Decentralized wastewater management in peri-urban areas in low-income countries

Introduction Recent debates surrounding the lagging covid-19 vaccination campaigns in low-income countries center around vaccine supply and financing. Yet, relatively little is known about attitudes towards covid-19 vaccines in these countries and in Africa in particular. In this paper, we provide cross-country comparable estimates of the willingness to accept a covid-19 vaccine in six Sub-Saharan African countries. Methods We use data from six national high-frequency phone surveys from countries representing 38% of the Sub-Saharan African population (Burkina Faso, Ethiopia, Malawi, Mali, Nigeria, and Uganda). Samples are drawn from large, nationally representative sampling frames providing a rich set of demographic and socio-economic characteristics by which we disaggregate our analysis. Using a set of re-calibrated survey weights, our analysis adjusts for the selection biases common in remote surveys. Results Acceptance rates in the six Sub-Saharan African countries studied are generally high, with at least four in five people willing to be vaccinated in all but one country. Vaccine acceptance ranges from nearly universal in Ethiopia (97.9%, 97.2% to 98.6%) to below what would likely be required for herd immunity in Mali (64.5%, 61.3% to 67.8%). We find little evidence for systematic differences in vaccine hesitancy by sex or age but some clusters of hesitancy in urban areas, among the better educated, and in richer households. Safety concerns about the vaccine in general and its side effects emerge as the primary reservations toward a covid-19 vaccine across countries. Conclusions Our findings suggest that limited supply, not inadequate demand, likely presents the key bottleneck to reaching high covid-19 vaccine coverage in Sub-Saharan Africa. To turn intent into effective demand, targeted communication campaigns bolstering confidence in the safety of approved vaccines and reducing concerns about side effects will be crucial to safeguard the swift progression of vaccine rollout in one of the world's poorest regions.

Download Full-text

Characterization of pit latrines to support the design and selection of emptying tools in peri-urban Mzuzu, Malawi

Journal of Water Sanitation and Hygiene for Development ◽

10.2166/washdev.2017.096 ◽

2017 ◽

Vol 7 (1) ◽

pp. 151-155 ◽

Cited By ~ 4

Author(s):

Rashid Chiposa ◽

Rochelle H. Holm ◽

Chimuleke Munthali ◽

Russel C. G. Chidya ◽

Francis L. de los Reyes

Keyword(s):

Low Income ◽

Urban Areas ◽

Technology Development ◽

Oxygen Demand ◽

Low Income Countries ◽

Urban Neighborhood ◽

Fecal Matter ◽

Pit Latrine ◽

Tool Diameter

The urban areas of many low-income countries must balance a rising demand for pit latrines for household sanitation provision against limitations in space, resulting in a need for pit latrine emptying services. This study was undertaken in the peri-urban neighborhood of Area 1B in the city of Mzuzu, Malawi, to examine the characteristics of household pit latrines for designing and selecting pit latrine emptying tools. We used 150 structured household surveys and field observations. From this, a subset was selected and 30 manual cone penetrometer tests were conducted at full latrines. Chemical oxygen demand analysis was also performed for 14 pit latrines. The results indicated that in addition to serving as a disposal for fecal matter, 90% of households also used pit latrines for domestic waste. Only 10% of the studied pit latrines were lined. The filling rate in the study area is calculated to be about three years, and no respondents reported previous emptying. It is suggested pit latrine emptying technology development focuses on a maximum tool diameter of 10 cm to fit through the keyhole (squat hole) and height of 146 cm to fit inside the superstructure, as well as supporting unlined pits and the ability to pump trash.

Download Full-text

Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2020-038520 ◽

2020 ◽

Vol 10 (9) ◽

pp. e038520

Author(s):

Maria Lisa Odland ◽

Tahir Bockarie ◽

Haja Wurie ◽

Rashid Ansumana ◽

Joseph Lamin ◽

...

Keyword(s):

Risk Factors ◽

Access To Care ◽

Sierra Leone ◽

Low Income ◽

Rural Areas ◽

Urban Areas ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Health System Strengthening ◽

Low Income Countries

IntroductionPrevalence of cardiovascular disease risk factors (CVDRFs) is increasing, especially in low-income countries. In Sierra Leone, there is limited empirical data on the prevalence of CVDRFs, and there are no previous studies on the access to care for these conditions.MethodsThis study in rural and urban Sierra Leone collected demographic, anthropometric measurements and clinical data from randomly sampled individuals over 40 years old using a household survey. We describe the prevalence of the following risk factors: diabetes, hypertension, dyslipidaemia, overweight or obesity, smoking and having at least one of these risk factors. Cascades of care were constructed for diabetes and hypertension using % of the population with the disease who had previously been tested (‘screened’), knew of their condition (‘diagnosed’), were on treatment (‘treated’) or were controlled to target (‘controlled’). Multivariable regression was used to test associations between prevalence of CVDRFs and progress through the cascade for hypertension with demographic and socioeconomic variables. In those with recognised disease who did not seek care, reasons for not accessing care were recorded.ResultsOf 2071 people, 49.6% (95% CI 49.3% to 50.0%) of the population had hypertension, 3.5% (3.4% to 3.6%) had diabetes, 6.7% (6.5% to 7.0%) had dyslipidaemia, 25.6% (25.4% to 25.9%) smoked and 26.5% (26.3% to 26.8%) were overweight/obese; a total of 77.1% (76.6% to 77.5%) had at least one CVDRF. People in urban areas were more likely to have diabetes and be overweight than those living in rural areas. Moreover, being female, more educated or wealthier increased the risk of having all CVDRFs except for smoking. There is a substantial loss of patients at each step of the care cascade for both diabetes and hypertension, with less than 10% of the total population with the conditions being screened, diagnosed, treated and controlled. The most common reasons for not seeking care were lack of knowledge and cost.ConclusionsIn Sierra Leone, CVDRFs are prevalent and access to care is low. Health system strengthening with a focus on increased access to quality care for CVDRFs is urgently needed.

Download Full-text

Africa's cancer burden to rise without funding shift

Emerald Expert Briefings ◽

10.1108/oxan-db201702 ◽

2015 ◽

Keyword(s):

Low Income ◽

Urban Areas ◽

Economic Benefits ◽

World Health ◽

Low Income Countries ◽

Health Priorities ◽

African Countries ◽

Content Type ◽

Cancer Burden ◽

Market Expansion

Subject Cancer burden in Africa. Significance Cancer is a growing public health threat in low-income countries, including African states. With the increase in urbanisation, population growth and improving mortality rates, the World Health Organisation (WHO) estimates that by 2020, 16 million new cases of cancer will be diagnosed each year, with 70% of those in low-income countries. However, the rise in cancer rates has not been met with changes to aid funding. Global health priorities continue to emphasise infectious diseases, and African countries remain ill-equipped to prevent, diagnose or treat cancer. Impacts Rising consumption of processed foods in urban areas will contribute to an overall rise in non-communicable diseases. African countries are some of the fastest growing markets for tobacco companies as health awareness rises in traditional markets. Global brewers will enjoy significant market expansion in Africa, contributing to increased alcohol consumption. Despite the economic benefits, delayed childbearing and lower fertility in women is set to increase the incidence of breast cancer.

Download Full-text

Cost comparison of wastewater treatment in Danubian countries

Water Science & Technology ◽

10.2166/wst.2010.271 ◽

2010 ◽

Vol 62 (2) ◽

pp. 223-230 ◽

Cited By ~ 21

Author(s):

Matthias Zessner ◽

Christoph Lampert ◽

H. Kroiss ◽

S. Lindtner

Keyword(s):

Wastewater Treatment ◽

Low Income ◽

Phosphorus Removal ◽

Cost Comparison ◽

Low Income Countries ◽

Wastewater Management ◽

Nitrogen And Phosphorus ◽

Nitrogen And Phosphorus Removal ◽

Danube Catchment ◽

Catchment Areas

This paper investigates the costs of wastewater treatment (including sludge management) within the Danube catchment countries A, CZ, SK, HU, SL, RO, BG and UA. TK is considered as well. Additionally, the paper compares the total costs of wastewater management (including sewerage) with the incomes in the different countries. The annual costs of wastewater treatment in Austria are about 30 €/p.e. y for large plants with nitrogen and phosphorus removal. In low income countries of the Danube and Black Sea catchment areas they are at a maximum 30% lower than in Austria. However, the incomes in countries like Bulgaria, Romania or Ukraine are 85% to 90% lower. The total annual costs for wastewater management (sewer development plus treatment) amount at least to 90€/p.e. y. Considering the level of income in those countries, financing of wastewater management completely by charges of the population equivalents connected is not feasible. Therefore other approaches for financing wastewater treatment are required.

Download Full-text

The Urban Mortality Transition and Poor-Country Urbanization

American Economic Journal Macroeconomics ◽

10.1257/mac.20170189 ◽

2019 ◽

Vol 11 (1) ◽

pp. 223-275 ◽

Cited By ~ 7

Author(s):

Remi Jedwab ◽

Dietrich Vollrath

Keyword(s):

Population Growth ◽

Low Income ◽

Urban Areas ◽

Poor Country ◽

Natural Increase ◽

Low Income Countries ◽

Poor Countries ◽

Locational Choice ◽

Amenity Effect ◽

Urbanization Rate

Today, the world’s fastest-growing cities lie in low-income countries, unlike the historical norm. Also, unlike the “killer cities” of history, cities in low-income countries grow not just through in-migration but also through their own natural increase. First, we use novel historical data to document that many poor countries urbanized at the same time as the postwar urban mortality transition. Second, we develop a framework incorporating location choice with heterogeneity in demographics and congestion costs across locations to account for this. In the framework, people prefer to live in low-mortality locations, and the aggregate rate of population growth and the locational choice of individuals interact. Third, we calibrate this to data from a sample of poor countries and find that informal urban areas (e.g., slums) can absorb additional population more easily than other locations. We show that between 1950 and 2005 the urban mortality transition could have doubled the urbanization rate as well as the size of informal urban areas in this sample. Of these effects, one-third could be attributed to the amenity effect of lower urban mortality rates, while the remainder is due to higher population growth disproportionately pushing people into informal urban areas. Fourth, simulations suggest that family planning programs, as well as industrialization or urban infrastructure and institutions may be effective in slowing poor-country urbanization. (JEL I12, J11, N30, O15, O18, R11, R23)

Download Full-text

Shared Sanitation Management and the Role of Social Capital: Findings from an Urban Sanitation Intervention in Maputo, Mozambique

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15102222 ◽

2018 ◽

Vol 15 (10) ◽

pp. 2222 ◽

Cited By ~ 3

Author(s):

Tess Shiras ◽

Oliver Cumming ◽

Joe Brown ◽

Becelar Muneme ◽

Rassul Nala ◽

...

Keyword(s):

Social Capital ◽

Low Income ◽

Urban Areas ◽

Management Practices ◽

Disease Risk ◽

Critical Role ◽

Management Strategies ◽

Formal System ◽

Low Income Countries ◽

Change Models

Shared sanitation—sanitation facilities shared by multiple households—is increasingly common in rapidly growing urban areas in low-income countries. However, shared sanitation facilities are often poorly maintained, dissuading regular use and potentially increasing disease risk. In a series of focus group discussions and in-depth interviews, we explored the determinants of shared sanitation management within the context of a larger-scale health impact evaluation of an improved, shared sanitation facility in Maputo, Mozambique. We identified a range of formal management practices users developed to maintain shared sanitation facilities, and found that management strategies were associated with perceived latrine quality. However—even within an intervention context—many users reported that there was no formal system for management of sanitation facilities at the compound level. Social capital played a critical role in the success of both formal and informal management strategies, and low social capital was associated with collective action failure. Shared sanitation facilities should consider ways to support social capital within target communities and identify simple, replicable behavior change models that are not dependent on complex social processes.

Download Full-text

Reevaluating Agricultural Productivity Gaps with Longitudinal Microdata

Journal of the European Economic Association ◽

10.1093/jeea/jvaa043 ◽

2020 ◽

Author(s):

Joan Hamory ◽

Marieke Kleemans ◽

Nicholas Y Li ◽

Edward Miguel

Keyword(s):

Cross Sections ◽

Low Income ◽

Urban Areas ◽

Fixed Effects ◽

Agricultural Sector ◽

Low Income Countries ◽

National Accounts ◽

Cross Sectional ◽

Individual Level ◽

Rural And Urban Areas

Abstract Recent research has pointed to large gaps in labor productivity between the agricultural and non-agricultural sectors in low-income countries, as well as between workers in rural and urban areas. Most estimates are based on national accounts or repeated cross-sections of microsurvey data, and as a result typically struggle to account for individual selection between sectors. This paper uses long-run individual-level panel data from two low-income countries (Indonesia and Kenya) to explore these gaps. Accounting for individual fixed effects leads to much smaller estimated productivity gains from moving into the non-agricultural sector (or urban areas), reducing estimated gaps by roughly 67%–92%. Furthermore, gaps do not emerge up to 5 years after a move between sectors. We evaluate whether these findings imply a re-assessment of the conventional wisdom regarding sectoral gaps, discuss how to reconcile them with existing cross-sectional estimates, and consider implications for the desirability of sectoral reallocation of labor.

Download Full-text