Abstract
Globally, one billion people live in informal settlements, and that number is expected to triple by 2050. Studies suggests that health in informal settlements is a serious and growing concern, yet there is a paucity of research focused on health outcomes and the correlates of health in these settlements. Studies cite individual, environmental and social correlates to health in informal settlements, but they often lack empirical evidence. In particular, research suggests that high rates of violence against women (VAW) in informal settlements may be associated with detrimental effects on women's health, but few studies have investigated this link. The purpose of this study was to fill this gap by empirically exploring associations between women's experiences of intimate partner violence (IPV) and their physical and mental health. Data for this study were collected in August 2018 in Mathare Valley Informal Settlement in Nairobi, Kenya. A total of 550 randomly-selected women participated in surveys; however, analyses for this study were run on a subpopulation of the women (n = 361). Multivariate logistic regressions were used to investigate the link between psychological, sexual, and emotional IPV and women's mental and physical health. Results suggest that while some socioeconomic, demographic, and environmental variables were significantly associated with women's mental and physical health outcomes, all types of IPV emerged key correlates in this context. In particular, women's experiences of IPV were associated with lower odds of normal-high physical health component scores (based on SF-36); higher odds of gynecological and reproductive health issues, psychological distress (based on K-10), depression, suicidality, and substance use. Findings from this study suggest that policies and interventions focused on prevention and response to VAW in informal settlements may make critical contributions to improving health for women in these rapidly growing settlements.
Highlights
Around one-quarter of the world’s urban population live in informal settlements—and that number is rising [1]
The formation and expansion of informal settlements are driven by a range of interrelated factors including population growth; rural-urban migration; lack of affordable housing; poor policy, planning, and land management; economic vulnerability; under- and unemployment; discrimination and marginalization; displacement caused by conflict, natural disasters, and climate change; and, in the case of many sub-Saharan African countries, colonialism [1,2,3]
A range of socio-ecological factors have been associated with higher risk of women experiencing violence, intimate partner violence (IPV), in these communities, which can have additional deleterious effects on women’s mental and physical health
Summary
Around one-quarter of the world’s urban population live in informal settlements—and that number is rising [1]. An informal settlement is defined as a residential area that lacks: durable housing, sufficient living and public spaces, access to basic infrastructure and services like water and sanitation, and secure tenancy [1]. These settlements exist in urban contexts around the world in various forms, scales, and locations, and they go by a range of names (e.g., slums, squatter settlements, favelas, barrios bajos) [1]. There have been few studies empirically investigating women’s physical and mental health and their correlates in informal settlements in Kenya. The purpose of this study was to empirically explore correlates of women’s physical health and mental health in a large informal settlement in Nairobi—focusing especially on intimate partner violence (IPV) as a potential correlate
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