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Urban Health in Vulnerable Environments: Water, Sanitation, and Hygiene Improvement Actions in School Areas in Makeni, Sierra Leone
Abstract
Adequate access to sanitation and safe water is a main challenge to improve urban health in low-income countries. Diseases derived of precarious hygiene conditions are a major burden in African rapidly growing urban areas. These challenges are embedded in complex stakeholder networks and need to be addressed through a holistic approach. It is argued that schools are a key objective for sanitation, water, and hygiene actions in the city. Concerns for improvement of hygiene conditions among school children have risen in the context of contemporary sanitary crisis. Furthermore, schools play a pivotal role between the public and the private realms and a potential to foster change. The study focuses on WASH actions implemented in schools of the city of Makeni, Sierra Leone. It seeks to define a set of context specific recommendations to improve the health-related conditions in the school environment.
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The African continent is predicted to be home to over half of the expected global population growth between 2015 and 2050, highlighting the importance of addressing population health in Africa for improving public health globally. By 2050, nearly 60% of the population of the continent is expected to be living in urban areas and 35–40% of children and adolescents globally are projected to be living in Africa. Urgent attention is therefore required to respond to this population growth - particularly in the context of an increasingly urban and young population. To this end, the Research Initiative for Cities Health and Equity in Africa (RICHE Africa) Network aims to support the development of evidence to inform policy and programming to improve urban health across the continent. This paper highlights the importance of action in the African continent for achieving global public health targets. Specifically, we argue that a focus on urban health in Africa is urgently required in order to support progress on the Sustainable Development Goals (SDGs) and other global and regional public health targets, including Universal Health Coverage (UHC), the new Urban Agenda, and the African Union’s Agenda 2063. Action on urban public health in Africa is critical for achieving global public health targets. Four key research and training priorities for improving urban health in Africa, are outlined: (1) increase intersectoral urban health literacy; (2) apply a healthy urban governance and systems approach; (3) develop a participatory and collaborative urban health planning process; and, (4) produce a new generation of urban health scholars and practitioners. We argue that acting on key priorities in urban health is critical for improving health for all and ensuring that we ‘leave no-one behind’ when working to achieve these regional and global agendas to improve health and wellbeing.
El siguiente artículo indaga sobre la definición de modelos de planificación y herramientas de gestión para ciudades con
crecimientos expansivos y amplios sectores informales, utilizando como caso de estudio la experiencia desarrollada en la ciudad
de Makeni, Sierra Leona. En un proceso de varios años que continua vivo, la Escuela de Arquitectura de la Universidad San
Pablo CEU (USP-CEU) ha impulsado acciones de planeamiento urbano participativo, aportando experiencia técnica desde la
colaboración con la Universidad de Makeni y con el Ayuntamiento de la ciudad. Avanzando en el conocimiento paulatino de una
realidad específica llena de retos, se han abordado propuestas urbanas en dos líneas fundamentales. Por un lado, mediante el
desarrollo de un Plan Espacial Estratégico para Makeni, destinado a la generación de propuestas para la ciudad y su territorio;
y, por otro, con la implementación del Programa de Mejoramiento de Barrios, centrado en la ciudad existente. En relación a los
resultados, en el territorio de Makeni, destacan el desarrollo de las capacidades formativas de los alumnos de la universidad
local, la generación de metodologías e instrumentos de planeamiento básicos, el reforzamiento de los cuadros administrativos
municipales, junto a la implicación y concienciación de la población local. A nivel global, hay que destacar la definición de un
marco coherente y sistemático, factible de ser replicado en otras realidades urbanas con similares características. Un aporte
que resulta especialmente válido en aquellos contextos urbanos desfavorecidos que, en sus procesos de crecimiento, afrontan
el mayor reto futuro vinculado a la habitabilidad a nivel global.
Background
As human populations become more and more urban, decision-makers at all levels face new challenges related to both the scale of service provision and the increasing complexity of cities and the networks that connect them. These challenges may take on unique aspects in cities with different cultures, political and institutional frameworks, and at different levels of development, but they frequently have in common an origin in the interaction of human and environmental systems and the feedback relationships that govern their dynamic evolution. Accordingly, systems approaches are becoming recognized as critical to understanding and addressing such complex problems, including those related to human health and wellbeing. Management of water resources in and for cities is one area where such approaches hold real promise.
Results
This paper seeks to summarize links between water and health in cities and outline four main elements of systems approaches: analytic methods to deal with complexity, interdisciplinarity, transdisciplinarity, and multi-scale thinking. Using case studies from a range of urban socioeconomic and regional contexts (Maputo, Mozambique; Surat and Kolkata, India; and Vienna, Austria).
Conclusion
We show how the inclusion of these elements can lead to better research design, more effective policy and better outcomes.
Electronic supplementary material
The online version of this article (doi:10.1186/s12940-016-0107-2) contains supplementary material, which is available to authorized users.
Over a billion people in urban and peri-urban areas of Africa, Asia, and Latin America are served by onsite sanitation technologies. Until now, the management of faecal sludge resulting from these onsite technologies has been grossly neglected. Financial resources are often lacking, and onsite sanitation systems tend to be regarded as temporary solutions until sewer-based systems can be implemented. However, the reality is that onsite sanitation is here to stay, either as an intermediate or permanent standalone solution, or in combination
with sewer-based systems. The appropriate and adequate management of faecal sludge deriving from onsite technologies is imperative for the protection of human and environmental health.
This is the first book dedicated to faecal sludge management. It compiles the current state of knowledge of this rapidly evolving field, and presents an integrated approach that includes technology, management and planning. It addresses the planning and organization of the entire faecal sludge management service chain, from the collection and transport of sludge and treatment options, to the final enduse or disposal of treated sludge. In addition to providing fundamentals and an overview of technologies, the book goes into details of operational, institutional and financial aspects, and provides guidance on how to plan a city-level faecal sludge management project with the involvement of all the stakeholders.
The application of the proposed approach in two districts of Maputo resulted in two different paths of evolution. In Magoanine B a more conventional approach seems to be adequate to its current low density characteristics and informally planned crosslinked structure. In Chamanculo D, the need for intervention is more urgent and is strongly blocked by both institutional and social issues and by the interdependence between different infrastructure systems. The identification of these blocks allows small and incremental solutions to be implemented, leading to the improvement of sanitation systems. The solution found involves working in different areas, from roads pavement, through storm water drainage and adequate collection of solid waste, which together enhance the implementation of new sanitation solutions. This solution does not have to be implemented at once, but it constitutes an indication of the path to be taken and may as well be considered a planning and coordination tool when working at a neighborhood scale.
The genesis of an interdisciplinary program on urban health and wellbeing was a meeting in Rio de Janeiro, Brazil on the occasion of the 27th General Assembly of the International Council for Science (ICSU) in September, 2002. With the support of ICSU Executive Director, Dr. Thomas Roswall, the meeting was convened by Professor Marvalee Wake, President of the International Union of Biological Sciences. It was attended by representatives of nine ICSU member Unions
Understanding waste flows within an urban area is important for identifying the main problems and improvement opportunities for efficient waste management. Assessment tools such as material flow analysis (MFA), an extensively applied method in waste management studies, provide a structured and objective evaluating process to characterize the waste management system best, to identify its shortcomings and to propose suitable strategies. This paper presents the application of MFA to municipal solid waste management (MSWM) in Maputo City, the capital of Mozambique. The results included the identification and quantification of the main input and output flows of the MSWM system in 2007 and 2014, from the generation, material recovery and collection, to final disposal and the unaccounted flow of municipal solid waste (MSW). We estimated that the waste generation increased from 397×103 tonnes in 2007 to 437×103 tonnes in 2014, whereas the total material recovery was insignificant in both years – 3×103 and 7×103 tonnes, respectively. As for collection and final disposal, the official collection of waste to the local dumpsite in the inner city increased about threefold, from 76×103 to 253×106 tonnes. For waste unaccounted for, the estimates indicated a reduction during the study period from 300×103 to 158×103 tonnes, due to the increase of collection services. The emphasized aspects include the need for practical waste reduction strategies, the opportunity to explore the potential for material recovery, careful consideration regarding the growing trend of illegal dumping and the urgency in phasing-out from the harmful practice of open dumping.
Introduction Rule 1: There Always Is a Client Rule 2: Your Client Does Not Understand His Own Problem Rule 3: The Original Problem Statement is too Specific: You Must Generalize the Problem to Give it Contextual Integrity Rule 4: The Client Does Not Understand the Concept of the Index of Performance Rule 5: You are the Analyst, Not the Decision-Maker Rule 6: Meet the Time Deadline and the Cost Budget Rule 7: Take a Goal-Centered Approach to the Problem, Not a Technology-Centered or Chronological Approach Rule 8: Nonusers Must be Considered in the Analysis and in the Final Recommendations Rule 9: The Universal Computer Model is a Fantasy Rule 10: The Role of Decision-Maker in Public Systems is Often a Confused One
The Institute for Public Policy Research (ippr), established in 1988, is Britain's leading inde-pendent think tank on the centre left. The values that drive our work include delivering social justice, deepening democracy, increasing environmental sustainability and enhancing human rights. Through our well-researched and clearly argued policy analysis, our publications, our media events, our strong networks in government, academia and the corporate and voluntary sector, we play a vital role in maintaining the momentum of progressive thought. ippr's aim is to bridge the political divide between the social democratic liberal traditions, the intellectual divide between the academics and the policy makers and the cultural divide between the policy-making establishment and the citizen. As an independent institute, we have the freedom to determine our research agenda. ippr has charitable status and is fund-ed by a mixture of corporate, charitable, trade union and individual donations. Research is ongoing, and new projects being developed, in a wide range of policy areas including sustainability, health and social care, social policy, citizenship and gover-nance, education, economics, democracy and community, media and digital society and public private partnerships. We will shortly embark on major new projects in the fields of social justice, overseas development and democratic renewal. In 2003 we aim to grow into a permanent centre for contemporary progressive thought, recognised both at home and globally.
Access to safe water and sanitation services is a chronic problem for 40% of people around the world and has remained intractable for decades. Inappropriate technology, systemic corruption in the allocation of funding, population growth, migration patterns, and the availability of water are some of the factors that contribute to the global problem. Any hope for sustainable development and improvements in human health and welfare in these developing communities is contingent on the resolution of these and other contributing factors. Holistic systems thinking is needed in these situations. This project examines the application of so-called ldquohardrdquo systems approaches to a community-based water and sanitation project in the Limpopo province of South Africa. In its first year of involvement, a student team of systems engineers developed a systems framework for managing this community-based project which brings together an international multidisciplinary team of engineers, environmental scientists, planners, physicians, and nurses. They have all worked and continue to work closely with two selected villages, municipal government officials, and traditional leaders from the region, to develop a comprehensive model for community-based delivery of sustained access to safe water, sanitation services, and improved outcomes in community health in the region. However, it is found that hard systems approaches prove to be inadequate in managing the plurality of rationalities, disciplines, and stakeholders typically involved in these types of development situations and that alternative systems approaches should be explored.
Creating Sustainable Cities
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- H.Girardet
A healthy city is a better city.
- Goldsteing
- Kickbuschi
- G.Goldstein
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- C.Chatterley
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Kenya - School Health Clubs: Can they change hygiene behaviours
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