Sanitation MDG is badly off track, but a community-led approach could fix that
Vast sums are wasted on programmes for free toilets, but the community-led total sanitation approach has helped millions avoid often fatal, faecally related infections.
Community-led total sanitation (CLTS) does not sound such a big deal, but it is revolutionary. We have so many “revolutions” in development that only last a year or two and then fade into history. But this one is different. In all the years I have worked in development this is as thrilling and transformative as anything I have been involved in. Let me explain.
Firstly, sanitation and scale: 2.6 billion people need improved sanitation and 1.1 billion defecate in the open. The millennium development goal (MDG) for sanitation is badly off track in most countries, which affects all the other MDGs.
Secondly, sanitation and hygiene matter much more than most people realise. Where they are lacking, the effects are horrendous. Faecally related infections are many. Everyone feels outrage because more than 2 million children are killed by diarrhoea each year. We hear about cholera outbreaks. But who hears about the guts of 1.5 billion people hosting greedy, parasitic, ascaris worms, about 740 million with hookworm voraciously devouring their blood, 200 million with debilitating schistosomiasis or up to 70 million with liver fluke? And what about dysentery, hepatitis, giardia, tapeworms, typhoid, polio, trachoma…?
Matern Child Health J. 2010 Nov;14(6):978-86.
Predictors of preterm births and low birthweight in an inner-city hospital in sub-Saharan Africa.
Olusanya BO, Ofovwe GE.
Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria. firstname.lastname@example.org
Adverse birth outcomes remain significant contributors to perinatal mortality as well as developmental disabilities worldwide but limited evidence exists in sub-Saharan Africa based on a conceptual framework incorporating neighborhood context. This study therefore set out to determine the prevalence and risk factors for preterm births and low birthweight in an urban setting from this region.
J Hum Ecol, 31(1): 19-26 (2010)
Urbanisation and the Choice of Fuel Wood as a Source of Energy in Nigeria
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Y.Y. Babanyara* and U. F. Saleh. Urban and Regional Planning Programme; Abubakar Tafawa Balewa University, P.M. B 0248, Bauchi, Nigeria
This paper discusses the problem of urbanization and fuel wood consumption in Nigeria and the main objective is to examine the causes and effects of degradation of the environment. Between 1990 and 2000, Nigeria lost an average of 409,700 hectares of forest, equal to an average annual deforestation rate of 2.38%. Additionally, between 2000 and 2005, Nigeria lost 35.7% of its forest cover, or around 6,145,000 hectares.
The paper found that the factors causing fuel wood demand in urban areas include, Rural-urban migration, Urbanization, Poverty, Hikes in prices of kerosene and cooking gas amongst others. The paper relied mainly on secondary information from both empirical and non-empirical researches. Furthermore, the consequences of indiscriminate felling of trees such as Deforestation, Desertification, Erosion and Bio-diversity loss were highlighted. The Prospects of harnessing other renewable sources of energy in Nigeria as a measure to reduce the rate of consumption of fuel wood is recommended.
Environmental Health Perspectives, June 2010
Urban Area Disadvantage and Under-5 Mortality in Nigeria: The Effect of Rapid Urbanization
Diddy Antai and Tahereh Moradi Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
Background: Living in socioeconomically disadvantaged areas is associated with increased childhood mortality risks. As city living becomes the predominant social context in low- and middle-income countries, the resulting rapid urbanization together with the poor economic circumstances of these countries greatly increases the risks of mortality for children < 5 years of age (under-5 mortality).
Objective: In this study we examined the trends in urban population growth and urban under‑5 mortality between 1983 and 2003 in Nigeria. We assessed whether urban area socioeconomic disadvantage has an impact on under-5 mortality.
Methods: Urban under-5 mortality rates were directly estimated from the 1990, 1999, and 2003 Nigeria Demographic and Health Surveys. Multilevel logistic regression analysis was performed on data for 2,118 children nested within data for 1,350 mothers, who were in turn nested within data for 165 communities.
Results: Urban under-5 mortality increased as urban population steadily increased between 1983 and 2003. Urban area disadvantage was significantly associated with under-5 mortality after adjusting for individual child- and mother-level demographic and socioeconomic characteristics.
Conclusions: Significant relative risks of under-5 deaths at both individual and community levels underscore the need for interventions tailored toward community- and individual-level interventions. We stress the need for further studies on community-level determinants of under-5 mortality in disadvantaged urban areas.
Nigeria: More Citizens Now Live in Slums – Experts
Lack of effective planning and programme in the housing sector have turned many Nigerian cities into slums, according to Inemesit Akpan
Most cities in Nigeria are fast developing into slums, according to experts at a recent conference on “Sustainable Cities” organised by the New Economic Partnership on African Development (NEPAD), held at the Transcorp Hilton, Abuja.
First to open the ‘pandora box,’ was the Country Representative of UN-Habitat, Professor Johnson Falade with his insightful paper entitled: ” Planned City as Foundation for Sustainable City Development.”
Prof. Falade, started with an explanation of what Sustainable Development is all about, which he defined, as “the development that meets the needs of the present generation without compromising the ability of future generations to meet their own needs.”
He added that sustainable development encompasses key concepts, the issue of ‘needs’ and the idea of ‘limitations: His words; “It contains within it two key concepts: the concepts of ‘needs’, in particular the essential needs of the world’s poor, to which overriding priority should be given; and the idea of limitations imposed by the state of technology and social organisation on the environment’s ability to meet present and future needs.”
An expert on urban development, Prof. Falade also spoke on issues regarding approaches to city developemnt, free interplay of the economic forces of supply and demand to detect land use decisions with many consequences like pollution, congestion and externalities.
Commenting on urbanisation in Nigeria and growth of cities, he spoke about Nigeria’s population which he put at 140 million (2006), population growth rate (2.8% per annum), urban population growth rate (5.8% per annum), urban population by 2007 (70 million – 50%), pointing out that by 2025, “more than 60% will live in towns and cities, while national population will double every three decades.”
He highlighted development challenges of rapid urbanisation without adequate city planning, to include: Emergence of fast growth and ill equipped settlements characterised by: (a) Inefficient and uncoordinated urban governance, (b) Poor economic and resource base of cities, (c) Lack of community participation in urban development, (d) Poor urban land management, (e) Insecurity of tenure, (f) Juvenile delinquency and crime, and (g) unsustainable development.
Another paper that generated attention, came from Kabir M. Yari, Managing Director, Urban Development Bank of Nigeria (UDBN). He opened up with an introduction which confirmed the popular views that cities in Nigeria and other African countries are growing at a very fast rate.
“Cities and urban settlements in Nigeria, like many other parts of Africa and other developing countries are growing at a very fast rate as a result of rural-urban migration and high urban population growth rates,” he asserted.
He said that one visible feature of these settlements is dominance of slums and informal settlements in the provision of land and shelter to their populace.” According to him, “it is estimated that “about 30 – 70% of the urban population in Nigerian cities live in unplanned or informal settlements.”
He told the audience made up of stakeholders in housing and urban development that the situation is so because the demand for serviced land and housing is so much greater than supply. He also noted that most urban poor households cannot afford to join the formal housing market “and are therefore forced to gain shelter through the informal housing supply system according to Hague finding in 2006.
BMC Public Health. 2010 Mar 9;10:116.
Migration and child immunization in Nigeria: individual- and community-level contexts.
Antai D. Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. email@example.com
BACKGROUND: Vaccine-preventable diseases are responsible for severe rates of morbidity and mortality in Africa. Despite the availability of appropriate vaccines for routine use on infants, vaccine-preventable diseases are highly endemic throughout sub-Saharan Africa. Widespread disparities in the coverage of immunization programmes persist between and within rural and urban areas, regions and communities in Nigeria. This study assessed the individual- and community-level explanatory factors associated with child immunization differentials between migrant and non-migrant groups.
METHODS: The proportion of children that received each of the eight vaccines in the routine immunization schedule in Nigeria was estimated. Multilevel multivariable regression analysis was performed using a nationally representative sample of 6029 children from 2735 mothers aged 15-49 years and nested within 365 communities. Odds ratios with 95% confidence intervals were used to express measures of association between the characteristics. Variance partition coefficients and Wald statistic i.e. the ratio of the estimate to its standard error were used to express measures of variation.
RESULTS: Individual- and community contexts are strongly associated with the likelihood of receiving full immunization among migrant groups. The likelihood of full immunization was higher for children of rural non-migrant mothers compared to children of rural-urban migrant mothers. Findings provide support for the traditional migration perspectives, and show that individual-level characteristics, such as, migrant disruption (migration itself), selectivity (demographic and socio-economic characteristics), and adaptation (health care utilization), as well as community-level characteristics (region of residence, and proportion of mothers who had hospital delivery) are important in explaining the differentials in full immunization among the children.
CONCLUSION: Migration is an important determinant of child immunization uptake. This study stresses the need for community-level efforts at increasing female education, measures aimed at alleviating poverty for residents in urban and remote rural areas, and improving the equitable distribution of maternal and child health services.
Environmental Health Perspectives, ahead of print, 2010
Diddy Antai, Tahereh Moradi
Background: Living in socio-economically disadvantaged areas is associated with increased childhood mortality risks. As city-living becomes the predominant social context in low- and middle-income countries, the resulting rapid urbanization together with the poor economic circumstances of these countries greatly increase the risks of under-five mortality.
Objective: This study examined the trends in urban population growth and urban under-five mortality between 1983 and 2003 in Nigeria. We assessed whether urban area socio-economic disadvantage has an impact on under-five mortality.
Methods: Urban under-five mortality rates were directly estimated from the 1990, 1999 and 2003 Nigeria Demographic and Health Surveys. Multilevel logistic regression analysis was performed on data containing 2118 children nested within 1350 mother, who were in turn nested within 165 communities.
Results: Urban under-five mortality increased as urban population steadily increased between 1983 and 2003. Urban area disadvantage was significantly associated with under-five mortality after adjusting for individual child- and mother-level demographic and socio-economic characteristics.
Conclusions: Significant relative risks of under-five deaths both at the individual and community levels underscore the need for interventions tailored towards community- and individual-level interventions. We stress the need for further studies on community-level determinants of under-five mortality in disadvantaged urban areas.