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Mokhele T, Mutyambizi C, Manyaapelo T, Ngobeni A, Ndinda C, Hongoro C. Determinants of Deteriorated Self-Perceived Health Status among Informal Settlement Dwellers in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4174. [PMID: 36901185 PMCID: PMC10001468 DOI: 10.3390/ijerph20054174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Self-perceived health (SPH) is a widely used measure of health amongst individuals that indicates an individual's overall subjective perception of their physical or mental health status. As rural to urban migration increases, the health of individuals within informal settlements becomes an increasing concern as these people are at high health and safety risk due to poor housing structures, overcrowding, poor sanitation and lack of services. This paper aimed to explore factors related to deteriorated SPH status among informal settlement dwellers in South Africa. This study used data from the first national representative Informal Settlements Survey in South Africa conducted by the Human Sciences Research Council (HSRC) in 2015. Stratified random sampling was applied to select informal settlements and households to participate in the study. Multivariate logistic regression and multinomial logistic regression analyses were performed to assess factors affecting deteriorated SPH among the informal settlement dwellers in South Africa. Informal settlement dwellers aged 30 to 39 years old (OR = 0.332 95%CI [0.131-0.840], p < 0.05), those with ZAR 5501 and more household income per month (OR = 0.365 95%CI [0.144-0.922], p < 0.05) and those who reported using drugs (OR = 0.069 95%CI [0.020-0.240], p < 0.001) were significantly less likely to believe that their SPH status had deteriorated compared to the year preceding the survey than their counterparts. Those who reported always running out of food (OR = 3.120 95%CI [1.258-7.737], p < 0.05) and those who reported having suffered from illness or injury in the past month preceding the survey (OR = 3.645 95%CI [2.147-6.186], p < 0.001) were significantly more likely to believe that their SPH status had deteriorated compared to the year preceding the survey than their counterparts. In addition, those who were employed were significantly (OR = 1.830 95%CI [1.001-3.347], p = 0.05) more likely to believe that their SPH status had deteriorated compared to the year preceding the survey than those who were unemployed with neutral SPH as a base category. Overall, the results from this study point to the importance of age, employment, income, lack of food, drug use and injury or illness as key determinants of SPH amongst informal settlement dwellers in South Africa. Given the rapid increasing number of informal settlements in the country, our findings do have implications for better understanding the drivers of deteriorating health in informal settlements. It is therefore recommended that these key factors be incorporated into future planning and policy development aimed at improving the standard of living and health of these vulnerable residents.
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Affiliation(s)
- Tholang Mokhele
- Geospatial Analytics, eResearch Knowledge Centre, Human Sciences Research Council, Pretoria 0001, South Africa
| | | | - Thabang Manyaapelo
- Africa Health Research Institute, KwaZulu-Natal, Somkhele 3935, South Africa
| | | | - Catherine Ndinda
- Human and Social Capabilities Division, Human Sciences Research Council, Cape Town 8000, South Africa
| | - Charles Hongoro
- Developmental, Capable and Ethical State Division, Human Sciences Research Council, Pretoria 0001, South Africa
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Ellison GT, Mattes RB, Rhoma H, de Wet T. Economic vulnerability and poor service delivery made it more difficult for shack-dwellers to comply with COVID-19 restrictions. S AFR J SCI 2022. [DOI: 10.17159/sajs.2022/13301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In South Africa, demand for housing close to viable/sustained sources of employment has far outstripped supply; and the size of the population living in temporary structures/shacks (and in poorly serviced informal settlements) has continued to increase. While such dwellings and settlements pose a number of established risks to the health of their residents, the present study aimed to explore whether they might also undermine the potential impact of regulations intended to safeguard public health, such as the stringent lockdown restrictions imposed to curb the spread of COVID-19 in 2020 and 2021. Using a representative sample of 1381 South African households surveyed in May–June 2021, the present study found that respondents in temporary structures/shacks were more likely to report non-compliance (or difficulty in complying) with lockdown restrictions when compared to those living in traditional/formal houses/ flats/rooms/hostels (OR: 1.61; 95% CI: 1.06, 2.45). However, this finding was substantially attenuated and lost precision following adjustment for preceding socio-demographic and economic determinants of housing quality (adjusted OR: 1.20; 95% CI: 0.78, 1.87). Instead, respondents were far more likely to report non-compliance (or difficulty in complying) with COVID-19 lockdown restrictions if their dwellings lacked private/indoor toilet facilities (adjusted OR: 1.56; 95% CI: 1.08, 2.22) or if they were ‘Black/ African’, young, poorly educated and under-employed (regardless of their socio-economic position, or whether they resided in temporary structures/shacks, respectively). Restrictions imposed to safeguard public health need to be more sensitively designed to accommodate the critical roles that poverty and inadequate service delivery play in limiting the ability of residents living in temporary structures/shacks and inadequately serviced dwellings/settlements to comply.
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Affiliation(s)
- George T.H. Ellison
- Faculty of Science and Technology, University of Central Lancashire, Preston, UK
- School of Medicine, University of Leeds, Leeds, UK
- Academic Development and Support, University of Johannesburg, Johannesburg, South Africa
| | - Robert B. Mattes
- Institute for Democracy, Citizenship and Public Policy in Africa, University of Cape Town, Cape Town, South Africa
- School of Government and Public Policy, University of Strathclyde, Glasgow, UK
| | - Hanan Rhoma
- School of Medicine, University of Leeds, Leeds, UK
| | - Thea de Wet
- Academic Development and Support, University of Johannesburg, Johannesburg, South Africa
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Gao Y, Zhang L, Kc A, Wang Y, Zou S, Chen C, Huang Y, Mi X, Zhou H. Housing environment and early childhood development in sub-Saharan Africa: A cross-sectional analysis. PLoS Med 2021; 18:e1003578. [PMID: 33872322 PMCID: PMC8092764 DOI: 10.1371/journal.pmed.1003578] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 05/03/2021] [Accepted: 03/08/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The influence of the safety and security of environments on early childhood development (ECD) has been under-explored. Although housing might be linked to ECD by affecting a child's health and a parent's ability to provide adequate care, only a few studies have examined this factor. We hypothesized that housing environment is associated with ECD in sub-Saharan Africa (SSA). METHODS AND FINDINGS From 92,433 children aged 36 to 59 months who participated in Multiple Indicator Cluster Survey (MICS) in 20 SSA countries, 88,271 were tested for cognitive and social-emotional development using the Early Childhood Development Index (ECDI) questionnaire and were thus included in this cross-sectional analysis. Children's mean age was 47.2 months, and 49.8% were girls. Children were considered developmentally on track in a certain domain if they failed no more than 1 ECDI item in that domain. In each country, we used conditional logistic regression models to estimate the association between improved housing (housing with finished building materials, improved drinking water, improved sanitation facilities, and sufficient living area) and children's cognitive and social-emotional development, accounting for contextual effects and socioeconomic factors. Estimates from each country were pooled using random-effects meta-analyses. Subgroup analyses were conducted by the child's gender, maternal education, and household wealth quintiles. On-track cognitive development was associated with improved housing (odds ratio [OR] = 1.15, 95% CI 1.06 to 1.24, p < 0.001), improved drinking water (OR = 1.07, 95% CI 1.00 to 1.14, p = 0.046), improved sanitation facilities (OR = 1.15, 95% CI 1.03 to 1.28, p = 0.014), and sufficient living area (OR = 1.06, 95% CI 1.01 to 1.10, p = 0.018). On-track social-emotional development was associated with improved housing only in girls (OR = 1.14, 95% CI 1.04 to 1.25, p = 0.006). The main limitations of this study included the cross-sectional nature of the datasets and the use of the ECDI, which lacks sensitivity to measure ECD outcomes. CONCLUSIONS In this study, we observed that improved housing was associated with on-track cognitive development and with on-track social-emotional development in girls. These findings suggest that housing improvement in SSA may be associated not only with benefits for children's physical health but also with broader aspects of healthy child development.
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Affiliation(s)
- Yaqing Gao
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Long Zhang
- University of Michigan School of Dentistry, Ann Arbor, Michigan, United States of America
| | - Ashish Kc
- International Maternal and Child Health, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Yinping Wang
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Siyu Zou
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Chunyi Chen
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yue Huang
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Xiaoyi Mi
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Hong Zhou
- Department of Maternal and Child Health, School of Public Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- * E-mail:
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Pasquini L, van Aardenne L, Godsmark CN, Lee J, Jack C. Emerging climate change-related public health challenges in Africa: A case study of the heat-health vulnerability of informal settlement residents in Dar es Salaam, Tanzania. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 747:141355. [PMID: 32777515 DOI: 10.1016/j.scitotenv.2020.141355] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
Heat has the potential to become one of the most significant public health impacts of climate change in the coming decades. Increases in temperature have been linked to both increasing mortality and morbidity. Cities have been recognized as areas of particular vulnerability to heat's impacts on health, and marginalized groups, such as the poor, appear to have higher heat-related morbidity and mortality. Little research has examined the heat vulnerability of urban informal settlements residents in Africa, even though surface temperatures across Africa are projected to increase at a rate faster than the global average. This paper addresses this knowledge gap through a mixed-methods analysis of the heat-health vulnerability of informal settlement residents in Dar es Salaam, Tanzania. The heat exposure, sensitivity and adaptive capacity of informal settlement residents were assessed through a combination of climate analyses, semi-structured interviews with local government actors and informal settlement residents, unstructured interviews with health sector respondents, a health impacts literature review, and a stakeholder engagement workshop. The results suggest that increasing temperatures due to climate change will likely be a significant risk to human health in Dar es Salaam, even though the city does not reach extreme temperature conditions, because informal settlement residents have high exposure, high sensitivity and low adaptive capacity to heat, and because the heat-health relationship is currently an under-prioritized policy issue. While numerous urban planning approaches can play a key role in increasing the resilience of citizens to heat, Dar es Salaam's past and current growth and development patterns greatly complicate the implementation and enforcement of such approaches. For African cities, the findings highlight an urgent need for more research on the vulnerability and resilience of residents to heat-health impacts, because many African cities are likely to present similar characteristics to those in Dar es Salaam that increase resident's vulnerability.
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Affiliation(s)
- Lorena Pasquini
- Climate System Analysis Group, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa; African Climate and Development Initiative, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
| | - Lisa van Aardenne
- Climate System Analysis Group, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
| | - Christie Nicole Godsmark
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork T12 XF62, Ireland; Environmental Research Institute, University College Cork, Lee Road, Cork T23 XE10, Ireland.
| | - Jessica Lee
- Climate System Analysis Group, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
| | - Christopher Jack
- Climate System Analysis Group, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
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Kalule JB, Smith AM, Vulindhlu M, Tau NP, Nicol MP, Keddy KH, Robberts L. Prevalence and antibiotic susceptibility patterns of enteric bacterial pathogens in human and non-human sources in an urban informal settlement in Cape Town, South Africa. BMC Microbiol 2019; 19:244. [PMID: 31694551 PMCID: PMC6836408 DOI: 10.1186/s12866-019-1620-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 10/22/2019] [Indexed: 11/13/2022] Open
Abstract
Background In light of rampant childhood diarrhoea, this study investigated bacterial pathogens from human and non-human sources in an urban informal settlement. Meat from informal abattoirs (n = 85), river water (n = 64), and diarrheic stool (n = 66) were collected between September 2015 and May 2016. A duplex real-time PCR, gel-based PCR, and CHROMagar™STEC were used to screen Tryptic Soy Broth (TSB) for diarrheic E. coli. Standard methods were used to screen for other selected food and waterborne bacterial pathogens. Results Pathogens isolated from stool, meat, and surface water included Salmonella enterica (6, 5, 0%), Plesiomonas shigelloides (9, 0, 17%), Aeromonas sobria (3, 3, 0%), Campylobacter jejuni (5, 5, 0%), Shigella flexneri (17, 5, 0%), Vibrio vulnificus (0, 0, 9%), and diarrheic E. coli (21, 3, 7%) respectively. All the isolates were resistant to trimethoprim–sulphamethoxazole. Conclusions There was a high burden of drug resistant diarrheal pathogens in the stool, surface water and meat from informal slaughter. Integrated control measures are needed to ensure food safety and to prevent the spread of drug resistant pathogens in similar settings.
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Affiliation(s)
- John Bosco Kalule
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Services, Cape Town, South Africa.
| | - Anthony M Smith
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa.,Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Nomsa P Tau
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Mark P Nicol
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Services, Cape Town, South Africa
| | - Karen H Keddy
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lourens Robberts
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Services, Cape Town, South Africa
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6
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Ezbakhe F, Giné-Garriga R, Pérez-Foguet A. Leaving no one behind: Evaluating access to water, sanitation and hygiene for vulnerable and marginalized groups. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 683:537-546. [PMID: 31146059 DOI: 10.1016/j.scitotenv.2019.05.207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
Achieving equitable access to water, sanitation and hygiene (WASH) services requires paying special attention to the most disadvantaged segments of the population. Yet, despite all the progress made to evaluate the access of vulnerable and marginalized groups, important knowledge gaps still remain with respect to identifying their specific barriers and needs. At the global level, for example, the two monitoring mechanisms for SDG 6 - the Joint Monitoring Programme (JMP) and Global Analysis and Assessment of Sanitation and drinking-water (GLAAS) - face difficulties in understanding how, and to what extent, vulnerable and marginalized groups access WASH services. In this context, this work examines the UNECE/WHO-Europe 'Equitable Access Score-card' for assessing the access to WASH services by vulnerable and marginalized groups. In particular, we: (i) analyse its strengths and limitations as a tool for revealing the needs of these groups in accessing WASH services; and (ii) propose an extended variant of the score-card that addresses these limitations. We test this version in two local-level case studies: Lima (Peru) and Castelló de la Plana (Spain). The score-card diagnosis is found to be particularly useful for collecting information on the level of access of the different vulnerable and marginalized groups, as well as the specific public policies and funding mechanisms in place that address and support their needs. However, the score-card should be complemented with specific assessments of all five normative dimensions of the human rights to water and sanitation (access, availability, quality, acceptability and affordability) in order to have a better understanding of the concerns for service delivery for the different vulnerable and marginalized groups.
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Affiliation(s)
- F Ezbakhe
- Department of Civil and Environmental Engineering (DECA), Engineering Sciences and Global Development (Esc&GD), Barcelona School of Civil Engineering, Universitat Politècnica de Catalunya, Barcelona, Spain.
| | - R Giné-Garriga
- Stockholm International Water Institute, Stockholm, Sweden.
| | - A Pérez-Foguet
- Department of Civil and Environmental Engineering (DECA), Engineering Sciences and Global Development (Esc&GD), Barcelona School of Civil Engineering, Universitat Politècnica de Catalunya, Barcelona, Spain.
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Godsmark CN, Irlam J, van der Merwe F, New M, Rother HA. Priority focus areas for a sub-national response to climate change and health: A South African provincial case study. ENVIRONMENT INTERNATIONAL 2019; 122:31-51. [PMID: 30573189 DOI: 10.1016/j.envint.2018.11.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/26/2018] [Accepted: 11/14/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The intersection of health and climate change is often absent or under-represented in sub-national government strategies. This analysis of the literature, using a new methodological framework, highlights priority focus areas for a sub-national government response to health and climate change, using the Western Cape (WC) province of South Africa as a case study. METHODS A methodological framework was created to conduct a review of priority focus areas relevant for sub-national governments. The framework encompassed the establishment of a Project Steering Group consisting of relevant, sub-national stakeholders (e.g. provincial officials, public and environmental health specialists and academics); an analysis of local climatic projections as well as an analysis of global, national and sub-national health risk factors and impacts. RESULTS Globally, the discussion of health and climate change adaptation strategies in sub-national, or provincial government is often limited. For the case study presented, multiple health risk factors were identified. WC climatic projections include a warmer and potentially drier future with an increased frequency and intensity of extreme weather events. WC government priority focus areas requiring further research on health risk factors include: population migration and environmental refugees, land use change, violence and human conflict and vulnerable groups. WC government priority focus areas for further research on health impacts include: mental ill-health, non-communicable diseases, injuries, poisonings (e.g. pesticides), food and nutrition insecurity-related diseases, water- and food-borne diseases and reproductive health. These areas are currently under-addressed, or not addressed at all, in the current provincial climate change strategy. CONCLUSIONS Sub-national government adaptation strategies often display limited discussion on the health and climate change intersect. The methodological framework presented in this case study can be globally utilized by other sub-national governments for decision-making and development of climate change and health adaptation strategies. Additionally, due to the broad range of sectoral issues identified, a primary recommendation from this study is that sub-national governments internationally should consider a "health and climate change in all policies" approach when developing adaptation and mitigation strategies to address climate change.
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Affiliation(s)
- Christie Nicole Godsmark
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - James Irlam
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, South Africa; Primary Health Care Directorate, University of Cape Town, South Africa
| | - Frances van der Merwe
- Department of Environmental Affairs and Development Planning, Western Cape Government, South Africa
| | - Mark New
- African Climate and Development Initiative, University of Cape Town, Cape Town, South Africa; School of International Development, University of East Anglia, Norwich, UK
| | - Hanna-Andrea Rother
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, South Africa.
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Salami RO, von Meding JK, Giggins H. Urban settlements' vulnerability to flood risks in African cities: A conceptual framework. JAMBA (POTCHEFSTROOM, SOUTH AFRICA) 2017; 9:370. [PMID: 29955335 PMCID: PMC6014121 DOI: 10.4102/jamba.v9i1.370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/24/2016] [Indexed: 06/08/2023]
Abstract
In the recent past, the frequency and gravity of large-scale flood disasters have increased globally, resulting in casualties, destruction of property and huge economic loss. The destructive flood disaster devastating Louisiana, USA, is a recent example. Despite the availability of advanced technological capabilities for dealing with floods in developed nations, flood disasters continue to become more rampant and disastrous. Developing countries in Africa such as Benin, Ghana, Nigeria, Senegal and Sudan have recently experienced severe flooding, leaving a considerable number of human casualties and thousands displaced. In African cities, most vulnerable urban residents usually have lesser capacity and fewer resources to recover from the shocks of disaster as a result of the failure of governments to build human security for poor African residents. Many scholars have acknowledged the lack of appropriate vulnerability assessment frameworks and policies, questioning the efficiency and effectiveness of the tested models in Africa. The ability to accurately identify, measure and evaluate the various vulnerabilities of affected people and communities is a right step towards reducing disaster risk. This article aimed at developing a framework for assessing urban settlements' vulnerability to flood risks in Africa. The framework is currently being tested to assess various dimensions of vulnerability drivers in three urban communities in Ibadan metropolis, the third largest city in Nigeria, focusing more on flood risk perceptions and behaviour of the risk bearers. It uses participatory and mixed method approaches to socially construct vulnerability of populations at risk. This model emanates from the evaluation of considerable relevant literature and an array of vulnerability assessment frameworks. It integrates some approaches that are applicable to African cities in a bid to create a versatile tool to assess, identify and mitigate the effects of flood disaster risk and reduce urban poor's vulnerability to natural and human-induced hazards.
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Affiliation(s)
- Rafiu O Salami
- School of Architecture and Built Environment, University of Newcastle, Australia
| | - Jason K von Meding
- School of Architecture and Built Environment, University of Newcastle, Australia
| | - Helen Giggins
- School of Architecture and Built Environment, University of Newcastle, Australia
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Awotiwon OF, Pillay-van Wyk V, Dhansay A, Day C, Bradshaw D. Diarrhoea in children under five years of age in South Africa (1997-2014). Trop Med Int Health 2016; 21:1060-70. [PMID: 27314457 DOI: 10.1111/tmi.12739] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To present evidence from available reliable published data on the prevalence, incidence and severity of diarrhoea in children aged under five years in South Africa. METHODS We searched seven electronic databases. Two reviewers assessed the studies independently and extracted outcome data. The heterogeneity of the studies did not allow for a meta-analysis. RESULTS We found only one nationally representative study conducted in 1998 reporting a diarrhoea prevalence of 13% in children under five. Other studies were conducted in smaller settings across the country. Diarrhoea incidence was 10.13 per 1000 person years in children admitted to a tertiary hospital. Three studies reported severity of diarrhoea; however, they differed across study settings and time period. CONCLUSION The paucity of nationally representative prevalence data for SA necessitates more national surveys with standardised data-collection methods to allow for more effective comparisons.
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Affiliation(s)
- Oluwatoyin F Awotiwon
- Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Victoria Pillay-van Wyk
- Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Ali Dhansay
- Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, South Africa.,Division of Human Nutrition, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa.,Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Candy Day
- Health Systems Research Unit, Health Systems Trust, Westville, South Africa
| | - Debbie Bradshaw
- Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, South Africa
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Maffacciolli R, Hahn GV, Rossetto M, Almeida CPBD, Manica ST, Paiva TS, Oliveira DLLCD. [Using the notion of vulnerability in the production of knowledge about tuberculosis: integrative review]. Rev Gaucha Enferm 2015; 36 Spec No:247-53. [PMID: 27057726 DOI: 10.1590/1983-1447.2015.esp.51537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 08/05/2015] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE to identify how the notion of vulnerability is used in national and international scientific publications that address the problem of tuberculosis. METHOD an integrative review of literature published in the databases of the Biblioteca Virtual em Saúde, the United States National Library of Medicine and the Biblioteca Digital Brasileira de Teses e Dissertações, considering the descriptors Tuberculosis and Vulnerability in Portuguese and English. RESULTS we selected fifty-eight studies published between 1992 and February 2014, which resulted in three categories of analysis. CONCLUSION the link between tuberculosis and the notion of vulnerability has not been sufficiently consolidated in national and international literature. This creates an obstacle for the achievement of the epistemological transformations and pragmatic measures that are required to obtain better results from interventions in the field.
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Affiliation(s)
- Rosana Maffacciolli
- Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| | | | - Maíra Rossetto
- Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| | | | - Silvia Troyahn Manica
- Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| | - Tiago Sousa Paiva
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brasil
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Nadjane Batista Lacerda S, Cristina de Abreu Temoteo R, Maria Ribeiro Monteiro de Figueiredo T, Darliane Tavares de Luna F, Alves Nunes de Sousa M, Carlos de Abreu L, Luiz Affonso Fonseca F. Individual and social vulnerabilities upon acquiring tuberculosis: a literature systematic review. Int Arch Med 2014; 7:35. [PMID: 25067955 PMCID: PMC4110238 DOI: 10.1186/1755-7682-7-35] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 07/02/2014] [Indexed: 11/13/2022] Open
Abstract
Tuberculosis is a contagious infectious disease mainly caused by the bacteria Mycobacterium tuberculosis that still meets the priority criteria - high magnitude, transcendence and vulnerability - due to the threat it poses to public health. When taking into consideration the vulnerability conditions that favor the onset of the disease, this article aimed to investigate the implications originated from individual and social vulnerability conditions in which tuberculosis patients are inserted. Databases like MEDLINE, LILACS and SciELO were searched in Portuguese, Spanish and English using the descriptors tuberculosis and vulnerability, and 183 articles were found. After the selection criterion was applied, there were 22 publications left to be discussed. Some of the aspects that characterize the vulnerability to tuberculosis are: low-income and low-education families, age, poor living conditions, chemical dependency, pre-existing conditions/aggravations like diabetes mellitus and malnutrition, indigenous communities, variables related to health professionals, intense border crossings and migration, difficulty in accessing information and health services and lack of knowledge on tuberculosis. Much as such aspects are present and favor the onset of the disease, several reports show high incidence rates of tuberculosis in low vulnerability places, suggesting that some factors related to the disease are still unclear. In conclusion, health promotion is important in order to disfavor such conditions or factors of vulnerability to tuberculosis, making them a primary target in the public health planning process and disease control.
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Kamndaya M, Thomas L, Vearey J, Sartorius B, Kazembe L. Material deprivation affects high sexual risk behavior among young people in urban slums, South Africa. J Urban Health 2014; 91:581-91. [PMID: 24481587 PMCID: PMC4074323 DOI: 10.1007/s11524-013-9856-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Young people in urban slums adopt HIV risk behaviors influenced by their neighborhood factors. Three critical factors in urban slums of Southern and Eastern Africa--the region most affected by the HIV epidemic in the world--are unmet needs of housing, food, and health care, which are associated with HIV sexual risks. Yet, there has been limited attention on how the combination of unmet needs of housing, food, and health care--i.e., material deprivation-relates to sexual risk behavior among young people in urban slums. Cross-sectional data were extracted from the LoveLife survey in South African four provinces--KwaZulu Natal, Mpumalanga, Eastern Cape, and Gauteng, to examine the association between material deprivation and sexual risk behavior among young people aged 18-23 years (263 males, 267 females) in urban slums. Adjusted logistic regression models showed that material deprivation was significantly associated with increased odds of high sexual risk taking for young men (adjusted OR = 1.20; 95 % CI = 1.10, 5.58) and young women (adjusted OR = 1.43; 95 % CI = 1.35, 3.28). Financial difficulty--a proxy for other deprivations--was the most salient influence on young women's high sexual risk taking (adjusted OR = 2.11; 95 % CI = 1.66, 2.70). Localized behavioral HIV prevention interventions should target young people in deprived households.
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Affiliation(s)
- Mphatso Kamndaya
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa,
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The Health Status and Unmet Health Needs of Old-Age Pensioners Living in Selected Urban Poor Communities in Cape Town, South Africa. J Community Health 2014; 39:1063-70. [DOI: 10.1007/s10900-014-9851-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Govender T, Barnes JM, Pieper CH. The impact of densification by means of informal shacks in the backyards of low-cost houses on the environment and service delivery in cape town, South Africa. ENVIRONMENTAL HEALTH INSIGHTS 2011; 5:23-52. [PMID: 21695092 PMCID: PMC3115642 DOI: 10.4137/ehi.s7112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This paper investigates the state-sponsored low cost housing provided to previously disadvantaged communities in the City of Cape Town. The strain imposed on municipal services by informal densification of unofficial backyard shacks was found to create unintended public health risks. Four subsidized low-cost housing communities were selected within the City of Cape Town in this cross-sectional survey. Data was obtained from 1080 persons with a response rate of 100%. Illegal electrical connections to backyard shacks that are made of flimsy materials posed increased fire risks. A high proportion of main house owners did not pay for water but sold water to backyard dwellers. The design of state-subsidised houses and the unplanned housing in the backyard added enormous pressure on the existing municipal infrastructure and the environment. Municipal water and sewerage systems and solid waste disposal cannot cope with the increased population density and poor sanitation behaviour of the inhabitants of these settlements. The low-cost housing program in South Africa requires improved management and prudent policies to cope with the densification of state-funded low-cost housing settlements.
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Affiliation(s)
- Thashlin Govender
- Division of Community Health, Department of Interdisciplinary Health Sciences, Faculty of Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
- Corresponding author
| | - Jo M. Barnes
- Division of Neonatal Medicine, School of Child and Adolescent Health, University of Cape Town and Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Clarissa H. Pieper
- Division of Neonatal Medicine, School of Child and Adolescent Health, University of Cape Town and Groote Schuur Hospital, Observatory, Cape Town, South Africa
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