Decision Making within the Built Environment as a Strategy for Mitigating the Risk of Malaria and Other Vector-Borne Diseases

Abstract

Although significant efforts have been made to combat the spread of vector-borne diseases (VBDs), they still account for more than 17% of all infectious diseases. According to the World Health Organization (WHO), there were 216 million estimated cases in 2016. The efforts that resulted in these positive outcomes lack long-term financial sustainability because of the significant amount of funding involved. There is, therefore, a need for more cost-effective intervention. The authors contend that design decisions in the built environment can have a positive impact on the efforts directed at mitigating the risk of malaria in a more cost-effective manner. It is known that the built environment, through features such as openings, can propagate the spread of malaria. There have been some significant efforts directed at addressing this risk. This notwithstanding, an extensive review of closely related work established that built environment professionals have limited access to information on specific ways through which their design decisions can contribute to mitigating the risk of malaria. The validity of this hypothesis was tested through evaluating the opportunities for synergies in selected parts of East Africa. Secondary data derived from relevant urban health journals as well as repositories curated by leading health agencies such as WHO were synthesized and analyzed using a web of causation approach. The outcome of the analysis is a schema of primary and secondary source (risk) factors. The use of the web of causation approach revealed the existing factor-to-factor interactions that could have a reinforcing effect. This information was used to identify the critical linkages and interdependencies across different factors. The outcome of the analysis was mapped against risk factors that can be linked to decisions made during the six primary phases of the construction life cycle: Preliminary phase, conceptual design, detailed design, construction, facilities management, and end of life/disuse. A conceptual architecture for a decision support framework has been proposed and will be developed into a prototype in subsequent efforts.

Identifying Barriers and Facilitators for Home Reconstruction for Prevention of Chagas Disease: An Interview Study in Rural Loja Province, Ecuador

“…These facilitators were directly related to the two barriers; low personal economy and extensive deterioration of the home limited their perceived ability to reconstruct their home. Previous home reconstruction efforts have reported on the important impact that availability of funding has on individual-level decision-making about home reconstruction [40,41]. Rebuilding homes is very expensive for community members; the full cost of reconstructing a home is about 25,000 USD, which could represent the lifetime earnings of a family.…”

A global building network research for advancing healthy and affordable housing

“…Some public health challenges can be attributed to design decisions concerning the use of building material/technologies/systems as well as their integration a building system within a specific site and neighborhood (Obonyo et al 2019). Health risks that can be attributed directly to these decisions can be mitigated through infusing evidence into decisions being made by the design team (architects, designers, engineers and construction managers).…”

“…The required systemic shift calls for both top-down and bottom-up approaches. Large systemic changes must be supported by local regulatory and policy frameworks (Obonyo et al 2019). Cities across the world have demonstrated the successful use zoning as well as modifications to the building codes and design guidelines as one of the levers for change.…”

“…Indoor environment factors such as inadequate ventilation, poor indoor air quality, chemical contaminants from indoor and outdoor environment and poor lighting can exacerbate the risks associated with diseases such as cardiovascular, pulmonary, respiratory and ocular diseases (Gehrt et al 2019, Cedeño-Laurent et al 2019. Some health problems have been linked to the context within which housing is constructed (see Obonyo et al 2019). Contributing external factors here include proximity to contamination of water or land, housing being situated in neighborhoods with outdoor air pollution problems, lack of public spaces for physical activities as well as the inadequate provision of water, sanitation and waste management infrastructural services.…”

“…We envision within our network, the emergence of a cadre of building science professionals who can work closely with their counterparts in epidemiology, sociology, law, business and environmental science. Their broad understanding of how health risks emerge within our housing stock will help mainstream the integration of a public health criteria into the planning, design and construction of affordable, resilient and sustainable housing (Obonyo et al 2019).…”