013年第4期5卷 783-791页

作者： John Bosco Isunju Samuel Etajak Beatrice Mwalwega Richard Kimwaga Peter Atekyereza William Bazeyo John C. Ssempebwa 1Disease Control and Environmental Health Department School of Public Health College of Health Sciences Makerere University Kampala Uganda Department of Sociology College of Humanities and Social Sciences Makerere University Kampala Uganda Department of Water Resources Engineering College of Engineering and Technology University of Dar es Salaam Dar es Salaam Tanzania Disease Control and Environmental Health Department School of Public Health College of Health Sciences Makerere University Kampala Uganda

This paper presents an assessment of the extent and conditions under which private financing can be a realistic approach for sanitation in slums. It is based on a cross-sectional study comparing two slum communities in East Africa, where 250 households from Bwaise III in Kampala, Uganda and 379 households from Temeke in Dar es Salaam, Tanzania were interviewed in 2010. Also, 10 key-informant interviews and 8 focus group discussions were conducted in addition to field observations. Findings show that majority (85%) of households used unimproved, private-shared pit latrines. These privately owned latrines had many structural shortfalls besides poor operation and maintenance while the public latrines provided by third-party were structurally sound but were under-utilized in residential slum neighorhoods. This is attributed to the presence free or at least cheaper alternatives which the community members preferred instead of paying per-visit user-fees. For the few who were willing to pay, willingness to pay was positively associated with the presence of a facility User committee and having been sensitized. In this context, a combination of these factors made cost recovery as well as operation and maintenance very minimal. The poor status of privately owned shared pit latrines matched the limited income levels of households. Similarly, cost recovery for public facilities was dependent on the number of users who were willing to pay: the more the users, the more the cost recovery. A combination of private and public financing is thus necessary to fund different but complementary aspects of sanitation in slums.

关键词： slums Sanitation Public Private Financing Approaches

Health Status and Access to Health Services in Indian slums

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Health 2015年第2期7卷 245-255页

作者： Indrani Gupta Pradeep Guin Health Policy Research Unit Institute of Economic Growth University of Delhi Enclave North Campus Delhi India School of Public Policy University of Maryland Baltimore County (UMBC) Baltimore USA

This paper analyzes the state of health and access to health services among the urban poor in India. Analysis is based on data from a primary survey conducted among 2000 households, covering 10,929 individuals from four cities of India. Summary statistics and regressions (using STATA) are used for data analysis. Results show lack of government facilities and services, a very high preference for private health facilities, high expenses especially in private but also in public facilities, and a perception that private facilities are offering high quality services as important concerns. An econometric analysis of the determinants of acute illness indicates the insufficiency of basic amenities like sanitation, garbage disposal and potable water. Together with the lack of availability of government health facilities in the vicinity, these results indicate continued vulnerability of the urban poor, and the need for urgent government action.

关键词： India Urban Poor Access to Health Services slums Public Policy

Detecting slums from SPOT Data in Casablanca Morocco Using an Object Based Approach

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Journal of Geographic Information System 2011年第3期3卷 217-224页

作者： Hassan Rhinane Atika Hilali Aziza Berrada Mustapha Hakdaoui Faculte des Sciences Ain Chock Universite Hassan II-Casablanca

Casablanca, Morocco's economic capital continues today to fight against the proliferation of informal settle- ments affecting its urban fabric illustrated especially by the slums. Actually Casablanca represents 25% of the total slums of Morocco [1]. These are the habitats of all deprived of healthy sanitary conditions and judged precarious from the perspective humanitarian and below the acceptable. The majority of the inhabi- tants of these slums are from the rural exodus with insufficient income to meet the basic needs of daily life. Faced with this situation and to eradicate these habitats, the Moroccan government has launched since 2004 an entire program to create cities without slums (C.W.S.) to resettle or relocate families. Indeed the process control and monitoring of this program requires first identifying and detecting spatial habitats. To achieve these tasks, conventional methods such as information gathering, mapping, use of databases and statistics often have shown their limits and are sometimes outdated. It is within this framework and that of the great German Morocco project “Urban agriculture as an integrative factor of development that fits our project de- tection of slums in Casablanca. The use of satellite imagery, particulary the HSR, has the advantage of providing the physical coverage of urban land but it raises the difficulty of choosing the appropriate method to *** paper is actually to develop new approaches based mainly on object-oriented classification of high spatial resolution satellite images for the detection of *** approach has been developed for mapping the urban land through by integration of several types of information (spectral, spatial, contextual ...) (Hofmann, P ., 2001, Herold et al. 2002b;Van Der Sande et al., 2003, Benz et al., 2004, Nobrega et al., 2006). In order to refine the result of classification, we applied mathematical morphology and in particular the closing filter. The data from this classification (b

关键词： slums Urban Remote Sensing SPOT 5 Object Based Image Analysis ArcGis

Pre-lacteal feeding practices among newborn in urban slums of Lucknow city UP, India

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Open Journal of Preventive Medicine 2012年第4期2卷 510-513页

作者： Pratibha Gupta Vinod K. Srivastava Vishwajeet Kumar Jyoti Prakash Srivastava Department of Community Medicine Era’s Lucknow Medical College & Hospital Lucknow India Integral Institute of medical Sciences Integral University Lucknow India KGMU-JHU Collaborative Projects King George’s Medical University Lucknow India

Aim: To study the Practices of Pre-lacteal feeding among Newborns in Urban slums of Lucknow city. Setting and Design: A cross-sectional study in Urban slums of Lucknow city, UP. Methods and Material: A cross-sectional study in Urban slums of Lucknow city, UP included 524 women who had a live birth during last one year preceding data collection. A pre-desined and pretested questionnaire was used for data collection. Statistical analysis used: The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 10.0 for Windows and Discrete data were analyzed using the chisquare test. Results: Study findings showed that Half (50.6%) of the mothers had given pre-lacteal feedings to their newborn. Out of those who had given pre-lacteal feed, 55.1 percent had given mugli ghutti/griipe water and 49.4 percent had given boiled water as pre-lacteal feed Only mother’s education (p < 0.01), father’s education (p < 0.001) and socioeconomic status (p < 0.05) were statistically associated with the practice of giving prelecteal feeding. Conclusion: It was concluded that maternal knowledge and awareness of correct feeding practices is essential for the normal growth, health and well being of the children. We therefore suggested that the primary focus of various nutrition related national programs in India for children should aim at imparting nutrition and health education to the mothers.

关键词： Newborn Prelacteal Feeding Urban slums

Approaches to urban slums

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Approaches to urban slums

Antimicrobial Susceptibility and Genetic Basis of Resistance of <i>Klebsiella spp</i>Isolated from Diarrheic and Non-Diarrheic Children at Health Facilities in Mukuru Informal Settlement, Nairobi, Kenya

2008年

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Advances in Microbiology 2021年第10期11卷 554-578页

作者： Celestine Wanjiku Wairimu Eddy Okoth Odari Celestine Khalechi Makobe Samuel Kariuki Department of Medical Microbiology College of health Science Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Centre for Microbiology Research Kenya Medical Research Institute Nairobi Kenya

Antimicrobial resistance (AMR) is a global threat to public health and particularly to children. This study aimed to determine the prevalence of multidrug resistance of fecal Klebsiella spp on selected beta lactam (3rd generation cephalosporins and carbapenems) and fluoroquinolone classes of drugs in four health facilities serving the slum communities of Nairobi city in Kenya. Additionally, determine the genetic basis for the multidrug resistance observed. A cross sectional laboratory based study was undertaken where a total of 1171 children below 16 years were selected, from whom stool samples were collected, tested and analyzed. 395 (33.73%) Klebsiella spp were isolated, consisting of 365 (92.4%) Klebsiella pneumoniae and 30 (7.6%) Klebsiella oxytoca were isolated. The proportion of multi-drug resistance (MDR) K. pneumoniae and MDR K. oxytoca was 64.1% (234/365) and 96.67% (29/30) respectively. Third generation cephalosporins, cefotaxime ceftriaxone and ceftazidime showed the highest resistance of 30.7%, 29.9% and 27.4% respectively, whereas carbapenems including imipenem and meropenem had the least resistance of 1.6%, each, to K. pneumoniae. A significant association was observed in diarrheic children (OR = 1.88;p = 0.01) and those below 50 months (OR = 0.43;p = 0.002) and carrying K. pneumoniae resistance to one or more third generation cephalosporins. Genes associated with resistance included bla TEM 100%, bla CTX-M 95.2%, bla SHV 57.1%, bla OXA-1 66.7%, qnrS 54.1%, qnrB 47.6% and bla NDM 7.1%. In conclusion, there’s need for more effective infection control measures, antimicrobial stewardship to reduce emergence of antimicrobial resistance, improved drinking water, sanitation and hygiene (WASH) practices.

关键词： Klebsiella Antimicrobial Resistance Carriage Community Children slums Kenya

Prevalence of <i>Helicobacter pylori</i>and hygiene practices among public secondary school students in Ikeja local government area, Lagos, Nigeria

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Health 2014年第4期6卷 250-258页

作者： Sridhar Kameswara Chandra Mynepalli Osamor Maureen Adejumo Mumuni Department of Environmental Health Sciences Faculty of Public Health College of Medicine University of Ibadan Ibadan Nigeria

This study determined prevalence of Helicobacter pylori and hygiene practices among public secondary school students in Ikeja Local Government Area (LGA), Lagos state, Nigeria. An institutional-based, cross-sectional study was conducted among two randomly selected secondary schools. One hundred (100) consented students participated in the study and interviews were conducted using a semi-structured questionnaire while blood samples were collected by venipuncture. Respondents’ ages were 16.1 ± 2.8 years and 54.0% were females. Mean number of persons living in a room was 7.0 ± 3.5, and however, 39.0% of the respondents lived in a room with 4 - 6 persons. The prevalence of H. pylori was 59.0% (59/100). Majority, 64.4% of those infected with H. pylori were 15 years and above while 62.7% females were tested positive to H. pylori. Some, 38.9% of the participants infected with H. pylori drink tap water while 84.7% did hand washing after visiting toilets with water and soap. Mostly, 64.0% of those tested positive to H. pylori did not experience abdominal pain in the last 4 weeks. No significant association existed between drinking water source, hand washing practice after defecation and H. pylori positivity. Routine examination of school students is required to detect Helicobacter pylori in order to commence treatment immediately and awareness about the H. pylori infection should be increased throughout secondary school to prevent further infection.

关键词： Helicobacter pylori Hygiene School Children Lagos slums Hand Washing Sanitation

Perceptions on Public Health Facilities by Slum Dwellers in the Metropolitan Cities of India

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Health 2016年第1期8卷 93-97页

作者： Palaniappan Marimuthu Grish N. Rao Manoj Kumar Sharma Ramasamy Dhanasekara Pandian Department of Biostatistics National Institute of Mental Health Neuro Sciences Bangalore India Department of Epidemiology National Institute of Mental Health Neuro Sciences Bangalore India Department of Clinical Psychology National Institute of Mental Health Neuro Sciences Bangalore India Department of Psychiatry Social Work National Institute of Mental Health Neuro Sciences Bangalore India

Rapid urbanisation and quest for better livelihood, push-pull factor of occupations education, policy changes attract large scale rural population to urban areas. It is well documented that in spite of better public health facilities including tertiary care hospitals which are available in the urban areas but the services are underutilised by the urban poor. Aim: Hence, in this paper, it is attempted to comprehend the reasons for underutilisation of available public health facilities and to compare the difference with non-slum areas of the major metropolitan cities of India. Methods: A secondary data from National Family Health Survey-III for five major metropolitan cities namely, Delhi, Hyderabad, Mumbai, Kolkata and Chennai is used for the analysis. Slum data which are classified by both the agencies, that is census of India and NFHS-III as slum households only considered for analysis. Results: In Mumbai slums about 90% of the households are having water sources from public tap or piped to yard followed by Hyderabad having better water supply and Chennai slum dwellers having minimum access to good water sources. About 11.4% of the households do not know where their toilet drainage is connected. There is a significant (P 0.05) 75% to 79%, Kolkata and Chennai have parallel high proportion, that is more than 95% (P > 0.05) and Mumbai stands as median percent age as 89.6. Apart from Delhi, about 40% to 45% of the slum population is in the opinion of “long waiting time” in the government hospitals, and the same trend of proportions is observed for “poor quality of service”.

关键词： slums Metropolitan Cities Government Health Facility Toilets Health Schemes Perceptions