title: A review and framework for understanding the potential impact of poor solid waste management on health in developing countries.
abstract: BACKGROUND
  The increase in solid waste generated per capita in Africa has not been accompanied by a commensurate growth in the capacity and funding to manage it. It is reported that less than 30% of urban waste in developing countries is collected and disposed appropriately. The implications of poorly managed waste on health are numerous and depend on the nature of the waste, individuals exposed, duration of exposure and availability of interventions for those exposed.
  
  
  OBJECTIVE
  To present a framework for understanding the linkages between poor solid waste management, exposure and associated adverse health outcomes. The framework will aid understanding of the relationships, interlinkages and identification of the potential points for intervention.
  
  
  METHODS
  Development of the framework was informed by a review of literature on solid waste management policies, practices and its impact on health in developing countries. A configurative synthesis of literature was applied to develop the framework. Several iterations of the framework were reviewed by experts in the field. Each linkage and outcomes are described in detail as outputs of this study.
  
  
  RESULTS
  The resulting framework identifies groups of people at a heightened risk of exposure and the potential health consequences. Using the iceberg metaphor, the framework illustrates the pathways and potential burden of ill-health related to solid waste that is hidden but rapidly unfolding with our inaction. The existing evidence on the linkage between poor solid waste management and adverse health outcomes calls to action by all stakeholders in understanding, prioritizing, and addressing the issue of solid waste in our midst to ensure that our environment and health are preserved.
  
  
  CONCLUSIONS
  A resulting framework developed in this study presents a clearer picture of the linkages between poor solid waste management and could guide research, policy and action.
authors.affiliation: African Population and Health Research Center, P. O. Box 10787-00100, Nairobi, Kenya.
authors.forename: Abdhalah K
authors.initials: AK
authors.lastname: Ziraba
authors.affiliation: African Population and Health Research Center, P. O. Box 10787-00100, Nairobi, Kenya.
authors.forename: Tilahun Nigatu
authors.initials: TN
authors.lastname: Haregu
authors.affiliation: African Population and Health Research Center, P. O. Box 10787-00100, Nairobi, Kenya.
authors.forename: Blessing
authors.initials: B
authors.lastname: Mberu
keywords: Conceptual framework; Hazardous waste; Health impact; Municipal waste; Solid waste; Urbanization