%0 Generic
%A Bayode, Taye
%C Heidelberg
%D 2025
%F heidok:37357
%R 10.11588/heidok.00037357
%T Reducing childhood malaria through sustainable urban planning:   A spatial risk modelling approach to Foster public health-based urban structure and Infrastructure in Akure, Nigeria
%U https://archiv.ub.uni-heidelberg.de/volltextserver/37357/
%X The health and well-being of inhabitants of cities in low- and middle-income countries like Nigeria are constantly threatened. Particularly, the striking urban health inequalities and the high burden of infectious diseases such as malaria with associated negative consequences. In addition to ill health among the malaria-infected individuals, other negative impacts of malaria include economic burden, loss of wages, and time away from school among children. However, these burdens are not evenly distributed in space and time. Existing studies on spatiality of malaria face three main shortcomings: They are done at a coarse scale resulting in the masking of local malaria hotspots, lacks important malaria socio-economic and socio-ecological variables essential for formulating tailored health policy interventions, and fall short in exploring the dynamics of city growth and its impact on impact on malaria in children under 5 years old (U5) given that the high level of urbanisation confronted by cities poses health risk on city inhabitants. Akure, Nigeria is an example of such city whereby the ongoing urbanisation processes with the potential to increase the risk of malaria among vulnerable groups has not been adequately investigated. Therefore, addressing these shortcomings are significant to improving health outcomes among city inhabitants in Nigeria.   This dissertation aims at closing these gaps by leveraging spatial and non-spatial cross-sectional mixed method approaches to answer two main questions: (i) What are the (spatial) growth dynamics and their impact on health in Akure? (ii) Where are the local pockets of U5 malaria, and what are their driving socio-economic and socio-ecological factors? These two main questions are further divided into nine sub-questions which were approached by gathering primary data from surveys and interviews as well as secondary data from policy documents and government repositories. The mixed methods used to analyse the data include descriptive and inferential statistics, machine learning and spatial data analysis.  The study reveals that Akure is rapidly urbanising, with a net increase of over 20 % in built-up areas between 1984 and 2023. However, the spatial growth of the city lacks formal urban planning, and its impact on health has been given little to no attention by local urban planning officials. Geostatistical modelling predicts that U5 malaria prevalence in Akure exceeds 35 % in certain locations. According to the exceedance probability model developed in line with the fifth National Malaria Strategic Plan of Nigeria, the study shows U5 malaria hotspots are primarily in peri-urban and informal settlements, suggesting the impact of urban structure on the malaria burden. Finally, the dissertation identifies five critical social determinants of U5 malaria: window protection, distance to waste disposal sites, use of insecticide-treated nets, source of drinking water, and availability of health infrastructure.  In conclusion, this dissertation emphasises the need to include multiple actors beyond the public health sector as well as multidisciplinary approaches in generating place-based evidence for malaria reduction/elimination policy formulation. Such strategies are essential for cities like Akure to achieve the Sustainable Development Goals 3 and 11 in low- and middle-income countries, thereby sustainably improving their inhabitants’ living conditions.