Fish Swim Bladder-Derived Porous Carbon for Defluoridation at Potable Water pH

This research article published by Scientific Research Publishing Inc., 2016The levels of fluoride in various ground water sources in East Africa are above the World Health Organization upper limit of 1.5 mg/L. Research on diverse defluoridation technologies has proven that adsorption stands out as an affordable, efficient, and facile technology. Fish swim bladder-derived porous carbon (FBPC) activated by KOH and surface oxidized by nitric acid was successfully investigated as an adsorbent for defluoridation at portable water pH. The FBPC was characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-raydiffraction (XRD) and energy dispersive spectroscopy (EDS). Batch methods were used to study physiochemical parameters viz., initial fluoride concentration, temperature, adsorbate dosage, contact time and pH. Freundlich, Temkin, Langmuir and Dubinin-Radushkevich isotherms were plotted and analyzed to understand the adsorption process. Bangham, Weber Morris, pseudo first and second-order models were used to elucidate the kinetics of adsorption. Optimal conditions for fluoride removal were found to be: pH of 6, FBPC adsorbent dose of 5.0 g/L and contact time of 50 min. Flouride adsorption followed pseudo second-order kinetic model and Langmuir isotherm best describes the adsorption process

The economics of healthcare access: a scoping review on the economic impact of healthcare access for vulnerable urban populations in low‑ and middle‑income countries

Background: The growing urban population imposes additional challenges for health systems in low- and middle income countries (LMICs). We explored the economic burden and inequities in healthcare utilisation across slum, non-slum and levels of wealth among urban residents in LMICs. Methods: This scoping review presents a narrative synthesis and descriptive analysis of studies conducted in urban areas of LMICs. We categorised studies as conducted only in slums, city-wide studies with measures of wealth and conducted in both slums and non-slums settlements. We estimated the mean costs of accessing healthcare, the incidence of catastrophic health expenditures (CHE) and the progressiveness and equity of health expenditures. The definitions of slums used in the studies were mapped against the 2018 UN-Habitat definition. We developed an evidence map to identify research gaps on the economics of healthcare access in LMICs. Results: We identified 64 studies for inclusion, the majority of which were from South-East Asia (59%) and classified as city-wide (58%). We found severe economic burden across health conditions, wealth quintiles and study types. Compared with city-wide studies, slum studies reported higher direct costs of accessing health care for acute conditions and lower costs for chronic and unspecified health conditions. Healthcare expenditures for chronic conditions were highest amongst the richest wealth quintiles for slum studies and more equally distributed across all wealth quintiles for city-wide studies. The incidence of CHE was similar across all wealth quintiles in slum studies and concentrated among the poorest residents in city-wide studies. None of the definitions of slums used covered all characteristics proposed by UN-Habitat. The evidence map showed that city-wide studies, studies conducted in India and studies on unspecified health conditions dominated the current evidence on the economics of healthcare access. Most of the evidence was classified as poor quality. Conclusions: Our findings indicated that city-wide and slums residents have different expenditure patterns when accessing healthcare. Financial protection schemes must consider the complexity of healthcare provision in the urban context. Further research is needed to understand the causes of inequities in healthcare expenditure in rapidly expanding and evolving cities in LMICs

Economics of healthcare access in low-income and middle-income countries: : a protocol for a scoping review of the economic impacts of seeking healthcare on slum-dwellers compared with other city residents

Introduction People living in slums face several challenges to access healthcare. Scarce and low-quality public health facilities are common problems in these communities. Costs and prevalence of catastrophic health expenditures (CHE) have also been reported as high in studies conducted in slums in developing countries and those suffering from chronic conditions and the poorest households seem to be more vulnerable to financial hardship. The COVID-19 pandemic may be aggravating the economic impact on the extremely vulnerable population living in slums due to the long-term consequences of the disease. The objective of this review is to report the economic impact of seeking healthcare on slum-dwellers in terms of costs and CHE. We will compare the economic impact on slum-dwellers with other city residents. Methods and analysis This scoping review adopts the framework suggested by Arksey and O’Malley. The review is part of the accountability and responsiveness of slum-dwellers (ARISE) research consortium, which aims to enhance accountability to improve the health and well-being of marginalised populations living in slums in India, Bangladesh, Sierra Leone and Kenya. Costs of accessing healthcare will be updated to 2020 prices using the inflation rates reported by the International Monetary Fund. Costs will be presented in International Dollars by using purchase power parity. The prevalence of CHE will also be reported. Ethics and dissemination Ethical approval is not required for scoping reviews. We will disseminate our results alongside the events organised by the ARISE consortium and international conferences. The final manuscript will be submitted to an open-access international journal. Registration number at the Research Registry: reviewregistry947

Improving accountability for equitable health and well-being in urban informal spaces: Moving from dominant to transformative approaches

This article critically reviews the literature on urban informality, inequity, health, well-being and accountability to identify key conceptual, methodological and empirical gaps in academic and policy discourses. We argue that critical attention to power dynamics is often a key missing element in these discourses and make the case for explicit attention to the operation of power throughout conceptualization, design and conduct of research in this space. We argue that: (a) urban informality reflects the exercise of power to confer and withhold advantage; (b) the dominant biomedical model of health poorly links embodied experiences and structural contexts; (c) existing models of accountability are inadequate in unequal, pluralistic governance and provision environments. We trace four conceptual and empirical directions for transformative approaches to power relations in urban health equity research