Slums Of Kampala Research Articles

Financing of sanitation services in the slums of Kampala and Dar es Salaam

This paper presents an assessment of the extent and conditions under which private financing can be a realistic approach for sanitation in slums. It is based on a cross-sectional study comparing two slum communities in East Africa, where 250 households from Bwaise III in Kampala, Uganda and 379 households from Temeke in Dar es Salaam, Tanzania were interviewed in 2010. Also, 10 key-informant interviews and 8 focus group discussions were conducted in addition to field observations. Findings show that majority (85%) of households used unimproved, private-shared pit latrines. These privately owned latrines had many structural shortfalls besides poor operation and maintenance while the public latrines provided by third-party were structurally sound but were under-utilized in residential slum neighorhoods. This is attributed to the presence free or at least cheaper alternatives which the community members preferred instead of paying per-visit user-fees. For the few who were willing to pay, willingness to pay was positively associated with the presence of a facility User committee and having been sensitized. In this context, a combination of these factors made cost recovery as well as operation and maintenance very minimal. The poor status of privately owned shared pit latrines matched the limited income levels of households. Similarly, cost recovery for public facilities was dependent on the number of users who were willing to pay: the more the users, the more the cost recovery. A combination of private and public financing is thus necessary to fund different but complementary aspects of sanitation in slums.

Sanitation facilities in Kampala slums, Uganda: users' satisfaction and determinant factors

Access to improved sanitation is a key preventive measure against sanitary-related gastro-enteric diseases such as diarrhoea. We assessed the access to sanitation facilities and users' satisfaction in 50 randomly selected slums of Kampala through a cross-sectional survey conducted in 2010. A total of 1500 household respondents were interviewed. Sixty-eight per cent of the respondents used shared toilets, 20% private, 11% public toilets and less than 1% reported using flying toilets or practising open defecation. More than half of the respondents (51.7%) were not satisfied with their sanitation facilities. Determinants for satisfaction with the facilities used included the nature and type of toilet facilities used, their cleanliness, and the number of families sharing them. The study findings showed that slum dwellers had high access to sanitation facilities. However, most of them were shared and majority of the respondents were not satisfied with their facilities, primarily due to cleanliness and over demand.

Addressing Injuries in Vulnerable Populations: Research Collaborations and Partnerships

Injury-related morbidity and mortality disproportionately impact vulnerable groups, including children under the age of 5, older adults, racial and ethnic minority populations, and people of low socioeconomic status.1–4 The Emory Center for Injury Control (ECIC) is a Centers for Disease Control and Prevention (CDC) Injury Control Research Center5 charged with reducing the health and economic impact of injuries in Atlanta, Georgia and worldwide. The ECIC seeks to achieve its mission by focusing specifically on translation research and vulnerable populations. Moreover, the ECIC is committed to encouraging innovative, interdisciplinary collaborations in the realms of research, training, and outreach. Examples of successful interdisciplinary activities include outreach to local emergency departments (ED) to screen patients for mental health symptoms and exposure to intimate partner violence and collaboration with the Georgia Child Fatality Review Panel to evaluate its processes and identify risk factors for death among children in state custody. At the grassroots level, the ECIC serves as the research/scientific arm of the Metropolitan Atlanta Violence Prevention Partnership, providing scientific support and technical assistance to this community-level organization of partners working in inner city, disadvantaged settings. In order to disseminate the research findings generated by faculty and researchers associated with the ECIC, a partnership with the Western Journal of Emergency Medicine editorial team was formed to dedicate special thematic journal issues featuring research underway by the ECIC. We are delighted to report that this is the third special issue from this partnership, and we are very excited to present the injury prevention community with new research findings to inform programs, policy, and future research. The current special issue presents findings on a range of topics that highlight injury-related health disparities and vulnerable populations. More specifically, there is a commentary regarding the healthcare disparities in trauma care as well as a manuscript addressing the benefit of a tiered trauma activation system.6,7 Another manuscript examines the predictors of post-traumatic stress disorder among trauma victims and yet another manuscript assesses ED visits for traumatic brain injuries among older adults.8,9 Two other manuscripts examine poisonings.10,11 In addition, there are several manuscripts on intimate partner violence and unwanted sexual intercourse. For example, 1 study examines the latent trajectories of intimate partner violence and seeks to determine if childhood experiences impact these trajectories.12 Three other studies examine intimate partner violence victimization and health behaviors among women, the racial and ethnic differences in unwanted sexual intercourse among girls, and the feasibility of using social media to study intimate partner violence among gay men. 13–15 Another manuscript related to youth examines bystander motivation in bullying incidents.16 Moreover, one manuscript examines the associations between temperature and violent crime.17 International research included in this special issue examines intimate partner violence and social pressure among gay men across 6 countries and violence victimization and perpetration among youth in the slums of Kampala, Uganda. 18,19 The range of manuscripts and professional affiliations reflected among the authors of the manuscripts included in this special issue underscore the strength and breadth of the ECIC – a ‘center without walls or silos.' The ECIC links numerous professionals and disciplines at Emory University with counterparts at Atlanta-area public universities, private colleges, government agencies, and community-based organizations. In addition to its academic partners, the ECIC is closely aligned with local hospitals (particularly Grady Memorial Hospital, Atlanta's largest Level I trauma and burn center), and stakeholder groups directly affected by violence and unintentional injuries. Our consortium includes individuals with national and international reputations in the fields of neuroscience, injury epidemiology, criminology, poison control, health policy, rehabilitation, prevention science, acute care, disaster preparedness, public health training, and translation research. It is through these partnerships we can build the momentum to truly reduce injuries in vulnerable populations and to strengthen our capacity to reach underserved populations.

Correlates of suicide ideation and attempt among youth living in the slums of Kampala.

While suicidal behavior is recognized as a growing public health problem world-wide, little is known about the prevalence and risk factors for suicidal behaviors among street and slum youth in Africa, and in Uganda, specifically. The number of youth who live on the streets and in the slums of Kampala appears to be growing rapidly, but their mental health needs have not been documented, which has hampered resource allocation and service implementation. This study of youth, ages 14–24, was conducted in May and June of 2011, to assess the prevalence and correlates of suicidal behavior. Participants (N = 457) were recruited for a 30-minute interviewer-administered survey through eight drop-in centers operated by the Uganda Youth Development Link for youth in need of services. Bivariate and multivariate logistic regression analyses were computed to determine associations between psychosocial correlates and suicide ideation and suicide attempt. Reporting both parents deceased Adj.OR = 2.36; 95% CI: 1.23–4.52), parental neglect due to alcohol use (Adj.OR = 2.09; 95% CI: 1.16–3.77), trading sex for food, shelter or money (Adj.OR = 1.95; 95% CI: 1.09–3.51), sadnesss (Adj.OR = 2.42; 95% CI: 1.20–4.89), loneliness (Adj.OR = 2.67; 95% CI: 1.12–6.40) and expectations of dying prior to age 30 (Adj.OR = 2.54; 95% CI: 1.53–4.23) were significantly associated with suicide ideation in multivariate analyses. Parental neglect due to alcohol use (Adj.OR = 2.04; 95% CI: 1.11–3.76), sadness (Adj.OR = 2.42; 95% CI: 1.30–7.87), and expectations of dying prior to age 30 (Adj.OR = 2.18; 95% CI: 1.25–3.79) were significantly associated with suicide attempt in multivariate analyses. Given the dire circumstances of this vulnerable population, increased services and primary prevention efforts to address the risk factors for suicidal behavior are urgently needed.

Serious Violence Victimization and Perpetration among Youth Living in the Slums of Kampala, Uganda.

IntroductionViolence among youth is a major public health issue globally. Despite these concerns, youth violence surveillance and prevention research are either scarce or non-existent, particularly in developing regions, such as sub-Saharan Africa. The purpose of this study is to quantitatively determine the prevalence of violence involving weapons in a convenience sample of service-seeking youth in Kampala. Moreover, the study will seek to determine the overlap between violence victimization and perpetration among these youth and the potentially shared risk factors for these experiences.MethodsWe conducted this study of youth in May and June of 2011 to quantify and describe high-risk behaviors and exposures in a convenience sample (N=457) of urban youth, 14–24 years of age, living on the streets or in the slums and who were participating in a Uganda Youth Development Link drop-in center for disadvantaged street youth. We computed bivariate and multivariate logistic regression analyses to determine associations between psychosocial factors and violence victimization and perpetration.ResultsThe overall prevalence of reporting violence victimization involving a weapon was 36%, and violence perpetration with a weapon was 19%. In terms of the overlap between victimization and perpetration, 16.6% of youth (11.6% of boys and 24.1% of girls) reported both. In multivariate analyses, parental neglect due to alcohol use (Adj.OR=2.28;95%CI: 1.12—4.62) and sadness (Adj.OR=4.36 ;95%CI: 1.81—10.53) were the statistically significant correlates of victimization only. Reporting hunger (Adj.OR=2.87 ;95%CI:1.30—6.33), any drunkenness (Adj.OR=2.35 ;95%CI:1.12—4.92) and any drug use (Adj.OR=3.02 ;95%CI:1.16—7.82) were significantly associated with both perpetration and victimization.ConclusionThe findings underscore the differential experiences associated with victimization and perpetration of violence involving weapons among these vulnerable youth. In particular, reporting hunger, drunkenness and drug use were specifically associated with victimization and perpetration. These are all modifiable risk factors that can be prevented. It is clear that these vulnerable youth are in need of additional services and guidance to ameliorate their adverse childhood experiences, current health risk behaviors and disadvantaged living context.

Vocational Training with HIV Prevention for Ugandan Youth

In a pilot study, young people in slums in Kampala, Uganda received an HIV prevention program (Street Smart) and were randomized to receive vocational training immediately (Immediate) or four months later (Delayed). Youth were monitored at recruitment, 4 months (85% retention), and 24 months (74% retention). Employment increased dramatically: Only 48% had ever been employed at recruitment, 86% were employed from months 21 to 24 post recruitment. Over two years, decreases were recorded in the number of sexual partners, mental health symptoms, delinquent acts, and drug use; condom use increased. Providing employment in low income countries, in conjunction with HIV prevention, may provide sustained support to young people to prevent HIV acquisition.

A study of the degree of Pollution in Nakivubo Channel, Kampala, Uganda

Nakivubo channel traverses highly populated Kampala slums, markets, industrial areas and a wetland. It discharges its water at Murchison bay in Lake Victoria. The degree of pollution in the channel has a directeffect on the aquatic life in the lake, the health of communities along the channel, and the cost of water treatment since its discharge point is only 2kms from the raw water intake for the city. This research investigated the degree of pollution in the channel so that appropriate purification measures may be taken either at the pollution source or in the channel before discharge to the lake. Samples were taken at four points along the channel during the wet and dry seasons. The samples were tested for pH, BOD, COD, TSS, E-Coli, EC, TN, and O-PO4. These were compared with the standards set by NEMA for waste water. It was found that there is a high degree of pollution in the channel. Thewetland before the lake helps to bring down pollution levels but this should be supplemented by pretreatment before discharge into the channel. Recommendations on reduction of pollution in the channel were made.

Why Does Ethnic Diversity Undermine Public Goods Provision? An Experimental Approach

A large and growing literature links high levels of ethnic diversity to low levels of public goods provision. Yet while the empirical connection between ethnic heterogeneity and the underprovision of public goods is widely accepted, there is little consensus on the specific mechanisms through which this relationship operates. To gain analytic leverage on the question of why ethnicity matters, we identify three families of mechanisms - what we term preference, technology, and strategy mechanisms. Our empirical strategy is to identify and run a series of experimental games that permit us to examine these mechanisms in isolation and then to compare the importance of ethnicity in each. Results from experimental games conducted with a random sample of 300 subjects in Kampala's slums reveal that successful collective action among homogenous ethnic communities in urban Uganda is attributable to the existence of norms and institutions that facilitate the sanctioning of non-contributors. We find no evidence for a commonality of tastes within ethnic groups, for greater degrees of altruism toward co-ethnics, or for an impact of shared ethnicity on the productivity of teams.