Peri-urban Settlements Research Articles

Locally led adaptation: drivers for appropriate grassroots initiatives

ABSTRACT Adapting to the impacts of climate change is one of the most urgent priorities of our time. Given that the impacts of climate change are experienced at local scales, it makes sense that adaptation should occur locally, and yet, despite this, locals often have little control over how adaptation is funded, designed and delivered in order to climate-proof their places and futures. Increasingly competitive access to funding and limited progress towards sustainable adaptation outcomes prompts our call to rethink adaptation at the local scale. Drawing from grounded research with locals, we explore three case examples from the Asia-Pacific region, ranging from the coastal belt of Bangladesh, to a peri-urban informal settlement in the Philippines, and to a small rural island in Vanuatu. These examples help illustrate how locally led adaptation (LLA) gives us hope for more equitable, effective and sustainable adaptation outcomes. We show how LLA can help to reduce dependency and support local autonomy, diverse capabilities and creativity. We propose nine mutually reinforcing drivers of LLA to improve grassroots initiatives. These drivers focus on locally led decision-making, local strengths and resources (e.g. institutions, social networks, local knowledge and coping mechanisms), local realities, local vulnerability contexts and inequalities, local metrics for measuring “success”, and local agendas which should be supported or enabled by external agencies. These drivers support local people to determine their own adaptation futures and ensure finite funding resources are utilised in meaningful ways.

Antibiotic Susceptibility Profile of Bacterial Isolates from Commercial Poultry Farms in Ile-Ife, Nigeria

Nontherapeutic antimicrobial usage in animal farms has been associated with the development and spread of resistant bacteria. The emergence of serious life-threatening infections from veterinary and environmental sources and treatment failures occurring with the available antibiotics warrants investigation into resistance of antimicrobial agents in poultry farms. This study therefore provides information on antibiotic resistance pattern of bacteria isolated from five commercial poultry farms in Ile Ife, a peri-urban settlement in Nigeria. Isolation of bacteria from droppings, feed and water samples, was performed by spread plate method using all purpose and selective media. Morphological and biochemical characterization of isolates was done. The antibiotics sensitivity of the recovered isolates was determined by Kirby-Bauer disk diffusion method. A total 151 bacterial isolates, comprising 11 genera of 8 Gram negative and 3 Gram positive bacteria were recovered.<i> E. coli</i> had highest incidence rate of 21.19%, followed by <i>Bacillus </i>sp.<i> </i>with 15.23%; while the least recorded incidence of 1.32% was <i>Citrobacter </i>sp. All five farms recorded a 100% resistance to at least two (2) classes of antibiotics. A 100% resistance was recorded for augmentin in all five (5) farms, while 100% resistance in four (4) farms was recorded for cloxacilin. Furthermore a 100% resistance against erythromycin and cefixime respectively was documented in three farms. The least percentage resistance of 30% was against ciprofloxacin in only one farm, while the overall highest susceptibility of 39% was to ofloxacin. The multiple antibiotic resistance index (MARI) of isolates from all farms ranged from 0.3 to 1. Up to 9 bacterial genera had MARI 1, including <i>E. coli</i>, <i>Salmonella</i>, <i>Bacillus</i>, <i>Klebsiella</i>, and<i> Pseudomonas</i>. This study is a further indication that poultry farms represents an important reservoir of antibiotic resistance bacteria. It also serves as a pointer to the need for enforcement of regulatory antibiotics use in poultry farming by the government, and controlled usage by all stakeholders.

Informal food environment is associated with household vegetable purchase patterns and dietary intake in the DECIDE study: Empirical evidence from food vendor mapping in peri-urban Dar es Salaam, Tanzania

We study the relationship between the food environment (FE) and the food purchase patterns, dietary intakes, and nutritional status of individuals in peri-urban Tanzania. In Africa, the prevailing high density of informal vendors creates challenges to characterizing the FE. We present a protocol and tool developed as part of the Diet, Environment, and Choices of positive living (DECIDE) study to measure characteristics of the FE. We mapped 6627 food vendors in a peri-urban settlement of Dar es Salaam, of which over 60% were semi-formal and informal (mobile) vendors. We compute and compare four FE metrics inspired by landscape ecology—density, dispersion, diversity, and dominance—to better understand how the informal food environment relates to food purchase patterns, diets, and nutritional status among households with persons living with human immunodeficiency virus (PLHIV).

Occurrence of a human-associated microbial source tracking marker and its relationship with faecal indicator bacteria in an urban estuary.

One of the main impacts of urban sprawl in rapidly growing countries has been contamination of coastal environments by waterborne pathogens, posing a critical risk to ecosystem and human health. Microbial source tracking (MST) has been a robust tool to identify the origin of these pathogens globally. This study compared the occurrence of a human-associated Bacteroides marker (BT-α) with faecal indicator bacteria (FIB) in an urban estuary (Golden Horn, Istanbul, Turkey). Faecal coliform (culture method), enterococci (both culture and qPCR method) concentrations and physicochemical variables were compared with the BT-α concentrations in monthly collected samples for a year (n=108). Enterococci concentrations detected by culture and qPCR were positively correlated (r=0·86, P<0·01) suggesting that qPCR can be an alternative method for monitoring. BT-α marker was positive for 30% of the samples and positively correlated with enterococci (r=0·61 and r=0·64 for culture and qPCR methods respectively, P<0·01). Rainfall had a moderate positive correlation with all faecal/MST indicators suggesting combined sewer overflows also severely impacted estuarine water quality. The high FIB and BT-α concentrations at upper estuary suggested that faecal pollution mainly originated from the peri-urban settlements around two creeks entering the estuary.

Cognitive Reserve and Its Determinants in Newly HIV Diagnosed Antiretroviral-Naive Adults From Periurban and Informal Settlements: Evidence From an HIV Hyperendemic South African Setting.

Cognitive reserve (CR), the brain's capacity to resist pathology, plays an essential role in preserving the cognitive health of people living with HIV. Cognitive health differs by the HIV clinical stage, but there are few studies on CR in newly diagnosed antiretroviral treatment (ART)-naive HIV-positive adults to inform early intervention in sub-Saharan Africa. We investigated the CR profile and its determinants among 211 newly diagnosed ART-naive HIV-positive participants from 2 clinics that serve periurban and informal settlement communities in KwaZulu-Natal, South Africa. CR domains in education, work, and leisure were assessed using the Cognitive Reserve Index questionnaire (CRIq). The CR determinants included major depression, substance use, CD4 count, history of head injury/medical comorbidity, in addition to sociodemographic status. Regression models were fitted to investigate relationships between the total/domain scores and their determinants. CRIq-Total scores were concentrated in the low-medium/medium functioning range with no individual in the extreme low or high CR functioning group. The determinants of CRIq-Total and CRIq-Education were older age, higher education attainment, and being employed. For the CRIq-Work domain, we found older age associated with lower CR. Major depression was only associated with lower CRIq-Leisure. ART scale-up will undoubtedly improve the longevity of individuals living with HIV, but we found high degree of suboptimal CR in a relatively young group of newly diagnosed ART-naive HIV-positive individuals from periurban and informal settlement communities. Early intervention focusing on increasing CR especially in socioeconomically vulnerable populations is needed to mitigate HIV-associated neurocognitive impairment and promote long-term healthy independent living.

The Smart City Mission in India And Prospects of Improvement in The Urban Environment

The skewed and rapid urbanization in developing country India has resulted in fissiparous and multipronged problems at different levels starting from city or perhaps regional levels to local or perhaps neighborhood in the lack of good urban planning and regulatory mechanism the urban environment adversely. Many issues that have been elevated in recent times are related to traffic congestion, reduction in the total amount of green cover, peri-urban settlement typology that has ultimately affected the natural ecosystem, and the surrounding areas’ environment adversely. These prevailing issues will worsen over the coming decades as the urban population increases at a phenomenal rate, thus highlighting the urgency to take appropriate actions. The growing urban environmental crisis has even more aggravated because of the constrained budgets and inefficient institutional machinery without clarified responsibilities. India is a nation of diverse geographical and climate zones with most of the climate, geographical conditions, and ecosystems of the globe found in various regions of the nation. These factors also affect the design, quality, and development of the urban built and unbuilt environment. The previous studies highlighted the role of meticulous, coordinated. They planned the development of urban cities and centers that are also self-sustaining and ecological to solve existing and upcoming challenges. The Smart City Mission launched by the Government of India is deemed the solution and emerging planning strategies to tackle and mitigate the issues of unregulated growth and rapid urbanization of the city currently and realize the objectives of the sustainable future. The unregulated urbanization with no due consideration to the ecosystem has turned into a significant source of deterioration of the quality of urban environment, a recurring and emerging disaster like urban flooding, Etc. And a significant cause of global climate change. This paper attempts to assess and evaluate the significance of smart city projects and missions in planning and developing cities that could deliver a much better urban environment and help achieve the goal of environmental resilience in the nation.

GOD IN CONTEXT: THE SYMBOLIC CONSTRUCTION OF A RELIGIOUS UNIVERSE IN A BASE CHRISTIAN COMMUNITY

‘We have depended,’ says Teresa Okure, ‘either on expatriates … or on African men to speak for us theologically and otherwise. Has the time now come to speak for ourselves? Okure’s question is asked as an African woman, but in South Africa at least, it can also be asked for marginalized and oppressed black groups as a whole. The concern of this essay is to reflect on the speaking of a small base Christian community in a large informal peri-urban settlement, similar to the favellas of Latin America, outside the Durban metropolitan area. The first step is ‘listening to’ what they have to say.

Analysis of Space Manipulation in an Informal Urban Settlement: The Case of Ng’ombe in Lusaka, Zambia

Urban informality remains a consistent challenge and matter of debate by planners and policymakers in the urbanising cities of sub-Saharan Africa. A common manifestation of urban informality in African cities is the sprawling informal settlements that constitute the only available housing option for the majority of the urban poor. The analysis of informal urban settlement’s environmental composition, physical modelling and socio-economic and policy analysis have been areas of recent study. However there is limited literature on how the urban poor communities in Zambia manipulate their social, spatial and economic environments to meet their needs. This article seeks to broaden the knowledge base on the way informal urban settlement communities manipulate their urban space. The built environment provides the setting for human interaction and the explanatory theory of Environment-Behaviour Relations provides a suitable analytical framework for the identification of useful parameters for developing future settlement interventions. The study employs a case study method of research to analyse the informal urban settlement settings. Ng’ombe, a peri-urban informal settlement in Lusaka, Zambia is the case study location for this research. Analysis of social, spatial and economic environment at neighbourhood level provides vital information about the informal urban settlement conditions. The study in particular addresses the question of how the social-spatial circumstances of the informal urban population in the developing world influence and defines their built environment. The study shows that systems of settings and system of activities in Ng’ombe offer a suitable analytical framework for studying the settlement characteristics that can guide in formulating strategies for settlement regularisation. Residents devise means of adapting and manipulating their informal urban space to suit their immediate needs and they also devise livelihood coping strategies in the midst of their informal settings. The paper likewise contributes to the growing body of knowledge in urban informality.

Risk of faecal pollution among waste handlers in a resource-deprived coastal peri-urban settlement in Southern Ghana.

Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscriminate solid waste disposal and open defecation practices. Persons engaged in waste handling in such communities perform their activities with little or no personal protective equipment. They are thus confronted with the risk of faecal pollution of the hands and other bodily parts. A mixed method approach was used to investigate 280 waste handlers performing different activities to estimate recent faecal pollution of their hands and to observe the utilization of personal protective equipment and sanitation/hygiene facilities during work. The log concentration of E. coli on hands of waste handlers after work (8.60 ± 4.20 CFU/hand, mean ± standard deviation) was significantly higher compared with the E. coli log concentration before work (2.95 ± 1.89 CFU/hand, mean ± standard deviation) (p<0.001). The odds of faecal pollution was significantly higher (aOR 4.2; 95% CI: 1.9–9.1) for workers aged 35 years and above compared with those less than 35 years; and for workers at public toilet facilities (aOR 3.0; 95% CI: 1.0–8.4) compared with those who worked for private waste handling companies. Female workers were, however, 60% less likely (aOR 0.4; 95% CI: 0.2–0.8) to experience faecal pollution of their hands compared with males. The workers had limited access to water and sanitation and hygiene facilities, and about one-fifth (n = 59; 21.1%) did not use personal protective equipment during work. Waste handlers should be provided and instructed in proper use of personal protective equipment, have access to sanitation facilities and adopt improved hygiene behaviour to avoid the risk of faecal pollution and associated disease risk.

Active TB case finding in a high burden setting; comparison of community and facility-based strategies in Lusaka, Zambia.

We conducted an implementation science study to increase TB case detection through a combination of interventions at health facility and community levels. We determined the impact of the study in terms of additional cases detected and notification rate and compared the yield of bacteriologically confirmed TB of facility based and community based case finding. Over a period of 18 months, similar case finding activities were conducted at George health facility in Lusaka Zambia and its catchment community, an informal peri-urban settlement. Activities included awareness and demand creation activities, TB screening with digital chest x-ray or symptom screening, sputum evaluation using geneXpert MTB/RIF, TB diagnosis and linkage to treatment. A total of 18,194 individuals were screened of which 9,846 (54.1%) were screened at the facility and 8,348 (45.9%) were screened in the community. The total number of TB cases diagnosed during the intervention period were 1,026, compared to 759 in the pre-intervention period; an additional 267 TB cases were diagnosed. Of the 563 bacteriologically confirmed TB cases diagnosed under the study, 515/563 (91.5%) and 48/563 (8.5%) were identified at the facility and in the community respectively (P<0.0001). The TB notification rate increased from 246 per 100,000 population pre-intervention to 395 per 100,000 population in the last year of the intervention. Facility active case finding was more effective in detecting TB cases than community active case finding. Strengthening health systems to appropriately identify and evaluate patients for TB needs to be optimised in high burden settings. At a minimum, provider initiated TB symptom screening with completion of the TB screening and diagnostic cascade should be provided at the health facility in high burden settings. Community screening needs to be systematic and targeted at high risk groups and communities with access barriers.

Structures and networks of accessing and securing land among peri-urban squatters: the case of Malawian migrants at Lydiate informal settlement in Zimbabwe

ABSTRACT The scholarly discourse on migrants and land access in peri-urban spaces is advancing theoretically and empirically. This paper contributes to this important discourse by examining the structures and networks used by migrants of international descent in accessing and securing the much coveted land in peri-urban spaces of destination countries. The study is qualitative, based on an ethnographic inquiry among Malawian migrants in Lydiate, an informal peri-urban squatter settlement in Zimbabwe’s Norton town. The finding of the paper is that migrants resort to alternative institutions including kinship, political networks and investors in accessing and securing land in peri-urban spaces. Migrants also establish themselves through the occult, a religious and ritual-based form of authority that is associated with deathly symbols. Because it is feared by adherence and indigenes alike, the occult is able to yield and guarantee land to migrants seeking it in its name. Migrant squatter settlements, therefore, emerge as dynamic spaces with novel forms of authority that regulate access to resources. Beneath the semblance of chaos that characterizes squatter settlements, there is another different ‘world’; ordered and shared by those who constitute it. The paper further argues that, the reason why migrants turn to alternative forms of authority in accessing and securing land is not because they prefer it; very often, there are no formal institutions that they can turn to. What this means for academia and policy makers is that, there is a broad scope of players that need to be engaged in the planning and governance of peri-urban spaces in the age of transnational mobility. These players include political patrons, investors, and other primordial forms of authority which include kinship and the feared occult. These players not only need to be understood but also require to be engaged in the ongoing construction and governance of peri-urban spaces.

Proximity Density Assessment and Characterization of Water and Sanitation Facilities in the Informal Settlements of Kisumu City: Implications for Public Health Planning.

Access to water and sanitation remain a challenge in many developing countries, especially in pro-poor urban informal settlements where socioeconomic livelihoods are generally low. The aim of this study was to characterise the water and sanitation facilities in the informal settlements of Kisumu City and to evaluate their effect on community hygiene and health. The study focussed on the five urban informal settlements of Nyalenda A, Nyalenda B, Manyatta A, Manyatta B and Obunga, and the three Peri-urban informal settlements of Kogony, Usoma and Otonglo. Using descriptive techniques, the researcher surveyed 114 water sources and all sanitation facilities within 0-15 m and 15-30 m radii of the water sources. The findings revealed dominance of shallow wells and traditional pit latrines as the primary water sources and sanitation facilities, respectively. Out of the water sources studied, 87.7% (100) were shallow wells (mean depth 1.5 m), 9.6% (11) springs and 2.6% (3) boreholes. Most of these shallow wells (83%) were within the urban informal settlements where uses range from washing and cleaning, cooking, and even drinking (13.5%), despite the majority being unprotected. The analysis of the density of sanitation facilities near the water points showed that 32.3% existed within a 15 m radius of the nearest water sources, in violation of the recommended safe distance of 30 m. With an increased density of toilets near critical water sources and other sanitary practices, public health is highly compromised.

Impact of malaria on haematological parameters of urban, peri-urban and rural residents in the Ashanti region of Ghana: a cross-sectional study.

Background: We aimed at investigating the impact of malaria on the haematological parameters of residents from different demographic settlements in the Ashanti Region of Ghana. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements may also influence these changes, but this has not been extensively studied in Ghana. Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. Results: Participants from the rural settlement had the highest malaria prevalence (21.3%) compared to urban (11.8%) and peri-urban areas (13.3%); however, the peri-urban area had the highest median parasite density (568; IQR=190.0-1312.0). Age was significantly associated with the odds of malaria positivity (OR: 0.97; CI:0.96 - 0.99; p=4.96*10 -4). When haematological parameters of the malaria-infected study participants were compared to the parameters of uninfected participants, red blood cell count (p=0.017), haemoglobin (p=0.0165), haematocrit (p=0.0015), mean corpuscular volume (p=0.0014), plateletcrit (p<0.0001) and platelet count (p<0.0001) were all significantly lower in the malaria infected group. In addition to age, haemoglobin and plateletcrit levels were also inversely correlated with the odds of testing positive for malaria, suggesting that children who were anaemic and/or thrombocytopaenic were likely to be infected. After fitting the data to a logistic regression model comprising the three variables, the model correctly categorised 78% of uninfected study participants, but only 50% of the malaria-positive participants. Conclusions: Study participants who were positive for malaria were younger and had low haemoglobin and plateletcrit levels compared to uninfected individuals. Further studies are needed to more precisely elucidate the relationship between malaria infection,demographic and haematological parameters.

Impact of malaria on haematological parameters of urban, peri-urban and rural residents in the Ashanti region of Ghana: a cross-sectional study

Background: We aimed at investigating the impact of malaria on the haematological parameters of residents from different demographic settlements in the Ashanti Region of Ghana. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements may also influence these changes, but this has not been extensively studied in Ghana. Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. Results: Participants from the rural settlement had the highest malaria prevalence (21.3%) compared to urban (11.8%) and peri-urban areas (13.3%); however, the peri-urban area had the highest median parasite density (568; IQR=190.0-1312.0). Age was significantly associated with the odds of malaria positivity (OR: 0.97; CI:0.96 — 0.99; p=4.96*10 -4). When haematological parameters of the malaria-infected study participants were compared to the parameters of uninfected participants, red blood cell count (p=0.017), haemoglobin (p=0.0165), haematocrit (p=0.0015), mean corpuscular volume (p=0.0014), plateletcrit (p<0.0001) and platelet count (p<0.0001) were all significantly lower in the malaria infected group. In addition to age, haemoglobin and plateletcrit levels were also inversely correlated with the odds of testing positive for malaria, suggesting that children who were anaemic and/or thrombocytopaenic were likely to be infected. After fitting the data to a logistic regression model comprising the three variables, the model correctly categorised 78% of uninfected study participants, but only 50% of the malaria-positive participants. Conclusions: Study participants who were positive for malaria were younger and had low haemoglobin and plateletcrit levels compared to uninfected individuals. Further studies are needed to more precisely elucidate the relationship between malaria infection,demographic and haematological parameters.

Impact of malaria on haematological parameters of urban, peri-urban and rural residents in the Ashanti region of Ghana: a cross-sectional study.

Background: We aimed at investigating the impact of malaria on the haematological parameters of residents from different demographic settlements in the Ashanti Region of Ghana. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements may also influence these changes, but this has not been extensively studied in Ghana. Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. Results: Participants from the rural settlement had the highest malaria prevalence (21.3%) compared to the urban (11.8%) and peri-urban areas (13.3%); however, the peri-urban area had the highest median parasite density (568; IQR=190.0-1312.0). Age was significantly associated with the odds of malaria positivity (OR: 0.97; CI:0.96 - 0.99). When haematological parameters of the malaria-infected study participants were compared to the parameters of uninfected participants, red blood cell count (p=0.017), haemoglobin (p=0.0165), haematocrit (p=0.0015), mean corpuscular volume (p=0.0014), plateletcrit (p<0.0001) and platelet count (p<0.0001) were all significantly lower in the malaria infected group. In addition to age, haemoglobin and plateletcrit levels were also inversely correlated with the odds of testing positive for malaria, suggesting that children who were anaemic and/or thrombocytopaenic were likely to be infected. After fitting the data to a logistic regression model comprising the three variables, the model correctly categorised 78% of uninfected study participants, but only 50% of the malaria-positive participants. Conclusions: Study participants who were positive for malaria were younger and had low haemoglobin and plateletcrit levels compared to uninfected individuals. Further studies are needed to more precisely elucidate the relationship between malaria infection,demographic and haematological parameters.

Understanding fish production and marketing systems in North-western Nigeria and identification of potential food safety risks using value chain framework

Fish production systems in North-western Nigeria have a significant role in food, nutrition and income generations to families, yet an important setup for zoonotic disease transmission. The aim of this study was to provide a broad knowledge of the structure, activities and food safety risks of the fish value chains operating in North-western Nigeria using the value chain framework. A total of 16 focus groups and 8 key informant interviews were conducted to gather data from fish producers, fish sellers and fish processors in selected peri-urban and rural settlements in Kaduna State. In addition, 129 semi-structured questionnaires and observation checklists were used in this study to gather evidence-based data, such as demography of value chain actors, product characterization, and food safety risks.The fish value-chain in North-western Nigeria is characterised by four main stakeholders, namely, fish producers, transporters, as well as raw- and processed-fish-sellers (wholesalers, retailers). Two major sources were identified supplying farmed fish to North-western Nigeria: the distributors from the central and southern part of the country and the fish farmers within the North-western and North-eastern regions of Nigeria. Raw-fish-wholesalers within the two major markets sold most of their high-value products to raw-fish-retailers, while low-value products were routed to raw-fish-retailers in the rural communities, processed-fish-retailers and household consumers in rural settlements. There were no large companies operating and no differentiation of chains between aquaculture and wild fishery. Raw fishes not sold and began to rot were sold to street vendors at a cheaper price and household consumers.Fish production and supply chains were characterised by poor structural and sanitary support for food safety and hygiene measures. Food safety risks identified were related to lack of biosecurity measures in fish farms, lack of cold chain and access to running water, poor hygiene practices by all handlers, lack of fish inspection at all levels, lack of use of protective clothing and limited health inspection of handlers.In overall, government control of activities in fish value chains was relatively poor leading to the absence of food safety regulatory enforcement characterised by lack of institutional goals on improving food safety measures in a chain-wide distribution. Hence, this study points the significant structural, sanitary and hygiene limitations along the fish value chain components. It provides a baseline for microbial food safety risk assessments, and information required for policy-making regarding implementation of disease control programmes, as the sector is fast-evolving in Sub-Saharan Africa.

The improved and the unimproved: Factors influencing sanitation and diarrhoea in a peri-urban settlement of Lusaka, Zambia.

Accounting for peri-urban sanitation poses a unique challenge due to its high density, unplanned stature, with limited space and funding for conventional sanitation instalment. To better understand users, needs and inform peri-urban sanitation policy, our study used multivariate stepwise logistic regression to assess the factors associated with use of improved (toilet) and unimproved (chamber) sanitation facilities among peri-urban residents. We analysed data from 205 household heads in 1 peri-urban settlement of Lusaka, Zambia on socio-demographics (economic status, education level, marital status, etc.), household sanitation characteristics (toilet facility, ownership and management) and household diarrhoea prevalence. Household water, sanitation and hygiene (WASH) facilities were assessed based on WHO-UNICEF criteria. Of particular interest was the simultaneous use of toilet facilities and chambers, an alternative form of unimproved sanitation with focus towards all-in-one suitable alternatives. Findings revealed that having a regular income, private toilet facility, improved drinking water and handwashing facility were all positively correlated to having an improved toilet facility. Interestingly, both improved toilets and chambers indicated increased odds for diarrhoea prevalence. Odds of chamber usage were also higher for females and users of unimproved toilet facilities. Moreover, when toilets were owned by residents, and hygiene was managed externally, use of chambers was more likely. Findings finally revealed higher diarrhoea prevalence for toilets with more users. Results highlight the need for a holistic, simultaneous approach to WASH for overall success in sanitation. To better access and increase peri-urban sanitation, this study recommends a separate sanitation ladder for high density areas which considers improved private and shared facilities, toilet management and all-inclusive usage (cancelling unimproved alternatives). It further calls for financial plans supporting urban poor access to basic sanitation and increased education on toilet facility models, hygiene, management and risk to help with choice and proper facility use to maximize toilet use benefit.

Effect of intercropping madumbe (Colocasia esculenta) and rice (Oryza sativa L.) on yield and land productivity under different irrigation water management techniques with effluent water

The need for the optimal use of land, without a yield penalty, in urban and peri-urban (UP) settlements is vital. This study investigated the effect of intercropping madumbe and rice with respect to yield and land productivity when irrigated with anaerobic baffled reactor (ABR) effluent under different irrigation water management techniques. It was hypothesized that intercropping under different irrigation water management techniques has no effect on the yield and land productivity. Field trials were conducted in the 2017 and 2018 cropping seasons with ABR effluent (without fertilizer) at the Newlands Mashu Experimental Site, Newlands East, Durban, South Africa. A randomized complete block design with 3 replications; cropping treatments of sole madumbe, sole rice and madumbe + rice (intercrop) and irrigation treatments of alternate wetting and drying (AWD), continuous flood irrigation (CFI) and wetting without flooding (WWF) was used. Growth and yield parameters at harvest were determined. Thereafter, land equivalent ratio (LER) was calculated to evaluate the productivity of the intercrop. The effect of intercropping was significant (P &lt; 0.05) on the total number of irrigation events and total water use. There was a significant reduction (P &lt; 0.05) in plant heights of both madumbe and rice at intercrop. However, the effect on plant height for treatment CFI was positive but not significant (P &gt; 0.05) for both seasons. A significant (P &lt; 0.05) reduction also occurred in the number of madumbe leaves/plant, and panicles/plant and tillers/plant for rice. Intercropping significantly reduced (P &lt; 0.05) madumbe corm and rice grain yield over the two seasons relative to sole cropping. LER showed that intercropping madumbe with rice was not more productive (LER &lt; 1) than sole cropping of madumbe. It was concluded that over the two-season period, intercropping madumbe and rice do not yield appreciably under any of the three irrigation management techniques applied and the study hypothesis is thus rejected.

Effect of intercropping madumbe (Colocasia esculenta) and rice (Oryza sativa L.) on yield and land productivity under different irrigation water management techniques with effluent water

The need for the optimal use of land, without a yield penalty, in urban and peri-urban (UP) settlements is vital. This study investigated the effect of intercropping madumbe and rice with respect to yield and land productivity when irrigated with anaerobic baffled reactor (ABR) effluent under different irrigation water management techniques. It was hypothesized that intercropping under different irrigation water management techniques has no effect on the yield and land productivity. Field trials were conducted in the 2017 and 2018 cropping seasons with ABR effluent (without fertilizer) at the Newlands Mashu Experimental Site, Newlands East, Durban, South Africa. A randomized complete block design with 3 replications; cropping treatments of sole madumbe, sole rice and madumbe + rice (intercrop) and irrigation treatments of alternate wetting and drying (AWD), continuous flood irrigation (CFI) and wetting without flooding (WWF) was used. Growth and yield parameters at harvest were determined. Thereafter, land equivalent ratio (LER) was calculated to evaluate the productivity of the intercrop. The effect of intercropping was significant (P &lt; 0.05) on the total number of irrigation events and total water use. There was a significant reduction (P &lt; 0.05) in plant heights of both madumbe and rice at intercrop. However, the effect on plant height for treatment CFI was positive but not significant (P &gt; 0.05) for both seasons. A significant (P &lt; 0.05) reduction also occurred in the number of madumbe leaves/plant, and panicles/plant and tillers/plant for rice. Intercropping significantly reduced (P &lt; 0.05) madumbe corm and rice grain yield over the two seasons relative to sole cropping. LER showed that intercropping madumbe with rice was not more productive (LER &lt; 1) than sole cropping of madumbe. It was concluded that over the two-season period, intercropping madumbe and rice do not yield appreciably under any of the three irrigation management techniques applied and the study hypothesis is thus rejected.

Effectiveness of a multi-level intervention to reduce men\u2019s perpetration of intimate partner violence: a cluster randomised controlled trial

BackgroundMen’s perpetration of intimate partner violence (IPV) limits gains in health and wellbeing for populations globally. Largely informal, rapidly expanding peri-urban settlements, with limited basic services such as electricity, have high prevalence rates of IPV. Evidence on how to reduce men’s perpetration, change social norms and patriarchal attitudes within these settings is limited. Our cluster randomised controlled trial aimed to determine the effectiveness of the Sonke CHANGE intervention in reducing use of sexual and/or physical IPV and severity of perpetration by men aged 18–40 years over 2 years.MethodologyThe theory-based intervention delivered activities to bolster community action, including door-to-door discussions, workshops, drawing on the CHANGE curriculum, and deploying community action teams over 18 months. In 2016 and 2018, we collected data from a cohort of men, recruited from 18 clusters; nine were randomised to receive the intervention, while the nine control clusters received no intervention. A self-administered questionnaire, using audio-computer assisted software, asked about sociodemographics, gender attitudes, mental health, and the use and severity of IPV. We conducted an intention-to-treat analysis at the cluster level comparing the expected risk to observed risk of using IPV while controlling for baseline characteristics. A secondary analysis used latent classes (LCA) of men to see whether there were differential effects of the intervention for subgroups of men.ResultsOf 2406 men recruited, 1458 (63%) were followed to 2 years. Overall, we saw a reduction in men’s reports of physical, sexual and severe IPV from baseline to endpoint (40.2% to 25.4%, 31.8% to 15.8%, and 33.4% to 18.2%, respectively). Intention-to-treat analysis showed no measurable differences between intervention and control clusters for primary IPV outcomes. Difference in the cluster-level proportion of physical IPV perpetration was 0.002 (95% confidence interval [CI] − 0.07 to 0.08). Similarly, differences between arms for sexual IPV was 0.01 (95% CI − 0.04 to 0.06), while severe IPV followed a similar pattern (Diff = 0.01; 95% CI − 0.05 to 0.07). A secondary analysis using LCA suggests that among the men living in intervention communities, there was a greater reduction in IPV among less violent and more law abiding men than among more highly violent men, although the differences did not reach statistical significance.ConclusionThe intervention, when implemented in a peri-urban settlement, had limited effect in reducing IPV perpetrated by male residents. Further analysis showed it was unable to transform entrenched gender attitudes and use of IPV by those men who use the most violence, but the intervention showed promise for men who use violence less.Trial registrationClinicalTrials.gov, NCT02823288. Registered on 30 June 2016.