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Uganda Ministry of Health, Uganda Ministry of Water and Environment, Uganda Bureau of Statistics, International Livestock Research Institute, World Resources Institute
October, 2009
Tags: equity mapping poverty uganda water
This report presents maps and analyses designed to inform the policies surrounding poverty reduction efforts in Uganda and to help reach the 2015 national targets on safe drinking water and improved sanitation.
Inquiries
* Florence Landsberg, GIS Associateflandsberg@wri.org+1 (202) 729-7693
Downloads
Full Report (PDF, 52 pages, 5.1 Mb)
* Front Matter & Executive Summary (PDF, 7 pages, 289 Kb)
* Introduction (PDF, 9 pages, 576 Kb)
* Safe Drinking Water Coverage & Poverty (PDF, 12 pages, 999 Kb)
* Improved Sanitation, Hygiene, & Poverty (PDF, 14 pages, 1.5 Mb)
* Conclusions, Recommendations & References (PDF, 6 pages, 193 Kb)
High Resolution Version (PDF, 52 pages, 30.0 Mb)
This larger document lets you print the maps at the highest available resolution.
Uganda GIS Data
Charts and Maps
*
Uganda: Density of Households Without Improved Sanitation Facilities, 2002
*
Uganda: Percentage of Households Relying on Open Sources of Drinking Water, 2002
More charts & maps »
Improving water supply, sanitation, and hygiene is central to Uganda’s successful development. Such measures would affect all Ugandans and are important to every sector of the economy, but they are particularly relevant to the poor. The availability of safe drinking water, adequate sanitation, and basic hygiene can improve health, lower mortality rates, and increase work and educational achievements. In particular, better sanitation and handwashing are among the most effective means to reduce morbidity and mortality from diarrheal diseases, which disproportionately affect the poor.
The central role of safe water and sanitation in addressing poverty in Uganda is reflected in national policy. The national framework for poverty eradication highlights the links between water, sanitation, and poverty reduction efforts. To implement the plans and policies related to safe drinking water coverage, Uganda’s policy-makers have established ambitious targets for 2015. As a result, the government and development partners have made large investments in the water sector, and signifi cant pro-poor benefi ts have been achieved. However, much work still remains to be done in order to ensure safe drinking water access and basic sanitation across Uganda.
One of the premises of the current report is that assuring future pro-poor benefits from water and sanitation investments will require more detailed poverty information. This is where maps such as those introduced in this publication can be helpful to decision-makers. Detailed information on the location of poor communities can help decisionmakers target these vulnerable areas for investment, thereby improving health while keeping implementation costs reasonable.
One of the principal challenges in planning and implementing effective pro-poor interventions in water and sanitation is coordinating multiple actors across many sectors and using many different data sets. This report offers new tools to meet this challenge. Examining subcounties in Uganda that have fallen behind in reaching 2015 targets, the report illustrates how integrating various spatial and demographic data on poverty, water, and sanitation can strengthen efforts to promote health. Stand-alone water supply interventions have less impact on health outcomes than well-coordinated interventions that improve water supply, sanitation infrastructure, and hygiene behavior simultaneously.
The unique information presented in this report is critical to achieving greater results and identifying additional pro-poor interventions to reach Uganda’s 2015 national targets. To this end, the authors identify the types of analyses available to Ugandan stakeholders, in order to encourage readers to develop their own poverty, water, and sanitation maps.
Audience and Aims
This report is intended for technical and high-level officers working both on poverty issues and in health and water departments at national and local levels.
* For decision-makers concerned with reducing poverty, the report demonstrates how comparing levels of poverty in a location with maps of access to safe drinking water, enhanced sanitation facilities, hygiene behavior, and other environmental health indicators can inform strategies to fight poverty.
* For decision-makers in the water and health sector, the publication shows how information on the location and severity of poverty can assist in setting priorities for interventions and how to integrate data sets about water supply, sanitation infrastructure, and hygiene behavior to support coordinated interventions.
Report Overview
*
Mapping a Healthier Future: How Spatial Analysis Can Guide Pro-Poor Water and Sanitation Planning in Uganda presents maps and analyses designed to inform the policies surrounding poverty reduction efforts in Uganda and to help reach the 2015 national targets on safe drinking water and improved sanitation.
*
Introduction: gives an overview of the links between water issues and poverty and sets the Ugandan policy context for pro-poor water and sanitation interventions.
*
Safe Drinking Water Coverage and Poverty: provides an overview of the national pattern of safe drinking water coverage; introduces a series of maps linking this subject to poverty rates to illustrate how poverty maps can inform future investments in safe drinking water infrastructure in order to make them more pro-poor.
*
Improved Sanitation, Hygiene, and Poverty: takes an in-depth look at policies and concerns surrounding sanitation and hygiene. Maps are included showing location-specific indicators of sanitation and hygiene coverage and poverty to help guide the discussion on resource allocation. Conclusions and Recommendations: summarizes observations from the map analyses and proposes recommendations for decision-makers regarding poverty reduction and water supply, sanitation, and hygiene in Uganda and in other developing countries.
Key Findings and Recommendations
Findings
While the maps and analyses discussed in this report are primarily illustrative in nature, they support the following conclusions:
* Poverty maps and maps of water and sanitation indicators can provide insight into the relationship between poverty, water, and sanitation;
* Maps showing water and sanitation indicators at the subcounty level can be used by planners to identify disadvantaged areas and examine equity issues;
* Combining map-based census data related to water, sanitation, and hygiene can guide more integrated campaigns to decrease the incidence of water-borne diseases; and
* The type of analysis presented in this report is most useful for identifying subcounties with similar poverty, water, and sanitation characteristics in order to guide geographic targeting.
Recommendations
Strengthening the supply of high-quality data and analytical capacity can improve future planning and prioritization of water, sanitation, and poverty reduction efforts. Priority actions for policy-makers include:
* Fill data gaps on sanitation and hygiene indicators; regularly update water, sanitation, and hygiene data; and continue supply of poverty data for small administrative areas; and
* Strengthen data integration, mapping, and analysis. Promoting the demand for such indicators and spatial analyses will require leadership from several government agencies. The following actions will help link relevant maps and analyses with specific decision-making opportunities:
* Incorporate poverty information into water, sanitation, and hygiene interventions and in regular performance reporting for the water and sanitation sector;
* Incorporate water, sanitation, and hygiene behavior information into poverty reduction efforts;
* Promote more integrated planning and implementation of water, sanitation, and hygiene interventions; and
* Incorporate poverty maps and maps of water, sanitation, and hygiene indicators into local decision-making.
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Related Links
* Uganda GIS Data
* Equity, Poverty, and the Environment
* People & Ecosystems
* Maps Guide Water and Sanitation Planning in Africa
* Uganda: Percentage of Households Relying on Open Sources of Drinking Water, 2002
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Thursday, October 21, 2010
Determinants of Child Mortality and Morbidity in China
Connection Speed:
: Determinants of Child Mortality and Morbidity in China
: 6/12/2002
: 52
: English
/ : World
: Environment
Health, Nutrition and Population
: Limin Wang
| Related Material | Recommendations |Related B-SPAN Videos |
This study examines the linkages between child mortality and morbidity, and the quality of the household and community environment in rural and urban China. The data source is the 1992 China National Survey for Children which resembles the demographic and health surveys (DHS). The methodologies used for the analysis are based on models widely employed in epidemiological studies. The findings from this study both confirm evidence from studies in other countries and add new information in the area of environmental health.
The key findings include (1) use of unclean cooking fuels (wood and coal) significantly reduces the neonatal survival probability in rural areas - an outcome that is also confirmed in two other studies (India and Guatemala); (2) access to safe water or sanitation reduces child mortality risks by about 34% in rural areas; (3) higher maternal education levels reduce child mortality and female education has strong health externalities (i.e. controlling for other factors, a child living in a neighborhood with more educated mothers has about 50% lower mortality risk); (4) access to safe water/sanitation, and immunization reduce diarrhea incidence in rural areas, while access to modern sanitation facilities (flush toilets) reduces diarrhea prevalence in urban areas; (5) significant linkages between ARI incidence and use of unclean cooking fuels are found using the city level data constructed from the survey.
This study indicates that effective policy interventions for improving health outcomes often lie both within and outside the health sector. Cross-sectoral approaches can potentially produce large health benefits.
Limin Wang of the Bank s Environment Department led the study. She noted that previous studies have shown developed countries have reduced incidences of diseases, and better case management in these countries also accounts for reduced child mortality. These studies imply there is a lack of integrated approach on health interventions in the developing world. Lack of access to safe drinking water, indoor and outdoor air pollution, poor nutrition are all well known factors. Policy interventions can be helpful in this area, because they can seek to prevent rather than cure problems, and often have a strong poverty focus. Global studies by the Bank and the UN suggest 20% of global diseases are linked to the environment. Other studies have linked environmental quality with child morbidity and mortality.
Wang said her study on China s data used household survey data, which had not been used in previous studies. Province level information was reviewed, as well as more disaggregated data in rural and urban areas. Most data is from 1992 and Wang said her study used more household data than previous studies. Key variables include housing characteristics and socioeconomic indicators such as education and health. She said she conducted a comparison of China s data with India and other countries. She looked at mortality, acute respiratory infections, and diarrhea and found China had lower mortality rates, but higher rates for respiratory infections, particularly in urban areas. Mortality rates also differed sharply between urban and rural areas. Respiratory problems in urban areas and diarrhea problems in rural areas varied little between income groups.
Based on the data, Wang projected that air quality in the cities and lack of access to clean water in the countryside are the key factors for children s health. She then looked at water, sanitation and cooking fuels as health indicators to verify this projection. She noted there is a great deal of literature identifying the key determinants of child morbidity. Mortality, on the other hand, is difficult to establish because information is often lacking, multiple causes are at play, and deaths often occur in the home. Wang looked at the age of death for children and found most death occurred in the first nine months. In rural areas, her results suggest unclean cooking fuel is a key factor in rural mortality rates for babies. These results are similar to evidence from India and Guatemala. Additional results include children born in hospitals and living in better neighborhoods are more likely to survive. Access to safe drinking water is another critical variable. The mother s education also plays a role in the survival rate for children under five years of age. Results in urban areas found male children had higher mortality rates than female children, a result Wang said is inconsistent with data from other countries. Access to flush toilets is also a significant factor in mortality rates.
: Determinants of Child Mortality and Morbidity in China
: 6/12/2002
: 52
: English
/ : World
: Environment
Health, Nutrition and Population
: Limin Wang
| Related Material | Recommendations |Related B-SPAN Videos |
This study examines the linkages between child mortality and morbidity, and the quality of the household and community environment in rural and urban China. The data source is the 1992 China National Survey for Children which resembles the demographic and health surveys (DHS). The methodologies used for the analysis are based on models widely employed in epidemiological studies. The findings from this study both confirm evidence from studies in other countries and add new information in the area of environmental health.
The key findings include (1) use of unclean cooking fuels (wood and coal) significantly reduces the neonatal survival probability in rural areas - an outcome that is also confirmed in two other studies (India and Guatemala); (2) access to safe water or sanitation reduces child mortality risks by about 34% in rural areas; (3) higher maternal education levels reduce child mortality and female education has strong health externalities (i.e. controlling for other factors, a child living in a neighborhood with more educated mothers has about 50% lower mortality risk); (4) access to safe water/sanitation, and immunization reduce diarrhea incidence in rural areas, while access to modern sanitation facilities (flush toilets) reduces diarrhea prevalence in urban areas; (5) significant linkages between ARI incidence and use of unclean cooking fuels are found using the city level data constructed from the survey.
This study indicates that effective policy interventions for improving health outcomes often lie both within and outside the health sector. Cross-sectoral approaches can potentially produce large health benefits.
Limin Wang of the Bank s Environment Department led the study. She noted that previous studies have shown developed countries have reduced incidences of diseases, and better case management in these countries also accounts for reduced child mortality. These studies imply there is a lack of integrated approach on health interventions in the developing world. Lack of access to safe drinking water, indoor and outdoor air pollution, poor nutrition are all well known factors. Policy interventions can be helpful in this area, because they can seek to prevent rather than cure problems, and often have a strong poverty focus. Global studies by the Bank and the UN suggest 20% of global diseases are linked to the environment. Other studies have linked environmental quality with child morbidity and mortality.
Wang said her study on China s data used household survey data, which had not been used in previous studies. Province level information was reviewed, as well as more disaggregated data in rural and urban areas. Most data is from 1992 and Wang said her study used more household data than previous studies. Key variables include housing characteristics and socioeconomic indicators such as education and health. She said she conducted a comparison of China s data with India and other countries. She looked at mortality, acute respiratory infections, and diarrhea and found China had lower mortality rates, but higher rates for respiratory infections, particularly in urban areas. Mortality rates also differed sharply between urban and rural areas. Respiratory problems in urban areas and diarrhea problems in rural areas varied little between income groups.
Based on the data, Wang projected that air quality in the cities and lack of access to clean water in the countryside are the key factors for children s health. She then looked at water, sanitation and cooking fuels as health indicators to verify this projection. She noted there is a great deal of literature identifying the key determinants of child morbidity. Mortality, on the other hand, is difficult to establish because information is often lacking, multiple causes are at play, and deaths often occur in the home. Wang looked at the age of death for children and found most death occurred in the first nine months. In rural areas, her results suggest unclean cooking fuel is a key factor in rural mortality rates for babies. These results are similar to evidence from India and Guatemala. Additional results include children born in hospitals and living in better neighborhoods are more likely to survive. Access to safe drinking water is another critical variable. The mother s education also plays a role in the survival rate for children under five years of age. Results in urban areas found male children had higher mortality rates than female children, a result Wang said is inconsistent with data from other countries. Access to flush toilets is also a significant factor in mortality rates.
Water, Sanitation, Hygiene, and Health: Results from the Last 45 Years
: 3/30/2004
: 76
: English
/ : World
: Water Supply and Sanitation
Health, Nutrition and Population
: Mariam Claeson
Lorna Fewtrell
Rachel Beth Kaufmann
It is well known that water supply, sanitation and hygiene education can improve health, but controversies persist about the relative importance of these factors. Is water quantity more important than water quality? Is sanitation more important than water supply? Is hygiene more important than hardware? And how does the impact compare to those from other "health" implications? Lorna Fewtrell of the Centre for Research into Environment and Health conducted a review that examined evidence from intervention trials over the past 45 years. The review used a meta-analytic technique to combine data from multiple studies into summary findings for each type of intervention. She presented the findings before a group of Bank public health specialists.
Rachel Beth Kaufmann, a senior public health specialist with the Bank’s South Asia region, and Mariam Claeson, a lead public health specialist in the Bank’s Human Development network, provided introductory remarks. Claeson said it was important to understand where the successful interventions were since resources were limited. Fewtrell said diarrhea remains a highly lethal disease in the developing world, especially for children. The key preventative action is clean water and sanitation services. She discussed an early 1990s study of diarrhea in countries with different sanitation systems that has been an important to subsequent research. Fewtrell said her study focuses on interventions. She looked at water quality and quantity, hygiene and drinking water. To maximize the number of studies that she could access, Fewtrell said she used morbidity rather than mortality as her criteria. She discussed some of the intervention criteria for hygiene, sanitation and water supply. Study periods, sample size, data collection methodologies varied substantially. The standard for study design, she said, is randomized, double blind trial. She then discussed relative risk adjustments. Meta- analysis uses statistical pooling of data to provide overall summary results. Fewtrell showed the stratification for developing countries for water, sanitation and hygiene. The research looked at pre-intervention scenarios for water and sanitation. Water sources and quality, and sanitation conditions varied widely. The data quantified rural and urban situations. Quality issues also were important. She discussed some of the difference between fixed and random effects models.
Some 60 studies were used to do the research. Water quality is the most popular intervention that was studied. Where there was no result or 95% confidence intervals, it could not be used in the meta analysis Fewtrell had described earlier. Only 11 studies were used in the meta analysis. She cited some of the findings. Hand washing is more effective than hygiene education on diarrhea reduction than dysentery. Under several scenarios, diarrhea was reduced markedly, as much as 44%. There were few sanitation studies, only two were used for the meta analysis. For water supply, she showed analysis for its impact on cholera and diarrhea. Hygiene seemed to be an added activity after water and sanitation had been improved in an area. Fewtrell said whenever hygiene is added, it is an effective intervention. She said there is a need for a good quality study on sanitation. Little data on water usage existed, she noted. Household connections probably play a more important role than village connections. She also noted that household storage had an important impact on hygiene and morbidity. More data is needed on water usage. Sustainability of interventions remains a question mark.
RELATED MATERIALS
* Water, sanitation and hygiene: interventions and diarrhoea – a review (PPT)
RELATED B-SPAN EVENTS
* Water Supply and Sanitation (31)
* Health, Nutrition and Population (116)
RELATED WORLD BANK LINKS
* Education and Water: Trying Harder but Could Do Better
* Determinants of Child Morbidity and Mortality in China
: 76
: English
/ : World
: Water Supply and Sanitation
Health, Nutrition and Population
: Mariam Claeson
Lorna Fewtrell
Rachel Beth Kaufmann
It is well known that water supply, sanitation and hygiene education can improve health, but controversies persist about the relative importance of these factors. Is water quantity more important than water quality? Is sanitation more important than water supply? Is hygiene more important than hardware? And how does the impact compare to those from other "health" implications? Lorna Fewtrell of the Centre for Research into Environment and Health conducted a review that examined evidence from intervention trials over the past 45 years. The review used a meta-analytic technique to combine data from multiple studies into summary findings for each type of intervention. She presented the findings before a group of Bank public health specialists.
Rachel Beth Kaufmann, a senior public health specialist with the Bank’s South Asia region, and Mariam Claeson, a lead public health specialist in the Bank’s Human Development network, provided introductory remarks. Claeson said it was important to understand where the successful interventions were since resources were limited. Fewtrell said diarrhea remains a highly lethal disease in the developing world, especially for children. The key preventative action is clean water and sanitation services. She discussed an early 1990s study of diarrhea in countries with different sanitation systems that has been an important to subsequent research. Fewtrell said her study focuses on interventions. She looked at water quality and quantity, hygiene and drinking water. To maximize the number of studies that she could access, Fewtrell said she used morbidity rather than mortality as her criteria. She discussed some of the intervention criteria for hygiene, sanitation and water supply. Study periods, sample size, data collection methodologies varied substantially. The standard for study design, she said, is randomized, double blind trial. She then discussed relative risk adjustments. Meta- analysis uses statistical pooling of data to provide overall summary results. Fewtrell showed the stratification for developing countries for water, sanitation and hygiene. The research looked at pre-intervention scenarios for water and sanitation. Water sources and quality, and sanitation conditions varied widely. The data quantified rural and urban situations. Quality issues also were important. She discussed some of the difference between fixed and random effects models.
Some 60 studies were used to do the research. Water quality is the most popular intervention that was studied. Where there was no result or 95% confidence intervals, it could not be used in the meta analysis Fewtrell had described earlier. Only 11 studies were used in the meta analysis. She cited some of the findings. Hand washing is more effective than hygiene education on diarrhea reduction than dysentery. Under several scenarios, diarrhea was reduced markedly, as much as 44%. There were few sanitation studies, only two were used for the meta analysis. For water supply, she showed analysis for its impact on cholera and diarrhea. Hygiene seemed to be an added activity after water and sanitation had been improved in an area. Fewtrell said whenever hygiene is added, it is an effective intervention. She said there is a need for a good quality study on sanitation. Little data on water usage existed, she noted. Household connections probably play a more important role than village connections. She also noted that household storage had an important impact on hygiene and morbidity. More data is needed on water usage. Sustainability of interventions remains a question mark.
RELATED MATERIALS
* Water, sanitation and hygiene: interventions and diarrhoea – a review (PPT)
RELATED B-SPAN EVENTS
* Water Supply and Sanitation (31)
* Health, Nutrition and Population (116)
RELATED WORLD BANK LINKS
* Education and Water: Trying Harder but Could Do Better
* Determinants of Child Morbidity and Mortality in China
Tuesday, August 10, 2010
Thursday, August 5, 2010
Stanford climate scientist Steve Schneider dead at 65
19 July 2010
(Updated 24 July 2010 9:42 a.m. EDT)
A scientist with a knack for communicating to the public dies Monday after a career that was both 'impressively long and all-too short.'
By Douglas Fischer
Daily Climate editor
Stanford climate scientist Stephen Schneider, one of the pre-eminent voices in the climate debate and a rare researcher who argued with wit and passion about the limits of climate science and the need for aggressive response, died Monday of an apparent heart attack while en route to London from a scientific conference in Stockholm. He was 65.
Over the course of his 40-year career, Schneider built the case that the accumulation of carbon dioxide in the atmosphere has dire consequences for the globe. He also studied the policy implications of human-caused global warming, publishing some 400 articles on climate change and society's response.
"Steve did for climate science what Carl Sagan did for astronomy," wrote Lawrence Livermore National Laboratory atmospheric scientist Benjamin Santer.
"The pathway he chose - to be a scientific leader, to be a leader in science communication, and to fully embrace the interdisciplinary nature of the climate change problem - was not an easy pathway," Santer added. "Yet without the courage of leaders like Stephen Schneider, the world would not be on the threshold of agreeing to radically change the way we use energy."
Responsible advocacy and popularization are not, in my view, oxymoronic - but it takes discipline to minimize trouble.
- Stephen Schneider, Mediarology
Schneider advised every U.S. president from Nixon to Obama on global warming and was involved in the Intergovernmental Panel on Climate Change since the beginning. But his contributions extend "far, far beyond his superb science," as Peter Gleick, president and co-founder of the Pacific Institute in California, noted.
"Schneider was perhaps the most important communicator on climate science issues to the public and to policymakers," Gleick wrote in a post on Huffington Post. "He taught us the importance of speaking up in defense of the integrity of science and the public interest."
Scientists, reporters and others from around the world reacted to the news. Here is a collection of remembrances and tributes.
To post your remembrance, or suggest the inclusion of one here, please email DailyClimate editor Douglas Fischer at dfischer [ at ] dailyclimate.org
News stories
(Updated 24 July 2010 9:42 a.m. EDT)
A scientist with a knack for communicating to the public dies Monday after a career that was both 'impressively long and all-too short.'
By Douglas Fischer
Daily Climate editor
Stanford climate scientist Stephen Schneider, one of the pre-eminent voices in the climate debate and a rare researcher who argued with wit and passion about the limits of climate science and the need for aggressive response, died Monday of an apparent heart attack while en route to London from a scientific conference in Stockholm. He was 65.
Over the course of his 40-year career, Schneider built the case that the accumulation of carbon dioxide in the atmosphere has dire consequences for the globe. He also studied the policy implications of human-caused global warming, publishing some 400 articles on climate change and society's response.
"Steve did for climate science what Carl Sagan did for astronomy," wrote Lawrence Livermore National Laboratory atmospheric scientist Benjamin Santer.
"The pathway he chose - to be a scientific leader, to be a leader in science communication, and to fully embrace the interdisciplinary nature of the climate change problem - was not an easy pathway," Santer added. "Yet without the courage of leaders like Stephen Schneider, the world would not be on the threshold of agreeing to radically change the way we use energy."
Responsible advocacy and popularization are not, in my view, oxymoronic - but it takes discipline to minimize trouble.
- Stephen Schneider, Mediarology
Schneider advised every U.S. president from Nixon to Obama on global warming and was involved in the Intergovernmental Panel on Climate Change since the beginning. But his contributions extend "far, far beyond his superb science," as Peter Gleick, president and co-founder of the Pacific Institute in California, noted.
"Schneider was perhaps the most important communicator on climate science issues to the public and to policymakers," Gleick wrote in a post on Huffington Post. "He taught us the importance of speaking up in defense of the integrity of science and the public interest."
Scientists, reporters and others from around the world reacted to the news. Here is a collection of remembrances and tributes.
To post your remembrance, or suggest the inclusion of one here, please email DailyClimate editor Douglas Fischer at dfischer [ at ] dailyclimate.org
News stories
Maine Voices: Protecting God's Creation means doing our part on climate change
July 24
The Catholic Church supports strong legislation that shows care for the Earth and its poor
PORTLAND - Partisan politics and the often polarizing effects of the media have caused many of us to forget that there is a common good: a global community for which we all must care.
ABOUT THE AUTHOR
The Most Rev. Richard J. Malone is Roman Catholic bishop of the Portland Diocese, which includes all of Maine.
The truth is we are all part of the same web of life. And climate change, perhaps more than any other crisis facing mankind today, demands that we recognize the interdependence of all life because its impacts are not isolated in any one corner of the Earth but affect every part of the living world.
Climate change highlights the links between concern for the person and for the Earth, between natural ecology and human ecology. Climate change is not just about economic theory or political platforms, and it should not be used for partisan advantage or influenced by interest group pressures.
It is about the future of God's Creation and the one human family. It is about protecting both "the human environment" and the natural environment.
Protecting the natural environment requires prudence -- careful management and efficient use of otherwise scarce natural resources.
Until more reliable energy alternatives are developed, oil and coal must be used sparingly as they are both finite and damaging to our environment. While they produce power necessary for modern life, fossil fuels also release harmful pollutants and heat-trapping greenhouse gases that are warming our planet.
Curtailing their use through conservation and making serious investments in renewable energy sources could help slow climate change and avoid much of the predicted damage to our natural world.
Protecting the human environment requires both compassion toward those most impacted by climate change and a much greater degree of personal and collective accountability for our lifestyle choices, particularly in a wealthy country like ours.
Our disproportionate consumption of non-renewable energy resources affects our brothers and sisters around the world.
The poor of the Earth offer a special test of our solidarity. Especially vulnerable to the impacts of climate change are many of the world's most impoverished communities. They live in regions already feeling the effects of climate change and, tragically, are the least equipped to cope with the problem.
Staff of Catholic Relief Services -- operating in 100 of the poorest countries around the world -- report that severe flooding and prolonged droughts threaten to unravel years of relief and development efforts and contribute to conflicts over scarce resources, food, and water.
Solidarity demands, as Pope Benedict said in this year's World Day of Peace Message, "a broad global vision of the world; a responsible common effort to move beyond approaches based on selfish nationalistic interests towards a vision constantly open to the needs of all peoples."
Our call to strive for peace and to love our neighbors must be more and more linked with the need for environmental stewardship.
In my tradition, we are promoting the St. Francis Pledge to Care for Creation and the Poor. This pledge is a commitment by Catholics to do five things with regards to climate change: to pray, learn, assess, act and advocate.
In this way, we might help protect God's Creation and advocate on behalf of people most impacted by global climate change.
As for public policies addressing climate change, the U.S. bishops have consistently called for policies that demonstrate both care for Creation and care for the poor.
The United States should lead the way by passing strong climate change legislation that reflects these priorities.
To win the support of the U.S. bishops, climate legislation must not add to the burdens of poor people in our own country and must provide substantial resources to help the poorest countries in the world adapt to a problem largely created by those of us in wealthier nations.
Our mistreatment of the natural world diminishes human dignity, threatens life -- all life -- and disregards the sacredness of Creation.
People of faith, including Catholics, must recapture ancient teachings about the reverence for Creation and about solidarity with all people.
As we work to protect and defend the life and dignity of the human person, we must increasingly recognize that this task cannot be separated from the care and defense of all of Creation.
The Catholic Church supports strong legislation that shows care for the Earth and its poor
PORTLAND - Partisan politics and the often polarizing effects of the media have caused many of us to forget that there is a common good: a global community for which we all must care.
ABOUT THE AUTHOR
The Most Rev. Richard J. Malone is Roman Catholic bishop of the Portland Diocese, which includes all of Maine.
The truth is we are all part of the same web of life. And climate change, perhaps more than any other crisis facing mankind today, demands that we recognize the interdependence of all life because its impacts are not isolated in any one corner of the Earth but affect every part of the living world.
Climate change highlights the links between concern for the person and for the Earth, between natural ecology and human ecology. Climate change is not just about economic theory or political platforms, and it should not be used for partisan advantage or influenced by interest group pressures.
It is about the future of God's Creation and the one human family. It is about protecting both "the human environment" and the natural environment.
Protecting the natural environment requires prudence -- careful management and efficient use of otherwise scarce natural resources.
Until more reliable energy alternatives are developed, oil and coal must be used sparingly as they are both finite and damaging to our environment. While they produce power necessary for modern life, fossil fuels also release harmful pollutants and heat-trapping greenhouse gases that are warming our planet.
Curtailing their use through conservation and making serious investments in renewable energy sources could help slow climate change and avoid much of the predicted damage to our natural world.
Protecting the human environment requires both compassion toward those most impacted by climate change and a much greater degree of personal and collective accountability for our lifestyle choices, particularly in a wealthy country like ours.
Our disproportionate consumption of non-renewable energy resources affects our brothers and sisters around the world.
The poor of the Earth offer a special test of our solidarity. Especially vulnerable to the impacts of climate change are many of the world's most impoverished communities. They live in regions already feeling the effects of climate change and, tragically, are the least equipped to cope with the problem.
Staff of Catholic Relief Services -- operating in 100 of the poorest countries around the world -- report that severe flooding and prolonged droughts threaten to unravel years of relief and development efforts and contribute to conflicts over scarce resources, food, and water.
Solidarity demands, as Pope Benedict said in this year's World Day of Peace Message, "a broad global vision of the world; a responsible common effort to move beyond approaches based on selfish nationalistic interests towards a vision constantly open to the needs of all peoples."
Our call to strive for peace and to love our neighbors must be more and more linked with the need for environmental stewardship.
In my tradition, we are promoting the St. Francis Pledge to Care for Creation and the Poor. This pledge is a commitment by Catholics to do five things with regards to climate change: to pray, learn, assess, act and advocate.
In this way, we might help protect God's Creation and advocate on behalf of people most impacted by global climate change.
As for public policies addressing climate change, the U.S. bishops have consistently called for policies that demonstrate both care for Creation and care for the poor.
The United States should lead the way by passing strong climate change legislation that reflects these priorities.
To win the support of the U.S. bishops, climate legislation must not add to the burdens of poor people in our own country and must provide substantial resources to help the poorest countries in the world adapt to a problem largely created by those of us in wealthier nations.
Our mistreatment of the natural world diminishes human dignity, threatens life -- all life -- and disregards the sacredness of Creation.
People of faith, including Catholics, must recapture ancient teachings about the reverence for Creation and about solidarity with all people.
As we work to protect and defend the life and dignity of the human person, we must increasingly recognize that this task cannot be separated from the care and defense of all of Creation.
Sunday, June 6, 2010
Health Promotion
Background to Health Promotion
While development in the Water and Sanitation Sector has been ongoing since the 1960’s, health promotion was first highlighted at Alma-Ata in 1978 with a call internationally for ‘Health for All by the Year 2000’. As safe drinking water was considered a primary prerequisite for good health, the 80’s was designated the Water Decade and strenuous efforts were made to provide safe drinking water for rural communities.
In an effort to improve conventional health ‘education’, which had been purely a top-down transfer of information from experts to recipients, the Ottawa Charter (WHO, 1986) revised the concept, which was now termed Health Promotion, defined in much broader terms as:
‘the process of enabling people to exert control over the determinants of health and thereby improve their health’
The Participatory Approach
The more people-centred ‘participatory approach’ in the 1990’s attempted to involve communities in their own development. The most well known varient of the participatory approach in the Water and Sanitation Sector is known as PHAST (Participatory Health and Sanitation Transformation) and was introduced into Sub Saharan Africa (Kenya, Uganda, Zimbabwe, Botswana and Ethiopia) as a regional pilot project in 1994. A number of projects were initiated and a “tool kit” of illustrations (100-200 drawings) were developed in each country for participatory activities such as ‘Nurse Tanaka’, 3 pile sorting, Story with a Gap, Blocking the Route, and un-serialised posters.
Constraints of Standard PHAST programmes
Whilst the activities in ‘Standard PHAST’ projects successfully empowered communities, (UNDP/WSP/IWSD, 1999) and increased health knowledge, the training tended to target the whole community loosely with no specific membership. Ad hoc meetings with the broad community meant that different people would attend different sessions so that there was no clear target audience. If no water and sanitation programmes followed the health promotion, expectations of assistance of the community were raised whilst nothing materialised. Lack of base line surveys, lack of identified indicators of hygiene behaviour change and ill defined target population meant that hygiene change was difficult to measure. Furthermore the process was time-consuming and with insufficient monitoring and support, extension staff did not always follow through or provide the necessary reinforcement to ensure implementation took place.
Although standard PHAST has theoretically seven steps, (Problem identification, Problem Analysis, Planning Solutions, Selecting options, Planning for new facilities and behaviour change, Planning for monitoring and evaluation, and Participatory evaluation) in actual fact there is more planning than action, and the ‘talking shops’ do not always translate into sustainable behaviour change in the home. Despite the planning, communities may not be sufficiently functional to operationalise these plans.
In 2005, an assessment of PHAST programmes in Uganda concluded that it was difficult to assess the difference between communities exposed to PHAST as against those where no health promotion programmes had taken place. Although with an estimated 4 million beneficiaries the cost of the programme (US$12 million) amounted to only 49c (US$) per beneficiary, the levels of hygiene behaviour change were marginal. PHAST areas had only a 9% higher latrine coverage after a 4 year programme and a basic hygiene habit such as covering drinking water appeared 2% higher in areas where no health promotion had taken place (World Bank-WSP, 2006). The 17 indicators that were presented showed an average difference between the intervention area and the control of 5.6% (with no p values published).
PHAST within Community Health Clubs
However the fact that Standard PHAST has largely failed to prove its cost-effectiveness to-date does not mean that the approach should be completely abandoned, as where it has been used in conjunction with Community Health Clubs there have been significant success in changing hygiene behaviour. The Consensus Approach uses the standard PHAST training but has been more successful in achieving behaviour change with most areas achieving total safe sanitation, and can demonstrate an average of 47% difference of over 15 indicators (p >0.0001). The community structure provided by a Community Health Club is the missing link, an effective mobilisation strategy that puts the final ‘T for Transformation’ in place.
Community Health Clubs ensures that participatory activities translate into action. Achievable hygiene changes are identified each week. Every session is backed up with homework for the week whilst group consensus and peer pressure encourages the compliance of members.
In addition, cost-effectiveness can be more easily measured in Community Health Clubs because:
* There is an identified membership
* There is a more structured programme of sessions
* There are pre-determined proxy indicators
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While development in the Water and Sanitation Sector has been ongoing since the 1960’s, health promotion was first highlighted at Alma-Ata in 1978 with a call internationally for ‘Health for All by the Year 2000’. As safe drinking water was considered a primary prerequisite for good health, the 80’s was designated the Water Decade and strenuous efforts were made to provide safe drinking water for rural communities.
In an effort to improve conventional health ‘education’, which had been purely a top-down transfer of information from experts to recipients, the Ottawa Charter (WHO, 1986) revised the concept, which was now termed Health Promotion, defined in much broader terms as:
‘the process of enabling people to exert control over the determinants of health and thereby improve their health’
The Participatory Approach
The more people-centred ‘participatory approach’ in the 1990’s attempted to involve communities in their own development. The most well known varient of the participatory approach in the Water and Sanitation Sector is known as PHAST (Participatory Health and Sanitation Transformation) and was introduced into Sub Saharan Africa (Kenya, Uganda, Zimbabwe, Botswana and Ethiopia) as a regional pilot project in 1994. A number of projects were initiated and a “tool kit” of illustrations (100-200 drawings) were developed in each country for participatory activities such as ‘Nurse Tanaka’, 3 pile sorting, Story with a Gap, Blocking the Route, and un-serialised posters.
Constraints of Standard PHAST programmes
Whilst the activities in ‘Standard PHAST’ projects successfully empowered communities, (UNDP/WSP/IWSD, 1999) and increased health knowledge, the training tended to target the whole community loosely with no specific membership. Ad hoc meetings with the broad community meant that different people would attend different sessions so that there was no clear target audience. If no water and sanitation programmes followed the health promotion, expectations of assistance of the community were raised whilst nothing materialised. Lack of base line surveys, lack of identified indicators of hygiene behaviour change and ill defined target population meant that hygiene change was difficult to measure. Furthermore the process was time-consuming and with insufficient monitoring and support, extension staff did not always follow through or provide the necessary reinforcement to ensure implementation took place.
Although standard PHAST has theoretically seven steps, (Problem identification, Problem Analysis, Planning Solutions, Selecting options, Planning for new facilities and behaviour change, Planning for monitoring and evaluation, and Participatory evaluation) in actual fact there is more planning than action, and the ‘talking shops’ do not always translate into sustainable behaviour change in the home. Despite the planning, communities may not be sufficiently functional to operationalise these plans.
In 2005, an assessment of PHAST programmes in Uganda concluded that it was difficult to assess the difference between communities exposed to PHAST as against those where no health promotion programmes had taken place. Although with an estimated 4 million beneficiaries the cost of the programme (US$12 million) amounted to only 49c (US$) per beneficiary, the levels of hygiene behaviour change were marginal. PHAST areas had only a 9% higher latrine coverage after a 4 year programme and a basic hygiene habit such as covering drinking water appeared 2% higher in areas where no health promotion had taken place (World Bank-WSP, 2006). The 17 indicators that were presented showed an average difference between the intervention area and the control of 5.6% (with no p values published).
PHAST within Community Health Clubs
However the fact that Standard PHAST has largely failed to prove its cost-effectiveness to-date does not mean that the approach should be completely abandoned, as where it has been used in conjunction with Community Health Clubs there have been significant success in changing hygiene behaviour. The Consensus Approach uses the standard PHAST training but has been more successful in achieving behaviour change with most areas achieving total safe sanitation, and can demonstrate an average of 47% difference of over 15 indicators (p >0.0001). The community structure provided by a Community Health Club is the missing link, an effective mobilisation strategy that puts the final ‘T for Transformation’ in place.
Community Health Clubs ensures that participatory activities translate into action. Achievable hygiene changes are identified each week. Every session is backed up with homework for the week whilst group consensus and peer pressure encourages the compliance of members.
In addition, cost-effectiveness can be more easily measured in Community Health Clubs because:
* There is an identified membership
* There is a more structured programme of sessions
* There are pre-determined proxy indicators
Share AfricaAHEAD information on your websites:
* Digg
* del.icio.us
* Google Bookmarks
* Blogosphere News
* MySpace
* NewsVine
* StumbleUpon
* Technorati
* Upnews
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