Evidence for Africa's toughest environment-health challenges.

The PRECISE Network is a broadly-based group of research scientists and health advocates mainly based in the UK and Africa, including the World Health Organization. PALs leads the health geography component and aims to understand geographical influences on placental disorders of pregnancy — including hypertension, fetal growth restriction, and stillbirth — across the Gambia, Mozambique, and Kenya. Funded by UK Research and Innovation (UKRI) Global Challenge Research Fund (GCRF).

This data science project quantifies the current and future impacts of air pollution on maternal and neonatal health in sub-Saharan Africa, where air quality is deteriorating with accelerated urbanization and population growth. It focuses on the synergistic association between heat waves and air pollution, developing adaptive interventions for vulnerable populations. Partners include NIH, Wellcome Trust, WITS, HE²AT Centre, and University of California Berkeley.

Sub-Saharan Africa is the most fire-affected region globally, responsible for nearly 70% of the world's burned area each year — 41% of fires being agricultural. This NIH-funded supplement addressed the knowledge gap in fire smoke exposure and birth outcomes in Africa, integrating SILAM atmospheric composition data with machine learning and distributed lag models. Partners: NIH, WITS, Finnish Meteorological Institute.

An initiative addressing the persistent scarcity of environmental exposure data in sub-Saharan Africa. ETIQUET develops scalable models to estimate exposure to air pollution (PM₂.₅, NO₂) and temperature at a daily resolution across unsampled locations, integrating high-resolution satellite data, sensor networks, and epidemiological surveillance datasets using spatio-temporal kriging, land use regression, and semi-supervised deep learning. Partners: HE²AT Centre, WITS University, Midlands State University.

A mobile app project helping women access maternal health care by accounting for road and weather conditions in near-real time and linking them to available local transport. In Zimbabwe, 73% of maternal deaths are attributed to delays in accessing care caused by long distances, limited transport options, and roads that become impassable in the wet season. Road-MApp aimed to establish micro-savings groups to finance transport, targeting a 25% increase in antenatal facility use and a 10% increase in in-facility deliveries.

PALs was appointed by the PRE-eclampsia-Eclampsia Monitoring, Prevention and Treatment (PRE-EMPT) initiative — a multi-million-dollar programme coordinated by the University of British Columbia's Department of Obstetrics and Gynaecology — to lead geospatial analyses for the Community Level Interventions for Pre-Eclampsia (CLIP) trials across India, Pakistan, and Mozambique. The work assessed the spatial epidemiology of adverse maternal and perinatal outcomes, identified communities and individuals showing better-than-expected resilience, and produced geo-visualizations communicating trial progress and impact.

Using Geographical Information Systems and a social determinants of health framework, MOM described the contextual factors — maternal characteristics, health systems and services, and socio-economic and environmental determinants — that elevate risk for adverse maternal outcomes, giving policymakers a geographically precise basis for targeted, community-level action.

Dr. Makanga was appointed as a consultant to map injury risks and outcomes linked to the off-license sale of alcohol in Elsies River, a low-to-middle income community in Cape Town, South Africa, producing map-based products communicating the spatial prevalence of illegal liquor outlets and their relationship to alcohol-related violence.