Transdisciplinary research has been increasingly advocated as necessary to address complex planetary health challenges spanning environmental and human health in different socio-economic contexts. Recognising global interdependence, such research must engage in equitable co-production for lasting, meaningful impact. Existing transdisciplinarity frameworks and practices from the environment, health, and development fields primarily focus on research processes and outcomes, generically mentioning ‘collaboration’ without sufficiently expanding how the process can be designed to facilitate equitable and sustained outcomes. This case study undertakes an empirical deep-dive into a planetary health research in Indonesia to better understand transdisciplinary collaboration from participants' experiences. Deductive and inductive analyses of the enabling and constraining factors offer novel insights into the collaborative process of stakeholder engagement, interaction, and integration. Rich examples from the case study were then synthesised into process design strategies to overcome structural constraints through boundary spanning, adaptive project management, and creating spaces for social learning and reflexivity. (150 words).

The number, scale and ambition of transdisciplinary research initiatives between the global north and the global south is increasing, yet there is very little theoretical or empirical scholarship on how to lead and manage implementation to promote responsible practice. Within science, technology and innovation (STI) studies and decolonising research frameworks, and utilising collaborative autoethnography, this study codifies experience with implementing the 'Revitalising Informal Settlements and their Environments' (RISE) program (2017-2020). Our specific aim is to explore the leadership and management tensions and challenges of implementing transboundary transdisciplinary research. The findings reaffirm the importance of research leaders and managers carefully operationalising north-south research by critically reflecting on power asymmetries between disciplines, partners and locations, leveraging the potential for transdisciplinary consortia to build research capabilities in the global south, and creating a culture of reflexivity on the historical and social positionality in which research is designed, funded, implemented and evaluated. The findings foreground the role of boundary-spanning 'integrators' and 'pracademics', roles that have received little attention to date but are essential for effective delivery and societal impact beyond scientific advances. A framework for implementing north-south transdisciplinary research is outlined with five domains: (1) collaborative leadership; (2) agile management; (3) flexible consortia; (4) researcher positionality; and (5) co-design and participation. The framework can support efforts for responsibly designing and implementing large, transdisciplinary, cross-country research programs in line with ambitions for decolonising north-south research.

Non-Technical Summary Despite growing recognition of the importance of transdisciplinary research in addressing complex sustainability challenges, in practice it has been much hampered by persistent inequities, power disparities, and epistemological disconnect. Planetary health as an emerging field offers a unique lens highlighting the need for knowledge integration across the environment, health, and development (EHD) nexus. Drawing upon extensive analyses, including a meta-analysis of existing transdisciplinary frameworks, a literature review of practices in these fields, and a case study of a planetary health action research project in Indonesia and Fiji, we propose a framework to guide the design and implementation of transdisciplinary research.Technical Summary The proposed framework was iteratively designed, starting with existing frameworks, complemented by findings and practice recommendations from a literature review of 36 publications of recent transdisciplinary practices in the EHD fields and an in-depth case study of a planetary health research from Indonesian perspectives. The practice framework focuses on the stakeholder collaboration process, and emphasizes reflexivity and co-learning throughout all research phases: initiation (co-design); implementation (adaptive co-management), and monitoring and refinement (co-monitoring). Foundational considerations for stakeholder engagement could inform process design by reflecting on stakeholder contributions, interactions, integration, and expected outcomes. As suggested by development studies, and implicitly agreed upon but insufficiently elaborated within environment and health, attention to the local context of the research, mapping of power dynamics, and the values of equity and inclusivity are pertinent if research is to produce credible, relevant, and legitimate knowledge and outcomes. A renewed focus on addressing power equities can help ensure stakeholders' perspectives and interests are equally valued and potential solutions are not inadvertently excluded as a legacy of systemic power imbalance. The practice framework is most effectively applied in the initial process co-design, by process initiators and funders assessing proposals for international transdisciplinary research in power-diverse settings or resource-poor contexts.Social Media Summary How can researchers across diverse fields collaborate with renewed focus on power inequities to accelerate progress towards the Sustainable Development Goals?

Integrative transdisciplinary approaches to watershed management are critical for addressing intersecting social, economic, and ecological processes that shape planetary health outcomes for humans, animals, and ecosystems. These challenges are acute in watersheds like the Citarum River in West Java, Indonesia, which suffers from severe pollution due to inadequate waste management infrastructure, and is worsened by rapid urbanisation and a changing climate, which further degrades the river ecosystem and threatens lives and livelihoods. Developing a unified approach to addressing these complex problems, and responding to real world social, governance, and biophysical conditions through integrated water management, is difficult to achieve in practice. Responding to this challenge, living labs have emerged as a mode of transdisciplinary research and implementation that incorporates the expertise of diverse stakeholders in real-world settings to learn and develop solutions to complex challenges, like those faced in the Citarum River. While living lab approaches have been used widely in Western cities, there is little research that investigates its usefulness in informal peri-urban settlements. This paper presents a case study of the Citarum Living Lab, a live action research program that aims to co-develop, test, and learn from socio-technical experiments in real-world settings in collaboration with an interdisciplinary international research consortium, government, NGOs, businesses, community leaders, and residents. With the ultimate aim of revitalising the Citarum river and its surrounding environments and communities, the program engages with community experiences, existing institutional frameworks, and changing environmental conditions. This paper identifies the conditions and factors that enable and constrain a living lab approach in a vulnerable peri-urban watershed from the perspective of the research team by employing a reflexive participatory action research methodology. Place-based, transdisciplinary responses to planetary health imperatives in this context require navigation of complex, multi-level governance contexts and novel resourcing models to support applied research, implementation, and learning.

Introduction: Deepening global inequalities in the health impacts of climate change highlight the need for transformative solutions through international and transdisciplinary collaborations. While the emerging field of planetary health provides a unique lens for recognizing interlinkages across a broader range of knowledge systems, a deeper understanding is needed about the processes through which such knowledge systems can be developed and integrated. Existing transdisciplinarity scholarship offers useful concepts of integration across boundaries; however, such understanding predominantly reflects the perspectives of Global North academic stakeholders, conceivably due to systemic power imbalance as an enduring colonial legacy. This study aims to identify opportunities for learning from the experiences of Global South stakeholders in transdisciplinary collaboration. Methods: We empirically explore the process of transdisciplinary collaboration in a case study of a large-scale planetary health research project. Through multi-method thematic analysis, this study seeks to understand Global South stakeholders' contributions, motivations, and interactions on transdisciplinary collaboration, through their experiences in the case study context. Results & Discussion: The study found that Global South stakeholders contributed a plethora of disciplinary and non-disciplinary knowledge and other resources, guided by strong cultural inclinations for collaboration. The opening up of boundary spaces was key to multi-directional knowledge integration. Analysis revealed concepts of interdependence and complementarity towards a common vision, and provides insight into stakeholders' motivations for initial and continuing engagement. Conclusion: Recognizing interdependence provides strong motivation for transdisciplinary collaboration and can help revalorize contributions from historically disadvantaged knowledge systems and stakeholders. (c) 2023 The Authors. Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

This chapter explores the ways in which residents of informal settlements have adapted to deal with compounding and cascading disasters in the City of Makassar, Indonesia. Analysing semi-structured interviews, this chapter aims to identify how communities understand and prepare for the most common cascading effects of floods in the region, such as the disruption of electricity and water supply services. The interviews were conducted with communities participating in the Revitalising Informal Settlements and their Environments (RISE) Program. The findings draw on the lessons from the 2019 extreme flood when the Bili-Bili dam was opened, which caused significant damage to the settlements in the South Eastern part of Makassar as its effects were compounded by local flash flooding. The findings of this chapter contribute to debates that frame natural hazards in the Asia–Pacific as complex and multidimensional phenomena that shape and are shaped by how communities occupy and make sense of their environments.

There is a significant challenge in global health and development research that pivots on the difficulties of delivering (cost-)effective treatments or interventions that are scalable andtransferable across settings. That is, how does one deliver "true effects", proven treatments, into new settings? This is often addressed in pragmatic trials or implementation research in which one makes adjustments to the delivery of the treatment to ensure that it works here and there. In this critical analytical review, we argue that the approach mis-characterises the cause-effect relationship and fails to recognise the local, highly contextual nature of what it means to say an intervention "works". We use an ongoing randomised controlled trial (RCT)-an informal settlement redevelopment intervention in Indonesia and Fiji to reduce human exposure to pathogenic faecal contamination-as a vehicle for exploring the ideas and implications of identifying interventions that work in global health and development. We describe the highly contextualised features of the research and the challenges these would pose in attempts to generalise the results. In other words, we detail that which is frequently elided from most RCTs. As our critical lens, we us the work of American philosopher, Nancy Cartwright, who argued that research produces dappled regions of causal insights-lacunae against a backdrop of causal ignorance. Rather than learn about a relationship between a treatment and an outcome, we learn that in the right sort of context, a treatment reliably produces a particular outcome. Moving a treatment from here to there becomes, therefore, something of an engineering exercise to ensure the right factors (or "shields") are in place so the cause-effect is manifest. As a consequence, one cannot assume that comparative effectiveness or cost-effectiveness would be maintained.

In recent decades, transdisciplinary research has been increasingly recognised as necessary to produce solutions for sustainable development; however, implementation challenges remain. The emerging field of planetary health offers a unique lens to guide a new synthesis of perspectives, recognising interlinkages between environmental and human health, and interdependence across global development contexts, that is, at the environment-health-development nexus. This broad, practice-based literature review consolidates learnings from previous transdisciplinary research across these diverse yet interrelated fields, and aims to deepen understanding of, and identify opportunities for, enabling collaborative practice. This review found structural, relational, and individual factors enabling and constraining collaboration. Local research contexts and academia's disciplinary traditions posed structural constraints that required relational efforts at the project, organisational and individual levels to address. This analysis revealed strategic opportunities for funding programs and researcher training that can be leveraged to increase capacity for relational work, further enabling collaboration in transdisciplinary research.

In the developing economies of the Global South, a fundamental challenge in the transition of settlements from rural or periurban to urban is increased environmental contamination as a result of poor sanitation and sanitation management. With governments’ limited ability to connect all neighbourhoods to a city’s existing municipal water, sewerage and other services, decentralised approaches using green infrastructure offer potential to address this challenge. In addition, green infrastructure might facilitate a move towards a holistic response to manage the full water cycle. This paper presents a narrative review of green infrastructure projects, involving constructed wetlands or their variants for wastewater treatment, within vulnerable communities in the Global South. It describes the scale and scope of each project, identifies the challenges of implementation, and reflects on their outcomes for different stakeholder groups. The review demonstrates that decentralised sanitation programs using constructed wetlands for wastewater treatment can provide a range of advantages/benefits/services, dependant on the specific sociocultural, political and biogeophysical contexts of each. Issues of governance and sociocultural appropriateness, rather than technical issues, challenged the implementation of green infrastructure for sanitation in these projects. Projects must be a collaboration between the government, nongovernment organisations and the community. Whether the project is organised from top-down or bottom-up, community consultation is essential. Context will determine the role of the community in the consultation process and the type of information required to guide the design, implementation and governance of the system. In every project to provide decentralised sanitation systems, the community must be participants, not simply beneficiaries.

Concerns regarding the impacts of climate change on marginalised communities in the Global South have led to calls for affected communities to be more active as agents in the process of planning for climate change. While the value of involving communities in risk management is increasingly accepted, the development of appropriate tools to support community engagement in flood risk management projects remains nascent. Using the Revitalising Informal Settlements and their Environments Program as a case study, the article interrogates the potential of citizen science to include disadvantaged urban communities in project-level flood risk reduction planning processes. This project collected more than 5,000 photos taken by 26 community members living in 13 informal settlements in Fiji and Indonesia between 2018 and 2020. The case study documents the method used as well as the results achieved within this two-year project. It discusses the method developed and implemented, outlines the main results, and provides lessons learned for others embarking on citizen science environmental monitoring projects. The case study indicates that the engagement model and the technology used were key to the success of the flood-monitoring project. The experiences with the practice of monitoring floods in collaboration with communities in Fiji and Indonesia provide insights into how similar projects could advance more participatory risk management practices. The article identifies how this kind of approach can collect valuable flood data while also promoting opportunities for local communities to be heard in the arena of risk reduction and climate change adaptation.

Tension and conflict are endemic to any upgrading initiative (including basic infrastructure provision) requiring private land contributions, whether in the form of voluntary donations or compensated land acquisitions. In informal urban contexts, practitioners must first identify well-suited land for public infrastructure, both spatially and with careful consideration for safeguarding claimed rights and preventing conflicts. At the same time, they need to defuse existing tensions over land ownership and land use rights while negotiating for the potential use of a unit of land for infrastructure. Even in the case of employing participatory methods, land negotiations are never tension-free. Despite the extensive literature on linkages between urban poverty, inefficient land management systems, and land disputes, in both rural and urban settings, land negotiations for community-scale infrastructure retrofit projects (e.g., neighbourhood roads, water and sanitation infrastructure) are yet to be fully explored. Drawing on a case study of a live green infrastructure retrofit project in six informal settlements in Makassar, Indonesia, we establish links to exchange theory, collective action, and negotiation theory to build a reliable analytical framework for understanding and explaining the land negotiations in small-scale infrastructure retrofit practices. We aim to describe and assess the fundamental conditions for land negotiations in an informal urban context and conclude the paper by summarising several key strategies developed and used in the case study area to forge land agreements.

Informal settlements represent a challenging operational context for local government service providers due to precarious contextual conditions. Location choice and land procurement for public infrastructure raise the complicated question: who has the right to occupy, control, and use a piece of land in informal settlements? There is currently a dearth of intelligence on how to identify well-located land for public infrastructure, spatially and with careful consideration for safeguarding the claimed rights and preventing conflicts. Drawing on a case study of green infrastructure retrofit in seven informal settlements in Makassar, Indonesia, we classify the informal settlers' land rights into four types: ownership, use, control, and management. This exploratory study uses a typological approach to investigate the spatial dimension of land rights in informal settlements. We introduce non-registrable land interests and the partial, dynamic, and informal land use rights that impact the land procurement for infrastructure retrofit. We also create a simple spatial matrix describing the control/power, responsibilities and land interests of different stakeholders involved in the location decision making for public infrastructure. We argue that without sufficient understanding of non-formal land rights, land procurement proposals for the public infrastructure upgrades can be frustrated by the individual or group claims on the land, making the service provision impossible in informal settlements.

Background: The intense interactions between people, animals and environmental systems in urban informal settlements compromise human and environmental health. Inadequate water and sanitation services, compounded by exposure to flooding and climate change risks, expose inhabitants to environmental contamination causing poor health and wellbeing and degrading ecosystems. However, the exact nature and full scope of risks and exposure pathways between human health and the environment in informal settlements are uncertain. Existing models are limited to microbiological linkages related to faecal-oral exposures at the individual level, and do not account for a broader range of human-environmental variables and interactions that affect population health and wellbeing. Methods: We undertook a 12-month health and environmental assessment in 12 flood-prone informal settlements in Makassar, Indonesia. We obtained caregiver-reported health data, anthropometric measurements, stool and blood samples from children < 5 years, and health and wellbeing data for children 5-14 years and adult respondents. We collected environmental data including temperature, mosquito and rat species abundance, and water and sediment samples. Demographic, built environment and household asset data were also collected. We combined our data with existing literature to generate a novel planetary health model of health and environment in informal settlements. Results: Across the 12 settlements, 593 households and 2764 participants were enrolled. Two-thirds (64.1%) of all houses (26.3-82.7% per settlement) had formal land tenure documentation. Cough, fever and diarrhoea in the week prior to the survey were reported among an average of 34.3%, 26.9% and 9.7% of children aged < 5 years, respectively; although proportions varied over time, prevalence among these youngest children was consistently higher than among children 5-14 years or adult respondents. Among children < 5 years, 44.3% experienced stunting, 41.1% underweight, 12.4% wasting, and 26.5% were anaemic. There was self-or carer-reported poor mental health among 16.6% of children aged 5-14 years and 13.9% of adult respondents. Rates of potential risky exposures from swimming in waterways, eating uncooked produce, and eating soil or dirt were high, as were exposures to flooding and livestock. Just over one third of households (35.3%) had access to municipal water, and contamination of well water with E. coli and nitrogen species was common. Most (79.5%) houses had an in-house toilet, but no houses were connected to a piped sewer network or safe, properly constructed septic tank. Median monthly settlement outdoor temperatures ranged from 26.2 degrees C to 29.3 degrees C, and were on average, 1.1 degrees C warmer inside houses than outside. Mosquito density varied over time, with Culex quinquefasciatus accounting for 94.7% of species. Framed by a planetary health lens, our model includes four thematic domains: (1) the physical/built environment; (2) the ecological environment; (3) human health; and (4) socio-economic wellbeing, and is structured at individual, household, settlement, and city/beyond spatial scales. Conclusions: Our planetary health model includes key risk factors and faecal-oral exposure pathways but extends beyond conventional microbiological faecal-oral enteropathogen exposure pathways to comprehensively account for a wider range of variables affecting health in urban informal settlements. It includes broader ecological interconnections and planetary health-related variables at the household, settlement and city levels. It proposes a composite framework of markers to assess water and sanitation challenges and flood risks in urban informal settlements for optimal design and monitoring of interventions.

This chapter explores strategies for operationalising PhD studies in the context of a large research project addressing the unrelenting problem of ill-health in the growing population of informal settlements in the Global South. We advocate that PhD training presents an opportunity to contribute to these contexts by both training a new kind of action-oriented scholar, but also by strategically deploying the enormous energies and original work generated through PhD candidates towards this critical mission. Driven by the desire to give agency and utility to PhD researchers in a much-needed domain of transdisciplinary research, the chapter chronicles the trials of a group of four PhD candidates embedded in a large health study using innovative approaches to the revitalisation of 24 informal settlement communities in the Asia-Pacific. Through a discussion between the candidates and supervisory team, the chapter uncovers three types of embedded PhD’s. It articulates the challenges and opportunities of the model and reflects on the forces at play, producing practical advice for instrumentalising PhD research in the context of transdisciplinary research.

Introduction Increasing urban populations have led to the growth of informal settlements, with contaminated environments linked to poor human health through a range of interlinked pathways. Here, we describe the design and methods for the Revitalising Informal Settlements and their Environments (RISE) study, a transdisciplinary randomised trial evaluating impacts of an intervention to upgrade urban informal settlements in two Asia-Pacific countries.Methods and analysis RISE is a cluster randomised controlled trial among 12 settlements in Makassar, Indonesia, and 12 in Suva, Fiji. Six settlements in each country have been randomised to receive the intervention at the outset; the remainder will serve as controls and be offered intervention delivery after trial completion. The intervention involves a water-sensitive approach, delivering site-specific, modular, decentralised infrastructure primarily aimed at improving health by decreasing exposure to environmental faecal contamination. Consenting households within each informal settlement site have been enrolled, with longitudinal assessment to involve health and well-being surveys, and human and environmental sampling. Primary outcomes will be evaluated in children under 5 years of age and include prevalence and diversity of gastrointestinal pathogens, abundance and diversity of antimicrobial resistance (AMR) genes in gastrointestinal microorganisms and markers of gastrointestinal inflammation. Diverse secondary outcomes include changes in microbial contamination; abundance and diversity of pathogens and AMR genes in environmental samples; impacts on ecological biodiversity and microclimates; mosquito vector abundance; anthropometric assessments, nutrition markers and systemic inflammation in children; caregiver-reported and self-reported health symptoms and healthcare utilisation; and measures of individual and community psychological, emotional and economic well-being. The study aims to provide proof-of-concept evidence to inform policies on upgrading of informal settlements to improve environments and human health and well-being.Ethics Study protocols have been approved by ethics boards at Monash University, Fiji National University and Hasanuddin University.Trial registration number ACTRN12618000633280; Pre-results.

Mapping is a cultural project, creating and building the world as much as describing it. In informal settlements land ownership may be shaped as much by social dynamics, such as kinship, social ties, and conflict, as by harder elements such as land use and regulatory frameworks. Infrastructure services retrofit is necessary for public health in these contexts. This process needs to take into account the socio-cultural as much as the technical dimensions to understand both the physical and the social conditions and challenges embedded in these generally undocumented contexts. The mapping of these conditions can provide productive directions for responding to such challenges. Mapping tools and processes that embrace this complexity, provide effective mechanisms for growing the socio-material capital of communities. Such processes also build relationships and potential for growing the socio-material capital of communities.

The COVID-19 pandemic represents a turning point in the way things are done, globally and across sectors. We reflect on approaches to informal settlements and argue for a turn from 'upgrading' to 'revitalisation'. We conceptualise revitalisation as encompassing three core tenets: planetary health, transdisciplinarity, and a people-centred approach. In our vision, revitalisation approaches would take a big-picture view of informal settlements that recognises the inter-connectedness of people and nature within complex urban systems; integrates perspectives from various academic disciplines, non-academic sectors, and communities for knowledge generation; and centres informal settlement residents and communities as experts and partners in urban praxis.