Publications by authors named "Meelan Thondoo"

Article Synopsis
  • Public space initiatives (PSIs) in African cities can improve health and social well-being, but there's a lack of research on their effectiveness and implementation across the continent.
  • This study synthesizes existing literature to assess the characteristics, locations, and outcomes of PSIs, finding that sports initiatives are predominant and that most research comes from South Africa.
  • Key challenges for PSIs include limited funding, historical marginalization, and competing land uses, highlighting the need for long-term evaluations and better collaboration for sustainable health-promoting public spaces.
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Increasing evidence suggests that urban health objectives are best achieved through a multisectoral approach. This approach requires multiple sectors to consider health and well-being as a central aspect of their policy development and implementation, recognising that numerous determinants of health lie outside (or beyond the confines of) the health sector. However, collaboration across sectors remains scarce and multisectoral interventions to support health are lacking in Africa.

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Background: The GoGreenRoutes project aims to introduce co-created nature-based solutions (NBS) to enhance environmental quality in six medium-sized cities (Burgas, Lahti, Limerick, Tallinn, Umeå, and Versailles). We estimated the mortality and economic impacts attributed to suboptimal exposure to green space and air pollution, economic impacts, and the distribution thereof the adult population by socioeconomic status.

Methods: We retrieved data from publicly accessible databases on green space (NDVI and % Green Area), air pollution (NO and PM) and population (≥20 years, n = 804,975) at a 250m × 250m grid-cell level, and mortality for each city for 2015.

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Introduction: In recent years, walking and cycling have moved into the focus as promising approaches to achieve public health, sustainable transport, climate goals and better urban resilience. However, they are only realistic transport and activity options for a large proportion of the population when they are safe, inclusive and convenient. One way to increase their recognition in transport policy is the inclusion of health impacts of walking and cycling into transport economic appraisals.

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Article Synopsis
  • - The study examines the impact of urban heat islands (UHIs) on health, finding that high temperatures increase premature deaths, with an estimated 6700 deaths in 93 European cities during the summer of 2015 linked to UHIs.
  • - By increasing urban tree coverage to 30%, cities could potentially reduce temperatures by 0.4°C and prevent around 2644 associated premature deaths, showcasing the benefits of urban green spaces.
  • - The research underscores the significant public health risks posed by UHIs, emphasizing the need for urban planning that incorporates more trees to mitigate heat-related mortality.
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One of the major consequences of Africa's rapid urbanisation is the worsening air pollution, especially in urban centres. However, existing societal challenges such as recovery from the COVID-19 pandemic, poverty, intensifying effects of climate change are making prioritisation of addressing air pollution harder. We undertook a scoping review of strategies developed and/or implemented in Africa to provide a repository to stakeholders as a reference that could be applied for various local contexts.

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Background: Road traffic is the main source of environmental noise in European cities and one of the main environmental risks to health and wellbeing. In this study we aimed to provide an in-depth assessment of available road traffic noise data and to estimate population exposure and health impacts for cities in Europe.

Methods: We conducted the analysis for 724 cities and 25 greater cities in 25 European countries.

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Introduction: Cities have long been known to be society's predominant engine of innovation and wealth creation, yet they are also hotspots of pollution and disease partly due to current urban and transport practices. The aim of the European Urban Burden of Disease project is to evaluate the health burden and its determinants related to current and future potential urban and transport planning practices and related exposures in European cities and make this evidence available for policy and decision making for healthy and sustainable futures.

Methods And Analysis: Drawing on an established comparative risk assessment methodology (ie, Urban and Transport Planning Health Impact Assessment) tool), in nearly 1000 European cities we will (1) quantify the health impacts of current urban and transport planning related exposures (eg, air pollution, noise, excess heat, lack of green space) (2) and evaluate the relationship between current levels of exposure, health impacts and city characteristics (eg, size, density, design, mobility) (3) rank and compare the cities based on exposure levels and the health impacts, (4) in a number of selected cities assess in-depth the linkages between urban and transport planning, environment, physical activity and health, and model the health impacts of alternative and realistic urban and transport planning scenarios, and, finally, (5) construct a healthy city index and set up an effective knowledge translation hub to generate impact in society and policy.

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Background: Conducting health impact assessments (HIAs) is a growing practice in various organizations and countries, yet scholarly interest in HIAs has primarily focused on the synergies between exposure and health outcomes. This limits our understanding of what factors influence HIAs and the uptake of their outcomes. This paper presents a framework for conducting participatory quantitative HIA (PQHIA) in low- and middle-income countries (LMICs), including integrating the outcomes back into society after an HIA is conducted.

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Background: Cities are an important driving force to implement the Sustainable Development Goals (SDGs) and the New Urban Agenda. The SDGs provide an operational framework to consider urbanization globally, while providing local mechanisms for action and careful attention to closing the gaps in the distribution of health gains. While health and well-being are explicitly addressed in SDG 3, health is also present as a pre condition of SDG 11, that aims at inclusive, safe, resilient and sustainable cities.

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Article Synopsis
  • Health Impact Assessments (HIAs) are essential for promoting public health in low and middle-income countries (LMICs) but are significantly underutilized and vary widely in implementation across these regions.* -
  • A systematic review of HIAs conducted in 156 LMICs revealed that only 57 studies met the criteria for inclusion, highlighting an unequal geographic distribution with predominant focuses on topics like air pollution and urban transport.* -
  • The evaluation of HIAs showed notable inconsistencies in reporting and methodology, with a majority using quantitative methods but only a small fraction incorporating participatory approaches, indicating potential areas for improvement in future assessments.*
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Background: Undernutrition during pregnancy leads to low birthweight, poor growth and inter-generational undernutrition. We did a non-blinded cluster-randomised controlled trial in the plains districts of Dhanusha and Mahottari, Nepal to assess the impact on birthweight and weight-for-age z-scores among children aged 0-16 months of community-based participatory learning and action (PLA) women's groups, with and without food or cash transfers to pregnant women.

Methods: We randomly allocated 20 clusters per arm to four arms (average population/cluster = 6150).

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The increasing availability and capabilities of mobile phones make them a feasible means of data collection. Electronic Data Capture (EDC) systems have been used widely for public health monitoring and surveillance activities, but documentation of their use in complicated research studies requiring multiple systems is limited. This paper shares our experiences of designing and implementing a complex multi-component EDC system for a community-based four-armed cluster-Randomised Controlled Trial in the rural plains of Nepal, to help other researchers planning to use EDC for complex studies in low-income settings.

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Background: Community health workers are reemerging as an essential component of health systems in low-income countries. However, there are concerns that unless they are adequately supported, their motivation and performance will be suboptimal. mHealth presents an opportunity to improve support for community health workers; however, most interventions to date have been designed through a top-down approach, rarely involve the end user, and have not focused on motivation.

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