The protection of human health and the environment are two major goals of international environmental law. However, there has been little coherent scrutiny of their scope or implementation at international and domestic levels in developing countries and Africa in particular. This thesis shows that international environmental law regimes with a health protection objective have not maximized opportunities to reinforce the promotion and protection of public health in Africa. Through inter alia a study of sustainable management of shared freshwaters, trans-boundary movement of hazardous wastes and their disposal and international climate law, the thesis shows that a range of legal frameworks comprised of substantive, institutional and procedural law mandates States to advance the health objective in international environmental law. However, the thesis demonstrates the limits of these regimes and suggests options to enhance their potential in promoting and protecting public health. An enhanced framework of adaptive governance is proposed to improve environmental health governance. The thesis illustrates how the discourse on health in international environmental law can strengthen international environmental health governance to improve environmental and public health outcomes. It contains seven publications that analyse the strengths and weaknesses and options for reform of the international environmental law regime for health. The implications of these findings for theory, practice and public policy are discussed.

Policy transfer defies the notion of national boundaries in policy making and development. With globalisation processes in the picture, purely state centric policy making models are not the only option. International and domestic policy entrepreneurs have been pivotal in transfer processes. For developing countries, international donor organisations have been instrumental through conditioning assistance to policy reform. Due to the prevailing hierarchical aid regimes, the assumption is that developing countries would implement these policies for the fear of losing the much-needed aid. However, this study argues that the actual implementation of reforms emanating from the global arena is not an automatic process even in the context of coercive transfers, as it is mediated by country specific contextual frameworks. Moreover, even if implemented, the extent to which the transfers attain the promised transformation ends depends on prevailing environmental factors, appropriateness of the reforms, and the implementers' in-depth understanding of the reform instruments. The analysis used the cases of hospital autonomy and district health management decentralisation reforms which are based on the new public management (NPM) paradigm to examine the mechanisms of policy transfer; factors constraining or facilitating the adoption and/or implementation of transferred policies; and the impacts of the policy programmes on service delivery transformation in Malawi. A multilevel framework was used to analyse the dynamics at international, national and application levels. It used a qualitative research strategy. Therefore, data was collected through in-depth interviews, focus group discussions, documents, and observations. The study finds that due to Malawi's heavy aid reliance, international donor organisations attempted to introduce the hospital autonomy and district health management decentralisation reforms on its policy agenda through aid conditioning mechanism which has coercive attributes. In the former, USAID as an international institutional entrepreneur was the driving force through its non-project assistance (NPA) aid regime while in the later case it was the European Commission within the institutional framework of the Lome IV Convention. A comparative analysis of the two reforms revealed that a combination of contextual issues of: mode of transfer, policy content and political-economic context, path dependence, parliament-cabinet configuration, bureaucratic politics, pressure from citizens, institutional compatibility and prerequisites, and social economic forces; determined their adoption and subsequent implementation. While hospital autonomy was rejected by cabinet, and not implemented, despite large amounts of donor resources invested in the transfer processes because of these contextual issues, decentralisation was implemented as the environment was favourable, although it met bureaucratic resistance. However, the study found that when implemented, decentralisation faced several contextual challenges including modest levels of application, reproductions, reversals, cultural factors, and unintended consequences so that it has not achieved the intended transformational results. To this end, the findings provide a better understanding of the dynamics of policy transfer in developing countries and work as a springboard for donor organisations to reorient their approach in aiding policy development in developing countries.

<p>The Lake Bosomtwe impact crater is located in the Ashanti region of Ghana, West Africa. The impact crater diameter from rim to rim is approximately 10.5 km wide with a lake located at the center. Three different districts touch the lake containing 155,000 hectacres of land. There are approximately 7,500 people from 24 villages, and 12 of those villages reside within walking distance of the lake shore. Within the last ten years, the lake has been subjected to overfishing and environmental degradation. The health of the lake has declined due to overfishing and algae blooms caused by improper fertilization rates. Because of these factors, residents of the area have been forced to transition to subsidence farming as their main vocation. According to the Ghana Statistical Service group, 97.6% of the population participates in some form of rural crop farming (Ghana Statistical Service, 2010). Experience with common practices such as crop rotation, fertilizer use, and erosion control is extremely limited. The lake has not been recommended for recreational use due to the excess runoff in the form of agrochemicals, liquid, and organic waste. Caged aquaculture and traditional fishing within Lake Bosomtwe is currently illegal.</p><p><br></p><p>A comprehensive Institutional Review Board (IRB) survey was developed for the six primary research questions to be examined. From these six research questions, 147 specific questions were developed. Three of the 147 questions were to obtain Global Positioning System (GPS) data for community households, pit latrines, and water wells or boreholes. This study sought to interview 10-15 farmers per village, for each of the 12 villages located along the shore of Lake Bosomtwe of their perspective on land use change/cover in the Lake Bosomtwe area, current farming practices, current water sanitation and hygiene practices, and current fishing practices. These surveys were collected in the form of oral responses, for which 118 small-holder farmers were interviewed. Of the participants surveyed, 66% were qualified to answer all questions, and 100% of participants completed the survey.</p><p><br></p><p>Some specific statistical tests were conducted based of market assessment survey. It was determined that no association between gender and level of education existed. Meaning, that female participants interviewed have just as many opportunities as male participants to pursue education beyond Junior High School (JHS). Yield averages between the villages on the north side of the lake with road access and villages on the southern portion of the lake with limited to no road access were determined to be significantly different. It was determined that road access does affect village yield. When comparing average usable yields between villages located on the northern side of the lake with road access or between villages on the southern side of the lake with limited to no road access, these results were not statistically significant. No significant difference in the scores for villages with road access on the northern side of the lake and villages with limited to no road access on the southern side of the lake existed. Therefore, road access does not affect village usable yield. Through statistical analysis an association was determined between people who practice bathing and washing in the lake and those who practice fishing as a form of livelihood.</p><p><br></p><p>Four decision matrices were created to prioritize the following items: Farm Components, technologies to showcase at an appropriate technology center, improved farming practices to showcase through Demonstration Plots, and extension outreach topics. The top three results for the Farm Components were: Appropriate Technology Center (ATC), Demonstration Plots, and a Micro-Credit Union. The top three technologies to showcase as part of the ATC are: PICS Bags, Moisture Meters, and Above-Ground Aquaculture. The three demonstration plots recommended terracing/erosion control, crop rotation, and cover crops. The highest priority extension outreach topics were: basic home/farm finance, improving health through washing stations, and post-harvest loss prevention. The top three priorities of each decision matrix will be the focus of further study, so that these topics can be developed and programs focusing on these needs can be implemented in collaboration with the community partners.</p>

<p>In developing countries water access is not always available. In many locations around the world, people lack sufficient access of water for both drinking and domestic purposes and use unsafe water sources. Particularly in sub-Saharan Africa, women and children walk great distances to obtain access to water. People must have equitable and affordable access to safe and sufficient water that is palatable and in sufficient quantity for both drinking and domestic purposes before any other long-term economic development or social improvement can occur. This research seeks to increase access to subsurface water by improving the driving capabilities of the Well-Driver PUP (Purdue Utility Project) vehicle. The Well-Driver PUP is a low-volume manufactured utility vehicle with a hydraulic post driver mated to it in order to mechanize tube well installation. </p> <p>Worldwide, there are many locations where the water table depth is less than 23 meters, specifically in the 10-20 meters range. These areas include sub-Saharan Africa, the Caribbean, South America, northern India, Asia, and parts of the Asia Pacific Islands. These locations are places where the Well-Driver PUP could potentially be utilized, if sufficient reliability and depth can be demonstrated on a repeatable basis. This would increase the number of locations throughout the world that the vehicle could be used to access ground water for those with limited to no current water access. Ghana is one of the many countries located within sub-Saharan Africa where the Well-Driver PUP could have a positive impact.</p> <p>The author has had significant professional experience working in Ghana on various international development projects related to agriculture, water, sanitation, and hygiene (WASH). She has been part of international development projects in Ghana, Tanzania, and Haiti, with experience working cross-culturally since 2014. She has worked on projects specifically in Ghana for more than 9 years and has been part of more than 32 different water resource projects within the country. Therefore, consideration is specifically given to the appropriateness of the Well-Driver PUP as first piloted in Ghana. For this work, a cost analysis of using the Well-Driver PUP per depth and comparison to current driven wells in Ghana was carried-out. </p> <p>A review of the literature was conducted. Four research questions and experiments were established. Experiment 1 carried-out three different pipe stack numerical loading studies that were simulated in Fusion 360® (Autodesk, San Rafael, CA). Load models were examined of a centered hit, a non-centered hit, and a well point only. It was shown that the average dynamic impact force applied by the driving ram was calculated to be 39 kN. FEA analysis was conducted in Fusion 360®, and it included Von Mises, safety factor, and displacement results. The average dynamic impact force that the Well-Driver PUP applies was less than both the yield stress and ultimate tensile strength of ASTM A53 steel, indicating that no deformation or breakage of the well point should be expected. </p> <p>Experiment 2 included increasing the weight of the driving ram, through the addition of weight plates. A series of wooden fence post installations using these new weight additions was conducted. This experiment allowed for a regression model to be developed predicting the impact of weight added to the driving ram, the drop height of the ram, and the soil moisture content, on the driving depth of the vehicle. The MLR model included the penetration depth (Y), weight added (X₁), drop height (X₂), and soil moisture content (X₃). The model coefficient estimates were determined, and the predictor variables were all found to be significant at p < 0.01.</p> <p>Experiment 3 focused on improved reliability and finding the maximum depth capabilities of the Well-Driver PUP with new weight additions added to the driving ram. Two attempts were made to determine the driving depth capabilities of the vehicle. Both well installations were conducted in Montgomery County Indiana. Water was struck at both locations. At the first location, final well depth was 2.1 m with a 0.76 m of water within the column. The driver encountered a layer of blue-gray clay that it was unable to pass through. </p> <p>A second driving attempt was made to install a deeper well. The final well depth was 5.0 m with 1.67 m of water within the column. At this location, it is believed that a layer of limestone, shale, or siltstone was encountered. Comparing the compressive strength of limestone, sandstone, and shale, the Well-Driver PUP was not capable of driving through such materials. Therefore, at both well locations, the maximum driving depth capabilities of the driver were achieved. At both installation locations, the wells were formally developed. Both sets of water quality samples were submitted to the Montgomery County Health Department and received satisfactory ratings. </p> <p>Experiment 4 resulted in the fabrication and design of a 4” well point. The fabricated well point was installed to create a completed well at a depth of 2.7 m in Linden IN. There was 0.1 m of water within the pipe column. The well was formally developed, and the water quality results received a satisfactory rating. A cost analysis of a 4” well by depth was conducted. The total cost to fabricate one well point totaled $661.42. Of the total cost, 81% of the costs came from the 4” base pipe and the specialty pre-perforated screen used to create the secondary screen. The completion of these experiments provides a better understanding of the driving capabilities of the Well-Driver Pup. Improving the driving depth capabilities of the Well-Driver Pup will help to push this low-cost alternative technology closer to release in the developing world.</p> <p><br></p>