Sustainable development in healthcare has been long-standing research across social and economic dimensions. Given the urge of climate issues and environmental imbalance, the integration of environmental sustainability into healthcare facility management remains insufficiently systematised. This systematic literature review addresses this gap by developing a holistic approach for developing future-focused, environmentally sustainable healthcare facilities. It synthesises sustainability principles, operational practices, organisational enabling capabilities, and implementation barriers within healthcare facility management, while also identifying research gaps and proposing future directions for the field. To achieve the study objectives, peer-reviewed articles were selected from Scopus, Web of Science, and PubMed in accordance with predefined inclusion parameters, the PRISMA guideline, and CASP quality appraisal. Guided by established sustainability frameworks, a top-down thematic analysis identified eight interrelated themes that shape sustainability implementation in healthcare facilities. The findings suggest that sustainability implementation requires a holistic approach that links system-level influences, organisational factors, and operational practices into an integrated implementation pathway. Healthcare organisations must address persistent technical, financial, and organisational constraints to enable this sustainability transition. Central to this transformation are leadership and governance, which emerge as the primary enablers of strategy execution in future-focused, environmentally sustainable healthcare facility management.
Climate change exacerbates water insecurity across Eastern Uganda by increasing the frequency and intensity of droughts, floods, and unpredictable rainfall fluctuations, which substantially compromise water availability, accessibility, and quality. While Traditional Ecological Knowledge (TEK) and community-based adaptation strategies have been reported to support local resilience, their systematic incorporation into formal water management frameworks remains inadequate. A narrative review of peer-reviewed publications spanning 2015–2025 was conducted across Scopus, Web of Science, Google Scholar, and grey literature. The synthesis examined key thematic areas including climate stressors, Traditional Ecological Knowledge, household and community adaptation strategies, gender and intergenerational roles, and policy gaps. Communities employ TEK strategies including rainwater harvesting and communal governance structures wherein women, elders, and youth actively participate in water management decisions. While TEK approaches complement contemporary methods such as hybrid technologies, top-down project implementation frequently conflicts with established local practices. Significant policy gaps persist across several dimensions: stakeholder participation, gender inclusion, knowledge documentation, and resource allocation. Additionally, further research is warranted to assess the efficacy of adaptation strategies and to understand the dynamics of collaborative knowledge production. The integration of Traditional Ecological Knowledge into water policy frameworks, achieved through participatory and culturally grounded approaches that prioritize gender inclusion, can foster more equitable, sustainable, and climate-resilient water management systems.
The adoption of sustainable solid waste management (SSWM) remains a major challenge in rapidly urbanising cities in developing countries. This study examined the influence of transformational leadership behaviours on households' adoption of SSWM practices in Kampala City alongside socio-economic and environmental governance factors. A cross-sectional survey of 411 households was conducted using multistage sampling. Data were collected through a structured questionnaire adapted from the Multifactor Leadership Questionnaire (MLQ-5X) and analysed using descriptive statistics, exploratory factor analysis, non-parametric tests and logistic regression. Only 43% of households had adopted at least one SSWM practice, indicating low adoption. Transformational leadership behaviours showed limited influence, with only individualised consideration significantly associated with adoption. Environmental governance and socio-economic factors were stronger predictors. The findings suggest that strengthening environmental governance, improving waste management services and addressing socio-economic constraints are more effective strategies for promoting household adoption of sustainable waste management practices in Kampala and similar urban settings.
Recognition of the global significance of peatland GHG emissions has led to growing investment in peatland restoration. However, a lack of robust, affordable measurement, reporting and verification (MRV) methods for reporting outcomes at scale acts as a barrier to wider investment. Here, we demonstrate a novel MRV solution based on Sentinel 1 radar backscatter data, which provides a detailed estimate of water table depth. The approach correctly identifies areas of periodic inundation and estimates the water table depth within the 0–20 cm range across a 400-ha raised bog complex. Combining satellite-derived water table predictions with published relationships between water table and CO2, and CH4 fluxes showed modelled uptake of 2.9–3.2 t CO2 ha−1 yr−1 compared to measured uptake of 1.8–3.5 t CO2 ha−1 yr−1. With further development, such an approach has the potential to facilitate a more detailed approach to restoration, MRV and GHG emissions reporting.
Drought remains a major threat to agricultural livelihoods in semi-arid regions. Most assessments analyze drought severity and preparedness separately, limiting a comprehensive understanding of response capacity. This study examines drought dynamics by using an integrated approach that combines the Standardized Precipitation Index (SPI), Drought Cycle Management (DCM), and the Community Drought Preparedness Index (CDPI). Monthly rainfall data from 1985 to 2024 were used to characterize short- and long-term droughts with SPI-3 and SPI-12. A survey of 406 households provided data to compute a CDPI by aggregating the main components of CDM. The SPI-3 results exhibited more short-term drought variability, while SPI-12 identified less frequent but longer-lasting and more severe droughts. The mean CDPI score of 44.12 indicates moderate community preparedness, with training and access to early-warning information as key preparedness factors. The findings highlight the need for integrated drought management strategies to enhance drought resilience in semi-arid communities.
