Health and Medical Geography in Africa: Methods, Applications and Development Linkages (Global Perspectives on Health Geography)

This contributed volume focuses on the evolution and current state of the sub-discipline of health and medical geography in Africa. It encompasses theoretical and methodological issues as well as the current teaching and research capacities of institutions offering programs in health and medical geography in Africa. Further, the book will review the level of adoption of the sub-discipline in State policies and practice and also provide practical illustrations, with case studies, of how studies in the sub-discipline are central to the actualization of Africa's development agenda. Particular attention is paid to the relationship between health and development. Through its direct and indirect impacts on labor productivity, population health and wellbeing matter for the social and economic development of households and national economies. Yet, health is not uniform in space. And so is development. Comparatively on many health and development indicators, Africa fairs poorly. The variation in health may present as differences in the occurrence and spread of diseases, the distribution of and access to healthcare facilities, and/or in health outcomes among the population. Reasons for these variations range from biology to the population’s levels of exposure and susceptibility to elements in their environment, including the social interactions taking place within the environment. The field of health and medical geography focuses on the spatial patterns and processes underlying these variations and provides pathways for understanding and addressing them. More specifically, the sub-discipline of health and medical geography focuses on, among others, how places (their characteristics and processes that go on in them) and environmental factors underlie and/or influence disease patterns, exposure and susceptibility to diseases, health variations, health behavior, health outcomes, and the provision of and access to healthcare services. This volume documents perspectives and applications in health and medical geography in Africa for academics, students, health practitioners, and development policymakers. Acknowledgements Contents Contributors Chapter 1: Health, Diseases and Development: An Introduction to Health and Medical Geography in Africa 1.1 Introduction 1.2 Rationale for the Book 1.3 Structure of the Book 1.3.1 Nature, Perspectives and Methods 1.3.2 Environment, Health and Disease 1.3.3 Health and Well-Being 1.3.4 Location and Health Behaviour 1.3.5 Health Inequalities and Healthcare Planning References Part I: Nature, Perspectives and Methods Chapter 2: Philosophy, Questions and Methods in Health and Medical Geography in Africa 2.1 Introduction 2.2 Philosophical Approaches 2.2.1 Empiricism 2.2.2 Positivism 2.2.3 Structuralism 2.2.4 Humanism 2.3 Themes in African Health and Medical Geography 2.3.1 Disease Mapping and Disease Ecology 2.3.2 Healthcare Planning 2.3.3 Social Determinants of Health 2.4 Methods of Investigation 2.5 Conclusion References Chapter 3: Medical Geography in Nigeria: History, Debates and State of the Discipline 3.1 Introduction 3.2 Debates on the Definition of Medical and Health Geography 3.3 Growth of Medical Geography Scholarship in Nigeria 3.3.1 Pre-1970: The Phase of Pace Setting 3.3.2 1970s–1980s: Pioneering Nigerian Medical Geography 3.3.3 The 1990s: The Latency Phase 3.3.4 2000–Date: The Expansion and Popularization Phase 3.4 Training of Medical Geographers 3.4.1 Undergraduate Training 3.4.2 Postgraduate Training 3.5 Research Interests and Contributions of Nigerian Medical Geographers to Health Research in Nigeria 3.5.1 Research Interests and Contribution to the Field 3.6 Technological Advancements in Medical Geography Studies in Nigeria 3.7 Challenges and Prospects 3.8 Conclusion Appendix 3.1: Select Bibliography of Works on Medical Geography by Nigerian Geographers (1975-2021) 1970–1979 1980–1989 1990–1999 2000–2009 2010–2020 2020–2022 References Chapter 4: Traditional and Non-traditional Data Sources Useful in Research in African Health and Medical Geography 4.1 Introduction 4.2 Traditional Data Sources 4.2.1 Institution-Based Data Sources 4.2.2 Population-Based Data Sources 4.3 Non-traditional Data Sources 4.3.1 Citizen Science 4.3.1.1 Crowdsourcing Innovations in Healthcare 4.3.1.2 Reporta Health 4.3.2 Search Engine Queries 4.3.2.1 Google Search in Africa 4.3.2.2 Bing Search in Africa 4.3.3 Using Social Media Data 4.3.3.1 Twitter 4.3.3.2 Facebook 4.3.3.3 YouTube 4.3.4 Mobile Phone Records 4.3.5 Data from Sensors 4.4 Potential Benefits of Using Non-traditional Data Sources 4.4.1 Speed of Detection of Diseases 4.4.2 Cost of Data Collection 4.4.3 Geographic Spread 4.5 Challenges to Using Non-traditional Data Sources for Health Research 4.5.1 Access 4.5.2 Privacy Concerns 4.5.3 Quality of Data References Chapter 5: Mixed Research Methods for Buruli Ulcer Prevention in Southern Benin Using Geographic Health Surveys 5.1 Introduction 5.2 The Ouémé/Plateau Region: An “Experimental Space” for Investigating Variations in the Incidence of the Disease 5.3 Preliminary Data and Methodological Advances 5.3.1 First Experimental Study (2016–2017): Relationship to the Establishment of Artificial Protected Water Sources 5.3.2 The GéANT Project (2017–2021): A Cross-Sectional Approach Focusing on Water Sources 5.4 Geographic Health Surveys: Shifting Focus to a Search for All Spaces Favourable to Vectors of the Disease 5.4.1 Long Interviews at Home: Collection of Qualitative and Quantitative Data on Lifestyle and Habits with Respect to Water 5.4.2 Guided Tours: Collection of Geolocalised and Environmental Data 5.4.3 Survey Tools Adapted for Use with Children Aged 8–14 Years 5.5 The Lessons Learned Mid-study References Part II: Environment, Health and Disease Chapter 6: Spatial Analysis of Antiretroviral Therapy Attrition Among Adults in Zimbabwe HIV: Geo-Additive Bayesian Survival Models 6.1 Introduction 6.2 Methods 6.2.1 Study Design 6.2.2 Study Site 6.2.3 Data Source 6.2.4 Study Variables 6.2.5 Statistical Analysis 6.3 Ethics 6.4 Results 6.4.1 Descriptive Statistics 6.4.2 Choropleth Map–Observed Attrition Rates at the District Level 6.4.3 Model Selection and Fixed Effect Estimates 6.4.4 Non-linear Effects Plots Based on the Convolutional Model 6.4.5 Spatial Effects Based on the Convolutional Model 6.5 Discussion 6.6 Research Implication 6.7 Study Limitations and Future Research 6.8 Conclusion References Chapter 7: Mobility and Disease Diffusion in East Africa: The Case of HIV/AIDS, Ebola, and COVID-19 7.1 Introduction 7.1.1 The East African Community (EAC) 7.1.2 Mobility and Migration Patterns in EAC 7.2 Migration and Disease Diffusion 7.3 Data and Methods 7.4 Results 7.4.1 Mobility and Diffusion of HIV/AIDS in East Africa 7.4.2 Mobility and Diffusion of Ebola in East Africa 7.4.3 Mobility and Diffusion of COVID-19 in East Africa 7.5 Conclusion References Chapter 8: Management and Prevention of HIV Infection in Migrant Miners in Lesotho and South Africa: A Capabilities Approach 8.1 Introduction 8.2 The Migration and Health Literature and the Capabilities Approach 8.2.1 Migration and Health 8.2.2 Capabilities, Migration and Health 8.3 Methods 8.4 Migrant Workers’ Constraints in Managing HIV 8.4.1 Constraining Social Factors 8.4.1.1 Acceptance of Commercial Sex 8.4.1.2 Social Isolation 8.4.1.3 Migration Policy 8.4.2 Constraining Environmental Factors 8.4.2.1 HIV Programmes 8.4.2.2 Housing 8.4.3 A Combination of Social and Environmental Constraints 8.5 Conclusion References Chapter 9: Geographical Analysis of Malaria in Nigeria – Spatiotemporal Patterns of National and Subnational Incidence 9.1 Introduction 9.1.1 The Geographical Context of the Country 9.2 Spatial Distribution of Incidence 9.2.1 Distribution by Geo-political Region 9.2.2 Distribution of Malaria Mean Incidence by States 9.3 Temporal Distribution of Malaria in Nigeria 9.3.1 Malaria Trend in the Geopolitical Regions 9.4 Environmental Determinants of Malaria 9.5 Demographic Distribution of Malaria 9.6 Malaria in Pregnancy 9.7 Conclusion References Chapter 10: Antimicrobial Resistance in a Changing Climatic Context: An Emerging Public Health Threat in Africa 10.1 Introduction 10.2 Methodology 10.2.1 Selection Criteria 10.3 Results 10.3.1 Status and Trend of AMR in Africa 10.3.1.1 Human 10.3.1.2 Domestic Animal 10.4 Discussion 10.4.1 Antimicrobial Resistance Prevalence in Africa 10.4.2 Challenges to Public Health Approach to Control of Antimicrobials in Africa 10.4.2.1 Health Facility Challenges 10.4.2.2 Suboptimal Antimicrobial Resistant Surveillance 10.4.2.3 Poor Water, Sanitation, and Hygiene Services 10.5 Conclusion and Way Forward References Part III: Health and Wellbeing Chapter 11: Climate-Related Diseases and Health Impacts of Climate Change in Sub-Saharan Africa 11.1 Introduction 11.2 Climate Change and Health 11.3 Diseases and Population Health Under Climate Change 11.3.1 Disease Prevalence 11.3.2 Climate Change and Population Groups 11.3.3 Climate Change and Sexual and Reproductive Health (SRH) 11.4 Conclusion References Chapter 12: Spatial Distribution and Pattern Analysis of Women Sexual Violence in Tanzania 12.1 Introduction 12.2 Data and Methods 12.3 Results and Discussion 12.4 Conclusion References Chapter 13: Associating Poverty with Gender-Based Violence (GBV) Against Rural and Poor Urban Women (RPUW) in Cameroon 13.1 Introduction 13.2 Literature Review 13.3 Research Methodology 13.3.1 Methods and Instruments 13.3.2 Location of Study Area 13.4 Results and Discussions 13.4.1 Causes of GBV against RPUW in Cameroon 13.4.1.1 Poverty/Economic Dependency 13.4.1.2 Rigid Gender Roles 13.4.1.3 Cultural and Social Norms/Community Tolerance 13.4.1.4 Language Barrier/Illiteracy 13.4.2 Forms of GBV and GBV Health Outcomes Among RPUW in Cameroon 13.4.2.1 Domestic Violence (DV) or Intimate Partner Violence (IPV) 13.4.2.1.1 Physical Violence (PV) 13.4.2.1.2 Emotional/Psychological Violence (EPV) 13.4.2.1.3 Sexual Violence (SV) or Sexual Abuse (SA) 13.4.2.2 Female Genital Mutilation (FGM) 13.4.3 Economic and Health Outcomes of GBV Against RPUW 13.4.4 The Interlock Between Poverty and GBV Against RPUW 13.5 Conclusion References Chapter 14: Menstrual Hygiene Management in the Context of Water, Sanitation and Hygiene (WASH) Policies – A Case of Schools in Nigeria 14.1 Introduction 14.2 Menstrual Hygiene: Definition of Concepts 14.2.1 Adolescence 14.2.2 Menstruation 14.2.3 Menstruation Cycle 14.2.4 Menstruation Hygiene Management 14.3 WASH Policies and Strategies in Nigeria 14.3.1 National Water Supply and Sanitation Policy (2000) 14.3.2 National Action Plan for Revitalization of Nigeria’s WASH Sector 14.3.3 National Hygiene Promotion Strategy in Nigeria 14.3.4 Partnership for Expanded Water Supply, Sanitation and Hygiene (PEWASH) 14.3.5 Guidelines for Hygiene Promotion ‘In and Through’ Schools in Nigeria 14.4 Geography and WASH Policy and Situation in Study Locations 14.4.1 Geography 14.4.2 WASH Policies and Situation 14.5 Menstrual Hygiene Management Practices in Bauchi and Lagos Schools 14.5.1 WASH in School Environment 14.5.2 Menstrual Hygiene Management (MHM) 14.6 Linking Policy with Practice 14.7 Recommendations and Development Implications 14.8 Conclusion References Chapter 15: The Nexus Between Development and Early Childhood Mortality in Nigeria 15.1 Introduction 15.2 Literature Review 15.3 Data and Methods 15.3.1 Analytical Strategy 15.4 Results 15.4.1 Levels, Trends and Differentials in Under-Five Mortality by Geo-political Zones 15.4.2 Levels, Trends and Differentials in Under-Five Mortality by States 15.4.3 Summary of Trends in Maternal Educational Attainment 15.4.4 Summary of Trends in Household Wealth Quintile 15.4.5 Summary of Trends in Maternal Care 15.5 Discussion and Conclusion References Part IV: Location and Health Behaviour Chapter 16: Sanitation, Health-Seeking Behaviour and Substance Use Among Street Children in Ibadan, Nigeria 16.1 Introduction 16.1.1 Research Hypothesis 16.1.2 Study Area 16.2 Conceptual Framework 16.3 Literature Review 16.4 Materials and Methods 16.5 Results and Discussions 16.5.1 Sociodemographic Profile of Street Children 16.5.2 Information About Family 16.5.3 Living and Working on the Street 16.5.4 Access to Basic Education, Healthcare and Housing 16.5.5 Identity, Social Relations and Substance Use 16.5.6 Streetism, Health and Development 16.6 Conclusion References Chapter 17: Human Geophagy (Soil Ingestion): Biochemical Functions and Potential Health Implications 17.1 Introduction 17.2 Prevalence of Geophagy in Africa 17.3 Biochemical Functions of Soil Ingestion 17.3.1 Absorption of Dietary and Bacterial Toxins 17.3.2 Nutritional Benefits 17.3.3 Treatment of Anaemia 17.3.4 Development and Growth of the Human Body and Stress Relief 17.4 Potential Human Health Implications of Geophagia 17.4.1 Exposure to Potentially Toxic Elements 17.4.2 Gastrointestinal Disturbance 17.4.3 Pathogenic Organisms and Microbe Ingestion 17.5 Indices for Assessing of Potential Health Risks of Geophagic Soils 17.5.1 Carcinogenic and Non-carcinogenic Risks 17.5.2 Hazard Quotient (HQ)/Non-carcinogenic Effect 17.5.3 Permissible Maximum Tolerable Daily Intake (PMTDI) 17.5.4 Bio-accessibility 17.6 Conclusion References Chapter 18: Spatial Analysis of Breastfeeding Practices and Childhood Morbidity Episodes in Ghana: A Cross-sectional Study of a National Dataset 18.1 Introduction 18.2 Methods 18.2.1 Study Setting 18.2.2 Research Design 18.2.3 Data Sources 18.2.4 Data Management 18.2.5 Outcome Variable 18.2.6 Exposure Variable 18.2.7 Explanatory Variables 18.2.8 Management of Spatial Data 18.2.9 Selections of Respondents 18.2.10 Data Analyses 18.3 Results 18.3.1 Spatial Autocorrelation of Breastfeeding Practices and Childhood Morbidity 18.3.2 Spatial Cluster Analysis of Breastfeeding Practices 18.3.3 Spatial Cluster Analysis of Childhood Morbidity 18.3.4 Hot Spots of Breastfeeding Practices and Childhood Morbidity 18.3.5 Association Between Breastfeeding and Childhood Morbidity with Covariates 18.4 Discussion 18.5 Conclusions 18.6 Policy Implications 18.7 Strengths and Limitations of the Study References Chapter 19: Test-Tube Transnationalism: Fertility Migrants and Reproductive Refugees and the Provision of Care Across Southern Africa 19.1 Introduction 19.2 Literature 19.2.1 Gender, Migrants and Refugees 19.2.2 Citizenship and Culture 19.2.3 Unmet Need and Development 19.3 Context and Methods 19.4 Case Studies 19.4.1 Fertility Migrants: Women and Technology 19.4.2 Twitter, Transnationalism and Assisted Reproductive Technologies 19.4.3 Dineo’s Story: Fertility Logics and New Digital Diasporas 19.4.4 Thaloganyo Phiri: A Barren Landscape 19.4.5 Esther Moseki: A Fertile Landscape 19.5 Discussion 19.6 Conclusions References Part V: Health Inequalities and Healthcare Planning Chapter 20: Location, Accessibility and Socioeconomic Correlates of Child Immunisation Coverage in Nigeria 20.1 Introduction 20.2 Immunisation Coverage in Nigeria 20.3 Determinants of Immunisation Coverage 20.3.1 Location 20.3.2 Accessibility 20.3.3 Socioeconomic Status 20.4 Challenges of Non-utilisation 20.5 Conclusions References Chapter 21: Approaches to Defining Health Facility Catchment Areas in Sub-Saharan Africa 21.1 Introduction 21.2 Methods 21.2.1 Search Strategy 21.2.2 Eligibility Criteria 21.2.3 Data Extraction 21.2.4 Data Synthesis 21.3 Result 21.4 Discussion References Chapter 22: Access to Health Facility and Frequency of Antenatal Care Visits in Malawi Using Bivariate Copula Regression Modelling 22.1 Introduction 22.2 Data 22.2.1 ANC Data Sources 22.2.2 Calculating Travel Time 22.3 Statistical Methods 22.4 Results 22.4.1 Description of Key Variables 22.4.2 Estimated Travel Time to Nearest Health Facility 22.4.3 Bivariate Spatial Model Results of Access and Antenatal Care Visits 22.5 Discussion 22.6 Conclusion References Chapter 23: Territorial Study of the Distribution of Doctors in Gabon 23.1 Introduction 23.2 Organisation of the Gabonese Healthcare System 23.3 Data and Method 23.4 Results 23.4.1 Concentration of Doctors in the Healthcare Region Libreville/Owendo 23.4.2 Spatial Planning and Distribution of Doctors 23.4.3 Quality of Care and Distribution of Doctors in Gabon 23.5 Discussion 23.6 Conclusion Bibliography Index