Publication: Cholera Risk in Lusaka: A Geospatial Analysis to Inform Improved Water and Sanitation Provision
Date
2023-06-26
ISSN
Published
2023-06-26
Author(s)
Gething, Peter W.
Ayling, Sophie
Mugabi, Josses
Muximpua, Odete Duarte
Kagulura, Solomon Sitinadziwe
Abstract
Urbanization combined with climate
change are exacerbating water scarcity for an increasing
number of the world’s emerging cities. Water and sanitation
infrastructure, which in the first place was largely built
to cater only to a small subsector of developing city
populations during colonial times, are increasingly coming
under excessive strain. In the rapidly growing cities of the
developing world, expansion does not always keep pace with
population demand, leading to waterborne diseases, such as
cholera (Vibrio cholerae) and typhoid (Salmonella serotype
Typhi). Funding gaps therefore make targeting for efficient
spending on infrastructure upgrades essential for reducing
the burden of disease. This paper applies geospatial
analysis in Lusaka, Zambia, in the context of the cholera
outbreak of October 2017 to May 2018, to identify different
water and sanitation infrastructure investment scenarios and
their relative impact on reducing the risk of cholera in the
city. The analysis presented uses cholera case location data
and geospatial covariates, including the location of and
access to networked and non-networked Water and sanitation
infrastructure, groundwater vulnerability, and drainage, to
generate a high-resolution map of cholera risk across the
city. The analysis presents scenarios of standalone or
combined investments across sewerage coverage and
maintenance, on-site sanitation improvements, piped water
network coverage and quality, and ensuring the safety of
point source water. It identifies the investment most
strongly correlated with the largest reduction in cholera
risk as the provision of flush to sewer infrastructure
citywide. However, it also considers the trade-offs in terms
of financial cost versus health benefits and takes note of
where the next highest health benefits could be achieved for
a much lower cost. Finally, the analysis was done in the
context of a considered restructuring of an existing World
Bank investment, the Lusaka Sanitation Program. It
identifies what appears to be the most efficient combined
initiative as partial sanitation investment scale-up and
investment in piped water in 10 priority wards where the
cholera risk was highest.
Link to Data Set
Citation
“Gething, Peter W.; Ayling, Sophie; Mugabi, Josses; Muximpua, Odete Duarte; Joseph, George; Kagulura, Solomon Sitinadziwe. 2023. Cholera Risk in Lusaka: A Geospatial Analysis to Inform Improved Water and Sanitation Provision. Policy Research Working Papers; 10469. © World Bank, Washington, DC. http://hdl.handle.net/10986/39920 License: CC BY 3.0 IGO.”