A critical evaluation of Rwanda's potential to achieve the millennium development goals for clean water and sanitation

2014 ◽  
Vol 5 (1) ◽  
pp. 136-142
Author(s):  
Pamela Abbott ◽  
Aimé Tsinda ◽  
Roger Sapsford ◽  
John Rwirahira
Keyword(s):  
Millennium Development Goals ◽  
Urban Poor ◽  
Critical Evaluation ◽  
Public Health Problem ◽  
Capital City ◽  
Individual Level ◽  
Original Definition ◽  
Improved Sanitation ◽  
Development Goals ◽  
The Individual

In the world-wide Millennium Development Goals initiative, Rwanda promised to halve by 2015 the number of people who lacked access to safe water and improved sanitation in 1990. Progress has been made in access to water, but the target figure will probably not be met. Targets for improved sanitation will be met on the original definition of ‘improved’, though probably not if shared provision is excluded. However, beyond the usual rural/urban divide, the article highlights how the numerical target conceals a serious problem in the capital city, where ‘informal settlements’ have grossly inadequate provision. We argue that the problems are not soluble at the individual level; a whole and unbreakable chain of provision is needed. Centralised provision is also not very feasible in Rwanda, so Government and/or development partners will probably have to work at the level of communities to set up sanitation chains and train communities in servicing them. Solving the problem is essential if the urban poor are to be offered a decent life and to solve the public health problem of contaminated water.

scholarly journals The Influence of Marginalization on Cultural Attitudes and Trash Disposal Practices in Esfuerzo de Paraíso of the Dominican Republic: A Qualitative Interview Study

2021 ◽  
Vol 18 (6) ◽  
pp. 2872
Author(s):  
Madison Sasman ◽  
Carrie B. Dolan ◽  
Daniel Villegas ◽  
Estelle Eyob ◽  
Catherine Barrett
Keyword(s):  
Dominican Republic ◽  
Municipal Government ◽  
Public Health Problem ◽  
Past Research ◽  
Major Public Health Problem ◽  
Structured Interviews ◽  
Cultural Attitudes ◽  
Individual Level ◽  
Qualitative Interview Study ◽  
The Individual

The inadequate management of municipal solid waste (MSW) in fast-developing nations is a major public health problem. Trash collection is often inconsistent, leaving residents to use unsafe disposal methods such as incineration or unregulated dumping. The issue is especially pronounced in marginalized communities, where public service provision is scarce. Past research has identified factors that perpetuate harmful disposal practices. The current study expanded on previous work by exploring how individuals’ perceptions of political, spatial, and economic marginalization affected their agency with regards to waste management. Researchers focused on a marginalized community in the Dominican Republic known as Esfuerzo de Paraíso. There, they conducted semi-structured interviews to explore residents’ perceptions of marginalization at the individual, interpersonal, community, and institutional levels, and its effects on their agency. A qualitative coding process revealed that most community members were discontent with their trash disposal practices, but that long-standing marginalization left them feeling ill equipped to generate change at the individual level. Interviewees believed that change should be initiated at the community level and implemented with the support of institutional-level actors, namely the municipal government. Residents did not identify any non-governmental organizations as possible sources of help, which may suggest a limited view of institutional support networks.

scholarly journals Prospective Time Periodic Geographical Covid-19 Surveillance in Ethiopia Using a Space-time Scan Statistics: Detecting and Evaluating Emerging Clusters

2020 ◽  
Author(s):  
Nuredin Nassir Azmach ◽  
Tesfay Gebremariam Tesfahannes ◽  
Samiya Abrar Abdulsemed ◽  
Temam Abrar Hamza
Keyword(s):  
Addis Ababa ◽  
Space Time ◽  
City Government ◽  
Capital City ◽  
Scan Statistics ◽  
Individual Level ◽  
Level Information ◽  
Public Health Officials ◽  
The Individual ◽  
Time Scan

Abstract Background: On December 31, 2019, multiple pneumonia cases, subsequently identified as coronavirus disease 2019 (COVID-19), was reported for the first time in Wuhan, the capital city of Hubei province in China. At that time, the Wuhan Municipal Health Commission had report 27 cases, of which seven are severely ill, and the remaining cases are stable and controllable. Since, then, the spread of COVID-19 has already taken on pandemic proportions, affecting over 100 countries in a matter of weeks. As of September 07, 2020, there had been more than 27 million confirmed cases and 889,000 total deaths, with an average mortality of about 3.3%, globally. In Ethiopia, 58,672 confirmed cases and 918 deaths and this number are likely to increase exponentially. It is critical to detect clusters of COVID-19 to better allocate resources and improve decision-making as the pandemics continue to grow.Methods: We have collected the individual-level information on patients with laboratory-confirmed COVID-19 on daily bases from the official reports of the Ethiopian Federal Ministry of Health (FMOH), regional, and city government of Addis Ababa and Dire Dawa health bureaus. Using the daily case data, we conducted a prospective space-time analysis with SaTScan version 9.6. We detect statistically significant space-time clusters of COVID-19 at the woreda and sub-city level in Ethiopia between March 13th-June 6th, 2020, and March 13th-June 24th, 2020.Results: The prospective space-time scan statistic detected “alive” and emerging clusters that are present at the end of our study periods; notably, nine more clusters were detected when adding the updated case data.Conclusions: These results can notify public health officials and decision-makers about where to improve the allocation of resources, testing areas; also, where to implement necessary isolation measures and travel bans. As more confirmed cases become available, the statistic can be rerun to support timely surveillance of COVID-19, demonstrated here. In Ethiopia, our research is the first geographic study that utilizes space-time statistics to monitor COVID-19.

scholarly journals Poverty and the Millennium Development Goals

2007 ◽  
Vol 7 (4) ◽  
pp. 467-477
Author(s):  
G. J. Ebrahim
Keyword(s):  
Millennium Development Goals ◽  
Urban Poor ◽  
Urban Poverty ◽  
Global Scale ◽  
National Budget ◽  
International Agencies ◽  
Target Date ◽  
Development Goals ◽  
Mind Set ◽  
Definition Of

Poverty has been defined variously at different times in different countries. An early attempt in 1899 in Britain was based on resources necessary for survival. This subsistence standard definition has been used as a measuring rod in one form or another in different countries. For example, less than half the average income has been used as a measure in Britain, and minimum wage or multiples of it in Latin America, and so on. Unless a proper definition of poverty can be agreed attempts at its alleviation can have no target to aim for. Alleviation of poverty, though championed by political leaders of all types has proven to be difficult because equitable division of the national budget requires consensus which is not always forthcoming when the "haves" control the levers of power and the "have nots" must make do with what they get. Measuring collective poverty on a global scale has been attempted by several international agencies. The definition used by the World Bank is stark - "people who live on US $1 per day". According to this definition in the Year 2001 one billion people lived in poverty with consumption levels of US $1 or less per day, and 2.7 billion on less than US $2 per day. Now that more than half the world's population is living in cities, urban poverty is presenting a challenge in most developing countries. Within the physical environment of deprivation there develops a culture of poverty with its prevalence of disease, social disruption, violence in the home and outside, and dependence on drugs and alcohol. In the mind set of the urban poor risk taking behaviour is common. The main victims of deprivation are women and children, the aged and the infirm. Evidence is presented to show the stultifying effects on children growing up in poverty. Remedial action is an uphill task, expensive and not always successful. An awakening of social conscience globally brought about by the stark realities of the urban poor living cheek by jowl in close vicinity of affluence and conspicuous consumption has led enlightened world leaders and economists to mobilise public opinion. A meeting of world leaders held at UN headquarters in the Year 2000 proposed and agreed Millennium Development Goals. The goals address not only poverty per se but also its effects. The target date for achieving the Millennium Development Goals is set at Year 2015.Progress towards the target has been patchy and depends upon national political maturity.

scholarly journals Sustainability-inspired composting latrine design

2017 ◽  
Vol 7 (3) ◽  
pp. 515-520
Author(s):  
D. Kierys ◽  
B. Barkdoll
Keyword(s):  
Millennium Development Goals ◽  
Future Generations ◽  
Storage Tanks ◽  
Control Valves ◽  
Water Washing ◽  
The World ◽  
Improved Sanitation ◽  
Development Goals ◽  
Urine Storage

In support of the Millennium Development Goals to provide improved sanitation to the world, a sustainability-inspired composting latrine design based on work in rural Panama, but also applicable to similar situations, is offered here. The design is based on the three aspects of sustainability namely economic, social, and technical. The new design will allow for improved health for current and future generations. The design is less costly (economic), is based on concepts to improve the likelihood of use based on interviews with potential users (social), and provides better quality compost through ammonia-based treatment (technical). The design consists of two ferrocement compost vaults to save money over conventional vaults, urine storage tanks to improve ammonia conditions in the compost, urine control valves for urine control, a water-washing bidet for personal washing (as preferred by the users), and a handwashing station within the latrine superstructure for convenience.

scholarly journals Treatment challenges for alcohol service users in Kampala, Uganda

2017 ◽  
Vol 6 (1) ◽  
pp. 27-35 ◽  
Author(s):  
David Kalema ◽  
Wouter Vanderplasschen ◽  
Sofie Vindevogel ◽  
Peter K Baguma ◽  
Ilse Derluyn
Keyword(s):  
Service Providers ◽  
Qualitative Interviews ◽  
Alcohol Treatment ◽  
Capital City ◽  
Treatment Center ◽  
Service Users ◽  
Individual Level ◽  
Treatment Participation ◽  
Sub Saharan ◽  
The Individual

Kalema, D., Vanderplasschen, W., Vindevogel, S., Baguma, P., & Derluyn, I. (2017). Treatment challenges for alcohol service users in Kampala, Uganda. The International Journal Of Alcohol And Drug Research, 6(1), 27-35. doi:http://dx.doi.org/10.7895/ijadr.v6i1.240Background and Aims: Enhancing treatment participation of persons with substance use disorders is a challenge worldwide. Obstacles keeping people from entering or continuing treatment are well documented in Western countries, but such knowledge is scarce in majority countries that face particular challenges when implementing alcohol policies. This study aimed at identifying factors challenging treatment participation in Uganda, a Sub-Saharan country with a considerable alcohol problem.Methods: Data were collected during 30 in-depth, qualitative interviews on treatment challenges with 20 service providers and 10 male service users, who were recruited at one public and one private alcohol treatment center in the Ugandan capital city, Kampala. Men comprise about 90% of the total number of service users in these centers. Interview data were analyzed thematically, using Nvivo software, and were categorized around three levels of treatment challenges: societal, institutional, and personal challenges.Findings: Interview findings showed several treatment challenges relating to institutional aspects like inadequate human resources, overall insufficiency of services, and the treatment philosophy of available services. Respondents identified stigma and cultural interference as important challenges at the societal level, while limited awareness about addiction and denial of problems can be situated at the individual level.Conclusions: Institutional, societal, and personal challenges keep persons with AUD from participating in alcohol treatment in public and private services in Uganda. Alcohol regulation, sensitization, and prevention are needed to raise awareness at the societal and individual level, while appropriate training and additional financial resources may help to overcome institutional challenges.

scholarly journals Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Wei-Teng Yang ◽  
Celine R. Gounder ◽  
Tokunbo Akande ◽  
Jan-Walter De Neve ◽  
Katherine N. McIntire ◽  
...  
Keyword(s):  
Gender Differences ◽  
Public Health Problem ◽  
System Level ◽  
Global Public Health ◽  
Community Members ◽  
Quantitative Evidence ◽  
Individual Level ◽  
Treatment Services ◽  
Quantitative Studies ◽  
The Individual

Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation.Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences.Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men.Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

scholarly journals Unmet Need for Healthcare Among People with Hypertension in Indonesia

2020 ◽  
Author(s):  
Asmaripa Ainy ◽  
Amrina Rosyada ◽  
Haerawati Idris ◽  
Asri Maharani
Keyword(s):  
Unmet Need ◽  
Public Health Problem ◽  
Care Utilization ◽  
Global Public Health ◽  
Cross Sectional ◽  
Household Level ◽  
Individual Level ◽  
Indonesia Family Life Survey ◽  
Education And Employment ◽  
The Individual

Abstract Background: Hypertension is a leading global public health problem in both developed and developing countries including Indonesia, mainly due to its high frequency and risks of cardiovascular diseases. Prevalence of hypertension in the Indonesian population aged> 18 years in 2018 was 34.11%. Unmet need for healthcare generally has been explored, but limited empirical study explores it among people with hypertension. The objective of this study is to investigate the determinants of unmet need for healthcare among people with hypertension. Methods: The design of this study is cross-sectional, using the data from the Indonesia Family Life Survey wave 5 (IFLS-5). The sample of the survey was 6,302 adults age >40 years old, stratified by rural/urban status. Three-level multilevel analysis was performed to estimate the individual level, household level, and community-level determinants of unmet needs for hypertension care. Results: The data shows that 78.4% of respondents with hypertension reported an unmet need for healthcare. Age, female, single, income, having insurance, living in the urban area, and the number of health posts for elderly (Posyandu Lansia) are significantly associated with meet needs for health care utilization among hypertension, while education and employment status shows no association with them. Conclusion: Improving access to healthcare and reducing health inequality are required to address this problem.

scholarly journals Evolution of the nervous system: a critical evaluation of how genetic changes translate into morphological changes

2010 ◽  
Vol 12 (4) ◽  
pp. 457-462
Keyword(s):  
Cultural Practices ◽  
Morphological Changes ◽  
Critical Evaluation ◽  
Genetic Changes ◽  
Individual Level ◽  
System A ◽  
Brain Circuits ◽  
Genetic Modifications ◽  
The Difference ◽  
The Individual

Living creatures evolve, and this evolution allows them to adapt to an ever-changing milieu. Two main adaptive strategies coexist. The first involves genetic mutations taking place at the species level. The second strategy occurs at the individual level, and primarily involves changes in chromatin organization and brain circuits. We shall illustrate how the two modes of adaptation are interdependent, and will show the difference in their respective importance depending on the species. It will be proposed that changes in developmental strategies, genetically selected, can lead to more or less epigenetic freedom, sometimes with dramatic consequences. In particular it will be shown, taking chimpanzees and humans as examples, how minor genetic modifications can translate into nonlinear changes in brain structure and cultural practices, placing the two types of primates at a much greater distance than had been anticipated.

scholarly journals Pengendalian Malaria dalam Upaya Percepatan Pencapaian Target Millennium Development Goals

2012 ◽  
Vol 7 (1) ◽  
pp. 22
Author(s):  
Tri Rini Puji Lestari
Keyword(s):  
Malaria Control ◽  
Millennium Development Goals ◽  
Health Workers ◽  
Public Health Problem ◽  
Health Official ◽  
Control Programs ◽  
Malaria Morbidity ◽  
Chain Transmission ◽  
Development Goals ◽  
Depth Interviews

Di Provinsi Maluku Utara, malaria berada pada level endemi tinggi dengan total Annual Parasite Incidence (API) > 5 ‰ dan masih menjadi masalah kesehatan masyarakat. Penelitian ini bertujuan untuk mengetahui perkembanganpengendalian penyakit malaria di Provinsi Maluku Utara dalam upaya percepatan pencapaian target 6C Millennium Development Goals (MDGs). Penelitian menggunakan metode studi kualitatif yang dilakukan pada informan terpilih meliputi petugas kesehatan Dinas Kesehatan Provinsi Maluku Utara, petugas kesehatan Malaria Center, dan tokoh masyarakat pemerhati malaria. Pengambilan data dilakukan pada tanggal10 – 16 April 2011 dengan menggunakan metode wawancara mendalam. Ditemukan bahwa program pengendalian malaria telah dilaksanakan oleh Dinas Kesehatan Provinsi Maluku Utara, tetapi belum mampu secara efektif menurunkan angka kesakitan malaria sebab pengendalian yang dilakukan tidak komprehensif. Penanganan masih lebih banyak ditujukan untuk memutuskan mata rantai penularan pada manusia, sementara pada nyamuk sebagai “mesin perang” serta habitatnya belum tersentuh secara maksimal.Kata kunci: Pengendalian malaria, millennium development goals, angka kesakitan malariaAbstractMalaria is one of public health problem in North Maluku Province because endemic levels are high with a total Annual Parasite Incidence (API) > 5 ‰. The purpose of this study was to determine the development of malaria controlin North Maluku in order to accelerate the achievement of Millennium Development Goals (MDGs) target related to malaria 6C. The study design used is qualitative that been done on selected informants. Informants consisted of health workers in Departement of Health North Maluku Province,health official Malaria Center, and community leaders who observe malaria. Retrieval of data time is 10 – 16 April 2011 by in-depth interviews. It was found that malaria control programs have been implemented by the Departement of Health North Maluku Province, but have not been able to effectively reduce malaria morbidity. This is because malaria control is performed is not comprehensive. Handling is more directed to break the chain transmission to human, their habitats have not been touched up.Key words: Control of malaria, millennium development goals, malaria morbidity

scholarly journals Sanitation for all: a Panglossian perspective?

2018 ◽  
Vol 8 (4) ◽  
pp. 718-729
Author(s):  
Priyam Das ◽  
Julia Crowley
Keyword(s):  
Low Income ◽  
Urban Poor ◽  
Central India ◽  
Household Survey ◽  
Group Discussions ◽  
Open Defecation ◽  
Sanitation Services ◽  
Improved Sanitation ◽  
Basic Services ◽  
Development Goals

Abstract At the deadline for meeting the Millennium Development Goals (MDGs), 2.1 billion (109) people had gained access to improved sanitation and 95 countries were able to meet the MDG sanitation target. However, 2.4 billion still lacked improved sanitation facilities. India is among those countries where open defecation stubbornly persists. Despite decades of government spending on the construction of toilets, and the recent Swachh Bharat Mission (SBM) to eradicate open defecation, toilet use remains a challenge. To draw attention to the deep deficits in sanitation services in smaller Indian cities, we explore what motivates sanitation uptake by the urban poor. Household survey data from 13 low-income settlements combined with interviews, focus-group discussions, and transect walks in three cities in central India allowed us to examine factors that influenced resource-constrained households' toilet ownership and toilet use versus open defecation. Our findings indicate that in urban settings, toilet ownership could, in fact, deter open defecation given the presence of other key conditions. Programs to build toilets under the SBM could, therefore, see favorable outcomes in cities provided there is a broadening of access to sanitation to include fecal sludge management. Our findings also underscore the importance of coproducing basic services.

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