Decision Making within the Built Environment as a Strategy for Mitigating the Risk of Malaria and Other Vector-Borne Diseases

Abstract

Although significant efforts have been made to combat the spread of vector-borne diseases (VBDs), they still account for more than 17% of all infectious diseases. According to the World Health Organization (WHO), there were 216 million estimated cases in 2016. The efforts that resulted in these positive outcomes lack long-term financial sustainability because of the significant amount of funding involved. There is, therefore, a need for more cost-effective intervention. The authors contend that design decisions in the built environment can have a positive impact on the efforts directed at mitigating the risk of malaria in a more cost-effective manner. It is known that the built environment, through features such as openings, can propagate the spread of malaria. There have been some significant efforts directed at addressing this risk. This notwithstanding, an extensive review of closely related work established that built environment professionals have limited access to information on specific ways through which their design decisions can contribute to mitigating the risk of malaria. The validity of this hypothesis was tested through evaluating the opportunities for synergies in selected parts of East Africa. Secondary data derived from relevant urban health journals as well as repositories curated by leading health agencies such as WHO were synthesized and analyzed using a web of causation approach. The outcome of the analysis is a schema of primary and secondary source (risk) factors. The use of the web of causation approach revealed the existing factor-to-factor interactions that could have a reinforcing effect. This information was used to identify the critical linkages and interdependencies across different factors. The outcome of the analysis was mapped against risk factors that can be linked to decisions made during the six primary phases of the construction life cycle: Preliminary phase, conceptual design, detailed design, construction, facilities management, and end of life/disuse. A conceptual architecture for a decision support framework has been proposed and will be developed into a prototype in subsequent efforts.