Improving health in cities through systems approaches for urban water management.

L C Rietveld,J G Siri,A M Arsénio,A Chatterjee,R Biswas,I Chakravarty

doi:10.1186/s12940-016-0107-2

Abstract

BackgroundAs human populations become more and more urban, decision-makers at all levels face new challenges related to both the scale of service provision and the increasing complexity of cities and the networks that connect them. These challenges may take on unique aspects in cities with different cultures, political and institutional frameworks, and at different levels of development, but they frequently have in common an origin in the interaction of human and environmental systems and the feedback relationships that govern their dynamic evolution. Accordingly, systems approaches are becoming recognized as critical to understanding and addressing such complex problems, including those related to human health and wellbeing. Management of water resources in and for cities is one area where such approaches hold real promise.ResultsThis paper seeks to summarize links between water and health in cities and outline four main elements of systems approaches: analytic methods to deal with complexity, interdisciplinarity, transdisciplinarity, and multi-scale thinking. Using case studies from a range of urban socioeconomic and regional contexts (Maputo, Mozambique; Surat and Kolkata, India; and Vienna, Austria).ConclusionWe show how the inclusion of these elements can lead to better research design, more effective policy and better outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-016-0107-2) contains supplementary material, which is available to authorized users.

Highlights

As human populations become more and more urban, decision-makers at all levels face new challenges related to both the scale of service provision and the increasing complexity of cities and the networks that connect them
This review paper summarizes the strong and complex relationships between urban water management and health, which are a primary impetus for the use of integrated systems approaches in this context
Modelling of complexity in the water and wastewater cycles is illustrated in the case study of Maputo, where mass flow analysis (MFA) gives insight as to probable demand for and sources of reclaimed wastewater

Summary

Introduction

As human populations become more and more urban, decision-makers at all levels face new challenges related to both the scale of service provision and the increasing complexity of cities and the networks that connect them. Unprecedented urban populations and densities, intra-urban inequities, and inter-urban mobility pose serious new problems, and climate change adds a novel and uncharted dimension [4, 5] This has, in some cases, led to worsening urban health, or to increased risks—for instance, some water-associated diseases like dengue are on the rise globally [6] while others, like cholera, nominally controlled in the developed countries, continue to pose serious threats elsewhere [7]; many regions face increased food and water scarcity, and many urban slums present conditions that challenge effective water management [8]

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Conclusion