Evaluating Access to Potable Water and Basic Sanitation in Ghana's Largest Urban Slum Community: Old Fadama, Accra

Access to potable water and basic sanitation in urban poor communities remains a critical issue in the developing world. This paper examines access to potable water and basic sanitation in Ghana's largest urban slum and the level of commitment by stakeholders to improve the current conditions. It drew on an extensive field survey, interviews, focus group discussions and drinking water quality analyses. The study revealed that the community depend entirely on vended water for their daily water supply needs. Apart from being sold at exorbitant prices, the sources of drinking water is also contaminated with attendant health risks. Household toilets are non-existent in the community and thus residents rely exclusively on public latrines; KVIP and pan latrines which are also inadequate. This partly accounts for the practice of open defecation in the community with possible health effects such as diarrhea and cholera. Indiscriminate dumping of refuse, choked drains and pools of stagnant water are ubiquitous thereby posing health threats. There is a low level of commitment to improving access to water and sanitation in the community by major stakeholders in spite of the glaring health effects. The outcomes of this study will be useful to relevant stakeholders and authorities in developing suitable strategies for improving access to water and sanitation for urban poor communities. Keywords: Accra, health, Old Fadama, sanitation, slum, wate

Water supply coping strategies in Accra

Many areas in Accra, the capital city of Ghana are experiencing shortfalls in water supply from the urban water utility, Ghana Water Company Limited (GWCL) resulting in various means of coping. This study examined the various coping strategies and the cost of coping based on a survey carried out among 170 households in Accra. The coping strategies were buying from neighbours, water tanker operators, building water storage facilities and buying bottled and sachet water for drinking. Coping strategies and cost for different income groups in Accra are discussed. High income consumers buying directly from tanker operators pay 7 times GWCL lifeline rate, Low income consumers buying from neighbours/vendors were paying 10 -13 times GWCL rates. The cost of sachet water was 150 times GWCL rates and that for bottled water was 900 times GWCL lifeline rate per cubic meter

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries