scholarly journals Will Households Invest in Safe Sanitation? Results from an Experimental Demand Trial in Nakuru, Kenya

2021 ◽  
Vol 18 (9) ◽  
pp. 4462
Author(s):  
Rachel Peletz ◽  
Caroline Delaire ◽  
Joan Kones ◽  
Clara MacLeod ◽  
Edinah Samuel ◽  
...  
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Health Concern ◽  
High Quality ◽  
Market Prices ◽  
Price Point ◽  
Improved Sanitation ◽  
Sanitation Infrastructure ◽  
The City ◽  
Experimental Demand

Unsafe sanitation is an increasing public health concern for rapidly expanding cities in low-income countries. Understanding household demand for improved sanitation infrastructure is critical for planning effective sanitation investments. In this study, we compared the stated and revealed willingness to pay (WTP) for high-quality, pour-flush latrines among households in low-income areas in the city of Nakuru, Kenya. We found that stated WTP for high-quality, pour-flush latrines was much lower than market prices: less than 5% of households were willing to pay the full costs, which we estimated between 87,100–82,900 Kenyan Shillings (KES), or 871–829 USD. In addition, we found large discrepancies between stated and revealed WTP. For example, 90% of households stated that they would be willing to pay a discounted amount of 10,000 KES (100 USD) for a high-quality, pour-flush latrine, but only 10% of households redeemed vouchers at this price point (paid via six installment payments). Households reported that financial constraints (i.e., lack of cash, other spending priorities) were the main barriers to voucher redemption, even at highly discounted prices. Our results emphasize the importance of financial interventions that address the sizable gaps between the costs of sanitation products and customer demand among low-income populations.

scholarly journals Understanding the Barriers and Opportunities for Effective Management of Shared Sanitation in Low-Income Settlements—The Case of Kumasi, Ghana

2020 ◽  
Vol 17 (12) ◽  
pp. 4528 ◽  
Author(s):  
Prince Antwi-Agyei ◽  
Bismark Dwumfour-Asare ◽  
Kwaku Amaning Adjei ◽  
Raphael Kweyu ◽  
Sheillah Simiyu
Keyword(s):  
Low Income ◽  
Management Practices ◽  
Facility Management ◽  
Low Income Countries ◽  
Group Discussions ◽  
High Quality ◽  
Water Closet ◽  
Daunting Task ◽  
Improved Sanitation ◽  
Barriers And Opportunities

Improved sanitation for all is a daunting task for low-income countries, and shared toilets often provide an alternative to private household sanitation for most urban residents. This study sought to provide better understanding of the existing barriers and opportunities for improved management of shared sanitation. The study used focus group discussions and in-depth interviews with 70 users (landlords and tenants) of shared sanitation in Kumasi, Ghana to assess barriers and opportunities of “high-quality” shared sanitation. The commonly used toilet facilities were dry toilets—Kumasi Ventilated Improved Pit latrine and Ventilated Improved Pit latrines; and flush systems—water closet and pour flush connected to septic tanks. Between 2 and 21 households, or 4 and 84 people, shared one facility. Participants’ description of “high-quality” (Ideal) shared sanitation was centred on cleanliness, user behaviour, smell, and user crowding. They also identified challenges of shared sanitation as overcrowded users, poor user behaviours, conflicts among users, and high cost associated with frequent desludging. However, opportunities for improvement included users’ preference for shared toilets due to enjoyed benefits, existing facility management practices, and mutual understanding among users (tenants and landlords). Interventions and policy guidelines to influence behaviour change of shared sanitation users are proposed and are intended to be delivered by local government and users.

scholarly journals Bias in the perceived prevalence of open defecation: evidence from Bihar, India

2020 ◽  
Author(s):  
Jinyi Kuang ◽  
Erik Thulin ◽  
Sania Ashraf ◽  
Alex Shpenev ◽  
Upasak Das ◽  
...  
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Health Concern ◽  
Open Defecation ◽  
Behavior Change Interventions ◽  
Significant Public Health Concern ◽  
False Consensus ◽  
Significant Public Health ◽  
Consensus Bias ◽  
Actual Prevalence

People often form perceptions about how prevalent a behavior is in a social group. However, these perceptions can be inaccurate and biased. While persistent undesirable practices in low-income countries have drawn global attention, evidence regarding people’s perception of how prevalent these practices are is scarce. Among those harmful practices, open defecation in India remains a significant public health concern, where it perpetuates the vicious cycle of disease and poverty. In this study, we focus on measuring the perceived prevalence of open defecation among respondents in Bihar, India. We examined the bias in perceived prevalence, which is defined as a pattern of deviation from the actual prevalence of open defecation. Results showed that respondents who defecate in the open overestimate the prevalence of open defecation, whereas those who consistently use toilets underestimate it. This finding suggests a false consensus bias in the perceived prevalence of open defecation. Scholars, policymakers, and program implementers who seek to correct misperceptions about open defecation by broadcasting real prevalence should be aware of biases in the perceived prevalence and address them in behavior change interventions.

Improving life after stroke needs global efforts to implement evidence-based physical activity pathways

2019 ◽  
Vol 14 (5) ◽  
pp. 457-459 ◽  
Author(s):  
Frederike van Wijck ◽  
Julie Bernhardt ◽  
Sandra A Billinger ◽  
Marie-Louise Bird ◽  
Janice Eng ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Best Practice ◽  
Recurrent Stroke ◽  
Cost Effective ◽  
Preliminary Evidence ◽  
Low Income Countries ◽  
Active Lifestyle ◽  
High Quality ◽  
The World

There is an urgent need to improve life after stroke across the world—especially in low-income countries—through methods that are effective, equitable and sustainable. This paper highlights physical activity (PA) as a prime candidate for implementation. PA reduces modifiable risk factors for first and recurrent stroke and improves function and activity during rehabilitation and following discharge. Preliminary evidence also indicates PA is cost-effective. This compelling evidence urgently needs to be translated into seamless pathways to enable stroke survivors across the world to engage in a more active lifestyle. Although more quality research is needed—particularly on how to optimize uptake and maintenance of PA—this should not delay implementation of high-quality evidence already available. This paper shares examples of best practice service models from low-, middle-, and high-income countries around the world. The authors call for a concerted effort to implement high-quality PA services to improve life after stroke for all.

scholarly journals Availability of ENT Surgical Procedures and Medication in Low-Income Nation Hospitals: Cause for Concern in Zambia

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Lufunda Lukama ◽  
Chester Kalinda ◽  
Warren Kuhn ◽  
Colleen Aldous
Keyword(s):  
Surgical Procedures ◽  
Low Income ◽  
Care Delivery ◽  
National Policy ◽  
Low Income Countries ◽  
Health Concern ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Essential Drugs ◽  
High Prevalence

Background. Ear, nose, and throat (ENT) diseases are an oft overlooked global health concern. Despite their high prevalence and associated morbidity and mortality, ENT diseases have remained neglected in health care delivery. In Zambia and many other low-income countries, ENT services are characterized by poor funding, unavailable surgical procedures, and erratic supply of essential drugs. Objective. To investigate ENT service provision in Zambia with regard to availability of surgical procedures and supply of essential drugs. Methods. A descriptive cross-sectional survey was conducted using a piloted structured questionnaire between 17 January 2017 and 2 January 2018. Included in the study were the 109 hospitals registered with the Ministry of Health (MoH) across the 10 provinces of Zambia. Results. Of the participating hospitals, only 5.9% (n=1) and 40% (n=2) of Second-Level Hospitals (SLH) and Third-Level Hospitals (TLH), respectively, carried out tympanoplasty, myringotomy, and grommet insertion (M+G). Frontal trephination and external ethmoidectomy were offered in 11.7% (n=2) and 40% (n=2) of SLH and TLH, respectively. While tracheostomy (39.3%, n=24), tonsillectomy (27.9%, n=17), and adenoidectomy (27.9%, n=17) were the most widely performed head and neck procedures, laryngectomy was carried out by 1 hospital. Between 14.8% (n=9) and 36.1% (n=22) of hospitals lacked antibiotic and/or antiseptic ear drops. Despite 96.7% (n=59) of the respondents acknowledging ENT as an important branch of clinical practice, only 15.3% (n=4) of the hospitals had a budget for ENT. Also, 6.6% (n=4) of the respondents thought the discipline of ENT had received enough attention. Conclusion. ENT service delivery in Zambia is limited with regard to performed surgical procedures and availability of essential drugs, necessitating urgent intervention. The findings from this study may be used to direct national policy on the improvement of provision of ENT services in Zambia.

scholarly journals Analysing Urban Development Patterns in a Conflict Zone: A Case Study of Kabul

2020 ◽  
Vol 12 (21) ◽  
pp. 3662
Author(s):  
Vineet Chaturvedi ◽  
Monika Kuffer ◽  
Divyani Kohli
Keyword(s):  
High Resolution ◽  
Urban Growth ◽  
Low Income ◽  
Image Features ◽  
Capital City ◽  
Aerial Photographs ◽  
Low Income Countries ◽  
Maximum Pressure ◽  
Rapid Urbanization ◽  
The City

A large part of the population in low-income countries (LICs) lives in fragile and conflict-affected states. Many cities in these states show high growth dynamics, but little is known about the relation of conflicts and urban growth. In Afghanistan, the Taliban regime, which lasted from 1996 to 2001, caused large scale displacement of the population. People from Afghanistan migrated to neighboring countries like Iran and Pakistan, and all developments came to a halt. After the US invasion in October 2001, all the major cities in Afghanistan experienced significant population growth, in particular, driven by the influx of internally displaced persons. Maximum pressure of this influx was felt by the capital city, Kabul. This rapid urbanization, combined with very limited capacity of local authorities to deal with this growth, led to unplanned urbanization and challenges for urban planning and management. This study analyses the patterns of growth between 2001 and 2017, and the factors influencing the growth in the city of Kabul with the help of high-resolution Earth Observation-based data (EO) and spatial logistic regression modelling. We analyze settlement patterns by extracting image features from high-resolution images (aerial photographs of 2017) and terrain features as input to a random forest classifier. The urban growth is analyzed using an available built-up map (extracted from IKONOS images for the year 2001). Results indicate that unplanned settlements have grown 4.5 times during this period, whereas planned settlements have grown only 1.25 times. The unplanned settlements expanded mostly towards the west and north west parts of the city, and the growth of planned settlements happened mainly in the central and eastern parts of the city. Population density and the locations of military bases are the most important factors that influence the growth, of both planned and unplanned settlements. The growth of unplanned settlement occurs predominantly in areas of steeper slopes on the hillside, while planned settlements are on gentle slopes and closer to the institutional areas (central and eastern parts of the city). We conclude that security and availability of infrastructure were the main drivers of growth for planned settlements, whereas unplanned growth, mainly on hillsides, was driven by the availability of land with poor infrastructure.

Improving access to water supply and sanitation in urban India: microfinance for water and sanitation infrastructure development

2008 ◽  
Vol 58 (4) ◽  
pp. 887-891 ◽  
Author(s):  
Jenna Davis ◽  
Gary White ◽  
Said Damodaron ◽  
Rich Thorsten
Keyword(s):  
Water Supply ◽  
Low Income ◽  
Infrastructure Development ◽  
Sanitation Services ◽  
Poor Households ◽  
Access To Water ◽  
Water And Sanitation Infrastructure ◽  
Sanitation Infrastructure ◽  
The City ◽  
Water Supply And Sanitation

This article summarises initial findings of a study to explore the potential of providing micro-financing for low-income households wishing to invest in improved water supply and sanitation services. Through in-depth interviews with more than 800 households in the city of Hyderabad in India, we conclude that, even if provided with market (not concessional) rates of financing, a substantial proportion of poor households would invest in water and sewer network connections.

scholarly journals Moving up the sanitation ladder with the help of microfinance in urban Malawi

2017 ◽  
Vol 8 (1) ◽  
pp. 100-112 ◽  
Author(s):  
Richard Chunga ◽  
M. W. Jenkins ◽  
Jeroen Ensink ◽  
Joe Brown
Keyword(s):  
Low Income ◽  
Stated Preference ◽  
Wealth Quintile ◽  
Local Market ◽  
Market Prices ◽  
Urban Settlements ◽  
Improved Sanitation ◽  
Sanitation Ladder ◽  
Improve Access ◽  
Gain Access

Abstract We carried out a stated preference survey in Malawi to examine whether access to microfinance for sanitation would significantly increase the proportion of households upgrading to improved pit latrines or alternative improved sanitation technologies (urine diverting dry toilet, fossa alterna, pour flush). We presented a range of sanitation options at local market prices, initially without and then with a real microfinance option, to 1,300 households sampled across 27 low-income urban settlements in the two largest cities, Lilongwe and Blantyre. When we gave respondents a microfinance option, the proportion of households stating an intention to install improved and unimproved pit latrines decreased significantly, while the proportion stating an intention to upgrade to alternative improved sanitation technologies increased significantly. However, households in the lowest wealth quintile were more likely to state a preference for unimproved pit latrines, suggesting that the benefits of microfinance for sanitation may not accrue equally across wealth strata. Organisations seeking to improve access to safely managed sanitation by promoting alternative sanitation technologies would succeed if households have access to affordable alternative sanitation technologies and microfinance for sanitation. However, poorer households would need more affordable improved sanitation technologies, flexible microfinance options and possibly targeted subsidies to gain access to safely managed sanitation.

scholarly journals Child Maltreatment and associated Sociodemographic factors among Children affected by HIV/AIDS in Ghana: A Multi-Informant Perspective

2021 ◽  
Author(s):  
Paul Narh Doku
Keyword(s):  
Child Maltreatment ◽  
Low Income ◽  
Sociodemographic Factors ◽  
Low Income Countries ◽  
Health Concern ◽  
Vulnerable Children ◽  
Cross Sectional ◽  
Orphans And Vulnerable Children ◽  
Systemic Risks ◽  
Hiv Aids

Abstract Background: Child maltreatment and its consequences are considered a major public health concern among children because they can cause significant physical and psychological problems. Child maltreatment is widespread but often underestimated. Surprisingly, there is hardly any data on the frequency of child maltreatment in general and particularly on orphans and vulnerable children in low-income countries. Method: This study employed cross-sectional, quantitative survey that involved 291 children aged 10–17 years in Lower Manya Krobo District, Ghana and examined their exposure to and experience of child maltreatment. The survey also examined parents/caregivers’ exposure and perpetuation of child maltreatment. Results: Some form of maltreatment within the household was reported by approximately 90% of children, and it was significantly higher among orphans and vulnerable children (OVC) as compared with comparison children. Children living with HIV/AIDS-infected parents and orphans of any type reported higher exposure to domestic violence and experienced significantly more neglect, psychological and physical abuse than the comparison children. Conclusion: The results of this survey demonstrate that maltreatment among children affected by HIV/AIDS are not rare, and that the dysfunction family conditions that they find themselves bear systemic risks for maltreatment. It is important that culturally appropriate and evidence-based interventions are implemented to address the maltreatment.

scholarly journals Prevalence and Associated Risk Factors for Anaemia Among Pregnant Women Attending Ante-Natal Clinic, Eswatini

2021 ◽  
Author(s):  
Rumbidzai Dodzo ◽  
Ropo Ebenezer Ogunsakin ◽  
Themba G. Ginindza
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Cross Sectional Study ◽  
Low Income Countries ◽  
Health Concern ◽  
Cross Sectional ◽  
Neonatal Deaths ◽  
Factors Associated ◽  
Anaemia In Pregnancy ◽  
Associated Risk Factors

Abstract Background: Anaemia is one of the most common nutritional deficiency diseases observed globally and it affects about a third of the world’s population. Anaemia in pregnant women is a worldwide public health concern that has severe consequences for both mothers and infants, including maternal death and foetal and infant mortality. In Low-income countries (LICs), 25% of indirect maternal mortality and 30% of neonatal deaths are due to anaemia in pregnancy. Therefore, this study aimed to determine the prevalence of anaemia and assess associated factors among pregnant women attending ante-natal care (ANC) clinic in the Kingdom of Eswatini, which might help for screening, prevention and treatment of anaemia and ultimately prevent its adverse effects. Method: A total of 550 pregnant women between 15 and 49 years from three health facilities were randomly enrolled using a cross-sectional study design, from January to March 2021. Non-probability sampling approach was used to select the appropriate study unit. A face-toface interview was done using a structured questionnaire to collect data. Multiple logistic regression was performed to assess the factors associated with anaemia among the women.Results: The overall anaemia prevalence among pregnant women was 43.1% (95% CI: 38.947.3). The mild, moderate and severe cases of anaemia were 21.3% (95%CI: 17.9-24.9); 21.1% (95%CI: 17.8-24.7) and 0.7% (95%CI: 0.2-1.9), respectively. The prevalence of anaemia was high among women aged 20-24 (11.1%, 95%CI: 8.6-14.0) and 25-29years (11.1%, 95%CI: 8.6-14.0). Factors associated with anaemia included living in the urban area (OR=1.8, 95%CI: 1.19-2.72, p=0.005) and having anaemia 6 months before pregnancy (OR=4.64, 95%CI: 1.1518.71, p=0.031). Additionally, gestational age at first ANC also was positively associated with anaemia: 3rd trimester (OR=10.42, 95%CI: 4.27-25.4, p<0.001) and 2nd trimester (OR=1.62, 95%CI: 1.02-2.60, p=0.043) Conclusion: Anaemia remains prevalent among pregnant women in Eswatini. Thus, a comprehensive anaemia prevention program would be justified and could lower the country’s burden of anemia.

scholarly journals Patterns of Injury and Mortality in Pediatric Patients Attending Emergency Department in a Tertiary Care Center in Eastern Nepal

2017 ◽  
Vol 56 (207) ◽  
pp. 331-334 ◽  
Author(s):  
Pramendra Prasad Gupta ◽  
Gyanendra Bahadur Malla ◽  
Rabin Bhandari ◽  
Rosan Prasad Shah Kalawar ◽  
Madan Mandal
Keyword(s):  
Emergency Department ◽  
Low Income ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Soft Tissue Injuries ◽  
Low Income Countries ◽  
Health Concern ◽  
Cross Sectional ◽  
Pattern Of Injury

Introduction: Trauma is a major and increasing global health concern in the recent world is now the leading cause of death among people less than 18 years old. Methods: This is a retrospective cross sectional study done in Emergency Department of B.P.Koirala Institute of Health Sciences. Patients aged less than 16 years were included with history of Trauma from January 1st 2013 to 31st December 2013.The details of patient were taken from computerized medical records of the hospital. The data Demographic data, Pattern of injury, Mode of injury, Diagnosis and outcomes were tabulated in Microsoft excel. Results: Total 3958 pediatrics patient were enrolled in this study. Male: Female=3.6:1,Mean age 9.6±3.2 years, fall injury & RTAs common modes and fractures of limbs, soft tissue injuries and cut injuries were common patterns. Conclusions: Injury is a serious problem for children in Low Income countries like Nepal.

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