Evidence-based strategies to reduce the burden of household air pollution in Accra, Ghana

In order to guide policy-makers in the development of strategic plans to protect their populations from the adverse health impacts of rapid urbanization, the WHO Urban Health Initiative has undertaken a series of projects to train government representatives in the use of tools to objectively evaluate health impact of policies and development trajectories. The integrated set of models provides a framework for rapid assessment of relative benefits using Global Burden of Disease (GBD) metrics. Given the difficulties in obtaining robust estimates of disease incidence, especially in sub-Saharan Africa, use of GBD estimates was a pragmatic choice for modelling the impacts of urban policies on disease outcomes. The modelled outcomes are not intended to be predictors of disease for the Greater Accra Metropolitan Area of Ghana, rather an objective assessment of the relative benefits of different urban policies. These assessments do not take the place of the detailed economic evaluations required to identify national energy priorities, national and global work on mapping disease incidence, nor the social and political considerations required in implementing major social interventions in public health. They do provide an evidence-based framework to compare the impacts of different urban policies on health, and provide an assessment of whether current efforts are likely to achieve policy goals over the next 10 years.