Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box CH-4002, Basel, Switzerland.
University of Basel, P.O. Box CH-4001, Basel, Switzerland.
Global Health. 2021 Jun 30;17(1):70. doi: 10.1186/s12992-021-00723-2.
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.
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.
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.
获得改良的水和环境卫生设施是健康的关键决定因素。特别是撒哈拉以南非洲地区，远未实现 2030 年可持续发展议程中确保人人获得改良和可靠的水和环境卫生的宏伟目标（可持续发展目标 6）。大型矿业项目可以促进经济增长，从而投资于水和环境卫生基础设施，但同时也会导致人口快速增长和环境退化。反过来，这些变化可能会给儿童健康带来风险和机遇（可持续发展目标 3）。在这项研究中，我们旨在利用来自撒哈拉以南非洲地区的 131 项人口与健康调查的数据，量化矿业项目对获得水和环境卫生设施以及儿童腹泻和营养不良的影响。
在大约 120 万户家庭中，选择了距离 52 个矿区面板较近的家庭进行纵向分析，结果得到了 41896 户家庭和 32112 名儿童的数据。与距离矿区较远的地区相比，矿区附近家庭获得现代水和环境卫生设施的改善要大得多（调整后的相对风险比（aRRR）水：18.60，95%置信区间（CI）：13.08-26.46 和 aRRR 卫生：2.56，95%CI：1.32-4.99）。然而，这些关联在较贫困的家庭中较弱。在靠近矿区的地区，矿区开放后，发育迟缓症和体重不足症的患病率下降更为明显（调整后的比值比（aOR）发育迟缓症：0.62，95%CI：0.43-0.90；aOR 体重不足症：0.55，95%CI：0.36-0.84）。未观察到消瘦和腹泻的差异变化。在国家内部和国家之间都观察到了很大的影响异质性。
我们的结果表明，矿山的开采与现代水和环境卫生设施（可持续发展目标 6）的改善以及一些健康结果（可持续发展目标 3）有关。然而，巨大的影响异质性表明，对矿业相关社区影响的评估和管理应该更加注重公平，以确保在实现 2030 年可持续发展议程的过程中“不让任何人掉队”。总的来说，这项研究的结果强调，资源开采部门有可能为实现可持续发展目标做出积极和实质性的贡献。
