Vulnerability to extreme weather events in cities: implications for infrastructure and livelihoods

Many cities in the Global South are facing challenges as they increasingly experience extreme weather events, which disproportionately affect the urban poor. Focussing on severe heat and surface water flooding, this paper explores how these extreme weather events impact on infrastructure provision and livelihoods in low- income urban communities in Ghana. Climate series, including temperature data recorded in people’s homes and workplaces, are linked to qualitative interview data collected in eight neighbourhoods within the cities of Accra and Tamale during 2018. Additional evidence was obtained through key informant interviews with health service, water and electricity supply officials. The paper demonstrates that extreme heat and flooding events are causing disruptions to infrastructure provision and impacting vulnerable populations through loss of goods and property, reduced incomes, restricted mobility, and poorer health, alongside interrupted and increasingly overstretched services. The paper concludes that improved understanding of the climate–infrastructure–livelihoods nexus can reveal entry points for adaptations that reduce the vulnerability of low-income communities to extreme weather events in cities

Migration in the Volta Delta : a review of the literature

This working paper covers dominant migration patterns in Ghana at the national level along with a literature review of existing research related to migration specifically to the Volta Delta region. Typical of many migration patterns, people in the Volta Delta have livelihoods dependent on land resources (farms and fisheries) and tend to migrate to other rural areas that can support their skills. The paper includes characteristics of those who stay, migrant networks, remittances and return migrant flows. There is a long tradition of migration in Ghana

Cities and extreme weather events: impacts of flooding and extreme heat on water and electricity services in Ghana

Extreme weather events disproportionately affect residents of low-income urban settlements in the Global South. This paper explores the impact of extreme heat and flooding on water and electricity services in Accra and Tamale, Ghana. Interviews with water/electricity providers and water quality analysis are combined with household interviews, focus group discussions and observations conducted in eight low-income urban settlements. The findings highlight the interconnected nature of service provision during extreme weather events, with challenges in one sector reinforcing problems in another, exacerbating difficulties with access. Although households can utilise rainwater during flooding, it is highly susceptible to faecal contamination, and electricity supplies are often disconnected. During extreme heat, demand for water and electricity outstrips supply, leading to severe shortages, especially in Tamale. Water and electricity service providers should consider their interconnected nature and adopt a joined-up approach to cope with extreme weather events, which are predicted to increase with climate chang

Impact of extreme weather conditions on healthcare provision in urban Ghana

Extreme weather events pose significant threats to urban health in low- and middle-income countries, particularly in sub-Saharan Africa where there are systemic health challenges. This paper investigates health system vulnerabilities associated with flooding and extreme heat, along with strategies for resilience building by service providers and community members, in Accra and Tamale, Ghana. We employed field observations, rainfall records, temperature measurements, and semi-structured interviews in health facilities within selected areas of both cities. Results indicate that poor building conditions, unstable power supply, poor sanitation and hygiene, and the built environment reduce access to healthcare for residents of poor urban areas. Health facilities are sited in low-lying areas with poor drainage systems and can be 6 °C warmer at night than reported by official records from nearby weather stations. This is due to a combination of greater thermal inertia of the buildings and the urban heat island effect. Flooding and extreme heat interact with socioeconomic conditions to impact physical infrastructure and disrupt community health as well as health facility operations. Community members and health facilities make infrastructural and operational adjustments to reduce extreme weather stress and improve healthcare provision to clients. These measures include: mobilisation of residents to clear rubbish and unclog drains; elevating equipment to protect it from floods; improving ventilation during extreme heat; and using alternative power sources for emergency surgery and storage during outages. Stakeholders recommend additional actions to manage flood and heat impacts on health in their cities, such as, improving the capacity of drainage systems to carry floodwaters, and routine temperature monitoring to better manage heat in health facilities. Finally, more timely and targeted information systems and emergency response plans are required to ensure preparedness for extreme weather events in urban areas

Attitudes towards vaccines and intention to vaccinate against COVID-19: a cross-sectional analysis - implications for public health communications in Australia

Objective To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study. Design and setting Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021. Participants Total of 1166 Australians from general population aged 18-90 years (mean 52, SD of 19). Main outcome measures Primary outcome: responses to question € If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?'. Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions. Results Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine. Conclusions Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor's recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates