scholarly journals Barriers and opportunities for cleanliness of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sheillah N. Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
World Health ◽  
Group Discussions ◽  
Kisumu City ◽  
Risk Of Disease ◽  
Joint Monitoring ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background The sharing of sanitation facilities is a common practice in low-income areas in sub-Saharan Africa. However, shared sanitation is currently categorized as a limited sanitation service, and may therefore not count towards meeting the global goals. These shared facilities are often the only option available for most residents in low-income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation facilities in low-income settlements of Kisumu city, Kenya. Methods Thirty-nine in-depth interviews and 11 focus group discussions were held with residents – mainly tenants and landlords – of a low-income settlement in Kisumu. Analysis followed a thematic approach to define the problem, specify the target behaviour and identify the changes needed. Results Sanitation facilities were mainly pit latrines, typically shared among landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem-solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation facilities. Conclusion The results highlight the need to focus on social aspects for improvement of cleanliness in shared sanitation facilities in low-income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to provide the millions of low-income residents in Kenya an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the World Health Organization’s (WHO) Joint Monitoring Program’s (JMP) recommendation for high quality shared facilities.

scholarly journals Barriers and opportunities for cleanliness of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Author(s):  
Sheillah Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
World Health ◽  
Group Discussions ◽  
Kisumu City ◽  
Risk Of Disease ◽  
Joint Monitoring ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background: The sharing of sanitation facilities is a common practice in low-income areas in sub-Saharan Africa. However, shared sanitation is currently categorized as a limited sanitation service, and may therefore not count towards meeting the global goals. These shared facilities are often the only option available for most residents in low-income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation facilities in low-income settlements of Kisumu city, Kenya. Methods: Thirty-nine in-depth interviews and 11 focus group discussions were held with residents – mainly tenants and landlords – of a low-income settlement in Kisumu. Analysis followed a thematic approach to define the problem, specify the target behaviour and identify the changes needed. Results: Sanitation facilities were mainly pit latrines, typically shared among landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem-solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation facilities. Conclusion: The results highlight the need to focus on social aspects for improvement of cleanliness in shared sanitation facilities in low-income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to provide the millions of low-income residents in Kenya an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the World Health Organization’s (WHO) Joint Monitoring Program’s (JMP) recommendation for high quality shared facilities

scholarly journals Barriers and opportunities for management of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Author(s):  
Sheillah Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Monitoring Program ◽  
Sub Saharan Africa ◽  
Group Discussions ◽  
Social Challenges ◽  
Risk Of Disease ◽  
Joint Monitoring ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background: Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, the Joint Monitoring Program (JMP) categorizes shared sanitation as a limited sanitation service. These shared facilities are often the only option available for most of the residents in low income settlements, and improving their management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved management of shared sanitation in low income settlements of Kisumu in Kenya. Methods: Thirty-nine In-depth interviews and 11 focus group discussions were held with residents, who mainly included tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change. Results: Pit latrines were commonly shared among landlords and tenants. Shared sanitation facilities were unclean due to poor use and lack of cleaning. Participants identified behavioural challenges such as poor use of the shared toilets, and social challenges such as lack of cooperation in cleaning. These results led to identification of opportunities for improvement such as instituting clear cleaning plans, communication among users, and problem solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the management of shared sanitation. Conclusion: The results highlight the need to focus on social aspects for improvement of shared sanitation management in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income dwellers an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for high quality shared facilities.

scholarly journals Barriers and opportunities for management of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Author(s):  
Sheillah Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
Group Discussions ◽  
Open Defecation ◽  
Key Stakeholders ◽  
Social Opportunities ◽  
Risk Of Disease ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, the JMP categorizes shared sanitation as a limited sanitation service due to concerns of cleanliness and safety. The shared facilities are often the only option available for most of the residents in low income settlements, and improving the management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved management of shared sanitation in low income settlements of Kisumu in Kenya.Methods Thirty nine In-depth interviews and 11 Focus group discussions were held with residents, including tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change.Results Pit latrines were commonly shared among landlords and tenants. Shared sanitation facilities were unclean due to poor use and lack of cleaning. As respondents specified attributes of clean and useable shared toilets, they also identified behavioural, physical, social and motivational opportunities for improvement, and the key stakeholders that should be involved in shared sanitation interventions. Social opportunities such as clear cleaning plans, communication, and problem solving mechanisms between landlords and tenants were most commonly reported.Conclusion The results highlight the need to focus on social aspects for improvement of shared sanitation management in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income dwellers an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for well managed shared facilities.

scholarly journals Barriers and opportunities for cleanliness of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Author(s):  
Sheillah Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
Group Discussions ◽  
Open Defecation ◽  
Social Approach ◽  
Target Behaviour ◽  
Risk Of Disease ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background: Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, shared sanitation is categorized as a limited sanitation service, and they may therefore not count towards achieving the global goals. These shared facilities are often the only option available for most residents in low income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation in low income settlements of Kisumu in Kenya. Methods: Thirty-nine In-depth interviews and 11 focus group discussions were held with residents, who were mainly tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change. Results: Sanitation facilities were mainly pit latrines commonly shared among landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation. Conclusion: The results highlight the need to focus on social aspects for improvement of shared sanitation cleanliness in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income residents an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for high quality shared facilities.

scholarly journals Mapping evidence on the distribution of paediatric cancers in sub-Saharan Africa: a scoping review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Sehlisiwe R. Ndlovu ◽  
Desmond Kuupiel ◽  
Themba G. Ginindza
Keyword(s):  
Scoping Review ◽  
Low Income ◽  
Relevant Literature ◽  
Sub Saharan Africa ◽  
World Health ◽  
Low Income Countries ◽  
Future Research ◽  
International Agency ◽  
Healthcare Needs ◽  
Sub Saharan

Abstract Background Paediatric cancers account for a minor fraction of deaths and hence receive little attention from policymakers. In low-income countries, the absence of comprehensive national paediatric strategies results in a lack of access for a majority of children with cancer. In sub-Saharan Africa (SSA), the burden of childhood cancers is underestimated due to a lack of paediatric cancer registries, poor health care systems and competing healthcare needs. The objective of this study is to map evidence on the distribution of paediatric cancers in the SSA region. Method A scoping review will be conducted to map literature on the distribution of paediatric cancers in SSA. An electronic literature search will be conducted from the following databases: PubMed, Google Scholar, EBSCOhost (CINAHL and Health Source) and World Health Organization (WHO)/International Agency for Research in Cancer (IARC) (GLOBOCAN databases). We will also search the reference lists of included studies to source relevant literature. A pilot search was conducted to determine the feasibility of the study. Study selection will be guided by the inclusion and exclusion criteria. After charting the data, a descriptive overview of the studies will be presented in a narrative format. An account of the study characteristics will be described in this narrative. The analysis will be mainly based on mapping the country-specific outcomes emerging from the studies, and a numerical summary of these outcomes will be conducted. Tables, maps and charts will be produced and presented in the result section. Discussion This review study will identify existing research gaps for future research to influence policy implementation and to improve the availability of diagnosis and treatment of paediatric cancers in SSA.

scholarly journals Access to improved sanitation facilities in low-income informal settlements of East African cities

2014 ◽  
Vol 5 (1) ◽  
pp. 89-99 ◽  
Author(s):  
K. Okurut ◽  
R. N. Kulabako ◽  
P. Abbott ◽  
J. M. Adogo ◽  
J. Chenoweth ◽  
...  
Keyword(s):  
Low Income ◽  
Urban Areas ◽  
Informal Settlement ◽  
Informal Settlements ◽  
Sub Saharan Africa ◽  
East African ◽  
Basic Sanitation ◽  
Improved Sanitation ◽  
Joint Monitoring ◽  
Sub Saharan

Throughout Africa, the population in urban areas is increasing rapidly, often exceeding the capacity and the resources of the cities and towns to accommodate the people. In sub-Saharan Africa, the majority of urban dwellers live in informal settlements served by inadequate sanitation facilities. These settlements present unique challenges to the provision of sustainable and hygienic sanitation, and there is insufficient information on access to improved facilities. This paper reports findings of a study undertaken in low-income informal settlements using a mixed methods approach to assess access to sanitation and identify the barriers to household uptake of improved sanitation facilities. More than half of the respondents (59.7%) reported using sanitation facilities that are included in the WHO/UNICEF Joint Monitoring Programme definition of improved sanitation. However, a high proportion of these facilities did not provide access to basic sanitation. Less than 5% of all the respondents did not report problems related to sustainable access to basic sanitation. The findings highlight the urgent need to develop specific and strategic interventions for each low-income informal settlement, to upscale the sustainable access and use of improved sanitation in urban centres.

scholarly journals The practice of evaluating epidemic response in humanitarian and low-income settings: a systematic review

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Abdihamid Warsame ◽  
Jillian Murray ◽  
Amy Gimma ◽  
Francesco Checchi
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Grey Literature ◽  
Sub Saharan Africa ◽  
World Health ◽  
Public Health Response ◽  
Wide Variability ◽  
Sub Saharan ◽  
Health Organization ◽  
Epidemic Response

Abstract Background Epidemics of infectious disease occur frequently in low-income and humanitarian settings and pose a serious threat to populations. However, relatively little is known about responses to these epidemics. Robust evaluations can generate evidence on response efforts and inform future improvements. This systematic review aimed to (i) identify epidemics reported in low-income and crisis settings, (ii) determine the frequency with which evaluations of responses to these epidemics were conducted, (iii) describe the main typologies of evaluations undertaken and (iv) identify key gaps and strengths of recent evaluation practice. Methods Reported epidemics were extracted from the following sources: World Health Organization Disease Outbreak News (WHO DON), UNICEF Cholera platform, Reliefweb, PROMED and Global Incidence Map. A systematic review for evaluation reports was conducted using the MEDLINE, EMBASE, Global Health, Web of Science, WPRIM, Reliefweb, PDQ Evidence and CINAHL Plus databases, complemented by grey literature searches using Google and Google Scholar. Evaluation records were quality-scored and linked to epidemics based on time and place. The time period for the review was 2010–2019. Results A total of 429 epidemics were identified, primarily in sub-Saharan Africa, the Middle East and Central Asia. A total of 15,424 potential evaluations records were screened, 699 assessed for eligibility and 132 included for narrative synthesis. Only one tenth of epidemics had a corresponding response evaluation. Overall, there was wide variability in the quality, content as well as in the disease coverage of evaluation reports. Conclusion The current state of evaluations of responses to these epidemics reveals large gaps in coverage and quality and bears important implications for health equity and accountability to affected populations. The limited availability of epidemic response evaluations prevents improvements to future public health response. The diversity of emphasis and methods of available evaluations limits comparison across responses and time. In order to improve future response and save lives, there is a pressing need to develop a standardized and practical approach as well as governance arrangements to ensure the systematic conduct of epidemic response evaluations in low-income and crisis settings.

Improving Hand Hygiene Practices in a Rural Hospital in Sub-Saharan Africa

2016 ◽  
Vol 37 (7) ◽  
pp. 834-839 ◽  
Author(s):  
Ian C. Holmen ◽  
Celestin Seneza ◽  
Berthine Nyiranzayisaba ◽  
Vincent Nyiringabo ◽  
Mugisha Bienfait ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Low Income ◽  
Rural Hospital ◽  
Sub Saharan Africa ◽  
World Health ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
Quasi Experimental ◽  
Sub Saharan

OBJECTIVETo improve hand hygiene (HH) compliance among physicians and nurses in a rural hospital in sub-Saharan Africa (SSA) using the World Health Organization’s (WHO’s) Guidelines on Hand Hygiene in Health Care.DESIGNThis study was a quasi-experimental design divided into 4 phases: (1) preparation of materials and acquisition of the hospital administration’s support, (2) baseline evaluation, (3) intervention, and (4) follow-up evaluation.SETTINGA 160-bed, non-referral hospital in Gitwe, RwandaPARTICIPANTSA total of 12 physicians and 54 nurses participated in this study.METHODSThe intervention consisted of introducing locally produced alcohol-based hand rub (ABHR); educating healthcare workers (HCWs) on proper HH practice; providing pocket-sized ABHR bottles for HCWs; placing HH reminders in the workplace; and surveying HCWs at surrounding health centers regarding HH compliance barriers. Hand hygiene infrastructure, compliance, and knowledge were assessed among physicians and nurses using baseline observations and a follow-up evaluation survey.RESULTSOverall, HH compliance improved from 34.1% at baseline to 68.9% post intervention (P<.001), and HH knowledge was significantly enhanced (P<.001). The 3 departments included in this study had only 1 sink for 29 patient rooms, and 100% of HH opportunities used ABHR. Hand hygiene compliance was significantly higher among physicians than nurses both before and after the intervention. All measures of HH compliance improved except for “after body fluid exposure,” which was 51.7% before intervention and 52.8% after intervention (P>.05).CONCLUSIONHand hygiene campaigns using WHO methods in SSA have been implemented exclusively in large, referral hospitals. This study shows that an HH program using the WHO tools successfully improved HH in a low-income, rural hospital in SSA.Infect Control Hosp Epidemiol2016;37:834–839

scholarly journals Influence of Religion and Religiosity on Fertility and Contraceptive Use in Continental Sub-Saharan Africa: A Comprehensive Review

2021 ◽  
Author(s):  
Nicola Turner
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Negative Relationship ◽  
Qualitative Studies ◽  
Sub Saharan Africa ◽  
Religious Leaders ◽  
Group Discussions ◽  
Sub Saharan ◽  
Indigenous Religions ◽  
Depth Interviews

The global human population has been increasing at an alarming rate over the last 100 years and is projected by the United Nations (UN) to continue to increase and reach 10 billion by 2057, despite a declining growth rate. Although some countries and regions, primarily Japan and Europe, have stabilised or declining populations, Sub-Saharan Africa is dramatically growing at an annual rate of 2.7% as of 2019, and is projected to sustain a rapid population growth up to 2100. Addressing the subject of population growth and overpopulation is an important but unfortunately neglected task. The consequences of a large, growing human population are already having distressing impacts on the planet, both on the natural environment and on humans, especially women and children. Until recently, there have been few studies on the effects of religion and religiosity on fertility and contraceptive use, and these factors are often overlooked as possible determinants. The aim of this review is to explore and seek to clarify the role of religion and religiosity on fertility and contraceptive use in continental Sub-Saharan African countries. The review of quantitative publications supported by insights and opinions from actual quotes of respondents from qualitative studies shows that followers of African Indigenous Religions and Islam have higher fertility rates than followers of Christianity. Across Christian denominations, Catholics generally had higher fertility than Protestants although the difference is small. Followers of the Apostolic Church exhibited the highest fertility among Christian groups. Focus group discussions and in-depth interviews from the qualitative studies found that religious beliefs were frequently cited as a barrier to contraceptive uptake. The findings clearly suggest that religion influences fertility and contraceptive use, although countries differ in this respect. Few studies mentioned religiosity; existing results show a positive relationship across Sub-Saharan Africa between degree of religiosity and fertility, and a negative relationship with contraceptive use. These relationships are stronger in Islamic and Indigenous religions compared with Christianity. Religious leaders across all religions were found to be highly influential and many participants were inclined to follow the recommendations of religious leaders regarding fertility and contraceptive use. The implication of this finding is that educating religious leaders about rights-based family planning and its benefits should be part of a comprehensive strategy to increase contraceptive uptake and reduce fertility. With knowledge of its benefits, religious leaders could spread accurate messages about family planning to their followers and promote higher contraceptive use and low fertility. In addition, other important socioeconomic and cultural factors influence fertility and contraceptive use. Education, economy and access to family planning have a negative relationship with religiosity, but the strength of this relationship varies depending on religion, residence and region, with Muslims generally reported as the most disadvantaged in terms of education and wealth across Sub-Saharan Africa. Polygyny, gender attitudes, social status and misconceptions about family planning were additional influences on fertility and contraceptive use mentioned in focus group discussions and in-depth interviews from the qualitative studies. Religion and religiosity have an important role to play in relation to fertility and contraceptive use, but they also depend on other factors, their interactions and their relative influences. They have variable relationships to education, economy, gender equality, residence (rural/urban) and access to family planning, due to the different levels of these factors among and within countries in Sub-Saharan Africa. The review suggests that with a more religiously open stance towards family planning, population policies can be more easily implemented. Religion and religiosity need to be considered in surveys and studies on fertility and contraceptive use to inform and help policymakers, economic planners, program managers, researchers and survey specialists. In addition, this has the potential to improve environmental conditions in Sub-Saharan Africa.

Monetary Policy in Sub-Saharan Africa

2018 ◽  
Keyword(s):  
Monetary Policy ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Policy Regimes ◽  
Export Prices ◽  
Policy Work ◽  
Sub Saharan ◽  
Policy Guidance

Having broadly stabilized inflation over the past two decades, many policymakers in sub-Saharan Africa are now asking more of their monetary policy frameworks. They are looking to avoid policy misalignments and respond appropriately to both domestic and external shocks, including swings in fiscal policy and spikes in food and export prices. In many cases they are finding current regimes—often characterized as ‘money targeting’—lacking, with opaque and sometimes inconsistent objectives, inadequate transmission of policy to the economy, and difficulties in responding to supply shocks. At the same time, little existing research on monetary policy is targeted to low-income countries. What do we know about the empirics of monetary transmission in low-income countries? (How) Does monetary policy work in countries characterized by a huge share of food in consumption, underdeveloped financial markets, and opaque policy regimes? (How) Can we use methods largely derived in advanced countries to answer these questions? And (how) can we use the results to guide policymakers? This book draws on years of research and practice at the IMF and in central banks from the region to shed empirical and theoretical light on these questions and to provide practical tools and policy guidance. A key feature of the book is the application of dynamic general equilibrium models, suitably adapted to reflect key features of low-income countries, for the analysis of monetary policy in sub-Saharan African countries.

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