Chronic disease conditions such as hypertension and diabetes are increasing worldwide with most of the burden shifting to low and middle-income countries which are still struggling with high infectious diseases burden. Chronic diseases require adequate medical intervention and most of them are expensive to treat. Since many of these diseases do not cause any symptoms some patients do not seek care even when they have been informed about the disease. A wide range of other personal social and physical environment influence their treatment behaviour. Management of chronic diseases by the patient is central to control of its effects. Patient self-help support groups thus provide an environment that would encourage better management of their health and have been shown in high-income countries to improve the management of some chronic diseases. The World Health Organization echoed the role of patient groups in the HIV treatment guidelines of 2013, however, these were limited to HIV care which is fairly well resourced. There have been a few successful programs of patient support groups but these have been theory based and not well evaluated. In the urban informal communities of Nairobi, informal groupings of patients with about 20-30 members each have existed since 2009 and more groups are being formed in other parts of Nairobi but have not been evaluated. These patient groups have been self-sustaining to the extent that they make their own financial contributions for bulk procurement of medicines making treatment quite affordable to low-income patients. These patient groups are a promising initiative that would help low-income patients who are not mostly insured access medications at a subsidized cost and have better adherence to care and better health outcomes. Nonetheless, serious gaps exist in understanding and improving disease management by patients because we do not know which aspects of this model of care have worked and if so, how a wider rollout would be implemented. Patient behavior and other challenges in managing the groups could potentially limit their success. Limitations of study designs coupled with short follow up periods have affected the quality of studies conducted to evaluate the patient groups. Before rolling out the patient groups widely, there is a need to identify which components of the groups make them successful and how such characteristics could be further developed and tested on a large scale. Here, we propose to develop a framework of care based on the longstanding experience of groups of patients with hypertension and diabetes who have been functioning independently with regular clinical support from a nurse from a local clinic. We will observe the group management processes, talk to group members individually and in groups and find their views on what worked well and what challenges they might have experienced. Then we will use this information to develop a framework together with them that we will test and evaluate. This small study will generate information needed to plan a larger trial that we intend to undertake in several African countries with a similar pool of untreated patients. This initial work will bring together investigators of various backgrounds from UK, Netherlands, South Africa and Kenya. The Ministry of Health in Kenya and the Nairobi County Health Department have assured us of their support in this work and commitment to translating this to policy when succesful. We are quite optimistic that given our interdiplinary background as researchers, and institutional support, this project will be feasible to conduct and will go along way saving millions of lives that would be lost due to untreated chronic conditions among vulnerable populations.

Introduction: The UN estimates that 2.5 billion people will be added to the planet over the next 30 years. A large portion of these populations will reside in deprived neighbourhoods including slums, informal settlements, and areas of inadequate housing and face a range of challenges from insecure tenure, to unplanned housing, pollution, environmental risk, and social exclusion. Spatial data on such neighbourhoods are commonly not available. On the occasions that they do exist, they quickly become out-dated. Without up-to-date information on the geography (location and extent) of deprived neighbourhoods and the specific social and physical environmental conditions faced by their inhabitants, the impact of these on health and social outcomes are not traceable and the development of effective interventions is not achievable. However, there is currently no systematic, scalable approach to map deprived neighbourhoods across cities, particularly in low- and middle-income countries (LMICs). Methodology: The project will design an Integrated Deprived Area Mapping System (IDEAMAPS) that will push the boundaries and overcome the weaknesses of each of these current approaches to mapping slums, informal settlements, and areas of inadequate housing. This will be accomplished by joining up a multisectoral and transdisciplinary network of researchers, technologists and societal stakeholders who will collaborate to co-design the IDEAMAPS approach to map and address neighbourhood deprivation and perform pilot studies in Nairobi, Accra, and Lagos, where we have existing strong partnerships and access to existing data (see details below). This approach will consist of an innovative combination of three components: (a) engagement of stakeholders in different scales; (b) modelling and data infrastructure techniques that aim to integrate and leverage the accuracy of field-based maps; (c) an integrative framework, which defines assessment criteria for characterising neighbourhood deprivation in connection with sustainable development. Work Groups: WP1. Stakeholder Engagement- This work package (WP) leads engagement of stakeholders across sectors (e.g. EO, demography, community, policy) in both established and innovative ways to further develop understanding of urban neighbourhood deprivation, and to create enabling environments in which a deprived area mapping system can be implemented. WP2. Integrative Frameworks- This will be dedicated to the synthesis of key requirements and a shared agenda for the IDEAMAPS approach. It will begin with collating existing literature reviews from current and past projects of the research team: specifically, the Improving Health in Slums Collaborative, Surveys for Urban Equity, Million Neighborhoods Initiative, Modelling African Urban Population Patterns, Accra women's health study, and Standardizing City-Level Data-Gathering in Lagos and Accra. WP3. Modelling and Data Infrastructure Techniques. This WP3 collate existing data and methods to test potential IDEAMAPS approaches. Based on the domains of deprivation framework developed in WP 2 with input from stakeholders of WP1, we will develop new area-level environmental (e.g. flood risk) and social datasets (e.g. open sewers), and evaluate modelling approaches that can capture domains of deprivation individually, as well as an overall deprivation "slumness" index. WP2 will also investigate different visualisation targeted at end-users in different scales. The evaluation criteria developed in WP 2 will be used to assess and compare model outputs. Expected Output: The work packages will create a foundation of stakeholder engagement approaches, frameworks, and techniques to scale-up over the next three years to flesh out an integrated deprivation area mapping system (IDEAMAPS) with a capacity to generate more accurate and usable maps and integrate them into community upgrading and advancing progress toward sustainable development goal.

Covid-19 is a decisive moment for political reform and social progress in Kenya, as in many other African states. The government response to date has mixed scientifically grounded public health interventions, on the one hand, with forthright coercion, on the other. Mass testing, social distancing, and the closure of public facilities, alongside a nationwide curfew, restrictions on movement in and out of, as well as within the cities of Nairobi and Mombasa. These decrees have been implemented by police and state paramilitaries using massive, indiscriminate and, in some cases, lethal force. Quarantine, imposed on new arrivals from abroad, has also been used as an ad hoc form of punishment for curfew violations. Restrictions have had a disproportionately severe economic impact on residents of already marginalized communities, unable to travel to work or procure adequate food for themselves and their dependents. The crisis is testing the durability of Kenya's constitution of 2010 which re-established the republic as a democratic polity based on the rule of law and is taken as model for reform across Africa. The fruit of popular consultation, the constitution broke with decades of colonial and post-colonial authoritarianism and social exclusion. It embeds Kenya in the international human rights order, guaranteeing civil and social rights, and making them enforceable by individual citizens and civil society groups. These gains are far from secure, however. The dominance of a law and order mentality at all levels of government, routine deployment of unchecked police violence, corruption, and a reluctance to abide by court orders have persisted well beyond 2010. The project asks whether the pandemic emergency has intensified these tendencies, or whether the new constitutional order will prove to be resilient. The research will take social rights implicated by the crisis (eg. health and access to food) as seriously as civil rights (eg. life and liberty), building on accepted international law that both are interdependent and ultimately indivisible. Consonant with the constitutional value of participation, it will work with community groups, policy makers, and civil society organizations to enable lessons to be learnt from the crisis on strengthening democratic and inclusive institutions and practices. The research will generate a legal and political record of the period by analysing and contextualizing legislative and judicial developments, and through qualitative and participatory research with affected citizens, officials, and professionals working in heath, law and nutrition. The project privileges a reciprocal process of exchange and learning, with grassroots insights informing legal doctrinal work on the one hand, and the human rights capacity of communities being developed by engagement with scholars and practitioners, on the other. It will generate academic outputs in high quality law, political science and public health journals. A documentary film, co-produced with community journalists will create an accessible, widely shared record of experiences and attitudes to the crisis at different levels of Kenyan society. Through a responsive communication and engagement strategy, including dedicated briefings and webinars, it will disseminate findings to project partners and other key stakeholders enabling them to intervene in a robust and timely fashion to shape the political and legal landscape during and after COVID-19 in ways that favour human rights and human welfare.

Air quality in most East African cities has declined dramatically over the last decades and it air pollution is now the leading environmental risk factor for human health. There is a critical lack of data to assess air quality in East Africa, and therefore to quantify its effect upon human health. Air quality networks in East Africa are still in their early days, with the long term and systematic measurement of air pollutants only available at less than a handful of sites. Large spatial and temporal gaps in data exist. From a historical perspective, very little is known of air pollution concentrations before 2010. The lack of historical data makes it extremely difficult to assess the deleterious effects of air pollution upon human health. It also poses challenges for assessing the efficacy of air quality interventions. Hence informed decisions about infrastructure, which take air quality into account are difficult to make. This proposal forms a new network to co-create strategy and protocols to bring together data that relate to air pollution in East African Urban areas. It targets the capitals of Ethiopia (Addis Ababa), Kenya (Nairobi) and Uganda (Kampala). New data science techniques will be developed to synthesize disparate data streams into spatially and temporally coherent outputs, which can be used to understand historic, contemporary and future air quality. The proposal will provide a road map to harness the power of new data analytics and big data technologies. To design this roadmap, three high intensity workshops and interspersed virtual meetings will be undertaken in Stage 1. Each workshop will tackle a key knowledge gap or development challenge: - Workshop 1: Parameterizing the data problem in East Africa for assessing the causes and effects of air pollution (Kampala) - Workshop 2: Big data approaches to improve East Africa air quality prediction (Addis Ababa) - Workshop 3: Creating greater capacity and capability in analytic air quality science (Nairobi) The Stage 1 research outcomes will enable the development of tailored mitigation strategies for improving air quality. The methodologies developed in the proposal will be translatable and scalable throughout urban East Africa. Hence, the proposal will help realise multiple sustainable development goals (SDGs), including SDG3: Good health and well-being, SDG11: Sustainable cities and communities, and SDG17: Partnerships for the goals. To ensure the project reaches its maximum potential, it includes an extensive array of research translation activities: workshops with academic and non-academic stakeholders; a professionally designed website, which will hold both academic and non-academic outputs including open source academic papers and presentations; briefing notes directed at a range of external stakeholders, including top down governance and bottom up grassroots organizations. Project partners from business, academia, governance and public engagement with science are involved and will attend the workshops. They are Uber, Amazon Web Services, PA Consulting, Kampala Capital City Authority, African Population Health Research Centre, Birmingham Open Media, GCRF Multi-Hazard Urban Disaster Risk Transitions Hub, and the Alan Turing Institute. They offer an additional £102,951 of in-kind contributions to the project. Their incorporation widens the available skillsets and will help deliver long-term impact in the East African region.