Slum Residents Research Articles

Navigating the Lay Referral System for Treatment-Seeking Decisions During Illness in the Digital Age: A Qualitative Study of Adults Living in Slums in Nigeria.

Interaction with a lay referral system (informal networks that provide health advice during illness) influences the treatment-seeking decisions of individuals with perceived healthcare needs. We examined how this occurred in urban slums in Nigeria with scarce formal healthcare and unstable social networks. Using existing theories of social networks and lay referral, we examined the use of these systems for treatment-seeking decisions in slums, including the use of digital technologies. We interviewed 30 adults (aged 18-64) of diverse age, gender, network size and use of digital technologies for health advice in two Nigerian slums. We analysed the data using a thematic inductive-deductive approach. Lay referral was multidimensional: discussion of illness during daily bonding, social demonstration of self and purposeful exchange of support. People limited lay referrals to a few family members and friends, avoiding wider interactions due to mistrust. Use of online sources was scarce due to limited access to smart devices and low digital health literacy. Lay referral motivated timely care seeking but also facilitated unhelpful advice. Slum residents were agentic in their use of their lay referral system. The effectiveness of their agency may be improved if trusted and reliable health advice sources are available in addition to their social network.

Urban slum housing quality, and its public health implications in Nigeria: a case of urban slum residents in Enugu metropolis, South East, Nigeria

IntroductionHousing remains a strategic social determinant of health. In Sub-Saharan Africa, most urban dwellers live in slums with attendant health implications. This study assessed the housing conditions of the slums of Enugu metropolis and the public health implications.MethodsThis is a community-based cross-sectional study of 459 slum residents of the Enugu metropolis. Ethical clearance was obtained from the UNTH, Health Research Ethics Committee (HREC). Data was collected using a pretested semi-structured interviewer-administered questionnaire and an observational checklist. Data was analysed using IBM SPSS version 23. Data were summarised using mean and standard deviation, frequency and proportion as appropriate and presented in tables and figures. The chi-square test was used for association at p-value ≤ 0.05 significance.ResultsThe mean age (SD) of the respondents was 32.93(12.34) years. A higher proportion (N = 180, 39.2%) were 18-27years, females (N = 282, 61.4%), married (N = 297, 64.7%), attained secondary education (N = 273, 59.5%), Igbo (N = 453, 98.7%), and self-employed (N = 327, 71.2%). They demonstrated good knowledge of standard housing specifications (N = 231, 50.3%) and the effects of housing conditions on health (N = 297, 64.7%). Also, most lived in a one-room apartment (N = 201, 43.8%) and cooked in a separate kitchen (N = 150, 32.7%) with a gas cooker as the major source of heat supply for cooking (N = 249, 54.2%). Sixty-three (13.7%) of the respondents didn’t have access to suitable toilet facilities. A higher proportion, (N = 171, 37.3%) used pipe-borne water, and electricity as the major source of light (N = 447, 97.4%). The most prevailing health condition was malaria/fever (N = 258, 97.4%). Despite having pests and rodents-infested dwellings, only (N = 156, 34.0%) had insecticides in the house. Equally, (N = 132, 28.8%) of them lived with broken floors.ConclusionsDespite good knowledge of the public health implications of poor housing, most dwellings remained substandard and unhealthful with associated prevalent health conditions.RecommendationThere is a need for a health campaign against the poor living conditions in the slums.

Holistic mapping of flood vulnerability in slums areas of Yaounde city, Cameroon through household and institutional surveys

Urbanization in major cities has resulted in increasing urban slum expansion. This, together with increased climate-change-driven hazards, and deplorable slum characteristics has led to considerably higher flood impacts in slum settlements. As such, there is a need for specialized flood vulnerability assessment tools that integrate features specific to the urban slums. Studies have consecrated efforts to integrated and multidimensional flood vulnerability studies. However, assessments that include social, economic, structural, and institutional realities of the slum settlements are rare in developing countries. This study comprehensively assessed the flood vulnerability in urban slums. It offers a simplified perspective of vulnerability in urban slums, capturing data from slum inhabitants, local councils, experts, and local NGOs since they often have profound insights into essential service availability, access, and quality within the study area. Utilizing data encompassing 40 indicators (exposure, susceptibility, and resilience), we assess the physical/structural, social, and economic/psychological vulnerability indices for slum households and the institutional vulnerability of 41 entities. Despite significant challenges of poor infrastructure and lack of basic disaster management tools, slum residents have developed recognizable strategies to overcome flooding. Institutions carrying out intervention activities in the slums were largely incompetent and plagued with challenges ranging from lack of technical know-how to access to funds and coordination. Finally, a significant gap exists between state efforts and the impacts of these efforts on the residents of these slums. These findings complement household-level data and provide an expanded understanding of vulnerability patterns, thus informing policymakers about interventions.

Understanding one health challenges in marginalized urban settings: A patient and public involvement (PPI) approach from the CHIP consortium activities across four global cities

BackgroundSlum communities face health risks influenced by environmental, human, and animal health factors, particularly antimicrobial resistance (AMR). Tailored, community-driven solutions are needed to address these multifactorial health determinants. This study explores One Health challenges in urban slums using a Patient and Public Involvement (PPI) approach. ObjectivesThis study aims to use qualitative methods within a PPI framework to examine the social, environmental, and animal health factors contributing to AMR and other health challenges in urban slums. Focusing on One Health, we engaged slum residents in Jaipur, Jakarta, Antofagasta, and Istanbul through participatory approaches like social mapping and transect walks to identify health risks and develop intervention strategies. MethodsA PPI approach was employed to involve communities in the research process, ensuring culturally relevant insights. Data collection included social mapping, transect walks, and key informant interviews in the four cities, highlighting critical health determinants such as environmental contamination, healthcare access, and animal-related risks. Thematic analysis identified common challenges and intervention opportunities within the One Health framework. ConclusionThe study underscores the importance of PPI in addressing One Health challenges in urban slums and reveals interconnected human, environmental, and animal health risks. Engaging communities fostered trust and provided locally relevant solutions to complex health issues like AMR. Future interventions should be co-designed with communities to address social determinants like sanitation and healthcare access for sustainable outcomes.

Conquerors of poverty – a case study of Colombo slum dwellers

PurposeWhile extensive research has explored poverty in various dimensions, there remains a notable dearth of studies focusing on success stories of slum dwellers overcoming adversity. This research seeks to address this gap by investigating the strategies employed by individuals to transcend poverty. Moreover, it evaluates the practicality and effectiveness of existing theories in real-world contexts through careful interpretation.Design/methodology/approachData were gathered from two distinct cases through comprehensive, in-depth interviews. These narratives were subjected to scrutiny employing the Description Analysis Interpretation method. Subsequent interpretation and theoretical exploration were guided by Bourdieu’s class theory. The overarching goal was to shed light on the remarkable journeys of specific slum residents who surpassed the constraints of poverty. This endeavor not only highlighted the practical efficacy of these theories but also underscored their relevance in illuminating real-world scenarios through interpretation.FindingsThe findings underscore the capacity of slum dwellers to rise above poverty, thereby emphasizing the practical utility of specific theories aimed at poverty alleviation in elucidating their experiences. Notably, social capital, a cornerstone of Bourdieu’s class theory, emerges as equally pivotal as economic capital in shaping individuals' trajectories.Research limitations/implicationsThe study’s scope is confined to narratives within the Colombo slums, offering a platform for future researchers to extend their investigations beyond this context. By employing alternative methodologies and exploring diverse geographical regions, scholars can broaden their understanding of poverty alleviation strategies and their applicability across varied socioeconomic landscapes. This calls for wider research for comprehensive exploration and comprehension of poverty dynamics beyond singular locales.Practical implicationsThe study provides invaluable insights for policymakers, governmental bodies and nongovernmental organizations, urging them to reconsider and reformulate policies, educational strategies and community development programs tailored to the needs of slum dwellers and their children. These insights offer a pathway toward more effective interventions aimed at fostering sustainable upliftment within these marginalized communities.Originality/valueThis research fills a critical gap in poverty literature by exploring success stories of slum dwellers overcoming adversity, an area often overlooked. It uniquely investigates the strategies these individuals employ to transcend poverty, offering fresh insights into the practical application of poverty alleviation theories. Utilizing Bourdieu’s class theory, the study highlights the importance of both social and economic capital in these success narratives. By focusing on real-life experiences, it underscores the relevance and utility of these theories in real-world contexts, enriching the theoretical discourse and providing valuable perspectives for policymakers and practitioners.

Misalignments in prepaid water technology: findings from urban poor settings of Kampala, Uganda

ABSTRACT Progressive urban water utilities in developing countries have, since the mid-2000s deployed prepaid dispensers (PPDs) to provide reliable and equitably priced water services to slum residents. This paper reports on a study that evaluates the performance of the PPDs first deployed in the slums of Kampala in 2006 by the National Water and Sewerage Corporation (NWSC), Uganda's main urban water utility. By February 2020, over 1,400 PPDs were installed in 20 slums, serving residents through over 33,000 access tokens. Data were collected in 2019/2020 through 275 household questionnaires, 17 key informant interviews, and 8 focus group discussions. The main finding was that although the PPD technology has achieved a relatively high diffusion rate, water drawn therefrom was an average of a paltry 7 litres per capita per day, meaning that many slum residents still rely on other water sources of doubtful quality. Key misalignments include misappropriation by local middlemen, who inflate the prices; high levels of technical malfunctions; and the utility's overreliance on international development financing for asset maintenance and expansion. NWSC should mainstream the pro-poor service department and build the necessary capabilities to ensure better technical functionality of the PPDs, including setting up smart partnerships where necessary.

Patronage Pattern and Accessibility of Healthcare Facilities in Urban Slums and Informal Settlements in Ibadan Metropolis

Slums and informal settlements are residential areas physically and socially disintegrated. In spite of this, inadequate health-related data on slum areas and informal settlements has led to inappropriate and unrealistic allocation of healthcare resources by the public and private health providers. This study investigates the patronage pattern and accessibility of healthcare facilities to residents of urban slums and Informal settlements in Ibadan Metropolis, a rapidly growing urban area in Nigeria facing challenges related to urbanization and healthcare infrastructure. Data were collected from both primary and secondary sources. Structured questionnaire was administered on 1,389 residents of the slummy neighbourhoods and informal settlements in Ibadan metropolis, and obtained data were analyzed using descriptive and inferential statistics. Results revealed that out of 109 neighbourhoods, 42.1% were categorized as slummy neighbourhoods, 36.7% as slums/informal settlements, while 21.2% were informal settlement using slummy and informality conditions respectively. Results revealed that distance to health facility (β= -0.353, p<0.05), educational qualification (β=-0.063, p<0.05) and household size (β= -0.052, p<0.05) had an inverse relationship with patronage of health facilities, while age (β=0.086, p< 0.05) had a positive relationship. It was also revealed that access to PHC and dispensary/clinic in slummy neighbouhoods and slum/informal settlements is higher compared to informal settlements in the study area. The study therefore recommends implementation of slum improvement program for the slummy and slums/informal neighbourhoods, provision of additional healthcare facilities to be located especially in the slummy neighbourhoods and informal settlements to ensure equitable distribution.

Knowledge, Attitude, and Awareness of Organ Donation among Residents of Urban Slums in Chennai, Tamil Nadu

Knowledge, Attitude, and Awareness of Organ Donation among Residents of Urban Slums in Chennai, Tamil Nadu

Neighbourhood effect and inequality in access to essential health services among mother–child paired samples: a decomposition analysis of data from 58 low- and middle-income countries

IntroductionNeighbourhood effect on health outcomes is well established, but little is known about its effect on access to essential health services (EHS). Therefore, this study aimed to assess the contributing factors to access to EHS in slum versus non-slum settings.MethodologyThe most recent data from 58 Demographic and Health Surveys (DHS) conducted between 2011 and 2018 were used, including a total of 157,000 pairs of currently married women aged 15–49 and their children aged 12–23 months. We used meta-analysis techniques to examine the inequality gaps in suboptimal access to EHS between mother-children pairs living in slums and non-slums. Blinder-Oaxaca decomposition technique was used to identify the factors contributing to the inequality gaps in each low- and middle-income country (LMIC) included.ResultThe percentage of mother–child pairs living in slums ranged from 0.5% in Egypt to 63.7% in Congo. Meta-analysis of proportions for the pooled sample revealed that 31.2% [27.1, 35.5] of slum residents and 20.0% [15.3, 25.2] among non-slum residents had suboptimal access to EHS. We observed significant pro-slum inequalities in suboptimal access to EHS in 28 of the 52 LMICs with sufficient data. Of the 34 African countries included, 16 showed statistically significant pro-slum inequality in suboptimal access to EHS, with the highest in Egypt and Mali (2.64 [0.84–4.44] and 1.76 [1.65, 1.87] respectively). Findings from the decomposition analysis showed that, on average, household wealth, neighbourhood education level, access to media, and neighbourhood-level illiteracy contributed mostly to slum & non-slum inequality gaps in suboptimal access to EHS.ConclusionThe study showed evidence of inequality in access to EHS due to neighbourhood effects in 26 LMICs. This evidence suggests that increased focus on the urban poor might be a important for increasing access to EHS and achieving the universal health coverage (UHC) goals.

Assessing the mental health of slum dwellers: an ordinal logistic approach

BackgroundStress, depression and anxiety are prevalent mental health concerns that are getting worse every day in the context of rapidly expanding megacities, where a rising number of people live in slums. The purpose of this study is to evaluate the state of mental health and related variables underlying mental health issues among the impoverished population.MethodologyA total of 384 slum residents from the Khulna division responded to our questionnaire, which included the DASS-21 and other pertinent questions. Using ordinal logistic regression, the significant factors were extracted.ResultsThe Cronbach’s reliability coefficient for the DASS-21 scale lies between 0.79 and 0.89 which indicates the high reliability of the DASS-21 scales. According to the findings, roughly 72.7%, 84.1%, and 69% of participants slum dwellers experienced anxiety, depression, and anxiety problems respectively. The result of ordinal logistic regression shows, slum dwellers of female gender (B = 0.669*, 95% CI 0.141, 1.197), married (B = 1.506*, 95% CI 0.119, 2.893), having only one earning member in the family (B = 1.224*, 95% CI 0.526, 1.922), day laborers (B = 2.294*, 95% CI 1.115, 3.473), not being able to educate children due to financial problem (B = 0.558*, 95% CI 0.183, 0.932) were more likely to report high levels of anxiety, depression, and stress.ConclusionThe study finds that a significant portion of people who live in slums struggle with mental health issues. It also points to the need for further support, intervention, and study on Khulna's slum inhabitants who are experiencing mental health issues. The authors anticipate that the results will spur policymakers and government representatives to enhance financing for slum dwellers and employ psychological intervention strategies, both of which will aid in achieving the Sustainable Development Goal.

Religious proximity and misinformation: Experimental evidence from a mobile phone-based campaign in India

We investigate how religion concordance influences the effectiveness of preventive health campaigns. Conducted during the early stages of the COVID-19 pandemic in two major Indian cities marked by Hindu–Muslim tensions, we randomly assigned a representative sample of slum residents to receive either a physician-delivered information campaign promoting health-related preventive practices, or uninformative control messages on their mobile phones. Messages, introduced by a local citizen (the sender), were cross-randomized to start with a greeting signaling either a Hindu or a Muslim identity, manipulating religion concordance between sender and receiver. We found that doctor messages increased compliance with recommended practices and beliefs in their efficacy. Our findings suggest that the campaign’s impact is primarily driven by shared religion between sender and receiver, leading to increased message engagement and compliance with recommended practices. Additionally, we observe that religion concordance helps protect against misinformation.

Financial inclusion and roof quality: Satellite evidence from Chilean slums

Although not all residents of slums are necessarily poor, and conversely, not all low-income individuals live in slums, housing precarity is a distinctive feature of these communities. This paper examines the relationship between financial inclusion and roof quality improvements for individuals living in slum settlements in Chile. We use satellite images to measure the quality of dwelling roofs as well as the CajaVecina initiative to measure the level of financial inclusion of the families that live there. Our results reveal that a higher level of financial inclusion results in an expanded presence of permanent-material roofs within slums. Moreover, we provide evidence that financial inclusion encourages self-employment activities among low-income individuals which is evidence of a transmission channel for the effect studied.

Status of Nutritional Services to Vulnerable Population in West Bengal and Their Hardship during COVID-19 Pandemic: A Community-based Qualitative Exploration

Introduction: In response to the COVID-19 pandemic, restrictions were imposed on various activities including nutritional services. This study was conducted with the objective to explore the status of the nutritional services and to identify the hardship and barriers faced by the vulnerable population and challenges for service providers and program managers during the initial phase of pandemic. Materials and Methods: A community-based cross-sectional qualitative study was conducted among three vulnerable population groups (slum dwellers, tribal population, and residents of disaster-prone area) in three districts of West Bengal, the reference period being April–September 2020. To assess the status of nutritional services and identify existing barriers or challenges, the study employed a mixed-methods approach utilizing focus group discussions (FGDs) as well as in-depth interviews (IDIs) conducted with beneficiaries, service providers and program managers. One habitation in each district was selected to obtain case scenarios on food insecurity and hardship. Descriptive analysis of household surveys and thematic analysis of FGDs and IDIs were done, and the findings were triangulated. Results: Different nutritional services (supplementary nutrition, micronutrient supplementation, growth monitoring, nutrition counseling, and nutrition rehabilitation) were disrupted. Shifting from hot-cooked meals to dry take-home ration was the most conspicuous change during restoration phase. Food security was absent in majority of the households. Reduction of income affected their affordability, which along with difficult accessibility to diverse food items contributed to their hardship. Service providers identified several challenges, including increased workload due to both COVID-19 activities and a rise in beneficiaries, transportation difficulties, and experiences of stigma and discrimination. Long administrative decision-making process, additional hurdles due to cyclone, and containment zones were identified as challenges by the program managers. Conclusion: As the hardship of vulnerable population was pervasive, it is necessary to formulate mitigating measures in light of the identified challenges and to combat similar crises in future.

The missing link for effective informal settlement upgrading: Appropriation shaping the outcome of new infrastructure

Infrastructure investments, a core element of slum upgrading, play a role in improving the livelihoods of over 1 billion slum residents globally. Established planning practices often successfully deliver functional infrastructure but evidence shows that their contribution to improved livelihoods often either is absent or declines sharply after some time. To explain this limited effectiveness, this article identifies the missing link between infrastructure delivery and livelihood improvements as lying in the appropriation process, that is, the uptake and embedding of infrastructures into the daily practices of residents. Recent insights from sociotechnical transitions studies help to conceptualise appropriation. The authors use Munyaka informal settlement in Eldoret town, Kenya as a case to investigate the mechanisms of new infrastructure uptake. Findings indicate that appropriation is a social process that proceeds in three steps: reception, domestication and institutionalisation. This process is driven by the need to maintain or adjust residents’ livelihood practices relative to prevailing socioeconomic and spatiotemporal conditions. The study concludes that appropriation is a significant process that planners should try to anticipate. Prevalent approaches to participation have to be modified accordingly. This is essential for planning to improve livelihoods in slums.

Exploring Spatio-Temporal Pattern of Gentrification Processes in Intracity Slums in the Lagos Megacity

There have been increasing calls in gentrification studies to examine the geography of gentrification in slums, as little is known about the patterns and processes of slum gentrification, especially in sub-Saharan African cities where slums house over 50% of the urban population. This study explored the spatiotemporal changes in slums in Lagos, Nigeria, between 1984 and 20 on the pattern and drivers of gentrification. Data were collected from 42 slums in Lagos through remote sensing (1984–2020) and a field survey (2020–2021). The study integrated geospatial analysis with quantitative and qualitative analysis to investigate the patterns and drivers of gentrification in Lagos slums. The findings show that between 1984 and 2020, all the sampled slums had undergone gentrification processes, apart from those that were completely cleared. However, many slums continue to have deprived areas as they continue to gentrify. Almost all the slum communities have experienced slum clearance in the past. Additionally, the current and new housing developments in the study have favored middle- to high-income groups, which has led to the displacement of previous slum residents. The study identified slum clearance, fires and floodings, the presence of palaces in the community, the proportion of deprived areas in 1984, government interest in the slum, and the size of the church as drivers of slum gentrification processes in Lagos. Finally, the findings show that the vulnerability of slum dwellers increases with slum gentrification. Therefore, this study recommended developing policies and programs, such as sustainable relocation and low-cost housing, to mitigate the negative consequences of slum gentrification, especially in cities with significant shares of low-income groups.

Prevalence and Assessment of Factors Associated With Malnutrition in Children Residing in Slums of Mumbai: A Cross-Sectional Study.

Background Malnutrition in children continues to be a serious public health problem in India. Therefore, this study aims to evaluate the prevalence of malnutrition and assess factors contributing to it in children of the marginalized slum population of India, masked in the metropolitan cities. Methods A retrospective data analysis with a cross-sectional model was conducted by medical volunteers affiliated with the Rotaract Club of Medicrew who had organized a free pediatric health check-up camp in the Dharavi village of Mumbai, India for children under five. Children under five years of age group of either sex residing in the slums of Dharavi and whose parents consented are included in the study. Neonates, children older than five years of age, and children whose parents did not consent for them to be included in the study were excluded. A pretested, pre-validated questionnaire was administered, and statistical analysis was done with p-values <0.05 considered to be statistically significant. Results A total of 126 children were included. Out of these children, 109 of them (86.50%) had a mid-arm circumference of more than 12.5 cm (normal), 11 (8.73%) were between 11.5 cm and 12.5 cm (moderate acute malnutrition), and five (4.77%) were less than 11.5 cm (severe acute malnutrition). Among the 126 kids, 86 kids were above the age of two and their BMI was assessed, 36 (44.19%) were found to be underweight (<5th percentile) while 14 (16.3%) were obese (>95th percentile), and four (4.65%) were overweight (85th-95th percentile). For 106 (84.13%) of these children, the caregivers were mothers while others were fathers (n=4; 3.18%), grandmothers (n=5; 3.97%), sisters (n=5; 3.97%), and aunts (n=6; 4.76%). Out of those who had commenced receiving formal education, only 39 (55.71%) were in an appropriate grade for their age. The mean expenditure on food as a proportion of the total household income was 36.40% (standard deviation (SD) 15.0%). On the single-item sleep quality scale, the sleep of only 36 kids (28.58%) was reported by their caregivers as excellent. A high proportion of other medical problems were reported in the children. Conclusion Our study reports a substantial burden of malnutrition among children residing in the slums of Dharavi. Rigorous strengthening and conceptualization of on-ground nutritional programs targeted towardslum children should be done by Indian healthcare policymakers.

The Allegory of the Favela: The Multifaceted Effects of Socioeconomic Mobility

What are the consequences of upward socioeconomic mobility for disenfranchised individuals? This article examines this question in the context of a business training program offered to residents of Brazilian urban slums, known as “favelas.” The study employs a randomized controlled trial complemented by quantile regressions, field visits, and interviews. The results show that training improves favela dwellers’ economic outcomes, such as by increasing income and participation in entrepreneurship, and some socio-psychological outcomes, such as by improving self-efficacy and optimism. However, these income improvements were accompanied by participants’ enhanced experiences of favela stigma, an adverse socio-psychological outcome related to their residential segregation. Both quantitative and qualitative findings demonstrate the multifaceted nature of socioeconomic mobility, through which favela dwellers who prosper economically become more exposed to prejudice from people living outside favelas. The study illustrates, through the “allegory of the favela,” the bittersweet process of socioeconomic mobility. This abductive research contributes to the literature by showing that while interventions designed to enfranchise individuals may effectively achieve economic inclusion in terms of income gains, they may simultaneously lead participants into discriminatory systems that further stigmatize people based on the same characteristics of their prior exclusion.

Cartographic Resources for Equitable University–Community Interaction in Slum Areas

Cartographic resources play a crucial role in facilitating communication across various sectors, including research projects focused on low-income communities. Despite this, some researchers still adhere to colonialist and exploitative approaches. This study aims to promote equitable university–community interaction though cartographic resources, aid academic and vulnerable community users in choosing a better platform for their work, and provide insights to developers for improving the platforms to better serve the user profiles of community members. To achieve this, we examined the use of cartographic resources in five projects within low-income communities (commonly referred to as favelas or so-called “slums”) in three Brazilian cities, all guided by equitable principles. The study unfolds in four stages: (i) data collection from documents and interviews; (ii) systematization into seven analytical categories—cartographic resources, data, personnel, processes, equipment, general objectives, and specific objectives; (iii) analysis of eight cartographic resources; and (iv) a critical examination of the outcomes. The synthesis of the collected information identified 65 characteristics/demands, with 17 common to all projects, including vector feature creation, thematic map design, printed map usage, and satellite imagery. We also identified 53 geographic information system (GIS) functionalities required for the projects, predominantly related to vector data generation and editing. The outcomes demonstrate the benefits of project methodologies, contributing to a decolonial university–community praxis. Additionally, they underscore the potential of digital cartographic resources, functioning not solely as data collection tools but also as powerful instruments that empower slum residents to advocate for improvements and foster local development.

A Global Estimate of the Size and Location of Informal Settlements

Slums are a structural feature of urbanization, and shifting urbanization trends underline their significance for the cities of tomorrow. Despite their importance, data and knowledge on slums are very limited. In consideration of the current data landscape, it is not possible to answer one of the most essential questions: Where are slums located? The goal of this study is to provide a more nuanced understanding of the geography of slums and their growth trajectories. The methods rely on the combination of different datasets (city-level slum maps, world cities, global human settlements layer, Atlas of Informality). Slum data from city-level maps form the backbone of this research and are made compatible by differentiating between the municipal area, the urbanized area, and the area beyond. This study quantifies the location of slums in 30 cities, and our findings show that only half of all slums are located within the administrative borders of cities. Spatial growth has also shifted outwards. However, this phenomenon is very different in different regions of the world; the municipality captures less than half of all slums in Africa and the Middle East but almost two-thirds of all slums in cities of South Asia. These insights are used to estimate land requirements within the Sustainable Development Goals time frame. In 2015, almost one billion slum residents occupied a land area as large as twice the size of the country of Portugal. The estimated 380 million residents to be added up to 2030 will need land equivalent to the size of the country of Egypt. This land will be added to cities mainly outside their administrative borders. Insights are provided on how this land demand differs within cities and between world regions. Such novel insights are highly relevant to the policy actions needed to achieve Target 11.1 of the Sustainable Development Goals (“by 2030, ensure access for all to adequate, safe and affordable housing and basic services, and upgrade slums”) as interventions targeted at slums or informal settlements are strongly linked to political and administrative boundaries. More research is needed to draw attention to the urban expansion of cities and the role of slums and informal settlements.

Exposure of Kiandutu slum residents to aflatoxin through maize-based products consumption

Kenyans have been highly affected by aflatoxicosis for a long time because of excessive exposure to high aflatoxin containing maize-based products. Maize has been the staple food in Kenya which is more highly consumed than any other cereal product. Many countries with strict aflatoxin threshold application, have consumers who still consume maize-based products, which has not gone through testing. The more remote and lower income areas are more affected by untested maize, ending up exposing themselves to Hepatocellular carcinoma which is a health hazard. The study was designed to determine the exposure of aflatoxin in Kiandutu slum which is a marginalized area in Thika, Kiambu County, Kenya. Ninety seven households were used in the study where number of maize-based products obtained from each household was sampled. Quantitative analysis was used to determine the aflatoxin levels by use of ELISA method. Questionnaires were used to collect the consumption data and sampling of maize- based products was done purposively. Aflatoxins were found in 30.93% of maize flour at between 0 to 34.19 µg /kg, 29.33% of composite flour at between 0 to 30.06 µg /kg, 18.67% of maize grain at between 0 and 20.92 µg /kg and 6.97% of Muthokoi at between 0 to 7.14 µg /kg. Across all sampled households, daily consumption of maize-based products in kilograms per body weight was found to be highest in maize flour, followed by whole maize grains, composite flour and muthokoi in that order. Monte Carlo risk simulation was used to generate the quantitative exposure data. Daily maize flour consumption was higher than other maize-based products with a mean of 0.0038 kg/kg bw/day. It also had the highest daily aflatoxin exposure at a mean of 0.0301 µg/kg/bw/day. The percentage level of the health risk was found to be highest through maize flour consumption at 68.65. Results showed that the frequency of consumption of maize-based products is an important contributor to dietary exposure risk. Key words: Aflatoxin, Exposure, Slum, Food safety, Maize-based products, Households, population