Large Informal Settlement Research Articles

Family Kinship Patterns and Female Sex Work in the Informal Urban Settlement of Kibera, Nairobi, Kenya.

A basic ecological and epidemiological question is why some women enter into commercial sex work while other women in the same socio-economic environment never do. To address this question respondent driven sampling principles were adopted to recruit and collect data for 161 female sex workers and 159 same aged women who never engaged in commercial sex in Kibera, a large informal settlement in Nairobi, Kenya. Univariate analysis indicated that basic kinship measures, including number of family members seen during adolescence and at present, not having a male guardian while growing up, and earlier times of ending relationships with both male and female guardians were associated with commercial sex work in Kibera. Multivariate analysis via logistic regression modeling showed that not having a male guardian during childhood, low education attainment and a small number of family members seen at adolescence were all significant predictors of entering sex work. By far the most important predictor of entering sex work was not having any male guardian, e.g., father, uncle, older brother, etc. during childhood. Results are interpreted in light of the historic pattern of sub-Saharan African child fostering and their relevance for young women in Kibera today.

“If in doubt, count”: the role of community-driven enumerations in blocking eviction in Old Fadama, Accra

This paper describes the community-driven enumerations undertaken in Old Fadama, the largest informal settlement in Accra, which has long been threatened with eviction. After meeting with members of shack dweller federations from other nations, residents formed the Ghana Homeless People’s Federation in 2003 (now known as the Ghana Federation of the Urban Poor (GHAFUP). Together with the NGO People’s Dialogue on Human Settlements, they supported the first community-driven enumeration in Old Fadama in 2004 to counter the threat of eviction, by showing the large scale of economic activities in the community and the gap in accurate population data. This was followed by further enumerations, in 2006–2007 and in 2009, to counter new eviction threats from new city governments. These enumerations increased the residents’ confidence, empowering them in terms of engagement with city government. They also changed government’s perspective on informal settlements and helped shape policy away from forced evictions towards participatory relocations or rehabilitation.

A novel extension of the anisotropic rotation-invariant built-up presence index to SAR data

Although the mechanisms underlying remote sensing images by optical and SAR sensors are very different, specific environments are represented on both types of imagery as largely similar spatial patterns. The anisotropic rotation-invariant built-up presence index makes use of these patterns on optical imagery for delineating and characterizing human settlements. This paper focuses on the necessity of a different definition for this index when it is applied to SAR data. Although the extension from optical to radar data is not straightforward, the formulation proposed in this paper makes it suitable for a good characterization of large urban areas and small informal settlements as well.After introducing and validating the slant-range version of the anisotropic rotation-invariant built-up presence index, a comparison of its effectiveness with respect to different radar viewing geometries and frequencies on the same test area is carried out, suggesting that the methodology works well in any situation.

Chemical monitoring and temporal variation in levels of endocrine disrupting chemicals (priority phenols and phthalate esters) from selected wastewater treatment plant and freshwater systems in Republic of South Africa

This study presents a quantitative estimation of the simultaneous analysis of 11 priority phenols and six phthalate esters in surface water from five rivers collected from the upstream and downstream of wastewater treatment plants (WWTPs) that emptied their final effluents into the rivers. In addition, influents and effluents from the WWTPs were collected on a quarterly basis between April 2010 and March 2011. Kirstenbosch Botanical Garden stream was used as a control site. Gas chromatography–mass spectrometry (GC–MS) was used for identification and quantification using N-methyl-N-(tert-butyldimethylsilyl)trifluoroacetamide (MTBSTFA). Chemical analysis by GC–MS revealed the presence of DEP, POH, PCP, DEHP, DBP, BBP, 2,4-DMP and 2-NP as the most abundant congeners. Zandvliet WWTP showed to be the most polluted as it receives wastewater from the largest informal settlement in the city. Generally, concentration ranged from below detection limit (LOD) for most of the congeners to 34.520mgl−1 for DBP at Zandvliet WWTP. Also, statistical analysis showed correlation between levels of analytes in effluent and downstream water samples, an indication of pollution from the WWTP. From the monitoring exercise, data obtained for most compounds analyzed showed that the congeners are effectively removed (approximately 80 to 100%) with the exception of 2-nitro phenol that was poorly removed. The production of 2,4-DMP is also noteworthy in the final effluent of all the investigated treatment plants.

Partners and clients of female sex workers in an informal urban settlement in Nairobi, Kenya

This paper compares and contrasts number of partners and condom use behaviour for female sex workers and a sample of women working in other economic activities, with both samples drawn from the large informal settlement of Kibera, Nairobi. As expected, univariate analysis revealed much higher numbers of overall sexual partners and higher levels of condom use among female sex workers compared to Kibera women in other occupations. An unexpected finding, however, was that female sex workers with a romantic partner had significantly fewer sexual partners per unit time than female sex workers without such a partner. This finding held for multivariate analysis, with negative binomial regression analyses showing that having a romantic partner was significantly associated with reductions in total number of both sexual partners overall and with sexual partners who did not use condoms. In contrast, HIV status, education, number of immediate family members and levels of alcohol consumption were non-significant factors for both regression analyses. Results suggest that female sex workers' romantic partners act as more than sources of possible HIV infection; rather, romantic partners appear to have an important positive impact on health. We discuss this finding in light of possible harm-reduction programmes focusing on female sex workers and their romantic partners.

A Talent for Living: Exploring Ghana’s ‘New’ Urban Childhood

This paper considers the lives of children living in a large informal settlement in central Accra, Ghana. Its contention is that children remain largely absent from the renewal of interest in slums and that where they do feature it is largely as objects of risk and vulnerability. Such an exclusive focus, it is argued, risks effacing the ways in which children are capable of actively confronting the terrible constraints posed by slum environments and the ‘talent for living’ that this involves. Drawing upon the findings of a small qualitative exploratory research project, the paper examines sources of support and cooperation between children and how their decisions to work are perceived as a strategy to actively support mothers and families struggling for a subsistence.

Alternative approaches to slum upgrading in Kibera, Nairobi

This paper discusses the sustainability of two different approaches to upgrade water and sanitation infrastructure in Kenya's largest informal settlement, Kibera. A background to the urbanisation of poverty is outlined along with approaches to urban slums. Two case studies of completed interventions of infrastructure upgrading have been investigated. In one case study, the upgrading method driven by a non-government organisation uses an integrated livelihoods and partnership technique at community level to create an individual project. In the other case study, the method is a collaboration between the government and a multi-lateral agency to deliver upgraded services as part of a country-wide programme. The ‘bottom-up’ (project) and ‘top-down’ (programme) approaches both seek sustainability and aim to achieve this in the same context using different techniques. This paper investigates the sustainability of each approach. The merits and challenges of the approaches are discussed with the projected future of Kibera. The paper highlights the valuable opportunity for the role of appropriate engineering infrastructure for sustainable urban development, as well as the alleviation of poverty in a developing context.

Access to water in a Nairobi slum: women's work and institutional learning

This paper describes the ways that households, and particularly women, experience water scarcity in a large informal settlement in Nairobi, Kenya, through heavy expenditures of time and money, considerable investments in water storage and routinized sequences of deferred household tasks. It then delineates three phases of adaptive water and social engineering undertaken in several informal settlements by the Nairobi Water Company in an ongoing attempt to construct effective municipal institutions and infrastructure to improve residential access to water and loosen the grip that informal vendors may have on the market for water in these localities.

Unofficial truths and everyday insights: understanding voice in visual research with the children of Accra's urban poor1

This article draws upon the use of photography to research the lives of children living in Accra, Ghana. Its aim is to consider method in visual research, and to reflect upon those modes of explanation and understanding that any consideration of method must require. It suggests a role for photography as a ‘vector’, as something capable of connecting our knowledge and understanding of the everyday with the everyday experiences and reality of others. Drawing upon the photographs and spoken testimonies of children who live and work on the street, and of children who live in a large informal settlement, the article advances an intimate connection between photography and knowledge of the everyday reality of children's lives, most evident in the capacity of children's photographs to surprise and highlight the fallibility of our understandings.

Built-in resilience: learning from grassroots coping strategies for climate variability

Significant lessons can be drawn from grassroots experiences of coping with extreme weather for reducing the vulnerability of the urban poor to climate change. This paper examines the household and community coping strategies used by low-income households living in Korail, the largest informal settlement in Dhaka. This includes how they use physical, economic and social means to reduce risk, reduce losses and facilitate recovery from flooding and high temperatures, and shows how grassroots adaptation differs according to the level of risk from flooding. The paper also discusses how local planning and governance mechanisms aimed at adaptation can support these coping strategies, including mainstreaming them into adaptation plans that can be scaled up to the citywide level.

Comparing Clinic Retention Between Residents and Nonresidents of Kibera, Kenya

treatment (ART) programs in urban slum settings. 1 Our article presented research performed at the African Medical and Research Foundation (AMREF) clinic in Kibera, one of Africa’s largest informal settlements, which showed that being a Kibera resident was significantly associated with ART program drop-out. Additionally, the Cox proportional hazard ratio for dropping-out among Kibera residents was 2.45 (P = 0.05), as compared with non–Kibera residents (result not presented in the original article). Chung et al did not find that Kibera residents who attended their study clinic at the Coptic Hope Centre had a higher loss to follow-up (Cox proportional hazard ratio: 1.02) than non–Kibera residents, and thus ‘‘caution against the conclusion that residing in Kibera or any urban slum is a risk factor for poor retention.’’ However, there are important differences in terms of geographical location, patient catchment area, and resources that make this comparison difficult. First, the Coptic Hope Centre clinic is located outside Kibera, whereas the AMREF clinic is located right in the centre of Kibera. Second Chung et al argue that: ‘‘Some residents are middle class Kenyans with a yearly salary and not necessarily day laborers with low income.’’ The Kibera population has not previously been well described in terms of sociodemographics and in our retrospective study; we lacked valid data on socioeconomic variables. However, our preliminary data from an ongoing prospective cohort study of HIV patients on ART at the AMREF Kibera clinic support our experience that most patients live under extremely poor conditions. Out of 515 ART patients enrolled so far in our prospective study, only 16% are employed, the other 84% are doing casual labor, are unemployed, or self-employed. Further, only 5% of the respondents have higher education (postsecondary school). Hence, our different findings are likely attributable to selection of more motivated and possibly less vulnerable patients from Kibera seeking care at the Coptic Hope Centre. Secondly, Chung et al speculate that patients dropping-out from the AMREF program might have sought care at a PEPFAR-funded clinic instead; however, the AMREF program at the Kibera clinic likewise receives funding from PEPFAR via CDC). We lack quantitative data on reasons for loss to follow-up, but our qualitative in-depth studies among HIV patients who have dropped out from the ART program in Kibera suggest that aside from death, migration, and the occasional patient changing provider, poverty and lack of food appear to be the major barriers to retention in an ART program in Kibera. 2 The time spent on clinic visits is considered better used to look for job opportunities, and taking ART is not perceived compatible with hunger and an empty stomach. In our forthcoming prospective study we will be able to further analyze determinants of retention in care. In addition, we used a more conservative definition of drop-out, 90 days, in order not to over estimate drop-out and to account for short-term migration in the mobile population of Kibera. Chung et al used 30 days as the cut-off. The Coptic Hope Centre clinic included only treatment-naive patients from the age of 15 years, whereas we included both treatmentnaive and treatment-experienced patients above the age of 18 years. Our results might thus

Systematic Observations of Health Damaging Factors in Informal Neighbourhoods in Aleppo, Syria-A Pilot Study

ISEE-0624 Background and Objectives: Systematic social observation is a method to evaluate pathways by which neighbourhood environments impact health. This method has mainly been used in developed country settings. In Aleppo (population 2,500,000) informal settlements occupy about 45% of the city’s inhabited area and are home to one million people. Informal settlements are neighbourhoods built without planning and for which environmental statistics are not available. The objective of this study was to pilot a context specific procedure and method to systematically assess characteristics of urban informal neighbourhoods relevant to health and wellbeing. Methods: An observational instrument was developed based on a literature review, observations in informal neighbourhoods and interviews with a purposive sample of key informants. The observational instrument measured land use (housing and industry); environmental quality and the social environment. The unit of observation (the spatial scale at which neighbourhood characteristics may differ) was identified as 100 meters of the right hand side of a street. The pilot study took place in Shaikh Maksoud, the largest informal settlement in Aleppo. We identified key pointers using a Garmin Global Positioning System and downloaded the waypoints into Google Earth Plus. Observation points were selected randomly. Results: The achieved sample comprised of twenty one random points, each consisting of three units of observations. We found big variability in the quality of the environment between the points of the observation within the same neighbourhood. For example, the eastern part had a high industrial-residential mix and the worse environmental quality. The best conditions were observed in the parts closer to the border with the formal area. The main challenge for adapting the methodology was to define the unit of observation. Conclusions: Systematic social observation can be a useful method in studies of health and place in developing countries.

Provider Characteristics Among Staff Providing Care to Sexually Transmitted Infection Self-Medicating Patients in Retail Pharmacies in Kibera Slum, Nairobi, Kenya

To evaluate the characteristics of providers in management of STI self-medicating patients in retail pharmacies within the largest informal settlement in Kenya. We collected sociodemographic, training, and work history attributes among pharmacy staff from a convenience sample of 50 retail pharmacies in Kibera slum using a self-administered questionnaire. We gathered the required data in 8 weeks, collecting completed self-administered questionnaires within 7 to 14 days after distribution. Two data collectors subsequently presented at these pharmacies as mystery patients seeking care for symptoms of genital ulcer disease and gonorrhea and completed a structured observation form within 10 minutes of leaving the pharmacy. Approximately half the respondents were men aged less than 28 years. Over 90% had 12 years of formal education and an additional 3 years of medical professional training. Two thirds (66%) had been trained in Government institutions. About 65% reported that patients presented without prescriptions, and 45% noted that patients requested specific medicines but were open to advice. One-third (36%) of the patients used the pharmacy as their first point of care. Using mystery patients to evaluate syndromic management of gonorrhea and genital ulcer disease, only 10% offered appropriate treatment per the Kenya Ministry of Health STI syndromic management guidelines. Although the majority of the pharmacy staff in this informal settlement have some medical training and some experience, a very low proportion offered adequate treatment for 2 common STIs.

Banking patronage motives of the urban informal poor

PurposeThe purpose of this paper is to provide an understanding of the banking needs of urban informal poor consumers in South Africa. These consumers find it difficult to obtain access to banking products.Design/methodology/approachA survey of consumers was undertaken in a large informal settlement outside Johannesburg. A qualitative exploratory pilot study was undertaken first to gain a better understanding of these consumers and to develop a research instrument. Second, a quantitative analysis was undertaken among 200 households.FindingsBanking products used by the sample are discussed as well as all their patronage motives. It was established that the majority of consumers did have a bank account and there was a significant association between having an account and various demographics such as income level, employment status and level of education.Research limitations/implicationsEach informal settlement may have unique characteristics and therefore it may be difficult to generalize the findings.Practical implicationsBanks will have to address the patronage factors of these consumers as they have very different needs when compared to middle and upper income customers. Specify strategies are recommended to bank management.Originality/valueNo study has been done on the banking needs of this segment of the market and very little is known about the urban informal poor in general. This paper gives insight into how banks can play their part in uplifting the poor in societies where they make up large segments of the population.

Social and Environmental Justice in South African Cities: Including ‘Invisible Stakeholders’ in Environmental Assessment Procedures

In South Africa an intensive reform process to democratize policy, legislation and related institutions in the country commenced after the first democratic elections in 1994. While environmental law reform includes active public participation and equity principles, it is proposed in this paper that ecological modernization dominates current environmental assessment practice. This paper presents a Social Impact Assessment (SIA) of a proposed landfill on the periphery of Durban, where large informal settlements and peri-urban areas exist as a relic of apartheid planning. The methodology of the SIA was explicitly designed within a framework of social justice to include poor and marginalized people, who remain excluded from environmental decision making despite the promise of democratic equality. The study claims to deepen democratic practice by demonstrating that alternative methodologies can be designed to include the interests of ‘invisible stakeholders’ in environmental assessments despite the dominance of ecological modernization in the implementation of environmental law and policy.

Alternate water supply arrangements in peri-urban localities: awami(people’s) tanks in Orangi township, Karachi

This paper describes the serious water shortages that have been a feature of life in Karachi in recent years, and how community-managed public tanks (awami tanks) have been used in Orangi, Karachi’s largest informal settlement, to cope with the situation. These tanks are an example of a water supply service developed as a cooperative arrangement between informally developed community organizations and public sector agencies. The paper explores the partnerships between service providers, recipients of the service and other related stakeholders.

Upgrading and low-income housing initiatives: Indicating their value to the people of Freedom Square, Bloemfontein

Since 1990, hundreds of informal settlements have grown rapidly around cities throughout South Africa as a result of the changing political context, poverty and the enormous housing backlog. The impact of this uncontrolled urbanisation became apparent in the fact that hundreds of thousands of poor people had to make a living with limited access to running water, electricity and formal housing. This article explores the development experiences, needs and expectations of the residents of Freedom Square – previously Bloemfontein's largest informal settlement and home to 17 200 people – over a period of 8 years. This is approached by means of a comparative overview of four surveys (1990, 1993, 1995 and 1997), all relating to the social impact of upgrading-orientated and low-income housing initiatives within the study community.

Who is afraid of ashwaiyyat? Urban change and politics in Egypt

Drawing on the 1996 census, this paper challenges the orthodox view that rural migrants are causing a rapid expansion of Egyptian cities and have created “cities of peasants”. It describes how most major cities have ceased to be centres for rural in-migration and looks at the spatial diffusion of urban development through the growth of agro-towns, urban villages and new industrial towns. Many settlements officially classified as “rural” are growing rapidly and acquiring urban characteristics. The paper also questions commonly held assumptions that the large informal settlements in which much of the urban population live are “abnormal” and associated with social deviance and political violence.

Conflict in development: Lessons from the housing initiatives in Freedom Square and Namibia Square

This article draws on observations made over five years during the upgrading of a large informal settlement in the Bloemfontein‐Mangaung area. Eight ‘conflict zones’ are identified and discussed, with the aim of promoting a better understanding of the dynamics of conflict in development in general and housing in particular. Understanding these dynamics is pivotal for ongoing development, the successful implementation of the Reconstruction and Development Programme and sustainable housing delivery.

The birds have nested: design direction for informal settlements

In most cities of the developing world, informal settlements are both the most common residential context and the dominant means of obtaining housing. Since many of these cities are rapidly approaching ‘megacity’ status, the issue of informal settlements becomes striking in its enormity. This paper aims to highlight the problems and potentials of informal settlements and review broad-brush design directions for their upgrading. Cognizance is taken of the organic morphology which characterizes these settlements and historic design reaction in this regard. South Africa's informal settlements can be traced back to the beginning of the 20th century and the early days of industry when a combination of crop failure and the lure of cash wages began to attract rural dwellers to urban areas. Almost immediately a housing shortage arose, yet while action was taken to house white migrants, little was done for blacks whose number was considerably larger. Informal settlements sprang up almost overnight, grew as rapidly, and despite aggressive state attempts to eradicate them, both persist and continue to expand today. One such ‘unwanted child’, Winterveldt, is a large informal settlement in the Pretoria metropolitan region. In existence since the early 1940s residents here have created their own homes, spaces and urban environment. Official response to them has varied over time, and reflects the alternate design directions examined in the first part of the paper.