Poor Urban Settlements Research Articles

Monitoring of Health and Demographic Outcomes in Poor Urban Settlements: Evidence from the Nairobi Urban Health and Demographic Surveillance System

The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was set up in Korogocho and Viwandani slum settlements to provide a platform for investigating linkages between urban poverty, health, and demographic and other socioeconomic outcomes, and to facilitate the evaluation of interventions to improve the wellbeing of the urban poor. Data from the NUHDSS confirm the high level of population mobility in slum settlements, and also demonstrate that slum settlements are long-term homes for many people. Research and intervention programs should take account of the duality of slum residency. Consistent with the trends observed countrywide, the data show substantial improvements in measures of child mortality, while there has been limited decline in fertility in slum settlements. The NUHDSS experience has shown that it is feasible to set up and implement long-term health and demographic surveillance system in urban slum settlements and to generate vital data for guiding policy and actions aimed at improving the wellbeing of the urban poor.

Access of urban poor to NGO/CBO-supplied sanitation and solid waste services in Uganda: The role of social proximity

Inadequate urban sanitation and solid waste management in Uganda has prompted policy reforms in the two sectors. As part of this reform, non-governmental organizations (NGOs) and community-based organizations (CBOs) have increasingly become involved in improving the sanitation and solid waste situation in poor urban informal settlements. This paper investigates whether social proximity influence access of the urban poor to sanitation and solid waste services provided by NGOs and CBOs. Using a sample of 337 households from 12 poor informal settlements in Kampala, social proximity in addition to other conventional factors proved relevant in explaining access of the poor to NGO and CBO solid waste and sanitation services.

Patterns and determinants of communal latrine usage in urban poverty pockets in Bhopal, India

To explore and explain patterns of use of communal latrine facilities in urban poverty pockets. Six poverty pockets with communal latrine facilities representing two management models (Sulabh and municipal) were selected. Sampling was random and stratified by poverty pocket population size. A seventh, community-managed facility was also included. Data were collected by exit interviews with facility users and by interviews with residents from a randomly selected representative sample of poverty pocket households, on social, economic and demographic characteristics of households, latrine ownership, defecation practices, costs of using the facility and distance from the house to the facility. A tally of facility users was kept for 1 day at each facility. Data were analysed using logistic regression modelling to identify determinants of communal latrine usage. Communal latrines differed in their facilities, conditions, management and operating characteristics, and rates of usage. Reported usage rates among non-latrine-owning households ranged from 15% to 100%. There was significant variation in wealth, occupation and household structure across the poverty pockets as well as in household latrine ownership. Households in pockets with municipal communal latrine facilities appeared poorer. Households in pockets with Sulabh-managed communal facilities were significantly more likely to own a household latrine. Determinants of communal facility usage among households without a latrine were access and convenience (distance and opening hours), facility age, cleanliness/upkeep and cost. The ratio of male to female users was 2:1 across all facilities for both adults and children. Provision of communal facilities reduces but does not end the problem of open defecation in poverty pockets. Women appear to be relatively poorly served by communal facilities and, cost is a barrier to use by poorer households. Results suggest improving facility convenience and access and modifying fee structures could lead to increased rates of usage. Attention to possible barriers to usage at household level associated particularly with having school-age children and with pre-school childcare needs may also be warranted.

Timing and Sequencing of Events Marking the Transition to Adulthood in Two Informal Settlements in Nairobi, Kenya

Young people living in poor urban informal settlements face unique challenges as they transition to adulthood. This exploratory paper uses retrospective information from the baseline survey of a 3-year prospective study to examine the timing and sequencing of four key markers (first sex, marriage, birth, and independent housing) of the transition to adulthood among 3,944 adolescents in two informal settlements in Nairobi city, Kenya. Event history analysis techniques are employed to examine the timing of the events. Results indicate that there is no significant gender difference with regard to first sexual debut among adolescents. For many boys and girls, the first sexual experience occurs outside of marriage or other union. For males, the sequencing of entry begins with entry into first sex, followed by independent housing. Conversely, for females, the sequencing begins with first sex and then parenthood. Apart from sexual debut, the patterns of entry into union and parenthood do not differ much from what was observed for Nairobi as a whole. The space constraints that typify the two slums may have influenced the pattern of leaving home observed. We discuss these and other findings in light of their implications for young people’s health and well-being in resource-poor settings in urban areas.

Microbiological quality of water from hand-dug wells used for domestic purposes in urban communities in Kumasi, Ghana

Assessment was done on the microbiological quality of water in hand-dug wells in urban communities in Kumasi, Ghana. A total of 256 water samples were taken from eight wells and examined for faecal coliforms, enterococci and helminths. High contamination levels were recorded in the wells, more so in the wet season, with faecal coliforms levels between 6.44 and 10.19 log units and faecal enterococci between 4.23 and 4.85 CFU per 100 ml. Influence on protection and lining of wells on water quality was not pronounced but mechanization reduced contamination significantly by about 3 log units. This study shows a stronger influence of poor sanitation and improper placement of wells on water quality compared to improvements made from lining and protection of wells. In the race to increase access to drinking water in poor urban settlements, quality of groundwater could be a major barrier, if provision of drinking water is not matched with improvements in sanitation and urban planning.

A Study on the Urban Residence in Changchun City, China with Special Reference to the Transition of Urban Poor Settlement from 1997 to 2007

A Study on the Urban Residence in Changchun City, China with Special Reference to the Transition of Urban Poor Settlement from 1997 to 2007

Empowering the Urban Poor to Solve their Sanitation Problem

SANIMAS (Sanitasi oleh Masyarakat) or Sanitation by Community is a nation-wide sanitation program for urban poor settlements in Indonesia and has already been implemented since 2003. Population density in urban settlement range between 600 to more than 1000 people per square km, which provides no room for proper sanitation infrastructures. The decentralized, communal, community-managed and cluster wise approach to solve sanitation problems in such high density has many types of challenges: technical, environmental, social and financial. Therefore there is the need to have concerted efforts for a careful yet reliable, high quality standard design, good supervision, sustainable operation and maintenance, as well as for continual monitoring and improvements. In the past, water and sanitation facilities in urban poor settlements were built for quantity and appearance not for quality and performance. As a result most of the infrastructures collapse and disfunction only a couple of months after the construction has been handed over to the community. Leaking or bottomless septic tanks are usually the reality and lack of maintenance is a common problem as no community committee is assigned to oversee or monitor the facilities. As a national program, SANIMAS is implemented in more than 70 urban poor community clusters or approximately 8,000-10,000 people every year which previously identified as unserved population. It is implemented in sequences of activities and accomplished only by good team work, guided by standardized steps. All team members, coordinators, field facilitators, technical team, relevant government officers and community committees must build and maintain good coordination and communication. Several capacity building packages are designed for and delivered to different groups to ensure that implementation steps are understood by the relevant team members. Various training modules are developed and delivered to technical teams, senior facilitators, field facilitators and community committees. Each training aims at communicating the minimum standard activities required to accomplish the program. To ensure that facilities serve their function in a sustainable way, a monthly community participatory monitoring has been designed. That way technical, environmental, financial and institutional aspect is mainly monitored by the community in assistance of team members. The monitoring results are used as inputs for improvement, local policy development and strategy. This paper shows that through the decentralised sanitation approach, a sustainable sanitation service for the poor is possible.

Social effects of poor sanitation and waste management on poor urban communities: a neighborhood‐specific study of Sabon Zongo, Accra

This paper provides a neighborhood‐specific study of the social effects of poor sanitation in a poor neighborhood in a developing country city, Accra. It examines the challenges of rapid urbanization with respect to sanitation and waste management, and the burdens placed on poor urban residents in Sabon Zongo, a poor community in Accra. Like many poor communities in Accra and other large Ghanaian cities, residents of Sabon Zongo unable to queue and pay for sanitation services tend to package their liquid and solid waste in plastic bags and dump them indiscriminately within the community. The paper argues that the inability of city authorities to deal with sanitation and waste management in the poor urban community of Sabon Zongo go beyond the much discussed issue of health. This is because the inadequacy of sanitation and waste management in this particular poor urban settlement also has social implications. The paper concludes that while slums and poor urban communities may exhibit certain similar characteristics, they are not homogenous. Neighborhood‐specific research such as the present study on Sabon Zongo offers opportunities for analyzing and understanding the internal dynamics, and the key stakeholders at the community level – critical conditions for tapping into the energies of residents toward addressing the challenges of sanitation and waste management in poor urban communities in Accra.

Comparing Clinic Retention Between Residents and Nonresidents of Kibera, Kenya

Comparing Clinic Retention Between Residents and Nonresidents of Kibera, Kenya

Vers l'institutionnalisation d'une délégation communautaire ?

This paper investigates the potential segmentation and building of hybrid management systems for urban water utilities in low-income countries. It analyses a unique water supply experiment for poor urban settlements in the city of Port-au-Prince, which combined a bulk water meter connection to the public water network and delegated management of water distribution to the local community. Using neo-institutional economics as a reference, the paper analyses implemented tools, as well as the processes and progressive methods applied which allowed for the institutional establishment and stabilization of this hybrid system. Finally, the paper highlights the limitations of institutional sustainability for the establishment of the water utility in the context of a weak state, further exacerbated in the aftermath of the devastating earthquake which occurred on the 12th January, 2010.

How does AIDS illness affect women's residential decisions? Findings from an ethnographic study in a Cape Town township

This paper explores the nature and consequences of residential decision-making for women on treatment for AIDS illness in a poor urban settlement in South Africa. Drawing on ethnographic data collected over a two-year period, it points to the subtle shifts in ‘householding’ practices and kinship relationships prompted by women's individual experiences and understanding of their HIV status, illness and treatment. Women's decisions to move or to arrange that other family members move can be explained by pre-existing threats to individual wellbeing or family residential security. But an HIV diagnosis can intensify a mother's thoughts and actions in relation to residential and emotional security, in particular on behalf of her children. In a context where extended periods of childcare by rural relatives is common, mothers with AIDS illness may gather all their children in their home to offer direct care, achieve intimacy and facilitate disclosure. They are likely to avoid making frequent contact with, and demands on, their elderly parents. Siblings are favoured as co-residents and confidants in disclosure, but their long-term support is contingent on reciprocity. Partners, where present, are valued for economic, social and emotional security. Women attempt to balance their children's nurturing, in the short and long term, with care of the self. Their efforts do not always succeed and can incur high costs to their wellbeing and relationships with their children.

Shifting spaces of power in Metro Manila

In this paper, the author argues that to preserve their primacy and dominance, national capitals construct and assert representations and projects of power before the nation and the world. Metro Manila or the national capital region (NCR) serves as the major locus and staging area of capital building strategies and assertions by the state and elite power as well as by the resistance of subaltern groups. The ways that flows of transnational capital, politics, and ideas are organized and channeled into the capital’s spatial and social fabric are mediated by local and national politics. In the Philippines, three major forces have shaped the process of capital city building and assertion during the past two decades, namely: (1) the decentralization of national government functions to the local government units of cities, municipalities, and provinces; (2) the democratization of socio‐political life; and the (3) nation’s bid to be globally competitive where its major insertion to the global economy is anchored on labor migration, business process outsourcing services, and light export‐oriented industries. These processes have raised questions regarding the quality of life and sustainability of the NCR, posing challenges to its continuing dominance, desirability, and representation of the nation‐state. In international media, contradicting images of high‐rise buildings in the financial district and urban poor settlements are presented to highlight these issues. These contradictions have presented erosions and challenges to the national capital’s project of hegemony and dominance, in part because of the multiple ways that state power, capital, and democratic movements have become decentralized (multi‐sited), heterogeneous, and porous. These processes are reflected in the shifting spaces, symbols, and representations of power in, and of, the national capital.

Homeless street children in Nepal: Use of allostatic load to assess the burden of childhood adversity

As challenges to child well-being through economic disadvantage, family disruption, and migration or displacement escalate world wide, the need for cross-culturally robust understanding of childhood adversity proportionately increases. Toward this end, developmental risk was assessed in four contrasting groups of 107 Nepali children ages 10-14 years that represent distinctive, common conditions in which contemporary children grow up. Relative cumulative burden (allostatic load) indexed by multiple dimensions of physical and psychosocial stress was ascertained among homeless street boys and three family-based groups, from poor urban squatter settlements, urban middle class, and a remote rural village. Biomarkers of stress and vulnerability to stress included growth status, salivary cortisol, antibodies to Epstein-Barr virus, acute phase inflammatory responses (alpha1-antichymotrypsin), and cardiovascular fitness and reactivity (flex heart rate and pressor response). Individual biomarkers of risk and allostatic load differed markedly among groups, were highest in villagers, and varied by components of allostatic load. Such data suggest a need for critical appraisal of homelessness and migration as a risk factor to youth, given prevailing local conditions such as rural poverty, and represents the only multidimensional study of childhood allostatic load and developmental risk in non-Western settings.

An Analysis of the Etiology of Anemia and Iron Deficiency in Young Women of Low Socioeconomic Status in Bangalore, India

Anemia and iron deficiency are significant public health problems in India, particularly among women and children. Recent figures suggest that nearly 50% of young Indian women are anemic. Few studies have comprehensively assessed etiologic factors contributing to anemia and iron deficiency in India. Hence, this study assessed the relative importance of various factors contributing to these problems in young women of low socioeconomic status in Bangalore, India. A random sample of 100 nonpregnant, nonlactating women 18 to 35 years of age, selected from among 511 women living in a poor urban settlement, participated in this study. Data were obtained on demography, socioeconomic status, anthropometry, three-day dietary intake, blood hemoglobin, hemoglobinopathies, serum ferritin, serum C-reactive protein, and stool parasites. The prevalence rates of anemia and iron deficiency were 39% and 62%, respectively; 95% of the anemic women were iron deficient. The mean dietary iron intake was 9.5 mg per day, predominantly from the consumption of cereals, pulses, and vegetables (77%). The estimated bioavailability of nonheme iron in this diet was 2.8%. Dietary intakes were suboptimal for several nutrients. Blood hemoglobin was significantly correlated with dietary intake of fat, riboflavin, milk and yogurt, and coffee. Serum ferritin was significantly correlated with intake of niacin, vitamin B12, and selenium. Parasitic infestation was low. An inadequate intake of dietary iron, its poor bioavailability, and concurrent inadequate intake of dietary micronutrients appear to be the primary factors responsible for the high prevalence of anemia and iron deficiency in this population.

Communities’ Environment Improvement Network: Strategy and Process toward Sustainable Urban Poor Housing Development

“Baan Mankong” program is presently the government’s major policy in urban poor housingdevelopment in Thailand, undertaken by Community Organization Development Institute (CODI). The mainstrategy of the program is to upgrade living conditions, secure tenure as well as community capacitybuilding through communities’ self-proposed projects and people participation process. This paper isderived from the experience in the development practice of a case study on Bang Bua canal in Bangkok,where on both sides of the waterfront are presently illegally occupied by a group of neighborhoods. Thesecommunities have invaded into public land and settled their housing trespassing into the canal. Theprevious attempts by the local authority to evict the waterfront urban poor communities, for being thecause of water pollutions and other associated environmental problems, had led to a long conflict in urbandevelopment.
 To achieve the goals of sustainable community development, it is vital that not only the coreproblems of urban poor housing such as the lack of secure tenure and development funding are systematicallysolved, but also to evoke residents’ participation and people awareness on environment related issues.The Bang Boa community development scheme under the “Baan ManKong” program is expected to highlightinitial guidelines and strategies for urban poor settlements’ redevelopment of other waterfront area ofBangkok. This paper will discuss how the process of community capacity building and empowerment havebeen undertaken and will be initiated, particularly in establishing various networks as a significantdevelopment strategy.

Stunting among young black children and the socio-economic and health status of their mothers/caregivers in poor areas of rural Limpopo and urban Gauteng – the NutriGro Study

Objectives. To determine the prevalence and immediate and underlying causes of stunting in black children aged 12 - 24 months living in rural and urban South Africa.Design. A cross-sectional survey.Setting. Two poor rural villages in Limpopo and two poor urban informal settlement areas in Atteridgeville, Gauteng.Population. All households with mothers/caregivers (M/Cs) of children aged 12 - 24 months in the selected areas. All households meeting the inclusion criteria in the urban areas ( N = 380) and in the two rural villages ( N = 156) were included in the sample.Methods. Trained interviewers collected data using a standardised socio-demographic questionnaire. Heights and weights of M/Cs and their children were measured. Stunting was defined as a z-score less than -2 for height for age. Body mass index (BMI) values were calculated for the M/C. Data were analysed using a stepwise logistical regression analysis.Results. A stunting rate of 18% was documented in the rural areas, with a difference of 8% between the two villages, and 19% in the urban areas. Statistically significant associations were found between low birth weight and stunting ( p = 0.0073). Households with stunted children were significantly larger than households with non-stunted children ( p = 0.0156). Stunted children were introduced to solid foods significantly earlier than nonstunted children ( p = 0.0415).Conclusions and recommendations. Similar prevalences of stunting were found in the urban and rural areas. Of the multifactorial causes of stunting, low birth weight, early complementary feeding and large household size were significantly associated with stunting. The data collected during this phase of the NutriGro Study will be the focus for all future community-based nutrition interventions.

Childcare in poor urban settlements in Swaziland in an era of HIV/AIDS

This paper explores the role of the family in caring for orphans and other children in poor urban communities having some of the highest levels of HIV/AIDS prevalence in the world. A range of family forms in Swaziland was found to be caring for orphans. Child-headed households and lone-elderly carers were not the most common; maternal kin played a more important role in orphan care than did paternal kin, indicating both stresses due to AIDS and the dynamic nature of the family. Women of all ages were bearing the brunt of the extra care responsibilities caused by the epidemic. There was limited involvement in children's well-being by agencies of any kind and orphan care remained largely situated within kin structures. The AIDS epidemic was impacting on families in a variety of ways, with a corresponding increase in poverty and vulnerability. Carers did not perceive orphans as a separate category of children requiring assistance over and above any other vulnerable child. Families require assistance at the household, community and national level. Meanwhile, community-based initiatives were poorly developed. Welfare sector policies should strengthen the family model of childcare by increasing support to the poorest families rather than treating orphans as a separate category of vulnerable children and thereby excluding other needy children.

Sanitation in Urban Poor Settlement and the Importance of Education for the Reduction of the Diffused Pollution - A Case Study of Bauniabad, Bangladesh

Many people in the world still cannot access to the appropriate sanitation. To halve this population is the global target. In Bauniabad, which is one of the poor settlements in Dhaka, Bangladesh, small-scale biogas plants connected to the latrines of about 100 households have been installed as a sanitation option. The purpose of this study is to clarify the background of how the local people came to use the biogas plant for sanitation purpose, and to examine the performance of the biogas plant for the reduction of the pollution load to the surrounding water bodies. The questionnaire to the local people about their behaviors regarding sanitation was conducted to know the change of their attitudes and the situation of their living environment before and after the installation of the sanitation options. The water quality analysis was conducted to review the performance of the biogas plant. From the questionnaire, it was revealed that the hygiene condition of the latrines was improved after the connection to the biogas plants. On the other hand, from the water quality analysis, it was revealed that the anaerobic digestion of the biogas plants did not work sufficiently good due to lack of maintenance.

Factores que contribuyen al éxito o fracaso de proyectos comunitarios experiencias en el barrio Pogolotti, La Habana, Cuba

The paper presents a personal and selective version of a research project in the Havana barrios just completed by an international group of urban researchers. The research examined the contributions of several factors to the success or the failure of community projects in poor urban settlements. This version examines the “origin of the projects”, as a factor that might influence the destiny of initiatives carried out in Pogolotti, a settlement characterized by poor living, particularly housing, conditions. The paper describes the difficult context in which urban processes take place in today’s Cuba. It then examines the measures adopted to stimulate the participation of the community in projects directed not only to ameliorate the material conditions in the barrios but also to express cultural and artistic values and to further the respect and solidarity amongst residents. Pogolotti was the first working class settlement built in Cuba at the start of the 20th Century. The paper presents it through its history, its people, and through a number of projects - some successful and some that failed – that show the creativity of a civil society living difficult times and how public institutions respond to critical demands.

Water, sanitation and urban children: the need to go beyond “improved” provision

This paper reviews the implications of inadequate provision of water and sanitation for children’s health and general development, especially in urban areas. Research into health differentials shows that child mortality and morbidity rates in poor urban settlements can equal or exceed those in rural areas. This review considers, in particular, the higher vulnerability of children to sanitation-related illness, the links between unsanitary conditions and malnutrition, the impacts for mental and social development, and the practical day-to-day realities of poor provision for children and their caregivers in urban areas. It argues that health education and health care, while essential complements to proper provision, can in no way be considered alternative solutions. The true costs for children of a failure to respond to this ongoing emergency lend another dimension to discussions of the cost-effectiveness of various solutions.