Schlüsselwörter
(Englisch)
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Urban health, well-being, risk, vulnerability, urban environment, urban dynamics
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Kurzbeschreibung
(Englisch)
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Urbanisation entails major demographic, social, cultural and environmental transitions and changes that have a marked impact on the health of the populations concerned. There is a substantial body of evidence about the status, trends and determinants of urban health in many countries, but there are still many unanswered questions about the frequency of major illnesses, especially among the poor and vulnerable. Comparative longitudinal studies will provide more knowledge about the frequency and distribution dynamics of the most important health problems in cities like Abidjan, Ouagadougou, N'Djaména, Nouakchott and Dakar, and estimates of the disease burden among low-income city dwellers. This approach is being complemented by a comprehensive demographic and environmental follow-up. Additional anthropological and gender-sensitive studies among the study populations, emphasising health and disease perceptions and health-related decision-making, will contribute to a comprehensive understanding of relations between urbanisation, migration, health and well-being, including both physical and mental health. Big cities have many different offers of health care. In looking at the utilisation of health care, the following questions arise. What are the elements that affect decisions about what to do when health problems arise, whom to consult, and where to go? How do these elements interact? What is the economic impact of the health and illness burden at the household/clan level for low-income city dwellers? These questions are best examined through a combination of qualitative and quantitative techniques, examining patterns of use of health care for different types of illness. Another approach is to establish and map the key risk factors for ill-health, risk behaviour and risk groups among low-income city dwellers, and to determine how they perceive health problems, health risks and priorities in relation to their actual health status.
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Projektziele
(Englisch)
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The goal of IP4 is to generate the scientific basis for the development and validation of adapted, efficient and innovative strategies for health interventions and health planning options that will improve health and well-being for disadvantaged urban (the "urban poor") and rural populations (nomadic populations), with a particular emphasis on women and children. Seven objectives guide the research undertaken within IP 4, namely:
Assess and compare the frequency and distribution dynamics of the most relevant health problems and their estimated disease burden among low income city dwellers and nomadic populations in relation to the demographic, environmental and epidemiological transitions.
Establish and map the key risk factors for ill-health, risk-behaviour and risk groups among low income city dwellers and of nomadic populations.
Determine how low income city dwellers and nomadic populations perceive health problems, health risks and priorities in relation to their actual health status.
Analyse health- and help-seeking patterns of low income city dwellers and nomadic populations and the factors that govern the patterns.
Determine the economic impact of health and illness burden at household / clan level of low income city dwellers and nomadic populations.
Review the concepts of "risks" and "vulnerability" in a transdisciplinary context and their implication and applicability for health, environmental and social interventions in urban and migrant settings.
Suggest, test and validate adapted intervention strategies to improve the health and well-being of low income city dwellers in centres of rapid urbanisation and of nomadic populations.
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Abstract
(Englisch)
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In West Africa, major social transformations are taking place as a result of global change. Great pressure on arable land is leading to unprecedented population movements, including an explosive growth of urban centres. The emphasis of the IP4 is on health and well-being, concentrating on two groups that are particularly vulnerable to syndromes of global change: poor urban populations and nomadic communities. The goal is to generate a scientific basis for the improvement of health and well-being in a situation where governments can no longer meet even the most urgent needs for health services and infrastructure. This includes not only addressing questions of disease burdens and health service planning, but also aspects of the biophysical, ecological, social and political environment. A concept of vulnerability is being developed which combines the epidemiological concept of risk and the perspectives of social sciences, in order to develop strategies to assess equity, poverty and well-being, and to alleviate social, health and economic burdens among population groups living at the margins.
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Publikationen / Ergebnisse
(Englisch)
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Boller C, Wyss K, Mtasiwa D, Tanner M. Quality and comparison of antenatal care in public and private providers in the United Republic of Tanzania. Bulletin World Health Organization. 2003, 81 (2): 116-122Hutton G, Wyss K, Yemadji N. Prioritisation of prevention activities to combat the spread of HIV/AIDS in resource constrained settings: a cost effectiveness analysis from Chad, Central Africa. International Journal of Health Planning and Management. In pressObrist B. Ohne Sauberkeit keine Gesundheit. Hygiene im Alltag von Dar es Salaam, Tansania." Tsantsa 2002,7:66-76.Obrist B., Tanner M. Building research networks and partnerships. Urban Health and Development Bulletin2003.5.3&4:5-10. Obrist, B. Urban health in daily practice. Livelihood, vulnerability and resilience in Dar es Salaam, Tanzania. Anthropology & Medicine 2003.10.3:275-290.Obrist, B., Eeuwijk, Peter van. eds. Afflictions of city life. Accounts from Africa and Asia. Anthropology & Medicine (Special Issue) 2003.10.3.Wyss K, Doumagoum MD, Callewaert B. Constraints to Scaling-up health related interventions: The case of Chad, Central Africa. Journal of International Development, 15, 2003: 87-100Wyss K, Yemadji N, Jeannée E. Research - Action - Capacity Building for new practices in the field of urban environmental management and international health. In: Local Environmental Management in a North - South Perspective. Issues of Participation and Knowledge Management (Editors: Flury M and Geiser U). vdf Hochschulverlag AG an der ETH Zürich, Zürich Singen: 79-90
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