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Are there aspects of complexity that are characteristic for research for development projects? Our study shows what are these aspects, how they affect research and what practices seem to be promising for dealing with the increasing levels of complexity.The need to deal with complexity is getting increasingly attention in research for development projects implemented through transboundary research partnerships between organisations from the Global North and the Global South. However, less is known about aspects beyond the systems under study that still affect complexity in the research project. We conducted an experience capitalization of five transboundary research partnerships undertaking research in 14 countries in the Global South. We found that the combination of multiple contexts, the cultural and disciplinary diversity of the transboundary research partnerships, and the set of rules and proceedings from the funding mechanism affect the levels of complexity. We further identified that a transdisciplinary approach and several related practices, like intercultural communication or integrative partnerships, are promising ways of dealing with complexity. Current structures in research for development need to improve in order to fully use the potential of transdisciplinarity for sustainability transformation.

BackgroundPrevious epidemiological studies have reported associations of pesticide exposure with poor cognitive function and behavioral problems. However, these findings have relied primarily on neuropsychological assessments. Questions remain about the neurobiological effects of pesticide exposure, specifically where in the brain pesticides exert their effects and whether compensatory mechanisms in the brain may have masked pesticide-related associations in studies that relied purely on neuropsychological measures.MethodsWe conducted a functional neuroimaging study in 48 farmworkers from Zarcero County, Costa Rica, in 2016. We measured concentrations of 13 insecticide, fungicide, or herbicide metabolites or parent compounds in urine samples collected during two study visits (approximately 3-5 weeks apart). We assessed cortical brain activation in the prefrontal cortex during tasks of working memory, attention, and cognitive flexibility using functional near-infrared spectroscopy (fNIRS). We estimated associations of pesticide exposure with cortical brain activation using multivariable linear regression models adjusted for age and education level.ResultsWe found that higher concentrations of insecticide metabolites were associated with reduced activation in the prefrontal cortex during a working memory task. For example, 3,5,6-trichloro-2-pyridinol (TCPy; a metabolite of the organophosphate chlorpyrifos) was associated with reduced activation in the left dorsolateral prefrontal cortex (β=-2.3; 95% CI: -3.9, -0.7 per two-fold increase in TCPy). Similarly, 3-phenoxybenzoic acid (3-PBA; a metabolite of pyrethroid insecticides) was associated with bilateral reduced activation in the dorsolateral prefrontal cortices (β=-3.1; 95% CI: -5.0, -1.2 and -2.3; 95% CI: -4.5, -0.2 per two-fold increase in 3-PBA for left and right cortices, respectively). These associations were similar, though weaker, for the attention and cognitive flexibility tasks. We observed null associations of fungicide and herbicide biomarker concentrations with cortical brain activation during the three tasks that were administered.ConclusionOur findings suggest that organophosphate and pyrethroid insecticides may impact cortical brain activation in the prefrontal cortex - neural dynamics that could potentially underlie previously reported associations with cognitive and behavioral function. Furthermore, our study demonstrates the feasibility and utility of fNIRS in epidemiological field studies.

The extraction of natural resources, such as minerals, oil, and gas, can have profound economic effects. The application of economic analysis methods in impact studies of resource extraction projects holds potential to inform decision-making in order to optimise gains and minimise negative externalities. This paper aims to identify and characterise peer-reviewed publications that report on economic studies implemented as part of impact assessments of resource extraction projects. We conducted a systematic scoping review in PubMed and Scopus of articles published between 1998 and 2020. Out of 1,579 raw hits, we identified 13 articles describing 15 economic analyses of resource extraction projects. Half of the identified papers presented economic analyses conducted in the context of mining and oil/gas projects. The majority of the identified studies dealt with the cost and/or benefits of environmental and/or social impacts. Only one study investigated economic aspects associated with potential health impacts. Given the small number of papers identified, economic analysis of impacts associated with natural resource extraction projects seems to be a small field of published research. Yet the inclusion of economic analysis in impact assessment of resource extraction projects holds promise to better harness benefits for local communities and governments while minimising negative externalities. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

A “Health in All” approach has been encouraged by India’s National Health Policy to address cross-sectoral health concerns. To illustrate how health concerns can be systematised in food system plan...

This study contributes to the ongoing discussion on how to attribute and evaluate the contribution of transdisciplinary research to sustainable development. As co-created knowledge is a key product of transdisciplinary research, we tested the hypothesis that the extent to which this knowledge is utilized beyond the project consortia, in different areas – from scientific methods and insights to policy decisions – and across a continuum of geographical scales can be used to identify potential impact pathways. For this purpose, we developed an analytical framework that links the transdisciplinary process to six possible utilization stages, which we used as indicators of the usability of co-created knowledge. We gathered data from 22 research projects active in 36 countries using a survey and semi-structured interviews. Our results show that even during implementation of the projects, co-created knowledge is utilized by multiple actors at different stages, in all areas and at all scales simultaneously, suggesting multiple impact pathways. Project knowledge is predominantly utilized for national-level policymaking, and research partners named co-creation of knowledge with key stakeholders as the most frequently used mechanism for promoting knowledge utilization. Closer analysis revealed different understandings of and approaches to knowledge co-creation. These can be linked to weaker or stronger definitions of transdisciplinarity. The analysis shows that researchers using strong transdisciplinarity approaches typically face challenges in encompassing multiple epistemologies and facilitating dialogue. Some results suggest that inclusion and collaboration in co-creating knowledge can empower actors otherwise excluded. Our research shows that although transdisciplinary projects have nonlinear impact pathways, these can be partially assessed using the proposed analytical framework. Further, our results indicate a link between usability, inclusion, and collaboration in transdisciplinary research. We conclude with the observation that transdisciplinarity and its requirements still need to be better understood by actors within and beyond the research community.

Background: Food systems affect nutritional and other health outcomes. Recent literature from India has described policy aspects addressing nutritional implications of specific foods (eg, fruits, vegetables, and trans-fats), and identified opportunities to tackle the double burden of malnutrition. This paper attempts to deepen the understanding on how health concerns and the role of the health sector are addressed across food systems policies in India. Methods: This qualitative study used two approaches; namely (i) the framework method and (ii) manifest content analysis, to investigate national-level policy documents from relevant sectors (ie, food security, agriculture, biodiversity, food processing, trade, and waste management, besides health and nutrition). The documents were selected purposively. The textual data were coded and compared, from which themes were identified, described, and interpreted. Additionally, mentions of various health concerns and of the health ministry in the included documents were recorded and collated. Results: A total of 35 policy documents were included in the analysis. A variety of health concerns spanning nutritional, communicable and non-communicable diseases (NCDs) were mentioned. Undernutrition received specific attention even beyond nutrition policies. Only few policies mentioned NCDs, infectious diseases, and injuries. Governing and advisory bodies were instituted by 17 of the analysed policies (eg, food safety, agriculture, and food processing), and often included representation from the health ministry (9 of the 17 identified inter-ministerial bodies). Conclusion: We found some evidence of concern for health, and inclusion of health ministry in food policy documents in India. The ongoing and planned intersectoral coordination to tackle undernutrition could inform actions to address other relevant but currently underappreciated concerns such as NCDs. Our study demonstrated a method for analysis of health consideration and intersectoral coordination in food policy documents, which could be applied to studies in other settings and policy domains.

Over the past three decades, the Vietnamese Mekong Delta has experienced a significant increase in agricultural productivity, partly achieved through increased agrochemical use. To abate negative effects on human and environmental health, several national programs were launched to enhance safer pesticide use. This study aimed to assess the patterns and relationships of official sustainable agriculture educational programs, pesticide safety knowledge, and practices of smallholder farmers in the Mekong Delta. A cross-sectional survey was conducted with 400 smallholder farmers from three communes in Thoi Lai district (Can Tho province) from March to May 2020. Twenty-four questions on pesticide safety knowledge and practices were used to identify traits using latent class analysis. Adjusted generalized linear regression was used to assess determinants of pesticide safety knowledge and estimate associations of pesticide safety knowledge with pesticide practices. 96.2% of participants have used at least one WHO class II pesticide during the past year while the use of specific personal protective equipment was limited mainly due to unavailability (37.0%) or discomfort (83.0%). High education (Odds Ratio (OR), 95% Confidence Interval; 3.84, 1.70-9.45), exposure to official educational programs (1.87, 1.13-3.12), peer-to-peer knowledge exchange (3.58, 2.18-6.00), and learning from governmental extension services (2.31, 1.14-4.98) were positively associated with increased pesticide safety knowledge. Compared to poor practices, pesticide safety knowledge was increasingly positively associated with intermediate (1.65, 1.02-2.66) and good pesticide practices (8.96, 2.58-31.12). These findings highlight the importance of school education and educational programs, access to PPE, and addressing discomforts of PPE to improve the protection of farmers from pesticide exposures. Simultaneously, pesticide market authorization processes should be reconsidered to promote the authorization of less toxic products. Further in-depth studies on the nature of pesticides used, nonuse of personal protective equipment, and effectiveness of educational programs will further define leverage points for safer pesticide use.

OBJECTIVES: The aim of this study was to assess the impact of natural resource extraction projects on HIV transmission risks in local communities in sub-Saharan Africa. DESIGN: Difference-in-differences design using repeated cross-sectional data from around newly opened mines. METHODS: We combined data on mine openings with HIV data from the Demographic and Health Surveys (DHS). Using logistic regression models, we compared HIV related indicators between mining (i.e. up to 10 km distance from the mine) and comparison (i.e. 10-50 km) areas before and after mine opening to identify their impact on HIV prevalence, sexual behavior and HIV knowledge. RESULTS: A total of 33,086 individuals across 39 mine openings were analyzed. Adjusting for baseline differences and temporal trends in the study regions, mine opening increased the odds of HIV infection almost two-fold (odds ratio (OR): 1.93, 95% confidence interval (CI): 1.19-3.14). Strongest effects were seen in high-prevalence countries and in the 20-29 years age group. In mining communities around operational mines there was a tendency towards lower HIV knowledge (OR: 0.81, 95% CI: 0.63-1.04). New mine openings increased the odds of risky sexual behaviors, such as having multiple sex partners (OR: 1.61, 95% CI: 1.02-2.55), high-risk sexual partners (OR: 1.45, 95% CI: 1.03-2.05) and unprotected sex with high-risk partners (OR: 1.77, 95% CI: 1.18-2.67). CONCLUSION: The findings suggest that in our sample of households surrounding industrial mines, HIV infection risks substantially increase upon mine opening. Existing strategies for addressing mining-related risks for HIV transmission seem to be insufficient. Further efforts for mitigating and monitoring impacts of mines are needed. Video Abstract: http://links.lww.com/QAD/C557.

We examine population mobility around a newly-developed large-scale copper mine in Zambia and analyse how socioeconomic and health indicators differed amongst migrants, resettled households, and non-mobile local (e.g. non-migrant/-resettled) populations. Two cross-sectional household surveys in 2015 and 2019 collected quan-titative data on health, socioeconomic indicators, and resettlement and migration status. A wealth index for the pooled sample (N =990 households) was computed using a simplified list of household assets adapted from the Zambia Demographic and Health Survey. Logistic regression models were conducted to assess associations with health outcomes. In-migrants were younger than non-mobile locals (mean age of household head 33.9 vs. 37.7 years), more highly educated (34.3% of household heads completed secondary school vs. 7.3%), had higher employment (43.8% vs. 15.8%), and higher mean wealth (3.6 vs. 3.0). The odds of having a child

BACKGROUND AND AIM: Animal studies have shown neurotoxic effects of glyphosate and glyphosate-based herbicides. However, only a few studies have examined the neurotoxicity of glyphosate in humans. ...

Studies suggest that acute pesticide poisonings (APP) may be linked with long-term neurological effects. To examine long-term neurological and psychological distress symptoms associated with having experienced an APP, we conducted a cross-sectional study of 300 conventional and organic smallholder farmers from Zarcero County, Costa Rica, May–August 2016. We collected self-reported data on sociodemographic characteristics, occupational history, pesticide exposure, APPs, neurological and psychological distress symptoms (using the Brief Symptom Inventory (BSI)). Adjusted logistic regression models were fit. A total of 14% of the farmers (98% male) reported experiencing at least one APP during their lifetime. Self-reported APP was associated with neurological symptoms during the 12 months prior to interview (e.g., fainting (Odds Ratio: 7.48, 95% Confidence Interval: 1.83, 30.74), shaking hands (3.50, 1.60, 7.60), numbness/tingling in hands or feet (3.23, 1.66, 6.32), insomnia (2.53, 1.34, 4.79), accelerated heartrate (2.42, 1.03, 5.47), dizziness (2.38, 1.19, 4.72), increased irritability/anger (2.37, 1.23, 4.55), low energy (2.33, 1.23, 4.46), and difficulty concentrating (2.01, 1.05, 3.85)). Farmers who reported an APP in the ten years prior to interview experienced increased odds of abnormal BSI scores for hostility (4.51, 1.16, 17.70) and paranoid ideation (3.76, 0.99, 18.18). Having experienced an APP may be associated with long-term neurological and psychological distress symptoms.

Noma (cancrum oris) is a severely debilitating orofacial disease. The global annual incidence and prevalence figures of noma are outdated and were not based on epidemiological studies. Therefore, we systematically reviewed the scientific literature about the prevalence, incidence, and reported global distribution of noma. We searched ten databases and Google Scholar from 1950 up to Sept 23, 2020. We used an adapted Newcastle-Ottawa scale for quality assessment of the studies we included. Epidemiological data could be extracted from eight publications. Because of the differences in quality and the limited geographical range of the studies, no new estimate of the global incidence and prevalence of noma could be calculated. Our updated world map indicates that patients with noma were diagnosed in at least 23 countries in the past decade. Additionally, we identified a strong focality, with most cases being reported from only a few countries in west Africa. This systematic review has identified a striking scarcity of research and surveillance programmes considering noma. We argue that a first step to noma elimination should be the inclusion of noma in the WHO list of neglected tropical diseases, followed by broad-based integrated control programmes aiming at noma elimination.

Natural resource extraction projects are often accompanied by complex environmental and social-ecological changes. In this paper, we evaluated the association between commodity extraction and the incidence of diseases. We retrieved council (district)-level outpatient data from all public and private health facilities from the District Health Information System (DHIS2). We combined this information with population data from the 2012 national population census and a geocoded list of resource extraction projects from the Geological Survey of Tanzania (GST). We used Poisson regression with random effects and cluster-robust standard errors to estimate the district-level associations between the presence of three types of commodity extraction (metals, gemstone, and construction materials) and the total number of patients in each disease category in each year. Metal extraction was associated with reduced incidence of several diseases, including chronic diseases (IRR = 0.61, CI: 0.47-0.80), mental health disorders (IRR = 0.66, CI: 0.47-0.92), and undernutrition (IRR = 0.69, CI: 0.55-0.88). Extraction of construction materials was associated with an increased incidence of chronic diseases (IRR = 1.47, CI: 1.15-1.87). This study found that the presence of natural resources commodity extraction is significantly associated with changes in disease-specific patient volumes reported in Tanzania's DHIS2. These associations differed substantially between commodities, with the most protective effects shown from metal extraction.

Flooding disasters in urban and suburban Dakar have been prioritised in various policy actions over the last two decades. Our research aimed to generate a historical overview of the progressive transformations of flood governance in Dakar. We found that flood governance policies have gone through three main phases, each representing a paradigm shift: the ‘emergency-relief’ phase, the ‘water-pull-out’ phase, and the ‘live-with-water’ phase. We argue that the second phase, which began in 2012, was supported by an engineering approach, where fresh water was literally pulled out using large-scale drainage infrastructure. This can be considered the ultimate stage of the conquest of urbanisation over nature. The resulting situation was a clear reduction in flood exposure, giving rise to smaller disasters. A new form of land competition also developed in the areas that were drained of water. These areas required the inclusion of local stakeholders into flood management processes. Although both the government and international partners have invested efforts in trying to coordinate flood management, the distribution of competences across several ministries and a lack of cooperation is provoking a “vertically divided authority”, leading to overlapping mandates and competition among state and non-state agencies. From 2014 onwards, what we called the ‘live-with-water’ phase supported the greater inclusion of local stakeholders and a change in articulation, which tried to consider water not as a threat but as a resource. The conclusion of this paper calls for the development of locally centred flood management bodies (including grass-root organisations and municipalities) as well as a more elaborate and complex articulation of the physical and institutional temporalities and scales of flood management.

Background Access to improved water and sanitation infrastructures are key determinants of health. The sub-Saharan African region in particular is lagging behind the ambitious goal of the 2030 Agenda for Sustainable Development to ensure universal access to improved and reliable water and sanitation for all (Sustainable Development Goal (SDG) 6). Large mining projects can promote economic growth and hence investments in water and sanitation infrastructures, but at the same time lead to rapid population growth and environmental degradation. In turn, these changes can pose risks and opportunities for child health (SDG 3). In this study we aim to quantify the impacts of mining projects on access to water and sanitation infrastructure as well as diarrhea and malnutrition among children using data from 131 Demographic and Health Surveys from sub-Saharan Africa. Results From a sample of around 1.2 million households, data within the proximity of 52 mine-panels were selected for longitudinal analyses, resulting in 41,896 households and 32,112 children. Improvements in access to modern water and sanitation infrastructures after mine opening were much larger in households near mining sites than in comparison areas located further away (adjusted relative risk ratio (aRRR) water: 18.60, 95 % confidence interval (CI): 13.08–26.46 and aRRR sanitation: 2.56, 95 % CI: 1.32–4.99). However, these associations were weaker among poorer households. In areas close to the mining sites, stunting and underweight prevalence decreased more strongly upon mine opening (adjusted odds ratio (aOR) stunting: 0.62, 95 % CI: 0.43–0.90; aOR underweight: 0.55, 95 % CI: 0.36–0.84). No differential changes were seen for wasting and diarrhea. Large impact heterogeneity was observed both within and across countries. Conclusions Our results suggest that the opening of mines is associated with improvements in access to modern water and sanitation infrastructures (SDG 6) as well as in some health outcomes (SDG 3). However, the large impact heterogeneity suggests that the assessment and management of mining-related impacts on communities should have an increased equity-focus, in order to “leave no one behind” in the work towards the 2030 Agenda for Sustainable Development. Overall, the findings of this study underscore that the resource extraction sector has the potential to make positive and substantial contributions towards achieving the SDGs. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-021-00723-2.

In 2011, an industrial copper mine was developed in northwestern Zambia. A health impact assessment was conducted to anticipate and address potential health impacts. To monitor these impacts, three community-based surveys were conducted in the area (2011, 2015 and 2019). We analysed these data to determine how household socioeconomic indicators – considered determinants of health – have changed in the area over time. In mine-impacted communities, between 2011 (pre-construction) and 2019, significant changes were observed for: (i) average household size (-0.6 members); (ii) proportion of mothers that have not completed primary school (+20.4%); (iii) ownership of economic assets (e.g. phones +29.3%; televisions +15.6%); (iv) access to safe drinking water (+27.4%); and (v) improved housing structures (e.g. finished roof +58.6%). When comparing changes between 2015 and 2019 in impacted communities to nearby comparison communities, there was (i) an increased proportion of mothers that had not completed primary school in comparison communities vs. no change in impacted communities; and (ii) increased ownership of economic assets in impacted vs. comparison communities in 2019. This study found generally positive changes in the socioeconomic development of impacted compared to comparison communities, with the most pronounced improvements in the early phases of mine development.

Mining projects affect the health of surrounding communities by inducing environmental, economic, social and cultural changes in different population groups. Health impact assessment (HIA) offers an opportunity to manage these impacts. This paper aims to explore gender differences of impacts on the wider determinants of health as described by communities impacted by industrial gold mining and consider the implications for impact assessment. We conducted 24 gender-separated, participatory focus group discussions at three study sites in northwestern Tanzania. Participants reported on a broad range of impacts on the wider determinants of health. Based on a thematic analysis, we identified gendered health impacts on men and women; in addition, children and adolescent boys and girls emerged as differently affected subpopulation groups. Located in the theory of the ‘triple role of women’, we suggest that different gender needs should be addressed more explicitly by HIA. Increased use of mitigation measures that recognise and address impacts on women’s engendered roles, and their health, through addressing women’s strategic gender needs, would strengthen HIA as a tool towards sustainable development.

Studies from India and several eastern African countries found that the impact of dairy animal ownership on household nutrition varied greatly, depending on the socio-geographic context. The purpose of this study was to examine the association between livestock ownership and household dietary quality in rural Kolar district, India. We collected data from a household survey in four study villages (n = all 195 households of the four villages) of Kolar district, applying a cross-sectional design. Kendall’s rank correlation coefficient was employed to determine the correlation between milk consumption and other dietary variables. Multivariable logistic regression was used to describe the relationship between dairy animal ownership and household milk consumption. Households owning dairy animals more often had access to irrigation (58.3% vs. 25.2%) and were less often woman-headed (2.4% vs. 22.5%). Household milk consumption was significantly correlated with consumption of vegetable variety, egg, and meat (all p-values &lt, 0.05). After adjusting for multiple confounders, the odds ratio of milk consumption between dairy animal-owning households as compared to other households was 2.11 (95% confidence interval 0.85, 5.45). While dairy animal ownership was found to be associated with improved dietary quality, larger households were in a better position to adopt dairy animals, which, in turn, might contribute to better household nutrition.

The development and operation of mining projects is associated both with health opportunities and with health risks for the workforce, as well as project-affected communities. Thus, mining has strong links to SDG 3, “Ensure healthy lives and promote well-being for all at all ages”, which is closely interlinked with all the other SDGs, representing determinants of health. Disease prevention and promotion of good health and wellbeing can only be achieved if a diverse group of stakeholders are partnering together. Consequently, companies need to adopt comprehensive health management systems that clarify the role and responsibilities of the different stakeholders. Internally, mining operations need to be committed to work across departments for improving long-term health outcomes, and not just focus on preventing adverse incidents.

Background: Watershed development (WSD) projects, aimed primarily at enhancing soil and water conservation and supporting livelihoods in semi-arid areas, have the potential to impact health by modifying the occupational and household environments in agrarian communities. To identify and address potential health concerns arising from a planned WSD project in Kolar district, India, a health impact assessment (HIA) was conducted. This necessitated understanding the health status and concerns in the project villages. Objective: To characterize the health of farmers and their household members in close proximity of the planned WSD project. Methods: We carried out a cross-sectional survey between April and July 2019. The study comprised: (i) a household survey covering the four project villages and two comparison villages (e.g. socio-demographic characteristics, occurrence of vector-borne diseases (VBDs), access to safe water, sanitation and hygiene, and utilization of healthcare); and (ii) an anthropometric survey for children under the age of 5 years in the four project villages and four comparison villages. Results: Respondents (n = 333) reported household-level occurrences of VBDs (chikungunya, 3.3%; and dengue, 1.5%), consuming unsafe water (54.5%) and frequent pesticide application in fields (26.7%). The prevalence of child underweight was 23.8%. Conclusions: VBDs, poor water quality and child undernutrition were found to be important local health concerns, amenable for preventive and promotive measures through the planned WSD project. Occupational environments in agricultural settings affect the workers and their households, and comprehensive projects such as WSD can seize the opportunity for improving health of farming and other rural households.

The application of a health impact assessment (HIA) for a large-scale copper mining project in rural Zambia triggered the long-term monitoring and evaluation of determinants of health and health outcomes in communities living in proximity to the mine. Three consecutive cross-sectional surveys were conducted at intervals of four years, thus, at baseline (2011), four (2015) and eight (2019) years into the project&rsquo, s development. Using the same field and laboratory procedures, the surveys allowed for determining changes in health indicators at the household level, in young children (&lt, 5 years), school attendees (9&ndash, 14 years) and women (15&ndash, 49 years). Results were compared between communities considered impacted by the project and communities outside the project area (comparison communities). The prevalence of Plasmodium falciparum infection increased in both the impacted and comparison communities between 2011 and 2019 but remained consistently lower in the impacted communities. Stunting in children &lt, 5 years and the prevalence of intestinal parasite infections in children aged 9&ndash, 14 years mostly decreased. In women of reproductive age, selected health indicators (i.e., anaemia, syphilis, underweight and place of delivery) either remained stable or improved. Impacted communities generally showed better health outcomes than comparison communities, suggesting that the health interventions implemented by the project as a consequence of the HIA have mitigated potential negative effects and enhanced positive effects. Caution is indicated to avoid promotion of health inequalities within and beyond the project area.

Health is central to sustainable development, and thus a cross-cutting issue of the SustainableDevelopment Goal (SDG) 2030 agenda. Natural resource extraction projects in Africa haveconsiderable potential to impact on health-related targets of the SDGs. This paper introducesthe rationale and organization of the HIA4SD Project; a 6-year research for development (r4d)project that aims to inform and facilitate a policy dialogue at the national and internationallevel on whether current regulatory approaches to impact assessment in Africa promotesustainable development, placing emphasis on SDG3Good Health and Well-being. TheHIA4SD Project has a focus on large-scale natural resource extraction projects and is imple-mented in four African countries, namely Burkina Faso, Ghana, Mozambique and Tanzania.

While population genetics of Schistosoma haematobium have been investigated in West Africa, only scant data are available from Côte d’Ivoire. The purpose of this study was to analyze both genetic variability and genetic structure among S. haematobium populations and to quantify the frequency of S. haematobium × S. bovis hybrids in school-aged children in different parts of Côte d’Ivoire. Urine samples were subjected to a filtration method and examined microscopically for Schistosoma eggs in four sites in the western and southern parts of Côte d’Ivoire. A total of 2692 miracidia were collected individually and stored on Whatman® FTA cards. Of these, 2561 miracidia were successfully genotyped for species and hybrid identification using rapid diagnostic multiplex mitochondrial cox1 PCR and PCR Restriction Fragment Length Polymorphism (PCR-RFLP) analysis of the nuclear ITS2 region. From 2164 miracidia, 1966 (90.9%) were successfully genotyped using at least 10 nuclear microsatellite loci to investigate genetic diversity and population structure. Significant differences were found between sites in all genetic diversity indices and genotypic differentiation was observed between the site in the West and the three sites in the East. Analysis at the infrapopulation level revealed clustering of parasite genotypes within individual children, particularly in Duekoué (West) and Sikensi (East). Of the six possible cox1-ITS2 genetic profiles obtained from miracidia, S. bovis cox1 × S. haematobium ITS2 (42.0%) was the most commonly observed in the populations. We identified only 15 miracidia (0.7%) with an S. bovis cox1 × S. bovis ITS2 genotype. Our study provides new insights into the population genetics of S. haematobium and S. haematobium × S. bovis hybrids in humans in Côte d’Ivoire and we advocate for researching hybrid schistosomes in animals such as rodents and cattle in Côte d’Ivoire., Alors que la génétique des populations de Schistosoma haematobium a été étudiée en Afrique de l’Ouest, seules quelques données sont disponibles pour la Côte d’Ivoire. Le but de cette étude était d’analyser à la fois la variabilité génétique et la structure génétique des populations de S. haematobium et de quantifier la fréquence des hybrides S. haematobium × S. bovis chez les enfants d’âge scolaire dans différentes régions de la Côte d’Ivoire. Des échantillons d’urine ont été soumis à une méthode de filtration et examinés au microscope pour les œufs de Schistosoma dans quatre sites de l’ouest et du sud de la Côte d’Ivoire. Au total, 2 692 miracidia ont été collectés individuellement et stockés sur des cartes Whatman® FTA. Parmi ceux-ci, 2 561 miracidia ont été génotypés avec succès pour l’identification des espèces et des hybrides à l’aide de la PCR multiplex de diagnostic rapide du cox1 mitochondrial et d’une analyse du polymorphisme de longueur des fragments de restriction de PCR (PCR-RFLP) de la région ITS2 de l’ADN nucléaire. Sur 2 164 miracidia, 1 966 (90,9 %) ont été génotypés avec succès en utilisant au moins 10 loci microsatellites nucléaires pour étudier la diversité génétique et la structure de la population. Des différences significatives ont été trouvées entre les sites dans tous les indices de diversité génétique et une différenciation génotypique a été observée entre le site de l’Ouest et les trois sites de l’Est. L’analyse au niveau de l’infrapopulation a révélé un regroupement des génotypes de parasites au sein de chaque enfant, en particulier à Duekoué (Ouest) et Sikensi (Est). Parmi les six profils génétiques cox1-ITS2 possibles obtenus à partir de miracidia, S. bovis cox1 × S. haematobium ITS2 (42,0 %) était le plus fréquemment observé dans les populations. Nous avons identifié seulement 15 miracidia (0,7 %) avec un génotype S. bovis cox1 × S. bovis ITS2. Notre étude apporte de nouvelles connaissances sur la génétique des populations de S. haematobium et des hybrides S. haematobium × S. bovis chez l’homme en Côte d’Ivoire et nous plaidons pour la recherche de schistosomes hybrides chez les animaux (rongeurs et bovins) en Côte d’Ivoire.

The critically important role of health for development was underlined in the 16th World Development Report entitled “Investing in health”, published in 1993 [1]. Put forth by the World Bank and enhanced with input from the World Health Organization (WHO), the report examined the interplay between human health, health policy, and economic development. In the period 2000-2015, health for development was strongly emphasized in the Millennium Development Goals (MDGs). Indeed, three of the eight MDGs explicitly featured health [2]. Meanwhile, major achievements have been made in population health. For instance, average global life expectancy has increased by more than 20 years between 1950 and 2010 [3]. Yet, there are areas of unfinished business, such as reducing child mortality and improving maternal health [4]. Key vulnerable groups, such as the poorest and most isolated populations, have been left excluded and marginalized [4,5]. In addition, there are new challenges, as for instance non-communicable diseases have surpassed infectious diseases in terms of global burden [6], novel infectious threats from zoonoses [7] and anti-microbial resistance [8] have emerged, there are toxic mixtures of chemicals compromising human, animal, and ecosystem health, while climate change, urbanization, and migration have amplified health problems and vulnerabilities [9]. Taken together, there are multifactorial stresses that ask for innovative, multi-partner, integrated approaches. ISSN:2047-2986

BACKGROUND Natural resource extraction projects offer both opportunities and risks for sustainable development and health in host communities. Often, however, the health of the community suffers. Health impact assessment (HIA) can mitigate the risks and promote the benefits of development but is not routinely done in the developing regions that could benefit the most. OBJECTIVE Our study aims to investigate health and health determinants in regions affected by extractive industries in Burkina Faso, Ghana, Mozambique, and Tanzania. The evidence generated in our study will inform a policy dialogue on how HIA can be promoted as a regulatory approach as part of the larger research initiative called the HIA4SD (Health impact assessment for sustainable development) project. METHODS The study is a concurrent triangulation, mixed methods, multi-stage, multi-focus project that specifically addresses the topics of governance and policy, social determinants of health, health economics, health systems, maternal and child health, morbidity and mortality, and environmental determinants, as well as the associated health outcomes in natural resource extraction project settings across four countries. To investigate each of these health topics, the project will (1) use existing population-level databases to quantify incidence of disease and other health outcomes and determinants over time using time series analysis; (2) conduct two quantitative surveys on mortality and cost of disease in producer regions; and (3) collect primary qualitative data using focus groups and key informant interviews describing community perceptions of the impacts of extraction projects on health and partnership arrangements between the projects and local and national governance. Differences in health outcomes and health determinants between districts with and without an extraction project will be analyzed using matched geographical analyses in quasi-Poisson regression models and binomial regression models. Costs to the health system and to the households from diseases found to be associated with projects in each country will be estimated retrospectively. RESULTS Fieldwork for the study began in February 2019 and concluded in February 2020. At the time of submission, qualitative data collection had been completed in all four study countries. In Burkina Faso, 36 focus group discussions and 74 key informant interviews were conducted in three sites. In Ghana, 34 focus group discussions and 64 key informant interviews were conducted in three sites. In Mozambique, 75 focus group discussions and 103 key informant interviews were conducted in four sites. In Tanzania, 36 focus group discussions and 84 key informant interviews were conducted in three sites. Quantitative data extraction and collection is ongoing in all four study countries. Ethical approval for the study was received in all four study countries prior to beginning the fieldwork. Data analyses are underway and results are expected to be published in 2020 and 2021. CONCLUSIONS Disentangling the complex interactions of resource extraction projects with their host communities requires an integrative approach drawing on many methodologies under the HIA umbrella. By using complementary data sources to address the question of population health in project areas from several angles, bias and missing data will be reduced, generating high-quality evidence to aid countries in moving toward sustainable development. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17138

Background Natural resource extraction projects can have positive but also negative effects on the health of affected communities, governed by demographic, economic, environmental, physical and social changes. Negative effects often prevail and these might widen existing health inequities. Health impact assessment (HIA) is a decision-support tool that aims at maximizing benefits and minimizing negative impacts on people's health. A core value of HIA is equity; yet, little is known about health equity in the frame of HIA, particularly in sub-Saharan Africa. Methodology We conducted a scoping review to determine whether and to what extent HIA in sub-Saharan Africa addresses health equity. We included peer-reviewed publications and guidelines pertaining to HIA, environmental impact assessment (EIA) and social impact assessment (SIA). Health equity was investigated by identifying (i) how health considerations were addressed and (ii) whether health was stratified by subgroups of the community. Results Out of 1′640 raw hits, we identified 62 articles (16 HIA, 36 EIA, one SIA and nine integrated assessments), 32 of which specifically addressed health. While 20 articles focused on a specific health topic, 12 articles used a more comprehensive approach to address health. In 15 articles there were specific subgroup analyses (e.g. mothers, children or marginalized groups) as a measure of health equity. Another 12 papers referred to the community in a more general way (e.g. affected). Without exception, health was an integral part of the nine included guidelines. HIA guidelines addressed health systematically through environmental health areas, risk assessment matrix or key performance indicators. Conclusions We found evidence that previously conducted HIA in sub-Saharan Africa and current guidelines address health equity. However, there is a need to stratify community subgroups more systematically in order to determine health differentials better. Future HIA should consider community heterogeneity in an effort to reduce health inequities by “leaving no one behind”, as suggested by the Sustainable Development Goals., Environmental impact assessment review, 79, ISSN:0195-9255

Soil-transmitted helminth (STH) infections caused 4.98 million years live with disability globally in 2014, mostly affecting the poor. When farmers handle excreta for reuse in agriculture, involunt...