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CONSIDERATIONS FOR IMPROVED URBAN HEALTH OUTCOMES IN AFRICANMEGACITIES.
CASE STUDY- THE LAGOS MEGACITY REGION.
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WHY LMCR/ AFRICAN MEGACITIES? Africa- fastest urbanizing region of the world Urbanization occurs in advance of an industrial basis
for growth Implications on health especially due to poverty LMCR- Located in Lagos state- smallest state in Nigeria Houses 1/3 of the urban residents of Nigeria Houses 90% of the population of Lagos state-
considered a city-state Largest conglomeration of the black race Projected to be 3rd largest megacity next to Tokyo and
Bombay by 2015 Case study for rapid urbanization especially in the
context of development
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Analytical evaluation of progress on social determinants of health in the Lagos megacity region
- Health equity- Transportation- Governance- Food security- Water and sanitation- Safety- Health care- Environment
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TRANSPORTATION IN THE CITY Transportation policies Infrastructure- mass transit options- non-motorized transport options- sidewalks, streetlights, traffic signals,
pedestrian and cycle safety,- integrated systems of transport Maintenance
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LMCR 71% of traffic congestion – infrastructural
inadequacies Poor maintenance Poor roads Poor traffic planning Lack of integrated transport systems Low road network density High traffic levels- Few roads carry most of the traffic Poorly developed connection between transport and
urban planning` Heavy reliance on motor vehicles Mobility is mostly road based Poor parking, streetlights, and pedestrian facilities
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HEALTH IMPLICATIONS
Poor quality of life- increased stress and time in commuting
Poor development- reduced productivity Increased incidence and risk of accidents Sub optimal physical activity level High incidence of accidents Poor air quality due to high traffic and poor quality
of cars- poor environmental and respiratory health Poverty- 20% of household budgets spent on
transport by the urban poor Use of healthy transportation options like cycling
and walking unsafe and impracticable
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ACHIEVEMENTS Lagos Metropolitan Area
Transport authority (LAMATA) (2003)
Road expansion Bus rapid lite transport
system (BRT-lite) - improved mobility
along corridors - reduced congestion - reduced travel and
waiting time - reduced emissions - reduced stress
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TO DO Increasing diversification of transport options Shift from mainly road based to water, railway, etc Need to integrate means of transport Expand coverage of the BRT-lite Choice of healthy transport options
functional and maintained streetlights, traffic signs, sidewalks, bike lanes, etc
Effects Reduced emissions- better air quality Reduced risk of accidents Reduced traffic congestion- improved well being Increased physical activity
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GOVERNANCE IN LMCR Lagos state- 20 Local government areas- 57
administrative units- LCDAs 20 of 16 LGAs- LMCR Governance mediates translation of policies
to development at the grassroots Therefore LGAs impact provision of social
determinants of health
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CHALLENGES 1. Role conflict between multiple governance
instrumentse.g. Downstream oil regulation Department of Petroleum Resources, National Oil Spill
Detection and Response Agency, Lagos State Environmental Agency, Federal Ministry of Environment, National Environmental Standards and Regulation Enforcement Agency, Nigerian Maritime Administration and Safety Agency, Nigerian Ports Authority
inefficiency and diffusion of responsibility
Need for strategic framework for intersectoral collaboration
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CHALLENGES 2. Constitutional ambiguities Item 17 in concurrent legislative list- right to make laws on health safety and
welfare – national assembly Item 19 in concurrent legislative list of
constitution of FRN- right to make laws on health safety and
welfare - state assemblies conflict in delivering social determinants of
health between agencies with similar mandates
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CHALLENGES 3. Need for improved monitoring and
accountability Govt policies↔ Local Govt ↔Grassroots development Poor accountability abandoned contractsoverestimation of project costs poor infrastructure- roads, health services, potable water
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THANK YOU!
Questions?