Pro-poor water service strategies in developing countries: promoting justice in Uganda’s urban project

Water service to the urban poor presents challenges to political leaders, regulators and managers. We identify technology mixes of yard taps, public water points (with and without pre-paid meters) to meet alternative constraints, and reflecting populations served and investment requirements. Three investment scenarios have different implications for improving water access to over 400,000 citizens in Kampala. One component, pre-paid water meters, can promote social equity and institutional sustainability. If procedural justice is given as much weight as distributive justice in the selection of pro-poor programs, pre-paid meters (the ultimate cost recovery tool) can have a place in the investment plan. The study examines how public stand pipes (and a combination of other options) can meet both financial constraints and social objectives. Financial considerations cannot be wished away when seeking effective strategies for achieving the Millennium Development Goals.Water utility optimization; pro-poor connections; pre-paid meters; cost recovery; Africa; Uganda

The influence of commercial and customer orientation on utility efficiency: empirical evidence from NWSC, Uganda

Many water utilities in low income countries, in an effort to revamp their performances often begin with heavy infrastructural investment projects. Experience has shown that focussing on this engineering approach alone does not deliver the required efficiency gains. In this paper, we make use of data drawn from the operations of 14 NWSC utilities and our study covers the period 1995-2004. Due the non-availability of input price data and the need to account for ‘noise’ the study uses stochastic frontier analysis(SFA) to show that after a long spell of engineering orientation, a shift in emphasis to commercial/commercial orientation has a positive impact on reduction of utility technical inefficiencies

Pro-poor water service strategies in developing countries: promoting justice in Uganda’s urban project

Water service to the urban poor presents challenges to political leaders, regulators and managers. We identify technology mixes of yard taps, public water points (with and without pre-paid meters) to meet alternative constraints, and reflecting populations served and investment requirements. Three investment scenarios have different implications for improving water access to over 400,000 citizens in Kampala. One component, pre-paid water meters, can promote social equity and institutional sustainability. If procedural justice is given as much weight as distributive justice in the selection of pro-poor programs, pre-paid meters (the ultimate cost recovery tool) can have a place in the investment plan. The study examines how public stand pipes (and a combination of other options) can meet both financial constraints and social objectives. Financial considerations cannot be wished away when seeking effective strategies for achieving the Millennium Development Goals

Pro-poor water service strategies in developing countries: promoting justice in Uganda’s urban project

Water service to the urban poor presents challenges to political leaders, regulators and managers. We identify technology mixes of yard taps, public water points (with and without pre-paid meters) to meet alternative constraints, and reflecting populations served and investment requirements. Three investment scenarios have different implications for improving water access to over 400,000 citizens in Kampala. One component, pre-paid water meters, can promote social equity and institutional sustainability. If procedural justice is given as much weight as distributive justice in the selection of pro-poor programs, pre-paid meters (the ultimate cost recovery tool) can have a place in the investment plan. The study examines how public stand pipes (and a combination of other options) can meet both financial constraints and social objectives. Financial considerations cannot be wished away when seeking effective strategies for achieving the Millennium Development Goals

An assessment of the readiness for introduction of the HPV vaccine in Uganda

Formative research assessing human papillomavirus (HPV) vaccine readiness in Uganda was conducted in 2007. The objective was to generate evidence for government decision-making and operationalplanning for HPV vaccine introduction. Qualitative research methods with children, parents, teachers, community leaders, health workers, technical experts and political leaders were used to captureunderstanding of socio-cultural, health system and policy environments. We found low levels of knowledge about cervical cancer and HPV. Vaccination and its benefits were well-understood;respondents were positive about HPV vaccination. Health systems were deemed adequate for HPV vaccine delivery. Schools were identifie as a vaccination venue, given high attendance by girls aged10-12 years. Communication and advocacy strategies to foster acceptance should provide information on cervical cancer, HPV vaccine safety, and side effects. Policymakers requested further detail on costs.Introduction of HPV vaccine could be integrated into existing reproductive health and immunization policies (Afr J Reprod Health 2008; 12[3]:159-172)

The Prevention and Control of HIV/AIDS, TB and Vector-borne Diseases in Informal Settlements: Challenges, Opportunities and Insights

Today’s urban settings are redefining the field of public health. The complex dynamics of cities, with their concentration of the poorest and most vulnerable (even within the developed world) pose an urgent challenge to the health community. While retaining fidelity to the core principles of disease prevention and control, major adjustments are needed in the systems and approaches to effectively reach those with the greatest health risks (and the least resilience) within today’s urban environment. This is particularly relevant to infectious disease prevention and control. Controlling and preventing HIV/AIDS, tuberculosis and vector-borne diseases like malaria are among the key global health priorities, particularly in poor urban settings. The challenge in slums and informal settlements is not in identifying which interventions work, but rather in ensuring that informal settlers: (1) are captured in health statistics that define disease epidemiology and (2) are provided opportunities equal to the rest of the population to access proven interventions. Growing international attention to the plight of slum dwellers and informal settlers, embodied by Goal 7 Target 11 of the Millennium Development Goals, and the considerable resources being mobilized by the Global Fund to fight AIDS, TB and malaria, among others, provide an unprecedented potential opportunity for countries to seriously address the structural and intermediate determinants of poor health in these settings. Viewed within the framework of the “social determinants of disease” model, preventing and controlling HIV/AIDS, TB and vector-borne diseases requires broad and integrated interventions that address the underlying causes of inequity that result in poorer health and worse health outcomes for the urban poor. We examine insights into effective approaches to disease control and prevention within poor urban settings under a comprehensive social development agenda

Assessing the risk of self-diagnosed malaria in urban informal settlements of Nairobi using self-reported morbidity survey

<p>Abstract</p> <p>Background</p> <p>Because of the belief that Nairobi is a low risk zone for malaria, little empirical data exists on malaria risk in the area. The aim of this study was to explore the risk of perceived malaria and some associated factors in Nairobi informal settlements using self-reported morbidity survey.</p> <p>Methods</p> <p>The survey was conducted from May to August 2004 on 7,288 individuals in two informal settlements of Nairobi. Participants were asked to report illnesses they experienced in the past 14 days. Logistic regression was used to estimate the odds of perceived-malaria. The model included variables such as site of residence, age, ethnicity and number of reported symptoms.</p> <p>Results</p> <p>Participants reported 165 illnesses among which malaria was the leading cause (28.1%). The risk of perceived-malaria was significantly higher in Viwandani compared to Korogocho (OR 1.61, 95%CI: 1.10–2.26). Participants in age group 25–39 years had significantly higher odds of perceived-malaria compared to those under-five years (OR 2.07, 95%CI: 1.43–2.98). The Kikuyu had reduced odds of perceived-malaria compared to other ethnic groups. Individuals with five and more symptoms had higher odds compared to those with no symptoms (OR 23.69, 95%CI: 12.98–43.23).</p> <p>Conclusion</p> <p>Malaria was the leading cause of illness as perceived by the residents in the two informal settlements. This was rational as the number of reported symptoms was highly associated with the risk of reporting the illness. These results highlight the need for a more comprehensive assessment of malaria epidemiology in Nairobi to be able to offer evidence-based guidance to policy on malaria in Kenya and particularly in Nairobi.</p

Theories for influencer identification in complex networks

In social and biological systems, the structural heterogeneity of interaction networks gives rise to the emergence of a small set of influential nodes, or influencers, in a series of dynamical processes. Although much smaller than the entire network, these influencers were observed to be able to shape the collective dynamics of large populations in different contexts. As such, the successful identification of influencers should have profound implications in various real-world spreading dynamics such as viral marketing, epidemic outbreaks and cascading failure. In this chapter, we first summarize the centrality-based approach in finding single influencers in complex networks, and then discuss the more complicated problem of locating multiple influencers from a collective point of view. Progress rooted in collective influence theory, belief-propagation and computer science will be presented. Finally, we present some applications of influencer identification in diverse real-world systems, including online social platforms, scientific publication, brain networks and socioeconomic systems.Comment: 24 pages, 6 figure

Determinants of bed net use in children under five and household bed net ownership on Bioko Island, Equatorial Guinea

BACKGROUND: As part of comprehensive malaria control strategies, the Bioko Island Malaria Control Project (BIMCP) distributed 110,000 long-lasting insecticide-treated nets (LLIN) in late 2007 with the aim of providing one net for each sleeping area. Despite attaining initially very high levels of net coverage and net use, many children under five years of age did not sleep under a net by 2009, according to annual malaria indicator surveys. The aim of this study was to assess the determinants of bed net use in children under five and bed net ownership of the households in which they live. METHODS: Using data from annual cross-sectional household surveys of 2008 and 2009, we investigated factors associated with sleeping under a mosquito net the night prior to the survey, and a households owning at least one net, in all households which had at least one child under five years. Amongst others, caregiver's knowledge of malaria and household characteristics including a socio-economic score (SES), based on ownership of household assets, were analysed for their effect on net ownership and use. RESULTS: There was a decline of around 32% in the proportion of households that owned at least one net between 2008 and 2009. Higher household bed net ownership was associated with knowing how malaria was prevented and transmitted, having the house sprayed in the previous 12 months, having fewer children under five in the household, and children being sick at some point in the previous 14 days. Higher bed net use in children < 5 was associated with being sick at some point in the last 14 days prior to the survey, living in an urban area, more years of education of the head of the household, household ownership of at least one ITN (as opposed to an untreated net) and the year in which the survey took place. CONCLUSIONS: The big fall in bed net use from 2008 to 2009 was attributable to the striking decline in ownership. Although ownership was similar in rural and urban areas, rural households were less likely to protect their children with bed nets. Knowledge about malaria was an important determinant of bed net ownership. Further research is needed to elucidate the decline in bed net ownership between 2008 and 2009