In addition to individual practices and access to water, sanitation, and hygiene (WASH) facilities, housing conditions may also be associated with the risk of diarrhea. Our study embraced a broad approach to health determinants by looking at housing deprivation characteristics as exposures of interest and confronting the latter’s spatial distribution to that of diarrheal cases. We tested the hypothesis that the risk of diarrhea in informal settlements is not only associated with WASH services, but also with inadequate dwelling characteristics, and that their spatial distributions follow similar patterns. We designed a cross-sectional study and collected primary data through georeferenced household surveys in two informal settlements in Abidjan, Côte d’Ivoire. We used local join count statistics to assess the spatial distribution of events and multiple logistic regressions to calculate adjusted odds ratios between diarrhea and exposures. A total of 567 households were enrolled. We found that constant access to basic WASH services, non-durable building materials, cooking outdoors, and water service discontinuity were associated with higher risks of diarrhea in the general population. The spatial distribution of diarrheal cases coincided with that of dwelling deprivation characteristics. We observed significant heterogeneity within the study sites regarding the spatial distribution of diarrheal cases and deprived dwellings. Along with WASH infrastructure, communities also need dignified housing to effectively prevent diarrhea. We recommend that decision-makers acknowledge a “spectrum” of deprivation within the heterogeneous universe of informal settlements, adopting a site-specific approach based on high-resolution data to address diarrhea and improve people’s well-being.
Despite efforts at the national and international levels to mitigate adverse effects of climate change on the environment and human health in developing countries, there is still a paucity of data and information concerning stakeholder’s engagement and their level of collaboration, responses and assistance in West Africa. This study aimed at assessing the perception of institutional stakeholders and limitations on coping strategies in flooding risk management in Abidjan (Côte d’Ivoire) and Lomé (Togo). Using a transdisciplinary framework, the methodological approach basically relied on qualitative data collected through desk review and key informant interviews with various stakeholders, covering a range of topics related to flooding risk. Findings show that flooding experiences cause serious environmental and health problems to populations. Poor hygiene practices and contacts with contaminated water are the main causes of risks. Collaboration between stakeholders is limited, reducing the efficiency of planned interventions. Furthermore, health risk prevention strategies are still inadequately developed and implemented. Findings also show limited capacities of affected and displaced people to cope and plan for their activities. Engaging various stakeholders in the health risk prevention plans is likely to improve the efficiency of coping strategies in flooding risk management in West Africa.