Urban Areas Of sub-Saharan Africa Research Articles

ANALYSE DE L’INFLUENCE DES PARAMETRES METEOROLOGIQUES SUR LA PLUVIOMETRIE A KINSHASA

The understanding of meteorological parameters influencing rainfall is essential to effectively address environmental challenges and anticipate the consequences of extreme weather events. In this study, we analyze meteorological data provided by the Airways Authority of Kinshasa (RVA), covering the period from 1992 to 2019. This in-depth statistical analysis aims to better understand the factors that influence precipitation in the region and to identify relevant climate trends for anticipating future environmental changes. We used logistic regression to assess the impact of various climatic factors such as temperature (daily extremes), relative humidity, and atmospheric pressure on precipitation. The results indicate that minimum temperature, relative humidity, and atmospheric pressure show a strong correlation with rainfall in Kinshasa, highlighting their significant influence on the likelihood of precipitation. In contrast, maximum temperature has a limited impact, making it a less reliable indicator of rainfall in the city. The conclusions of this study provide valuable tools for local authorities in developing effective strategies for managing climate variations and predicting weather phenomena. These insights enable precise modeling of the impacts of meteorological fluctuations on ecosystems and urban infrastructure. Furthermore, the results of this research can guide local farmers in optimizing their agricultural practices by adjusting planting and harvesting schedules based on detailed weather forecasts, thereby minimizing economic losses and enhancing crop resilience to climate variations. Finally, this study provides climatologists with robust data for in-depth analysis of the effects of climate change on meteorological phenomena in Kinshasa. This knowledge is crucial for refining regional climate models and developing specific adaptation strategies for other urban areas in sub-Saharan Africa.

A framework for assessing social structure in community governance of sustainable urban drainage systems: insights from a literature review

The utilization of Sustainable Urban Drainage Systems (SUDS) as Nature-based Solutions (NBS) holds significant promise for enhancing resilience against climate change-induced flooding and promoting community well-being in urban areas of Sub-Saharan Africa. While existing research predominantly emphasizes technical aspects within the NBS framework, understanding the socio-governance dynamics at the community level is equally imperative, particularly given the decentralized nature of SUDS. This study aims to complement the prevailing technical focus by examining the social dimensions of community governance related to SUDS implementation. Through a literature review, key determinants of social structure influencing successful community governance in SUDS management are identified, and categorized into actors, resources, discourses, and rules of engagement. An innovative assessment framework comprising 65 indicators is proposed to evaluate these determinants, offering a comprehensive tool for scholars and practitioners. By integrating social considerations into SUDS management practices, this research seeks to inform policy formulation and strategies tailored to Sub-Saharan African cities, facilitating equitable and participatory urban stormwater management initiatives crucial for addressing climate change challenges.

Colorectal cancer disease profile and treatment patterns at an urban tertiary hospital in Rwanda.

The incidence of colorectal cancer (CRC) in sub-Saharan Africa (SSA) is rising, due to improving cancer registration efforts on one hand and an increasing westernisation of diets and lifestyle on the other as well as increasing rates of comorbidities. We present data for the clinical characteristics, pathology, treatments received, and survival outcomes of patients diagnosed with CRC at King Faisal Hospital (KFH) between January 2019 and May 2023. KFH is an urban tertiary hospital in Rwanda that provides chemotherapy and surgery to cancer patients. The data were extracted from electronic medical records, imaging and histopathology reports from the patient's time of diagnosis. We plotted Kaplan-Meier estimation of survival, defined as the time from presentation to death, within the study period (2019-2023). Seventy-four patients diagnosed with CRC with complete information were identified in the KFH oncology records. The mean age at diagnosis was 54.6 years, with ages ranging between 22 and 81 years. At diagnosis, 24 (32.4%) patients were less than 50 years old and 29 (39.2%) were females. The rectum (36.5%) was the most common tumour location, and 58.1 tumours were left-sided. Most patients presented with Stage III (41.9%) or IV (35.1%) disease. Adenocarcinoma was the most common histological type (98.6%) including adenocarcinoma not otherwise specified (NOS) (86.5%), mucinous adenocarcinoma (10.8%), signet ring cell carcinoma (1.4%) and followed by squamous cell carcinoma (1.4%). In terms of treatment, 19 (25.7%) patients received only chemotherapy, 43 (58.1%) patients received neo-adjuvant or adjuvant chemotherapy, 9 (12.2%) of patients received both neo-adjuvant and adjuvant chemotherapy, 49 patients (66.2%) underwent surgery and 17 (23%) patients also received radiation. At the end of the follow up period, 63 (85.1%) patients remained in surveillance, 10 (13.5%) patients died, and 1 (1.3%) patient was lost to follow up. Mean overall survival was 45.5 (SD ± 2.0) months. CRC patients presented at an advanced stage and required complex treatment regimens at KFH. Further epidemiologic and molecular research is needed to characterise CRC incidence and presentation at a national level in Rwanda as increasing westernisation continues to change the face of CRC in urban areas of SSA.

Characterising sources of PM2·5 exposure for school children with asthma: a personal exposure study across six cities in sub-Saharan Africa

Air pollution is the second largest risk to health in Africa, and children with asthma are particularly susceptible to its effects. Yet, there is a scarcity of air pollution exposure data from cities in sub-Saharan Africa. We aimed to identify potential exposure reduction strategies for school children with asthma living in urban areas in sub-Saharan Africa. This personal exposure study was part of the Achieving Control of Asthma in Children in Africa (ACACIA) project. Personal exposure to particulate matter (PM) was monitored in school children in six cities in sub-Saharan Africa (Blantyre, Malawi; Durban, South Africa; Harare, Zimbabwe; Kumasi, Ghana; Lagos, Nigeria; and Moshi, Tanzania). Participants were selected if they were aged 12-16 years and had symptoms of asthma. Monitoring was conducted between June 21, and Nov 26, 2021, from Monday morning (approximately 1000 h) to Friday morning (approximately 1000 h), by use of a bespoke backpack with a small air pollution monitoring unit with an inbuilt Global Positioning System (GPS) data logger. Children filled in a questionnaire detailing potential sources of air pollution during monitoring and exposures were tagged into three different microenvironments (school, commute, and home) with GPS coordinates. Mixed-effects models were used to identify the most important determinants of children's PM2·5 (PM <2·5 μm in diameter) exposure. 330 children were recruited across 43 schools; of these, 297 had valid monitoring data, and 1109 days of valid data were analysed. Only 227 (20%) of 1109 days monitored were lower than the current WHO 24 h PM2·5 exposure health guideline of 15 μg/m3. Children in Blantyre had the highest PM2·5 exposure (median 41·8 μg/m3), whereas children in Durban (16·0 μg/m3) and Kumasi (17·9 μg/m3) recorded the lowest exposures. Children had significantly higher PM2·5 exposures at school than at home in Kumasi (median 19·6 μg/m3vs 14·2 μg/m3), Lagos (32·0 μg/m3vs 18·0 μg/m3), and Moshi (33·1 μg/m3vs 23·6 μg/m3), while children in the other three cities monitored had significantly higher PM2·5 exposures at home and while commuting than at school (median 48·0 μg/m3 and 43·2 μg/m3vs 32·3 μg/m3 in Blantyre, 20·9 μg/m3 and 16·3 μg/m3vs 11·9 μg/m3 in Durban, and 22·7 μg/m3 and 25·4 μg/m3vs 16·4 μg/m3 in Harare). The mixed-effects model highlighted the following determinants for higher PM2·5 exposure: presence of smokers at home (23·0% higher exposure, 95% CI 10·8-36·4), use of coal or wood for cooking (27·1%, 3·9-56·3), and kerosene lamps for lighting (30·2%, 9·1-55·2). By contrast, 37·2% (95% CI 22·9-48·2) lower PM2·5 exposures were found for children who went to schools with paved grounds compared with those whose school grounds were covered with loose dirt. Our study suggests that the most effective changes to reduce PM2·5 exposures in these cities would be to provide paving in school grounds, increase the use of clean fuel for cooking and light in homes, and discourage smoking within homes. The most efficient way to improve air quality in these cities would require tailored interventions to prioritise different exposure-reduction policies in different cities. UK National Institute for Health and Care Research.

Rural-urban differentials in the association between sex preference for children and marital dissolution in sub-Saharan Africa.

Marital dissolution, which refers to being divorced or separated, is considered one of the most dramatic demographic events that significantly disrupt families. Unearthing the factors predicting marital dissolution would support actions to reduce the incidence of this phenomenon. The present study sought to examine the association between sex preference for children and marital dissolution segregated by place of residence. Data for the study were extracted from the most recent Demographic and Health Surveys (DHS) of 25 countries in sub-Saharan Africa. Percentages were used to summarise the proportion of marital dissolution among women in sub-Saharan Africa. Binary logistic regression models were fitted to examine the association between sex preference for children and marital dissolution per place of residence. Results of the regression analysis were presented using adjusted odds ratios (aOR) with their respective 95% confidence interval (CI). The overall prevalence of marital dissolution was 5.92% (95% CI: 5.83-6.00), and this ranged from 1.63% (95% CI: 1.41-1.85) in Burkina Faso to 15.62% (95% CI: 14.70-16.54) in Mozambique. In urban sub-Saharan Africa, the overall prevalence of marital dissolution was 8.88% (95% CI:8.78-8.99), with the lowest prevalence in Mali (3.30%; 95% CI: 2.91-3.69) and the highest in Uganda (18.60%; 95% CI: 17.95-19.25). For rural sub-Saharan Africa, the pooled prevalence was 4.11% (95% CI: 4.03-4.18), with the lowest (0.80%; 95% CI: 0.65-0.95) and highest (14.40%; 95% CI: 13.51-15.29) prevalences in Burkina Faso and Mozambique, respectively. Compared to women with no sex preference, the preference for boys was less likely to result in marital dissolution (aOR = 0.87; 95%CI = 0.83-0.90) in both urban and rural areas, whereas the preference for girls was more likely to result in marital dissolution (aOR = 1.06; 95%CI = 1.02-1.10). When the results were disaggregated by place of residence, in both urban (aOR = 0.87; 95%CI = 0.80-0.95) and rural areas (aOR = 0.87; 95%CI = 0.82-0.92), women who preferred boys were less likely to experience marital dissolution compared to those who had no preference. However, the preference for girls showed no statistically significant association with marital dissolution. Our study has shown that sex preference for children has a significant association with marital dissolution in both rural and urban areas in sub-Saharan Africa. Whereas the preference for male children serves as a protective factor against marital dissolution, the preferences for females was found to increase the likelihood of marital dissolution. Thus, underscoring a need for anti-marital dissolution campaigns and initiatives to prioritise the sensitisation of society about the value of female children. Religious groups and leaders can leverage their platform to quell sex preferences and dissuade marital dissolution. Policies and programmes aimed at reducing the risk of marital dissolution in sub-Saharan Africa must also focus on enlightening the population on intimate partner violence prevention.

Portable Water Shortages on Households in Bomaka in the Buea Municipality, South West Region of Cameroon: Challenges and Coping Strategies

Today, in most urban areas in Sub-Saharan Africa, dwellers are facing difficulties in adequately accessing potable water in sufficient quantity and quality for their daily needs and uses. Analogously, there have been fledgling challenges triggered by portable water Shortage in Bomaka. This study aims to assess the problem of potable water accessibility in Bomaka in the Buea Municipality and the coping strategies developed by dwellers to meet their needs. The study used exploratory, inferential and descriptive research approaches. In this light, the cross-sectional research design was adopted to address the overall problem. A preliminary reconnaissance survey was accomplished whereby questionnaire and interview guides were administered. A total of 200 households were selected and investigated based on purposive and systematic random sampling, particularly around the water points. Secondary information was sought from published and unpublished materials. Results reveal that in Bomaka 100% of the households sourced their water from alternative sources (boreholes, wells, streams and springs) without any pre-treatment. Most of these sources do not flow regularly because of siltation or a drop in the volume of flow, especially in the dry season. The Cameroon Water Utilities Corporation (CAMWATER) is absent in this locality. Results also revealed that water sources were located at reasonable distances. This study records that the major causes of portable water shortages were population increase, poor planning and water pollution. The implications of irregular and portable water shortages are increased health risks, poor hygienic condition, disruption of economic activities and domestic routines. The study concludes that water remains the yard stick and a panacea to many countries and households. Thus, adequate planning, undivided attention and holistic measures should be implemented in order to sustain its accessibility.

The persistent gap in urban sanitation

• Studies, including the authors research, show that onsite sanitation is unsafe in dense low-income urban areas in and outside sub-Saharan Africa, exposing the population to sanitation-related diseases. • Public funding for sanitation is too low, in many cases below the 0,5% of the GDP African countries committed to in the 2008 eThekwini Declaration and the 2015 N’gor declaration. • Public investment and engagement are urgently needed in sanitation in dense low-income urban areas in sub-Saharan Africa, as well as alternatives to onsite sanitation.

High-resolution estimates of social distancing feasibility, mapped for urban areas in sub-Saharan Africa

Social distancing has been widely-implemented as a public health measure during the COVID-19 pandemic. Despite widespread application of social distancing guidance, the feasibility of people adhering to such guidance varies in different settings, influenced by population density, the built environment and a range of socio-economic factors. Social distancing constraints however have only been identified and mapped for limited areas. Here, we present an ease of social distancing index, integrating metrics on urban form and population density derived from new multi-country building footprint datasets and gridded population estimates. The index dataset provides estimates of social distancing feasibility, mapped at high-resolution for urban areas across 50 countries in sub-Saharan Africa.

Urban surface water quality and the potential of phytoremediation to improve water quality in peri-urban and urban areas in sub-Saharan Africa – a review

AbstractIn 2017, 400 million people in sub-Saharan Africa (SSA) were still using unimproved drinking water sources, 80 million of whom relied on untreated surface water. Urban areas are vastly expanding all over the continent and many larger cities in SSA struggle to provide safely managed drinking water. Phytoremediation implemented in constructed wetlands (CWs) is a low-cost and sustainable alternative to highly costly and energy-consuming wastewater treatment plants. In addition, CWs offer the potential to be integrated into farming and aqua-culture systems and can therefore improve food quality and production. The most prominent pollutants in urban SSA surface waters and the pollutant removal efficiencies for microbial and chemical contaminations of different plant species were identified from the literature and the accumulation rates for Pb, Cr, and Cd were compared with each other. A strong focus was given to studies conducted in SSA or other (sub)tropical regions. This review identified a range of potential phytoremediators to treat contaminated surface water and highlights the need for further in situ studies in SSA. Plant species such as Lemna minor, Ipomoea aquatica, Spirodela polyrhiza and Brachiaria mutica show a high potential to phytoremediate the heavy metals Pb, Cr and Cd from surface water.

Renewable Energy Technologies in the Global South: Sub-Saharan Africa Trends and Perspectives

Sub Saharan Africa (SSA) and other parts of the Global South are richly endowed with renewable energy resources (RERs) that are grossly untapped. The integration of these resources, such as hydro, wind, solar, and biomass will facilitate the desired net zero-CO2-emissions economy. If these RERs are adequately harnessed, the perennial power supply challenges in the region will be resolved, and the negative power supply narrative changed. Presently, a greater percentage of the population without access to electricity live in the Global South with SSA having the highest share. This inadequacy has been attributed to many factors, which include lack of connection to the national grid; lack of adequate technical capacities to design and manufacture efficient power generation and transmission components and systems; insufficient funds; unreliable, limited, and poor energy data. A comprehensive study of the renewable energy potential (REP) and technologies in the Global South is imperative to the management, regulation, and policies concerning energy, in this era of energy transition (ET). This study presents - a summary of REP of SSA; statistical analysis of the proposed and installed RE capacity across the region; and discussion on the pressing need for renewable energy integration (REI) to mitigate climate change. In addition, to develop RE schemes to facilitate greater access to clean, affordable, and adequate energy supply. Actualization of the integration of RERs into the national portfolio will promote CO2 reduction and improve the socio-economic benefits to the populace in both rural and urban areas of SSA and the Global South generally. Keywords— Renewable energy system; Net-zero-CO2 emissions, renewable energy in Global South; hydro; wind; solar; biomass

Suspect screening to support source identification and risk assessment of organic micropollutants in the aquatic environment of a Sub-Saharan African urban center

Organic micropollutants (OMPs) are contaminants of global concern and have garnered increasing attention in Africa, particularly in urban and urbanizing areas of Sub-Saharan Africa (SSA). In this work, we coupled suspect screening enabled by liquid chromatography-high-resolution mass spectrometry (LC-HRMS) with multivariate analysis to characterize OMPs in wastewater, surface water, and groundwater samples collected from Kampala, the capital and largest city of Uganda. Suspect screening prioritized and confirmed 157 OMPs in Kampala samples for target quantification. Many OMPs detected in Kampala samples occurred within concentration ranges similar to those documented in previous studies reporting OMP occurrence in SSA, but some have never or rarely been quantified in environmental water samples from SSA. Hierarchical cluster analysis established the source-related co-occurrence profiles of OMPs. Partial least squares regression and multiple linear regression analyses further pinpointed the concentration of nitrate and the content of a fluorescent organic matter component with excitation/emission maxima around 280/330 nm as predictors for the sample-specific cumulative concentrations of OMPs, suggesting the likely contribution of diffuse runoff and wastewater discharges to OMP occurrence in the aquatic environment of Kampala. Parallel calculations of exposure-activity ratios and multi-substance potentially affected fractions provided insights into the potential for biological effects associated with OMPs and highlighted the importance of expanded analytical coverage for screening-level risk assessments. Overall, our study demonstrates a versatile database-driven screening and data analysis methodology for the multipronged characterization of OMP contamination in a representative SSA urban center.

GAP FILLERS OR PIONEERS: INFORMAL WATER SUPPLIERS IN PERI-URBAN AREAS OF THE TECHIMAN MUNICIPALITY OF GHANA

There is continuous expansion and growth of urban and peri urban areas in Sub-Saharan Africa with projections indicating that this will double. Some peri-urban areas such as those in the Techiman municipality of Ghana are experiencing this trend. Nonetheless, the spate of growth of these areas outstrips the supply of utilities by municipal water distribution networks. As a result, some areas have little or no public provision. In order to address the water supply challenge, places with favourable hydrological settings are witnessing the emergence of informal water suppliers as “gap fillers” or “pioneers”, providing water services. Noteworthy, however, existing studies about informal water suppliers in peri-urban areas in Ghana lump them together, without considering the water source. This study differs in that it specifically examines the evolution and the features of informal water suppliers who privately and independently abstract and supply groundwater. Additionally, it attempts to understand the nature of informality of the suppliers and the possibility of formalisation. The paper is an exploratory study using the case of private mechanised borehole operators who supply water in their respective areas. The findings showed that in some peri-urban areas in the Techiman municipality, some dwellers constructed and operated mechanised boreholes, which provide in-situ water and utilities to others. They are mostly pioneer water suppliers in some of the areas. Their services are informal by nature because they are largely independent of the formal sector and apply informal arrangements in rendering their services. Seen also as business enterprises, they are not licenced. However, the boreholes are registered with the Municipal Assembly, which indicated some level of formalisation. The study recommended that efforts to formalise them further should focus on improving water quality monitoring for consumption and promoting sustainable abstraction.

Malian Thick Porridges (tô) of Pearl Millet Are Made Thinner in Urban Than Rural Areas and Decrease Satiety.

Changes in preparation, preference, and consumption of traditional staple foods between rural and urban areas in sub-Saharan Africa may be associated with the nutrition transition. Millet porridge thickness and postprandial hunger were investigated in Mali with the aim of understanding consumer preference and satiety properties. Rural and urban residents from 3 regions (N = 60) were surveyed regarding their porridge consumption frequency and thickness preference. Influence of millet porridge thickness on satiety was investigated. Ten participants consumed 4 porridges of different thicknesses (3 of millet and 1 thin porridge of rice) and rated their subjective hunger on 4 different days. Thicker porridges were consumed more frequently in rural areas than in urban (P < .05). For the satiety study, thicker porridges induced higher satiety than thinner ones at 2 and 4 hours postconsumption (P < .05; Visual Analog Scale rating). A greater amount of flour, but not volume, was consumed for the thicker porridges (P < .05). Urban participants preferred and consumed porridges that are less satiating, potentially contributing to higher food consumption related to the nutrition transition in Africa.

How land tenure and labor relations mediate charcoal’s environmental footprint in Zambia: Implications for sustainable energy transitions

• Land tenure and labor market conditions structure charcoal production’s environmental footprint in Zambia. • Charcoal is a one-off byproduct of agricultural conversion on customary and private lands, so from an unsustainable source. • Charcoal drives forest degradation in Forest Reserves (State Lands), with low regeneration potential. • Charcoal production creates a biomass loss of at least 50% from extraction of most tree species of all sizes (≥10 cm dbh). • Charcoal producers' effort responds to un(der)employment, specially during the season when agricultural labor demand wanes. Charcoal is the main cooking fuel in urban areas of sub-Saharan Africa and demand is expected to rise with urbanization. We explore the environmental footprint and socioeconomic drivers of charcoal production, using data from original field vegetation and producer surveys in a hotspot charcoal production area outside Lusaka, Zambia. We find that land tenure and labor market conditions structure the environmental footprint of charcoal production. Agricultural expansion is the main driver of forest conversion on customary and private (leasehold) lands where charcoal is a one-off byproduct of land-use change by farmers. By contrast, charcoal production drives forest degradation on State land, especially in Forest Reserves where agriculture is prohibited but the more intact forest is intensively harvested, largely by urban residents or, during the dry season, by nearby farmers lacking remunerative employment. Charcoal producers are remarkably varied, with sharp variation in net financial gains that are positively and significantly associated with volume produced. Strategies for improving the sustainability of charcoal production differ by land tenure type but require a combination of enhanced enforcement of existing land use restrictions, improved labor market conditions, greater support for sustainable agricultural intensification, devolution of forest management to more local level, and adoption of alternative cooking fuel sources by urban residents.

Foodscapes in urban spaces of Africa: implications for food and nutrition security among the urban poor

Food security has been a global development agenda for several decades, and rightly so: nearly 945 million people were food insecure in 2005 and a decade later, this number declined to 784 million in 2014, only to rise to 821 million three years later in 2017. These global figures, however, mask variations in the extent of progress in different regions of the world. Progress towards achieving food security has been much slower in sub-Saharan Africa, and the region continues to be the worst hit by food insecurity. Furthermore, it is increasingly being recognised that food insecurity is prevalent in urban, and not just rural areas, and that the urban poor rather than the rural poor are particularly vulnerable, and at increased risk of being food insecure. Additionally, nutrition insecurity, a closely related component of food insecurity, is common among the urban poor and contributes to malnutrition. While several factors have been explored in trying to address the issue of food security, the potential role of foodscapes in urban spaces of Africa has been less researched. Recent evidence, however, indicates that foodscapes in urban areas of sub-Saharan Africa potentially contribute to food and nutrition insecurity, particularly among the urban poor. Addressing food and nutrition insecurity in sub-Saharan Africa will thus first require reframing the discourse about these issues from solely a rural to also an urban problem, and secondly improving access, especially availability of healthy and nutritious options that are also economically accessible, for vulnerable and at-risk groups; in particularly, the urban poor.

Energy Drink Consumption among Adolescents Attending Schools in Lubumbashi, Democratic Republic of Congo.

Background: The consumption of energy drinks (EDs) is increasing in the general population, but little is known about the consumption of EDs among pupils in Africa. This study was designed to assess the consumption of EDs among pupils between 10 and 17 years of age and to assess average caffeine concentrations contained in EDs sold in Lubumbashi. Methods: We conducted a cross-sectional survey in five schools using a standardised questionnaire taken face-to-face. Samples of locally purchased EDs were analysed by High Performance Liquid Chromatography with Ultra-Violet spectrometry (HPLC-UV). Results: Of 338 pupils (54% girls), 63% reported having consumed at least one ED in the last week and 34% drank at least one ED a day. The cheapest ED was the most widely consumed. Among pupils having consumed at least one ED in the last week, 79% reported consuming it for refreshment and 15% to get energy. For those who reported not consuming EDs, 40% reported that their parents or teachers forbade them to drink EDs. Some (14%) teenagers, mainly boys, mixed ED with alcohol. The concentrations of caffeine measured in twelve brands of EDs ranged from 7.6 to 29.4 mg/100 mL (median 23.3), giving caffeine contents of 37.5 to 160 mg (median 90 mg) per can or bottle. The estimated daily intake of caffeine through EDs was between 51.3 mg and 441.3 mg among those consuming EDs regularly. Conclusion: Our study convincingly demonstrates that caffeine-containing EDs are not only consumed by youngsters living in affluent societies. We documented widespread regular consumption of EDs among (pre-)adolescent schoolchildren living in Lubumbashi, a large city of the Democratic Republic of Congo (DRC). In view of the global market expansion of caffeinated EDs, it is reasonable to suspect that similar surveys in other urban areas of sub-Saharan Africa would yield similar findings. Pricing and advertising regulations and education on EDs are necessary to limit the regular consumption of EDs among adolescents.

Water sanitation and hygiene in Sub-Saharan Africa: Coverage, risks of diarrheal diseases, and urbanization

Sub-Saharan Africa (SSA) has a rapidly growing urban population, with water, sanitation, and hygiene (WASH) services representing the central needs for this population. Incidentally, this region has the lowest global WASH coverage. Data from the ‘WHO/UNICEF Joint Monitoring Programme for Water supply, Sanitation and Hygiene’ and the ‘Global Burden of Disease’ study from the Institute for Health Metrics and Evaluation were used to assess WASH coverage and related health burden in SSA, its subregions, and rural and urban areas in SSA. WASH coverage in the SSA region appears to be low, but urban coverage is better than that in rural areas; however, there is unequal access to urban WASH and poor urban areas are underserved. In addition, 7.75% (5.99–9.7%) of total deaths due to diarrheal diseases across SSA are attributed to unsafe WASH with a risk factor attribution (RFA) percentage of 95.93% (91.94–98.24%). Therefore, a correlation between WASH coverage and mortality due to diarrheal diseases could be established.There is a lack of data on WASH coverage in poor urban areas, although these areas have high incidence of WASH-related diseases including diarrhea. Disaggregated urban WASH data are needed to better understand the WASH service needs of poor urban areas, which would be helpful in ensuring a more inclusive implementation of WASH services.

Challenges facing sustainable water supply, sanitation and hygiene achievement in urban areas in sub-Saharan Africa

ABSTRACT Better water supply, sanitation and hygiene systems are among the sustainable development goals which need to be achieved by 2030. However, it is challenging for developing countries especially sub-Saharan Africa to achieve sustainable sanitation and hygiene. Thus, a systematic review has been conducted to provide a deep discussion of the current and previous works on challenges facing sanitation and hygiene sector in SSA countries. The results indicate that lack of financial resources, rapid population increase, socioeconomic disparities among the urban inhabitants, topography, lack of skilled, and experienced personnel, inadequate policies and strategies, and people’s behaviours and attitudes were identified as the main constraints to sustainable sanitation and hygiene in SSA. Moreover, it recommended that SSA countries can achieve sustainable sanitation and hygiene if there are political commitments, an increase of education and awareness on sanitation to the community, and cooperation among the government, non-government organisations, civil societies, and communities in addressing the issues of sanitation. These efforts will lead to enhanced and improved sanitation and hygiene services in the SSA region.

The relationship between spatial access and modern contraceptive use: is proximity to a healthcare facility a determinant of use among women in Kinshasa, DRC?

Background: Spatial access has a direct effect on health service utilization in many settings. Distance to health facility has proven to affect family planning (FP) service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay. This study analyzed the significance of proximity to family planning services, service availability, and quality of family planning services on modern contraceptive use in Kinshasa, Democratic Republic of the Congo. Methods: We used a pool of four rounds of facility- and population-based survey data in Kinshasa from PMA2020 between 2014 and 2016. We used GPS coordinates to calculate the distance between the health facilities and households. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: 10,968 women were interviewed over four rounds of data collection. Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are strong barriers for women in Kinshasa to use modern contraceptives. Proximity to quality services did not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusions: This study notes that barriers other than proximity to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.

Mapping 20 Years of Urban Expansion in 45 Urban Areas of Sub-Saharan Africa

By 2050, half of the net increase in the world’s population is expected to reside in sub-Saharan Africa (SSA), driving high urbanization rates and drastic land cover changes. However, the data-scarce environment of SSA limits our understanding of the urban dynamics in the region. In this context, Earth Observation (EO) is an opportunity to gather accurate and up-to-date spatial information on urban extents. During the last decade, the adoption of open-access policies by major EO programs (CBERS, Landsat, Sentinel) has allowed the production of several global high resolution (10–30 m) maps of human settlements. However, mapping accuracies in SSA are usually lower, limited by the lack of reference datasets to support the training and the validation of the classification models. Here we propose a mapping approach based on multi-sensor satellite imagery (Landsat, Sentinel-1, Envisat, ERS) and volunteered geographic information (OpenStreetMap) to solve the challenges of urban remote sensing in SSA. The proposed mapping approach is assessed in 17 case studies for an average F1-score of 0.93, and applied in 45 urban areas of SSA to produce a dataset of urban expansion from 1995 to 2015. Across the case studies, built-up areas averaged a compound annual growth rate of 5.5% between 1995 and 2015. The comparison with local population dynamics reveals the heterogeneity of urban dynamics in SSA. Overall, population densities in built-up areas are decreasing. However, the impact of population growth on urban expansion differs depending on the size of the urban area and its income class.