Delivering on a gendered definition of health needs in local government budgeting: experiences and concepts

Background: Local governments are granted budgetary power in the Local Governments Act of the Republic of Uganda2, which allows for local-level participation and flexibility in the allocation of financial grants channelled annually from central to local governments. The act prescribes a legal mandate to allocate public resources based on local priorities including the health needs of women compared with men. This study investigated the responsiveness of local government budgeting to the health needs of women as compared to men.Methodology: A qualitative study was conducted in Mpigi district using a set of data collection methods including: a) three (3) focus group discussions with 8 female and 8 male respondents in each group; b) face-to-face interviews with a random sample of 120 households, 75% of which were male-headed and 25% female-headed ; c) key informant interviews with asample of 10 administrative officers in Mpigi district ; and d) desk-review of the Mpigi district Budget Framework Paper 4.Results: Health needs consist of the daily requirements, which, arise out of common disease infections and the socioeconomic constraints that affect the well-being of women and men. However, the primary concern of the district health sector is disease control measures, without emphasis on the differing socio-economic interests of women as compared to men. Local government budgeting, therefore, does not reflect the broad community-wide understanding of health needs.Conclusion: Local government budgeting should be informed by a two-fold framework for the gendered definition of health needs. The two-fold framework combines both disease-based health needs and socio-economic needs of women as compared to men.Keywords: Gender, Health Needs and Local Government BudgetingAfrican Health Sciences 2009; 9(S2):S90-S9

Delivering on a gendered definition of health needs in local government budgeting: experiences and concepts

Background: Local governments are granted budgetary power in the Local Governments Act of the Republic of Uganda2, which allows for local-level participation and flexibility in the allocation of financial grants channelled annually from central to local governments. The act prescribes a legal mandate to allocate public resources based on local priorities including the health needs of women compared with men. This study investigated the responsiveness of local government budgeting to the health needs of women as compared to men. Methodology: A qualitative study was conducted in Mpigi district using a set of data collection methods including: a) three (3) focus group discussions with 8 female and 8 male respondents in each group; b) face-to-face interviews with a random sample of 120 households, 75% of which were male-headed and 25% female-headed ; c) key informant interviews with a sample of 10 administrative officers in Mpigi district ; and d) desk-review of the Mpigi district Budget Framework Paper 4. Results: Health needs consist of the daily requirements, which, arise out of common disease infections and the socio-economic constraints that affect the well-being of women and men. However, the primary concern of the district health sector is disease control measures, without emphasis on the differing socio-economic interests of women as compared to men. Local government budgeting, therefore, does not reflect the broad community-wide understanding of health needs. Conclusion: Local government budgeting should be informed by a two-fold framework for the gendered definition of health needs. The two-fold framework combines both disease-based health needs and socio-economic needs of women as compared to men

Building capacity towards what? Proposing a framework for the analysis of energy transition governance in the context of urban informality in Sub-Saharan Africa

There is an emerging scholarship that criticises the conceptualisation of urban informality from a deficit view and emphasises that informality constitutes a way of life, a practice in its own right. We argue that energy is part of the informal way of life and that energy transitions need to take into account the specificities of urban informality when used for policy. Acknowledging energy practices is necessary to improve the justice of energy transitions, including the urban poor in energy transitions without denying the legitimacy of slum dwellers’ ways of life. In this paper, we analyse energy governance in informal urban settlements as implemented by national governments, municipalities and non-governmental organisations, with case studies from Sub-Saharan Africa. We develop a policy analysis framework that assesses (1) the practices of problem definition; (2) the creation of policy options and strategy; (3) the mix of capacities mobilised; and (4) the type of instruments used. The framework is applied to three case studies of energy policies in informal settlements in Kenya, South Africa and Uganda. Results show a strong preference for regulation and technological fixes and do not create capacity to acknowledge and integrate the specific challenges of urban informality and informal ways of life in energy policy, hence falling short of addressing social justice in energy transitions

Interrogating differences: A comparative analysis of Africa's informal settlements

Urban development in Africa is a very diverse and ambivalent phenomenon with aspects that do not fall neatly into global standards. Informal settlements therefore challenge governance by standards. We argue that quantifying and interrogating differences offers a better basis for governance. By drawing on a comparative analysis of three different informal settlements in Sub-Saharan Africa, this paper explores what differences reveal about the governance of informal settlements. The paper uses an urban societal metabolism approach, focussed on gender, energy and health, based on questionnaires and focus group discussions in Enkanini (Stellenbosch, South Africa), Mathare (Nairobi, Kenya), and Kasubi-Kawaala (Kampala, Uganda). The contribution of the paper is both empirical and theoretical. Empirically, we provide new evidence about the metabolism of urban informality at multiple levels of analysis: the individual, the household and the settlement. Findings show the gender asymmetries in urban poverty and the intricate links between energy choices, health and economic status. Theoretically, we argue that different levels of analysis produce different understandings of urban informality, and that analyzing informal settlements only by population aggregates means missing information. We conclude by arguing that understanding differences leads to the formulation of modest and localised goals, which are better able to take into account the complexity of urban informality

Mediating household energy transitions through co-design in urban Kenya, Uganda and South Africa

Approaches to providing sustainable energy in cities have generated considerable interest in academic and policy circles. The development of this body of work, however, has not shed much light on the modes of intermediation that are needed to reconfigure urban energy systems towards sustainability in energy-poor countries. This paper focuses on the role of academics as knowledge intermediaries who can trigger cross-sector collaborations around innovations for a sustainable energy transition in African cities. The research presented here was generated by an interdisciplinary research team made up of partners in Kenya, Uganda and South Africa. The research partners set out to better understand how sustainable energy transitions can be achieved through collaborative efforts between community members, experts and policy actors in the three countries. This paper provides evidence-based reflections on how the research partners used participatory methods to facilitate solution co-design and knowledge co-production over a period of two years under the Leading Integrated Research for Agenda 2030 in Africa (LIRA 2030) program. A key knowledge outcome of the research partnership is an improved understanding of how transdisciplinary research across the sub-region can be used to unearth the socio-spatial, cultural and political dimensions of energy in relation to other urban services such as health and housing. Based on this understanding, the paper proposes transdisciplinary co-design as a promising approach to providing sustainable energy in urban informal settlements in Sub-Saharan Africa

The socio-economic determinants of infant mortality in Nepal: analysis of Nepal Demographic Health Survey, 2011

BACKGROUND: Infant mortality reflects not only the health of infants but societal well-being as a whole. This study explores distal socioeconomic and related proximate determinants of infant mortality and provides evidence for designing targeted interventions. METHODS: Survival information on 5391 live born infants (2006–2010) was examined from the nationally representative Nepal Demographic Health Survey 2011. Bivariate logistic regression and multivariate hierarchical logistic regression approaches were performed to analyze the distal-socioeconomic and related proximate determinants of infant mortality. RESULTS: Socio-economic distal determinants are important predictors for infant mortality. For example, in reference to infants of the richest class, the adjusted odds ratio of infant mortality was 1.66 (95 % CI: 1.00–2.74) in middle class and 1.87 (95 % CI: 1.14–3.08) in poorer class, respectively. Similarly, the populations of the Mountain ecological region had a higher odds ratio (aOR =1.39, 95 % CI: 0.90–2.16) of experiencing infant mortality compared with the populations of the Terai plain region. Likewise, the population of Far-western development region had a higher adjusted odds ratio (aOR =1.62, 95 % CI: 1.02–2.57) of experiencing infant mortality than the Western development region. Moreover, the association of proximate determinants with infant mortality was statistically significant. For example, in reference to size at birth, adjusted odds ratio of infant dying was higher for infants whose birth size, as reported by mothers, was very small (aOR = 3.41, 95 % CI: 2.16–5.38) than whose birth size was average. Similarly, fourth or higher birth rank infants with a short preceding birth interval (less than or equal to 2 years) were at greater risk of dying (aOR =1.74, 95 % CI: 1.16–2.62) compared to the second or third rank infants with longer birth intervals. A short birth interval of the second or the third rank infants also increased the odds of infant death (aOR = 2.03, 95 % CI: 1.23–3.35). CONCLUSIONS: Socioeconomic distal and proximate determinants are associated with infant mortality in Nepal. Infant mortality was higher in the poor and middle classes than the wealthier classes. Population of Mountain ecological region and Far western development region had high risk of infant mortality. Similarly, infant dying was higher for infants whose birth size, as reported by mothers, was very small and who has higher birth rank and short preceding birth interval. This study uniquely addresses both broader socioeconomic distal and proximate determinants side by side at the individual, household and community levels. For this, both comprehensive, long-term, equity-based public health interventions and immediate infant care programs are recommended