The case for community-based approaches to integrated governance of climate change and health: perspectives from Lagos, Nigeria

2021 ◽  
Vol 9s7 ◽  
pp. 7-32
Author(s):  
Tolu Oni ◽  
Taibat Lawanson ◽  
Ebele Mogo

In many low- and middle-income countries, urbanisation and urban development are characterised by hazards that conspire with climatic risks and socio-economic vulnerability to influence population health inequality now and in the future. A large part of the epidemiological profile across countries in the �Global South�, has been influenced by a rapid rate of urbanisation and interlinked factors such as climate and ecology. This necessitates an integrated approach to governance for health and climate change. Through three case studies in Lagos, we explore real-life examples that demonstrate these interdependencies, noting approaches taken and missed opportunities. We conclude by reflecting on these experiences, as well as historical examples of comprehensive systems approaches to health, to propose a community-oriented model for integrated climate change and health action in rapidly growing cities.

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Guy Howard ◽  
Anisha Nijhawan ◽  
Adrian Flint ◽  
Manish Baidya ◽  
Maria Pregnolato ◽  
...  

AbstractClimate change presents a major threat to water and sanitation services. There is an urgent need to understand and improve resilience, particularly in rural communities and small towns in low- and middle-income countries that already struggle to provide universal access to services and face increasing threats from climate change. To date, there is a lack of a simple framework to assess the resilience of water and sanitation services which hinders the development of strategies to improve services. An interdisciplinary team of engineers and environmental and social scientists were brought together to investigate the development of a resilience measurement framework for use in low- and middle-income countries. Six domains of interest were identified based on a literature review, expert opinion, and limited field assessments in two countries. A scoring system using a Likert scale is proposed to assess the resilience of services and allow analysis at local and national levels to support improvements in individual supplies, identifying systematic faults, and support prioritisation for action. This is a simple, multi-dimensional framework for assessing the resilience of rural and small-town water and sanitation services in LMICs. The framework is being further tested in Nepal and Ethiopia and future results will be reported on its application.


2020 ◽  
Author(s):  
Master R.O. Chisale ◽  
Sheena Ramazanu ◽  
Joseph Tsung-Shu Wu ◽  
Frank W. Sinyiza ◽  
Thokozani Bvumbwe ◽  
...  

Abstract Background World Health Organisation (WHO) has approved and recommended several public health measures to halt the Coronavirus Disease 2019 (COVID-19) pandemic. The implementation of recommended interventions vary between higher income and Low and Middle-Income Countries (LMICs). The economical constraints within LMICs posed challenges in accessing resources for COVID-19 prevention. The study aimed to identify the workable community-based interventions being utilised in LMICs.Main body We applied systematic review approach for this study. Included articles were searched in eight online databases. The analysis was guided by the acceptable of best practice developed by the PROSPERO and COCHRANE for systematic search and selection of articles using pre-defined search terms. Furthermore, a PRISMA flow diagram was used to show the number of articles retrieved, retained, excluded with rationales given for every action. Studies conducted on community-based intervention for preventing COVID-19 and levels of knowledge, attitudes and practice (KAP) on community-based intervention for preventing COVID-19 regardless of the design were included. A mixed method appraisal tool (MMAT) was used to appraise studies.Six studies from LMICs were included for detail analysis after the systematic review screening process from 10,100 articles. The quality assessment using MMAT tool appraised these articles were all in highest quality. Among the six articles, 10 community-based interventions were implemented in LMICs. The three key workable and implemented interventions are: use of masks, social distance and hand wash. The review identified varying levels of KAP between LMICs and social-demographical factors affecting KAP in these settings.Conclusion This systematic review has identified the community-based interventions implemented in LMICs to prevent COVID-19 during the pandemic and key factors affecting the level of KAP among the population. This study re-affirms the importance of effective and suitable implementation of the identified interventions. More studies need to be conducted in LMICs to establish the effectiveness and adoption of the implemented and recommended interventions.


2020 ◽  
Vol 35 (7) ◽  
pp. 855-866 ◽  
Author(s):  
Sergio Torres-Rueda ◽  
Giulia Ferrari ◽  
Stacey Orangi ◽  
Regis Hitimana ◽  
Emmanuelle Daviaud ◽  
...  

Abstract Violence against women and girls (VAWG) is a global problem with profound consequences. Although there is a growing body of evidence on the effectiveness of VAWG prevention interventions, economic data are scarce. We carried out a cross-country study to examine the costs of VAWG prevention interventions in low- and middle-income countries. We collected primary cost data on six different pilot VAWG prevention interventions in six countries: Ghana, Kenya, Pakistan, Rwanda, South Africa and Zambia. The interventions varied in their delivery platforms, target populations, settings and theories of change. We adopted a micro-costing methodology. We calculated total costs and a number of unit costs common across interventions (e.g. cost per beneficiary reached). We used the pilot-level cost data to model the expected total costs and unit costs of five interventions scaled up to the national level. Total costs of the pilots varied between ∼US $208 000 in a small group intervention in South Africa to US $2 788 000 in a couples and community-based intervention in Rwanda. Staff costs were the largest cost input across all interventions; consequently, total costs were sensitive to staff time use and salaries. The cost per beneficiary reached in the pilots ranged from ∼US $4 in a community-based intervention in Ghana to US $1324 for one-to-one counselling in Zambia. When scaled up to the national level, total costs ranged from US $32 million in Ghana to US $168 million in Pakistan. Cost per beneficiary reached at scale decreased for all interventions compared to the pilots, except for school-based interventions due to differences in student density per school between the pilot and the national average. The costs of delivering VAWG prevention vary greatly due to differences in the geographical reach, number of intervention components and the complexity of adapting the intervention to the country. Cost-effectiveness analyses are necessary to determine the value for money of interventions.


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