People In Urban Slums Research Articles

NGOs' initiatives and grassroots approach for accessing to health care services for the slum people in Dhaka.

This study holds significant importance as it aims to delve into the impactful NGOs' initiatives and grassroots approaches instrumental in providing healthcare services to Dhaka's underserved slum people. It focuses on understanding how these factors influence the use and access to health services, which is a crucial aspect for researchers, policymakers, and healthcare professionals. This study was meticulously designed, utilizing a comprehensive cross-sectional mixed-methods design. By incorporating qualitative and quantitative data collection methods, we ensured a thorough understanding of NGOs' initiatives and grassroots approaches to providing healthcare services to slum dwellers in Dhaka, thereby instilling confidence in the validity of our research for the audience. A face-to-face interview was used to survey the participants (n = 722) using semi-structured questionnaires, following a systematic sampling technique. Four focus group discussions (FGDs) were also conducted with the slum people. Binary logistic regression was performed to know NGOs' initiatives, roles, and grassroots approach as predictors or independent variables and healthcare services as an outcome or dependent variable. The quantitative data were analyzed using SPSS version 23.0. At the same time, thematic analysis was conducted following Philip Adu's Qualitative data analysis process and Braun and Clarke's six steps of the thematic analysis system, integrating the 11 subthemes with the quantitative findings to highlight the interpretative findings of the qualitative data. Major findings revealed that NGOs' initiative roles and grassroots approach had a significant impact on slum dwellers' use and access to healthcare services. The initiatives included affordable health services (OR = 22.86, 95% CI = 3.87, 35.00, P = 0.01), special health services (OR = 5.63, 95% CI = 3.36, 9.42, P = 0.00), engagement of responsible community leaders (OR = 1.72, 95% CI = 1.14, 2.59, P = 0.01), distribution of health and medicine items (OR = 1.92, 95% 2 CI = 1.40, 2.63, P = 0.01), provision of updated information to slum dwellers (OR = 1.37, 95% CI = .99, 1.90, P = 0.05), telehealth and telemedicine (OR = 1.82, 95% CI = 1.55, 2.13, P = 0.01), BCC strategy (OR = 1.26, 95% CI = 1.00, 1.57, P = 0.05), and doorstep services as NGOs' grassroots approach (OR = 1.84, 95% CI = 1.00, 3.38, P = 0.05). Qualitative findings supported the quantitative findings through 2 main themes and 11 sub-themes, which were integrated with quantitative findings to highlight the interpretative findings of qualitative data. Health services and other facilities for urban slum people through NGOs' initiatives and grassroots approaches are highly affordable and practical, special health services with the involvement of special exceptional health professionals, community supportive services, BCC strategies, and doorstep health services may trigger the use and access to health services for slum dwellers. Results suggest and recommend capitalizing and investing in such initiatives and grassroots approaches from the government, policymakers, and donors with NGOs to find accessible, affordable health services for the unprivileged slum people.

Integrating health belief model and theory of planned behavior to assess COVID-19 vaccine acceptance among urban slum people in Bangladesh.

The vaccination against coronavirus disease 2019 (COVID-19) has been identified as a promising strategy to reduce the severity of the pandemic. Despite the safe and effective COVID-19 vaccines, bringing socioeconomically disadvantaged people under vaccination coverage has been challenging for developing countries like Bangladesh. Therefore, this study explored the determinants of vaccine acceptance among urban slum residents of Bangladesh using the Health Belief Model (HBM) and Theory of Planned Behavior (TPB). A face-to-face survey of 400 urban slum dwellers in two large cities in Bangladesh was conducted between July 5 to August 5, 2021. The questionnaire included vaccine acceptance, socio-demographics, health-related characteristics, trust in health authorities, reasons for vaccine hesitancy, and dimensions of HBM and TPB frameworks. Hierarchical logistic regression was performed to evaluate the association between these characteristics and vaccination acceptance. Around 82% (n = 327) of respondents were willing to accept the COVID-19 vaccine. In a fully adjusted model, respondents with secondary level education had higher intention (OR = 46.93, 95%CI = 1.21-1807.90, p < 0. 05) to accept COVID-19 vaccine. Respondents with bad (OR = 0.11, 95%CI = 0.01-0.35, p<0.05) or very bad (OR = 0.01, 95%CI = 0.01-0.35, p<0.05) health conditions were less interested in the COVID-19 vaccination. In regard to HBM dimensions, greater perceived susceptibility (OR = 1.75, 95% CI = 1.12-2.75, p < 0.05), and perceived benefits (OR = 3.28, 95% CI = 1.17-6.00, p < 0.001) were associated with a greater willingness to get vaccinated. In regard to TPB, higher self-efficacy in preventing illness without the vaccine increased the desire to get vaccinated (OR = 1.55, 95% CI = 1.02-2.37, p < 0.05). Fear of unknown side effects, religious beliefs, contraindications to vaccination, and insufficient information on the vaccine were the main reasons for vaccine hesitancy. These findings offer valuable insights for policymakers in Bangladesh to design targeted interventions that address vaccine hesitancy and increase vaccination acceptability among socially disadvantaged individuals in urban areas. Strategies should focus on providing accurate and accessible information about the vaccine, communicating its positive impact effectively, engaging with religious leaders to address misconceptions, and tailoring vaccination campaigns to meet the unique needs of different demographic groups.

Oral Health Status and Oral Hygiene Practices among Urban Slum Dwellers in Rawalpindi, Islamabad, Pakistan

Poor oral hygiene is a major factor for oral diseases. Urban slums are recognized as a risk group population as the burden of oral diseases is highest among them. Objectives: To evaluate the oral health status of slums using Decayed, Missed, and Filled Tooth index. To evaluate the oral health status of slums using Community Periodontal Index for Treatment Need. Methods: A cross-sectional study was carried out on 385 urban slum people aged between 20 to 50 years. A convenient sampling method was adopted. Data were collected by structured questionnaire included information related to patient’s knowledge, attitude, and behavior towards oral hygiene and interviewed by trained staff. Oral examinations were performed in line with WHO guidelines. After taking informed consent oral examinations were done by fresh graduate and DMFT and CPITN index were evaluated. Results: Study participants were assessed for attitude, knowledge and oral health behavior, 47% had Good Attitude, only 6% had Very Good Knowledge and &lt; 1% had Very Good oral health behavior. Mean DMFT and CPITN score among Slums came 8.91 + 7.627 and 1.93 + 0.971 respectively. More than a third of the slums population required emergency levels dental treatments. Conclusions: The residents of slums have poor oral hygiene and high prevalence of dental caries. Low socioeconomic status, and lack of primary dental care programs and session are main reasons for poor oral health

Healthcare-seeking behaviour of marginalised older people in urban slums: a cross-sectional survey study in Khulna City, Bangladesh

ObjectivesThis study aimed to measure healthcare-seeking behaviour and determine its associated factors among older people in the slums of the Khulna City Corporation (KCC) areas of Bangladesh.DesignCross-sectional survey.SettingsFour slums in...

Psychological determinants of COVID-19 vaccine acceptance among urban slum dwellers of Bangladesh.

IntroductionCoronavirus disease 2019 (COVID-19) vaccination has emerged as a promising approach to counter the harmful impacts of the pandemic. Understanding the psychological components that may impact an individual's attitude toward COVID-19 vaccination is crucial for generating evidence-based ways to minimize vaccine hesitancy. This study determined the psychological antecedents regarding vaccine acceptance among urban slum people of Bangladesh.MethodsFrom 5 July to 5 August 5, 2021, a face-to-face survey was conducted in the urban slum of two large cities in Bangladesh. The questionnaire considered socio-demographics, health-related characteristics, psychological determinants, sources of information, and conspiracy beliefs regarding COVID-19. The 5C sub-scales were used to assess psychological antecedents. Five stepwise binary logistic regression models evaluated significant predictors for confidence, complacency, calculation, constraints, and collective responsibility. Multinomial logistic regression was used to determine the relationship between psychological antecedents and vaccine acceptability.ResultsThe study revealed that the slum residents with a high level of confident (89.94%), complacent (72.73%), having constraints (82.31%), calculative (84.80%), and responsible (93.30%) showed a higher vaccine acceptance rate. Higher vaccine acceptance was related to the believer in natural-made origin (85.96%) and those who rejected anti-vaccination (88.44%). The information acquired from newspapers differed significantly (p < 0.05), though TV or radio was the most common primary information source about COVID-19 vaccines (74.75%). The regression result revealed that marital status, education, family income, and perceived health condition were significantly associated with the 5C domains. Two psychological antecedents including complacency (OR = 3.97; p < 0.001) and collective responsibility (OR = 0.23; p < 0.001) were significantly associated with vaccine acceptance.ConclusionsDifferent predictors significantly affect psychological antecedents related to COVID-19 vaccine uptake. Therefore, considering the factors, targeted actions based on the findings may help to lower vaccine reluctance and boost vaccination rates.

Seroprevalence of Chikungunya Virus Infection in an Urban Slum Population of Bangladesh: A Cross-Sectional Study

Background: Chikungunya virus is common in Bangladesh. Objective: The aim of the study was to estimate the post-outbreak seroprevalence of chikungunya virus infection in a Bangladeshi urban slum population. Methodology: From April to May 2018, a cross-sectional study was conducted in Bauniabadh, an underprivileged slum area in Mirpur Thana (subdistrict), Dhaka, Bangladesh. Randomly selected residents of this area were interviewed and screened for chikungunya IgM and IgG antibodies in sera using the immunochromatographic process. Results: Randomly selected 403 residents were recruited of which 200 cases were male and 203 cases were female. Chikungunya seroprevalence was 4.7% cases with males being more vulnerable than females (6.5% vs. 3.0% ). People over the age of 60 years were found to be infected at a higher rate (7.2%) than people between the ages of 18 and 59 years (5.5%) and those in the pediatric age group (1%). During the outbreak, 22% of patients with joint pain and 17% with fever were diagnosed as having chikungunya. Conclusion Urban slum people, especially the elderly, are affected by chikungunya outbreak in Bangladesh characterized by fever and joint pain. Journal of Current and Advance Medical Research, January 2022;9(1):3-8

The Right to Water, Law and Municipal Practice: Case Studies from India

Recognition of the right to water in Indian courts has had little impact on the ground. This paper explores the seeming disjuncture between what happens in the court and the everyday reality of living with a less-than-perfect claim on city water services in India’s urban slums. The paper seeks to understand and contextualise a court ruling which looks like it declares a right to water for people in urban slums, but in effect gives them little beyond what they already had. The paper also looks at the ‘everyday reality’ of municipal administration and the provision of drinking water in slums through in-house connections and community taps. In both case studies, the author looks to understand how the practice relates to frameworks of law and policy that shape the rationality and scope of action of the actors concerned, both judges and municipal officials. She found that the issue of land was the main stumbling block in both places, but it was conceptualized a little differently in each situation. These case studies underscore the critical importance of making the local interface between poor people and the state more empowering in order for rights to become local and meaningful.

Realistic personal exposure assessment of air pollutants and health outcomes - A cross-sectional study among Kolkata slum dwellers.

Rapid, unplanned, and unsustainable patterns of urban development can result in many emerging environmental and health hazards. One of the important public health problems of urban environment is regular exposure to dust and pollutants and consequence of such exposure in the form of changes in the pulmonary function. Being the immediate environment, indoor pollution poses a higher risk to human health than the ambient environment. Realistic personal exposure assessment gives the actual idea about the exposure status. This study determined the household principal environmental exposures (Dust, SO2, NO2, and total volatile organic compound) among urban slum dwellers and assessment of the respiratory function to determine any possible relationship between those exposures and outcomes. The study also described the knowledge, attitude, and practice of these urban slum people regarding air pollution and its effect. A cross-sectional study was carried out among 442 urban slum people residing in the slums of the Kolkata Municipal area. Household environmental exposures were collected by standardized methods and outcome was observed by conducting a pulmonary function test. Finally, knowledge, attitude, and practice regarding air pollution were carried out with the help of a questionnaire-based survey. Almost all the pollutants exposure was associated with impairment of lung function. Younger age and female gender were statistically associated protective factors for the development of any lung disease. Those who had an overall good awareness regarding the means and effects of air pollution were found to be protected from developing lung disease. Using exhaust ventilation, relocation to inner side of slums, using personal protective measures, and adequate pollution awareness can help the slum citizens to overcome the problem.

A study on substance abuse among young people (10-24 years) in urban slums of Jorhat, Assam

Objective: To find out the substances abused by the people in urban slums and also find factors contributing to it. Also to recommend suggestions based on the study Material and Methods: It was a community based cross sectional study and data was collected using Interviewers Performa after getting approved by the Institutional Ethics Committee. A sample size of 174 was calculated . Young People (10 to 24yrs) who were willing to participate were included and whose not ready to take part were opted out. Results: It was found that males usually 22 to 24yrs used abusive substances than females. Tobacco was the most common substance abused followed by alcohol and majority had been introduced to the substances by their peers between 17 to 24 yrs. Most people consumed the drug multiple times daily followed by weekly and had procured the drug from local retailers. These substances gave them a sense of hallucination and euphoria on consumption. Among the side effects oral problems like ulcers and malignancy topped the list. Respiratory and gastrointestinal issues along with inability to concentrate on work were other side effects. Conclusions: Based on the results several recommendations were made especially awareness workshops and camps. These programs mainly stressed upon the necessity to create social awareness among the people and their families about the ill effects of substance abuse. All the results were tabulated.

Oral hygiene behaviour and practices of urban slum population: a cross-sectional study

Background: Poor oral hygiene is a major etiological factor for oral diseases. Urban slums are identified as a risk group population as the burden of oral diseases is high among them. So, the aim of the study was to evaluate oral hygiene status among the urban slum population.Methods: A cross-sectional study was carried out on 480 urban slum people aged between 18 to 75 years. A cluster random sampling method was adopted. Data were collected by structured questionnaire. The questionnaire included information related to patient’s knowledge, attitude, and practices related to their oral hygiene. Descriptive statistics were used to analyse the data.Results: The majority of people brushed their teeth once a daily (58.3%) by using a toothbrush and toothpaste (65%) followed by mishri and charcoal. 81.7% of people did not use any other oral hygiene aid. The majority of people did not use interdental aids, tongue cleaner, mouthwash. The majority of people (72%) know the harmful effect of tobacco still they consume various forms of tobacco. The results showed an acute lack of oral hygiene awareness and practices as well as the effect of poor oral hygiene on systemic health.Conclusions: There is a need to educate the urban slum population regarding proper dental care, oral hygiene methods, and prevention of dental diseases through dentists, outreach programs, effective oral health education, and promotion programs to make healthy individuals and healthy society.

PERCEPTION OF INHABITANTS IN URBAN SLUMS OF BOUAKE (COTE D’IVOIRE) ABOUT THE HEALTH RISKS OF UNSANITARY ENVIRONMENTS

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Throughout the world, one-third of the urban population continues to dwell in unplanned neighborhoods mostly located within unhygienic slums. The impact on their health could be far-reaching. The present study, which was cross-sectional, examined the perception of people in urban slums of Bouaké, Cote d’Ivoire vis-à-vis the attendant health risks. Majority of respondents selected for the study had lived within the study area for at least 2 years. Two persons per household were selected for the study; including the head of the household and any other occupant within the ages of 8 and 15 years. Overall, 423 people were interviewed. The median age was 21 years, with an average residency of 14 years. A total of 98.8% of the respondents agreed strongly that living in slums exposed inhabitants to grave health risks. However, only 2.9% agreed that an unsanitary environment contributed to pollution of ambient air. The perception of health risks related to exposure to unsanitary slums was statistically associated with the age (p = 0.0152) and the number of years of residency (p = 0.0156). Although, the survey suggested that living in urban slums exposed inhabitants to health risks especially disease epidemics, the fact that these residences had subsisted for very long periods within these slums changed their perception about acceptability.

Community faecal sludge management strategy among urban slum people of Khulna city-Bangladesh

Community faecal sludge management strategy among urban slum people of Khulna city-Bangladesh

Quality of Life of People in Urban Slums in Indian States

Quality of Life of People in Urban Slums in Indian States

Study of Prevalence of Risk Factors of Obesity and Hypertension among Urban Slum People of Uttar Pradesh

92 male and 80 female patients of obesity were studied. BMI of males was 26 to 30, and in female BMI was 28 to 30. In males 62 (67.3%) and 48 (60%), females were without HTN, in male 30 (32.6%) and 32 (40%) female were with HTN. In males 18(9.5%) were leading sedentary life, 35(38%) were alcoholic 17(18.4%) were smokers, 22(23.9%) were tobacco chewers. In females 38(47.5%) were leading sedentary life, 19(23.7%) were alcoholic 23(28.7%) were tobacco chewers this study urban slum dwells suffering with dual problems of obesity and HTN will certainly help the community medical people to create awareness regarding. risk factors caused by obesity and HTN. As the consequence of risk factors are fatal and cannot be affordable by slum dwellers because of low profile of socio-economic status and Income, moreover slum dwellers work around the clock at the expense of their health which leads to stress and strain, untimely taking food and sleep which are the root cause of HTN and obesity.

Folk Medicinal Use of Plants to Treat Skin Disorders in Chandpur District, Bangladesh

Title: Folk medicinal use of plants to treat skin disorders in Chandpur district, Bangladesh. Background: Folk medicinal practitioners (FMPs) possibly form the largest group of traditional medicinal practitioners in Bangladesh. FMPs essentially use plants for treatment of diseases; however, the selection of plants can differ widely among FMPs even within the same region. The objective of the present study was to document the phytotherapeutic practices of several FMPs in Chandpur district, who treated various types of skin disorders. Methods and findings: Interviews of the FMPs regarding their phytotherapeutic practices were carried out with the help of a semi-structured questionnaire and the guided field-walk method between 2016-2017. The FMPs used a total of 10 plants distributed into 10 families in their 9 formulations. Conclusions: Skin diseases are common in Bangladesh, particularly among the rural and urban slum people. These people most often cannot afford a visit to allopathic doctors. As such, the medicinal plants of the FMPs can prove useful in the treatment of skin disorders.

Prevalence of hypertension and diabetes mellitus at selected urban slums in Bangalore, India: a cross sectional study

Background: Non communicable diseases are increasingly affecting urban slum people. This study was carried out by our institute at the behest of MOHFW, GOI, as a combined initiative with the Director of Health & Family Welfare Services, Karnataka State and Bruhat Bengaluru Mahanagara Palike. The objective of the study was to estimate the prevalence of Hypertension and Diabetes Mellitus among the residents of selected slums of Bangalore. To correlate the association of these morbidities with variables such as overweight/obesity. Methods: Cross-sectional study from October 2010-February 2011. Slums in and around the urban field practice area of Bangalore Medical College and Research Institute (BMCRI), Bangalore, India. One thousand three hundred and six (1306). Sampling method: All slums under BMCRI urban field practice area and few adjacent urban slums chosen at random. People aged more than 30years were pooled in by the local link health workers to the camps. A pre-tested, semi-structured questionnaire was used. Blood pressure (Using sphygmomanometer) and random blood sugar (Glucometer) were measured. Hypertension was classified as per JNC VII criteria and Diabetes as per the ADA guidelines. Results: 1306 subjects participated at the survey. 255 were males and 1051 were females. Average age being 51.88+20 years. 209 (16%) subjects were using tobacco in any forms. 88 (6.7%) subjects had family H/O Diabetes and 46 (3.5%) had Hypertension in the family. 417 (31.92%) were found to be having Diabetes and 247 (18.9%) were diagnosed as hypertensives. 147 (11.2%) subjects were having both Diabetes and hypertension. Conclusions: The reason for high prevalence of the morbidities seemed to be lack of awareness regarding health care seeking and lack of compliance to treatment. Subjects with diagnosed morbidities were given health education and referred to higher center for further management.

English

BACKGROUND: Non communicable diseases are increasingly affecting urban slum people. This study was carried out by our institute at the behest of MOHFW, GOI, as a combined initiative with the Director of Health & Family Welfare Services, Karnataka State and Bruhat Bengaluru Mahanagara Palike. OBJECTIVES: To estimate the prevalence of Hypertension and Diabetes Mellitus among the residents of selected slums of Bangalore. To correlate the association of these morbidities with variables such as overweight/obesity. MATERIALS AND METHODS: Study design: Cross-sectional study. STUDY DURATION: October 2010-Feb. 2011. STUDY SETTING: Slums in and around the urban field practice area of Bangalore Medical College and Research Institute (BMCRI). Study sample: one thousand three hundred and six (1306). SAMPLING METHOD: All slums under BMCRI urban field practice area and few adjacent urban slums chosen at random. METHODOLOGY: People aged more than 30years were pooled in by the local link health workers to the camps. A pre-tested, semi-structured questionnaire was used. Blood pressure (Using sphygmomanometer) and random blood sugar (Glucometer) were measured. Hypertension was classified as per JNC VII criteria and Diabetes as per the ADA guidelines. RESULTS: 1306 subjects participated at the survey. 255 were males and 1051 were females. Average age being 51.88+20 years. 209(16%) subjects were using tobacco in any forms. 88(6.7%) subjects had family H/O Diabetes and 46(3.5%) had Hypertension in the family. 417(31.92%) were found to be having Diabetes and 247(18.9%) were diagnosed as hypertensives. 147(11.2%) subjects were having both Diabetes and Hypertension. CONCLUSION: The reason for high prevalence of the morbidities seemed to be lack of awareness regarding health care seeking and lack of compliance to treatment. Subjects with diagnosed morbidities were given health education and referred to higher center for further management.

Current state and trends of access to sanitation in Ethiopia and the need to revise indicators to monitor progress in the Post-2015 era.

BackgroundInvestigating the current level and trends of access and identifying the underlying challenges to sanitation system development will be useful in determining directions developing countries are heading as they plan to promote sustainable development goals (post 2015 agenda). This research investigates the status and trends of access to improved sanitation coverage (ISC) in relation to the MDG target in Ethiopia with the aim of identifying prevailing constraints and suggesting the way forward in the post-MDG era.MethodWe examined data from a nationwide inventory conducted in accordance with the sanitation ladder at the national level and from a household survey in randomly selected urban slums in Addis Ababa. The inventory data were analyzed and interpreted using the conceptual model of the sanitation ladder. We used administrative reports and survey results to plot the time trend of the ISC.ResultsThe data from the nationwide inventory of sanitation facilities, which are presented along the sanitation ladder reveal that more than half of the Ethiopian population (52.1%) still used unimproved sanitation facilities in 2014. The majority (35.6%) practiced open defecation, implying that the country is far from the MDG target for access to improved sanitation (56%). Most people in urban slums (88.6%) used unimproved sanitation facilities, indicating that the urban poor did not receive adequate sanitation services. Trend analysis shows that access to ISC has increased, but Central Statistical Authority (CSA) data reveal a decline. This discrepancy is due to differences in data collection methods and tools. Dry pit latrines are the most widely used toilet facilities in Ethiopia, accounting for about 97.5% of the ISC.ConclusionThe sanitation coverage is far from the MDG target and the majority of the population, mainly the urban poor, are living in a polluted environment, exposed to water and sanitation-related diseases. The sanitation coverage estimates might be even lower if proper utilization, regular emptying, and fecal sludge management (FSM) of dry pit latrines were considered as indicators. In order to enhance sanitation services for all in the post-MDG era, urgent action is required that will establish proper monitoring and evaluation systems that can measure real access to ISC.

Material Deprivation Affects High Sexual Risk Behavior among Young People in Urban Slums, South Africa

Young people in urban slums adopt HIV risk behaviors influenced by their neighborhood factors. Three critical factors in urban slums of Southern and Eastern Africa--the region most affected by the HIV epidemic in the world--are unmet needs of housing, food, and health care, which are associated with HIV sexual risks. Yet, there has been limited attention on how the combination of unmet needs of housing, food, and health care--i.e., material deprivation-relates to sexual risk behavior among young people in urban slums. Cross-sectional data were extracted from the LoveLife survey in South African four provinces--KwaZulu Natal, Mpumalanga, Eastern Cape, and Gauteng, to examine the association between material deprivation and sexual risk behavior among young people aged 18-23 years (263 males, 267 females) in urban slums. Adjusted logistic regression models showed that material deprivation was significantly associated with increased odds of high sexual risk taking for young men (adjusted OR = 1.20; 95 % CI = 1.10, 5.58) and young women (adjusted OR = 1.43; 95 % CI = 1.35, 3.28). Financial difficulty--a proxy for other deprivations--was the most salient influence on young women's high sexual risk taking (adjusted OR = 2.11; 95 % CI = 1.66, 2.70). Localized behavioral HIV prevention interventions should target young people in deprived households.

Mortality Trends Observed in Population-Based Surveillance of an Urban Slum Settlement, Kibera, Kenya, 2007–2010

BackgroundWe used population based infectious disease surveillance to characterize mortality rates in residents of an urban slum in Kenya.MethodsWe analyzed biweekly household visit data collected two weeks before death for 749 cases who died during January 1, 2007 to December 31, 2010. We also selected controls matched by age, gender and having a biweekly household visit within two weeks before death of the corresponding case and compared the symptoms reported.ResultsThe overall mortality rate was 6.3 per 1,000 person years of observation (PYO) (females: 5.7; males: 6.8). Infant mortality rate was 50.2 per 1000 PYOs, and it was 15.1 per 1,000 PYOs for children <5 years old. Poisson regression indicates a significant decrease over time in overall mortality from (6.0 in 2007 to 4.0 in 2010 per 1000 PYOs; p<0.05) in persons ≥5 years old. This decrease was predominant in females (7.8 to 5.7 per 1000 PYOs; p<0.05). Two weeks before death, significantly higher prevalence for cough (OR = 4.7 [95% CI: 3.7–5.9]), fever (OR = 8.1 [95% CI: 6.1–10.7]), and diarrhea (OR = 9.1 [95% CI: 6.4–13.2]) were reported among participants who died (cases) when compared to participants who did not die (controls). Diarrhea followed by fever were independently associated with deaths (OR = 14.4 [95% CI: 7.1–29.2]), and (OR = 11.4 [95% CI: 6.7–19.4]) respectively.ConclusionsDespite accessible health care, mortality rates are high among people living in this urban slum; infectious disease syndromes appear to be linked to a substantial proportion of deaths. Rapid urbanization poses an increasing challenge in national efforts to improve health outcomes, including reducing childhood mortality rates. Targeting impoverished people in urban slums with effective interventions such as water and sanitation interventions are needed to achieve national objectives for health.