In slum areas where the water supply is irregular and clean water must be purchased, per capita consumption is less than half that of middle-class neighborhoods. Water is contaminated during transport and is rarely boiled for sterilization, which spreads disease. Illegal garbage dumps have choked the roadside, drains and open spaces in residential areas, creating breeding grounds for insects and rodents. Incineration of garbage results in air pollution and acute respiratory diseases. Accra's hot, moist climate also fosters disease, especially malaria-transmitting mosquitoes, houseflies, cockroaches, bed bugs and lice.
Toxic pesticides can also have negative health consequences.
A World Bank study has demonstrated that a disproportionately small part of public budgets was allocated to preventative and routine equipment maintenance in public hospitals in Nigeria, Tanzania, Guinea-Bissau and Malawi. As a result of these budget decisions, health facilities in many developing countries have deteriorated. A World Bank survey of 15 publicly operated hospitals in Kenya found that 40 percent of the buildings were in poor or unsatisfactory condition. Hospitals such as Tres de Agosto in Guinea-Bissau have crumbled beyond repair, and health facilities in many countries, such as Somalia and Mozambique, have been severely damaged by civil war. Essential health equipment also is often in disrepair.