Slums Of Nairobi Research Articles

Exploring the complex relationship between women\u2019s sanitation practices and household diarrhea in the slums of Nairobi: a cross-sectional study

BackgroundDiarrheal disease kills over half a million people each year in sub-Saharan Africa; the majority are children under 5 years. About 58% of diarrhea cases are associated with poor water, sanitation, and hygiene—a critical issue for people living in informal settlements. In Kenya, 60% of Nairobi’s population lives in informal settlements; yet, there is a paucity of research exploring the relationship between water, sanitation and hygiene (WASH) conditions in these settlements and associated health outcomes.MethodsThe study examines characteristics of women’s WASH behaviors and environments as potential factors associated with household diarrhea in Mathare Valley Informal Settlement in Nairobi using cross-sectional survey data collected from 550 women.ResultsApproximately 17% of participants reported that at least one member of the household suffered from diarrhea in the previous 2 weeks—48% of the cases were children under five. Results from a logistic regression exploring factors associated with reports of household diarrhea suggest that women’s sanitation management strategies are associated with recent household diarrhea. Women who use toilets for defecation during the day, but rely on bags, buckets, or open defecation (OD) for urination during the day and for urination and defecation at night have over five time the odds of recent household diarrhea than women who use a toilet for all their sanitation needs. The odds of diarrhea were also higher for participants who walk up to 2 min to reach their toilets/sites for defecation and those who rely on water from taps inside buildings and plots. Odds were 62% lower for participants with clean toilets.ConclusionsFindings suggest that health targets to reduce the prevalence of diarrheal diseases in informal settlements may not be met unless particular attention is paid to the needs of women living in these environments.

Influence of container cleanliness, container disinfection with chlorine, and container handling on recontamination of water collected from a water kiosk in a Kenyan slum.

The study assessed whether using clean containers that had been disinfected with chlorine at a water kiosk in the Kangemi slum in Nairobi reduced recontamination of treated water during drinking transport and storage. At the same time, the impacts of container handling and hygiene conditions at the household level on water quality changes during storage were evaluated. Data were collected during interviews with 135 households using either new, clean Maji Safi containers (MSCs) that had been disinfected with chlorine or normal uncleaned jerrycans (NJCs). Bacteriological water quality and free chlorine levels in both types of containers were measured after container filling at the kiosk and in the same containers after 24 h storage in households. The use of MSCs significantly reduced the risk of recontaminating the treated water. After water filling at the kiosk, none of the MSCs contained Escherichia coli bacteria, and 2.8% were contaminated after 24 h storage. In contrast, 6.2% of NJCs were contaminated after filling, and 15.2% after 24 h storage. Multivariate logistic regression indicated that the use of a clean water container and sufficient chlorine and the frequency of cleaning the container in the household mitigated recontamination. We suggest further investigation of water container designs that facilitate cleaning.

Malnutrition, morbidity and infection in the informal settlements of Nairobi, Kenya: an epidemiological study

BackgroundMalnutrition constitutes one of the major public health challenges throughout the developing world. Urban poverty and malnutrition have been on the rise, with an increased rate of morbidity. We herein explore the relationship between infections and nutritional status and the related association with hygienic conditions as risk of infection in children residing in the slums of Nairobi.MethodsCase-control study based on a secondary analysis of quantitative data collected from a cluster randomized trial carried out in two slums of Nairobi. The following information about resident children were selected: babies’ anthropometric measurements, related life conditions, data on infant-feeding practices, food security, hygiene, immunization coverage and morbidity were collected and updated with structured questionnaires until 12 months of life. Prevalence of malnutrition was calculated, then both bivariate and multivariate analysis were used to explore the relationship between malnutrition and its determinants.ResultsThe study involved a total of 1119 babies registered at birth (51.28% male and 48.03% female infants). Overall the prevalence of malnutrition was high, with 26.3% of the children being stunted, 6.3% wasted and 13.16% underweight. Prevalence of wasting was higher in the first months of life, while in older children more case of stunting and underweight were captured. Wasted infants were significantly associated with common childhood illnesses: with cough and rapid breathing as well as with diarrhea (p-value< 0.05). Stunting was associated with hygienic conditions (p-value< 0.05 in households that did not perform any water treatment and for children that had a toilet within the house compound), immunization program and low-birth-weight. Moreover, regression analysis showed that significant determinants of stunting were sex and feeding practices. Underweight was significantly associated with socio-demographic factors.ConclusionsIn the specific environment where the study was conducted acute malnutrition is correlated with acute infections, while chronic malnutrition is more influenced by WASH conditions. Therefore, our findings suggest that one cannot separate infection and its risk factors as determinants of the whole malnutrition burden.

Household air pollution in Nairobi's slums: A long-term policy evaluation using participatory system dynamics

58% of Nairobi's population live in informal settlements in extremely poor conditions. Household air pollution is one of the leading causes of premature death and disease in these settlements. Regulatory frameworks and government budgets for household air pollution do not exist and humanitarian organisations remain largely inattentive and inactive on this issue. The purpose of this paper is to evaluate the effectiveness of potential indoor-air related policies, as identified together with various stakeholders, in lowering household air pollution in Nairobi's slums. Applying a novel approach in this context, we used participatory system dynamics within a series of stakeholder workshops in Nairobi, to map and model the complex dynamics surrounding household air pollution and draw up possible policy options. Workshop participants included community members, local and national policy-makers, representatives from parastatals, NGOs and academics. Simulation modelling demonstrates that under business-as-usual, the current trend of slowly improving indoor air quality will soon come to a halt. If we aim to continue to substantially reduce household PM2.5 levels, a drastic acceleration in the uptake of clean stoves is needed. We identified the potentially high impact of redirecting investment towards household air quality monitoring and health impact assessment studies, therefore raising the public's and the government's awareness and concern about this issue and its health consequences. Such investments, due to their self-reinforcing nature, can entail high returns on investment, but are likely to give ‘worse-before-better’ results due to the time lags involved. We also discuss the usefulness of the participatory process within similar multi-stakeholder contexts. With important implications for such settings this work advances our understanding of the efficacy of high-level policy options for reducing household air pollution. It makes a case for the usefulness of participatory system dynamics for such complex, multi-stakeholder, environmental issues.

Anemia & its associated factors among pregnant women attending antenatal clinic at Mbagathi County Hospital, Nairobi County, Kenya

Introduction: Anemia is one of the most common nutritional deficiency diseases observed globally. It affects more than a quarter of the world’s population. Globally, 41.8% of pregnant women and close to one third of non-pregnant women (30.2%) are anemic. The paper describes factors associated with anemia in pregnant women at Mbagathi County Hospital which admits many patients coming from Kibera. A low income slum in Nairobi. Kenya. Objective: The objective was to determine the prevalence of anemia and its associated factors among pregnant women attending antenatal care at Mbagathi County Hospital in Nairobi, Kenya. Methodology: A Hospital based cross-sectional study was conducted from September 01 to October 30, 2016 employing a systematic random sampling method to select participants. Analysis was done using SPSS version 17.0 to obtain descriptive statistics such as Frequency, Percentage, Mean and Standard deviation. This was used to describe selected variables. Chisquare test and odds ratio (OR) with corresponding 95% confidence intervals (CI) was computed to determine the association between INDEPENDENT and DEPENDENT variables. Logistic regression analysis was done to determine factors significantly and independently predicting anemia during pregnancy. Results: The results revealed the prevalence of anemia among pregnant women to be 40.7% with a significant association of Helminthic infestation and anemia (p =0.003). Education showed statistically significant relationship with anemia (p =0.001). There was a strong association between prevalence of anemia and the dietary practices (p =0.003). Anemia among pregnant women is found to be a severe public health problem, based on the World Health Organization classification of anemia. Conclusion: Thus, this study concluded that routine iron supplementation in pregnancy and early initiation of antenatal clinic attendance could reduce the prevalence of anemia in pregnancy. Hence, daily intake of foods rich in iron is recommended for women to reduce prevalence of iron deficiency (anemia) during pregnancy. In fact, girl child education can be used to further mitigate anemia in communities. Moreover, stringent measures should be taken to control parasitic infestations and other risk factors of anemia amongst women by disseminating Information to the public.

Exposure to Outdoor Particles (PM2.5) and Associated Child Morbidity and Mortality in Socially Deprived Neighborhoods of Nairobi, Kenya

Exposure to air pollution is associated with adverse health outcomes. However, the health burden related to ambient outdoor air pollution in sub-Saharan Africa remains unclear. This study examined the relationship between exposure to outdoor air pollution and child health in urban slums of Nairobi, Kenya. We conducted a semi-ecological study among children under 5 years of age from two slum areas and exposure measurements of particulate matter (PM2.5) at the village level were aligned to data from a retrospective cohort study design. We used logistic and Poisson regression models to ascertain the associations between PM2.5 exposure level and child morbidity and mortality. Compared to those in low-pollution areas (PM2.5 &lt; 25 µg/m3), children in high-pollution areas (PM2.5 ≥ 25 µg/m3) were at significantly higher risk for morbidity in general (odds ratio (OR) = 1.25, 95% confidence interval (CI): 1.11–1.41) and, specifically, cough (OR = 1.38, 95% CI: 1.20–1.48). Exposure to high levels of pollution was associated with a high child mortality rate from all causes (IRR = 1.22, 95% CI: 1.08–1.39) and respiratory causes (IRR = 1.12, 95% CI: 0.88–1.42). The findings indicate that there are associated adverse health outcomes with air pollution in urban slums. Further research on air pollution health impact assessments in similar urban areas is required.

Balancing paid work and child care in a slum of Nairobi, Kenya: the case for centre-based child care

ABSTRACT As a growing number of women across sub-Saharan Africa engage in paid work, they face the challenge of finding suitable child care arrangements. Drawing on survey data from over 1,200 mothers and in-depth interviews with 31 of these women, we find that mothers living in a slum of Nairobi, Kenya, employ three main strategies to balance their work and child care responsibilities: (1) combine work and child care, (2) rely on kin and neighbours, or (3) use centre-based care. Mothers reported numerous disadvantages to either bringing their children to work or depending on others for child care assistance. In contrast, mothers highlighted several perceived benefits of centre-based child care for themselves and their children, while noting that costs were often prohibitive. These findings suggest that providing affordable centre-based child care could be a key strategy to improving the lives and welfare of women and children living in African slums.

Method‐Specific Attributes that Influence Choice of Future Contraception Among Married Women in Nairobi's Informal Settlements

Despite an extensive evidence base on contraceptive method choice, it remains uncertain which factors are most influential in predisposing women toward certain methods and against others. This paper addresses this gap in knowledge by making use of rarely‐measured perceptions about specific methods, perceived social network experience of methods, and women's own past experiences using specific methods. We draw on baseline data from the project, “Improving Measurement of Unintended Pregnancy and Unmet Need for Family Planning.” Using conditional logit analysis, we ascertain which perceived method‐specific attributes, including past experience of methods by women themselves and by their friends, predict preferred future contraceptive method among 317 women living in Nairobi slums who are using no method but intend to start in the next 12 months. Results show that satisfaction with past use, positive experience of use by a woman's social network, husband/partner's approval, lack of interference with menses, and perception of safety for long term use were all associated with choice of a future method.

Making Sense of Marriage: Gender and the Transition to Adulthood in Nairobi, Kenya.

The objective of this study was to examine how young people in Nairobi, Kenya, are making sense of marriage, both in terms of their own lives and its social significance. In many sub-Saharan African communities, marriage has been a fundamental marker of the transition to adulthood. However, union formation is changing, particularly in urban areas-partnering is occurring later and nonmarital cohabitation is increasingly common with the pathways to union formation differing by gender. Young people's perspectives on marriage are valuable for a deeper understanding of these trends. A total of 74 in-depth interviews with youth living in the slums of Nairobi, Kenya, were qualitatively analyzed with particular attention to personal and normative understandings of marriage along with how they vary by gender. Marriage emerged as an important part of most respondents' life projects, whether or not they considered it key to socially recognized adulthood. Attitudes differed by gender, with young women's greater ambivalence and aversion toward marriage, particularly early marriage, contrasting with young men's frustrated desire for marriage amidst economic constraints. Young men's main worry about marriage was not being able to support a family, whereas young women were often concerned that marrying would thwart their aspirations regarding education and work. Marriage continues to be a significant social marker of adulthood despite a shifting demographic reality. Differences in young people's attitudes are related to gendered concerns around marriage and economic independence.

A facility-based study of women\u2019 satisfaction and perceived quality of reproductive and maternal health services in the Kenya output-based approach voucher program

BackgroundThis is a facility-based study designed to assess perceived quality of care and satisfaction of reproductive health services under the output-based approach (OBA) services in Kenya from clients’ perspective.MethodAn exit interview was conducted on 254 clients in public health facilities, non-governmental organizations, faith-based organizations and private facilities in Kitui, Kilifi, Kiambu, and Kisumu counties as well as in the Korogocho and Viwandani slums in Nairobi, Kenya using a 23-item scale questionnaire on quality of reproductive health services. Descriptive analysis, exploratory factor analysis, reliability test, and subgroup analysis using linear regression were performed.ResultsClients generally had a positive view on staff conduct and healthcare delivery but were neutral on hospital physical facilities, resources, and access to healthcare services. There was a high overall level of satisfaction among the clients with quick service, good handling of complications, and clean hospital stated as some of the reasons that enhanced satisfaction. The County of residence was shown to impact the perception of quality greatly with other social demographic characteristics showing low impact.ConclusionMajority of the women perceived the quality of OBA services to be high and were happy with the way healthcare providers were handling birth related complications. The conduct and practice of healthcare workers is an important determinant of client’s perception of quality of reproductive and maternal health services. Findings can be used by health care managers as a guide to evaluate different areas of healthcare delivery and to improve resources and physical facilities that are crucial in elevating clients’ level of satisfaction.

Sociodemographic and behavioural factors associated with body mass index among men and women in Nairobi slums: AWI-Gen Project

ABSTRACTBackground: Body mass index (BMI) is rising globally with a faster increase in urban areas in low- and middle-income countries. It is critical to identify modifiable risk factors for BMI to prevent the occurrence of associated health consequences.Objective: To investigate socio-demographic, behavioural and biological factors associated with BMI in Nairobi slums.Methods: In 2014-2015, a cross sectional study of men and women aged 40–60 years in Nairobi slums (Korogocho and Viwandani) was conducted. Data were collected on socio-demographic, behavioural and biological characteristics. Mean BMI, overweight and obesity were computed. Hierarchical multiple linear regression analysis was conducted separately for men and women to explore factors associated with BMI.Results: In total, 1942 study participants (54.4%, women) with a mean age (SD) of 48.3 (5.3) years and 48.8(5.6) years for women and men respectively were recruited. Mean BMI was higher among women than men (27.6 versus 22.8; p < 0.001). More women were overweight (30.9% versus 19.6%; p < 0.001) and obese (32.1% versus 5.1%; p < 0.001) than men. Among men, BMI was independently associated with wealth index, bread consumption and self-reported diabetes and was negatively associated with current tobacco smoking, HIV and TB infections. Among women, BMI was independently associated with wealth, current non-problematic drinking, and sedentary time, but was lower among other ethnicities compared to Kikuyu, among current smokers, women with longer sleep, and those with HIV infection and tuberculosis. Wealth index contributed the most variance in BMI among women and men (10.4%, 7.5%, respectively), but behavioural factors (7.4%) among men and biological factors (6.5%) among women accounted for most of the additional BMI variance.Conclusions: Adults aged 40–60 years in the urban slums of Nairobi have a high BMI associated with wealth. Bread consumption by men and sedentary life among women are the main risky behaviours that need urgent targeted interventions.

Support to Children’s Education in the Urban Slums of Nairobi: Community and Parents’ Perceptions with an Expanded Phase of an Education Intervention Program

The objective of this paper is to examine the perceptions of community elders and parents on their roles regarding support to their children’s education. Data come from the qualitative component of a baseline survey conducted in Korogocho and Viwandani, two urban informal settlements in Nairobi, Kenya. Data were collected in April-May 2016 through in-depth interviews, key informant interviews and focus group discussions. Results demonstrated that community elders internalized their role as the face of government in their respective communities, and enforced the implementation of education policies on behalf of all children. The community leaders also saw as part of their role the need to encourage parents to be active participants in their children’s education. Female parents with boys in the program perceived that parental monitoring and follow-up was important to ensure that their children attended school, and completed work assigned by the teachers, more so in Korogocho. Overall, parents recognized the importance of the role they played in their children’s education. This is a good entry point as parental support will ensure the success and sustainability of the intervention to improve educational outcomes for children, which in turn will help their children navigate the challenging period that adolescence presents.

Vulnerability Multiplied: Health Needs Assessment of 13–18‐Year‐Old Female Orphan and Vulnerable Children in Kenya

Globally, orphans and vulnerable children (OVCs) affected/infected by HIV/AIDS face many health risks, including malnutrition, early/unprotected sex, early forced marriage, HIV and other sexually transmitted infections (STIs), substance abuse, child labor, and high rates of mental health problems. We conducted formative research on mental health issues and HIV/STI risk behavior in Kasarani, a large slum in Nairobi, to guide the development of future interventions. Collaborating with a local community hospital, we used focus groups in the community to gather information that was used to generate a survey of 261 OVCs aged 13–18 years. Focus groups converged in deeming that OVCs were a high‐risk group, and girls were especially at higher health risk. Living within an impoverished environment makes these girls vulnerable to marginalization and exploitation. Specific concerns for girls included peer pressure, depression, suicidal ideation, sexual relationship with infected partners, lack of health education (specifically HIV/STI prevention information), and sexual exploitation by older men.

Women\u2019s attitudes and beliefs towards specific contraceptive methods in Bangladesh and Kenya

BackgroundMissing from the huge literature on women’s attitudes and beliefs concerning specific contraceptive methods is any detailed quantitative documentation for all major methods in low- and middle-income countries. The objectives are to provide such a documentation for women living in Matlab (rural Bangladesh), Nairobi slums and Homa Bay (rural Kenya) and to compare the opinions and beliefs of current, past and never users towards the three most commonly used methods (oral contraceptives, injectables and implants).MethodsIn each site, 2424 to 2812 married women aged 15–39 years were interviewed on reproduction, fertility preferences, contraceptive knowledge and use, attitudes and beliefs towards family planning in general and specific methods. We analysed the data from round one of the prospective cohort study.ResultsWhile current users typically expressed satisfaction and held more positive beliefs about their method than past or never users, nevertheless appreciable minorities of current users thought the method might pose serious damage to health, might impair fertility and was unsafe for prolonged use without taking a break. Larger proportions, typically between 25% and 50%, associated their method with unpleasant side effects. Past users of pills and injectables outnumbered current users and their beliefs were similar to those of never users. In all three sites, about half of past injectable users reported satisfaction with the method and the satisfaction of past implant users was lower.ConclusionsHigh levels of contraceptive use can clearly co-exist with widespread misgivings about methods, even those that are widely used. Serious concerns about damage to health, long term fertility impairment, and dangers of prolonged use without taking a break were particularly common in the Kenyan sites and these beliefs may explain the high levels of discontinuation observed in Kenya and elsewhere in Africa. This documentation of beliefs provides useful guidance for counselling and informational campaigns. The generally negative views of past users imply that programmes may need not only to improve individual counselling but also strengthen community information campaign to change the overall climate of opinion which may have been influenced by dissatisfaction among past users.

Cost of being a slum dweller in Nairobi: Living under dismal conditions but still paying a housing rent premium

Abstract The UN notes that the current global slum population of nearly one billion not only reflects “a rather unacceptable contemporary reality, but one whose numbers are continuously swelling.” Not surprisingly, its latest global development priorities, announced through its Sustainable Development Goals agenda in 2015, emphasize addressing the slum challenge in developing countries as a major goal. Our study focuses on gaining an in-depth understanding of the nature and extent of such slum challenge faced by Nairobi. Specifically, using data from a recent (2012–13) statistically representative survey, we conduct a systematic empirical analysis of the rental housing market conditions faced by households living in slum versus formal areas of Nairobi. Our analysis findings establish relevant benchmarking for key policy relevant measures against which to evaluate the efficacy of new policy initiatives. Taken together, our findings show that the households in Nairobi’s slum areas, compared to their counterparts in formal areas, are currently facing a substantial double jeopardy. On one hand, they face significant disparity gaps – about 24 percentage points in less coverage – across a myriad of housing and living condition indicators. For some basic services like water, toilet and public sewage disposal, the gaps are as high as 40–50 percentage points. On the other hand, we were able to quantify for the first time the extent of rent premium – about 16 percent – that Nairobi’s slum tenants are paying relative to their formal area counterparts, after adjusting for housing quality conditions. While our study’s primary goal was on demonstrating the presence and the extent of the double jeopardy, it also sheds important insights from normative policy perspectives. A novel insight here is that although formal tenure agreements are rare in Nairobi’s slums, the tenants do pay a rent premium of about 18 percent if they possess such agreements.

Speculative futures at the bottom of the pyramid

AbstractCelebrated as creative, flexible catalysts of inclusive capitalism, urban youth are central to bottom‐of‐the‐pyramid (BoP) models of development, which set out to repurpose the jobless as entrepreneurs in the making. We explore the multiple (at times conflicting) temporalities – the practices, technologies, and representations of time – which figure in a BoP initiative offering entrepreneurial opportunities to unemployed youth in Nairobi's slums: from the invocation of clock‐time discipline to the professional time of entrepreneurial subjectivities and the enchantments of the not‐yet. But the appeal of BoP, we suggest, does not turn either on the here‐and‐now of survival or on an impossible pipe dream of prosperity, but rather resides firmly in the medium term: a foreseeable future of modest desires, which nonetheless remain tantalizingly just out of reach for most. By examining how these temporal conflicts play out in attempts to fashion a cadre of self‐willed, aspiring entrepreneurs, we reveal the limits to entrepreneurial agency, and the contradictions inherent in the mission of (self‐)empowerment through enterprise upon which the ideology of inclusive markets is built.

‘Inexperienced’? Patterns in romantic and sexual experiences among urban poor early adolescents in Nairobi, Kenya

The need for early prevention approaches to improve young people’s sexual and reproductive health is gaining attention, yet little is known about the sexual experiences of early adolescents aged 10–14 years. Drawing on cross-sectional survey data collected from 365 early adolescents in a Nairobi slum, we used latent class analysis to identify subgroups based on self-reported awareness about sex and involvement in romantic and sexual activities. Multivariate regression models were fitted to examine the characteristics of each subgroup. Results revealed three subgroups: Involved (12%, high probability of being aware of sex and to have engaged in romantic/sexual activities); Observant (48%, high awareness but little own experience); and Naïve (40%, little awareness or personal experience). Being in the Involved group was associated with older age, having commenced puberty/orphanhood, and living in the least poor households. Findings suggest that while most early adolescents in this setting have not initiated romantic and sexual activities, there are distinct subgroups of who would not be captured by looking only at the prevalence of sexual intercourse. Understanding the characteristics and needs of specific subgroups may help to strengthen efforts to improve young people’s sexual and reproductive health in urban poor environments.

Leveraging Web 2.0 technologies to foster collective civic environmental initiatives among low-income urban communities

There are a number of challenges facing the low-income urban communities living in slums in most of the developing countries such as the Mathare slum. Provision of essential public basic services in the Nairobi slums is lower compared to what is offered to the rest of the City. But, services such as the garbage removal also requires participation of the residents for successful service delivery. The objective of this study was to investigate whether use of Facebook, as a Web 2.0 technology, can support the residents of Mathare slum to actively participate in civic environmental initiatives and to foster community activeness towards civic environmental protection. The study employed a mixed methods approach to investigate the problem. This was achieved through a preliminary survey (700 respondents) to collect data on use of Web 2.0 among the residents of Mathare slum, an experiment with 175 residents, who participated in a community civic environmental initiative using Facebook and a survey to measure continuance intentions on use of Web 2.0 technologies for collective community Web 2.0-mediated activities towards protecting the environment among low-income urban communities. The study constructed and successfully tested a model of Web 2.0 use and online environmental protection initiatives. Use of Web 2.0 technologies for environmental protection emerged as a significant predictor of online social capital, community environmental activeness and continuance intentions to participate in environmental initiatives, while perceived cost negatively moderates the relationship between Web 2.0 use and continuance intentions. Implications and recommendations for policy, practice and research are provided.

Establishment and development process of nonformal school environments in a Nairobi slum: Focusing on the relationship between the school and the local community

AbstractThis paper found the following environmental setting characteristics of nonformal schools in a Nairobi slum: (i) The schools tend to move from rental houses to their own properties. (ii) In “congested areas,” they lay out classrooms that are scattered in the community. Meanwhile, in “not‐congested areas,” they lay them out from the corner of the plot to protect them from “land‐grabbing.” (iii) Many of the schools do not have latrines or playgrounds and do not serve lunch. They supplement these functions by using community resources, such as rental latrines, open lands, and children's houses. Therefore, children spend break time outside, making children's activities more diverse and producing greater demand for neighboring shops.

Caregiving for Children Living with Disability in the Informal Settlements in Kenya: Exploring the Social Experiences of the Urban Poor Living in Mukuru Slums in Nairobi

Caregiving for Children Living with Disability in the Informal Settlements in Kenya: Exploring the Social Experiences of the Urban Poor Living in Mukuru Slums in Nairobi