Catastrophic health expenditure and its determinants in Kenya slum communities.

PubMed

Buigut, Steven; Ettarh, Remare; Amendah, Djesika D

2015-05-14

In Kenya, where 60 to 80% of the urban residents live in informal settlements (frequently referred to as slums), out-of-pocket (OOP) payments account for more than a third of national health expenditures. However, little is known on the extent to which these OOP payments are associated with personal or household financial catastrophe in the slums. This paper seeks to examine the incidence and determinants of catastrophic health expenditure among urban slum communities in Kenya. We use a unique dataset on informal settlement residents in Kenya and various approaches that relate households OOP payments for healthcare to total expenditures adjusted for subsistence, or income. We classified households whose OOP was in excess of a predefined threshold as facing catastrophic health expenditures (CHE), and identified the determinants of CHE using multivariate logistic regression analysis. The results indicate that the proportion of households facing CHE varies widely between 1.52% and 28.38% depending on the method and the threshold used. A core set of variables were found to be key determinants of CHE. The number of working adults in a household and membership in a social safety net appear to reduce the risk of catastrophic expenditure. Conversely, seeking care in a public or private hospital increases the risk of CHE. This study suggests that a substantial proportion of residents of informal settlements in Kenya face CHE and would likely forgo health care they need but cannot afford. Mechanisms that pool risk and cost (insurance) are needed to protect slum residents from CHE and improve equity in health care access and payment.

Water, Sanitation and Hygiene Situation in Kenya's Urban Slums.

PubMed

Kamau, Njoroge; Njiru, Haron

2018-01-01

Kenya has undergone rapid urbanization as people migrate to the cities in search of economic opportunities. This has given rise to informal settlements characterized by overcrowding, poor infrastructure, and inadequate social amenities. A cross-sectional study on water, sanitation, and hygiene (WASH) status was carried out in Mathare, an informal settlement in Nairobi. A random sample of 380 households was used. The average household size was five people, and 26% of the household heads had completed secondary or higher level of education. The main source of income (70%) was self-employment with 41% of the households living on less than 1.5 USD per day. The WASH situation in the urban slums is below the minimum standard recommended by the World Health Organization (WHO). There is need to improve the situation by improving and installing basic infrastructure including water, sanitation, and solid waste collection.

Urban slum structure: integrating socioeconomic and land cover data to model slum evolution in Salvador, Brazil.

PubMed

Hacker, Kathryn P; Seto, Karen C; Costa, Federico; Corburn, Jason; Reis, Mitermayer G; Ko, Albert I; Diuk-Wasser, Maria A

2013-10-20

The expansion of urban slums is a key challenge for public and social policy in the 21st century. The heterogeneous and dynamic nature of slum communities limits the use of rigid slum definitions. A systematic and flexible approach to characterize, delineate and model urban slum structure at an operational resolution is essential to plan, deploy, and monitor interventions at the local and national level. We modeled the multi-dimensional structure of urban slums in the city of Salvador, a city of 3 million inhabitants in Brazil, by integrating census-derived socioeconomic variables and remotely-sensed land cover variables. We assessed the correlation between the two sets of variables using canonical correlation analysis, identified land cover proxies for the socioeconomic variables, and produced an integrated map of deprivation in Salvador at 30 m × 30 m resolution. The canonical analysis identified three significant ordination axes that described the structure of Salvador census tracts according to land cover and socioeconomic features. The first canonical axis captured a gradient from crowded, low-income communities with corrugated roof housing to higher-income communities. The second canonical axis discriminated among socioeconomic variables characterizing the most marginalized census tracts, those without access to sanitation or piped water. The third canonical axis accounted for the least amount of variation, but discriminated between high-income areas with white-painted or tiled roofs from lower-income areas. Our approach captures the socioeconomic and land cover heterogeneity within and between slum settlements and identifies the most marginalized communities in a large, complex urban setting. These findings indicate that changes in the canonical scores for slum areas can be used to track their evolution and to monitor the impact of development programs such as slum upgrading.

Urban slum structure: integrating socioeconomic and land cover data to model slum evolution in Salvador, Brazil

PubMed Central

2013-01-01

Background The expansion of urban slums is a key challenge for public and social policy in the 21st century. The heterogeneous and dynamic nature of slum communities limits the use of rigid slum definitions. A systematic and flexible approach to characterize, delineate and model urban slum structure at an operational resolution is essential to plan, deploy, and monitor interventions at the local and national level. Methods We modeled the multi-dimensional structure of urban slums in the city of Salvador, a city of 3 million inhabitants in Brazil, by integrating census-derived socioeconomic variables and remotely-sensed land cover variables. We assessed the correlation between the two sets of variables using canonical correlation analysis, identified land cover proxies for the socioeconomic variables, and produced an integrated map of deprivation in Salvador at 30 m × 30 m resolution. Results The canonical analysis identified three significant ordination axes that described the structure of Salvador census tracts according to land cover and socioeconomic features. The first canonical axis captured a gradient from crowded, low-income communities with corrugated roof housing to higher-income communities. The second canonical axis discriminated among socioeconomic variables characterizing the most marginalized census tracts, those without access to sanitation or piped water. The third canonical axis accounted for the least amount of variation, but discriminated between high-income areas with white-painted or tiled roofs from lower-income areas. Conclusions Our approach captures the socioeconomic and land cover heterogeneity within and between slum settlements and identifies the most marginalized communities in a large, complex urban setting. These findings indicate that changes in the canonical scores for slum areas can be used to track their evolution and to monitor the impact of development programs such as slum upgrading. PMID:24138776

Optimal reblocking as a practical tool for neighborhood development

DOE PAGES

Brelsford, Christa; Martin, Taylor; Bettencourt, Luís M. A.

2017-06-12

Fast urbanization is a common feature of many developing human societies. In many cases, past and present, explosive population growth in cities outstrips the rate of provision of housing and urban services and leads to the formation of informal settlements or slums. Slums are extremely varied in terms of their histories, infrastructure, and rates of change, but they share certain common features: informal land use, lack of physical accesses, and nonexistent or poor quality urban services. Currently, about 1 billion people worldwide live in slums, a number that could triple by 2050 if no practical solutions are enacted to reversemore » this trend. Underlying most problems of slums is the issue of lack of physical accesses to places of work and residence. This prevents residents and businesses from having an address, obtaining basic services such as water and sanitation, and being helped in times of emergency. In this paper, we show how the physical layout of any neighborhood can be classified quantitatively in terms of its access topology in a way that is independent of its geometry. Topological indices capturing levels of access to structures within a city block can then be used to define a constrained optimization problem, whose solution generates an access network that makes each structure in the settlement accessible to services with minimal disruption and cost. We discuss the general applicability of these techniques to several informal settlements in developing cities and demonstrate various technical aspects of our solutions. In conclusion, we discuss how these techniques could be used on a large scale to speed up human development processes in cities throughout the world while respecting their local identity and history.« less

Optimal reblocking as a practical tool for neighborhood development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brelsford, Christa; Martin, Taylor; Bettencourt, Luís M. A.

Fast urbanization is a common feature of many developing human societies. In many cases, past and present, explosive population growth in cities outstrips the rate of provision of housing and urban services and leads to the formation of informal settlements or slums. Slums are extremely varied in terms of their histories, infrastructure, and rates of change, but they share certain common features: informal land use, lack of physical accesses, and nonexistent or poor quality urban services. Currently, about 1 billion people worldwide live in slums, a number that could triple by 2050 if no practical solutions are enacted to reversemore » this trend. Underlying most problems of slums is the issue of lack of physical accesses to places of work and residence. This prevents residents and businesses from having an address, obtaining basic services such as water and sanitation, and being helped in times of emergency. In this paper, we show how the physical layout of any neighborhood can be classified quantitatively in terms of its access topology in a way that is independent of its geometry. Topological indices capturing levels of access to structures within a city block can then be used to define a constrained optimization problem, whose solution generates an access network that makes each structure in the settlement accessible to services with minimal disruption and cost. We discuss the general applicability of these techniques to several informal settlements in developing cities and demonstrate various technical aspects of our solutions. In conclusion, we discuss how these techniques could be used on a large scale to speed up human development processes in cities throughout the world while respecting their local identity and history.« less

Tuberculosis DALY-Gap: Spatial and Quantitative Comparison of Disease Burden Across Urban Slum and Non-slum Census Tracts.

PubMed

Marlow, Mariel A; Maciel, Ethel Leonor Noia; Sales, Carolina Maia Martins; Gomes, Teresa; Snyder, Robert E; Daumas, Regina Paiva; Riley, Lee W

2015-08-01

To quantitatively assess disease burden due to tuberculosis between populations residing in and outside of urban informal settlements in Rio de Janeiro, Brazil, we compared disability-adjusted life years (DALYs), or "DALY-gap." Using the 2010 Brazilian census definition of informal settlements as aglomerados subnormais (AGSN), we allocated tuberculosis (TB) DALYs to AGSN vs non-AGSN census tracts based on geocoded addresses of TB cases reported to the Brazilian Information System for Notifiable Diseases in 2005 and 2010. DALYs were calculated based on the 2010 Global Burden of Disease methodology. DALY-gap was calculated as the difference between age-adjusted DALYs/100,000 population between AGSN and non-AGSN. Total TB DALY in Rio in 2010 was 16,731 (266 DALYs/100,000). DALYs were higher in AGSN census tracts (306 vs 236 DALYs/100,000), yielding a DALY-gap of 70 DALYs/100,000. Attributable DALY fraction for living in an AGSN was 25.4%. DALY-gap was highest for males 40-59 years of age (501 DALYs/100,000) and in census tracts with <60% electricity (12,327 DALYs/100,000). DALY-gap comparison revealed spatial and quantitative differences in TB burden between slum vs non-slum census tracts that were not apparent using traditional measures of incidence and mortality. This metric could be applied to compare TB burden or burden for other diseases in mega-cities with large informal settlements for more targeted resource allocation and evaluation of intervention programs.

Typology of Slum Management in Coastal Settlement as a Reference of Neighborhood Planning in Konawe

NASA Astrophysics Data System (ADS)

Santi; Bachrun, Ratna; Ornam, Kurniati

2017-05-01

Handling slum area actually needs to be done not only in slum areas that are part of a metropolitan city or a large town, but it also need to be conducted in the slum areas in the middle city, small town, and coastal areas. A slum generally includes physical condition, socio-economic conditions of cultural communities who live in the settlements, and the impact of both of these conditions. Environmental coastal settlements in Konawe located in the riverside that lead to loss of quality due to environmental stress of the condition of settlement that are not habitable, can be seen from the problems that exist, namely the existence of housing that goes into river body which causes malfunction of watershed river (DAS), and that is prone to flooding. The purpose of this study is to identify slums in coastal settlements in an effort to improve the quality of structured settlements to obtain a picture of the slum in Konawe, to know the problems regarding the existence of slums and future recommendation of the slum settlement in Konawe. Normative analysis was carried out in this research together with quantitative and qualitative description, as well as methods of spatial analysis (spatial). Identification of slum areas was analyzed based on indicators and parameters issued by the Directorate General of Human Settlements. Problems in some districts in Konawe located in the coastal rivers and coastal areas, consist of drainage, disposal of waste water, waste, and the settlement which is not in accordance with the Spatial Konawe. Among those, there are settlements categorized as slums and some are recommended for refurbishment.

Contraceptive method choice among women in slum and non-slum communities in Nairobi, Kenya.

PubMed

Ochako, Rhoune; Izugbara, Chimaraoke; Okal, Jerry; Askew, Ian; Temmerman, Marleen

2016-07-12

Understanding women's contraceptive method choices is key to enhancing family planning services provision and programming. Currently however, very little research has addressed inter and intra-regional disparities in women's contraceptive method choice. Using data from slum and non-slum contexts in Nairobi, Kenya, the current study investigates the prevalence of and factors associated with contraceptive method choice among women. Data were from a cross-sectional quantitative study conducted among a random sample of 1,873 women (aged 15-49 years) in two non-slum and two slum settlement areas in Nairobi, Kenya. The study locations were purposively sampled by virtue of being part of the Nairobi Urban Health and Demographic Surveillance System. Bivariate and multivariate logistic regression were used to explore the association between the outcome variable, contraceptive method choice, and explanatory variables. The prevalence of contraceptive method choice was relatively similar across slum and non-slum settlements. 34.3 % of women in slum communities and 28.1 % of women in non-slum communities reported using short-term methods. Slightly more women living in the non-slum settlements reported use of long-term methods, 9.2 %, compared to 3.6 % in slum communities. Older women were less likely to use short-term methods than their younger counterparts but more likely to use long-term methods. Currently married women were more likely than never married women to use short-term and long-term methods. Compared to those with no children, women with three or more children were more likely to report using long term methods. Women working outside the home or those in formal employment also used modern methods of contraception more than those in self-employment or unemployed. Use of short-term and long-term methods is generally low among women living in slum and non-slum contexts in Nairobi. Investments in increasing women's access to various contraceptive options are urgently needed to help increase contraceptive prevalence rate. Thus, interventions that focus on more disadvantaged segments of the population will accelerate contraceptive uptake and improve maternal and child health in Kenya.

Informal settlements and a relational view of health in Nairobi, Kenya: sanitation, gender and dignity.

PubMed

Corburn, Jason; Karanja, Irene

2016-06-01

On an urban planet, slums or informal settlements present an increasing challenge for health promotion. The living conditions in complex informal settlements interact with how people navigate through their daily lives and political institutions to shape health inequities. In this article, we suggest that only a relational place-based characterization of informal settlements can accurately capture the forces contributing to existing urban health inequities and inform appropriate and effective health promotion interventions. We explore our relational framework using household survey, spatial mapping and qualitative focus group data gathered in partnership with residents and non-governmental organizations in the Mathare informal settlement in Nairobi, Kenya. All data interpretation included participation with local residents and organizations. We focus on the inter-relationships between inadequate sanitation and disease, social, economic and human rights for women and girls, who we show are most vulnerable from poor slum infrastructure. We suggest that this collaborative process results in co-produced insights about the meanings and relationships between infrastructure, security, resilience and health. We conclude that complex informal settlements require relational and context-specific data gathering and analyses to understand the multiple determinants of health and to inform appropriate and effective healthy city interventions. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Prevalence and determinants of unintended pregnancy among women in Nairobi, Kenya.

PubMed

Ikamari, Lawrence; Izugbara, Chimaraoke; Ochako, Rhoune

2013-03-19

The prevalence of unintended pregnancy in Kenya continues to be high. The 2003 Kenya Demographic and Health Survey (KDHS) showed that nearly 50% of unmarried women aged 15-19 and 45% of the married women reported their current pregnancies as mistimed or unwanted. The 2008-09 KDHS showed that 43% of married women in Kenya reported their current pregnancies were unintended. Unintended pregnancy is one of the most critical factors contributing to schoolgirl drop out in Kenya. Up to 13,000 Kenyan girls drop out of school every year as a result of unintended pregnancy. Unsafe pregnancy termination contributes immensely to maternal mortality which currently estimated at 488 deaths per 100 000 live births. In Kenya, the determinants of prevalence and determinants of unintended pregnancy among women in diverse social and economic situations, particularly in urban areas, are poorly understood due to lack of data. This paper addresses the prevalence and the determinants of unintended pregnancy among women in slum and non-slum settlements of Nairobi. This study used the data that was collected among a random sample of 1262 slum and non-slum women aged 15-49 years in Nairobi. The data was analyzed using simple percentages and logistic regression. The study found that 24 percent of all the women had unintended pregnancy. The prevalence of unintended pregnancy was 21 per cent among women in slum settlements compared to 27 per cent among those in non-slum settlements. Marital status, employment status, ethnicity and type of settlement were significantly associated with unintended pregnancy. Logistic analysis results indicate that age, marital status and type of settlement had statistically significantly effects on unintended pregnancy. Young women aged 15-19 were significantly more likely than older women to experience unintended pregnancy. Similarly, unmarried women showed elevated risk for unintended pregnancy than ever-married women. Women in non-slum settlements were significantly more likely to experience unintended pregnancy than their counterparts in slum settlements.The determinants of unintended pregnancy differed between women in each type of settlement. Among slum women, age, parity and marital status each had significant net effect on unintended pregnancy. But for non-slum women, it was marital status and ethnicity that had significant net effects. The study found a high prevalence of unintended pregnancy among the study population and indicated that young and unmarried women, irrespective of their educational attainment and household wealth status, have a higher likelihood of experiencing unintended pregnancy. Except for the results on educational attainments and household wealth, these results compared well with the results reported in the literature.The results indicate the need for effective programs and strategies to increase access to contraceptive services and related education, information and communication among the study population, particularly among the young and unmarried women. Increased access to family planning services is key to reducing unintended pregnancy among the study population. This calls for concerted efforts by all the stakeholders to improve access to family planning services among the study population. Increased access should be accompanied with improvement in the quality of care and availability of information about effective utilization of family planning methods.

Early childhood development in deprived urban settlements.

PubMed

Nair, M K C; Radhakrishnan, S Rekha

2004-03-01

Poverty, the root cause of the existence of slums or settlement colonies in urban areas has a great impact on almost all aspects of life of the urban poor, especially the all-round development of children. Examples from countries, across the globe provide evidence of improved early child development, made possible through integrated slum improvement programs, are few in numbers. The observed 2.5% prevalence of developmental delay in the less than 2 year olds of deprived urban settlements, the presence of risk factors for developmental delay like low birth weight, birth asphyxia, coupled with poor environment of home and alternate child care services, highlights the need for simple cost effective community model for promoting early child development. This review on early child development focuses on the developmental status of children in the deprived urban settlements, who are yet to be on the priority list of Governments and international agencies working for the welfare of children, the contributory nature-nurture factors and replicable working models like infant stimulation, early detection of developmental delay in infancy itself, developmental screening of toddlers, skill assessment for preschool children, school readiness programs, identification of mental sub-normality and primary education enhancement program for primary school children. Further, the review probes feasible intervention strategies through community owned early child care and development facilities, utilizing existing programs like ICDS, Urban Basic Services and by initiating services like Development Friendly Well Baby Clinics, Community Extension services, Child Development Referral Units at district hospitals and involving trained manpower like anganwadi/creche workers, public health nurses and developmental therapists. With the decentralization process the local self-government at municipalities and city corporations are financially equipped to be the prime movers to initiate, monitor and promote early child development programs, to emerge as a part and parcel of community owned sustainable development process.

Childhood vaccination in informal urban settlements in Nairobi, Kenya: who gets vaccinated?

PubMed

Mutua, Martin K; Kimani-Murage, Elizabeth; Ettarh, Remare R

2011-01-04

Recent trends in global vaccination coverage have shown increases with most countries reaching 90% DTP3 coverage in 2008, although pockets of undervaccination continue to persist in parts of sub-Saharan Africa particularly in the urban slums. The objectives of this study were to determine the vaccination status of children aged between 12-23 months living in two slums of Nairobi and to identify the risk factors associated with incomplete vaccination. The study was carried out as part of a longitudinal Maternal and Child Health study undertaken in Korogocho and Viwandani slums of Nairobi. These slums host the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) run by the African Population and Health Research Centre (APHRC). All women from the NUHDSS area who gave birth since September 2006 were enrolled in the project and administered a questionnaire which asked about the vaccination history of their children. For the purpose of this study, we used data from 1848 children aged 12-23 months who were expected to have received all the WHO-recommended vaccinations. The vaccination details were collected during the first visit about four months after birth with follow-up visits repeated thereafter at four month intervals. Full vaccination was defined as receiving all the basic childhood vaccinations by the end of 24 months of life, whereas up-to-date (UTD) vaccination referred to receipt of BCG, OPV 1-3, DTP 1-3, and measles vaccinations within the first 12 months of life. All vaccination data were obtained from vaccination cards which were sighted during the household visit as well as by recall from mothers. Multivariate models were used to identify the risk factors associated with incomplete vaccination. Measles coverage was substantially lower than that for the other vaccines when determined using only vaccination cards or in addition to maternal recall. Up-to-date (UTD) coverage with all vaccinations at 12 months was 41.3% and 51.8% with and without the birth dose of OPV, respectively. Full vaccination coverage (57.5%) was higher than up-to-date coverage (51.8%) at 12 months overall, and in both slum settlements, using data from cards. Multivariate analysis showed that household assets and expenditure, ethnicity, place of delivery, mother's level of education, age and parity were all predictors of full vaccination among children living in the slums. The findings show the extent to which children resident in slums are underserved with vaccination and indicate that service delivery of immunization services in the urban slums needs to be reassessed to ensure that all children are reached.

Hypertension in a Brazilian urban slum population.

PubMed

Unger, Alon; Felzemburgh, Ridalva D M; Snyder, Robert E; Ribeiro, Guilherme S; Mohr, Sharif; Costa, Vinícius B A; Melendez, Astrid X T O; Reis, Renato B; Santana, Francisco S; Riley, Lee W; Reis, Mitermayer G; Ko, Albert I

2015-06-01

Low- and middle-income countries account for the majority of hypertension disease burden. However, little is known about the distribution of this illness within subpopulations of these countries, particularly among those who live in urban informal settlements. A cross-sectional hypertension survey was conducted in 2003 among 5649 adult residents of a slum settlement in the city of Salvador, Brazil. Hypertension was defined as either an elevated arterial systolic (≥140 mmHg) or diastolic (≥90 mmHg) blood pressure. Sex-specific multivariable models of systolic blood pressure were constructed to identify factors associated with elevated blood pressure. The prevalence of hypertension in the population 18 years and older was 21% (1162/5649). Men had 1.2 times the risk of hypertension compared with women (95% confidence intervals (CI), 1.05, 1.36). Increasing age and lack of any schooling, particularly for women, were also significantly associated with elevated blood pressure (p < 0.05). There was also a direct association between men who were black and an elevated blood pressure. Among those who were hypertensive, 65.5% were aware of their condition, and only 36.3% of those aware were actively using anti-hypertensive medications. Men were less likely to be aware of their diagnosis or to use medications (p < 0.01 for both) than women. The prevalence of hypertension in this slum community was lower than reported frequencies in the non-slum population of Brazil and Salvador, yet both disease awareness and treatment frequency were low. Further research on hypertension and other chronic non-communicable diseases in slum populations is urgently needed to guide prevention and treatment efforts in this growing population.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vatsavai, Raju; Cheriyadat, Anil M; Bhaduri, Budhendra L

The high rate of urbanization, political conflicts and ensuing internal displacement of population, and increased poverty in the 20th century has resulted in rapid increase of informal settlements. These unplanned, unauthorized, and/or unstructured homes, known as informal settlements, shantytowns, barrios, or slums, pose several challenges to the nations, as these settlements are often located in most hazardous regions and lack basic services. Though several World Bank and United Nations sponsored studies stress the importance of poverty maps in designing better policies and interventions, mapping slums of the world is a daunting and challenging task. In this paper, we summarize ourmore » ongoing research on settlement mapping through the utilization of Very high resolution (VHR) remote sensing imagery. Most existing approaches used to classify VHR images are single instance (or pixel-based) learning algorithms, which are inadequate for analyzing VHR imagery, as single pixels do not contain sufficient contextual information (see Figure 1). However, much needed spatial contextual information can be captured via feature extraction and/or through newer machine learning algorithms in order to extract complex spatial patterns that distinguish informal settlements from formal ones. In recent years, we made significant progress in advancing the state of art in both directions. This paper summarizes these results.« less

Environmental and comfort upgrading through lean technologies in informal settlements: Case study in Nairobi, Kenia and New Delhi, India

NASA Astrophysics Data System (ADS)

De Angelis, Enrico; Tagliabue, Lavinia Chiara; Zecchini, Paolo; Milanesi, Mattia

2016-07-01

Informal settlements, namely slums (or bidonville or favelas) are one of the stronger challenge for urban context in developing countries. The increase of urban population leads to a widespread poverty and critical life conditions for a large segment of population, in particular in Sub-Saharan Africa, where a high percentage of people lives in informal settlements. The problems in slums are multiple: people suffer malnutrition and poor sanitation, flooding or drought, and live in shelters providing no thermal comfort in many days of the year, furthermore scarce and highly polluting energy sources are available. Climate change and an unavoidable heat island effect make these living conditions nearly catastrophic. This paper focuses on the main characters of these slums and on how to what promote the improvement of living conditions with a lean, low cost, low impact, feasible upgrading of the housing or more properly shelters. The subject of the analysis is the Mathare 4A Upgrading Programme in the city of Nairobi, Kenya, one of the highest slum-dwellers growing rate. The technological solutions applied in this context have been verified in a different climate condition such as the city of New Delhi, India where the phenomenon of the slums is significantly burdensome. The analysis of the comfort conditions inside a type housing has been carried out using hourly weather data and dynamic heat transfer simulation, without any HVAC system and striving only natural ventilation. Data about internal temperature and relative humidity conditions have been applied to evaluate the comfort hours using the Predicted Mean Vote method, the adaptive thermal comfort principles and the bioclimatic charts for the two climates in Nairobi and New Delhi. The percentage of hours within the comfort range and the amount of degree-hours exceeding comfort values showed for different upgrading strategies, how it is possible to deeply influence the living conditions by technological and affordable choices on the envelope of such simple housing. A simplified LCA (Life Cycle Assessment) evaluation on embodied energy in the proposed upgrading materials used for the housing allows assessing the environmental impact of the considered alternatives. The present study aims to find out and to propose lean technological solutions to improve users' comfort levels with simple DIY (do it yourself) modification of shelter's envelopes and basic education for the use of the housing. The paper presents the study of lean technological solutions to improve comfort conditions and durability of informal settlements located in two climate zones in the world where slums are a critical issue in the urban development. The opportunity to improve such conditions can promote an upgrading of health and wealth status in such a critical situation in which millions of people are living today. The lean, affordable and low impact technologies that have been proposed and tested by dynamic simulation could allow a widespread diffusion of the concept without burden on the strongly compromised environment. The weak and fragile areas affected by the slums have pollution problems and a main task is not to worsen them during the life of the shelters/houses.

Prospective study of leptospirosis transmission in an urban slum community: role of poor environment in repeated exposures to the Leptospira agent.

PubMed

Felzemburgh, Ridalva D M; Ribeiro, Guilherme S; Costa, Federico; Reis, Renato B; Hagan, José E; Melendez, Astrid X T O; Fraga, Deborah; Santana, Francisco S; Mohr, Sharif; dos Santos, Balbino L; Silva, Adriano Q; Santos, Andréia C; Ravines, Romy R; Tassinari, Wagner S; Carvalho, Marília S; Reis, Mitermayer G; Ko, Albert I

2014-01-01

Leptospirosis has emerged as an urban health problem as slum settlements have rapidly spread worldwide and created conditions for rat-borne transmission. Prospective studies have not been performed to determine the disease burden, identify risk factors for infection and provide information needed to guide interventions in these marginalized communities. We enrolled and followed a cohort of 2,003 residents from a slum community in the city of Salvador, Brazil. Baseline and one-year serosurveys were performed to identify primary and secondary Leptospira infections, defined as respectively, seroconversion and four-fold rise in microscopic agglutination titers. We used multinomial logistic regression models to evaluate risk exposures for acquiring primary and secondary infection. A total of 51 Leptospira infections were identified among 1,585 (79%) participants who completed the one-year follow-up protocol. The crude infection rate was 37.8 per 1,000 person-years. The secondary infection rate was 2.3 times higher than that of primary infection rate (71.7 and 31.1 infections per 1,000 person-years, respectively). Male gender (OR 2.88; 95% CI 1.40-5.91) and lower per capita household income (OR 0.54; 95% CI, 0.30-0.98 for an increase of $1 per person per day) were independent risk factors for primary infection. In contrast, the 15-34 year age group (OR 10.82, 95% CI 1.38-85.08), and proximity of residence to an open sewer (OR 0.95; 0.91-0.99 for an increase of 1 m distance) were significant risk factors for secondary infection. This study found that slum residents had high risk (>3% per year) for acquiring a Leptospira infection. Re-infection is a frequent event and occurs in regions of slum settlements that are in proximity to open sewers. Effective prevention of leptospirosis will therefore require interventions that address the infrastructure deficiencies that contribute to repeated exposures among slum inhabitants.

Geospatial and Remote Sensing-based Indicators of Settlement Type---Differentiating Informal and Formal Settlements in Guatemala City

NASA Astrophysics Data System (ADS)

Owen, Karen K.

This research addresses the need for reliable, repeatable, quantitative measures to differentiate informal (slum) from formal (planned) settlements using commercial very high resolution imagery and elevation data. Measuring the physical, spatial and spectral qualities of informal settlements is an important precursor for evaluating success toward improving the lives of 100 million slum dwellers worldwide, as pledged by the United Nations Millennium Development Goal Target 7D. A variety of measures were tested based on surface material spectral properties, texture, built-up structure, road network accessibility, and geomorphology from twelve communities in Guatemala City to reveal statistically significant differences between informal and formal settlements that could be applied to other parts of the world without the need for costly or dangerous field surveys. When information from satellite imagery is constrained to roads and residential boundaries, a more precise understanding of human habitation is produced. A classification and regression tree (CART) approach and linear discriminant function analysis enabled a variable dimensionality reduction from the original 23 to 6 variables that are sufficient to differentiate a settlement as informal or formal. The results demonstrate that the entropy texture of roads, the degree of asphalt road surface, the vegetation patch compactness and patch size, the percent of bare soil land cover, the geomorphic profile convexity of the terrain, and the road density distinguish informal from formal settlements with 87--92% accuracy when results are cross-validated. The variables with highest contribution to model outcome that are common to both approaches are entropy texture of roads, vegetation patch size, and vegetation compactness suggesting that road texture, surface materials and vegetation provide the necessary characteristics to distinguish the level of informality of a settlement. The results will assist urban planners and settlement analysts who must process vast amounts of imagery worldwide, enabling them to report annually on slum conditions. An added benefit is the ability to use the measures in data-poor regions of the world without field surveys.

Childhood vaccination in informal urban settlements in Nairobi, Kenya: Who gets vaccinated?

PubMed Central

2011-01-01

Background Recent trends in global vaccination coverage have shown increases with most countries reaching 90% DTP3 coverage in 2008, although pockets of undervaccination continue to persist in parts of sub-Saharan Africa particularly in the urban slums. The objectives of this study were to determine the vaccination status of children aged between 12-23 months living in two slums of Nairobi and to identify the risk factors associated with incomplete vaccination. Methods The study was carried out as part of a longitudinal Maternal and Child Health study undertaken in Korogocho and Viwandani slums of Nairobi. These slums host the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) run by the African Population and Health Research Centre (APHRC). All women from the NUHDSS area who gave birth since September 2006 were enrolled in the project and administered a questionnaire which asked about the vaccination history of their children. For the purpose of this study, we used data from 1848 children aged 12-23 months who were expected to have received all the WHO-recommended vaccinations. The vaccination details were collected during the first visit about four months after birth with follow-up visits repeated thereafter at four month intervals. Full vaccination was defined as receiving all the basic childhood vaccinations by the end of 24 months of life, whereas up-to-date (UTD) vaccination referred to receipt of BCG, OPV 1-3, DTP 1-3, and measles vaccinations within the first 12 months of life. All vaccination data were obtained from vaccination cards which were sighted during the household visit as well as by recall from mothers. Multivariate models were used to identify the risk factors associated with incomplete vaccination. Results Measles coverage was substantially lower than that for the other vaccines when determined using only vaccination cards or in addition to maternal recall. Up-to-date (UTD) coverage with all vaccinations at 12 months was 41.3% and 51.8% with and without the birth dose of OPV, respectively. Full vaccination coverage (57.5%) was higher than up-to-date coverage (51.8%) at 12 months overall, and in both slum settlements, using data from cards. Multivariate analysis showed that household assets and expenditure, ethnicity, place of delivery, mother's level of education, age and parity were all predictors of full vaccination among children living in the slums. Conclusions The findings show the extent to which children resident in slums are underserved with vaccination and indicate that service delivery of immunization services in the urban slums needs to be reassessed to ensure that all children are reached. PMID:21205306

Using a Birth Center Model of Care to Improve Reproductive Outcomes in Informal Settlements-a Case Study.

PubMed

Wallace, Jacqueline

2018-06-04

The world is becoming increasingly urban. For the first time in history, more than 50% of human beings live in cities (United Nations, Department of Economic and Social Affairs, Population Division, ed. (2015)). Rapid urbanization is often chaotic and unstructured, leading to the formation of informal settlements or slums. Informal settlements are frequently located in environmentally hazardous areas and typically lack adequate sanitation and clean water, leading to poor health outcomes for residents. In these difficult circumstances women and children fair the worst, and reproductive outcomes for women living in informal settlements are grim. Insufficient uptake of antenatal care, lack of skilled birth attendants and poor-quality care contribute to maternal mortality rates in informal settlements that far outpace wealthier urban neighborhoods (Chant and McIlwaine (2016)). In response, a birth center model of maternity care is proposed for informal settlements. Birth centers have been shown to provide high quality, respectful, culturally appropriate care in high resource settings (Stapleton et al. J Midwifery Women's Health 58(1):3-14, 2013; Hodnett et al. Cochrane Database Syst Rev CD000012, 2012; Brocklehurst et al. BMJ 343:d7400, 2011). In this paper, three case studies are described that support the use of this model in low resource, urban settings.

Women's use of private and government health facilities for childbirth in Nairobi's informal settlements.

PubMed

Bazant, Eva S; Koenig, Michael A; Fotso, Jean-Christophe; Mills, Samuel

2009-03-01

The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home.

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh

PubMed Central

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-01-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5–6 days/week, but close by 4–5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. PMID:25759453

Prospective Study of Leptospirosis Transmission in an Urban Slum Community: Role of Poor Environment in Repeated Exposures to the Leptospira Agent

PubMed Central

Felzemburgh, Ridalva D. M.; Ribeiro, Guilherme S.; Costa, Federico; Reis, Renato B.; Hagan, José E.; Melendez, Astrid X. T. O.; Fraga, Deborah; Santana, Francisco S.; Mohr, Sharif; dos Santos, Balbino L.; Silva, Adriano Q.; Santos, Andréia C.; Ravines, Romy R.; Tassinari, Wagner S.; Carvalho, Marília S.; Reis, Mitermayer G.; Ko, Albert I.

2014-01-01

Background Leptospirosis has emerged as an urban health problem as slum settlements have rapidly spread worldwide and created conditions for rat-borne transmission. Prospective studies have not been performed to determine the disease burden, identify risk factors for infection and provide information needed to guide interventions in these marginalized communities. Methodology/Principal Findings We enrolled and followed a cohort of 2,003 residents from a slum community in the city of Salvador, Brazil. Baseline and one-year serosurveys were performed to identify primary and secondary Leptospira infections, defined as respectively, seroconversion and four-fold rise in microscopic agglutination titers. We used multinomial logistic regression models to evaluate risk exposures for acquiring primary and secondary infection. A total of 51 Leptospira infections were identified among 1,585 (79%) participants who completed the one-year follow-up protocol. The crude infection rate was 37.8 per 1,000 person-years. The secondary infection rate was 2.3 times higher than that of primary infection rate (71.7 and 31.1 infections per 1,000 person-years, respectively). Male gender (OR 2.88; 95% CI 1.40–5.91) and lower per capita household income (OR 0.54; 95% CI, 0.30–0.98 for an increase of $1 per person per day) were independent risk factors for primary infection. In contrast, the 15–34 year age group (OR 10.82, 95% CI 1.38–85.08), and proximity of residence to an open sewer (OR 0.95; 0.91–0.99 for an increase of 1 m distance) were significant risk factors for secondary infection. Conclusions/Significance This study found that slum residents had high risk (>3% per year) for acquiring a Leptospira infection. Re-infection is a frequent event and occurs in regions of slum settlements that are in proximity to open sewers. Effective prevention of leptospirosis will therefore require interventions that address the infrastructure deficiencies that contribute to repeated exposures among slum inhabitants. PMID:24875389

Investigation on the separability of slums by multi-aspect TerraSAR-X dual-co-polarized high resolution spotlight images based on the multi-scale evaluation of local distributions

NASA Astrophysics Data System (ADS)

Schmitt, Andreas; Sieg, Tobias; Wurm, Michael; Taubenböck, Hannes

2018-02-01

Following recent advances in distinguishing settlements vs. non-settlement areas from latest SAR data, the question arises whether a further automatic intra-urban delineation and characterization of different structural types is possible. This paper studies the appearance of the structural type ;slums; in high resolution SAR images. Geocoded Kennaugh elements are used as backscatter information and Schmittlet indices as descriptor of local texture. Three cities with a significant share of slums (Cape Town, Manila, Mumbai) are chosen as test sites. These are imaged by TerraSAR-X in the dual-co-polarized high resolution spotlight mode in any available aspect angle. Representative distributions are estimated and fused by a robust approach. Our observations identify a high similarity of slums throughout all three test sites. The derived similarity maps are validated with reference data sets from visual interpretation and ground truth. The final validation strategy is based on completeness and correctness versus other classes in relation to the similarity. High accuracies (up to 87%) in identifying morphologic slums are reached for Cape Town. For Manila (up to 60%) and Mumbai (up to 54%), the distinction is more difficult due to their complex structural configuration. Concluding, high resolution SAR data can be suitable to automatically trace potential locations of slums. Polarimetric information and the incidence angle seem to have a negligible impact on the results whereas the intensity patterns and the passing direction of the satellite are playing a key role. Hence, the combination of intensity images (brightness) acquired from ascending and descending orbits together with Schmittlet indices (spatial pattern) promises best results. The transfer from the automatically recognized physical similarity to the semantic interpretation remains challenging.

Sleep and Quality of Life in Urban Poverty: The Effect of a Slum Housing Upgrading Program

PubMed Central

Simonelli, Guido; Leanza, Yvan; Boilard, Alexandra; Hyland, Martín; Augustinavicius, Jura L.; Cardinali, Daniel P.; Vallières, Annie; Pérez-Chada, Daniel; Vigo, Daniel E.

2013-01-01

Study Objectives: To evaluate the effect of a housing transition on sleep quality and quality of life in slum dwellers, participating in a slum housing upgrading program. Design: Observational before-and-after study with a convergent-parallel mixed method design. Setting: Five slums located in the metropolitan area of Buenos Aires, Argentina. Participants: A total of 150 slum dwellers benefited by a housing program of the nonprofit organization TECHO (spanish word for “roof”). Interventions: Participants moved from their very low-quality house to a basic prefabricated 18 m2 modular house provided by TECHO. Measurements and Results: The Pittsburgh Sleep Quality Index (PSQI) and World Health Organization Quality of Life brief scale (WHOQOL-BREF) were administered before and after housing upgrading. Data about housing conditions, income, education, sleeping conditions, and cardiovascular risk were also collected. Semistructured interviews were used to expand and nuance quantitative data obtained from a poorly educated sample. Results showed that sleep quality significantly increased after the housing program (z = -6.57, P < 0.001). Overall quality of life (z = -6.85, P < 0.001), physical health domain (z = -4.35, P < 0.001), psychological well-being domain (z = -3.72, P < 0.001) and environmental domain (z = -7.10, P < 0.001) of WHOQOL-BREF were also improved. Interviews demonstrated the importance of serenity for improving quality of life. Conclusions: A minimal improvement in the quality of basic housing can significantly increase sleep quality and quality of life among slum dwellers. Understanding sleep and daily life conditions in informal urban settlements could help to define what kind of low-cost intervention may improve sleep quality, quality of life, and reduce existent sleep disparity. Citation: Simonelli G; Leanza Y; Boilard A; Hyland M; Augustinavicius JL; Cardinali DP; Vallières A; Pérez-Chada D; Vigo DE. Sleep and quality of life in urban poverty: the effect of a slum housing upgrading program. SLEEP 2013;36(11):1669-1676. PMID:24179300

In their own words: assessment of satisfaction with residential location among migrants in Nairobi slums.

PubMed

Mudege, Netsayi Noris; Zulu, Eliya M

2011-06-01

Using qualitative data collected from a sample of rural-urban migrants over the age of 15 in two Nairobi slums interviewed in 2008, this paper discusses the migrants' extent of satisfaction with their residential location and decision to migrate. The study sheds light on why people continue to migrate to, and stay in, the rapidly growing slum settlements despite the high levels of poverty and poor health conditions in these areas. Tenure status is related to satisfaction for all ages. Environmental factors were frequently mentioned as a source of dissatisfaction. Life cycle and 'age-cohort effects' may also affect satisfaction for different age groups in terms of who is satisfied as well as the issues that are considered for satisfaction. High levels of dissatisfaction with slum life may be responsible for high out-migration in slum areas, although it does not mean that those who remain do so because they are satisfied. At the same time, challenges associated with slum life do not automatically signify dissatisfaction. Perceived success, as well as conditions in the area of origin can be used to explain and understand satisfaction/dissatisfaction with slum life. Satisfaction with migration and residential location may be related not only to the destination place, but also to events in the area of origin.

Model of slums rejuvenation in Telaga Tujuh village: the case of Langsa city, Aceh, Indonesia

NASA Astrophysics Data System (ADS)

Irwansyah, Mirza; Caisarina, Irin; Solehati, Dini

2018-05-01

Telaga Tujuh village is the only island inhabited compared to other islands in Langsa City, Aceh. Most of the houses are on stilts with very limited infrastructure such as lack of road facilities, local drainage, drinking water, wastewater, and garbage disposals. In determining the model of the slum settlements arrangement of Telaga Tujuh Village, there are some things to know that the characteristics of slums themselves and the causes of slum settlement. The aim of this study is to determine model of slum settlement arrangement that is suitable to be applied in the location. The method used is qualitative with sampling technique and qualitative analysis. To obtain the primary data used observation method, questionnaires, and interview. Secondary data obtained from agencies related to slum settlement arrangement. Based on characteristic analysis found that 365 residential buildings are irregular with the percentage of 100%, 365 residential buildings do not have safe drinking water supply, 365 residential buildings do not have waste water management. From the analysis shows that the appropriate model to be applied to Telaga Tujuh village is the rejuvenation model with the land consolidation system through the re-arrangement divided by two, 60% for the existing residential development and 40% for commercial development.

“Making it”: Understanding adolescent resilience in two informal settlements (slums) in Nairobi, Kenya

PubMed Central

Kabiru, Caroline W.; Beguy, Donatien; Ndugwa, Robert P.; Zulu, Eliya M.; Jessor, Richard

2013-01-01

Many adolescents living in contexts characterized by adversity achieve positive outcomes. We adopt a protection-risk conceptual framework to examine resilience (academic achievement, civic participation, and avoidance of risk behaviors) among 1,722 never-married 12-19 year olds living in two Kenyan urban slums. We find stronger associations between explanatory factors and resilience among older (15-19 years) than younger (12-14 years) adolescents. Models for pro-social behavior and models for anti-social behavior emerge as key predictors of resilience. Further accumulation of evidence on risk and protective factors is needed to inform interventions to promote positive outcomes among youth situated in an ecology of adversity. PMID:24382935

"Making it": Understanding adolescent resilience in two informal settlements (slums) in Nairobi, Kenya.

PubMed

Kabiru, Caroline W; Beguy, Donatien; Ndugwa, Robert P; Zulu, Eliya M; Jessor, Richard

2012-03-16

Many adolescents living in contexts characterized by adversity achieve positive outcomes. We adopt a protection-risk conceptual framework to examine resilience (academic achievement, civic participation, and avoidance of risk behaviors) among 1,722 never-married 12-19 year olds living in two Kenyan urban slums. We find stronger associations between explanatory factors and resilience among older (15-19 years) than younger (12-14 years) adolescents. Models for pro-social behavior and models for anti-social behavior emerge as key predictors of resilience. Further accumulation of evidence on risk and protective factors is needed to inform interventions to promote positive outcomes among youth situated in an ecology of adversity.

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh.

PubMed

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-03-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5-6 days/week, but close by 4-5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

Phosphorus transport and retention in a channel draining an urban, tropical catchment with informal settlements

NASA Astrophysics Data System (ADS)

Nyenje, P. M.; Meijer, L. M. G.; Foppen, J. W.; Kulabako, R.; Uhlenbrook, S.

2014-03-01

Urban catchments in sub-Saharan Africa (SSA) are increasingly becoming a major source of phosphorus (P) to downstream ecosystems. This is primarily due to large inputs of untreated wastewater to urban drainage channels, especially in informal settlements (or slums). However, the processes governing the fate of P in these catchments are largely unknown. In this study, these processes are investigated. During high runoff events and a period of base flow, we collected hourly water samples (over 24 h) from a primary channel draining a 28 km2 slum-dominated catchment in Kampala, Uganda, and from a tertiary channel draining one of the contributing slum areas (0.54 km2). The samples were analysed for orthophosphate (PO4-P), particulate P (PP), total P (TP), suspended solids (SS) and hydrochemistry. We also collected channel bed and suspended sediments to determine their geo-available metals, sorption characteristics and the dominant phosphorus forms. Our results showed that the catchment exported high fluxes of P (0.3 kg km2 d-1 for PO4-P and 0.95 for TP), which were several orders of magnitude higher than values normally reported in literature. A large proportion of P exported was particulate (56% of TP) and we inferred that most of it was retained along the channel bed. The retained sediment P was predominantly inorganic (> 63% of total sediment P) and consisted of mostly Ca and Fe-bound P, which were present in almost equal proportions. Ca-bound sediment P was attributed to the adsorption of P to calcite because surface water was near saturation with respect to calcite in all the events sampled. Fe-bound sediment P was attributed to the adsorption of P to iron oxides in suspended sediment during runoff events given that surface water was undersaturated with respect to iron phosphates. We also found that the bed sediments were P-saturated and showed a tendency to release P by mineralisation and desorption. During rain events, there was a flushing of PP which we attributed to the resuspension of P-rich bed sediment that accumulated in the channel during low flows. However, first-flush effects were not observed. Our findings provide useful insights into the processes governing the fate and transport of P in urban slum catchments in SSA.

Adverse life events and delinquent behavior among Kenyan adolescents: a cross-sectional study on the protective role of parental monitoring, religiosity, and self-esteem.

PubMed

Kabiru, Caroline W; Elung'ata, Patricia; Mojola, Sanyu A; Beguy, Donatien

2014-01-01

Past research provides strong evidence that adverse life events heighten the risk of delinquent behavior among adolescents. Urban informal (slum) settlements in sub-Saharan Africa are marked by extreme adversity. However, the prevalence and consequences of adverse life events as well as protective factors that can mitigate the effects of exposure to these events in slum settlements is largely understudied. We examine two research questions. First, are adverse life events experienced at the individual and household level associated with a higher likelihood of delinquent behavior among adolescents living in two slums in Nairobi, Kenya? Second, are parental monitoring, religiosity, and self-esteem protective against delinquency in a context of high adversity? We used cross-sectional data from 3,064 males and females aged 12-19 years who participated in the Transitions to Adulthood Study. We examined the extent to which a composite index of adverse life events was associated with delinquent behavior (measured using a composite index derived from nine items). We also examined the direct and moderating effects of three protective factors: parental monitoring, religiosity, and self-esteem. Fifty-four percent of adolescents reported at least one adverse life event, while 18% reported three or more adverse events. For both males and females, adversity was positively and significantly associated with delinquency in bivariate and multivariate models. Negative associations were observed between the protective factors and delinquency. Significant adverse events × protective factor interaction terms were observed for parental monitoring (females and males), religiosity (males), and self-esteem (females). Similar to research in high income countries, adverse life events are associated with an increased likelihood of delinquent behavior among adolescents living in urban slums in Kenya, a low-income country. However, parental monitoring, religiosity, and self-esteem may moderate the effect of adversity on delinquent behavior and pinpoint possible avenues to develop interventions to reduce delinquency in resource-poor settings in low and middle income countries.

Social determinants of health in selected slum areas in Jordan: challenges and policy directions.

PubMed

Ajlouni, Musa T

2016-01-01

The unplanned urbanization in Jordan has over time created many informal settlements "slums" around big cities as Amman, Zerka and Aqaba. The purpose of this study was to highlight the most common challenges related to social determinants of health in two selected slum areas in Amman and Aqaba and suggest policy directions and interventions to meet these challenges. In addition to a prestructured interview with all household heads living in the two slum sites, focus group meetings with a purposefully selected sample of 12 slum dwellers in each site were used to assess the structural and intermediary determinants of health as perceived by slum residents in the two study locations. The study found that slum residents in the two locations suffer from many challenges as severe poverty; unemployment; illiteracy and low education attainments; gender discrimination; insufficient and poor diet; social and official exclusion; unhealthy environment; lack of water supply, electricity and basic sanitation facilities; high prevalence of diseases; and insufficient and inappropriate health services. Specific policy directions to meet these challenges were recommended and grouped into three main clusters: social protection, social inclusion and empowerment. New plans and tools should be developed by local authorities in Jordan to understand, protect, include and empower those vulnerable people who are forced to live in these unhealthy and inhuman environments. Copyright © 2014 John Wiley & Sons, Ltd.

Sleep and quality of life in urban poverty: the effect of a slum housing upgrading program.

PubMed

Simonelli, Guido; Leanza, Yvan; Boilard, Alexandra; Hyland, Martín; Augustinavicius, Jura L; Cardinali, Daniel P; Vallières, Annie; Pérez-Chada, Daniel; Vigo, Daniel E

2013-11-01

To evaluate the effect of a housing transition on sleep quality and quality of life in slum dwellers, participating in a slum housing upgrading program. Observational before-and-after study with a convergent-parallel mixed method design. Five slums located in the metropolitan area of Buenos Aires, Argentina. A total of 150 slum dwellers benefited by a housing program of the nonprofit organization TECHO (spanish word for "roof"). Participants moved from their very low-quality house to a basic prefabricated 18 m(2) modular house provided by TECHO. The Pittsburgh Sleep Quality Index (PSQI) and World Health Organization Quality of Life brief scale (WHOQOL-BREF) were administered before and after housing upgrading. Data about housing conditions, income, education, sleeping conditions, and cardiovascular risk were also collected. Semistructured interviews were used to expand and nuance quantitative data obtained from a poorly educated sample. Results showed that sleep quality significantly increased after the housing program (z = -6.57, P < 0.001). Overall quality of life (z = -6.85, P < 0.001), physical health domain (z = -4.35, P < 0.001), psychological well-being domain (z = -3.72, P < 0.001) and environmental domain (z = -7.10, P < 0.001) of WHOQOL-BREF were also improved. Interviews demonstrated the importance of serenity for improving quality of life. A minimal improvement in the quality of basic housing can significantly increase sleep quality and quality of life among slum dwellers. Understanding sleep and daily life conditions in informal urban settlements could help to define what kind of low-cost intervention may improve sleep quality, quality of life, and reduce existent sleep disparity.

The Prevention and Control of HIV/AIDS, TB and Vector-borne Diseases in Informal Settlements: Challenges, Opportunities and Insights

PubMed Central

Mercado, Susan P.; Becker, Daniel; Edmundo, Katia; Mugisha, Frederick

2007-01-01

Today’s urban settings are redefining the field of public health. The complex dynamics of cities, with their concentration of the poorest and most vulnerable (even within the developed world) pose an urgent challenge to the health community. While retaining fidelity to the core principles of disease prevention and control, major adjustments are needed in the systems and approaches to effectively reach those with the greatest health risks (and the least resilience) within today’s urban environment. This is particularly relevant to infectious disease prevention and control. Controlling and preventing HIV/AIDS, tuberculosis and vector-borne diseases like malaria are among the key global health priorities, particularly in poor urban settings. The challenge in slums and informal settlements is not in identifying which interventions work, but rather in ensuring that informal settlers: (1) are captured in health statistics that define disease epidemiology and (2) are provided opportunities equal to the rest of the population to access proven interventions. Growing international attention to the plight of slum dwellers and informal settlers, embodied by Goal 7 Target 11 of the Millennium Development Goals, and the considerable resources being mobilized by the Global Fund to fight AIDS, TB and malaria, among others, provide an unprecedented potential opportunity for countries to seriously address the structural and intermediate determinants of poor health in these settings. Viewed within the framework of the “social determinants of disease” model, preventing and controlling HIV/AIDS, TB and vector-borne diseases requires broad and integrated interventions that address the underlying causes of inequity that result in poorer health and worse health outcomes for the urban poor. We examine insights into effective approaches to disease control and prevention within poor urban settings under a comprehensive social development agenda. PMID:17431796

Urban population genetics of slum-dwelling rats (Rattus norvegicus) in Salvador, Brazil

PubMed Central

Kajdacsi, Brittney; Costa, Federico; Hyseni, Chaz; Porter, Fleur; Brown, Julia; Rodrigues, Gorete; Farias, Helena; Reis, Mitermeyer G.; Childs, James E.; Ko, Albert I.; Caccone, Adalgisa

2013-01-01

Throughout the developing world, urban centers with sprawling slum settlements are rapidly expanding and invading previously forested ecosystems. Slum communities are characterized by untended refuse, open sewers, and overgrown vegetation, which promote rodent infestation. Norway rats (Rattus norvegicus), are reservoirs for epidemic transmission of many zoonotic pathogens of public health importance. Understanding the population ecology of R. norvegicus is essential to formulate effective rodent control strategies, as this knowledge aids estimation of the temporal stability and spatial connectivity of populations. We screened for genetic variation, characterized the population genetic structure, and evaluated the extent and patterns of gene flow in the urban landscape using 17 microsatellite loci in 146 rats from 9 sites in the city of Salvador, Brazil. These sites were divided between three neighborhoods within the city spaced an average of 2.7 km apart. Surprisingly, we detected very little relatedness among animals trapped at the same site and found high levels of genetic diversity, as well as structuring across small geographic distances. Most FST comparisons among sites were statistically significant, including sites <400 m apart. Bayesian analyses grouped the samples in three genetic clusters, each associated with distinct sampling sites from different neighborhoods or valleys within neighborhoods. These data indicate the existence of complex genetic structure in R. norvegicus in Salvador, linked to the heterogeneous urban landscape. Future rodent control measures need to take into account the spatial and temporal linkage of rat populations in Salvador, as revealed by genetic data, to develop informed eradication strategies. PMID:24118116

Exclusive breastfeeding practices among mothers in urban slum settlements: pooled analysis from three prospective birth cohort studies in South India.

PubMed

Velusamy, Vasanthakumar; Premkumar, Prasanna S; Kang, Gagandeep

2017-01-01

The World Health Organization (WHO) recommends six months of exclusive breastfeeding. Despite documented health, social and economic benefits, the practice of exclusive breastfeeding is quite low and information on influencing factors is limited especially from slum settlements. Our goal is to assess the prevalence and evaluate factors associated with early cessation of exclusive breastfeeding in the first six months of life among mothers in urban slums of Vellore, Southern India. We pooled data from three similar birth cohort studies ( n = 1088) conducted between 2002 and 2009. Breastfeeding information was obtained soon after birth and then from follow-up home visits conducted once every two weeks by the field workers. Multivariable Cox regression analyses were used to assess factors associated with early cessation of exclusive breastfeeding. The prevalence of exclusive breastfeeding for the first six months was 11.4%, based on prospective data since birth. Results from multivariable analyses revealed maternal education (Adjusted Hazard Ratio [AHR] 1.18 , 95% CI 1.03, 1.35), pucca type of house (AHR 1.25 , 95% CI 1.10, 1.43), two or more number of children in the family (AHR 1.26 , 95% CI 1.10, 1.43), joint family structure (AHR 1.20 , 95% CI 1.02, 1.40) and birth during summer (AHR 1.16, 95% CI 1.01, 1.31) were associated with early cessation of exclusive breastfeeding in the first six months. Our results indicate that exclusive breastfeeding rates are well below the recommended levels. Educational interventions providing comprehensive breastfeeding information to mothers and their families can be evaluated to assess its effect on improving infant feeding practices.

The concentration of disadvantage and the rise of an urban penalty: urban slum prevalence and the social production of health inequalities in the developing countries.

PubMed

Rice, James; Rice, Julie Steinkopf

2009-01-01

Urban slums are proliferating in the developing countries. A corollary of this structural transformation is the increasing recognition of an urban penalty wherein slum populations exhibit notable inequalities in health relative to non-slum urban residents and even rural populations. The built urban environment, in turn, is a crucial context within which the social production of disproportionate morbidity and mortality is enacted. The authors develop this assertion and use bivariate and partial correlation analysis to highlight the association of urban slum prevalence, or proportion of the total population living in urban slum conditions, with indicators of mortality and gender parity, measured at the national level. Data for 99 developing countries show that greater urban slum prevalence is strongly correlated with higher levels of infant, child, and maternal mortality. Further, urban slum prevalence exhibits strong, deleterious correlations with gender parity (measured by the gender development index) and fertility rate, factors that have a crucial direct impact in shaping variant mortality levels. Future research is warranted on the social inequalities in health and illness derived from the expansion of urban slum conditions in the developing countries.

Transition into first sex among adolescents in slum and non-slum communities in Nairobi, Kenya

PubMed Central

Kabiru, Caroline W.; Beguy, Donatien; Undie, Chi-Chi; Zulu, Eliya Msiyaphazi; Ezeh, Alex C.

2014-01-01

While early sexual experiences are a key marker of the transition from childhood to adulthood, it is widely acknowledged that precocious initiation of sexual activity predisposes adolescents to negative health and psychological outcomes. Extant studies investigating adolescent sexuality in sub-Saharan Africa often rely on cross-sectional data lacking information on the social-psychological underpinnings of adolescent behavior. Through the theoretical lens of the protection-risk conceptual framework, this paper draws on two waves of longitudinal data collected from 2,134 adolescents to examine sociodemographic, psychosocial and behavioral predictors of transition to first sex among adolescents living in slum and non-slum settlements in urban Kenya. We employ logistic regression models to examine the effect of antecedent sociodemographic and risk and protective factors measured during the first wave of data collection on transition to first sex by the second wave. We observe that transition to first sex is influenced by age, slum residence, perceived parental monitoring, and peer behavior. We also find evidence for coupling of risk behaviors. Study findings underscore the need to focus on very young adolescents and those growing up in resource poor settings as these young people may be highly vulnerable to negative health outcomes stemming from precocious sexual activity. PMID:24955020

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.

PubMed

Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C

2016-01-01

It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum-rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities.

Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil.

PubMed

Hagan, José E; Moraga, Paula; Costa, Federico; Capian, Nicolas; Ribeiro, Guilherme S; Wunder, Elsio A; Felzemburgh, Ridalva D M; Reis, Renato B; Nery, Nivison; Santana, Francisco S; Fraga, Deborah; Dos Santos, Balbino L; Santos, Andréia C; Queiroz, Adriano; Tassinari, Wagner; Carvalho, Marilia S; Reis, Mitermayer G; Diggle, Peter J; Ko, Albert I

2016-01-01

Rat-borne leptospirosis is an emerging zoonotic disease in urban slum settlements for which there are no adequate control measures. The challenge in elucidating risk factors and informing approaches for prevention is the complex and heterogeneous environment within slums, which vary at fine spatial scales and influence transmission of the bacterial agent. We performed a prospective study of 2,003 slum residents in the city of Salvador, Brazil during a four-year period (2003-2007) and used a spatiotemporal modelling approach to delineate the dynamics of leptospiral transmission. Household interviews and Geographical Information System surveys were performed annually to evaluate risk exposures and environmental transmission sources. We completed annual serosurveys to ascertain leptospiral infection based on serological evidence. Among the 1,730 (86%) individuals who completed at least one year of follow-up, the infection rate was 35.4 (95% CI, 30.7-40.6) per 1,000 annual follow-up events. Male gender, illiteracy, and age were independently associated with infection risk. Environmental risk factors included rat infestation (OR 1.46, 95% CI, 1.00-2.16), contact with mud (OR 1.57, 95% CI 1.17-2.17) and lower household elevation (OR 0.92 per 10m increase in elevation, 95% CI 0.82-1.04). The spatial distribution of infection risk was highly heterogeneous and varied across small scales. Fixed effects in the spatiotemporal model accounted for the majority of the spatial variation in risk, but there was a significant residual component that was best explained by the spatial random effect. Although infection risk varied between years, the spatial distribution of risk associated with fixed and random effects did not vary temporally. Specific "hot-spots" consistently had higher transmission risk during study years. The risk for leptospiral infection in urban slums is determined in large part by structural features, both social and environmental. Our findings indicate that topographic factors such as household elevation and inadequate drainage increase risk by promoting contact with mud and suggest that the soil-water interface serves as the environmental reservoir for spillover transmission. The use of a spatiotemporal approach allowed the identification of geographic outliers with unexplained risk patterns. This approach, in addition to guiding targeted community-based interventions and identifying new hypotheses, may have general applicability towards addressing environmentally-transmitted diseases that have emerged in complex urban slum settings.

Urban population genetics of slum-dwelling rats (Rattus norvegicus) in Salvador, Brazil.

PubMed

Kajdacsi, Brittney; Costa, Federico; Hyseni, Chaz; Porter, Fleur; Brown, Julia; Rodrigues, Gorete; Farias, Helena; Reis, Mitermayer G; Childs, James E; Ko, Albert I; Caccone, Adalgisa

2013-10-01

Throughout the developing world, urban centres with sprawling slum settlements are rapidly expanding and invading previously forested ecosystems. Slum communities are characterized by untended refuse, open sewers and overgrown vegetation, which promote rodent infestation. Norway rats (Rattus norvegicus) are reservoirs for epidemic transmission of many zoonotic pathogens of public health importance. Understanding the population ecology of R. norvegicus is essential to formulate effective rodent control strategies, as this knowledge aids estimation of the temporal stability and spatial connectivity of populations. We screened for genetic variation, characterized the population genetic structure and evaluated the extent and patterns of gene flow in the urban landscape using 17 microsatellite loci in 146 rats from nine sites in the city of Salvador, Brazil. These sites were divided between three neighbourhoods within the city spaced an average of 2.7 km apart. Surprisingly, we detected very little relatedness among animals trapped at the same site and found high levels of genetic diversity, as well as structuring across small geographical distances. Most F(ST) comparisons among sites were statistically significant, including sites <400 m apart. Bayesian analyses grouped the samples in three genetic clusters, each associated with distinct sampling sites from different neighbourhoods or valleys within neighbourhoods. These data indicate the existence of complex genetic structure in R. norvegicus in Salvador, linked to the heterogeneous urban landscape. Future rodent control measures need to take into account the spatial and temporal linkage of rat populations in Salvador, as revealed by genetic data, to develop informed eradication strategies. © 2013 John Wiley & Sons Ltd.

Comparative prevalence of otitis media in children living in urban slums, non-slum urban and rural areas of Delhi.

PubMed

Chadha, Shelly K; Gulati, Kriti; Garg, Suneela; Agarwal, Arun K

2014-12-01

The study aimed to determine the prevalence and profile of otitis media in different parts of a city, i.e. non-slum urban areas, urban slums and rural areas. A door to door survey was conducted in identified areas of Delhi. A total of 3000 children (0-15 years) were randomly selected and examined for presence of otitis media. These children were equally distributed in the three areas under consideration. Data was analyzed to establish the prevalence of different types of otitis media. Chi-square test was then applied to compare disease prevalence among the three areas. 7.1% of the study population was identified with otitis media, which includes CSOM (4.26%), OME (2.5%) and ASOM (0.4%). In the non-slum urban parts of the city, 4.6% children had otitis media. This was significantly lower compared to 7% children in rural parts of Delhi and 9.9% in urban slums of the city. The prevalence of CSOM was considerably higher in slum areas (7.2%) as compared with rural (3%) and non-slum urban areas (2.6%). Ear infections are significantly more common in urban slums as compared to non-slum city areas and rural parts of Delhi. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effects of individual, household and community characteristics on child nutritional status in the slums of urban Bangladesh.

PubMed

Ahsan, Karar Zunaid; Arifeen, Shams El; Al-Mamun, Md Abdullah; Khan, Shusmita H; Chakraborty, Nitai

2017-01-01

Bangladesh urban population is expected to overtake rural population by 2040, and a significant part of the increase will be in slums. Wide disparities between urban slums and the rest of the country can potentially push country indicators off track unless the specific health and nutrition needs of the expanding slum communities are addressed. The study aims at describing the individual, household and community determinants of undernutrition status among children living in major urban strata, viz. City Corporation slums and non-slums, in order to understand the major drivers of childhood undernutrition in urban slum settings. Data are derived from Bangladesh Urban Health Survey conducted in 2013. This survey is a large-scale, nationally representative of urban areas, household survey designed specifically to provide health and nutrition status of women and children in urban Bangladesh. Data showed that 50% of under-5 children in slums are stunted and 43% are underweight, whereas for non-slums these rates are 33 and 26% respectively. In terms of severity, proportion of under-5 children living in slums severely underweight or stunted are nearly double than the children living in non-slums. Logistic analyses indicate that mother's education, child's age, and household's socio-economic status significantly affects stunting and underweight levels among children living in the urban slums. Logistic models also indicate that all individual-level characteristics, except exposure to mass media and mother's working outside home, significantly affect undernutrition levels among children living on non-slums. Among the household- and community-level characteristics, only household's socioeconomic status remains significant for the non-slums. Poor nutritional status is a major concern in slum areas, particularly as this group is expected to grow rapidly in the next few years. The situation calls for specially designed and well targeted interventions that take into account that many of the mothers are poorer and less educated, which affects their ability to provide care to their children.

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

PubMed Central

Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

2016-01-01

Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum–rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Conclusion Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities. PMID:27924741

Adverse life events and delinquent behavior among Kenyan adolescents: a cross-sectional study on the protective role of parental monitoring, religiosity, and self-esteem

PubMed Central

2014-01-01

Background Past research provides strong evidence that adverse life events heighten the risk of delinquent behavior among adolescents. Urban informal (slum) settlements in sub-Saharan Africa are marked by extreme adversity. However, the prevalence and consequences of adverse life events as well as protective factors that can mitigate the effects of exposure to these events in slum settlements is largely understudied. We examine two research questions. First, are adverse life events experienced at the individual and household level associated with a higher likelihood of delinquent behavior among adolescents living in two slums in Nairobi, Kenya? Second, are parental monitoring, religiosity, and self-esteem protective against delinquency in a context of high adversity? Methods We used cross-sectional data from 3,064 males and females aged 12–19 years who participated in the Transitions to Adulthood Study. We examined the extent to which a composite index of adverse life events was associated with delinquent behavior (measured using a composite index derived from nine items). We also examined the direct and moderating effects of three protective factors: parental monitoring, religiosity, and self-esteem. Results Fifty-four percent of adolescents reported at least one adverse life event, while 18% reported three or more adverse events. For both males and females, adversity was positively and significantly associated with delinquency in bivariate and multivariate models. Negative associations were observed between the protective factors and delinquency. Significant adverse events × protective factor interaction terms were observed for parental monitoring (females and males), religiosity (males), and self-esteem (females). Conclusions Similar to research in high income countries, adverse life events are associated with an increased likelihood of delinquent behavior among adolescents living in urban slums in Kenya, a low-income country. However, parental monitoring, religiosity, and self-esteem may moderate the effect of adversity on delinquent behavior and pinpoint possible avenues to develop interventions to reduce delinquency in resource-poor settings in low and middle income countries. PMID:25210535

Application of Satellite Remote Sensing to Identify Climatic and Anthropogenic Changes Related to Water and Health Conditions in Emerging Megacities

NASA Astrophysics Data System (ADS)

Akanda, A. S.; Serman, E. A.; Jutla, A.

2014-12-01

By 2050, more than 70% of the world's population is expected to be living in a city. In many of the urbanizing regions in Asia and Africa, most new development is taking place without adequate urban or regional planning, and a majority population is crowded into densely populated unplanned settlements, also known as slums. During the same period, precipitation and temperature patterns are likely to see significant changes in many of these regions while coastal megacities will have to accommodate sea-level rise in their ecosystems. The rapid increase in population is usually observed in fringes of the urban sprawl without adequate water or sanitation facilities or access to other municipal amenities (such as utilities, healthcare, and education). Collectively, these issues make the ever increasing slum dwellers in emerging megacities significantly vulnerable to a combination of climatic and anthropogenic threats. However, how the growth of unplanned urban and peri-urban sprawl and simultaneous change in climatic patterns have impacted public health in the emerging megacities remain largely unexplored due to lack of readily available and usable data. We employ a number of Remote Sensing products (GRACE, LANDSAT, MODIS) to bridge above knowledge gaps and to identify relevant hydrologic and anthropogenic changes in emerging megacities that are most vulnerable due to the climate-water-health nexus. We explore one of the largest and the fastest growing megacities in the world - Dhaka, Bangladesh - on identifying and investigating the changes in the water environment and growth of slum areas, and impact on water services and health outcomes. The hydroclimatology of South Asia is highly seasonal and the asymmetric availability of water affects vast areas of Bangladesh differently in space and time, exposing the population of Dhaka region to both droughts and floods and periodic spring-fall outbreaks of diarrheal diseases, such as cholera and rotavirus. This research focuses on stretching this understanding to water and health implications in this growing megacity and adjoining slum areas, and how satellite remote sensing data products and derived knowledge can inform urban planning, water management, and public health sectors to adapt to these climatic and anthropogenic changes for the benefit of societies.

Transmission of Streptococcus pneumoniae in an Urban Slum Community

PubMed Central

Palma, Tania; Ribeiro, Guilherme S.; Pinheiro, Ricardo M; Ribeiro, Cassio Tâmara; Cordeiro, Soraia Machado; da Silva Filho, H. P.; Moschioni, Monica; Thompson, Terry A.; Spratt, Brian; Riley, Lee W.; Barocchi, Michele A.; Reis, Mitermayer G.; Ko, Albert I.

2008-01-01

Background Inhabitants of slum settlements represent a significant proportion of the population at risk for pneumococcal disease in developing countries. Methods We conducted a household survey of pneumococcal carriage among residents of a slum community in the city of Salvador, Brazil. Results Among 262 subjects, 95 (36%) were colonized with S. pneumoniae. Children <5 years of age (OR, 8.0; 95%CI, 3.5-18.6) and those who attended schools (OR 2.7, 95%CI, 1.2-6.0) had significantly higher risk of being colonized. Of 94 isolates obtained from colonized individuals, 51% had serotypes included in the seven-valent pneumococcal conjugate vaccine. Overall, 10% (9 of 94 isolates) were nonsusceptible to penicillin and 28% (27 of 94 isolates) were resistant to cotrimoxazole. BOX-PCR, PFGE and MLST analysis found that 44% of the carriage isolates belonged to 14 distinct clonal groups. Strains of the same clonal group were isolated from multiple members of 9 out of the 39 study households. Nineteen carriage isolates had genotypes that were the same as those identified among 362 strains obtained from active surveillance for meningitis. Conclusions The study's findings indicate that there is significant intra and inter-household spread of S. pneumoniae in the slum community setting. However, a limited number of clones encountered during carriage among slum residents were found to cause invasive disease. PMID:18672297

Probabilistic Impact Assessment of Domestic Rainwater Harvesting in Urban Slums: West Africa Case Study

NASA Astrophysics Data System (ADS)

Cowden, J. R.; Watkins, D. W.; Mihelcic, J. R.; Fry, L. M.

2007-12-01

Urban populations now exceed rural populations worldwide, creating unique challenges in providing basic services, especially in developing countries where informal or illegal settlements grow in peri-urban areas. West Africa is an acute example of the problems created by rapid urban growth, with high levels of urban poverty and low water and sanitation access rates. Although considerable effort has been made in providing improved water access and urban services to slum communities, research indicates that clean water access rates are not keeping up with urbanization rates in several areas of the world and that rapidly growing slum communities are beginning to overwhelm many prior water improvements projects. In the face of these challenges, domestic rainwater harvesting is proposed as a technologically appropriate and economically viable option for enhancing water supplies to urban slum households. However, assessing the reliability, potential health impacts, and overall cost-effectiveness of these systems on a regional level is difficult for several reasons. First, long daily rainfall records are not readily available in much of the developing world, including many regions of sub-Saharan Africa. Second, significant uncertainties exist in the relevant cost, water use, and health data. Third, to estimate the potential future impacts at the regional scale, various global change scenarios should be investigated. Finally, in addition to these technical challenges, there is also a need to develop relatively simple and transparent assessment methods for informing policy makers. A procedure is presented for assessment of domestic rainwater harvesting systems using a combination of scenario, sensitivity, and trade-off analyses. Using data from West Africa, simple stochastic weather models are developed to generate rainfall sequences for the region, which are then used to estimate the reliability of providing a range of per capita water supplies. Next, a procedure is proposed for quantifying the health impacts of improved water supplies, and sensitivity analysis of cost and health data provides an indication of cost- effectiveness. Climate change impacts are assessed via weather model parameter adjustment according to statistical downscaling of general circulation model output. Future work involving the interpolation of model parameters to ungaged sites, incorporation of additional global change scenarios (e.g., population, emissions), and extension of the procedure to a full Monte Carlo analysis will be discussed as time allows.

Fuzzy B-spline optimization for urban slum three-dimensional reconstruction using ENVISAT satellite data

NASA Astrophysics Data System (ADS)

Marghany, Maged

2014-06-01

A critical challenges in urban aeras is slums. In fact, they are considered a source of crime and disease due to poor-quality housing, unsanitary conditions, poor infrastructures and occupancy security. The poor in the dense urban slums are the most vulnerable to infection due to (i) inadequate and restricted access to safety, drinking water and sufficient quantities of water for personal hygiene; (ii) the lack of removal and treatment of excreta; and (iii) the lack of removal of solid waste. This study aims to investigate the capability of ENVISAT ASAR satellite and Google Earth data for three-dimensional (3-D) slum urban reconstruction in developed countries such as Egypt. The main objective of this work is to utilize some 3-D automatic detection algorithm for urban slum in ENVISAT ASAR and Google Erath images were acquired in Cairo, Egypt using Fuzzy B-spline algorithm. The results show that the fuzzy algorithm is the best indicator for chaotic urban slum as it can discriminate between them from its surrounding environment. The combination of Fuzzy and B-spline then used to reconstruct 3-D of urban slum. The results show that urban slums, road network, and infrastructures are perfectly discriminated. It can therefore be concluded that the fuzzy algorithm is an appropriate algorithm for chaotic urban slum automatic detection in ENVSIAT ASAR and Google Earth data.

Prevalence and correlates of tobacco use among urban adult men in India: a comparison of slum dwellers vs non-slum dwellers.

PubMed

Rooban, T; Joshua, Elizabeth; Rao, Umadevi K; Ranganathan, K

2012-01-01

Tobacco use is reported to be rampant in urban slums in developing countries. Demographical variations in tobacco use between males living in urban slums vs those living in non-slum areas in India has not been reported, and this study was undertaken to address this issue. Secondary data analysis of National Family Health Survey-3 (NFHS-3) was undertaken to study demographical variations in tobacco use between urban slum dwellers and non-slum dwellers in eight Indian cities. Demographic determinants for use of smoking and chewing forms of tobacco in the two groups were analyzed. SPSS version 16.0 (SPSS Inc., IL, USA) was used for statistical analysis. The study population comprised 6887 (41.8%) males from slum areas and 9588 (58.2%) from non-slum areas of eight urban cities. Cigarette/beedi smoking was the commonest form of tobacco use among the study population. Pan masala use was the least common form of smokeless tobacco use, next only to snuff. There was a high statistical significance observed within the various demographic parameter studied in both the slum and non-slum dwelling males in study population. However, on studying the differences between the two groups, it was observed that statistical significance of P≤.001 was observed with age (15-49), secondary education, religion, household structure and marital status. The difference between the two groups in the mean number of cigarettes/beedis smoked was not statistically significant (P=.598). Male slum dwellers are a distinct urban population, whose health needs assessment requires a different approach than that for non-slum dwellers who often can afford the services that an urban Indian city can offer.

How do slums change the relationship between urbanization and the carbon intensity of well-being?

PubMed

McGee, Julius Alexander; Ergas, Christina; Greiner, Patrick Trent; Clement, Matthew Thomas

2017-01-01

This study examines how the relationship between urbanization (measured as the percentage of total population living in urban areas) and the carbon intensity of well-being (CIWB) (measured as a ratio of carbon dioxide emissions and life expectancy) in most nations from 1960-2013 varies based on the economic context and whereabouts of a substantial portion of a nation's urban population. To accomplish this, we use the United Nations' (UN) definition of slum households to identify developing countries that have substantial slum populations, and estimate a Prais-Winsten regression model with panel-corrected standard errors (PCSE), allowing for disturbances that are heteroskedastic and contemporaneously correlated across panels. Our findings indicate that the rate of increase in CIWB for countries without substantial slum populations begins to slow down at higher levels of urbanization, however, the association between urbanization and CIWB is much smaller in countries with substantial slum populations. Overall, while urbanization is associated with increases in CIWB, the relationship between urban development and CIWB is vastly different in developed nations without slums than in under-developed nations with slums.

How do slums change the relationship between urbanization and the carbon intensity of well-being?

PubMed Central

McGee, Julius Alexander

2017-01-01

This study examines how the relationship between urbanization (measured as the percentage of total population living in urban areas) and the carbon intensity of well-being (CIWB) (measured as a ratio of carbon dioxide emissions and life expectancy) in most nations from 1960–2013 varies based on the economic context and whereabouts of a substantial portion of a nation’s urban population. To accomplish this, we use the United Nations’ (UN) definition of slum households to identify developing countries that have substantial slum populations, and estimate a Prais-Winsten regression model with panel-corrected standard errors (PCSE), allowing for disturbances that are heteroskedastic and contemporaneously correlated across panels. Our findings indicate that the rate of increase in CIWB for countries without substantial slum populations begins to slow down at higher levels of urbanization, however, the association between urbanization and CIWB is much smaller in countries with substantial slum populations. Overall, while urbanization is associated with increases in CIWB, the relationship between urban development and CIWB is vastly different in developed nations without slums than in under-developed nations with slums. PMID:29220352

Three-dimensional slum urban reconstruction in Envisat and Google Earth Egypt

NASA Astrophysics Data System (ADS)

Marghany, M.; Genderen, J. v.

2014-02-01

This study aims to aim to investigate the capability of ENVISAT ASAR satellite and Google Earth data for three-dimensional (3-D) slum urban reconstruction in developed country such as Egypt. The main objective of this work is to utilize 3-D automatic detection algorithm for urban slum in ENVISAT ASAR and Google Erath images were acquired in Cairo, Egypt using Fuzzy B-spline algorithm. The results show that fuzzy algorithm is the best indicator for chaotic urban slum as it can discriminate them from its surrounding environment. The combination of Fuzzy and B-spline then used to reconstruct 3-D of urban slam. The results show that urban slums, road network, and infrastructures are perfectly discriminated. It can therefore be concluded that fuzzy algorithm is an appropriate algorithm for chaotic urban slum automatic detection in ENVSIAT ASAR and Google Earth data.

Prevalence of Tinea capitis in school going children from Mathare, informal settlement in Nairobi, Kenya.

PubMed

Moto, Jedidah Ndunge; Maingi, John Muthini; Nyamache, Anthony Kebira

2015-06-27

Tinea capitis is a common infection especially in poor resource settings. This study was aimed at determining the prevalence Tinea capitis in children from selected schools from an urban slum in Nairobi city of Kenya. A cross-sectional study was carried out in 150 school going children during the period between May and September 2013. A questionnaire was administered and cultures of scalps, skin scrapping/hair stubs samples were performed and the etiological agents identified and confirmed. In a total of one hundred and fifty (150) children recruited 89 (59.3%) were males and 61 (40.7%) females aged between 3 and 14 years. The overall prevalence rates in dermatophytes infection was 81.3% (122/150) with etiological agents consisting Trichophyton spp. (61.3%), Microsporum spp. (13.3%) and Epidermophyton spp. (7.3%) infections with infections occurring either singly (56%), duo (38%) or tipple co-infections (6%). This study demonstrates a high prevalence of Tinea infections with Trichophyton tonsurans as the predominant etiological agent in school going children of the urban slums of Nairobi.

Prevalence and correlates of smoking among urban adult men in Bangladesh: slum versus non-slum comparison

PubMed Central

Khan, Md Mobarak Hossain; Khan, Aklimunnessa; Kraemer, Alexander; Mori, Mitsuru

2009-01-01

Background Smoking is one of the leading causes of premature death particularly in developing countries. The prevalence of smoking is high among the general male population in Bangladesh. Unfortunately smoking information including correlates of smoking in the cities especially in the urban slums is very scarce, although urbanization is rapid in Bangladesh and slums are growing quickly in its major cities. Therefore this study reported prevalences of cigarette and bidi smoking and their correlates separately by urban slums and non-slums in Bangladesh. Methods We used secondary data which was collected by the 2006 Urban Health Survey. The data were representative for the urban areas in Bangladesh. Both slums and non-slums located in the six City Corporations were considered. Slums in the cities were identified by two steps, first by using the satellite images and secondly by ground truthing. At the next stage, several clusters of households were selected by using proportional sampling. Then from each of the selected clusters, about 25 households were randomly selected. Information of a total of 12,155 adult men, aged 15–59 years, was analyzed by stratifying them into slum (= 6,488) and non-slum (= 5,667) groups. Simple frequency, bivariable and multivariable logistic regression analyses were performed using SPSS. Results Overall smoking prevalence for the total sample was 53.6% with significantly higher prevalences among men in slums (59.8%) than non-slums (46.4%). Respondents living in slums reported a significantly (P < 0.001) higher prevalence of smoking cigarettes (53.3%) as compared to those living in non-slums (44.6%). A similar pattern was found for bidis (slums = 11.4% and non-slums = 3.2%, P < 0.001). Multivariable logistic regression revealed significantly higher odds ratio (OR) of smoking cigarettes (OR = 1.12, 95% CI = 1.03–1.22), bidis (OR = 1.90, 95% CI = 1.58–2.29) and any of the two (OR = 1.23, 95% CI = 1.13–1.34) among men living in slums as compared to those living in non-slums when controlled for age, division, education, marital status, religion, birth place and types of work. Division, education and types of work were the common significant correlates for both cigarette and bidi smoking in slums and non-slums by multivariable logistic regressions. Other significant correlates of smoking cigarettes were marital status (both areas), birth place (slums), and religion (non-slums). Similarly significant factors for smoking bidis were age (both areas), marital status (slums), religion (non-slums), and birth place (both areas). Conclusion The men living in the urban slums reported higher rates of smoking cigarettes and bidis as compared to men living in the urban non-slums. Some of the significant correlates of smoking e.g. education and division should be considered for prevention activities. Our findings clearly underscore the necessity of interventions and preventions by policy makers, public health experts and other stakeholders in slums because smoking was more prevalent in the slum communities with detrimental health sequelae. PMID:19463157

Slum inhabitants' perceptions and decision-making processes related to an innovative sanitation service: evaluating the Blue Diversion Toilet in Kampala (Uganda).

PubMed

O'Keefe, Mark; Messmer, Ulrike; Lüthi, Christoph; Tobias, Robert

2015-01-01

The inadequate provision of sanitation in informal urban settlements, also known as slums, continues to be an important issue. New technologies and services are being designed to solve this problem. However, the history of failed sanitation programmes and projects highlights a lack of understanding of how slum inhabitants decide on investing in such products and services. In this paper, we gather perspectives from potential clients and investigate how slum inhabitants (1) perceive the current situation and whether they desire improvements of sanitation, (2) how they evaluate a new toilet that is still in development, and how (3) social processes and (4) constraints affect decisions. Data were collected through interviewing 1538 people within a general household survey. People using shared and public latrines desire an improvement of their sanitation facilities. The lack of water for washing is perceived by residents as a the biggest problem when accessing current latrines. The new toilet was mostly evaluated positively: people like it, expect large health benefits from it and it complies with cultural norms. However, people also expect some problems with the functioning of the toilet and expect opposition to pay for the service, due to the high costs and a lack of space to set up new toilets.

Why women choose to give birth at home: a situational analysis from urban slums of Delhi

PubMed Central

Devasenapathy, Niveditha; George, Mathew Sunil; Ghosh Jerath, Suparna; Singh, Archna; Negandhi, Himanshu; Alagh, Gursimran; Shankar, Anuraj H; Zodpey, Sanjay

2014-01-01

Objectives Increasing institutional births is an important strategy for attaining Millennium Development Goal -5. However, rapid growth of low income and migrant populations in urban settings in low-income and middle-income countries, including India, presents unique challenges for programmes to improve utilisation of institutional care. Better understanding of the factors influencing home or institutional birth among the urban poor is urgently needed to enhance programme impact. To measure the prevalence of home and institutional births in an urban slum population and identify factors influencing these events. Design Cross-sectional survey using quantitative and qualitative methods. Setting Urban poor settlements in Delhi, India. Participants A house-to-house survey was conducted of all households in three slum clusters in north-east Delhi (n=32 034 individuals). Data on birthing place and sociodemographic characteristics were collected using structured questionnaires (n=6092 households). Detailed information on pregnancy and postnatal care was obtained from women who gave birth in the past 3 months (n=160). Focus group discussions and in-depth interviews were conducted with stakeholders from the community and healthcare facilities. Results Of the 824 women who gave birth in the previous year, 53% (95% CI 49.7 to 56.6) had given birth at home. In adjusted analyses, multiparity, low literacy and migrant status were independently predictive of home births. Fear of hospitals (36%), comfort of home (20.7%) and lack of social support for child care (12.2%) emerged as the primary reasons for home births. Conclusions Home births are frequent among the urban poor. This study highlights the urgent need for improvements in the quality and hospitality of client services and need for family support as the key modifiable factors affecting over two-thirds of this population. These findings should inform the design of strategies to promote institutional births. PMID:24852297

Why women choose to give birth at home: a situational analysis from urban slums of Delhi.

PubMed

Devasenapathy, Niveditha; George, Mathew Sunil; Ghosh Jerath, Suparna; Singh, Archna; Negandhi, Himanshu; Alagh, Gursimran; Shankar, Anuraj H; Zodpey, Sanjay

2014-05-22

Increasing institutional births is an important strategy for attaining Millennium Development Goal -5. However, rapid growth of low income and migrant populations in urban settings in low-income and middle-income countries, including India, presents unique challenges for programmes to improve utilisation of institutional care. Better understanding of the factors influencing home or institutional birth among the urban poor is urgently needed to enhance programme impact. To measure the prevalence of home and institutional births in an urban slum population and identify factors influencing these events. Cross-sectional survey using quantitative and qualitative methods. Urban poor settlements in Delhi, India. A house-to-house survey was conducted of all households in three slum clusters in north-east Delhi (n=32 034 individuals). Data on birthing place and sociodemographic characteristics were collected using structured questionnaires (n=6092 households). Detailed information on pregnancy and postnatal care was obtained from women who gave birth in the past 3 months (n=160). Focus group discussions and in-depth interviews were conducted with stakeholders from the community and healthcare facilities. Of the 824 women who gave birth in the previous year, 53% (95% CI 49.7 to 56.6) had given birth at home. In adjusted analyses, multiparity, low literacy and migrant status were independently predictive of home births. Fear of hospitals (36%), comfort of home (20.7%) and lack of social support for child care (12.2%) emerged as the primary reasons for home births. Home births are frequent among the urban poor. This study highlights the urgent need for improvements in the quality and hospitality of client services and need for family support as the key modifiable factors affecting over two-thirds of this population. These findings should inform the design of strategies to promote institutional births. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Predicting Intra-Urban Population Densities in Africa using SAR and Optical Remote Sensing Data

NASA Astrophysics Data System (ADS)

Linard, C.; Steele, J.; Forget, Y.; Lopez, J.; Shimoni, M.

2017-12-01

The population of Africa is predicted to double over the next 40 years, driving profound social, environmental and epidemiological changes within rapidly growing cities. Estimations of within-city variations in population density must be improved in order to take urban heterogeneities into account and better help urban research and decision making, especially for vulnerability and health assessments. Satellite remote sensing offers an effective solution for mapping settlements and monitoring urbanization at different spatial and temporal scales. In Africa, the urban landscape is covered by slums and small houses, where the heterogeneity is high and where the man-made materials are natural. Innovative methods that combine optical and SAR data are therefore necessary for improving settlement mapping and population density predictions. An automatic method was developed to estimate built-up densities using recent and archived optical and SAR data and a multi-temporal database of built-up densities was produced for 48 African cities. Geo-statistical methods were then used to study the relationships between census-derived population densities and satellite-derived built-up attributes. Best predictors were combined in a Random Forest framework in order to predict intra-urban variations in population density in any large African city. Models show significant improvement of our spatial understanding of urbanization and urban population distribution in Africa in comparison to the state of the art.

Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil

PubMed Central

Hagan, José E.; Moraga, Paula; Costa, Federico; Capian, Nicolas; Ribeiro, Guilherme S.; Wunder, Elsio A.; Felzemburgh, Ridalva D. M.; Reis, Renato B.; Nery, Nivison; Santana, Francisco S.; Fraga, Deborah; dos Santos, Balbino L.; Santos, Andréia C.; Queiroz, Adriano; Tassinari, Wagner; Carvalho, Marilia S.; Reis, Mitermayer G.; Diggle, Peter J.; Ko, Albert I.

2016-01-01

Background Rat-borne leptospirosis is an emerging zoonotic disease in urban slum settlements for which there are no adequate control measures. The challenge in elucidating risk factors and informing approaches for prevention is the complex and heterogeneous environment within slums, which vary at fine spatial scales and influence transmission of the bacterial agent. Methodology/Principal Findings We performed a prospective study of 2,003 slum residents in the city of Salvador, Brazil during a four-year period (2003–2007) and used a spatiotemporal modelling approach to delineate the dynamics of leptospiral transmission. Household interviews and Geographical Information System surveys were performed annually to evaluate risk exposures and environmental transmission sources. We completed annual serosurveys to ascertain leptospiral infection based on serological evidence. Among the 1,730 (86%) individuals who completed at least one year of follow-up, the infection rate was 35.4 (95% CI, 30.7–40.6) per 1,000 annual follow-up events. Male gender, illiteracy, and age were independently associated with infection risk. Environmental risk factors included rat infestation (OR 1.46, 95% CI, 1.00–2.16), contact with mud (OR 1.57, 95% CI 1.17–2.17) and lower household elevation (OR 0.92 per 10m increase in elevation, 95% CI 0.82–1.04). The spatial distribution of infection risk was highly heterogeneous and varied across small scales. Fixed effects in the spatiotemporal model accounted for the majority of the spatial variation in risk, but there was a significant residual component that was best explained by the spatial random effect. Although infection risk varied between years, the spatial distribution of risk associated with fixed and random effects did not vary temporally. Specific “hot-spots” consistently had higher transmission risk during study years. Conclusions/Significance The risk for leptospiral infection in urban slums is determined in large part by structural features, both social and environmental. Our findings indicate that topographic factors such as household elevation and inadequate drainage increase risk by promoting contact with mud and suggest that the soil-water interface serves as the environmental reservoir for spillover transmission. The use of a spatiotemporal approach allowed the identification of geographic outliers with unexplained risk patterns. This approach, in addition to guiding targeted community-based interventions and identifying new hypotheses, may have general applicability towards addressing environmentally-transmitted diseases that have emerged in complex urban slum settings. PMID:26771379

Hepatitis B, Hepatitis C and HIV-1 Coinfection in Two Informal Urban Settlements in Nairobi, Kenya.

PubMed

Kerubo, Glennah; Khamadi, Samoel; Okoth, Vincent; Madise, Nyovani; Ezeh, Alex; Ziraba, Abdhalah; Abdalla, Ziraba; Mwau, Matilu

2015-01-01

HIV-1 and Hepatitis B and C viruses coinfection is common in Sub-Saharan Africa due to similar routes of transmission and high levels of poverty. Most studies on HIV-1 and Hepatitis B and C viruses have occurred in hospital settings and blood transfusion units. Data on Hepatitis B and C viruses and HIV-1 coinfection in informal urban settlements in Kenya are scanty, yet they could partly explain the disproportionately high morbidity and mortality associated with HIV-1 infections in these slums. The objective of this study was to determine the prevalence of HIV and Hepatitis B and C dual infection in urban slums in Nairobi. Blood samples were collected from residents of Viwandani and Korogocho between 2006 and 2007. A structured questionnaire was used to obtain socio-demographic data from participants. Samples were screened for Hepatitis B surface antigen (HBsAg), anti-HCV and anti-HIV-1. Statistical analysis was done using STATA. Samples were successfully collected from 418 (32%) men and 890 (68%) females. The HIV-1, HBV and HCV prevalence was 20.4%, 13.3% and 0.76% respectively at the time of the study. Of the 268 (20.4%) HIV-1 positive participants, 56 (4.26%) had HBV while 6 (0.46%) had HCV. Of the 1041 HIV-1 negative participants, 117 (8.9%) had HBV while 4 (0.31%) had HCV. Only two people (0.15%) were co-infected with all the three viruses together. The odds of getting hepatitis infection were higher in HIV-1 participants (for HBV OR 2.08,p<0.005 and for HCV OR 5.93, p<0.005). HIV prevalence rates were similar in both informal settlements. HIV infection was highest in age group 35-39 years and among the divorced/separated or widowed. Prevalence of all viruses was highest in those who did not have any formal education. The HIV prevalence in these informal settlements suggests a higher rate than what is observed nationally. The prevalence rates of HBV are significantly higher in the HIV-1 positive and negative populations. HCV as well as triple HIV-1, HBV and HCV coinfection are uncommon in Korogocho and Viwandani. This clearly indicates the need for HIV-1 control programmes and hepatitis B virus vaccination to be promoted through public awareness as preventive strategy.

Slum Definitions in Urban India: Implications for the Measurement of Health Inequalities.

PubMed

Nolan, Laura B

2015-03-01

Half the population of low- and middle-income countries will live in urban areas by 2030, and poverty and inequality in these contexts is rising. Slum dwelling is one way in which to conceptualize and characterize urban deprivation but there are many definitions of what constitutes a slum. This paper presents four different slum definitions used in India alone, demonstrating that assessments of both the distribution and extent of urban deprivation depends on the way in which it is characterized, as does slum dwelling's association with common child health indicators. Using data from India's National Family and Health Survey from 2005-2006, two indictors of slum dwelling embedded in the survey and two constructed from the household questionnaire are compared using descriptive statistics and linear regression models of height- and weight-for-age z-scores. The results highlight a tension between international and local slum definitions, and underscore the importance of improving empirical representations of the dynamism of slum and city residents.

Slum Definitions in Urban India: Implications for the Measurement of Health Inequalities

PubMed Central

Nolan, Laura B.

2015-01-01

Half the population of low- and middle-income countries will live in urban areas by 2030, and poverty and inequality in these contexts is rising. Slum dwelling is one way in which to conceptualize and characterize urban deprivation but there are many definitions of what constitutes a slum. This paper presents four different slum definitions used in India alone, demonstrating that assessments of both the distribution and extent of urban deprivation depends on the way in which it is characterized, as does slum dwelling’s association with common child health indicators. Using data from India’s National Family and Health Survey from 2005–2006, two indictors of slum dwelling embedded in the survey and two constructed from the household questionnaire are compared using descriptive statistics and linear regression models of height- and weight-for-age z-scores. The results highlight a tension between international and local slum definitions, and underscore the importance of improving empirical representations of the dynamism of slum and city residents. PMID:26877568

Vulnerability to typhoon hazards in the coastal informal settlements of Metro Manila, the Philippines.

PubMed

Morin, Véronique M; Ahmad, Mokbul Morshed; Warnitchai, Pennung

2016-10-01

In many low- and middle-income countries informal communities-also termed slum and squatter areas-have become a dominant and distinct form of urban settlement, with ever increasing populations. Such communities are often located in areas of high hazard exposure and frequently affected by disasters. While often recognised as one of the highest 'at risk' populations, this paper will argue that informal settlers have been directly and indirectly excluded from many formal mechanisms, thereby increasing their vulnerability to disaster events. Household surveys were conducted across several frequently flooded informal coastal communities in Metro Manila, the Philippines, following a major typhoon and storm surge disaster. The study revealed a large level of diversity in socio-economic vulnerability, although all households faced similar levels of physical exposure and physical vulnerability. Disaster risk reduction policies and responses need to better integrate informal settlement areas and recognise the diversity within these communities. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya

PubMed Central

J. Madise, Nyovani; Ziraba, Abdhalah K.; Inungu, Joseph; Khamadi, Samoel A.; Ezeh, Alex; Zulu, Eliya M.; Kebaso, John; Okoth, Vincent; Mwau, Matilu

2012-01-01

In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence. PMID:22591621

Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements.

PubMed

Twigg, John; Christie, Nicola; Haworth, James; Osuteye, Emmanuel; Skarlatidou, Artemis

2017-02-01

Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum) settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix.

Survey-based socio-economic data from slums in Bangalore, India

NASA Astrophysics Data System (ADS)

Roy, Debraj; Palavalli, Bharath; Menon, Niveditha; King, Robin; Pfeffer, Karin; Lees, Michael; Sloot, Peter M. A.

2018-01-01

In 2010, an estimated 860 million people were living in slums worldwide, with around 60 million added to the slum population between 2000 and 2010. In 2011, 200 million people in urban Indian households were considered to live in slums. In order to address and create slum development programmes and poverty alleviation methods, it is necessary to understand the needs of these communities. Therefore, we require data with high granularity in the Indian context. Unfortunately, there is a paucity of highly granular data at the level of individual slums. We collected the data presented in this paper in partnership with the slum dwellers in order to overcome the challenges such as validity and efficacy of self reported data. Our survey of Bangalore covered 36 slums across the city. The slums were chosen based on stratification criteria, which included geographical location of the slum, whether the slum was resettled or rehabilitated, notification status of the slum, the size of the slum and the religious profile. This paper describes the relational model of the slum dataset, the variables in the dataset, the variables constructed for analysis and the issues identified with the dataset. The data collected includes around 267,894 data points spread over 242 questions for 1,107 households. The dataset can facilitate interdisciplinary research on spatial and temporal dynamics of urban poverty and well-being in the context of rapid urbanization of cities in developing countries.

Ante natal care (ANC) utilization, dietary practices and nutritional outcomes in pregnant and recently delivered women in urban slums of Delhi, India: an exploratory cross-sectional study.

PubMed

Ghosh-Jerath, Suparna; Devasenapathy, Niveditha; Singh, Archna; Shankar, Anuraj; Zodpey, Sanjay

2015-03-20

Antenatal Care (ANC) is one of the crucial factors in ensuring healthy outcomes in women and newborns. Nutrition education and counselling is an integral part of ANC that influences maternal and child health outcomes. A cross sectional study was conducted in Pregnant Women (PW) and mothers who had delivered in the past three months; Recently Delivered Women (RDW) in urban slums of North-east district of Delhi, India, to explore ANC utilization, dietary practices and nutritional outcomes. A household survey was conducted in three urban slums to identify PW and RDW. Socio-economic and demographic profile, various components of ANC received including nutrition counselling, dietary intake and nutritional outcomes based on anthropometric indices and anaemia status were assessed. Socio-demographic characteristics, nutrient intake and nutritional status were compared between those who availed ANC versus those who did not using logistic regression. Descriptive summary for services and counselling received; dietary and nutrient intake during ANC were presented. Almost 80% (274 out of 344) women received some form of ANC but the package was inadequate. Determinants for non-utilization of ANC were poverty, literacy, migration, duration of stay in the locality and high parity. Counselling on nutrition was reported by a fourth of the population. Nutrient intake showed suboptimal consumption of protein and micronutrients like iron, calcium, vitamin A, vitamin C, thiamine, riboflavin niacin, zinc and vitamin B12 by more than half of women. A high prevalence of anaemia among PW (85%) and RDW (97.1%) was observed. There was no difference in micronutrient intake and anaemia prevalence among women who received ANC versus who did not. Pregnant women living in urban poor settlements have poor nutritional status. This may be improved by strengthening the nutrition counselling component of ANC which was inadequate in the ANC package received. Empowering community based health workers in providing effective nutrition counselling should be explored given the overburdened public health system.

Automated detection of slum area change in Hyderabad, India using multitemporal satellite imagery

NASA Astrophysics Data System (ADS)

Kit, Oleksandr; Lüdeke, Matthias

2013-09-01

This paper presents an approach to automated identification of slum area change patterns in Hyderabad, India, using multi-year and multi-sensor very high resolution satellite imagery. It relies upon a lacunarity-based slum detection algorithm, combined with Canny- and LSD-based imagery pre-processing routines. This method outputs plausible and spatially explicit slum locations for the whole urban agglomeration of Hyderabad in years 2003 and 2010. The results indicate a considerable growth of area occupied by slums between these years and allow identification of trends in slum development in this urban agglomeration.

Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya.

PubMed

Madise, Nyovani J; Ziraba, Abdhalah K; Inungu, Joseph; Khamadi, Samoel A; Ezeh, Alex; Zulu, Eliya M; Kebaso, John; Okoth, Vincent; Mwau, Matilu

2012-09-01

In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence. Copyright © 2012 Elsevier Ltd. All rights reserved.

Survey-based socio-economic data from slums in Bangalore, India

PubMed Central

Roy, Debraj; Palavalli, Bharath; Menon, Niveditha; King, Robin; Pfeffer, Karin; Lees, Michael; Sloot, Peter M. A.

2018-01-01

In 2010, an estimated 860 million people were living in slums worldwide, with around 60 million added to the slum population between 2000 and 2010. In 2011, 200 million people in urban Indian households were considered to live in slums. In order to address and create slum development programmes and poverty alleviation methods, it is necessary to understand the needs of these communities. Therefore, we require data with high granularity in the Indian context. Unfortunately, there is a paucity of highly granular data at the level of individual slums. We collected the data presented in this paper in partnership with the slum dwellers in order to overcome the challenges such as validity and efficacy of self reported data. Our survey of Bangalore covered 36 slums across the city. The slums were chosen based on stratification criteria, which included geographical location of the slum, whether the slum was resettled or rehabilitated, notification status of the slum, the size of the slum and the religious profile. This paper describes the relational model of the slum dataset, the variables in the dataset, the variables constructed for analysis and the issues identified with the dataset. The data collected includes around 267,894 data points spread over 242 questions for 1,107 households. The dataset can facilitate interdisciplinary research on spatial and temporal dynamics of urban poverty and well-being in the context of rapid urbanization of cities in developing countries. PMID:29313840

Trends in childhood mortality in Kenya: the urban advantage has seemingly been wiped out.

PubMed

Kimani-Murage, E W; Fotso, J C; Egondi, T; Abuya, B; Elungata, P; Ziraba, A K; Kabiru, C W; Madise, N

2014-09-01

We describe trends in childhood mortality in Kenya, paying attention to the urban-rural and intra-urban differentials. We use data from the Kenya Demographic and Health Surveys (KDHS) collected between 1993 and 2008 and the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) collected in two Nairobi slums between 2003 and 2010, to estimate infant mortality rate (IMR), child mortality rate (CMR) and under-five mortality rate (U5MR). Between 1993 and 2008, there was a downward trend in IMR, CMR and U5MR in both rural and urban areas. The decline was more rapid and statistically significant in rural areas but not in urban areas, hence the gap in urban-rural differentials narrowed over time. There was also a downward trend in childhood mortality in the slums between 2003 and 2010 from 83 to 57 for IMR, 33 to 24 for CMR, and 113 to 79 for U5MR, although the rates remained higher compared to those for rural and non-slum urban areas in Kenya. The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Place of Residence Moderates the Risk of Infant Death in Kenya: Evidence from the Most Recent Census 2009.

PubMed

Gruebner, Oliver; Lautenbach, Sven; Khan, M M H; Kipruto, Samuel; Epprecht, Michael; Galea, Sandro

2015-01-01

Substantial progress has been made in reducing childhood mortality worldwide from 1990-2015 (Millennium Development Goal, target 4). Achieving target goals on this however remains a challenge in Sub-Saharan Africa. Kenya's infant mortality rates are higher than the global average and are more pronounced in urban areas as compared to rural areas. Only limited knowledge exists about the differences in individual level risk factors for infant death among rural, non-slum urban, and slum areas in Kenya. Therefore, this paper aims at 1) assess individual and socio-ecological risk factors for infant death in Kenya, and at 2) identify whether living in rural, non-slum urban, or slum areas moderated individual or socio-ecological risk factors for infant death in Kenya. We used a cross-sectional study design based on the most recent Kenya Population and Housing Census of 2009 and extracted the records of all females who had their last child born in 12 months preceding the survey (N = 1,120,960). Multivariable regression analyses were used to identify risk factors that accounted for the risk of dying before the age of one at the individual level in Kenya. Place of residence (rural, non-slum urban, slum) was used as an interaction term to account for moderating effects in individual and socio-ecological risk factors. Individual characteristics of mothers and children (older age, less previously born children that died, better education, girl infants) and household contexts (better structural quality of housing, improved water and sanitation, married household head) were associated with lower risk for infant death in Kenya. Living in non-slum urban areas was associated with significantly lower infant death as compared to living in rural or slum areas, when all predictors were held at their reference levels. Moreover, place of residence was significantly moderating individual level predictors: As compared to rural areas, living in urban areas was a protective factor for mothers who had previous born children who died, and who were better educated. However, living in urban areas also reduced the health promoting effects of better structural quality of housing (i.e. poor or good versus non-durable). Furthermore, durable housing quality in urban areas turned out to be a risk factor for infant death as compared to rural areas. Living in slum areas was also a protective factor for mothers with previous child death, however it also reduced the promoting effects of older ages in mothers. While urbanization and slum development continues in Kenya, public health interventions should invest in healthy environments that ideally would include improvements to access to safe water and sanitation, better structural quality of housing, and to access to education, health care, and family planning services, especially in urban slums and rural areas. In non-slum urban areas however, health education programs that target healthy diets and promote physical exercise may be an important adjunct to these structural interventions.

Temperature and heat in informal settlements in Nairobi.

PubMed

Scott, Anna A; Misiani, Herbert; Okoth, Jerrim; Jordan, Asha; Gohlke, Julia; Ouma, Gilbert; Arrighi, Julie; Zaitchik, Ben F; Jjemba, Eddie; Verjee, Safia; Waugh, Darryn W

2017-01-01

Nairobi, Kenya exhibits a wide variety of micro-climates and heterogeneous surfaces. Paved roads and high-rise buildings interspersed with low vegetation typify the central business district, while large neighborhoods of informal settlements or "slums" are characterized by dense, tin housing, little vegetation, and limited access to public utilities and services. To investigate how heat varies within Nairobi, we deployed a high density observation network in 2015/2016 to examine summertime temperature and humidity. We show how temperature, humidity and heat index differ in several informal settlements, including in Kibera, the largest slum neighborhood in Africa, and find that temperature and a thermal comfort index known colloquially as the heat index regularly exceed measurements at the Dagoretti observation station by several degrees Celsius. These temperatures are within the range of temperatures previously associated with mortality increases of several percent in youth and elderly populations in informal settlements. We relate these changes to surface properties such as satellite-derived albedo, vegetation indices, and elevation.

Newborn care practices among slum dwellers in Dhaka, Bangladesh: a quantitative and qualitative exploratory study.

PubMed

Moran, Allisyn C; Choudhury, Nuzhat; Uz Zaman Khan, Nazib; Ahsan Karar, Zunaid; Wahed, Tasnuva; Faiz Rashid, Sabina; Alam, M Ashraful

2009-11-17

Urbanization is occurring at a rapid pace, especially in low-income countries. Dhaka, Bangladesh, is estimated to grow to 50 million by 2015, with 21 million living in urban slums. Although health services are available, neonatal mortality is higher in slum areas than in urban non-slum areas. The Manoshi program works to improve maternal, newborn, and child health in urban slums in Bangladesh. This paper describes newborn care practices in urban slums in Dhaka and provides program recommendations. A quantitative baseline survey was conducted in six urban slum areas to measure newborn care practices among recently delivered women (n = 1,256). Thirty-six in-depth semi-structured interviews were conducted to explore newborn care practices among currently pregnant women (n = 18) and women who had at least one delivery (n = 18). In the baseline survey, the majority of women gave birth at home (84%). Most women reported having knowledge about drying the baby (64%), wrapping the baby after birth (59%), and cord care (46%). In the in-depth interviews, almost all women reported using sterilized instruments to cut the cord. Babies are typically bathed soon after birth to purify them from the birth process. There was extensive care given to the umbilical cord including massage and/or applying substances, as well as a variety of practices to keep the baby warm. Exclusive breastfeeding was rare; most women reported first giving their babies sweet water, honey and/or other foods. These reported newborn care practices are similar to those in rural areas of Bangladesh and to urban and rural areas in the South Asia region. There are several program implications. Educational messages to promote providing newborn care immediately after birth, using sterile thread, delaying bathing, and ensuring dry cord care and exclusive breastfeeding are needed. Programs in urban slum areas should also consider interventions to improve social support for women, especially first time mothers. These interventions may improve newborn survival and help achieve MDG4.

Prevalence of Diabetic Retinopathy in Urban Slums: The Aditya Jyot Diabetic Retinopathy in Urban Mumbai Slums Study-Report 2.

PubMed

Sunita, Mohan; Singh, Arvind Kumar; Rogye, Ashwini; Sonawane, Manish; Gaonkar, Ravina; Srinivasan, Radhika; Natarajan, Sundaram; Stevens, Fred C J; Scherpbier, A J J A; Kumaramanickavel, Govindasamy; McCarty, Catherine

2017-10-01

The aims of the study were to estimate the prevalence of diabetic retinopathy (DR) and enumerate history-based risk factors in the urban slums of Western India. The population-based study was conducted in seven wards of Mumbai urban slums, where we screened 6569 subjects of ≥ 40 years age, with a response rate of 98.4%, for type 2 diabetes mellitus (T2DM) based on American Diabetes Association criteria. All subjects with T2DM underwent dilated 30° seven-field stereo-fundus-photography for DR severity grading based on modified Airlie House classification. A multivariate logistic regression model was used to assess the correlation of DR with the history-based risk factors. The prevalence of DR in the general population of Mumbai urban slums was 1.41% (95% CI 0.59-2.23) and in the T2DM population it was 15.37% (95% CI 8.87-21.87). The positive associations with DR were the longer duration of DM (≥ 11 years: OR, 12.77; 95% CI 2.93-55.61) and male gender (OR, 2.05; 95% CI 1.08-3.89); increasing severity of retinopathy was also significantly associated with longer duration of DM (p < 0.001). However, history of hypertension, family history of DM, consanguineous marriage and migration status were not associated with DR in the study population. The prevalence of DR in the general population and T2DM subjects were 1.41% and 15.37% respectively in Mumbai urban slums. Duration of DM and male gender were significantly associated with DR. The slums in Western India show the trends of urban lifestyle influences similar to the rest of urban India.

Trends in childhood mortality in Kenya: The urban advantage has seemingly been wiped out

PubMed Central

Kimani-Murage, E.W.; Fotso, J.C.; Egondi, T.; Abuya, B.; Elungata, P.; Ziraba, A.K.; Kabiru, C.W.; Madise, N.

2014-01-01

Background We describe trends in childhood mortality in Kenya, paying attention to the urban–rural and intra-urban differentials. Methods We use data from the Kenya Demographic and Health Surveys (KDHS) collected between 1993 and 2008 and the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) collected in two Nairobi slums between 2003 and 2010, to estimate infant mortality rate (IMR), child mortality rate (CMR) and under-five mortality rate (U5MR). Results Between 1993 and 2008, there was a downward trend in IMR, CMR and U5MR in both rural and urban areas. The decline was more rapid and statistically significant in rural areas but not in urban areas, hence the gap in urban–rural differentials narrowed over time. There was also a downward trend in childhood mortality in the slums between 2003 and 2010 from 83 to 57 for IMR, 33 to 24 for CMR, and 113 to 79 for U5MR, although the rates remained higher compared to those for rural and non-slum urban areas in Kenya. Conclusions The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums. PMID:25024120

A rapid assessment scorecard to identify informal settlements at higher maternal and child health risk in Mumbai.

PubMed

Osrin, David; Das, Sushmita; Bapat, Ujwala; Alcock, Glyn A; Joshi, Wasundhara; More, Neena Shah

2011-10-01

The communities who live in urban informal settlements are diverse, as are their environmental conditions. Characteristics include inadequate access to safe water and sanitation, poor quality of housing, overcrowding, and insecure residential status. Interventions to improve health should be equity-driven and target those at higher risk, but it is not clear how to prioritise informal settlements for health action. In implementing a maternal and child health programme in Mumbai, India, we had conducted a detailed vulnerability assessment which, though important, was time-consuming and may have included collection of redundant information. Subsequent data collection allowed us to examine three issues: whether community environmental characteristics were associated with maternal and newborn healthcare and outcomes; whether it was possible to develop a triage scorecard to rank the health vulnerability of informal settlements based on a few rapidly observable characteristics; and whether the scorecard might be useful for future prioritisation. The City Initiative for Newborn Health documented births in 48 urban slum areas over 2 years. Information was collected on maternal and newborn care and mortality, and also on household and community environment. We selected three outcomes-less than three antenatal care visits, home delivery, and neonatal mortality-and used logistic regression and classification and regression tree analysis to test their association with rapidly observable environmental characteristics. We developed a simple triage scorecard and tested its utility as a means of assessing maternal and newborn health risk. In analyses on a sample of 10,754 births, we found associations of health vulnerability with inadequate access to water, toilets, and electricity; non-durable housing; hazardous location; and rental tenancy. A simple scorecard based on these had limited sensitivity and positive predictive value, but relatively high specificity and negative predictive value. The scorecard needs further testing in a range of urban contexts, but we intend to use it to identify informal settlements in particular need of family health interventions in a subsequent program.

Community participation to refine measures of socio-economic status in urban slum settings in Kenya.

PubMed

Ngongo, Carrie Jane; Mathingau, Florence Alice; Burke, Heather; Brieger, William; Frick, Kevin; Chapman, Kimberly; Breiman, Robert

Ownership of household durable assets can be a useful proxy for determining relative socio-economic status in a community, but the assets that should be measured are not always unambiguous. Often the selection of asset variables has been ad hoc or not well explained in the literature. Although the benefits of conducting focus groups to design surveys are widely recognized, the use of focus groups to adapt community-specific asset indices has not previously been reported in Kenya. This article describes how focus group discussions can allow communities to express how residents value assets and distinguish relative wealth. Focus group discussions were conducted within the informal urban settlement of Kibera in Nairobi, Kenya. Participants identified assets that distinguish between the poorest and the least poor in their community. They considered whether they would move away from the slum if they had the opportunity, and many would not, citing reasons ranging from loyalty to the community to greater living expenses on the outside. Local perceptions of relative poverty and mobility provide insight into how quality of life in this setting can be assessed and potentially improved. Moreover, a qualitative approach can lead to the adaptation of a community asset index for use in further research.

Urbanization as a determinant of health: a socioepidemiological perspective.

PubMed

Patil, Rajan R

2014-01-01

Urbanization is a process that leads to the growth of cities due to industrialization and economic development and that leads to urban-specific changes. Urbanization is associated with profound changes in diet and exercise that in turn increase the prevalence of obesity with attendant increases in risk of type II diabetes and cardiovascular disease. The growing burden of disease among vulnerable populations and pervasive socioeconomic inequities within urban systems exaggerates the adverse impacts of urbanization on health. More than one half of children younger than age 5 of urban poor are stunted and/or underweight. More than one half of the child births occur at home, in slums, putting the life of the mother and newborn in serious risk. Inadequate reach of services due to illegality, social exclusion of slums, hidden slum pockets, and weak social fabric have resulted in a rapid proliferation of the unqualified private health sector, leading to high health expenditures and continuing a vicious cycle of poverty and ill health in urban slums.

Healthcare seeking practices and barriers to accessing under-five child health services in urban slums in Malawi: a qualitative study.

PubMed

Lungu, Edgar Arnold; Biesma, Regien; Chirwa, Maureen; Darker, Catherine

2016-08-19

Access to child health services is an important determinant of child health. Whereas, child health indicators are generally better in urban than rural areas, some population groups in urban areas, such as children residing in urban slums do not enjoy this urban health advantage. In the context of increasing urbanisation and urban poverty manifesting with proliferation of urban slums, the health of under-five children in slum areas remains a public health imperative in Malawi. This paper explores healthcare-seeking practices for common childhood illnesses focusing on use of biomedical health services and perceived barriers to accessing under-five child health services in urban slums of Lilongwe, Malawi's capital city. Qualitative data from 8 focus group discussions with caregivers and 11 in-depth interviews with key informants conducted from September 2012 to April 2013 were analysed using conventional content analysis. Whereas, caregivers sought care from biomedical health providers, late care-seeking also emerged as a major theme and phenomenon. Home management was actively undertaken for childhood illnesses. Various health system barriers: lack of medicines and supplies; long waiting times; late facility opening times; negative attitude of health workers; suboptimal examination of the sick child; long distance to health facility; and cost of healthcare were cited in this qualitative inquiry as critical health system factors affecting healthcare-seeking for child health services. Interventions to strengthen the health system's responsiveness to expectations are essential to promote utilisation of child health services among urban slum populations, and ultimately improve child health and survival.

Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements

PubMed Central

Twigg, John; Christie, Nicola; Haworth, James; Osuteye, Emmanuel; Skarlatidou, Artemis

2017-01-01

Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum) settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix. PMID:28157149

Introducing a model of cardiovascular prevention in Nairobi's slums by integrating a public health and private-sector approach: the SCALE-UP study.

PubMed

van de Vijver, Steven; Oti, Samuel; Tervaert, Thijs Cohen; Hankins, Catherine; Kyobutungi, Catherine; Gomez, Gabriela B; Brewster, Lizzy; Agyemang, Charles; Lange, Joep

2013-10-21

Cardiovascular disease (CVD) is a leading cause of death in sub-Saharan Africa (SSA), with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited. To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD) and African Population and Health Research Center (APHRC), collaborated with private-sector Boston Consulting Group (BCG) to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility. The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year). The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO), and leading non-governmental organizations (NGOs). Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by relevant policymakers and NGOs.

Policy directions in urban health in developing countries--the slum improvement approach.

PubMed

Harpham, T; Stephens, C

1992-07-01

The urban development, or housing, sector has a longer experience of addressing the problems of the urban poor in developing countries than the health sector. In recent years the policy of 'slum improvement', which involves both sectors, has attracted the support of international donors. This article documents the development of the slum improvement approach and addresses key issues of the approach which have implications for health planning: covering the poorest dwellers; relocation; land tenure; gentrification; debt burdens and the impact on women. Questions about the approach which still need answering are defined and a summary of the constraints in slum improvement and potential solutions is presented.

Effect of modelling slum populations on influenza spread in Delhi

PubMed Central

Chen, Jiangzhuo; Chu, Shuyu; Chungbaek, Youngyun; Khan, Maleq; Kuhlman, Christopher; Marathe, Achla; Mortveit, Henning; Vullikanti, Anil; Xie, Dawen

2016-01-01

Objectives This research studies the impact of influenza epidemic in the slum and non-slum areas of Delhi, the National Capital Territory of India, by taking proper account of slum demographics and residents’ activities, using a highly resolved social contact network of the 13.8 million residents of Delhi. Methods An SEIR model is used to simulate the spread of influenza on two different synthetic social contact networks of Delhi, one where slums and non-slums are treated the same in terms of their demographics and daily sets of activities and the other, where slum and non-slum regions have different attributes. Results Differences between the epidemic outcomes on the two networks are large. Time-to-peak infection is overestimated by several weeks, and the cumulative infection rate and peak infection rate are underestimated by 10–50%, when slum attributes are ignored. Conclusions Slum populations have a significant effect on influenza transmission in urban areas. Improper specification of slums in large urban regions results in underestimation of infections in the entire population and hence will lead to misguided interventions by policy planners. PMID:27687898

Urbanization and Slum Formation

PubMed Central

Phua, Kai Hong

2007-01-01

The formation of slums need not be inevitable with rapid urbanization. Such an argument appears to be contradicted by evidence of large slum populations in a large number of developing countries and particularly in rapidly urbanizing regions like Asia. The evidence discussed suggests that city authorities faced with rapid urban development lack the capacity to cope with the diverse demands for infrastructural provision to meet economic and social needs. Not only are strategic planning and intervention major issues in agenda to manage rapid urbanization, but city governments are not effectively linking the economic development trajectory to implications for urban growth and, hence, housing needs. In the following discussion, a case study is presented in support of the argument that city governments have to first recognize and then act to establish the link that is crucial between economic development, urban growth, and housing. This is the agendum that has been largely neglected by city and national governments that have been narrowly focused on economic growth with the consequent proliferation of slum formation as a housing solution. PMID:17387618

Association between malnutrition in children living in slums, maternal nutritional status, and environmental factors.

PubMed

Silveira, Kátia B R; Alves, Jullyana F R; Ferreira, Haroldo S; Sawaya, Ana L; Florêncio, Telma M M T

2010-01-01

To investigate the association of malnutrition in children living in substandard settlements (slums) of Maceió, Brazil, with maternal nutritional status and environmental conditions. Cross-sectional study involving a probability sample of 2,075 mothers (18 to 45 years) and their children (4 months to 6 years), living in the slums of the city of Maceió. First, we conducted a cluster analysis with the purpose of choosing the settlements and the administrative region of the city of Maceió with the lowest human development index. After this analysis, the 7th Administrative Region was designated for the study, including its 23 substandard settlements. Socioeconomic, demographic, anthropometric, and maternal and child health data were collected by means of household survey. The statistical analysis included the odds ratio of a child to be malnourished, and the univariate regression was used to check which maternal variables were associated with this malnutrition. Chronic malnutrition (-2 standard deviations/height for age) was found in 8.6% of children and was associated with mother's age and educational level, type of residence, number of rooms, flooring, water supply, and low birth weight (< 2,500 g) in children aged < or = 24 months. We also found an association between child malnutrition and maternal height. Such association was not observed regarding body mass index. The high prevalence of malnutrition observed in these settlements was related to social and environmental conditions and short maternal height, who had weight deficit or weight excess.

Fever treatment in the absence of malaria transmission in an urban informal settlement in Nairobi, Kenya.

PubMed

Ye, Yazoume; Madise, Nyovani; Ndugwa, Robert; Ochola, Sam; Snow, Robert W

2009-07-15

In sub-Saharan Africa, knowledge of malaria transmission across rapidly proliferating urban centres and recommendations for its prevention or management remain poorly defined. This paper presents the results of an investigation into infection prevalence and treatment of recent febrile events among a slum population in Nairobi, Kenya. In July 2008, a community-based malaria parasite prevalence survey was conducted in Korogocho slum, which forms part of the Nairobi Urban Health and Demographic Surveillance system. Interviewers visited 1,069 participants at home and collected data on reported fevers experienced over the preceding 14 days and details on the treatment of these episodes. Each participant was tested for malaria parasite presence with Rapid Diagnostic Test (RDT) and microscopy. Descriptive analyses were performed to assess the period prevalence of reported fever episodes and treatment behaviour. Of the 1,069 participants visited, 983 (92%) consented to be tested. Three were positive for Plasmodium falciparum using RDT; however, all were confirmed negative on microscopy. Microscopic examination of all 953 readable slides showed zero prevalence. Overall, from the 1,004 participants who have data on fever, 170 fever episodes were reported giving a relatively high period prevalence (16.9%, 95% CI:13.9%-20.5%) and higher among children below five years (20.1%, 95%CI:13.8%-27.8%). Of the fever episodes with treatment information 54.3% (95%CI:46.3%-62.2%) were treated as malaria using mainly sulphadoxine-pyrimethamine or amodiaquine, including those managed at a formal health facility. Only four episodes were managed using the nationally recommended first-line treatment, artemether-lumefantrine. The study could not demonstrate any evidence of malaria in Korogocho, a slum in the centre of Nairobi. Fever was a common complaint and often treated as malaria with anti-malarial drugs. Strategies, including testing for malaria parasites to reduce the inappropriate exposure of poor communities to expensive anti-malarial drugs provided by clinical services and drug vendors, should be a priority for district planners.

Understanding the fate of sanitation-related nutrients in a shallow sandy aquifer below an urban slum area

NASA Astrophysics Data System (ADS)

Nyenje, P. M.; Havik, J. C. N.; Foppen, J. W.; Muwanga, A.; Kulabako, R.

2014-08-01

We hypothesized that wastewater leaching from on-site sanitation systems to alluvial aquifers underlying informal settlements (or slums) may end up contributing to high nutrient loads to surface water upon groundwater exfiltration. Hence, we conducted a hydro-geochemical study in a shallow sandy aquifer in Bwaise III parish, an urban slum area in Kampala, Uganda, to assess the geochemical processes controlling the transport and fate of dissolved nutrients (NO3, NH4 and PO4) released from on-site sanitation systems to groundwater. Groundwater was collected from 26 observation wells. The samples were analyzed for major ions (Ca, Mg, Na, Mg, Fe, Mn, Cl and SO4) and nutrients (o-PO4, NO3 and NH4). Data was also collected on soil characteristics, aquifer conductivity and hydraulic heads. Geochemical modeling using PHREEQC was used to determine the level of o-PO4 control by mineral solubility and sorption. Groundwater below the slum area was anoxic and had near neutral pH values, high values of EC (average of 1619 μS/cm) and high concentrations of Cl (3.2 mmol/L), HCO3 (11 mmol/L) and nutrients indicating the influence from wastewater leachates especially from pit latrines. Nutrients were predominantly present as NH4 (1-3 mmol/L; average of 2.23 mmol/L). The concentrations of NO3 and o-PO4 were, however, low: average of 0.2 mmol/L and 6 μmol/L respectively. We observed a contaminant plume along the direction of groundwater flow (NE-SW) characterized by decreasing values of EC and Cl, and distinct redox zones. The redox zones transited from NO3-reducing in upper flow areas to Fe-reducing in the lower flow areas. Consequently, the concentrations of NO3 decreased downgradient of the flow path due to denitrification. Ammonium leached directly into the alluvial aquifer was also partially removed because the measured concentrations were less than the potential input from pit latrines (3.2 mmol/L). We attributed this removal (about 30%) to anaerobic ammonium oxidation (anammox) given that the cation exchange capacity of the aquifer was low (< 6 meq/100 g) to effectively adsorb NH4. Phosphate transport was, on the other hand, greatly retarded and our results showed that this was due to the adsorption of P to calcite and the co-precipitation of P with calcite and rhodochrosite. Our findings suggest that shallow alluvial sandy aquifers underlying urban slum areas are an important sink of excessive nutrients leaching from on-site sanitation systems.

Riparian planning in Yogyakarta City

NASA Astrophysics Data System (ADS)

Rachmawati, R.; Prakoso, E.; Sadali, M. I.; Yusuf, M. G.

2018-04-01

Riparian is a potential for slums in urban areas. The city of Yogyakarta is passed by three rivers namely Code, Gajahwong, and Winongo, crossing the city. Riparian in the three rivers are potential for slum if the area is not well managed. This paper is based on the survey results of the structured interview with the people living in the riparian area in Yogyakarta City. They were 75 respondents from the three riparian. The result shows that several reasons why people prefer to remain living in the area are limited spaces and high land price in the city as well as inherited from their parents. The facts that there are still several problems related to the condition of settlement environment in the riparian, i.e., The condition of densely-populated areas, limited availability of land, and limited public spaces. Efforts that can be done to solve problems related to the riparian planning are anticipating disasters like flood and landslide, paying attention to densely-populated and unwell-planned areas, and handling garbage that has been abandoned into the river. The program expected by those living along both riversides is intended to give priorities on providing some aid for those whose houses are not in good condition, controlling buildings without a permit, and building a dike along the river. Efficiency can be made by making use of the space adequately between the one for settlement and the other one for open-green space for both aesthetic and economic purposes.

School Enrollment among Urban Non-Slum, Slum and Rural Children in Kenya: Is the Urban Advantage Eroding?

ERIC Educational Resources Information Center

Mugisha, Frederick

2006-01-01

For long now, the urban child has been considered to be more likely than his/her rural counterpart in being able to realize the dream of fully participating in school. This observation has mainly been attributed to what is commonly known as the "urban advantage." This "urban advantage" is associated with increased access to…

Beliefs and practices during pregnancy and childbirth in urban slums of Dhaka, Bangladesh.

PubMed

Choudhury, Nuzhat; Moran, Allisyn C; Alam, M Ashraful; Ahsan, Karar Zunaid; Rashid, Sabina F; Streatfield, Peter Kim

2012-09-17

Worldwide urbanization has become a crucial issue in recent years. Bangladesh, one of the poorest and most densely-populated countries in the world, has been facing rapid urbanization. In urban areas, maternal indicators are generally worse in the slums than in the urban non-slum areas. The Manoshi program at BRAC, a non governmental organization, works to improve maternal, newborn, and child health in the urban slums of Bangladesh. This paper describes maternal related beliefs and practices in the urban slums of Dhaka and provides baseline information for the Manoshi program. This is a descriptive study where data were collected using both quantitative and qualitative methods. The respondents for the quantitative methods, through a baseline survey using a probability sample, were mothers with infants (n = 672) living in the Manoshi program areas. Apart from this, as part of a formative research, thirty six in-depth semi-structured interviews were conducted during the same period from two of the above Manoshi program areas among currently pregnant women who had also previously given births (n = 18); and recently delivered women (n = 18). The baseline survey revealed that one quarter of the recently delivered women received at least four antenatal care visits and 24 percent women received at least one postnatal care visit. Eighty-five percent of deliveries took place at home and 58 percent of the deliveries were assisted by untrained traditional birth attendants. The women mostly relied on their landladies for information and support. Members of the slum community mainly used cheap, easily accessible and available informal sectors for seeking care. Cultural beliefs and practices also reinforced this behavior, including home delivery without skilled assistance. Behavioral change messages are needed to increase the numbers of antenatal and postnatal care visits, improve birth preparedness, and encourage skilled attendance at delivery. Programs in the urban slum areas should also consider interventions to improve social support for key influential persons in the community, particularly landladies who serve as advisors and decision-makers.

Community perception regarding rabies prevention and stray dog control in urban slums in India.

PubMed

Herbert, Mrudu; Riyaz Basha, S; Thangaraj, Selvi

2012-12-01

The lack of community awareness about rabies control is a major issue that thwarts efforts to prevent human deaths caused by rabies. The objectives of this study were (1) to assess community knowledge and attitudes about rabies, rabies prevention and stray dog control in an urban slum community and (2) to determine the factors that influence rabies awareness in urban slums. Using a systematic random sampling strategy, 185 participants were selected from 8 urban slums. The data were collected by direct interview using a pre-tested, structured questionnaire. In the study population, 74.1% of the participants had heard about rabies, and 54.1% knew that rabies is a fatal disease. Only 33.5% of the interviewees felt that people in the community had a role to play in controlling the stray dog population. Gender, age and educational status were significantly associated with rabies awareness. Our study indicates that there are gaps in the knowledge and attitudes of individuals living in urban slums regarding rabies prevention and control. Efforts to promote awareness should be targeted at men, older people and uneducated individuals. Copyright © 2012 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Urbanisation, poverty and sexual behaviour: the tale of five African cities.

PubMed

Greif, Meredith J; Dodoo, F Nii-Amoo; Jayaraman, Anuja

2011-01-01

The question of how urbanisation and poverty are linked in sub-Saharan Africa is an increasingly pressing one. The urban character of the HIV epidemic in sub-Saharan Africa exacerbates concern about the urbanisation - poverty relationship. Recent empirical work has linked urban poverty, and particularly slum residence, to risky sexual behaviour in Kenya's capital city, Nairobi. This paper explores the generalisability of these assertions about the relationship between urban poverty and sexual behaviour using Demographic and Health Survey data from five African cities: Accra (Ghana), Dar-es-Salaam (Tanzania), Harare (Zimbabwe), Kampala (Uganda) and Nairobi (Kenya). The study affirms that, although risky behaviour varies across the five cities, slum residents demonstrate riskier sexual behaviour compared with non-slum residents. There is earlier sexual debut, lower condom usage and more multiple sexual partners among women residing in slum households regardless of setting, suggesting a relatively uniform effect of urban poverty on sexual risk behaviour.

Knowledge, Attitudes, and Practices Related to Leptospirosis among Urban Slum Residents in Brazil

PubMed Central

Navegantes de Araújo, Wildo; Finkmoore, Brooke; Ribeiro, Guilherme S.; Reis, Renato B.; Felzemburgh, Ridalva D. M.; Hagan, José E.; Reis, Mitermayer G.; Ko, Albert I.; Costa, Federico

2013-01-01

Leptospirosis disproportionately affects residents of urban slums. To understand the knowledge, attitudes, and practices regarding leptospirosis, we conducted a cross-sectional study among residents of an urban slum community in Salvador, Brazil. Of the 257 residents who were interviewed, 225 (90%) were aware of leptospirosis and more than two-thirds of respondents correctly identified the modes of disease transmission and ways to reduce exposure. However, study participants who performed risk activities such as cleaning open sewers had limited access to protective clothing such as boots (33%) or gloves (35%). Almost all respondents performed at least one activity to prevent household rat infestation, which often included use of an illegal poison. Our findings support the need for interventions targeted at the individual and household levels to reduce risk of leptospirosis until large-scale structural interventions are available to residents of urban slum communities. PMID:23269657

Beliefs and practices during pregnancy and childbirth in urban slums of Dhaka, Bangladesh

PubMed Central

2012-01-01

Background Worldwide urbanization has become a crucial issue in recent years. Bangladesh, one of the poorest and most densely-populated countries in the world, has been facing rapid urbanization. In urban areas, maternal indicators are generally worse in the slums than in the urban non-slum areas. The Manoshi program at BRAC, a non governmental organization, works to improve maternal, newborn, and child health in the urban slums of Bangladesh. This paper describes maternal related beliefs and practices in the urban slums of Dhaka and provides baseline information for the Manoshi program. Methods This is a descriptive study where data were collected using both quantitative and qualitative methods. The respondents for the quantitative methods, through a baseline survey using a probability sample, were mothers with infants (n = 672) living in the Manoshi program areas. Apart from this, as part of a formative research, thirty six in-depth semi-structured interviews were conducted during the same period from two of the above Manoshi program areas among currently pregnant women who had also previously given births (n = 18); and recently delivered women (n = 18). Results The baseline survey revealed that one quarter of the recently delivered women received at least four antenatal care visits and 24 percent women received at least one postnatal care visit. Eighty-five percent of deliveries took place at home and 58 percent of the deliveries were assisted by untrained traditional birth attendants. The women mostly relied on their landladies for information and support. Members of the slum community mainly used cheap, easily accessible and available informal sectors for seeking care. Cultural beliefs and practices also reinforced this behavior, including home delivery without skilled assistance. Conclusions Behavioral change messages are needed to increase the numbers of antenatal and postnatal care visits, improve birth preparedness, and encourage skilled attendance at delivery. Programs in the urban slum areas should also consider interventions to improve social support for key influential persons in the community, particularly landladies who serve as advisors and decision-makers. PMID:22978705

The Rise of Syria’s Urban Poor: Why the War for Syria’s Future Will Be Fought Over the Country’s New Urban Villages

DTIC Science & Technology

2014-01-01

those urban poor living in the slums sprouting up around Syria’s cities. This “village-izing” of Syria’s ancient cit- ies has changed the complexion...1986 to 20.8 million in 2010.6 This population rose predominantly in the slums surrounding Syria’s cities. From 2000 to 2010, Syria grew by 4.92...opposition activity. Baba Amr, a slum of Homs adjacent to the orchards that once fed the city, is synonymous with the THE RISE OF SYRIA’S POOR

Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya

PubMed Central

2011-01-01

Background The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Methods Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. Results There was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence). Conclusions The study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning. PMID:21615957

Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya.

PubMed

Kimani-Murage, Elizabeth W; Madise, Nyovani J; Fotso, Jean-Christophe; Kyobutungi, Catherine; Mutua, Martin K; Gitau, Tabither M; Yatich, Nelly

2011-05-26

The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. There was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence). The study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning.

Non-communicable disease (NCD) risk factors and diabetes among adults living in slum areas of Dhaka, Bangladesh.

PubMed

Rawal, Lal B; Biswas, Tuhin; Khandker, Nusrat Nausheen; Saha, Shekhar Ranjan; Bidat Chowdhury, Mohammed Mahiul; Khan, Abdullah Nurus Salam; Chowdhury, Enamul Hasib; Renzaho, Andre

2017-01-01

Despite one-third of the urban population in Bangladesh living in urban slums and at increased risk of non-communicable diseases (NCDs), little is known about the NCD risk profile of this at-risk population. The aim of the study was to identify the prevalence of the NCD risk factors and the association of NCD risk factors with socio-demographic factors among the adults of urban slums in Dhaka, Bangladesh. A cross-sectional study was conducted among adult slum dwellers (aged 25 and above) residing in three purposively selected urban slums of Dhaka for at least six months preceding the survey. The risk factors assessed were- currently smoking, fruit and vegetable intake, physical activity, hypertension and body mass index (BMI). Information on self-reported diabetes was also taken. A total of 507 participants (252 females; 49.7%) were interviewed and their physical measures were taken using the WHO NCD STEPS instrument. The overall prevalence of NCD risk factors was: 36.0% (95% CI: 31.82-40.41) for smoking; 95.60% (95% CI: 93.60-97.40) for insufficient fruit and vegetable intake; 15.30% (95% CI:12.12-18.71) for low physical activity;13.70% (95% CI: 10.71-16.92) for hypertension; 22.70% (95% CI: 19.31-26.02) for overweight or obesity; and 5.00% (95%: 3.20-7.00) for self-reported diabetes. In the logistic regression model, the clustering of three or more NCD risk factors was positively associated with younger age groups (p = 0.02), no formal education (p <0.001) and primary education level (p = 0.01), but did not differ by sex of the participants, monthly income and occupation. All NCD risk factors are markedly high among the urban slum adults. These findings are important to support the formulation and implementation of NCD-related polices and plan of actions that recognize urban slum populations in Bangladesh as a priority sub-population.

Women's reproductive health in slum populations in India: evidence from NFHS-3.

PubMed

Hazarika, Indrajit

2010-03-01

The urban population in India is one of the largest in the world. Its unprecedented growth has resulted in a large section of the population living in abject poverty in overcrowded slums. There have been limited efforts to capture the health of people in urban slums. In the present study, we have used data collected during the National Family Health Survey-3 to provide a national representation of women's reproductive health in the slum population in India. We examined a sample of 4,827 women in the age group of 15-49 years to assess the association of the variable slum with selected reproductive health services. We have also tried to identify the sociodemographic factors that influence the utilization of these services among women in the slum communities. All analyses were stratified by slum/non-slum residence, and multivariate logistic regression was used to analyze the strength of association between key reproductive health services and relevant sociodemographic factors. We found that less than half of the women from the slum areas were currently using any contraceptive methods, and discontinuation rate was higher among these women. Sterilization was the most common method of contraception (25%). Use of contraceptives depended on the age, level of education, parity, and the knowledge of contraceptive methods (p < 0.05). There were significant differences in the two populations based on the timing and frequency of antenatal visits. The probability of ANC visits depended significantly on the level of education and economic status (p < 0.05). We found that among slum women, the proportion of deliveries conducted by skilled attendants was low, and the percentage of home deliveries was high. The use of skilled delivery care was found to be significantly associated with age, level of education, economic status, parity, and prior antenatal visits (p < 0.05). We found that women from slum areas depended on the government facilities for reproductive health services. Our findings suggest that significant differences in reproductive health outcomes exist among women from slum and non-slum communities in India. Efforts to progress towards the health MDGs and other national or international health targets may not be achieved without a focus on the urban slum population.

Food security and nutritional outcomes among urban poor orphans in Nairobi, Kenya.

PubMed

Kimani-Murage, Elizabeth W; Holding, Penny A; Fotso, Jean-Christophe; Ezeh, Alex C; Madise, Nyovani J; Kahurani, Elizabeth N; Zulu, Eliya M

2011-06-01

The study examines the relationship between orphanhood status and nutritional status and food security among children living in the rapidly growing and uniquely vulnerable slum settlements in Nairobi, Kenya. The study was conducted between January and June 2007 among children aged 6-14 years, living in informal settlements of Nairobi, Kenya. Anthropometric measurements were taken using standard procedures and z scores generated using the NCHS/WHO reference. Data on food security were collected through separate interviews with children and their caregivers, and used to generate a composite food security score. Multiple regression analysis was done to determine factors related to vulnerability with regards to food security and nutritional outcomes. The results show that orphans were more vulnerable to food insecurity than non-orphans and that paternal orphans were the most vulnerable orphan group. However, these effects were not significant for nutritional status, which measures long-term food deficiencies. The results also show that the most vulnerable children are boys, those living in households with lowest socioeconomic status, with many dependants, and female-headed and headed by adults with low human capital (low education). This study provides useful insights to inform policies and practice to identify target groups and intervention programs to improve the welfare of orphans and vulnerable children living in urban poor communities.

Water Security, Climate Forcings and Public Health Impacts in Emerging Regions

NASA Astrophysics Data System (ADS)

Serman, E. A.; Akanda, A. S.; Craver, V.; Boving, T. B.

2014-12-01

Our world is rapidly urbanizing, with more than 80% of world's population is expected to be living in a city by the end of the century. A majority of these nations are rapidly urbanizing due to massive rural-to-urban migratory trends, with rapid development of unplanned urban settlements, or slums, with lack of adequate water or sanitation facilities and other municipal amenities. With global environmental change, natural disasters will expose millions more to drought, floods, and disease epidemics, and existing vulnerabilities will worsen. At the same time, rapid urbanization and fast changing land-use leads to widespread damage of infrastructure by stormwater, especially in lowlands and economically poor areas. The factor that consistently stands out among different cities from both the developed and the developing worlds is that the slums are typically the most vulnerable to water related natural hazards and climatic threats, such as water scarcity and quality issues in drought conditions, or water and sanitation breakdown and stormwater contamination problems. Onsite or decentralized water, wastewater and stormwater treatment as well as point-of-use water treatment options can be an economic, safe, and reliable alternative to conventional large-scale treatment especially, in urban fringes as well as rural areas. These systems can be designed to fit communities in terms of their economic, cultural, environmental, and demographic resources. As part of this study, we develop a database of urban water quality and quantity indices such as with urban land-use, water usage, climate, and socio-economic characteristics in various emerging regions in the world. We analyze past and current data to identify and quantify long-term trends and the impacts of large-scale climatic and anthropogenic changes on urban hydrology and health impacts. We specifically focus on five major cities from distinct groups of countries and geographies: Providence, RI, USA from the developed world, Lagos, Nigeria, Lima, Peru and Jakarta, Indonesia from the Middle-Income Countries, and Dhaka, Bangladesh from the Least Developed Countries, to compare and contrast leading drivers and sensitivities of water, climate, and health indicators.

Understanding the fate of sanitation-related nutrients in a shallow sandy aquifer below an urban slum area.

PubMed

Nyenje, P M; Havik, J C N; Foppen, J W; Muwanga, A; Kulabako, R

2014-08-01

We hypothesized that wastewater leaching from on-site sanitation systems to alluvial aquifers underlying informal settlements (or slums) may end up contributing to high nutrient loads to surface water upon groundwater exfiltration. Hence, we conducted a hydro-geochemical study in a shallow sandy aquifer in Bwaise III parish, an urban slum area in Kampala, Uganda, to assess the geochemical processes controlling the transport and fate of dissolved nutrients (NO3, NH4 and PO4) released from on-site sanitation systems to groundwater. Groundwater was collected from 26 observation wells. The samples were analyzed for major ions (Ca, Mg, Na, Mg, Fe, Mn, Cl and SO4) and nutrients (o-PO4, NO3 and NH4). Data was also collected on soil characteristics, aquifer conductivity and hydraulic heads. Geochemical modeling using PHREEQC was used to determine the level of o-PO4 control by mineral solubility and sorption. Groundwater below the slum area was anoxic and had near neutral pH values, high values of EC (average of 1619μS/cm) and high concentrations of Cl (3.2mmol/L), HCO3 (11mmol/L) and nutrients indicating the influence from wastewater leachates especially from pit latrines. Nutrients were predominantly present as NH4 (1-3mmol/L; average of 2.23mmol/L). The concentrations of NO3 and o-PO4 were, however, low: average of 0.2mmol/L and 6μmol/L respectively. We observed a contaminant plume along the direction of groundwater flow (NE-SW) characterized by decreasing values of EC and Cl, and distinct redox zones. The redox zones transited from NO3-reducing in upper flow areas to Fe-reducing in the lower flow areas. Consequently, the concentrations of NO3 decreased downgradient of the flow path due to denitrification. Ammonium leached directly into the alluvial aquifer was also partially removed because the measured concentrations were less than the potential input from pit latrines (3.2mmol/L). We attributed this removal (about 30%) to anaerobic ammonium oxidation (anammox) given that the cation exchange capacity of the aquifer was low (<6meq/100g) to effectively adsorb NH4. Phosphate transport was, on the other hand, greatly retarded and our results showed that this was due to the adsorption of P to calcite and the co-precipitation of P with calcite and rhodochrosite. Our findings suggest that shallow alluvial sandy aquifers underlying urban slum areas are an important sink of excessive nutrients leaching from on-site sanitation systems. Copyright © 2014 Elsevier B.V. All rights reserved.

Prevalence and correlates of physical spousal violence against women in slum and non-slum areas of urban Bangladesh

PubMed Central

Sambisa, William; Angeles, Gustavo; Lance, Peter; Naved, Ruchira T.; Thornton, Juliana

2013-01-01

This study explored the prevalence and correlates of past-year physical violence against women in slum and non-slum areas of urban Bangladesh. We used multivariate logistic regression to analyze data from the 2006 Urban Health Survey, a population-based survey of 9122 currently married women aged 15–49 selected using a multi-stage cluster sampling design. The prevalence of reported past-year physical spousal violence was 31%. Prevalence of past-year physical spousal violence was higher in slums (35%) than in non-slums (20%). Slapping/arm-twisting and pushing/shaking/throwing something at the women were the most commonly reported acts of physical abuse. Multivariate analysis showed that the risk of physical spousal abuse was lower among older women, women with post-primary education, and those belonging to rich households and women whose husband considered their opinion in decision-making. Women were at higher risk of abuse if they had many children, believed that married woman should work if the husband is not making enough money, and approved wife beating norms. This study serves to confirm the commonness of physical spousal abuse in urban Bangladesh demonstrating the seriousness of this multifaceted phenomenon as a social and public health issue. The present findings suggest the need for comprehensive prevention and intervention strategies that capitalize on the interplay of individual and sociocultural factors that cause physical spousal violence. Our study adds to a growing literature documenting domestic violence against women in urban areas of developing south Asian nations. PMID:21831870

Barriers and facilitators to Electronic Medical Record (EMR) use in an urban slum.

PubMed

Jawhari, Badeia; Keenan, Louanne; Zakus, David; Ludwick, Dave; Isaac, Abraam; Saleh, Abdullah; Hayward, Robert

2016-10-01

Rapid urbanization has led to the growth of urban slums and increased healthcare burdens for vulnerable populations. Electronic Medical Records (EMRs) have the potential to improve continuity of care for slum residents, but their implementation is complicated by technical and non-technical limitations. This study sought practical insights about facilitators and barriers to EMR implementation in urban slum environments. Descriptive qualitative method was used to explore staff perceptions about a recent open-source EMR deployment in two primary care clinics in Kibera, Nairobi. Participants were interviewed using open-ended, semi-structured questions. Content analysis was used when exploring transcribed data. Three major themes - systems, software, and social considerations - emerged from content analysis, with sustainability concerns prevailing. Although participants reported many systems (e.g., power, network, Internet, hardware, interoperability) and software (e.g., data integrity, confidentiality, function) challenges, social factors (e.g., identity management, training, use incentives) appeared the most important impediments to sustainability. These findings are consistent with what others have reported, especially the importance of practical barriers to EMR deployments in resource-constrained settings. Other findings contribute unique insights about social determinants of EMR impact in slum settings, including the challenge of multiple-identity management and development of meaningful incentives to staff compliance. This study exposes front-line experiences with opportunities and shortcomings of EMR implementations in urban slum primary care clinics. Although the promise is great, there are a number of unique system, software and social challenges that EMR advocates should address before expecting sustainable EMR use in resource-constrained settings. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Urban upgrading and its impact on health: a "quasi-experimental" mixed-methods study protocol for the BH-Viva Project.

PubMed

Friche, Amélia Augusta de Lima; Dias, Maria Angélica de Salles; Reis, Priscila Brandão Dos; Dias, Cláudia Silva; Caiaffa, Waleska Teixeira

2015-11-01

There is little scientific evidence that urban upgrading helps improve health or reduce inequities. This article presents the design for the BH-Viva Project, a "quasi-experimental", multiphase, mixed-methods study with quantitative and qualitative components, proposing an analytical model for monitoring the effects that interventions in the urban environment can have on residents' health in slums in Belo Horizonte, Minas Gerais State, Brazil. A preliminary analysis revealed intra-urban differences in age-specific mortality when comparing areas with and without interventions; the mortality rate from 2002 to 2012 was stable in the "formal city", increased in slums without interventions, and decreased in slums with interventions. BH-Viva represents an effort at advancing methodological issues, providing learning and theoretical backing for urban health research and research methods, allowing their application and extension to other urban contexts.

Immunization, urbanization and slums - a systematic review of factors and interventions.

PubMed

Crocker-Buque, Tim; Mindra, Godwin; Duncan, Richard; Mounier-Jack, Sandra

2017-06-08

In 2014, over half (54%) of the world's population lived in urban areas and this proportion will increase to 66% by 2050. This urbanizing trend has been accompanied by an increasing number of people living in urban poor communities and slums. Lower immunization coverage is found in poorer urban dwellers in many contexts. This study aims to identify factors associated with immunization coverage in poor urban areas and slums, and to identify interventions to improve coverage. We conducted a systematic review, searching Medline, Embase, Global Health, CINAHL, Web of Science and The Cochrane Database with broad search terms for studies published between 2000 and 2016. Of 4872 unique articles, 327 abstracts were screened, leading to 63 included studies: 44 considering factors and 20 evaluating interventions (one in both categories) in 16 low or middle-income countries. A wide range of socio-economic characteristics were associated with coverage in different contexts. Recent rural-urban migration had a universally negative effect. Parents commonly reported lack of awareness of immunization importance and difficulty accessing services as reasons for under-immunization of their children. Physical distance to clinics and aspects of service quality also impacted uptake. We found evidence of effectiveness for interventions involving multiple components, especially if they have been designed with community involvement. Outreach programmes were effective where physical distance was identified as a barrier. Some evidence was found for the effective use of SMS (text) messaging services, community-based education programmes and financial incentives, which warrant further evaluation. No interventions were identified that provided services to migrants from rural areas. Different factors affect immunization coverage in different urban poor and slum contexts. Immunization services should be designed in collaboration with slum-dwelling communities, considering the local context. Interventions should be designed and tested to increase immunization in migrants from rural areas.

Determinants of immunization inequality among urban poor children: evidence from Nairobi's informal settlements.

PubMed

Egondi, Thaddaeus; Oyolola, Maharouf; Mutua, Martin Kavao; Elung'ata, Patricia

2015-02-27

Despite the relentless efforts to reduce infant and child mortality with the introduction of the National Expanded Programmes on Immunization (EPI) in 1974, major disparities still exist in immunizations coverage across different population sub-groups. In Kenya, for instance, while the proportion of fully immunized children increased from 57% in 2003 to 77% in 2008-9 at national level and 73% in Nairobi, only 58% of children living in informal settlement areas are fully immunized. The study aims to determine the degree and determinants of immunization inequality among the urban poor of Nairobi. We used data from the Nairobi Cross-Sectional Slum Survey of 2012 and the health outcome was full immunization status among children aged 12-23 months. The wealth index was used as a measure of social economic position for inequality analysis. The potential determinants considered included sex of the child and mother's education, their occupation, age at birth of the child, and marital status. The concentration index (CI) was used to quantify the degree of inequality and decomposition approach to assess determinants of inequality in immunization. The CI for not fully immunized was -0.08 indicating that immunization inequality is mainly concentrated among children from poor families. Decomposition of the results suggests that 78% of this inequality is largely explained by the mother's level of education. There exists immunization inequality among urban poor children in Nairobi and efforts to reduce this inequality should aim at targeting mothers with low level of education during immunization campaigns.

Understanding HIV risks among adolescent girls and young women in informal settlements of Nairobi, Kenya: Lessons for DREAMS.

PubMed

Ziraba, Abdhalah; Orindi, Benedict; Muuo, Sheru; Floyd, Sian; Birdthistle, Isolde J; Mumah, Joyce; Osindo, Jane; Njoroge, Pauline; Kabiru, Caroline W

2018-01-01

High incidence of HIV infection among adolescent girls and young women (AGYW) has been attributed to the numerous and often layered vulnerabilities that they encounter including violence against women, unfavourable power relations that are worsened by age-disparate sexual relations, and limited access to sexual and reproductive health information and services. For AGYW living in urban informal settlements (slums), these vulnerabilities are compounded by pervasive poverty, fragmented social networks, and limited access to social services including health and education. In this paper, we assess sexual risk behaviours and their correlates among AGYW in two slum settlements in Nairobi, Kenya, prior to the implementation of interventions under the Determined Resilient Empowered AIDS-free Mentored and Safe (DREAMS) Partnership. We drew on secondary data from the Transition to Adulthood study, the most recent representative study on adolescent sexual behaviour in the two settlements. The study was nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). Data were collected in 2009 from 1,390 AGYW aged 12-23 years. We estimated the proportions of AGYW reporting ever tested for HIV, condom use, multiple sexual partners and age-disparate sex by socio-demographic characteristics. "High risk" sexual behaviour was defined as a composite of these four variables and age at first sex. Multivariable regression analyses were performed to identify factors associated with risk behaviours. Fifty-one percent of AGYW reported that they had ever tested for HIV and received results of their last test, with the proportion rising steeply by age (from 15% to 84% among those <15 years and 20-23 years, respectively). Of 578 AGYW who were sexually active in the 12 months preceding the survey, 26% reported using a condom at last sex, 4% had more than one sexual partner, and 26% had sex with men who were at least 5 years older or younger. All girls aged below 15 years who had sex (n = 9) had not used condoms at last sex. The likelihood of engaging in "high risk" sexual risk behaviour was higher among older AGYW (19-23 years), those in marital unions, of Luo ethnicity, out of school, living alone or with a friend (versus parents), living with spouse (versus parents), and those whose friends engaged in risky/anti-social behaviours. In contrast, Muslim faith, co-residence with both parents, and belonging to an organised social group were associated with lower odds of risky sexual behaviours. Our study findings suggest that multifaceted approaches addressing the educational and social mediators of AGYW's vulnerability and that also reach the people with whom AGYW live and interact, are needed to reduce the rapid onset of sexual risk during the adolescent years. There is a particular need to reach the youngest adolescent girls in poor urban settings, among whom condom use and awareness of HIV status is rare.

Socioeconomic factors associated with contraceptive use and method choice in urban slums of Bangladesh.

PubMed

Kamal, S M Mostafa

2015-03-01

This article explores the socioeconomic factors affecting contraceptive use and method choice among women of urban slums using the nationally representative 2006 Bangladesh Urban Health Survey. Both bivariate and multivariate statistical analyses were applied to examine the relationship between a set of sociodemographic factors and the dependent variables. Overall, the contraceptive prevalence rate was 58.1%, of which 53.2% were modern methods. Women's age, access to TV, number of unions, nongovernmental organization membership, working status of women, number of living children, child mortality, and wealth index were important determinants of contraceptive use and method preference. Sex composition of surviving children and women's education were the most important determinants of contraceptive use and method choice. Programs should be strengthened to provide nonclinical modern methods free of cost among the slum dwellers. Doorstep delivery services of modern contraceptive methods may raise the contraceptive prevalence rate among the slum dwellers in Bangladesh. © 2011 APJPH.

Food Store Choice Among Urban Slum Women Is Associated With Consumption of Energy-Dense Food.

PubMed

Anggraini, Roselynne; Februhartanty, Judhiastuty; Bardosono, Saptawati; Khusun, Helda; Worsley, Anthony

2016-07-01

The aim of this study was to examine the associations of food store choice with food consumption among urban slum women. A cross-sectional survey was carried out among 188 urban slum women (19-50 years old) in Jakarta, Indonesia. A semiquantitative food frequency questionnaire was used to assess food consumption. Associations between food consumption and food store choice were tested by linear regression. This study found that frequencies of buying food from small shops (warung), street food vendors, and modern food stores were significantly associated with consumption of snacks, mixed dishes, and fruit respectively. In addition, buying food from traditional markets and small cafes (warung makan) was not significantly associated with particular types of food consumption. As modern food stores are rarely utilized by these women, small shops (warung) and street food vendors are likely to be important channels to improve slum dwellers' diet. © 2016 APJPH.

Understanding shallow groundwater contamination in Bwaise slum, Kampala, Uganda

NASA Astrophysics Data System (ADS)

Nyenje, P. M.; Havik, J.; Foppen, J. W.; Uhlenbrook, S.

2012-04-01

Groundwater in unsewered urban areas is heavily contaminated by onsite sanitation activities and is believed to be an important source of nutrients ex-filtrating into streams and thus contributing to eutrophication of Lakes in urban areas. Currently the fate of nutrients and especially phosphorus leached into groundwater in such areas is not well known. In this study, we undertook an extensive investigation of groundwater in Bwaise slum, Kampala Uganda to understand the distribution and fate of sanitation-related nutrients N and P that are leached into groundwater. Transects of monitoring wells were installed in Bwaise slum and downstream of the slum. From these wells, water levels were measured and water quality analyses done to understand the distribution and composition of the nutrients, how they evolve downstream and the possible subsurface processes affecting their fate during transport. These findings are necessary to evaluate the risk of eutrophication posed by unsewered areas in urban cities and to design/implement sanitation systems that will effectively reduce the enrichment of these nutrients in groundwater. Key words: fate, groundwater, nutrients, processes, slums

Prevalence and Correlates of Physical Spousal Violence against Women in Slum and Nonslum Areas of Urban Bangladesh

ERIC Educational Resources Information Center

Sambisa, William; Angeles, Gustavo; Lance, Peter M.; Naved, Ruchira T.; Thornton, Juliana

2011-01-01

This study explores the prevalence and correlates of past-year physical violence against women in slum and nonslum areas of urban Bangladesh. The authors use multivariate logistic regression to analyze data from the 2006 Urban Health Survey, a population-based survey of 9,122 currently married women aged between 15 and 49 who were selected using a…

Our Housing Mess...And What Can Be Done About It.

ERIC Educational Resources Information Center

Blake, Peter

The housing crisis in the United States is primarily urban. Unlike areas of urban blight, rural alums are not slums of despair by any means. "Slums of despair" is a term used in a recent study of urban life to describe those areas in some of our inner cities whose inhabitants feel they are utterly trapped--that they stand little chance of…

Spatial Growth of Informal Settlements in Delhi; An Application of Remote Sensing

NASA Astrophysics Data System (ADS)

Prakash, Mihir

Slum development and growth is quite popular in developing countries. Many studies have been done on what social and economic factors are the drivers in establishment of informal settlements at a single cross-section of time, however limited work has been done in studying their spatial growth patterns over time. This study attempts to study a sample of 30 informal settlements that exist in the National Capital Territory of India over a period of 40 years and identify relationships between the spatial growth rates and relevant factors identified in previous socio-economic studies of slums using advanced statistical methods. One of the key contributions of this paper is indicating the usefulness of satellite imagery or remote sensing data in spatial-longitudinal studies. This research utilizes readily available LANDSAT images to recognize the decadal spatial growth from 1970 to 2000, and also in extension, calculate the BI (transformed NDVI) as a proxy for the intensity of development for the settlements. A series of regression models were run after processing the data, and the levels of significance were then studied and compared to see which relationships indicated the highest levels of significance. It was observed that the change in BI had a higher strength of relationships with the change in independent variables than the settlement area growth. Also, logarithmic and cubic models showed the highest R-Square values than any other tested models.

Economic Context and HIV Vulnerability in Adolescents and Young Adults Living in Urban Slums in Kenya: A Qualitative Analysis Based on Scarcity Theory.

PubMed

Jennings, Larissa; Mathai, Muthoni; Linnemayr, Sebastian; Trujillo, Antonio; Mak'anyengo, Margaret; Montgomery, Brooke E E; Kerrigan, Deanna L

2017-09-01

Urban slum adolescents and young adults have disproportionately high rates of HIV compared to rural and non-slum urban youth. Yet, few studies have examined youth's perceptions of the economic drivers of HIV. Informed by traditional and behavioral economics, we applied a scarcity theoretical framework to qualitatively examine how poverty influences sexual risk behaviors among adolescents and young adults. Focus group discussions with one hundred twenty youth in Kenyan's urban slums were transcribed, coded, and analyzed using interpretive phenomenology. Results indicated that slum youth made many sexual decisions considered rational from a traditional economics perspective, such as acquiring more sex when resources were available, maximizing wealth through sex, being price-sensitive to costs of condoms or testing services, and taking more risks when protected from adverse sexual consequences. Youth's engagement in sexual risk behaviors was also motivated by scarcity phenomena explained by behavioral economics, such as compensating for sex lost during scarce periods (risk-seeking), valuing economic gains over HIV risks (tunneling, bandwidth tax), and transacting sex as an investment strategy (internal referencing). When scarcity was alleviated, young women additionally described reducing the number of sex partners to account for non-economic preferences (slack). Prevention strategies should address the traditional and behavioral economics of the HIV epidemic.

Occupational health and the environment in an urban slum in India.

PubMed

Shukla, A; Kumar, S; Ory, F G

1991-01-01

The Indo-Dutch Environmental & Sanitary Engineering Project under the Ganga action Plan in Kanpur and Mirzapur is being executed within the Indo-Dutch bilateral development cooperation framework. The project aims to integrate physical, social and health related improvements. It is expected that the development approach and methodology can be replicated in other urban settlements in India. The project is being supplemented by a training and institutional strengthening programme to facilitate the transfer of new technologies and improvement of operation and maintenance of the new facilities. The project is also aimed at the improvement of the living conditions of the population, by installing drinking water and drainage systems. A socio-economic unit in the project supports the technical interventions by enhancing the community to participate in project activities. The Occupational Health Programme in Jajmau, an industrial slum of Kanpur, aims to improve the working conditions of tannery workers. Four hundred and ninety-seven tannery workers and 80 employees not engaged in leather work, from 20 tanneries, were interviewed and underwent physical examination. The mean age of tannery workers was 32 years, about half of them recently migrated to Kanpur. The majority of the workers are illiterate, have temporary jobs and 85% have a monthly income between 300 and 600 Rs. Occupational morbidity was 28.2%. Regular meetings with tannery owners, the training of tannery workers in first aid, and support for the installation of safety and health councils in tanneries are the main programme activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Do slums matter? Location and early childhood preventive care choices among urban residents of Bangladesh.

PubMed

Heller, Lauren R

2013-10-01

Upward trends in the relative proportions of slum residents in developing countries have led to widespread concern regarding the impact of slum residency on health behaviors. Measurement of these impacts requires recognizing that unobservable household characteristics that affect the location decision may also affect health care choices and outcomes. To address the potential for bias, this paper models the location decision and the household's demand for maternal and child health services simultaneously using a flexible, semi-parametric approach. It uses a unique urban data set from Bangladesh that incorporates sophisticated geographical mapping techniques to carefully delineate between slum and non-slum areas at a particular point in time. The results suggest that accounting for the endogenous location decision of a family substantially reduces bias in estimated marginal effects of slum residence on preventive care demand. While community infrastructure variables appear correlated with preventive care demand, the causal effect of the availability of primary health care facilities is indistinguishable from zero when unobserved heterogeneity is taken into account. The findings suggest that improvements in community infrastructure in urban areas of developing countries are a more favorable health policy solution at the margin than the construction of additional health care facilities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Association of Urban Slum Residency with Infant Mortality and Child Stunting in Low and Middle Income Countries

PubMed Central

Kyu, Hmwe Hmwe; Shannon, Harry S.; Georgiades, Katholiki; Boyle, Michael H.

2013-01-01

This study aimed to (i) examine the contextual influences of urban slum residency on infant mortality and child stunting over and above individual and household characteristics and (ii) identify factors that might modify any adverse effects. We obtained data from Demographic and Health Surveys conducted in 45 countries between 2000 and 2009. The respondents were women (15–49 years) and their children (0–59 months). Results showed that living in a slum neighborhood was associated with infant mortality (OR = 1.34, 95% CI = 1.15–1.57) irrespective of individual and household characteristics and this risk was attenuated among children born to women who had received antenatal care from a health professional (OR = 0.79, 95% CI = 0.63–0.99). Results also indicated that increasing child age exacerbated the risk for stunting associated with slum residency (OR = 1.19, 95% CI = 1.16–1.23). The findings suggest that improving material circumstances in urban slums at the neighborhood level as well as increasing antenatal care coverage among women living in these neighborhoods could help reduce infant mortality and stunted child growth. The cumulative impact of long-term exposure to slum neighborhoods on child stunting should be corroborated by future studies. PMID:24151612

Association of urban slum residency with infant mortality and child stunting in low and middle income countries.

PubMed

Kyu, Hmwe Hmwe; Shannon, Harry S; Georgiades, Katholiki; Boyle, Michael H

2013-01-01

This study aimed to (i) examine the contextual influences of urban slum residency on infant mortality and child stunting over and above individual and household characteristics and (ii) identify factors that might modify any adverse effects. We obtained data from Demographic and Health Surveys conducted in 45 countries between 2000 and 2009. The respondents were women (15-49 years) and their children (0-59 months). Results showed that living in a slum neighborhood was associated with infant mortality (OR = 1.34, 95% CI = 1.15-1.57) irrespective of individual and household characteristics and this risk was attenuated among children born to women who had received antenatal care from a health professional (OR = 0.79, 95% CI = 0.63-0.99). Results also indicated that increasing child age exacerbated the risk for stunting associated with slum residency (OR = 1.19, 95% CI = 1.16-1.23). The findings suggest that improving material circumstances in urban slums at the neighborhood level as well as increasing antenatal care coverage among women living in these neighborhoods could help reduce infant mortality and stunted child growth. The cumulative impact of long-term exposure to slum neighborhoods on child stunting should be corroborated by future studies.

Coping Strategies among Urban Poor: Evidence from Nairobi, Kenya

PubMed Central

Amendah, Djesika D.; Buigut, Steven; Mohamed, Shukri

2014-01-01

Aims In Kenya, it is estimated that 60 to 80% of urban residents live in slum or slum-like conditions. This study investigates expenditures patterns of slum dwellers in Nairobi, their coping strategies and the determinants of those coping strategies. Method We use a dataset from the Indicator Development for Surveillance of Urban Emergencies (IDSUE) research study conducted in four Nairobi slums from April 2012 to September 2012. The dataset includes information related to household livelihoods, earned incomes of household members, expenditures, shocks, and coping strategies. Results Food spending is the single most important component, accounting for 52% of total households' income and 42% of total expenditures. Households report a variety of coping strategies over the last four weeks preceding the interview. The most frequently used strategy is related to reduction in food consumption, followed by the use of credit, with 69% and 52% of households reporting using these strategies respectively. A substantial proportion of households also report removing children from school to manage spending shortfalls. Formal employment, owning a business, rent-free housing, belonging to the two top tiers of income brackets, and being a member of social safety net reduced the likelihood of using any coping strategy. Exposure to shocks and larger number of children under 15 years increased the probability of using a coping strategy. Policy Implications Policies that contain food price inflation, improve decent-paying job opportunities for the urban poor are likely to reduce the use of negative coping strategies by providing urban slum dwellers with steady and reliable sources of income. In addition, enhancing access to free primary schooling in the slums would help limit the need to use detrimental strategies like “removing” children from school. PMID:24427272

Coping strategies among urban poor: evidence from Nairobi, Kenya.

PubMed

Amendah, Djesika D; Buigut, Steven; Mohamed, Shukri

2014-01-01

In Kenya, it is estimated that 60 to 80% of urban residents live in slum or slum-like conditions. This study investigates expenditures patterns of slum dwellers in Nairobi, their coping strategies and the determinants of those coping strategies. We use a dataset from the Indicator Development for Surveillance of Urban Emergencies (IDSUE) research study conducted in four Nairobi slums from April 2012 to September 2012. The dataset includes information related to household livelihoods, earned incomes of household members, expenditures, shocks, and coping strategies. Food spending is the single most important component, accounting for 52% of total households' income and 42% of total expenditures. Households report a variety of coping strategies over the last four weeks preceding the interview. The most frequently used strategy is related to reduction in food consumption, followed by the use of credit, with 69% and 52% of households reporting using these strategies respectively. A substantial proportion of households also report removing children from school to manage spending shortfalls. Formal employment, owning a business, rent-free housing, belonging to the two top tiers of income brackets, and being a member of social safety net reduced the likelihood of using any coping strategy. Exposure to shocks and larger number of children under 15 years increased the probability of using a coping strategy. Policies that contain food price inflation, improve decent-paying job opportunities for the urban poor are likely to reduce the use of negative coping strategies by providing urban slum dwellers with steady and reliable sources of income. In addition, enhancing access to free primary schooling in the slums would help limit the need to use detrimental strategies like "removing" children from school.

Prevalence of hypertension and associated cardiovascular risk factors in an urban slum in Nairobi, Kenya: a population-based survey.

PubMed

Joshi, Mark David; Ayah, Richard; Njau, Elijah Kaharo; Wanjiru, Rosemary; Kayima, Joshua Kyateesa; Njeru, Erastus Kennedy; Mutai, Kenneth Kipyegon

2014-11-18

Urbanisation has been described as a key driver of the evolving non-communicable disease (NCD) epidemic. In Africa, hypertension is the commonest cardiovascular problem. We determined the prevalence and risk factor correlates of hypertension in the largest Nairobi slum. In 2010 we conducted a population-based household survey in Kibera, a large informal settlement in Nairobi City; utilising cluster sampling with probability proportional to size. Households were selected using a random walk method. The WHO instrument for stepwise surveillance (STEPS) of chronic disease risk factors was administered by trained medical assistants, who also recorded blood pressure (BP) and anthropometric measures. BP was recorded using a mercury sphygmomanometer utilising the American Heart Association guidelines. Hypertension was defined as per the 7th Report of the Joint National Committee or use of prescribed antihypertensive medication. Those with hypertension or with random capillary blood sugar (RCBS) >11.1 mmol/l had an 8 hours fasting venous blood sugar sample drawn. Age standardised prevalence was computed and multivariate analysis to assess associations. We screened 2200 and enrolled 2061 adults; 50.9% were males; mean age was 33.4 years and 87% had primary level education. The age-standardised prevalence of hypertension (95% CI) was 22.8% (20.7, 24.9). 20% (53/258) were aware of their hypertensive status; 59.3% had pre-hypertension; 80% reported high levels of physical activity and 52% were classified as harmful alcohol drinkers; 10% were current smokers and 5% had diabetes. Majority of males had normal BMI and waist circumference, whereas a third of females were obese or overweight and 40% had central obesity. Older age, higher general and central obesity were independently associated with hypertension and higher SBP and DBP readings. Our findings of high prevalence of hypertension, in association with excess body weight in this poor urban slum community, point to the need for greater awareness and implementation of primary preventive strategies.

DOWRY DEMAND AND HARASSMENT: PREVALENCE AND RISK FACTORS IN INDIA.

PubMed

Jeyaseelan, Visalakshi; Kumar, Shuba; Jeyaseelan, L; Shankar, Viswanathan; Yadav, Bijesh Kumar; Bangdiwala, Shrikant I

2015-11-01

The practice of dowry is widespread in India and refers to the payment of cash/gifts by the bride's family to the bridegroom's family before marriage. Though prohibited by law, dowry is widely practised, and often contributes to severe injuries and even death of young brides. This study examined the prevalence and risk factors for dowry demand and dowry harassment and its psychosocial correlates across different social strata in India, and also by husband and mother-in-law characteristics. In a cross-sectional survey of 9938 women in rural, urban and urban non-slum sites across India conducted in 1998-99, dowry demand was found to be significantly higher (p<0.001) in the urban non-slum and rural areas (26% and 23% respectively) than in urban slum areas (18%). Overall, 17% of groom's families were not satisfied with the dowry, this being higher in rural areas (21%) than in urban slum and non-slum areas (about 14% in both). The overall prevalence of dowry harassment among this group of women was 13.3%. Mothers-in-law who had themselves experienced dowry demand were 14 (95% CI 5.0-40.4) and 5 (95% CI 1.3-18.9) times more likely to demand and harass daughters-in-law over dowry, respectively. Another significant risk factor for dowry-related harassment was mother-in law's status in the family. Interventions related to modifiable risk factors, such as increased social support at the community level, should help reduce dowry harassment.

Does living in slums or non-slums influence women's nutritional status? Evidence from Indian mega-cities.

PubMed

Gaur, Kirti; Keshri, Kunal; Joe, William

2013-01-01

This article examines the intra-city distribution of women's nutritional status across eight Indian mega-cities with a specific focus on slum-non-slum divide. The analysis is based on the National Family Health Survey (2005-06) of India and highlights the dual burden of malnutrition among urban women. The results show that one in every two women in mega-cities is malnourished (either undernourished or overnourished), but a biased, analytical focus on citywide averages conceals the nature of the problem. Overnutrition among women is notably higher in non-slum areas whereas underweight persists as a key concern among slum dwellers. Cities located in the Central India (Nagpur and Indore) have the highest proportion of underweight women whereas the cities in South India (Chennai and Hyderabad) show a high prevalence of overweight women across both slum and non-slum areas. The intensity of income-related inequalities in underweight outcome is much greater for non-slum areas, whereas inequalities in overweight outcomes are higher among slums. Furthermore, regression analysis indicates that place of residence as such has no significant impact on women's nutritional status and that this elementary association is primarily a ramification mediated through other key socioeconomic correlates. Results suggest that, it would be rational to develop a comprehensive urban nutritional plan that focuses on dietary planning and behaviour change to address both type of malnutrition at the same time. Copyright © 2012 Elsevier Ltd. All rights reserved.

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

PubMed Central

Ezeh, Alex; Oronje, Rose

2008-01-01

In sub-Saharan Africa, the unprecedented population growth that started in the second half of the twentieth century has evolved into unparalleled urbanization and an increasing proportion of urban dwellers living in slums and shanty towns, making it imperative to pay greater attention to the health problems of the urban poor. In particular, urgent efforts need to focus on maternal health. Despite the lack of reliable trend data on maternal mortality, some investigators now believe that progress in maternal health has been very slow in sub-Saharan Africa. This study uses a unique combination of health facility- and individual-level data collected in the slums of Nairobi, Kenya to: (1) describe the provision of obstetric care in the Nairobi informal settlements; (2) describe the patterns of antenatal and delivery care, notably in terms of timing, frequency, and quality of care; and (3) draw policy implications aimed at improving maternal health among the rapidly growing urban poor populations. It shows that the study area is deprived of public health services, a finding which supports the view that low-income urban residents in developing countries face significant obstacles in accessing health care. This study also shows that despite the high prevalence of antenatal care (ANC), the proportion of women who made the recommended number of visits or who initiated the visit in the first trimester of pregnancy remains low compared to Nairobi as a whole and, more importantly, compared to rural populations. Bivariate analyses show that household wealth, education, parity, and place of residence were closely associated with frequency and timing of ANC and with place of delivery. Finally, there is a strong linkage between use of antenatal care and place of delivery. The findings of this study call for urgent attention by Kenya’s Ministry of Health and local authorities to the void of quality health services in poor urban communities and the need to provide focused and sustained health education geared towards promoting use of obstetric services. PMID:18389376

Serological trail of Brucella infection in an urban slum population in Brazil

PubMed Central

Angel, Martha Olivera; Ristow, Paula; Ko, Albert I.; Di-Lorenzo, Cecilia

2013-01-01

Introduction Brucellosis is a re-emerging zoonosis with new cases reported each year in many Latin American countries, but it is mostly under-recognized. This study presents a serological investigation of infection with Brucella abortus and Brucella canis in a poor urban community in the city of Salvador, Brazil. Methodology Human sera (n = 180) were randomly selected from 3,171 samples taken from healthy individuals during 2003-2004 and tested with C-ELISA for B. abortus and I-ELISA for B. canis. Results Thirteen percent (24/180) of the individuals were positive for B. abortus and 4.6 % (8/174) were positive for B. canis. Among the variables studied only age (older than 45 years) appeared to be a risk factor for the detection of Brucella antibodies. Conclusion These results indicate the presence of Brucella infection in this settlement and highlight the need to understand the epidemiology of infection under these circumstances to establish the necessary measures for surveillance and control. PMID:23000868

Determinants of undernutrition among primary school children residing in slum areas of a Nigerian city.

PubMed

Ndukwu, C I; Egbuonu, I; Ulasi, T O; Ebenebe, J C

2013-01-01

Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria, characterized by widespread poverty and inequitable distribution of wealth. This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors, and the nutritional status of children residing in a typical urban slum. A cross-sectional descriptive study of 788 children aged 6-12 years selected by stratified, multistage random sampling method from public primary schools in slum and non-slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmental variables of interest were analyzed to determine their relationship with undernutrition in the children. Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non-slum areas (χ2 = 66.69, P = 0.000). This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition.

Community-Based Health Programmes: Role Perceptions and Experiences of Female Peer Facilitators in Mumbai's Urban Slums

ERIC Educational Resources Information Center

Alcock, Glyn A.; More, Neena Shah; Patil, Sarita; Porel, Maya; Vaidya, Leena; Osrin, David

2009-01-01

Community-based initiatives have become a popular approach to addressing the health needs of underserved populations, in both low- and higher-income countries. This article presents findings from a study of female peer facilitators involved in a community-based maternal and newborn health intervention in urban slum areas of Mumbai. Using…

Healthcare behavior and expenditure in an urban slum in relation to birth experience and newborn care.

PubMed

Saini, Arushi G; Bharti, Bhavneet; Gautam, Suman

2012-06-01

Newborn care practices and healthcare seeking are important determinants of neonatal morbidity and mortality in the resource-limited settings of the urban slums. To examine the current patterns of healthcare-seeking behavior and estimate out-of-pocket expenditure for delivery and common neonatal problems in the urban slums of Chandigarh. Community-based cross-sectional survey. Structured questionnaire was used to collect data from the clusters selected by the World Health Organisation (WHO) Expanded Program for Immunization's cluster survey method. Independent t-test, one-way ANOVA and Pearson's Chi-square tests were used to analyze the data. All tests were two-tailed and p < 0.05 was taken as significant. 31.7% of the mothers delivered at home with 4.18 ± 2.16 mean number of antenatal visits and 73.9% used prelacteals. Factors significantly predicting home deliveries were identified. About 44.7% of the neonates had problems after birth, with 40.3% requiring hospitalization. Choice of private healthcare providers governed the care seeking in the majority (61.4%). Out-of-pocket expenditure was significantly high for the private care providers in terms of the cost of delivery and the overall cost of neonatal illness though no gender-based differences were seen. Private sector emerged as the major healthcare provider in the urban slums resulting in higher out-of-pocket expenditure. A comprehensive health strategy comprising of health education, improvement in antenatal practices, institutional deliveries, behavior change communication activities and quality perinatal care is required for these urban slums.

Prevalence, awareness, treatment and control of diabetes among elderly persons in an urban slum of delhi.

PubMed

Singh, Arvind Kumar; Mani, Kalaivani; Krishnan, Anand; Aggarwal, Praveen; Gupta, Sanjeev Kumar

2012-10-01

The increasing proportion of elderly persons is contributing to an increase in the prevalence of diabetes. The residents of urban slums are more vulnerable due to poverty and lack of access to health care. To estimate the prevalence of diabetes in elderly persons in an urban slum and to assess their awareness, treatment and control of this condition. All persons aged 60 years and above, residing in an urban slum of Delhi, were included in this cross-sectional community- based study. Data were collected on sociodemographic variables. The participants' awareness and treatment of diabetes was recorded. Their fasting blood sugar was estimated using an automated glucometer. Diabetes was diagnosed if fasting blood glucose was ≥126 mg/dL, or if the participant was taking treatment for diabetes. Impaired fasting blood glucose was diagnosed if fasting blood glucose was 110-125 mg/dL. Among the 474 participants studied, the prevalence of diabetes was estimated to be 18.8% (95% CI 15.3-21.5). It decreased with increasing age, and was higher among women. The prevalence of impaired fasting blood glucose was 19.8% (95% CI 16.3-23.7). It was higher among women. One-third of the diabetic participants were aware of their condition; two-thirds of these were on treatment and three-fourths of those on treatment had controlled fasting blood sugar level. The awareness, treatment and control were better among women. Diabetes is common among elderly persons in urban slums. Its magnitude and low awareness warrant effective public health interventions for their treatment and control.

Factors that Prevent Children from Gaining Access to Schooling: A Study of Delhi Slum Households

ERIC Educational Resources Information Center

Tsujita, Yuko

2013-01-01

This paper examines the factors that prevent slum children aged 5-14 from gaining access to schooling in light of the worsening urban poverty and sizable increase in rural-to-urban migration. Bias against social disadvantage in terms of gender and caste is not clearly manifested in schooling, while migrated children are less likely to attend…

Transport and retention of phosphorus in surface water in an urban slum area

NASA Astrophysics Data System (ADS)

Nyenje, P. M.; Meijer, L. M. G.; Foppen, J. W.; Kulabako, R.; Uhlenbrook, S.

2013-08-01

The transport of excessive phosphorus (P) discharged from unsewered informal settlements (slums) due to poor on-site sanitation is largely unknown. Hence, we investigated the processes governing P transport in a 28 km2 slum-dominated catchment in Kampala, Uganda. During high runoff events and a period of base flow, we collected hourly water samples (over 24 h) from a primary channel draining the catchment and from a small size tertiary channel draining one of the contributing slum areas (0.5 km2). Samples were analyzed for orthophosphate (PO4-P), particulate P (PP), total P (TP) and selected hydro-chemical parameters. Channel bed and suspended sediments were collected to determine their sorption potential, geo-available metals and dominant P forms. We found that P inputs in the catchment originated mainly from domestic wastewater as evidenced by high concentrations of Cl (36-144 mg L-1), HCO3 and other cations in the channels. Most P discharged during low flow conditions was particulate implying that much of it was retained in bed sediments. Retained P was mostly bound to Ca and Fe/Al oxides. Hence, we inferred that mineral precipitation and adsorption to Ca-minerals were the dominant P retention processes. Bed sediments were P-saturated and showed a tendency to release P to discharging waters. P released was likely due to Ca-bound P because of the strong correlation between Ca and total P in sediments (r2 = 0.9). High flows exhibited a strong flush of PP and SS implying that part of P retained was frequently flushed out of the catchment by surface erosion and resuspension of bed sediment. Our findings suggest that P accumulated in the channel bed during low flows and then was slowly released into surface water. Hence, it will likely take some time, even with improved wastewater management practices, before P loads to downstream areas can be significantly reduced.

Factors affecting carriage and intensity of infection of Calodium hepaticum within Norway rats (Rattus norvegicus) from an urban slum environment in Salvador, Brazil.

PubMed

Walker, R; Carvalho-Pereira, T; Serrano, S; Pedra, G; Hacker, K; Taylor, J; Minter, A; Pertile, A; Panti-May, A; Carvalho, M; Souza, F N; Nery, N; Rodrigues, G; Bahiense, T; Reis, M G; Ko, A I; Childs, J E; Begon, M; Costa, F

2017-01-01

Urban slum environments in the tropics are conducive to the proliferation and the spread of rodent-borne zoonotic pathogens to humans. Calodium hepaticum (Brancroft, 1893) is a zoonotic nematode known to infect a variety of mammalian hosts, including humans. Norway rats (Rattus norvegicus) are considered the most important mammalian host of C. hepaticum and are therefore a potentially useful species to inform estimates of the risk to humans living in urban slum environments. There is a lack of studies systematically evaluating the role of demographic and environmental factors that influence both carriage and intensity of infection of C. hepaticum in rodents from urban slum areas within tropical regions. Carriage and the intensity of infection of C. hepaticum were studied in 402 Norway rats over a 2-year period in an urban slum in Salvador, Brazil. Overall, prevalence in Norway rats was 83% (337/402). Independent risk factors for C. hepaticum carriage in R. norvegicus were age and valley of capture. Of those infected the proportion with gross liver involvement (i.e. >75% of the liver affected, a proxy for a high level intensity of infection), was low (8%, 26/337). Sixty soil samples were collected from ten locations to estimate levels of environmental contamination and provide information on the potential risk to humans of contracting C. hepaticum from the environment. Sixty percent (6/10) of the sites were contaminated with C. hepaticum. High carriage levels of C. hepaticum within Norway rats and sub-standard living conditions within slum areas may increase the risk to humans of exposure to the infective eggs of C. hepaticum. This study supports the need for further studies to assess whether humans are becoming infected within this community and whether C. hepaticum is posing a significant risk to human health.

The high cost of diarrhoeal illness for urban slum households-a cost-recovery approach: a cohort study.

PubMed

Patel, Ronak B; Stoklosa, Hanni; Shitole, Shrutika; Shitole, Tejal; Sawant, Kiran; Nanarkar, Mahesh; Subbaraman, Ramnath; Ridpath, Alison; Patil-Deshmuk, Anita

2013-01-01

Rapid urbanisation has often meant that public infrastructure has not kept pace with growth leading to urban slums with poor access to water and sanitation and high rates of diarrhoea with greater household costs due to illness. This study sought to determine the monetary cost of diarrhoea to urban slum households in Kaula Bandar slum in Mumbai, India. The study also tested the hypotheses that the cost of water and sanitation infrastructure may be surpassed by the cumulative costs of diarrhoea for households in an urban slum community. A cohort study using a baseline survey of a random sample followed by a systematic longitudinal household survey. The baseline survey was administered to a random sample of households. The systematic longitudinal survey was administered to every available household in the community with a case of diarrhoea for a period of 5 weeks. Every household in Kaula Bandar was approached for the longitudinal survey and all available and consenting adults were included. The direct cost of medical care for having at least one person in the household with diarrhoea was 205 rupees. Other direct costs brought total expenses to 291 rupees. Adding an average loss of 55 rupees per household from lost wages and monetising lost productivity from homemakers gave a total loss of 409 rupees per household. During the 5-week study period, this community lost an estimated 163 600 rupees or 3635 US dollars due to diarrhoeal illness. The lack of basic water and sanitation infrastructure is expensive for urban slum households in this community. Financing approaches that transfer that cost to infrastructure development to prevent illness may be feasible. These findings along with the myriad of unmeasured benefits of preventing diarrhoeal illness add to pressing arguments for investment in basic water and sanitation infrastructure.

Slumdog cities: rethinking subaltern urbanism.

PubMed

Roy, Ananya

2011-01-01

This article is an intervention in the epistemologies and methodologies of urban studies. It seeks to understand and transform the ways in which the cities of the global South are studied and represented in urban research, and to some extent in popular discourse. As such, the article is primarily concerned with a formation of ideas - "subaltern urbanism" - which undertakes the theorization of the megacity and its subaltern spaces and subaltern classes. Of these, the ubiquitous ‘slum’ is the most prominent. Writing against apocalyptic and dystopian narratives of the slum, subaltern urbanism provides accounts of the slum as a terrain of habitation, livelihood, self-organization and politics. This is a vital and even radical challenge to dominant narratives of the megacity. However, this article is concerned with the limits of and alternatives to subaltern urbanism. It thus highlights emergent analytical strategies, utilizing theoretical categories that transcend the familiar metonyms of underdevelopment such as the megacity, the slum, mass politics and the habitus of the dispossessed. Instead, four categories are discussed — peripheries, urban informality, zones of exception and gray spaces. Informed by the urbanism of the global South, these categories break with ontological and topological understandings of subaltern subjects and subaltern spaces.

Practices, Concerns, and Willingness to Participate in Solid Waste Management in Two Urban Slums in Central Uganda

PubMed Central

Ndejjo, Rawlance; Musoke, David; Musinguzi, Geofrey; Halage, Abdullah Ali; Carpenter, David O.; Ssempebwa, John C.

2016-01-01

Poor solid waste management is among the major challenges facing urban slums in developing countries including Uganda. Understanding community concerns and willingness towards involvement in solid waste management improvement initiatives is critical for informing interventions in slums. Methods. We used a cross-sectional study to collect quantitative data from 435 residents in two urban slums in central Uganda. A semistructured questionnaire was used which assessed waste collection practices, separation and disposal methods, concerns regarding solid wastes, and willingness to participate in waste separation and composting. Data was analysed using STATA 12. Results. Food remains (38%) and plastics (37%) formed the biggest proportion of wastes generated in households. Most households (35.9%) disposed of general wastes by open dumping while 27% disposed of plastics by burning. Only 8.8% of households conducted composting while 55% carried out separation for some decomposable wastes. Separation was carried out for only banana peelings and leftover foods for feeding animals. Respondents expressed high willingness to separate (76.6%) and compost (54.9%) solid wastes. Conclusion. Practices in waste disposal and separation were poor despite high willingness to participate in initiatives to improve waste management, highlighting a need for authorities to engage residents of slums to improve their practices. PMID:27066081

Practices, Concerns, and Willingness to Participate in Solid Waste Management in Two Urban Slums in Central Uganda.

PubMed

Mukama, Trasias; Ndejjo, Rawlance; Musoke, David; Musinguzi, Geofrey; Halage, Abdullah Ali; Carpenter, David O; Ssempebwa, John C

2016-01-01

Poor solid waste management is among the major challenges facing urban slums in developing countries including Uganda. Understanding community concerns and willingness towards involvement in solid waste management improvement initiatives is critical for informing interventions in slums. We used a cross-sectional study to collect quantitative data from 435 residents in two urban slums in central Uganda. A semistructured questionnaire was used which assessed waste collection practices, separation and disposal methods, concerns regarding solid wastes, and willingness to participate in waste separation and composting. Data was analysed using STATA 12. Food remains (38%) and plastics (37%) formed the biggest proportion of wastes generated in households. Most households (35.9%) disposed of general wastes by open dumping while 27% disposed of plastics by burning. Only 8.8% of households conducted composting while 55% carried out separation for some decomposable wastes. Separation was carried out for only banana peelings and leftover foods for feeding animals. Respondents expressed high willingness to separate (76.6%) and compost (54.9%) solid wastes. Practices in waste disposal and separation were poor despite high willingness to participate in initiatives to improve waste management, highlighting a need for authorities to engage residents of slums to improve their practices.

Partnership in Action: Introducing Family-Based Intervention for Children with Disability in Urban Slums of Kolkata, India

ERIC Educational Resources Information Center

Sen, Reena; Goldbart, Juliet

2005-01-01

This paper presents the processes and findings of a three-year action research project implemented in a small number of urban slums in the city of Kolkata (previously known as Calcutta), the capital of the state of West Bengal in Eastern India. The project involved partnership between an established institute for cerebral palsy in Kolkata, two…

Experience of intimate partner violence among young pregnant women in urban slums of Kathmandu Valley, Nepal: a qualitative study.

PubMed

Deuba, Keshab; Mainali, Anustha; Alvesson, Helle M; Karki, Deepak K

2016-03-05

Intimate partner violence (IPV) is an urgent public health priority. It is a neglected issue in women's health, especially in urban slums in Nepal and globally. This study was designed to better understand the IPV experienced by young pregnant women in urban slums of the Kathmandu Valley, as well as to identify their coping strategies, care and support seeking behaviours. Womens' views on ways to prevent IPV were also addressed. 20 young pregnant women from 13 urban slums in the Kathmandu valley were recruited purposively for this qualitative study, based on pre-defined criteria. In-depth interviews were conducted and transcribed, with qualitative content analysis used to analyse the transcripts. 14 respondents were survivors of violence in urban slums. Their intimate partner(s) committed most of the violent acts. These young pregnant women were more likely to experience different forms of violence (psychological, physical and sexual) if they refused to have sex, gave birth to a girl, or if their husband had alcohol use disorder. The identification of foetal gender also increased the experience of physical violence at the prenatal stage. Interference from in-laws prevented further escalation of physical abuse. The most common coping strategy adopted to avoid violence among these women was to tolerate and accept the husbands' abuse because of economic dependence. Violence survivors sought informal support from their close family members. Women suggested multiple short and long term actions to reduce intimate partner violence such as female education, economic independence of young women, banning identification of foetal gender during pregnancy and establishing separate institutions within their community to handle violence against young pregnant women. Diversity in the design and implementation of culturally and socially acceptable interventions might be effective in addressing violence against young pregnant women in humanitarian settings such as urban slums. These include, but are not limited to, treatment of alcohol use disorder, raising men's awareness about pregnancy, addressing young women's economic vulnerability, emphasising the role of health care professionals in preventing adverse consequences resulting from gender selection technologies and working with family members of violence survivors.

The determinants of exclusive breast feeding in urban slums: a community based study.

PubMed

Tiwari, Ranjana; Mahajan, P C; Lahariya, Chandrakant

2009-02-01

The actual rate of Exclusive Breast Feeding (EBF) (up to the age of 6 months) is dismally low in urban slums of India. The reasons and determinants of this are debatable. The study was planned to understand the determinants of EBF in the infants in urban slums. A community-based cross sectional study was done in urban slums of Gwalior, India. The data were collected by interviewing the caregivers of 279 infants aged between 6 and 11 months from November 2005 to July 2006. Only 11 (3.8%) mothers knew that EBF should be done till six months and 22 (7.8%) actually practiced EBF. A total of 178 (63.8%) and 212 (76.0%) newborns were given pre- and post-lacteal feeds with 26.2% discarding colostrum. Only 22 (7.8%) practiced EBF. The early breastfeeding (BF) initiation, Ante Natal Clinic (ANC) visits, mothers' education and immunization visits were significantly associated with higher probability of EBF. There were a number of myths and misconceptions about BF in this urban slum population. The correct information about BF was more common amongst the women who had frequent contacts with health facilities due to any reason or during ANC or immunization visit. Similarly, it is the continuum of good health and feeding practices and the mothers who start early BF or get their child immunized regularly are more likely to EBF their children. Considering the widely prevalent myths and low rate of utilization of health services along with high potential benefits of EBF, every opportunity of mothers' interaction with the health facility should be utilized for promoting correct and EBF practices.

Sustained high incidence of injuries from burns in a densely populated urban slum in Kenya: an emerging public health priority.

PubMed

Wong, Joshua M; Nyachieo, Dhillon O; Benzekri, Noelle A; Cosmas, Leonard; Ondari, Daniel; Yekta, Shahla; Montgomery, Joel M; Williamson, John M; Breiman, Robert F

2014-09-01

Ninety-five percent of burn deaths occur in low- and middle-income countries (LMICs); however, longitudinal household-level studies have not been done in urban slum settings, where overcrowding and unsafe cook stoves may increase likelihood of injury. Using a prospective, population-based disease surveillance system in the urban slum of Kibera in Kenya, we examined the incidence of household-level burns of all severities from 2006-2011. Of approximately 28,500 enrolled individuals (6000 households), we identified 3072 burns. The overall incidence was 27.9/1000 person-years-of-observation. Children <5 years old sustained burns at 3.8-fold greater rate compared to (p<0.001) those ≥5 years old. Females ≥5 years old sustained burns at a rate that was 1.35-fold (p<0.001) greater than males within the same age distribution. Hospitalizations were uncommon (0.65% of all burns). The incidence of burns, 10-fold greater than in most published reports from Africa and Asia, suggests that such injuries may contribute more significantly than previously thought to morbidity in LMICs, and may be increased by urbanization. As migration from rural areas into urban slums rapidly increases in many African countries, characterizing and addressing the rising burden of burns is likely to become a public health priority. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Environmental Transmission of Typhoid Fever in an Urban Slum.

PubMed

Akullian, Adam; Ng'eno, Eric; Matheson, Alastair I; Cosmas, Leonard; Macharia, Daniel; Fields, Barry; Bigogo, Godfrey; Mugoh, Maina; John-Stewart, Grace; Walson, Judd L; Wakefield, Jonathan; Montgomery, Joel M

2015-12-01

Enteric fever due to Salmonella Typhi (typhoid fever) occurs in urban areas with poor sanitation. While direct fecal-oral transmission is thought to be the predominant mode of transmission, recent evidence suggests that indirect environmental transmission may also contribute to disease spread. Data from a population-based infectious disease surveillance system (28,000 individuals followed biweekly) were used to map the spatial pattern of typhoid fever in Kibera, an urban informal settlement in Nairobi Kenya, between 2010-2011. Spatial modeling was used to test whether variations in topography and accumulation of surface water explain the geographic patterns of risk. Among children less than ten years of age, risk of typhoid fever was geographically heterogeneous across the study area (p = 0.016) and was positively associated with lower elevation, OR = 1.87, 95% CI (1.36-2.57), p <0.001. In contrast, the risk of typhoid fever did not vary geographically or with elevation among individuals more than ten years of age [corrected]. Our results provide evidence of indirect, environmental transmission of typhoid fever among children, a group with high exposure to fecal pathogens in the environment. Spatially targeting sanitation interventions may decrease enteric fever transmission.

Environmental Transmission of Typhoid Fever in an Urban Slum

PubMed Central

Matheson, Alastair I.; Cosmas, Leonard; Macharia, Daniel; Fields, Barry; Bigogo, Godfrey; Mugoh, Maina; John-Stewart, Grace; Walson, Judd L.; Wakefield, Jonathan; Montgomery, Joel M.

2015-01-01

Background Enteric fever due to Salmonella Typhi (typhoid fever) occurs in urban areas with poor sanitation. While direct fecal-oral transmission is thought to be the predominant mode of transmission, recent evidence suggests that indirect environmental transmission may also contribute to disease spread. Methods Data from a population-based infectious disease surveillance system (28,000 individuals followed biweekly) were used to map the spatial pattern of typhoid fever in Kibera, an urban informal settlement in Nairobi Kenya, between 2010–2011. Spatial modeling was used to test whether variations in topography and accumulation of surface water explain the geographic patterns of risk. Results Among children less than ten years of age, risk of typhoid fever was geographically heterogeneous across the study area (p = 0.016) and was positively associated with lower elevation, OR = 1.87, 95% CI (1.36–2.57), p <0.001. In contrast, the risk of typhoid fever did not vary geographically or with elevation among individuals less than 6b ten years of age. Conclusions Our results provide evidence of indirect, environmental transmission of typhoid fever among children, a group with high exposure to fecal pathogens in the environment. Spatially targeting sanitation interventions may decrease enteric fever transmission. PMID:26633656

Hygienic practices and diarrheal illness among persons living in at-risk settings in Kabul, Afghanistan: a cross-sectional study.

PubMed

Mubarak, Mohammad Yousuf; Wagner, Abram L; Asami, Mari; Carlson, Bradley F; Boulton, Matthew L

2016-08-31

Sustained civil and military conflict, resulting in large numbers of internally displaced persons (IDP), in combination with rapid urbanization has strained public health and sanitation within cities in Afghanistan. In order to examine the association between preventive sanitary behaviors and diarrhea within two high risk settings located within Kabul, Afghanistan, this study aimed to evaluate the prevalence of hygienic practices and diarrheal illness in an IDP camp and an urban slum. In this cross sectional study, a convenience sample of residents of an IDP camp and an urban slum in Kabul, Afghanistan, was used. Participants were asked to describe their hygienic practices and interviewers independently documented household sanitation. The knowledge and attitudes about and practice of hygienic activities to prevent diarrhea were compared between the two settings. Two hundred participants, 100 from each setting, were enrolled. Knowledge, attitudes, and practices regarding hygienic activities to prevent diarrhea were greater among the slum dwellers than the IDP. Fewer than half of participants washed their hands with soap before eating or after eating: 31 % of slum dwellers washed before eating compared to 11 % of IDPs (P = 0.0050), and 25 % of slum dwellers washed after defecating compared to 4 % of IDPs (P = 0.0020). The IDPs were more likely to share a latrine (P = 0.0144) and less likely to disinfect their latrine than slum dwellers. Diarrhea in the household within the past 3 months was more common in the IDP camp (54 %) than the slum (20 %) (P = 0.0020). Even though certain sanitary and hygienic practices were more common among slum dwellers than IDPs, the lack of hygienic activities in both setting indicates that interventions to change behavior, like increasing the availability of soap and encouraging hand washing, are needed. Any initiative will have to be developed in the context of pervasive illiteracy among persons in both of these settings.

Striving to Reduce Vulnerability:Lessons from the Poor Community Livelihoodsin the Jakarta Bay Facing High Risk of Rapid Urbanization and Climate Changes

NASA Astrophysics Data System (ADS)

Hidayati, D.; Delinom, R. M.; Abdurachim, A. Y.; Dalimunthe, S.; Haba, J.; Pawitan, H.

2014-12-01

This paper discusses water-food issues in relation to how livelihoods of the poor community in Jakarta Bayarein high risk ofrapid urbanization and climate changes. As a part of the capital city of Indonesia, this area has experienced rapid increase in populationand extensive developments causing significant increase in the built up area. This city is unable to keep with demand on sewers, water and solid waste management, leading to settlement with concentrated slum pockets areas and widespread of flooding. The community is mostly poor people of productive group, live with urban pressure in fragile home and livelihoods.The situation becomes much worse due to the impact of climate change with flooding as the greatest climate and disaster risk. With lack of basic services, coastal water inundation (BanjirRob)commonly occursand floods the community housing areaswithout patternanymore. The community has lack of fresh and clean water sources and facedeconomic problem, particularly significant reduction of fishing activities. Coastal reclamation and water pollution from nearby industries are blamed as the main reason for these problems. Strategies therefore have to be developed, especially increasing community awareness and preparedness, and poverty alleviation, to sustain their livelihoods in this high risk urban area.

Whether and where to Enrol? Choosing a Primary School in the Slums of Urban Dhaka, Bangladesh

ERIC Educational Resources Information Center

Cameron, Stuart

2011-01-01

Slums account for around a third of the population of Dhaka, Bangladesh, and are thought to be growing rapidly. But there is little in the research literature about education of children who live in slums and it is doubtful whether they are covered in official statistics such as those on enrolment rates. This paper addresses this gap with…

Assessment of an Integrated Nutrition Communication Approach to Educate the School-Going Adolescent Girls Living in Urban Slums of Hyderabad, Telangana State, India

ERIC Educational Resources Information Center

Rao, D. Raghunatha; Vijayapushpam, T.; Rao, N. Amulya; Dube, Anilkumar; Venkaiah, K.

2016-01-01

Purpose: Consumption of right diet during the adolescent phase is a critical issue among the adolescent population as their eating behavior is significantly influenced by the peers. Therefore, a study was carried out to educate the school-going adolescent girls living in urban slums of Hyderabad, Telangana, India on right nutrition. Methods: The…

Access to and Exclusion from Primary Education in Slums of Dhaka, Bangladesh. CREATE Pathways to Access. Research Monograph No. 45

ERIC Educational Resources Information Center

Cameron, Stuart

2010-01-01

Bangladesh's urban population is rising fast. In the capital, Dhaka, some 4 million people live in slums. They are lacking in wealth, power and social connections; probably under-counted in national surveys; and under-served by both government and non-government organisations, many of whom still see poverty as a rural issue or see the urban poor…

Correlates of HIV-status awareness among adults in Nairobi slum areas.

PubMed

Ettarh, Remare Renner; Kimani, James; Kyobutungi, Catherine; Wekesah, Frederick

2012-12-01

The prevalence of HIV in the adult population in slum areas in Nairobi, Kenya, is higher than for residents in the city as a whole. This disparity suggests that the characteristics of slum areas may adversely influence the HIV-prevention strategies directed at reducing the national prevalence of HIV. The objective of the study was to identify some of the sociodemographic and behavioural correlates of HIV-status awareness among the adult population of two slums in Nairobi. In a household-based survey conducted by the African Population and Health Research Center (APHRC), 4 767 men and women aged between 15 and 54 years were randomly sampled from two slums (Korogocho and Viwandani) in Nairobi and data were collected on the social and health context of HIV and AIDS in these settlements. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with HIV-status awareness. The proportion of respondents that had ever been tested and knew their HIV status was 53%, with the women having greater awareness of their HIV status (62%) than the men (38%). Awareness of HIV status was significantly associated with age, sex, level of education, marital status and slum of residence. The lower level of HIV-status awareness among the men compared with the women in the slums suggests a poor uptake of HIV-testing services by males. Innovative strategies are needed to ensure greater access and uptake of HIV-testing services by the younger and less-educated residents of these slums if the barriers to HIV-status awareness are to be overcome.

Perception of receiving SMS based health messages among hypertensive individuals in urban slums.

PubMed

Mudgapalli, Vikas; Sharan, Swati; Amadi, Chioma; Joshi, Ashish

2016-01-01

Hypertension rates are increasing in India, and prior research has not explored the perception of using mobile based SMS among urban hypertensive individuals living in slum settings in India. To explore the perception of receiving SMS based health messages among hypertensive individuals in urban slums. A cross sectional study was conducted during the period of December 2013 in an urban slum setting of South Delhi, New Delhi, India. Eligible study participants included: 45 individuals aged 30 years and above, with confirmed diagnosis of high blood pressure, owned a mobile phone/landline and were willing to participate. Results of our study showed participants (n= 45) had an average age of 48 years (SD = 12), mostly female (64%, n= 29), and currently married (80%, n= 36). Their most common perceived hypertension risk factors included: worry/anxiety/stress (84%, n= 38), and high fat diet (68%, n= 30). Mobile calls were the most preferred mode of receiving lifestyle counseling among study participants (71%, n= 32). Majority preferred to receive counseling in Hindi language (67%, n= 30), and more than half were willing to pay for these services (60%, n= 27). Our findings suggest the need for innovations that utilize basic phone platforms, mobile calling feature, and language tailored interventions.

The role of material deprivation and consumerism in the decisions to engage in transactional sex among young people in the urban slums of Blantyre, Malawi

PubMed Central

Kamndaya, Mphatso; Vearey, Jo; Thomas, Liz; Kabiru, Caroline W.; Kazembe, Lawrence N.

2016-01-01

Transactional sex has been associated with a high risk of HIV acquisition and unintended pregnancy among young women in urban slums in sub-Saharan Africa. However, few studies have explored the structural drivers of transactional sex from the perspective of both genders in these settings. This paper explores how young men and women understand the factors that lead to transactional sex among their peers, and how deprivation of material resources (housing, food and health care access) and consumerism (a desire for fashionable goods) may instigate transactional sex in the urban slums of Blantyre, Malawi. Data from 5 focus group discussions and 12 in-depth interviews undertaken with a total of 60 young men and women aged 18–23 years old, conducted between December 2012 and May 2013, were analysed using anticipated and grounded codes. Housing and food deprivation influenced decisions to engage in transactional sex for both young men and women. Poor health care access and a desire for fashionable goods (such as the latest hair or clothing styles and cellular phones) influenced the decisions of young women that led to transactional sex. Interventions that engage with deprivations and consumerism are essential to reducing sexual and reproductive health risks in urban slums. PMID:25741631

The role of material deprivation and consumerism in the decisions to engage in transactional sex among young people in the urban slums of Blantyre, Malawi.

PubMed

Kamndaya, Mphatso; Vearey, Jo; Thomas, Liz; Kabiru, Caroline W; Kazembe, Lawrence N

2015-03-05

Transactional sex has been associated with a high risk of HIV acquisition and unintended pregnancy among young women in urban slums in sub-Saharan Africa. However, few studies have explored the structural drivers of transactional sex from the perspective of both genders in these settings. This paper explores how young men and women understand the factors that lead to transactional sex among their peers, and how deprivation of material resources (housing, food and health care access) and consumerism (a desire for fashionable goods) may instigate transactional sex in the urban slums of Blantyre, Malawi. Data from 5 focus group discussions and 12 in-depth interviews undertaken with a total of 60 young men and women aged 18-23 years old, conducted between December 2012 and May 2013, were analysed using anticipated and grounded codes. Housing and food deprivation influenced decisions to engage in transactional sex for both young men and women. Poor health care access and a desire for fashionable goods (such as the latest hair or clothing styles and cellular phones) influenced the decisions of young women that led to transactional sex. Interventions that engage with deprivations and consumerism are essential to reducing sexual and reproductive health risks in urban slums.

Vegetation in Bangalore's Slums: Composition, Species Distribution, Density, Diversity, and History

NASA Astrophysics Data System (ADS)

Gopal, Divya; Nagendra, Harini; Manthey, Michael

2015-06-01

There is widespread acknowledgement of the need for biodiversity and greening to be part of urban sustainability efforts. Yet we know little about greenery in the context of urban poverty, particularly in slums, which constitute a significant challenge for inclusive development in many rapidly growing cities. We assessed the composition, density, diversity, and species distribution of vegetation in 44 slums of Bangalore, India, comparing these to published studies on vegetation diversity in other land-use categories. Most trees were native to the region, as compared to other land-use categories such as parks and streets which are dominated by introduced species. Of the most frequently encountered tree species, Moringa oleifera and Cocos nucifera are important for food, while Ficus religiosa plays a critical cultural and religious role. Tree density and diversity were much lower in slums compared to richer residential neighborhoods. There are also differences in species preferences, with most plant (herb, shrub and vines) species in slums having economic, food, medicinal, or cultural use, while the species planted in richer residential areas are largely ornamental. Historic development has had an impact on species distribution, with older slums having larger sized tree species, while recent slums were dominated by smaller sized tree species with greater economic and food use. Extensive focus on planting trees and plant species with utility value is required in these congested neighborhoods, to provide livelihood support.

A system for household enumeration and re-identification in densely populated slums to facilitate community research, education, and advocacy.

PubMed

Thomson, Dana R; Shitole, Shrutika; Shitole, Tejal; Sawant, Kiran; Subbaraman, Ramnath; Bloom, David E; Patil-Deshmukh, Anita

2014-01-01

We devised and implemented an innovative Location-Based Household Coding System (LBHCS) appropriate to a densely populated informal settlement in Mumbai, India. LBHCS codes were designed to double as unique household identifiers and as walking directions; when an entire community is enumerated, LBHCS codes can be used to identify the number of households located per road (or lane) segment. LBHCS was used in community-wide biometric, mental health, diarrheal disease, and water poverty studies. It also facilitated targeted health interventions by a research team of youth from Mumbai, including intensive door-to-door education of residents, targeted follow-up meetings, and a full census. In addition, LBHCS permitted rapid and low-cost preparation of GIS mapping of all households in the slum, and spatial summation and spatial analysis of survey data. LBHCS was an effective, easy-to-use, affordable approach to household enumeration and re-identification in a densely populated informal settlement where alternative satellite imagery and GPS technologies could not be used.

A million dollar exit from the anarchic slum-world: Slumdog Millionaire's hollow idioms of social justice.

PubMed

Sengupta, Mitu

2010-01-01

This article contests the characterisation of the popular and acclaimed film, Slumdog Millionaire, as a realistic portrayal of India's urban poverty that will ultimately serve as a tool of advocacy for India's urban poor. It argues that the film's reductive view of slum-spaces will more probably reinforce negative attitudes towards slum-dwellers, lending credibility to the sorts of policies that have historically dispossessed them of power and dignity. By drawing attention to the film's celebration of characters and spaces that symbolise Western culture and Northern trajectories of 'development', the article also critically engages with some of the issues raised by the film's enormous success.

Evaluation of Maternal Health Service Indicators in Urban Slum of Bangladesh

PubMed Central

Jolly, Saira Parveen; Rahman, Mahfuzar; Afsana, Kaosar; Yunus, Fakir Md; Chowdhury, Ahmed M. R.

2016-01-01

Background A continuous influx of poor people to urban slums poses a challenge to Bangladesh’s health system as it has failed to tackle maternal morbidity and mortality. BRAC is the largest non-governmental organisation in Bangladesh. BRAC has been working to reduce maternal, neonatal and under-five children morbidity and mortality of slum dwellers in cities. BRAC has been doing this work for a decade through a programme called MANOSHI. This programme provides door-to-door services to its beneficiaries through community health workers (CHWs) and normal delivery service through its delivery and maternity centres. BRAC started the ‘MANOSHI’ programme in Narayanganj City Corporation during 2011 to address maternal, neonatal and child health problems facing slum dwellers. We investigated the existing maternal health-service indicators in the slums of Narayanganj City Corporation and compared the findings with a non-intervention area. Methods This cross-sectional study was conducted during 2012, in 47 slums of Narayanganj City Corporation as intervention and 10 slums of Narsingdi Sadar Municipality as comparison area. A total of 1206 married women, aged 15–49 years, with a pregnancy outcome in the previous year were included for interview. Data on socio-demographic characteristics, reproductive and maternal health-care practices like use of contraceptive methods, antenatal care (ANC), delivery care, postnatal care (PNC) were collected through a structured questionnaire. The chi-square test, Student t test, Mann Whitney U-test, factor analysis and log-binominal test were performed by using STATA statistical software for analysing data. Results The activities of BRAC CHWs significantly improved four or more ANC (47% vs. 21%; p<0.000) and PNC (48% vs. 39%; p<0.01) coverage in the intervention slums compared to comparison slums. Still, about half of the deliveries in both areas were attended at home by unskilled birth attendants, of which a very few received PNC within 48 hours after delivery. The poorest and illiterate women received fewer maternal health services from medically trained providers (MTPs). The poorest had a lower likelihood of receiving services from MTPs during delivery complications. Conclusion The MANOSHI programme service coverage for delivery care and PNC-checkup for women who prefer home delivery needs to be improved. For sustainable improvement of maternal health outcomes in urban slums, the programme needs to facilitate access to services for poor and illiterate women. PMID:27732596

Evaluation of Maternal Health Service Indicators in Urban Slum of Bangladesh.

PubMed

Jolly, Saira Parveen; Rahman, Mahfuzar; Afsana, Kaosar; Yunus, Fakir Md; Chowdhury, Ahmed M R

2016-01-01

A continuous influx of poor people to urban slums poses a challenge to Bangladesh's health system as it has failed to tackle maternal morbidity and mortality. BRAC is the largest non-governmental organisation in Bangladesh. BRAC has been working to reduce maternal, neonatal and under-five children morbidity and mortality of slum dwellers in cities. BRAC has been doing this work for a decade through a programme called MANOSHI. This programme provides door-to-door services to its beneficiaries through community health workers (CHWs) and normal delivery service through its delivery and maternity centres. BRAC started the 'MANOSHI' programme in Narayanganj City Corporation during 2011 to address maternal, neonatal and child health problems facing slum dwellers. We investigated the existing maternal health-service indicators in the slums of Narayanganj City Corporation and compared the findings with a non-intervention area. This cross-sectional study was conducted during 2012, in 47 slums of Narayanganj City Corporation as intervention and 10 slums of Narsingdi Sadar Municipality as comparison area. A total of 1206 married women, aged 15-49 years, with a pregnancy outcome in the previous year were included for interview. Data on socio-demographic characteristics, reproductive and maternal health-care practices like use of contraceptive methods, antenatal care (ANC), delivery care, postnatal care (PNC) were collected through a structured questionnaire. The chi-square test, Student t test, Mann Whitney U-test, factor analysis and log-binominal test were performed by using STATA statistical software for analysing data. The activities of BRAC CHWs significantly improved four or more ANC (47% vs. 21%; p<0.000) and PNC (48% vs. 39%; p<0.01) coverage in the intervention slums compared to comparison slums. Still, about half of the deliveries in both areas were attended at home by unskilled birth attendants, of which a very few received PNC within 48 hours after delivery. The poorest and illiterate women received fewer maternal health services from medically trained providers (MTPs). The poorest had a lower likelihood of receiving services from MTPs during delivery complications. The MANOSHI programme service coverage for delivery care and PNC-checkup for women who prefer home delivery needs to be improved. For sustainable improvement of maternal health outcomes in urban slums, the programme needs to facilitate access to services for poor and illiterate women.

Vulnerability to food insecurity in urban slums: experiences from Nairobi, Kenya.

PubMed

Kimani-Murage, E W; Schofield, L; Wekesah, F; Mohamed, S; Mberu, B; Ettarh, R; Egondi, T; Kyobutungi, C; Ezeh, A

2014-12-01

Food and nutrition security is critical for economic development due to the role of nutrition in healthy growth and human capital development. Slum residents, already grossly affected by chronic poverty, are highly vulnerable to different forms of shocks, including those arising from political instability. This study describes the food security situation among slum residents in Nairobi, with specific focus on vulnerability associated with the 2007/2008 postelection crisis in Kenya. The study from which the data is drawn was nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS), which follows about 70,000 individuals from close to 30,000 households in two slums in Nairobi, Kenya. The study triangulates data from qualitative and quantitative sources. It uses qualitative data from 10 focus group discussions with community members and 12 key-informant interviews with community opinion leaders conducted in November 2010, and quantitative data involving about 3,000 households randomly sampled from the NUHDSS database in three rounds of data collection between March 2011 and January 2012. Food security was defined using the Household Food Insecurity Access Scale (HFIAS) criteria. The study found high prevalence of food insecurity; 85% of the households were food insecure, with 50% being severely food insecure. Factors associated with food security include level of income, source of livelihood, household size, dependence ratio; illness, perceived insecurity and slum of residence. The qualitative narratives highlighted household vulnerability to food insecurity as commonplace but critical during times of crisis. Respondents indicated that residents in the slums generally eat for bare survival, with little concern for quality. The narratives described heightened vulnerability during the 2007/2008 postelection violence in Kenya in the perception of slum residents. Prices of staple foods like maize flour doubled and simultaneously household purchasing power was eroded due to worsened unemployment situation. The use of negative coping strategies to address food insecurity such as reducing the number of meals, reducing food variety and quality, scavenging, and eating street foods was prevalent. In conclusion, this study describes the deeply intertwined nature of chronic poverty and acute crisis, and the subsequent high levels of food insecurity in urban slum settings. Households are extremely vulnerable to food insecurity; the situation worsening during periods of crisis in the perception of slum residents, engendering frequent use of negative coping strategies. Effective response to addressing vulnerability to household food insecurity among the urban poor should focus on both the underlying vulnerabilities of households due to chronic poverty and added impacts of acute crises.

Soil Ingestion is Associated with Child Diarrhea in an Urban Slum of Nairobi, Kenya.

PubMed

Bauza, Valerie; Ocharo, R M; Nguyen, Thanh H; Guest, Jeremy S

2017-03-01

Diarrhea is a leading cause of mortality in children under 5 years of age. We conducted a cross-sectional study of 54 children aged 3 months to 5 years old in Kibera, an urban slum in Nairobi, Kenya, to assess the relationship between caregiver-reported soil ingestion and child diarrhea. Diarrhea was significantly associated with soil ingestion (adjusted odds ratio = 9.9, 95% confidence interval = 2.1-47.5). Soil samples from locations near each household were also collected and analyzed for Escherichia coli and a human-associated Bacteroides fecal marker (HF183). Escherichia coli was detected in 100% of soil samples (mean 5.5 log colony forming units E. coli per gram of dry soil) and the Bacteroides fecal marker HF183 was detected in 93% of soil samples. These findings suggest that soil ingestion may be an important transmission pathway for diarrheal disease in urban slum settings.

Soil Ingestion is Associated with Child Diarrhea in an Urban Slum of Nairobi, Kenya

PubMed Central

Bauza, Valerie; Ocharo, R. M.; Nguyen, Thanh H.; Guest, Jeremy S.

2017-01-01

Diarrhea is a leading cause of mortality in children under 5 years of age. We conducted a cross-sectional study of 54 children aged 3 months to 5 years old in Kibera, an urban slum in Nairobi, Kenya, to assess the relationship between caregiver-reported soil ingestion and child diarrhea. Diarrhea was significantly associated with soil ingestion (adjusted odds ratio = 9.9, 95% confidence interval = 2.1–47.5). Soil samples from locations near each household were also collected and analyzed for Escherichia coli and a human-associated Bacteroides fecal marker (HF183). Escherichia coli was detected in 100% of soil samples (mean 5.5 log colony forming units E. coli per gram of dry soil) and the Bacteroides fecal marker HF183 was detected in 93% of soil samples. These findings suggest that soil ingestion may be an important transmission pathway for diarrheal disease in urban slum settings. PMID:28093532

Horizontal inequity in public health care service utilization for non-communicable diseases in urban Vietnam

PubMed Central

Kien, Vu Duy; Van Minh, Hoang; Giang, Kim Bao; Weinehall, Lars; Ng, Nawi

2014-01-01

Background A health system that provides equitable health care is a principal goal in many countries. Measuring horizontal inequity (HI) in health care utilization is important to develop appropriate and equitable public policies, especially policies related to non-communicable diseases (NCDs). Design A cross-sectional survey of 1,211 randomly selected households in slum and non-slum areas was carried out in four urban districts of Hanoi city in 2013. This study utilized data from 3,736 individuals aged 15 years and older. Respondents were asked about health care use during the previous 12 months; information included sex, age, and self-reported NCDs. We assessed the extent of inequity in utilization of public health care services. Concentration indexes for health care utilization and health care needs were constructed via probit regression of individual utilization of public health care services, controlling for age, sex, and NCDs. In addition, concentration indexes were decomposed to identify factors contributing to inequalities in health care utilization. Results The proportion of healthcare utilization in the slum and non-slum areas was 21.4 and 26.9%, respectively. HI in health care utilization in favor of the rich was observed in the slum areas, whereas horizontal equity was achieved among the non-slum areas. In the slum areas, we identified some key factors that affect the utilization of public health care services. Conclusion Our results suggest that to achieve horizontal equity in utilization of public health care services, policy should target preventive interventions for NCDs, focusing more on the poor in slum areas. PMID:25095780

A Comparative Assessment of Track Plates to Quantify Fine Scale Variations in the Relative Abundance of Norway Rats in Urban Slums

PubMed Central

Begon, Mike; Diggle, Peter J.; Serrano, Soledad; Reis, Mitermayer G.; Childs, James E.; Ko, Albert I.; Costa, Federico

2016-01-01

Norway rats (Rattus norvegicus) living in urban environments are a critical public health and economic problem, particularly in urban slums where residents are at a higher risk for rat borne diseases, yet convenient methods to quantitatively assess population sizes are lacking. We evaluated track plates as a method to determine rat distribution and relative abundance in a complex urban slum environment by correlating the presence and intensity of rat-specific marks on track plates with findings from rat infestation surveys and trapping of rats to population exhaustion. To integrate the zero-inflated track plate data we developed a two-component mixture model with one binary and one censored continuous component. Track plate mark-intensity was highly correlated with signs of rodent infestation (all coefficients between 0.61 and 0.79 and all p-values < 0.05). Moreover, the mean level of pre-trapping rat-mark intensity on plates was significantly associated with the number of rats captured subsequently (Odds ratio1.38; 95% CI 1.19-1.61) and declined significantly following trapping (Odds ratio 0.86; 95% CI 0.78-0.95). Track plates provided robust proxy measurements of rat abundance and distribution and detected rat presence even when populations appeared ‘trapped out’. Tracking plates are relatively easy and inexpensive methods that can be used to intensively sample settings such as urban slums, where traditional trapping or mark-recapture studies are impossible to implement, and therefore the results can inform and assess the impact of targeted urban rodent control campaigns. PMID:27453682

Human rights and reproductive health: political realities and pragmatic choices for married adolescent women living in urban slums, Bangladesh

PubMed Central

2011-01-01

Background In Bangladesh, particularly in urban slums, married adolescent women’s human rights to life, health, and reproductive and sexual health remain adversely affected because of the structural inequalities and political economic, social and cultural conditions which shape how rights are understood, negotiated and lived. Methods The focus of the research and methods was anthropological. An initial survey of 153 married adolescent women was carried out and from this group, 50 in-depth interviews were conducted with selected participants and, from the in-depth interviews, a further eight case studies of women and their families were selected for in-depth repeated interviews and case histories. Results This paper speaks of the unanticipated complexities when writing on reproductive rights for poor adolescent women living in the slums, where the discourses on ‘universal human rights’ are often removed from the reality of adolescent women’s everyday lives. Married adolescent women and their families remain extremely vulnerable in the unpredictable, crime-prone and insecure urban slum landscape because of their age, gender and poverty. Adolescent women’s understanding of their rights such as the decision to marry early, have children, terminate pregnancies and engage in risky sexual behaviour, are different from the widely accepted discourse on rights globally, which assumes a particular kind of individual thinking and discourse on rights and a certain autonomy women have over their bodies and their lives. This does not necessarily exist in urban slum populations. Conclusions The lived experiences and decisions made pertaining to sexual and reproductive health and ‘rights’ exercised by married adolescent women, their families and slum communities, allow us to reflect on the disconnect between the international legal human rights frameworks as applied to sexual and reproductive health rights, and how these are played out on the ground. These notions are far more complex in environments where married adolescent women and their families live in conditions of poverty and socioeconomic deprivation. PMID:22376023

Identification of priority health conditions for field-based screening in urban slums in Bangalore, India.

PubMed

Abdi, Sarah; Wadugodapitiya, Avanti; Bedaf, Sandra; George, Carolin Elizabeth; Norman, Gift; Hawley, Mark; de Witte, Luc

2018-03-02

Urban slums are characterised by unique challenging living conditions, which increase their inhabitants' vulnerability to specific health conditions. The identification and prioritization of the key health issues occurring in these settings is essential for the development of programmes that aim to enhance the health of local slum communities effectively. As such, the present study sought to identify and prioritise the key health issues occurring in urban slums, with a focus on the perceptions of health professionals and community workers, in the rapidly growing city of Bangalore, India. The study followed a two-phased mixed methods design. During Phase I of the study, a total of 60 health conditions belonging to four major categories: - 1) non-communicable diseases; 2) infectious diseases; 3) maternal and women's reproductive health; and 4) child health - were identified through a systematic literature review and semi-structured interviews conducted with health professionals and other relevant stakeholders with experience working with urban slum communities in Bangalore. In Phase II, the health issues were prioritised based on four criteria through a consensus workshop conducted in Bangalore. The top health issues prioritized during the workshop were: diabetes and hypertension (non-communicable diseases category), dengue fever (infectious diseases category), malnutrition and anaemia (child health, and maternal and women's reproductive health categories). Diarrhoea was also selected as a top priority in children. These health issues were in line with national and international reports that listed them as top causes of mortality and major contributors to the burden of diseases in India. The results of this study will be used to inform the development of technologies and the design of interventions to improve the health outcomes of local communities. Identification of priority health issues in the slums of other regions of India, and in other low and lower middle-income countries, is recommended.

Human rights and reproductive health: political realities and pragmatic choices for married adolescent women living in urban slums, Bangladesh.

PubMed

Rashid, Sabina Faiz

2011-12-16

In Bangladesh, particularly in urban slums, married adolescent women's human rights to life, health, and reproductive and sexual health remain adversely affected because of the structural inequalities and political economic, social and cultural conditions which shape how rights are understood, negotiated and lived. The focus of the research and methods was anthropological. An initial survey of 153 married adolescent women was carried out and from this group, 50 in-depth interviews were conducted with selected participants and, from the in-depth interviews, a further eight case studies of women and their families were selected for in-depth repeated interviews and case histories. This paper speaks of the unanticipated complexities when writing on reproductive rights for poor adolescent women living in the slums, where the discourses on 'universal human rights' are often removed from the reality of adolescent women's everyday lives. Married adolescent women and their families remain extremely vulnerable in the unpredictable, crime-prone and insecure urban slum landscape because of their age, gender and poverty. Adolescent women's understanding of their rights such as the decision to marry early, have children, terminate pregnancies and engage in risky sexual behaviour, are different from the widely accepted discourse on rights globally, which assumes a particular kind of individual thinking and discourse on rights and a certain autonomy women have over their bodies and their lives. This does not necessarily exist in urban slum populations. The lived experiences and decisions made pertaining to sexual and reproductive health and 'rights' exercised by married adolescent women, their families and slum communities, allow us to reflect on the disconnect between the international legal human rights frameworks as applied to sexual and reproductive health rights, and how these are played out on the ground. These notions are far more complex in environments where married adolescent women and their families live in conditions of poverty and socioeconomic deprivation.

Community Mobilization in Mumbai Slums to Improve Perinatal Care and Outcomes: A Cluster Randomized Controlled Trial

PubMed Central

More, Neena Shah; Bapat, Ujwala; Das, Sushmita; Alcock, Glyn; Patil, Sarita; Porel, Maya; Vaidya, Leena; Fernandez, Armida; Joshi, Wasundhara; Osrin, David

2012-01-01

Introduction Improving maternal and newborn health in low-income settings requires both health service and community action. Previous community initiatives have been predominantly rural, but India is urbanizing. While working to improve health service quality, we tested an intervention in which urban slum-dweller women's groups worked to improve local perinatal health. Methods and Findings A cluster randomized controlled trial in 24 intervention and 24 control settlements covered a population of 283,000. In each intervention cluster, a facilitator supported women's groups through an action learning cycle in which they discussed perinatal experiences, improved their knowledge, and took local action. We monitored births, stillbirths, and neonatal deaths, and interviewed mothers at 6 weeks postpartum. The primary outcomes described perinatal care, maternal morbidity, and extended perinatal mortality. The analysis included 18,197 births over 3 years from 2006 to 2009. We found no differences between trial arms in uptake of antenatal care, reported work, rest, and diet in later pregnancy, institutional delivery, early and exclusive breastfeeding, or care-seeking. The stillbirth rate was non-significantly lower in the intervention arm (odds ratio 0.86, 95% CI 0.60–1.22), and the neonatal mortality rate higher (1.48, 1.06–2.08). The extended perinatal mortality rate did not differ between arms (1.19, 0.90–1.57). We have no evidence that these differences could be explained by the intervention. Conclusions Facilitating urban community groups was feasible, and there was evidence of behaviour change, but we did not see population-level effects on health care or mortality. In cities with multiple sources of health care, but inequitable access to services, community mobilization should be integrated with attempts to deliver services for the poorest and most vulnerable, and with initiatives to improve quality of care in both public and private sectors. Trial registration Current Controlled Trials ISRCTN96256793 Please see later in the article for the Editors' Summary PMID:22802737

Implications of Pearl, Gold, Silver (PGS) craft industrial cluster towards settlements region in Karang Pule Village, Sekarbela District Of Mataram City

NASA Astrophysics Data System (ADS)

Sushanti, I. R.; Fitri, I. S.

2017-06-01

The existence of industry clusters in Mataram City gave effect to the surrounding residential areas [1]. In accordance Spatial Plan of Mataram City in 2011-2031 PGS industry cluster in the village of Karang Pule, Sekarbela district established as shopping tourism area. Distribution of industrial locations were in four of seven environments in Karang Pule. Distribution of PGS industry is divided into three (3) groups: craftsmen, craftsmen who is also a seller, and the seller (merchant). The location of the craftsmen, craftsmen who are also businessmen and entrepreneurs are also used as a dwelling house or workshop and store. So most of the people living in settlements around clusters of industry that there is a link between industry cluster and settlements. This study aims to determine the implications or the impact of the presence of PGS industry clusters the surrounding residential areas. The method used in this research is descriptive qualitative with the collection of primary data through direct observation and questionnaires. Based on direct observation on the shopping tourism area there are inequality between the conditions of industry clusters and settlements area by the presence of slums. The results showed that the PGS industry cluster impact on social, economic and environment near settlements area. Impacts that occur are: 1) the social aspect, there is a significant change in the level of education, social welfare and social disparities but less significant to the formation of institutions, particularly in community participation, 2) the economic aspect of the change status of community work, and increased revenue and 3) the environmental aspects of the change to the condition of the building, the quality of public housing, the presence of slums, changes in infrastructure and the environmental pollution.

Beyond the Beaten Track: Resettlement Initiatives of Pavement Dwellers and Slum Dwellers in Bombay.

ERIC Educational Resources Information Center

Patel, Sheela

1988-01-01

The Society for Promotion of Adult Resource Centres was created to alleviate the problem of railway settlement families and pavement dwellers in Bombay, India. The area resource center provides information, analysis of available resources, discussion of problems, and sharing of experiences. (JOW)

Dietary adequacy of Indian children residing in an urban slum--analysis of proximal and distal determinants.

PubMed

Kulsum, Asma; A, Jyothi Lakshmi; Prakash, Jamuna

2009-01-01

The influences of proximal and distal determinants of dietary adequacy of children from an urban slum in India were analyzed. Children numbering 271 (5-14 years) and their mothers were enrolled for the study. Intake of all nutrients except protein was inadequate in the dietaries of children. Among distal determinants, associations were found between (i) calorie intake and maternal nutritional status; (ii) protein, iron and B-complex intakes and economic status, and (iii) retinol, calcium and fat intakes and family size. Literacy status was not associated with dietary adequacy. Age of children and economic status of family were important determinants of dietary adequacy of children from slum area. Copyright © Taylor & Francis Group, LLC

Mental health in the slums of Dhaka - a geoepidemiological study

PubMed Central

2012-01-01

Background Urban health is of global concern because the majority of the world's population lives in urban areas. Although mental health problems (e.g. depression) in developing countries are highly prevalent, such issues are not yet adequately addressed in the rapidly urbanising megacities of these countries, where a growing number of residents live in slums. Little is known about the spectrum of mental well-being in urban slums and only poor knowledge exists on health promotive socio-physical environments in these areas. Using a geo-epidemiological approach, the present study identified factors that contribute to the mental well-being in the slums of Dhaka, which currently accommodates an estimated population of more than 14 million, including 3.4 million slum dwellers. Methods The baseline data of a cohort study conducted in early 2009 in nine slums of Dhaka were used. Data were collected from 1,938 adults (≥ 15 years). All respondents were geographically marked based on their households using global positioning systems (GPS). Very high-resolution land cover information was processed in a Geographic Information System (GIS) to obtain additional exposure information. We used a factor analysis to reduce the socio-physical explanatory variables to a fewer set of uncorrelated linear combinations of variables. We then regressed these factors on the WHO-5 Well-being Index that was used as a proxy for self-rated mental well-being. Results Mental well-being was significantly associated with various factors such as selected features of the natural environment, flood risk, sanitation, housing quality, sufficiency and durability. We further identified associations with population density, job satisfaction, and income generation while controlling for individual factors such as age, gender, and diseases. Conclusions Factors determining mental well-being were related to the socio-physical environment and individual level characteristics. Given that mental well-being is associated with physiological well-being, our study may provide crucial information for developing better health care and disease prevention programmes in slums of Dhaka and other comparable settings. PMID:22404959

Creating a sustainable, participatory palliative care programme in an urban slum in Dhaka, Bangladesh.

PubMed

Ahmad, Nezamuddin

2018-01-01

The Centre for Palliative Care, based at the only medical university [Bangabandhu Sheikh Mujib Medical University (BSMMU)] in Dhaka, Bangladesh, in collaboration with Worldwide Hospice Palliative Care Alliance, piloted a one-year project focussed on improving the quality of life of 100 older people and their families in two slum settings in Dhaka. This project was developed following the identification of significant palliative care needs of older people in the slum settings. In addition, the project was formed in response to the absence of programmes delivering palliative care to the poorest and most marginalised in poor urban settings, in a sustainable manner within the context of the low development of palliative care and the human and financial resource limitations in Bangladesh. The programme was developed using a participatory approach which focussed on engaging members of the community in the delivery of the project through the identification and training of 8 palliative care assistants from the slum setting itself, who delivered basic care supported by health professionals, the development of palliative care activists within the community and the engagement of the slum community leadership. The impact of the project showed improved quality of life for the target population and the potential for further development as a sustainable, community owned model over a further 2 years, which could be translated into other urban settings. This presentation will highlight lessons learned from the development and implementation of the project, and findings from the independent evaluation completed in December 2016, overseen by Glasgow University. The presentation will outline the successes and challenges of developing a participatory, community owned palliative care service within a slum in Dhaka, Bangladesh for older people and their families.

Family planning use among urban poor women from six cities of Uttar Pradesh, India.

PubMed

Speizer, Ilene S; Nanda, Priya; Achyut, Pranita; Pillai, Gita; Guilkey, David K

2012-08-01

Family planning has widespread positive impacts for population health and well-being; contraceptive use not only decreases unintended pregnancies and reduces infant and maternal mortality and morbidity, but it is critical to the achievement of Millennium Development Goals. This study uses baseline, representative data from six cities in Uttar Pradesh, India to examine family planning use among the urban poor. Data were collected from about 3,000 currently married women in each city (Allahabad, Agra, Varanasi, Aligarh, Gorakhpur, and Moradabad) for a total sample size of 17,643 women. Participating women were asked about their fertility desires, family planning use, and reproductive health. The survey over-sampled slum residents; this permits in-depth analyses of the urban poor and their family planning use behaviors. Bivariate and multivariate analyses are used to examine the role of wealth and education on family planning use and unmet need for family planning. Across all of the cities, about 50% of women report modern method use. Women in slum areas generally report less family planning use and among those women who use, slum women are more likely to be sterilized than to use other methods, including condoms and hormonal methods. Across all cities, there is a higher unmet need for family planning to limit childbearing than for spacing births. Poorer women are more likely to have an unmet need than richer women in both the slum and non-slum samples; this effect is attenuated when education is included in the analysis. Programs seeking to target the urban poor in Uttar Pradesh and elsewhere in India may be better served to identify the less educated women and target these women with appropriate family planning messages and methods that meet their current and future fertility desire needs.

Socioenvironmental conditions and intestinal parasitic infections in Brazilian urban slums: a cross-sectional study

PubMed Central

Ignacio, Caroline Ferraz; da Silva, Milena Enderson Chagas; Handam, Natasha Berendonk; Alencar, Maria de Fatima Leal; Sotero-Martins, Adriana; Barata, Martha Macedo de Lima; de Moraes, Antonio Henrique Almeida

2017-01-01

ABSTRACT Intestinal parasitic infections (IPIs) are neglected diseases with limited data regarding prevalence in Brazil and many other countries. In increasingly urban societies, investigating the profile and socioenvironmental determinants of IPIs in the general population of slum dwellers is necessary for establishing appropriate public policies catered to these environments. This study assessed the socioenvironmental conditions and prevalence of IPIs in slums of Rio de Janeiro, RJ State, Brazil. Methods A cross-sectional study covering an agglomeration of urban slums was conducted between 2015 and 2016 using participants observation, a socioeconomic survey, and the spontaneous sedimentation method with three slides per sample to analyze fresh stool specimens ( n =595) searching for intestinal parasites. Results Endolimax nana ( n =95, 16.0%) and Entamoeba coli ( n =65, 10.9%) were the most frequently identified agents, followed by Giardia intestinalis ( n =24, 4.0%) and Ascaris lumbricoides ( n =11, 1.8%). Coinfections caused by E. nana and E. histolytica/dispar and by Entamoeba coli/A. lumbricoides were significant. The use of piped water as drinking water, the presence of A. lumbricoides , and contamination with coliform bacteria and Escherichia coli were more common in major area (MA) 1. Children (0-19 years) had a greater chance of living in poverty (OR 3.36; 95% CI: 2.50- 4.52; p <0.001) which was pervasive. The predominance of protozoa parasites suggests that a one-size-fits-all approach focusing on preventive chemotherapy for soil-transmitted helminths is not appropriate for all communities in developing countries. It is important that both residents and health professionals consider the socioenvironmental conditions of urban slums when assessing intestinal parasitic infections for disease control and health promotion initiatives. PMID:28793024

The Design of Housing and Shelter Programs: The Social and Environmental Determinants of Inequalities

PubMed Central

Howden-Chapman, Philippa; Patel, Sheela

2007-01-01

Both developed and less developed countries are becoming increasingly urbanized. The earlier industrialized countries have developed more infrastructure to support the building of healthy housing, in neighborhoods that are strongly linked to municipal and global health initiatives, but to some degree housing and neighborhood issues vary only in degree between the developing and developed worlds. Overall, a billion people, a third of people living in urban areas, live in slums, where environmental determinants lead to disease. Although communicable diseases predominate in the developing world and have reemerged in the developed world, noncommunicable diseases are also growing disproportionately in the developing world. At a global level, the Millennium Development Goals explicitly focus on an integrated approach to slum upgrading. The per capita cost of slum upgrading is almost twice the cost of providing new affordable housing at the outset. It is argued that to improve health and well-being in the slums we need to have interventions that reduce urban poverty in the broadest sense and improve the deficiencies associated with slums. There is an urgent need to scale up the best-practice interventions. Examples are given of successful local community initiatives that have been set up under national strategies in Tanzania and by Indian women’s collectives that are globally linked and have helped develop housing and sanitation improvements. The unit costs for such interventions are within the reach of all the key stakeholders. Global commitment is the only missing link. PMID:17387617

The design of housing and shelter programs: the social and environmental determinants of inequalities.

PubMed

Sheuya, Shaaban; Howden-Chapman, Philippa; Patel, Sheela

2007-05-01

Both developed and less developed countries are becoming increasingly urbanized. The earlier industrialized countries have developed more infrastructure to support the building of healthy housing, in neighborhoods that are strongly linked to municipal and global health initiatives, but to some degree housing and neighborhood issues vary only in degree between the developing and developed worlds. Overall, a billion people, a third of people living in urban areas, live in slums, where environmental determinants lead to disease. Although communicable diseases predominate in the developing world and have reemerged in the developed world, noncommunicable diseases are also growing disproportionately in the developing world. At a global level, the Millennium Development Goals explicitly focus on an integrated approach to slum upgrading. The per capita cost of slum upgrading is almost twice the cost of providing new affordable housing at the outset. It is argued that to improve health and well-being in the slums we need to have interventions that reduce urban poverty in the broadest sense and improve the deficiencies associated with slums. There is an urgent need to scale up the best-practice interventions. Examples are given of successful local community initiatives that have been set up under national strategies in Tanzania and by Indian women's collectives that are globally linked and have helped develop housing and sanitation improvements. The unit costs for such interventions are within the reach of all the key stakeholders. Global commitment is the only missing link.

Mental health, quality of life, and nutritional status of adolescents in Dhaka, Bangladesh: comparison between an urban slum and a non-slum area.

PubMed

Izutsu, Takashi; Tsutsumi, Atsuro; Islam, Akramul Md; Kato, Seika; Wakai, Susumu; Kurita, Hiroshi

2006-09-01

This study aims to clarify the quality of life (QOL), mental health, and nutritional status of adolescents in Dhaka city, Bangladesh by comparing non-slum areas and slums, and to find the factors associated with their mental health problems. A sample of 187 boys and 137 girls from non-slum areas, and 157 boys and 121 girls from slums, between 11-18 years old were interviewed with a questionnaire consisting of a Bangla translation of the World Health Organization Quality of Life Assessment Instrument (WHOQOL-BREF), Self Reporting Questionnaire (SRQ), Youth Self-Report (YSR) and other questions. The height and weight of the respondents were measured. All significant differences in demographic characteristics, anthropometric measures, and WHOQOL-BREF were found to reflect worse conditions in slum than in non-slum areas. Contrarily, all differences in SRQ and YSR were worse in non-slum areas for both genders, except that the "conduct problems" score for YSR was worse for slum boys. Mental states were mainly associated with school enrollment and working status. Worse physical environment and QOL were found in slums, along with gender and area specific mental health difficulties. The results suggest gender specific needs and a requirement for area sensitive countermeasures.

The history, geography, and sociology of slums and the health problems of people who live in slums.

PubMed

Ezeh, Alex; Oyebode, Oyinlola; Satterthwaite, David; Chen, Yen-Fu; Ndugwa, Robert; Sartori, Jo; Mberu, Blessing; Melendez-Torres, G J; Haregu, Tilahun; Watson, Samuel I; Caiaffa, Waleska; Capon, Anthony; Lilford, Richard J

2017-02-04

Massive slums have become major features of cities in many low-income and middle-income countries. Here, in the first in a Series of two papers, we discuss why slums are unhealthy places with especially high risks of infection and injury. We show that children are especially vulnerable, and that the combination of malnutrition and recurrent diarrhoea leads to stunted growth and longer-term effects on cognitive development. We find that the scientific literature on slum health is underdeveloped in comparison to urban health, and poverty and health. This shortcoming is important because health is affected by factors arising from the shared physical and social environment, which have effects beyond those of poverty alone. In the second paper we will consider what can be done to improve health and make recommendations for the development of slum health as a field of study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Addressing Inequities in Urban Health: Do Decision-Makers Have the Data They Need? Report from the Urban Health Data Special Session at International Conference on Urban Health Dhaka 2015.

PubMed

Elsey, H; Thomson, D R; Lin, R Y; Maharjan, U; Agarwal, S; Newell, J

2016-06-01

Rapid and uncontrolled urbanisation across low and middle-income countries is leading to ever expanding numbers of urban poor, defined here as slum dwellers and the homeless. It is estimated that 828 million people are currently living in slum conditions. If governments, donors and NGOs are to respond to these growing inequities they need data that adequately represents the needs of the urban poorest as well as others across the socio-economic spectrum.We report on the findings of a special session held at the International Conference on Urban Health, Dhaka 2015. We present an overview of the need for data on urban health for planning and allocating resources to address urban inequities. Such data needs to provide information on differences between urban and rural areas nationally, between and within urban communities. We discuss the limitations of data most commonly available to national and municipality level government, donor and NGO staff. In particular we assess, with reference to the WHO's Urban HEART tool, the challenges in the design of household surveys in understanding urban health inequities.We then present two novel approaches aimed at improving the information on the health of the urban poorest. The first uses gridded population sampling techniques within the design and implementation of household surveys and the second adapts Urban HEART into a participatory approach which enables slum residents to assess indicators whilst simultaneously planning the response. We argue that if progress is to be made towards inclusive, safe, resilient and sustainable cities, as articulated in Sustainable Development Goal 11, then understanding urban health inequities is a vital pre-requisite to an effective response by governments, donors, NGOs and communities.

Pregnant Women's and Community Health Workers' Perceptions of Root Causes of Malnutrition Among Infants and Young Children in the Slums of Dhaka, Bangladesh

PubMed Central

Faiz, Sabina; Bogin, Barry A.; Griffiths, Paula L.

2011-01-01

Research in Bangladesh shows that malnutrition among infants and young children is most severe in urban slums. We examined the root causes of malnutrition as perceived by pregnant women and community health workers. We conducted 10 focus group discussions in the slums of Dhaka in 2008 and 2009. Participants accurately perceived inappropriate care, inappropriate environment, inappropriate food, and flooding to be major causes. Recurrent flooding has not traditionally been identified by experts as a cause of malnutrition. We recommend further research to address the nutritional risks flooding creates for vulnerable slum populations. PMID:21653248

Influence of School and Environment on Selective Memory.

ERIC Educational Resources Information Center

Wilkinson, Alex; And Others

1979-01-01

Subjects were 943 mestizo and Quechua Indian children aged five and six years who lived in jungle villages near Lanas and in slum settlements in Lima, Peru. Some six year olds attended school and others did not. The children were tested with a task that assessed memory for central and incidental features of drawings. (JMB)

Socio-demographic factors associated with domestic violence in urban slums, Mumbai, Maharashtra, India.

PubMed

Begum, Shahina; Donta, Balaiah; Nair, Saritha; Prakasam, C P

2015-06-01

Domestic violence is identified as a public heath problem. It is associated with adverse maternal health. This study examined the prevalence and determinants of domestic violence among women in urban slums of Mumbai, India. A community based cross-sectional household survey was carried out among eligible women for the study during September 2012 to January 2013. A total of 1137 currently married women aged 18-39 yr with unmet need for family planning and having at least one child were selected using cluster systematic random sampling from two urban slums. Information on socio-demographic, reproductive and domestic violence was collected through face-to-face interview using a pretested structured questionnaire after obtaining informed written consent. Bivariate and multivariate analyses were carried out to find the socio-demographic factors associated with ever experienced domestic violence among women. The prevalence of women ever experiencing domestic violence in the community was 21.2 per cent. Women whose husband consumed alcohol [RR: 2.17, (95% CI: 1.58-2.98)] were significantly at an increased risk of ever experiencing domestic violence than their counterparts. Risk of domestic violence was twice [RR: 2.00, (95% CI: 1.35-2.96)] for women who justified wife beating than women who did not justify wife beating. The findings showed that domestic violence was prevalent in urban slums. Factors like early marriage, working status, justified wife beating and husbands use of alcohol were significantly associated with domestic violence.

Socio-demographic factors associated with domestic violence in urban slums, Mumbai, Maharashtra, India

PubMed Central

Begum, Shahina; Donta, Balaiah; Nair, Saritha; Prakasam, C.P.

2015-01-01

Background & objectives: Domestic violence is identified as a public heath problem. It is associated with adverse maternal health. This study examined the prevalence and determinants of domestic violence among women in urban slums of Mumbai, India. Methods: A community based cross-sectional household survey was carried out among eligible women for the study during September 2012 to January 2013. A total of 1137 currently married women aged 18-39 yr with unmet need for family planning and having at least one child were selected using cluster systematic random sampling from two urban slums. Information on socio-demographic, reproductive and domestic violence was collected through face-to-face interview using a pretested structured questionnaire after obtaining informed written consent. Bivariate and multivariate analyses were carried out to find the socio-demographic factors associated with ever experienced domestic violence among women. Results: The prevalence of women ever experiencing domestic violence in the community was 21.2 per cent. Women whose husband consumed alcohol [RR: 2.17, (95% CI: 1.58-2.98)] were significantly at an increased risk of ever experiencing domestic violence than their counterparts. Risk of domestic violence was twice [RR: 2.00, (95% CI: 1.35-2.96)] for women who justified wife beating than women who did not justify wife beating. Interpretation & conclusions: The findings showed that domestic violence was prevalent in urban slums. Factors like early marriage, working status, justified wife beating and husbands use of alcohol were significantly associated with domestic violence. PMID:26205021

Illness perception of tuberculosis (TB) and health seeking practice among urban slum residents of Bangladesh: a qualitative study.

PubMed

Bam, Kiran; Bhatt, Lokesh Prasad; Thapa, Rajshree; Dossajee, Hussein Karimjee; Angdembe, Mirak Raj

2014-08-27

Combating tuberculosis (TB) in urban slums is more complex than in rural areas due to reasons such as over-crowding, unhygienic living conditions and poverty. This study aimed to assess illness perception of TB and identify barriers and facilitators for health seeking practice among the residents of Badda slum, Dhaka, Bangladesh. The Badda slum was purposively selected. Convenience sampling was carried out to select participants aged 18 years and above. Twenty two in-depth interviews, two key informants' interviews and participatory rapid appraisal (PRA) were conducted. Data were analyzed manually by using defined a priori codes and color coding of the quotes in data matrix table. TB was commonly recognized as Jokkha (pulmonary TB), Sas rog (disease associated to breathing) followed by TB. More females than males had knowledge about TB related illness. Very few perceived of being at risk of TB despite the high risk behavior and environment. Prime barriers for health seeking practice of TB were cost along with other barriers like prevailing stigma on TB, lack of information on service sites and unavailability of accompanying person. Training and orientation to community organizations and people, awareness on TB and free treatment through advertisements/media, community level diagnostic and home based care were identified as the facilitators for the health seeking practice of TB. Perceptions of TB and knowledge associated with the disease shape the health seeking practice, therefore promotion of media awareness campaign, targeting the people of urban slums for reducing misconceptions and promotion of home based service is needed to encourage health seeking practice in the future.

Prevalence of VDRL sero-positivity in women in reproductive age group in an urban slum community in Bombay.

PubMed

Pandit, D D; Angadi, S A; Chavan, M K; Pai, N P

1995-01-01

A cross sectional survey was carried in an Urban Slum Community in Bombay having a population of 60,000. A total of 393 women in reproductive age group were screened for VDRL reactivity. The highest prevalence was in 15 to 29 years of age group. The sero-positivity rate at 1:8 dilution and above was 0.50%. The seropositivity rate can be further brought down by properly planned and implemented STD (Sexually Transmitted Diseases) Control activities at a community level.

Using Case Studies to Teach About Global Issues, The Urban Poor in Northeast Brazil

ERIC Educational Resources Information Center

Desmond, Kathleen

1974-01-01

The city of Salvador, Brazil, is growing rapidly; yet 100,000 people still live in the slums and unemployment is high. This article examines the lifestyle of one of these slum dwellers and his family focusing on their poverty. Discussion questions and activities are provided. (DE)

PROJECT CONCERN--A CASE STUDY IN URBAN-SUBURBAN COOPERATION. POSITION PAPER.

ERIC Educational Resources Information Center

MAHAN, THOMAS W.

PROJECT CONCERN SEEKS TO DEMONSTRATE THAT THE LOWER ACHIEVEMENT OF DISADVANTAGED STUDENTS IS AN "ARTIFACT" OF A NEGATIVE INTERACTION BETWEEN THE SLUM NEIGHBORHOOD AND THE SLUM SCHOOL. TO COUNTERACT THIS EFFECT, THE PROJECT HAS BUSED OVER 250 INNER CITY MINORITY GROUP CHILDREN, FROM KINDERGARTEN THROUGH FIFTH GRADE, TO FIVE MIDDLE CLASS…

24 CFR 510.1 - Multi-family property loans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Multi-family property loans. 510.1 Section 510.1 Housing and Urban Development Regulations Relating to Housing and Urban Development... URBAN DEVELOPMENT SLUM CLEARANCE AND URBAN RENEWAL SECTION 312 REHABILITATION LOAN PROGRAM § 510.1 Multi...

24 CFR 511.52 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true [Reserved] 511.52 Section 511.52 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.34 - [Reserved

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true [Reserved] 511.34 Section 511.34 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.74 - Audit.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false Audit. 511.74 Section 511.74 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.52 - [Reserved

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true [Reserved] 511.52 Section 511.52 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.52 - [Reserved

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false [Reserved] 511.52 Section 511.52 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Definitions. 511.2 Section 511.2 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.74 - Audit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Audit. 511.74 Section 511.74 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.34 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false [Reserved] 511.34 Section 511.34 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.34 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false [Reserved] 511.34 Section 511.34 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.34 - [Reserved

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false [Reserved] 511.34 Section 511.34 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Definitions. 511.2 Section 511.2 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false Definitions. 511.2 Section 511.2 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Definitions. 511.2 Section 511.2 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.52 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false [Reserved] 511.52 Section 511.52 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.74 - Audit.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Audit. 511.74 Section 511.74 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.52 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false [Reserved] 511.52 Section 511.52 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Definitions. 511.2 Section 511.2 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.74 - Audit.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Audit. 511.74 Section 511.74 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

24 CFR 511.34 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true [Reserved] 511.34 Section 511.34 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM...

Influence of household rat infestation on leptospira transmission in the urban slum environment.

PubMed

Costa, Federico; Ribeiro, Guilherme S; Felzemburgh, Ridalva D M; Santos, Norlan; Reis, Renato Barbosa; Santos, Andreia C; Fraga, Deborah Bittencourt Mothe; Araujo, Wildo N; Santana, Carlos; Childs, James E; Reis, Mitermayer G; Ko, Albert I

2014-12-01

The Norway rat (Rattus norvegicus) is the principal reservoir for leptospirosis in many urban settings. Few studies have identified markers for rat infestation in slum environments while none have evaluated the association between household rat infestation and Leptospira infection in humans or the use of infestation markers as a predictive model to stratify risk for leptospirosis. We enrolled a cohort of 2,003 urban slum residents from Salvador, Brazil in 2004, and followed the cohort during four annual serosurveys to identify serologic evidence for Leptospira infection. In 2007, we performed rodent infestation and environmental surveys of 80 case households, in which resided at least one individual with Leptospira infection, and 109 control households. In the case-control study, signs of rodent infestation were identified in 78% and 42% of the households, respectively. Regression modeling identified the presence of R. norvegicus feces (OR, 4.95; 95% CI, 2.13-11.47), rodent burrows (2.80; 1.06-7.36), access to water (2.79; 1.28-6.09), and un-plastered walls (2.71; 1.21-6.04) as independent risk factors associated with Leptospira infection in a household. We developed a predictive model for infection, based on assigning scores to each of the rodent infestation risk factors. Receiver operating characteristic curve analysis found that the prediction score produced a good/excellent fit based on an area under the curve of 0.78 (0.71-0.84). Our study found that a high proportion of slum households were infested with R. norvegicus and that rat infestation was significantly associated with the risk of Leptospira infection, indicating that high level transmission occurs among slum households. We developed an easily applicable prediction score based on rat infestation markers, which identified households with highest infection risk. The use of the prediction score in community-based screening may therefore be an effective risk stratification strategy for targeting control measures in slum settings of high leptospirosis transmission.

A two-step crushed lava rock filter unit for grey water treatment at household level in an urban slum.

PubMed

Katukiza, A Y; Ronteltap, M; Niwagaba, C B; Kansiime, F; Lens, P N L

2014-01-15

Decentralised grey water treatment in urban slums using low-cost and robust technologies offers opportunities to minimise public health risks and to reduce environmental pollution caused by the highly polluted grey water i.e. with a COD and N concentration of 3000-6000 mg L(-1) and 30-40 mg L(-1), respectively. However, there has been very limited action research to reduce the pollution load from uncontrolled grey water discharge by households in urban slums. This study was therefore carried out to investigate the potential of a two-step filtration process to reduce the grey water pollution load in an urban slum using a crushed lava rock filter, to determine the main filter design and operation parameters and the effect of intermittent flow on the grey water effluent quality. A two-step crushed lava rock filter unit was designed and implemented for use by a household in the Bwaise III slum in Kampala city (Uganda). It was monitored at a varying hydraulic loading rate (HLR) of 0.5-1.1 m d(-1) as well as at a constant HLR of 0.39 m d(-1). The removal efficiencies of COD, TP and TKN were, respectively, 85.9%, 58% and 65.5% under a varying HLR and 90.5%, 59.5% and 69%, when operating at a constant HLR regime. In addition, the log removal of Escherichia coli, Salmonella spp. and total coliforms was, respectively, 3.8, 3.2 and 3.9 under the varying HLR and 3.9, 3.5 and 3.9 at a constant HLR. The results show that the use of a two-step filtration process as well as a lower constant HLR increased the pollutant removal efficiencies. Further research is needed to investigate the feasibility of adding a tertiary treatment step to increase the nutrients and microorganisms removal from grey water. Copyright © 2013 Elsevier Ltd. All rights reserved.

Co-occurrence of behavioral risk factors of common non-communicable diseases among urban slum dwellers in Nairobi, Kenya.

PubMed

Haregu, Tilahun Nigatu; Oti, Samuel; Egondi, Thaddaeus; Kyobutungi, Catherine

2015-01-01

The four common non-communicable diseases (NCDs) account for 80% of NCD-related deaths worldwide. The four NCDs share four common risk factors. As most of the existing evidence on the common NCD risk factors is based on analysis of a single factor at a time, there is a need to investigate the co-occurrence of the common NCD risk factors, particularly in an urban slum setting in sub-Saharan Africa. To determine the prevalence of co-occurrence of the four common NCDs risk factors among urban slum dwellers in Nairobi, Kenya. This analysis was based on the data collected as part of a cross-sectional survey to assess linkages among socio-economic status, perceived personal risk, and risk factors for cardiovascular and NCDs in a population of slum dwellers in Nairobi, Kenya, in 2008-2009. A total of 5,190 study subjects were included in the analysis. After selecting relevant variables for common NCD risk factors, we computed the prevalence of all possible combinations of the four common NCD risk factors. The analysis was disaggregated by relevant background variables. The weighted prevalences of unhealthy diet, insufficient physical activity, harmful use of alcohol, and tobacco use were found to be 57.2, 14.4, 10.1, and 12.4%, respectively. Nearly 72% of the study participants had at least one of the four NCD risk factors. About 52% of the study population had any one of the four NCD risk factors. About one-fifth (19.8%) had co-occurrence of NCD risk factors. Close to one in six individuals (17.6%) had two NCD risk factors, while only 2.2% had three or four NCD risk factors. One out of five of people in the urban slum settings of Nairobi had co-occurrence of NCD risk factors. Both comprehensive and differentiated approaches are needed for effective NCD prevention and control in these settings.

Designing urban rules from emergent patterns: co-evolving paths of informal and formal urban systems - the case of Portugal

NASA Astrophysics Data System (ADS)

Silva, Paulo

2018-05-01

In many societies, informality has been a relevant part of the construction of the urban fabric. This is valid along a city’s history and in recent urbanization processes. In the past, informality was in the origin of many of urban planning. Very soon urban planning adopted, as one of their main missions malfunctions in cities. Therefore, the need of formalization became one of the main reasons on the emergence, the control of informal processes. As an answer to informal individual solutions, urban planning responded with standardized rules and the urge of creating spaces fitting into pre-established rules instead of rules fitting into spaces. Urban planning as a discipline has gradually changed its path. The contrast between urbanization promoted under formal urban planning and informal urbanization is only one sign of the mismatch between urban planning actions and informal urbanization dynamics. Considering this tension between formal and informal dynamics, in some cases, planning rules and planning processes continue ignoring informal dynamics; in other cases, planning rules are designed to integrate informality “without losing its face” through “planning games” [1]; and a third and less explored way in which planning systems interact with informality and from that interaction learn how to improve (we consider it a process of enrichment) planning rules while they promote an upgrade of informal interventions [2]. This latter win-win situation in which both informal and formal systems benefit from their interaction is still rare: most of the time either only one side benefits or none benefit from the interaction. Nevertheless, there are signs that from this interaction co-dependent adaptation might occur with positive outcomes for the urban system – in which co-evolutionary dynamics can be traced. We propose to look at the way building rules have been designed in Europe in a context considered successful in the sense of dealing of informality – the one of Portugal. The country experienced a wave of informality associated with illegal urbanization since the 1960’s in the main urban areas. The process of interaction between informal and formal urban systems proved to be a success in statistic terms. Slum clearance reduced the existence of informal occupations to almost zero. Informal settlements involving land tenure have been dealt with in the last two decades with considerable positive impact in the urban fabric. Based on this, with this paper we will evaluate how informal and formal systems are impacting each other and changing along the time the shape of building and of planning rules. For this we will look at the planning tools created to formalize informal settlements in the Lisbon Metropolitan Area from the last forty years to see how urban and building rules were adapted to respond to the specific needs of informal settlements; how this adaptation moved from temporary and exceptional to permanent rules; finally, how were these new rules able to “contaminate” the general planning and building codes. We aim that these findings would help us to contribute to a “healthier” relation between formal and informal urban systems, not ignoring each other, not controlling each other but instead learning with each other. By achieving this, planning systems become more responsive; on the other hand, informal occupations can be upgraded without being destroyed with the contribution of the planning systems.

Socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with non-communicable diseases in urban Hanoi, Vietnam.

PubMed

Kien, Vu Duy; Van Minh, Hoang; Giang, Kim Bao; Dao, Amy; Tuan, Le Thanh; Ng, Nawi

2016-10-13

The catastrophic health expenditure and impoverishment indices offer guidance for developing appropriate health policies and intervention programs to decrease financial inequity. This study assesses socioeconomic inequalities in catastrophic health expenditure and impoverishment in relation to self-reported non-communicable diseases (NCD) in urban Hanoi, Vietnam. A cross-sectional survey was conducted from February to March 2013 in Hanoi, the capital city of Vietnam. We estimated catastrophic health expenditure and impoverishment using information from 492 slum household and 528 non-slum households. We calculated concentration indexes to assess socioeconomic inequalities in catastrophic health expenditure and impoverishment. Factors associated with catastrophic health expenditure and impoverishment were modelled using logistic regression analysis. The poor households in both slum and non-slum areas were at higher risk of experiencing catastrophic health expenditure, while only the poor households in slum areas were at higher risk of impoverishment because of healthcare spending. Households with at least one member reporting an NCD were significantly more likely to face catastrophic health expenditure (odds ratio [OR] = 2.4; 95 % confidence interval [CI], 1.8-4.0) and impoverishment (OR = 2.3; 95 % CI, 1.1-6.3) compared to households without NCDs. In addition, households in slum areas, with people age 60 years and above, and belonging to the poorest socioeconomic group were significantly associated with increased catastrophic health expenditure, while only households that lived in slum areas, and belonging to the poor or poorest socioeconomic groups were significantly associated with increased impoverishment because of healthcare spending. Financial interventions to prevent catastrophic health expenditure and impoverishment should target poor households, especially those with family members suffering from NCDs, with older members and those located in slum areas in Hanoi Vietnam. Potential interventions derived from this study include targeting and monitoring of health insurance enrolment, and developing a specialized NCD service package for Vietnam's social health insurance program.

Emerging changes in reproductive behaviour among married adolescent girls in an urban slum in Dhaka, Bangladesh.

PubMed

Rashid, Sabina Faiz

2006-05-01

Structural and social inequalities, a harsh political economy and neglect on the part of the state have made married adolescent girls an extremely vulnerable group in the urban slum environment in Bangladesh. The importance placed on newly married girls' fertility results in high fertility rates and low rates of contraceptive use. Ethnographic fieldwork among married adolescent girls, aged 15-19, was carried out in a Dhaka slum from December 2001-January 2003, including 50 in-depth interviews and eight case studies from among 153 married adolescent girls, and observations and discussions with family and community members. Cultural and social expectations meant that 128 of the girls had borne children before they were emotionally or physically ready. Twenty-seven had terminated their pregnancies, of whom 11 reported they were forced to do so by family members. Poverty, economic conditions, marital insecurity, politics in the household, absence of dowry and rivalry among family, co-wives and in-laws made these young women acquiesce to decisions made by others in order to survive. Young married women's status is changing in urban slum conditions. When their economical productivity takes priority over their reproductive role, the effects on reproductive decision-making within families may be considerable. This paper highlights the vulnerability of young women as they pragmatically make choices within the social and structural constraints in their lives.

The lot of female child in an economically weaker society.

PubMed

Grover, V L; Roy, S N

1990-01-01

The study aim was to determine the demographic profile of female children 0-14 years old living in urban slums in Delhi, India. The sample included 1680 slum dwellers in 386 households, of whom 733 were children 0-14 years old. The sex ratio of the sample population was 900 females per 1000 males, compared to the national ratio of 933 females per 1000 males. The sample population included 796 females and 884 males. The sex ratio among children 0-14 years old in the sample was 960 females per 1000 males. School enrollment of children 5-14 years old numbered 232 (50.4%): 46% males and 27.5% females. The lower enrollment of females in slum areas compared to the national average was attributed to the greater participation of young girls in domestic work. 22% of children 0-14 years old were married. The infant mortality rate was 143.2/1000 live births. The crude death rate was 19.64/1000 population, which was 150% higher than the national rate. Female mortality among those 0-6 years old was higher than male mortality; after 6 years of age, male mortality was higher. The study revealed the needs of female children in urban slum areas of India. Government and voluntary agencies must work together in the areas of social work, nutrition, education, health among the poor urban female population in India.

Moderated Effects of Risky Behavior on Academic Performance among Adolescent Girls Living in Urban Slums of Kenya

ERIC Educational Resources Information Center

Ngware, Moses W.; Mahuro, Gerald M.; Hungi, Njora; Abuya, Benta; Nyariro, Milka P.; Mutisya, Maurice

2016-01-01

This paper examines effects of life-skills, mentoring, and counseling education intervention implemented among primary school attending girls aged between 10 and 19 years, living in Nairobi slums. We hypothesized that interaction between the intervention and aspiration, self-confidence and interest in schooling, mediates the impact of risky…

Educating the Urban Poor: A Case Study of Running Preschools in Non-Notified Slums of India

ERIC Educational Resources Information Center

Vaijayanti, K.; Subramanian, Mathangi

2015-01-01

United Nations Children's Fund (UNICEF) recently reported that the world's population is shifting to its cities. India is no exception. Throughout the country, an increasing number of migrants are leaving agricultural lifestyles in search of economic and educational opportunities, often relocating to non-notified slums. Despite the fact that many…

Material deprivation and unemployment affect coercive sex among young people in the urban slums of Blantyre, Malawi: A multi-level approach.

PubMed

Kamndaya, Mphatso; Kazembe, Lawrence N; Vearey, Jo; Kabiru, Caroline W; Thomas, Liz

2015-05-01

We explore relations among material deprivation (measured by insufficient housing, food insecurity and poor healthcare access), socio-economic status (employment, income and education) and coercive sex. A binary logistic multi-level model is used in the estimation of data from a survey of 1071 young people aged 18-23 years, undertaken between June and July 2013, in the urban slums of Blantyre, Malawi. For young men, unemployment was associated with coercive sex (odds ratio [OR]=1.77, 95% confidence interval [CI]: 1.09-3.21) while material deprivation (OR=1.34, 95% CI: 0.75-2.39) was not. Young women in materially deprived households were more likely to report coercive sex (OR=1.37, 95% CI: 1.07-2.22) than in non-materially deprived households. Analysis of local indicators of deprivation is critical to inform the development of effective strategies to reduce coercive sex in urban slums in Malawi. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effect of mother's education on child's nutritional status in the slums of Nairobi.

PubMed

Abuya, Benta A; Ciera, James; Kimani-Murage, Elizabeth

2012-06-21

Malnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that historically accrued to residents of cities as compared to residents in rural settings is being eroded due to increasing proportion of urban residents living in slum settings. This study sought to determine effect of mother's education on child nutritional status of children living in slum settings. Data are from a maternal and child health project nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study involves 5156 children aged 0-42 months. Data on nutritional status used were collected between October 2009 and January 2010. We used binomial and multiple logistic regression to estimate the effect of education in the univariable and multivariable models respectively. Results show that close to 40 % of children in the study are stunted. Maternal education is a strong predictor of child stunting with some minimal attenuation of the association by other factors at maternal, household and community level. Other factors including at child level: child birth weight and gender; maternal level: marital status, parity, pregnancy intentions, and health seeking behaviour; and household level: social economic status are also independently significantly associated with stunting. Overall, mothers' education persists as a strong predictor of child's nutritional status in urban slum settings, even after controlling for other factors. Given that stunting is a strong predictor of human capital, emphasis on girl-child education may contribute to breaking the poverty cycle in urban poor settings.

Effect of mother’s education on child’s nutritional status in the slums of Nairobi

PubMed Central

2012-01-01

Background Malnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that historically accrued to residents of cities as compared to residents in rural settings is being eroded due to increasing proportion of urban residents living in slum settings. This study sought to determine effect of mother’s education on child nutritional status of children living in slum settings. Methods Data are from a maternal and child health project nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study involves 5156 children aged 0–42 months. Data on nutritional status used were collected between October 2009 and January 2010. We used binomial and multiple logistic regression to estimate the effect of education in the univariable and multivariable models respectively. Results Results show that close to 40 % of children in the study are stunted. Maternal education is a strong predictor of child stunting with some minimal attenuation of the association by other factors at maternal, household and community level. Other factors including at child level: child birth weight and gender; maternal level: marital status, parity, pregnancy intentions, and health seeking behaviour; and household level: social economic status are also independently significantly associated with stunting. Conclusion Overall, mothers’ education persists as a strong predictor of child’s nutritional status in urban slum settings, even after controlling for other factors. Given that stunting is a strong predictor of human capital, emphasis on girl-child education may contribute to breaking the poverty cycle in urban poor settings. PMID:22721431

The urban features of informal settlements in Jakarta, Indonesia.

PubMed

Alzamil, Waleed

2017-12-01

This data article contains the urban features of three informal settlements in Jakarta: A. Kampung Bandan; B. Kampung Luar Batang; And C. Kampung Muara Baru. The data describes the urban features of physical structures, infrastructures, and public services. These data include maps showing locations of these settlements, photography of urban status, and examples of urban fabric. The data are obtained from the statistical records and field surveys of three settlements cases.

Durbolota (weakness), chinta rog (worry illness), and poverty: explanations of white discharge among married adolescent women in an urban slum in Dhaka, Bangladesh.

PubMed

Rashid, Sabina Faiz

2007-03-01

I carried out ethnographic fieldwork among 153 married adolescent girls, aged 15-19, in a Dhaka slum from December 2001 to January 2003, including 50 in-depth interviews and eight case studies. I also held discussions with family and community members. In this article, I focus on popular understandings of vaginal discharge being caused by durbolota (weakness) and chinta rog (worry illness), as mentioned by young women. Eighty-eight young women reported that they had experienced white discharge, blaming it on a number of factors such as stress and financial hardships, tensions in the household, marital instability, hunger anxiety, and reproductive burdens. For married adolescent women in the urban slum, white discharge has many levels of meaning linked to the broader social, political, and material inequalities in their everyday lives.

Hymenolepis nana: a common cause of paediatric diarrhoea in urban slum dwellers in India.

PubMed

Mirdha, Bijay Ranjan; Samantray, Jyotish Chandra

2002-12-01

The prevalence of intestinal parasitic infections was studied for a period of 5 years (April 1996-April 2001) among urban slum dwellers. All age groups were represented in the study. Parasitological examinations were performed on 939 faecal specimens collected on a household basis. The total prevalence of pathogenic parasites was 33.6 per cent. No significant age and sex differences in pathogenic parasites were observed. The prevalence of intestinal helminths and pathogenic protozoa was as follows: Hymenolepis nana (9.9 per cent), Ascaris lumbricoides (8.5 per cent), Giardia lamblia (8.4 per cent) and Entamoeba histolyticaldispar (3.7 per cent). Thirty-four E. histolytica/dispar positive samples were cultured and speciation was done using polymerase chain reaction (PCR). The predominant isolate was E. dispar compared to E. histolytica. The notable finding of the present study was high prevalence of Hymenolepis nana compared with other parasitic infections in slum dwellers.

Infant and young child feeding practice among mothers with 0-24 months old children in Slum areas of Bahir Dar City, Ethiopia.

PubMed

Demilew, Yeshalem Mulugeta; Tafere, Tadese Ejigu; Abitew, Dereje Berhanu

2017-01-01

Adequate nutrition during infancy and early childhood is essential to ensure the health, growth and development of children. However, infant feeding practice is suboptimal in Bahir Dar City, Ethiopia. The slum area is a heavily populated urban informal settlement characterized by substandard housing, squalor, with a lack of reliable sanitation services, supply of clean water, reliable electricity, law enforcement and other basic services. Residents of the slum area were poor and less educated. This further compromises infant feeding practice. The aim of this study was to assess infant and young child feeding practice among mothers with 0-24 month old children in the study area. A community based cross-sectional study was conducted among 423 mothers with 0-24 month old children from June 01-30 / 2016. Simple random sampling technique was used to select the respondents. Infant and young child feeding practice was assessed using the fifteen World Health Organisation (WHO) criteria. The prevalence of exclusive breastfeeding practice was 113 (84%). Sixty (15%) mothers gave prelacteal feeds and, 96 (23%) mothers used a bottle to feed their index child. Appropriate complementary feeding practice was only 20 (7%). Thirty nine out of forty mothers introduced complementary food timely, 131 (47%) of mothers gave the minimum meal frequency, and 20 (7%) children took the minimum food diversity and acceptable diet. Independent predictors for complementary feeding practice were having secondary and above education of the mother, receiving postnatal care, possession of radio and giving birth at hospital. In this study infant and young child feeding (IYCF) practice was poor. Therefore, there is a need for strengthening the promotion on IYCF practice during postnatal care and using mass media to giving emphasis for optimal complementary feeding practices, especially for mothers with a lower educational status.

Migration and Vulnerability among Adolescents in Slum Areas of Addis Ababa, Ethiopia

ERIC Educational Resources Information Center

Erulkar, Annabel S.; Mekbib, Tekle-Ab; Simie, Negussie; Gulema, Tsehai

2006-01-01

Studies of urban rural migration often find the most likely migrants are adolescents and young people. Yet few studies have explored patterns of adolescent migration and the role of migration in transitions to adulthood. This study uses data from a population-based survey of over 1000 adolescents aged 10-19 in slum areas of Addis Ababa.…

Growing Up at the "Margins": Concerns, Aspirations, and Expectations of Young People Living in Nairobi's Slums

ERIC Educational Resources Information Center

Kabiru, Caroline W.; Mojola, Sanyu A.; Beguy, Donatien; Okigbo, Chinelo

2013-01-01

We explore the concerns, challenges, aspirations, and expectations of sub-Saharan African youth, and investigate how these youth cope with neighborhood constraints to aspiration achievement. We draw on cross-sectional survey data from 4,033 12-22-year-olds (50.3% males) from two Kenyan urban slums and subsequent in-depth interviews conducted with…

Environmental predictors of diarrhoeal infection for rural and urban communities in south India in children and adults.

PubMed

Kattula, D; Francis, M R; Kulinkina, A; Sarkar, R; Mohan, V R; Babji, S; Ward, H D; Kang, G; Balraj, V; Naumova, E N

2015-10-01

Diarrhoeal diseases are major causes of morbidity and mortality in developing countries. This longitudinal study aimed to identify controllable environmental drivers of intestinal infections amidst a highly contaminated drinking water supply in urban slums and villages of Vellore, Tamil Nadu in southern India. Three hundred households with children (<5 years) residing in two semi-urban slums and three villages were visited weekly for 12-18 months to monitor gastrointestinal morbidity. Households were surveyed at baseline to obtain information on environmental and behavioural factors relevant to diarrhoea. There were 258 diarrhoeal episodes during the follow-up period, resulting in an overall incidence rate of 0·12 episodes/person-year. Incidence and longitudinal prevalence rates of diarrhoea were twofold higher in the slums compared to rural communities (P < 0·0002). Regardless of study site, diarrhoeal incidence was highest in infants (<1 year) at 1·07 episodes/person-year, and decreased gradually with increasing age. Increasing diarrhoeal rates were associated with presence of children (<5 years), domesticated animals and low socioeconomic status. In rural communities, open-field defecation was associated with diarrhoea in young children. This study demonstrates the contribution of site-specific environmental and behavioural factors in influencing endemic rates of urban and rural diarrhoea in a region with highly contaminated drinking water.

Socio spatial adaptation as a resilience form of native unplanned settlement in confrontation with new planned settlement development pressure (case study: enclave native settlement in Serpong, Tangerang)

NASA Astrophysics Data System (ADS)

Ischak, Mohammad; Setioko, Bambang; Nurgandarum, Dedes

2017-12-01

Urban growth refers to expansion of a metropolitan into sub urban areas as the surrounding environment, with no exception of Jakarta city due to limited availability and high price of land within the city. The city of Jakarta, as a metropolitan, carries of expansion in its surrounding environment including Tangerang. Privat developers may an important role in this urban growth through their large scale of new settlement development project. The formation of establishment of enclave native unplanned sub urban settlement scattered within planned new settlement in Tangerang is to be an consequence of Jakarta urban growth. This fenomena could be comprehended as a form of resilience native settlement in confrontation with the new planned settlement pressure. The aim of this research, presented in this paper is to understand the socio-spatial concept of those enclave native settlement as an adaptation form to the new planned settlement pressure. Through descriptive qualitative research method, with indepth interview as a main research instrument, this research could depict or uncover the facts that there are various form of socio-spatial adaptation as the main theme of resilience native suburban settlement formation.

Contextualizing mental health: gendered experiences in a Mumbai slum.

PubMed

Parkar, Shubhangi R; Fernandes, Johnson; Weiss, Mitchell G

2003-12-01

Urban mental health programmes in developing countries remain in their infancy. To serve low-income communities, research needs to consider the impact of common life experience in slums, including poverty, bad living conditions, unemployment, and crowding. Our study in the Malavani slum of Mumbai examines afflictions of the city affecting the emotional well-being and mental health of women and men with respect to gender. This is a topic for which mental health studies have been lacking, and for which psychiatric assumptions based on middle-class clinical experience may be most tenuous. This study employs ethnographic methods to show how environmental and social contexts interact in shaping local experience with reference to common mental health problems. Focusing on the social and environmental context of the mental health of communities, rather than psychiatric disorders affecting individuals, findings are broadly applicable and sorely needed to guide the development of locally appropriate community mental health programmes. Identified afflictions affecting mental health include not only access to health care, but also sanitation, addictions, criminality, domestic violence, and the so-called bar-girl culture. Although effective clinical interventions are required for mental health services to treat psychiatric disorders, they cannot directly affect the conditions of urban slums that impair mental health.

Population-based prevalence of high blood pressure among adults in an urban slum in Enugu, South East Nigeria.

PubMed

Ezeala-Adikaibe, B A; Orjioke, C; Ekenze, O S; Ijoma, U; Onodugo, O; Okudo, G; Okwara, C; Chime, P; Mbadiwe, N; Eddy, A; Onyekonwu, C; Onyebueke, G; Ulasi, I; Mba, A U

2016-04-01

In sub-Saharan Africa (SSA), rapid urbanization and changing lifestyle have modified the profile and pattern of various medical disorders. Apart from high prevalence rates, recent trends with regard to hypertension in Africa include: low levels of awareness, treatment and control. Although a large number of studies provide data about hypertension in SSA, few studies focused on special populations such as urban slum dwellers. The WHO STEP-wise approach to surveillance of noncommunicable diseases was used to access the prevalence of hypertension among adults in one of the urban slums in Enugu. Out of the 811 individuals aged 20 years and above surveyed, 774 (95.4%) cases were analyzed. About 4.7% and 2.7% reported a past history of diabetes and stroke, respectively, whereas 15% had a positive family history of hypertension. The mean (95% confidence interval (CI)) body mass index (BMI) was 23.7 (23.2-24.2) kg m(-2) among males and 26.6 (25.7-26.7) kg m(-2) among females (P<0.0001). The prevalence of hypertension was 52.5% (95% CI: 48.9-56.0) and 55.4% (95% CI: 49.5-61.3) in males and 50.8% (95% CI: 46.4-55.1) in females (P=0.23). It increased with age peaking at 45-54 years in females and ⩾55 years in males. About 40.1% were aware of their hypertension and 28.8% of those aware had normal blood pressure. In regression analysis, systolic (R(2)=0.192) and diastolic (R(2)=0.129) blood pressures increased with age and BMI. The prevalence of high blood pressure among adults in Enugu slums is very high and a cause for concern, and calls for urgent attention.

Proportion and factors associated with depressive symptoms among elderly in an urban slum in Bangalore.

PubMed

Thirthahalli, Chethana; Suryanarayana, S P; Sukumar, Gautham Melur; Bharath, Srikala; Rao, Girish N; Murthy, Nandagudi Srinivasa

2014-12-01

Depression among elderly is emerging as an important public health issue in developing countries like India. Published evidence regarding the magnitude and determinants of depression among elderly hailing from urban slum is currently limited. Hence, the current study was conducted to assess magnitude of the problem and identify factors associated with depression among the elderly in an urban slum. A cross-sectional study was done to cover total of 473 elderly persons from an urban slum in Bangalore, India. They were assessed for depression using Center for Epidemiologic Studies Depression scale. The overall prevalence of depression was found to be 37.8 (95% CI = 33.43-42.16). Multivariate analysis revealed that unemployment (self or children) (odds ratio (OR) 2.6; 95% confidence interval (CI) 1.41-4.72), illness of self (OR 2.2; 95% CI 1.45-3.21), female gender (OR 1.9; 95% CI 1.19-2.89), conflicts in family (OR 1.6; 95% CI 1.03-2.43), and marriage of children or grandchildren (OR 1.6; 95% CI 1.02-2.68) as independent risk factors. Depression among elderly is an important health issue of this area. Psychological intervention need to be provided for all elderly persons especially at the time of being diagnosed with any kind of illness. Strategies should be targeted to the females. The stressful life events need to be identified and remedial actions taken. This facility should be made available to them at the primary level of health care. There is a need to include screening of depression in our national health programs.

Building on people: in search of urban solutions in Latin America.

PubMed

Belisle, F J

1984-01-01

In Latin America most migrants are young adults with higher educational levels than nonmigrants. They come to the city seeking better economic opportunities. In the rural areas, opportunities are severely limited by unequal land ownership, the vast majority of the land being concentrated in the hands of a small number of very wealthy families. In addition, agricultural productivity and incomes are low and population growth is rapidly increasing pressure on available land. The result is environmental degradation in many areas. Thus, many rural people move to the cities in the hope of finding better livelihoods. Urban life means a marked change in lifestyle for the rural migrant. Jobs tend to be more specialized and frequently require skills that the migrant needs to develop. Economic interdependence is high, as households are no longer in a position to produce as much of what they consume. In sum, new social, economic, and political characteristics evolve as urbanization advances. On the average, residents of urban areas in Latin America have higher incomes than people in rural areas. Additionally, they have better access to education and health services and to improved and more diversified services, such as water and electricity. They enjoy a much wider range of work, recreation, and social interaction opportunites. Cities in Latin America do have a number of problems, such as massive slums, high unemployment, transportation congestion, rapidly increasing land prices resulting from diminishing land availability, high pollution levels, and crime. Lima, Peru is an example of a problem ridden city. Its population increased from 600,000 in 1940 to over 5 million at present. Lima concentrates 1/4 of the country's population but over half the gross national product (GNP), 3/5 of the industrial firms, and 3/4 of the bank deposits. Despite this concentration of economic activity, the state of the city's housing and service infrastructure is deplorable. There are increasing numbers of people living in conditions of abject poverty. Over 1/3 of the city's population lives in some 400 "pueblos jovenes," or recent low income settlements on the outer urban rim. Only half the households in these settlements have water and electricity indoors. Schools are very few, and hospitals nonexistent. In Latin America there is wide variation in urbanization levels, pace, and patterns. Generally, the higher the level of urbanization the lower the rate of urban population growth. The diversity in urbanization suggests that research subjects and methods necessary to provide solutions to the problems should also be diverse.

Tobacco Smoking and Its Association with Illicit Drug Use among Young Men Aged 15-24 Years Living in Urban Slums of Bangladesh

PubMed Central

Kabir, Mohammad Alamgir; Goh, Kim-Leng; Kamal, Sunny Mohammad Mostafa; Khan, Md. Mobarak Hossain

2013-01-01

Background Tobacco smoking (TS) and illicit drug use (IDU) are of public health concerns especially in developing countries, including Bangladesh. This paper aims to (i) identify the determinants of TS and IDU, and (ii) examine the association of TS with IDU among young slum dwellers in Bangladesh. Methodology/Principal Findings Data on a total of 1,576 young slum dwellers aged 15–24 years were extracted for analysis from the 2006 Urban Health Survey (UHS), which covered a nationally representative sample of 13,819 adult men aged 15–59 years from slums, non-slums and district municipalities of six administrative regions in Bangladesh. Methods used include frequency run, Chi-square test of association and multivariable logistic regression. The overall prevalence of TS in the target group was 42.3%, of which 41.4% smoked cigarettes and 3.1% smoked bidis. The regression model for TS showed that age, marital status, education, duration of living in slums, and those with sexually transmitted infections were significantly (p<0.001 to p<0.05) associated with TS. The overall prevalence of IDU was 9.1%, dominated by those who had drug injections (3.2%), and smoked ganja (2.8%) and tari (1.6%). In the regression model for IDU, the significant (p<0.01 to p<0.10) predictors were education, duration of living in slums, and whether infected by sexually transmitted diseases. The multivariable logistic regression (controlling for other variables) revealed significantly (p<0.001) higher likelihood of IDU (OR = 9.59, 95% CI = 5.81–15.82) among users of any form of TS. The likelihood of IDU increased significantly (p<0.001) with increased use of cigarettes. Conclusions/Significance Certain groups of youth are more vulnerable to TS and IDU. Therefore, tobacco and drug control efforts should target these groups to reduce the consequences of risky lifestyles through information, education and communication (IEC) programs. PMID:23935885

Unsightly urban menaces and the rescaling of residential segregation in the United States.

PubMed

Hanlon, James

2011-01-01

In this article, the author uses a slum clearance project in Lexington, Kentucky, as a lens through which to examine the spatial dynamics of racial residential segregation during the first half of the twentieth century. At the time, urban migration and upward socioeconomic mobility on the part of African Americans destabilized extant residential segregation patterns. Amid this instability, various spatial practices were employed in the interest of maintaining white social and economic supremacy. The author argues that such practices were indicative of a thoroughgoing reinvention of urban socio-spatial order that in turn precipitated the vastly expanded scale of residential segregation still found in U.S. cities today. Evidence of this reinvented ordering of urban space lies in the rendering of some long-standing African American neighborhoods as “out of place” within it and the use of slum clearance to remove the “menace” such neighborhoods posed to it.

Roundtable on Urban Living Environment Research (RULER).

PubMed

Vlahov, David; Agarwal, Siddharth Raj; Buckley, Robert M; Caiaffa, Waleska Teixeira; Corvalan, Carlos F; Ezeh, Alex Chika; Finkelstein, Ruth; Friel, Sharon; Harpham, Trudy; Hossain, Maharufa; de Faria Leao, Beatriz; Mboup, Gora; Montgomery, Mark R; Netherland, Julie C; Ompad, Danielle C; Prasad, Amit; Quinn, Andrew T; Rothman, Alexander; Satterthwaite, David E; Stansfield, Sally; Watson, Vanessa J

2011-10-01

For 18 months in 2009-2010, the Rockefeller Foundation provided support to establish the Roundtable on Urban Living Environment Research (RULER). Composed of leading experts in population health measurement from a variety of disciplines, sectors, and continents, RULER met for the purpose of reviewing existing methods of measurement for urban health in the context of recent reports from UN agencies on health inequities in urban settings. The audience for this report was identified as international, national, and local governing bodies; civil society; and donor agencies. The goal of the report was to identify gaps in measurement that must be filled in order to assess and evaluate population health in urban settings, especially in informal settlements (or slums) in low- and middle-income countries. Care must be taken to integrate recommendations with existing platforms (e.g., Health Metrics Network, the Institute for Health Metrics and Evaluation) that could incorporate, mature, and sustain efforts to address these gaps and promote effective data for healthy urban management. RULER noted that these existing platforms focus primarily on health outcomes and systems, mainly at the national level. Although substantial reviews of health outcomes and health service measures had been conducted elsewhere, such reviews covered these in an aggregate and perhaps misleading way. For example, some spatial aspects of health inequities, such as those pointed to in the 2008 report from the WHO's Commission on the Social Determinants of Health, received limited attention. If RULER were to focus on health inequities in the urban environment, access to disaggregated data was a priority. RULER observed that some urban health metrics were already available, if not always appreciated and utilized in ongoing efforts (e.g., census data with granular data on households, water, and sanitation but with little attention paid to the spatial dimensions of these data). Other less obvious elements had not exploited the gains realized in spatial measurement technology and techniques (e.g., defining geographic and social urban informal settlement boundaries, classification of population-based amenities and hazards, and innovative spatial measurement of local governance for health). In summary, the RULER team identified three major areas for enhancing measurement to motivate action for urban health-namely, disaggregation of geographic areas for intra-urban risk assessment and action, measures for both social environment and governance, and measures for a better understanding of the implications of the physical (e.g., climate) and built environment for health. The challenge of addressing these elements in resource-poor settings was acknowledged, as was the intensely political nature of urban health metrics. The RULER team went further to identify existing global health metrics structures that could serve as platforms for more granular metrics specific for urban settings.

Modelling the Kampungkota: A quantitative approach in defining Indonesian informal settlements

NASA Astrophysics Data System (ADS)

Anindito, D. B.; Maula, F. K.; Akbar, R.

2018-02-01

Bandung City is home to 2.5 million inhabitants, some of which are living in slums and squatter. However, the terms conveying this type of housing is not adequate to describe that of Indonesian called as kampungkota. Several studies suggest various variables in constituting kampungkota qualitatively. This study delves to define kampungkota in a quantitative manner, using the characteristics of slums and squatter. The samples for this study are 151 villages (kelurahan) in Bandung City. Ordinary Least Squares, Geographically Weighted Regression, and Spatial Cluster and Outlier Analysis are employed. It is suggested that kampungkota may have distinguished variables regarding to its location. As kampungkota may be smaller than administrative area of kelurahan, it can develop beyond the jurisdiction of kelurahan, as indicated by the clustering pattern of kampungkota.

Temperature and heat in informal settlements in Nairobi

PubMed Central

Misiani, Herbert; Okoth, Jerrim; Jordan, Asha; Gohlke, Julia; Ouma, Gilbert; Arrighi, Julie; Zaitchik, Ben F.; Jjemba, Eddie; Verjee, Safia; Waugh, Darryn W.

2017-01-01

Nairobi, Kenya exhibits a wide variety of micro-climates and heterogeneous surfaces. Paved roads and high-rise buildings interspersed with low vegetation typify the central business district, while large neighborhoods of informal settlements or “slums” are characterized by dense, tin housing, little vegetation, and limited access to public utilities and services. To investigate how heat varies within Nairobi, we deployed a high density observation network in 2015/2016 to examine summertime temperature and humidity. We show how temperature, humidity and heat index differ in several informal settlements, including in Kibera, the largest slum neighborhood in Africa, and find that temperature and a thermal comfort index known colloquially as the heat index regularly exceed measurements at the Dagoretti observation station by several degrees Celsius. These temperatures are within the range of temperatures previously associated with mortality increases of several percent in youth and elderly populations in informal settlements. We relate these changes to surface properties such as satellite-derived albedo, vegetation indices, and elevation. PMID:29107977

HIV/AIDS among youth in urban informal (slum) settlements in Kenya: what are the correlates of and motivations for HIV testing?

PubMed

Kabiru, Caroline W; Beguy, Donatien; Crichton, Joanna; Zulu, Eliya M

2011-09-03

Although HIV counseling and testing (HCT) is widely considered an integral component of HIV prevention and treatment strategies, few studies have examined HCT behavior among youth in sub-Saharan Africa-a group at substantial risk for HIV infection. In this paper we examine: the correlates of HIV testing, including whether associations differ based on the context under which a person gets tested; and the motivations for getting (or not getting) an HIV test. Drawing on data collected in 2007 from 4028 (51% male) youth (12-22 years) living in Korogocho and Viwandani slum settlements in Nairobi (Kenya), we explored the correlates of and motivations for HIV testing using the Health Belief Model (HBM) as a theoretical framework. Multinomial and binary logistic regression analyses were employed to examine correlates of HIV testing. Bivariate analyses were employed to assess reasons for or against testing. Nineteen percent of males and 35% of females had been tested. Among tested youth, 74% of males and 43% of females had requested for their most recent HIV test while 7% of males and 32% of females reported that they were required to take their most recent HIV test (i.e., the test was mandatory). About 60% of females who had ever had sex received an HIV test because they were pregnant. We found modest support for the HBM in explaining variation in testing behavior. In particular, we found that perceived risk for HIV infection may drive HIV testing among youth. For example, about half of youth who had ever had sex but had never been tested reported that they had not been tested because they were not at risk. Targeted interventions to help young people correctly assess their level of risk and to increase awareness of the potential value of HIV testing may help enhance uptake of testing services. Given the relative success of Prevention of Mother-to-Child Transmission (PMTCT) services in increasing HIV testing rates among females, routine provider-initiated testing and counseling among all clients visiting medical facilities may provide an important avenue to increase HIV status awareness among the general population and especially among males.

Spatial Distribution of Dengue in a Brazilian Urban Slum Setting: Role of Socioeconomic Gradient in Disease Risk.

PubMed

Kikuti, Mariana; Cunha, Geraldo M; Paploski, Igor A D; Kasper, Amelia M; Silva, Monaise M O; Tavares, Aline S; Cruz, Jaqueline S; Queiroz, Tássia L; Rodrigues, Moreno S; Santana, Perla M; Lima, Helena C A V; Calcagno, Juan; Takahashi, Daniele; Gonçalves, André H O; Araújo, Josélio M G; Gauthier, Kristine; Diuk-Wasser, Maria A; Kitron, Uriel; Ko, Albert I; Reis, Mitermayer G; Ribeiro, Guilherme S

2015-01-01

Few studies of dengue have shown group-level associations between demographic, socioeconomic, or geographic characteristics and the spatial distribution of dengue within small urban areas. This study aimed to examine whether specific characteristics of an urban slum community were associated with the risk of dengue disease. From 01/2009 to 12/2010, we conducted enhanced, community-based surveillance in the only public emergency unit in a slum in Salvador, Brazil to identify acute febrile illness (AFI) patients with laboratory evidence of dengue infection. Patient households were geocoded within census tracts (CTs). Demographic, socioeconomic, and geographical data were obtained from the 2010 national census. Associations between CTs characteristics and the spatial risk of both dengue and non-dengue AFI were assessed by Poisson log-normal and conditional auto-regressive models (CAR). We identified 651 (22.0%) dengue cases among 2,962 AFI patients. Estimated risk of symptomatic dengue was 21.3 and 70.2 cases per 10,000 inhabitants in 2009 and 2010, respectively. All the four dengue serotypes were identified, but DENV2 predominated (DENV1: 8.1%; DENV2: 90.7%; DENV3: 0.4%; DENV4: 0.8%). Multivariable CAR regression analysis showed increased dengue risk in CTs with poorer inhabitants (RR: 1.02 for each percent increase in the frequency of families earning ≤1 times the minimum wage; 95% CI: 1.01-1.04), and decreased risk in CTs located farther from the health unit (RR: 0.87 for each 100 meter increase; 95% CI: 0.80-0.94). The same CTs characteristics were also associated with non-dengue AFI risk. This study highlights the large burden of symptomatic dengue on individuals living in urban slums in Brazil. Lower neighborhood socioeconomic status was independently associated with increased risk of dengue, indicating that within slum communities with high levels of absolute poverty, factors associated with the social gradient influence dengue transmission. In addition, poor geographic access to health services may be a barrier to identifying both dengue and non-dengue AFI cases. Therefore, further spatial studies should account for this potential source of bias.

Exploring the Influence of Impervious Surface Density and Shape on Urban Heat Islands in the Northeast USA Using MODIS and Landsat

NASA Technical Reports Server (NTRS)

Zhang, Ping; Imhoff, Marc L.; Bounoua, Lahouri; Wolfe, Robert E.

2011-01-01

Impervious surface area (ISA) from the National Land Cover Database (NLCD) 2001 and land surface temperature (LST) from MODIS averaged over three annual cycles (2003-2005) are used in a spatial analysis to assess the urban heat island (UHI) signature and its relationship to settlement size and shape, development intensity distribution, and land cover composition for 42 urban settlements embedded in forest biomes in the Northeastern United States. Development intensity zones, based on percent ISA, are defined for each urban area emanating outward from the urban core to nearby rural areas and are used to stratify land surface temperature. The stratification is further constrained by biome type and elevation to insure objective intercomparisons between urban zones within an urban settlement and between settlements. Stratification based on ISA allows the definition of hierarchically ordered urban zones that are consistent across urban settlements and scales. In addition to the surrounding ecological context, we find that the settlement size and shape as well as the development intensity distribution significantly influence the amplitude of summer daytime UHI. Within the Northeastern US temperate broadleaf mixed forest, UHI magnitude is positively related to the logarithm of the urban area size. Our study indicates that for similar urban area sizes, the development intensity distribution is one of the major drivers of UHI. In addition to urban area size and development intensity distribution, this analysis shows that both the shape of the urban area and the land cover composition in the surrounding rural area play an important role in modulating the UHI magnitude in different urban settlements. Our results indicate that remotely sensed urban area size and shape as well as the development intensity distribution influence UHI amplitude across regional scales.

Prevalence of diabetes and pre-diabetes and assessments of their risk factors in urban slums of Bangalore

PubMed Central

Dasappa, Hemavathi; Fathima, Farah Naaz; Prabhakar, Rugmani; Sarin, Sanjay

2015-01-01

Background: To determine the prevalence of diabetes and pre-diabetes and to assess the risk factors associated with diabetes and pre-diabetes in the urban slums of Bangalore. Materials and Methods: A cross-sectional study was conducted in four slums of Bangalore in the age group of 35 years and above comprising of total 2013 subjects. Risk factors like age, sex, family history, behavior, physical activity, BMI, waist hip ration, diet habits were assessed to find their association with diabetes. Results: Prevalence of diabetes was 12.33% and of pre-diabetes was 11.57%. Prevalence was more among the females compared to males. Increasing age, over weight and obesity, sedentary life style, tobacco consumption, diet habits showed statistically significant association with prevalence of diabetes and pre-diabetes. Conclusion: Physical activity like regular exercises both at the office and at home, fibers-rich diet, blood sugar estimation after 35 years are some of the recommendations which can control diabetes. PMID:26288781

Reproductive healthcare utilization in urban poor settlements of Delhi: Baseline survey of ANCHUL (Ante Natal and Child Health care in Urban Slums) project.

PubMed

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Allen, Elizebeth; Sharma, Saket; Shankar, Anuraj H; Zodpey, Sanjay

2015-09-08

Disparity in utilization of reproductive healthcare services between the urban poor and the urban non-poor households in the developing nations is well known. However, disparity may also exist within urban poor households. Our objective was to document the extent of disparity in reproductive healthcare utilization among the urban poor and to identify the socio-demographic determinants of underutilization with a view to characterizing this vulnerable subpopulation. A survey of 16,221 households was conducted in 39 clusters from two large urban poor settlements in Delhi. From 13,451 consenting households, socio-demographic data and information on births, maternal and child deaths within the previous year was collected. Details of antenatal care (ANC) was collected from 597 pregnant women. Information on ANC and postnatal care was also obtained from 596 recently delivered (within six months) mothers. All data were captured electronically using a customized and validated smart phone application. Households were categorized into quintiles of socio-economic position (SEP) based on dwelling characteristics and possession of durable assets using principal component analysis. Potential socio-demographic determinants of reproductive healthcare utilization were examined using random effects logistic regression. The prevalence of facility based birthing was 77% (n = 596 mothers). Of the 596 recently delivered mothers only 70% had an ANC registration card, 46.3% had ANC in their first trimester, 46% had visited a facility within 4 weeks post-delivery and 27% were using modern contraceptive methods. Low socio-economic position was the most important predictor of underutilization with a clear gradient across SEP quintiles. Compared to the poorest, the least poor women were more likely to be registered for ANC (OR 1.96, 95%CI 0.95-4.15) and more likely to have made ≥ 4 ANC visits (OR 5.86, 95%CI 2.82-12.19). They were more likely to have given birth in a facility (OR 4.87, 95%CI 2.12-11.16), to have visited a hospital within one month of childbirth (OR 3.18, 95%CI 1.62-6.26). In general, government funded health insurance and conditional cash transfers schemes were underutilized in this community. The poorest segment of the urban poor population utilizes reproductive healthcare facilities the least. Strategies to improve access and utilization of healthcare services among the poorest of the poor may be necessary to achieve universal health coverage.

A program to provide antiretroviral therapy to residents of an urban slum in Nairobi, Kenya.

PubMed

Marston, Barbara J; Macharia, Doris K; Nga'nga, Lucy; Wangai, Mary; Ilako, Festus; Muhenje, Odylia; Kjaer, Mette; Isavwa, Anthony; Kim, Andrea; Chebet, Kenneth; DeCock, Kevin M; Weidle, Paul J

2007-06-01

To evaluate retention in care and response to therapy for patients enrolled in an antiretroviral treatment program in a severely resource-constrained setting. We evaluated patients enrolled between February 26, 2003, and February 28, 2005, in a community clinic in Kibera, an informal settlement, in Nairobi, Kenya. Midlevel providers offered simplified, standardized antiretroviral therapy (ART) regimens and monitored patients clinically and with basic laboratory tests. Clinical, immunologic, and virologic indicators were used to assess response to ART; adherence was determined by 3-day recall. A total of 283 patients (70% women; median baseline CD4 count, 157 cells/ mm(3); viral load, 5.16 log copies/mL) initiated ART and were followed for a median of 7.1 months (n = 2384 patient-months). At 1 year, the median CD4 count change was +124.5 cells/mm(3) (n = 74; interquartile range, 42 to 180), and 71 (74%) of 96 patients had viral load <400 copies/mL. The proportion of patients reporting 100% adherence over the 3 days before monthly clinic visits was 94% to 100%. As of February 28, 2005, a total of 239 patients (84%) remained in care, 22 (8%) were lost to follow-up, 12 (4%) were known to have died, 5 (2%) had stopped ART, 3 (1%) moved from the area, and 2 (< 1% ) transferred care. Response to ART in this slum population was comparable to that seen in industrialized settings. With government commitment, donor support, and community involvement, it is feasible to implement successful ART programs in extremely challenging social and environmental conditions.

Access to Health Services Among Slum Dwellers in an Industrial Township and Surrounding Rural Areas: A Rapid Epidemiological Assessment

PubMed Central

Banerjee, Amitav; Bhawalkar, J.S.; Jadhav, S.L.; Rathod, Hetal; Khedkar, D.T.

2012-01-01

Context: The biggest challenge in implementing the primary health care principles is of equitable distribution of health care to all. The rural masses and urban slum dwellers are most vulnerable to lack of access to health care. Aim: To study access to health services among slum dwellers and rural population. Setting and Design: A cross-sectional survey in an urban slum and surrounding rural areas in field practice area of a medical college. Materials and Methods: Structured instrument along with qualitative techniques such as focus group discussions, were used to collect information on access and utilization of health services from 865 individuals of both sexes and all ages selected from urban slums, villages, and indoor and outdoor patients. Access to basic determinants of good health such as housing, water, and sanitation was also elicited. Besides, health needs based on self-reported disease conditions were compiled. Results: More than 50% of respondents were living in poor housing and insanitary conditions. Besides the burden of communicable diseases and malnutrition (especially in children), risk of lifestyle diseases as evidenced by high Body mass index in 25% of adults surveyed was found. Private medical practitioners were more accessible than government facilities. More than 60% sought treatment from private medical facilities for their own ailments (for sickness in children this proportion was 74%). People who visited government facilities were more dissatisfied with the services (30.88%) than those who visited private facilities (18.31%). This difference was significant (OR=1.99, 95% confidence interval 1.40 to 2.88; χ2 =15.95, df=1, P=0.007). The main barriers to health care identified were waiting time long, affordability, poor quality of care, distance, and attitude of health workers. Conclusion: The underprivileged in India continue to have poor access to basic determinants of good health as well as to curative services from government sources during illness. PMID:24478995

Pathotyping of Escherichia coli isolated from community toilet wastewater and stored drinking water in a slum in Bangladesh.

PubMed

Harada, H; Fujimori, Y; Gomi, R; Ahsan, Md N; Fujii, S; Sakai, A; Matsuda, T

2018-06-01

This study investigated the occurrence of Escherichia coli pathotypes in sanitary wastewater and drinking water in a Bangladeshi urban slum and the potential associations between these sources. We examined 621 E. coli isolates from sanitary wastewater and stored drinking water by multiplex PCR and dual-index sequencing, classifying them into eight pathotypes based on 14 virulence genes and additionally evaluating the possession of the human-specific E. coli genetic biomarker H8. The proportions of pathogenic E. coli were significantly different (P < 0·001) between wastewater (18·6%) and drinking water (1·7%). StIb-positive enterotoxigenic E. coli (ETEC) were predominant in wastewater, indicating that people in the site carried ETEC. In contrast, no ETEC was present in drinking water and the proportion of H8-positive isolates was significantly smaller (7·8%) than that in wastewater (16·3%) (P = 0·001). Our findings indicate that sanitary wastewater from the slum was heavily contaminated with pathogenic E. coli, posing a great health risk. Furthermore, E. coli contamination of drinking water could be derived from not only human but also other sources. Sanitary wastewater from an urban slum was heavily contaminated with pathogenic Escherichia coli. It is worth noting a great health risk of accidental exposure to pathogenically contaminated wastewater improperly discharged in and around urban slums. The distinct difference in pathotypes between wastewater and drinking water and the significantly smaller positive proportion of the human-specific E. coli genetic biomarker (H8) in drinking water indicate that drinking water contamination could be derived from not only human but also other sources. This highlights that pathotyping in association with the H8 marker provides an indication of pathogen contamination sources of environmental transmission media. © 2018 The Society for Applied Microbiology.

Public Health Risks in Urban Slums: Findings of the Qualitative ‘Healthy Kitchens Healthy Cities’ Study in Kathmandu, Nepal

PubMed Central

Manandah, Shraddha; Sah, Dilip; Khanal, Sudeepa; MacGuire, Frances; King, Rebecca; Wallace, Hilary; Baral, Sushil Chandra

2016-01-01

Background Communities in urban slums face multiple risks to their health. These are shaped by intermediary and structural determinants. Gaining a clear understanding of these determinants is a prerequisite for developing interventions to reduce the health consequences of urban poverty. With 828 million people living in slum conditions, the need to find ways to reduce risks to health has never been greater. In many low income settings, the kitchen is the epicentre of activities and behaviours which either undermine or enhance health. Methods We used qualitative methods of semi-structured interviews, observation and participatory workshops in two slum areas in Kathmandu, Nepal to gain women’s perspectives on the health risks they faced in and around their kitchens. Twenty one women were interviewed and four participatory workshops with a total of 69 women were held. The women took photographs of their kitchens to trigger discussions. Findings The main health conditions identified by the women were respiratory disease, gastrointestinal disease and burn injuries. Women clearly understood intermediary (psychosocial, material and behavioural) determinants to these health conditions such as poor ventilation, cooking on open fires, over-crowding, lack of adequate child supervision. Women articulated the stress they experienced and clearly linked this to health conditions such as heart disease and uptake of smoking. They were also able to identify protective factors, particularly social capital. Subsequent analysis highlighted how female headed-households and those with disabilities had to contend with greater risks to health. Conclusions Women living in slums are very aware of the intermediary determinants–material, behavioural and psycho-social, that increase their vulnerability to ill health. They are also able to identify protective factors, particularly social capital. It is only by understanding the determinants at all levels, not just the behavioural, that we will be able to identify appropriate interventions. PMID:27685999

Air pollution and environmental risk factors for altered lung function among adult women of an urban slum area of Delhi: A prevalence study.

PubMed

Arora, Shweta; Rasania, S K; Bachani, D; Gandhi, Asha; Chhabra, S K

2018-01-01

Household and ambient air pollution are jointly responsible for about 7 million premature deaths annually. Women living in slums, with unhealthy environment, both indoors and outdoors, particularly those living close to industrial and/or vehicular pollution zones due to multiple sources of air pollution, are at the higher risk of having impaired lung function tests. The aim of this study was to estimate the prevalence of abnormal lung functions and to identify the environmental risk factors associated with them among adult women of 18-59 years. A total of 550 women aged 18-59 years were approached in a representative urban slum. Five hundred consented to participate and 299 had prebronchodilator spirometry satisfying ATS standards. House visits to assess environmental conditions were conducted to determine their association with forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Chi-square test was used to test the association of risk factors with lung functions. ANOVA was used to test the association of mean values of FEV1 and FVC with age. Out of 299 participants with acceptable spirometric curves, 5% had reduced FEV1/FVC ratio than the normal and 26.8% and 17.4% had lower values than predicted for FVC and FEV1, respectively. Altered lung function was related to age, tobacco smoking, and history of respiratory disease. Both ambient and household air pollution have a deleterious pulmonary effect on long-term women residents of a representative urban slum in Delhi.

Children's health in slum settings.

PubMed

Unger, Alon

2013-10-01

Rapid urbanisation in the 20th century has been accompanied by the development of slums. Nearly one-third of the world's population and more than 60% of urban populations in the least developed countries live in slums, including hundreds of millions of children. Slums are areas of broad social and health disadvantage to children and their families due to extreme poverty, overcrowding, poor water and sanitation, substandard housing, limited access to basic health and education services, and other hardships (eg, high unemployment, violence). Despite the magnitude of this problem, very little is known about the potential impact of slum life on the health of children and adolescents. Statistics that show improved mortality and health outcomes in cities are based on aggregated data and may miss important intraurban disparities. Limited but consistent evidence suggests higher infant and under-five years mortality for children residing in slums compared with non-slum areas. Children suffer from higher rates of diarrhoeal and respiratory illness, malnutrition and have lower vaccination rates. Mothers residing in slums are more poorly educated and less likely to receive antenatal care and skilled birth assistance. Adolescents have earlier sexual debut and higher rates of HIV, and adopt risky behaviours influenced by their social environment. We also know little about the consequences of this form of early childhood on long-term health-related behaviour (eg, diet and exercise) and non-communicable disease outcomes, such as obesity, heart disease and mental illness. Further attention to understanding and addressing child health in slum settings is an important priority for paediatricians and those committed to child health worldwide.

Barriers and Facilitators to Health Behaviour Change and Economic Activity among Slum-Dwelling Adolescent Girls and Young Women in Nairobi, Kenya: The Role of Social, Health and Economic Assets

ERIC Educational Resources Information Center

Austrian, Karen; Anderson, Althea D.

2015-01-01

Adolescent girls and young women in urban slum areas in developing countries face a myriad of challenges regarding education, sexual health, livelihoods and gender-based violence. One way of understanding how these challenges interact with each other is through the Asset Building Framework, which posits that girls need a combination of social,…

24 CFR 3500.9 - Reproduction of settlement statements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Reproduction of settlement... HOUSING AND URBAN DEVELOPMENT REAL ESTATE SETTLEMENT PROCEDURES ACT § 3500.9 Reproduction of settlement... in sections F and H, respectively. (3) Reproduction of the HUD-1 must conform to the terminology...

A Pilot Study to Understand the Variation in Indoor Air Quality in Different Economic Zones of Delhi University

NASA Astrophysics Data System (ADS)

Garg, Abhinav; Ghosh, Chirashree

Today, one of the most grave environmental health problems being faced by the urban population is the poor air quality one breathes in. To testify the above statement, the recent survey report, World health statistics (WHO, 2012) reflects the fact that childhood mortality ratio from acute respiratory infection is one of the top leading causes of death in developing countries like India. Urban areas have a complex social stratification which ultimately results in forming different urban economic zones. This research attempts to understand the Indoor Air Quality (IAQ) by taking into consideration different lifestyle of occupants inhabiting these economic zones. The Study tries to evaluate the outdoor and indoor air quality by understanding the variation of selected pollutants (SPM, SOx, NOx) for the duration of four months - from October, 2012-January, 2013. For this, three economic zones (EZ) of Delhi University’s North Campus, were selected - Urban Slum (EZ I), Clerical (EZ II) and Faculty residence (EZ III). The statistical study indicates that Urban Slum (EZ I) was the most polluted site reporting maximum concentration of outdoor pollutants, whereas no significant difference in pollution load was observed in EZ II and EZ III. Further, the indoor air quality was evaluated by quantifying the indoor and outdoor pollution concentration ratios that shows EZ III have most inferior indoor air quality, followed by EZ I and EZ II. Moreover, it was also observed that ratio (phenomenon of infiltration) was dominant at the EZ II but was low for the EZ I and EZ III. With the evidence of high Indoor air pollution, the risk of pulmonary diseases and respiratory infections also increases, calling for an urgent requisite for making reforms to improve IAQ. Key words: Urban Area, Slum, IAQ, SOx, NOx, SPM

Quantitative estimates of dietary intake with special emphasis on snacking pattern and nutritional status of free living adults in urban slums of Delhi: impact of nutrition transition

PubMed Central

Singh, Archna; Gupta, Vidhu; Ghosh, Arpita; Lock, Karen; Ghosh-Jerath, Suparna

2016-01-01

Background The nutritional landscape of India is experiencing the fallout of urbanization and globalization. The changes are manifest in dietary patterns as well as health outcomes. The study aimed at assessing household dietary intake pattern with special emphasis on snacking pattern, anthropometric and lipid profiles in low socio-economic status households in an urban slum of Delhi. Methods Community based cross-sectional study in 260 households of a purposively selected urban slum in North-East district of Delhi, India. Family dietary surveys including consumption pattern of commercial food products rich in Partially Hydrogenated Vegetable Oils (PHVOs), 24 h dietary recall and assessment of dietary diversity using Household Diet Diversity Scores (HDDS) were done. Assessment of nutritional status using anthropometric and lipid profile on a subsample (n =130) were also conducted. Results Median energy and fat intake were adequate. Micronutrient intake was found to be inadequate for vitamin A, riboflavin, calcium and folate. PHVO usage was low (<20 % households). Milk (39 %), green leafy vegetables (25 %) and fruits (25 %) intake were below recommendations. Mean HDDS was 7.87. Prevalence of overweight/obesity was high (66.7 %). Lipid profile showed mean HDL-C levels lower than recommendations for females. Conclusion Community based awareness programs for prevention of non-communicable diseases should incorporate healthy diet and lifestyle practices with emphasis on quantity and quality of nutrient intake. This must be considered as an integral part of chronic disease prevention strategy for underprivileged communities in urban India. PMID:26918196

Prevalence and correlates of physical spousal violence against women in slum and nonslum areas of urban Bangladesh.

PubMed

Sambisa, William; Angeles, Gustavo; Lance, Peter M; Naved, Ruchira T; Thornton, Juliana

2011-09-01

This study explores the prevalence and correlates of past-year physical violence against women in slum and nonslum areas of urban Bangladesh. The authors use multivariate logistic regression to analyze data from the 2006 Urban Health Survey, a population-based survey of 9,122 currently married women aged between 15 and 49 who were selected using a multistage cluster sampling design. The prevalence of reported past-year physical spousal violence is 31%. Prevalence of past-year physical spousal violence is higher in slums (35%) than in nonslums (20%). Slapping/arm-twisting and pushing/shaking/ throwing something at the women are the most commonly reported acts of physical abuse. Multivariate analysis shows that the risk of physical spousal abuse is lower among older women, women with post-primary education, and those belonging to rich households and women whose husbands considered their opinion in decision making. Women are at higher risk of abuse if they had many children, believe that married woman should work if the husband is not making enough money, and approve wife-beating norms. This study serves to confirm the commonness of physical spousal abuse in urban Bangladesh, demonstrating the seriousness of this multifaceted phenomenon as a social and public health issue. The present findings suggest the need for comprehensive prevention and intervention strategies that capitalize on the interplay of individual and sociocultural factors that cause physical spousal violence. Our study adds to a growing literature documenting domestic violence against women in urban areas of developing south Asian nations.

Quantitative estimates of dietary intake with special emphasis on snacking pattern and nutritional status of free living adults in urban slums of Delhi: impact of nutrition transition.

PubMed

Singh, Archna; Gupta, Vidhu; Ghosh, Arpita; Lock, Karen; Ghosh-Jerath, Suparna

2015-10-14

The nutritional landscape of India is experiencing the fallout of urbanization and globalization. The changes are manifest in dietary patterns as well as health outcomes. The study aimed at assessing household dietary intake pattern with special emphasis on snacking pattern, anthropometric and lipid profiles in low socio-economic status households in an urban slum of Delhi. Community based cross-sectional study in 260 households of a purposively selected urban slum in North-East district of Delhi, India. Family dietary surveys including consumption pattern of commercial food products rich in Partially Hydrogenated Vegetable Oils (PHVOs), 24 h dietary recall and assessment of dietary diversity using Household Diet Diversity Scores (HDDS) were done. Assessment of nutritional status using anthropometric and lipid profile on a subsample ( n =130) were also conducted. Median energy and fat intake were adequate. Micronutrient intake was found to be inadequate for vitamin A, riboflavin, calcium and folate. PHVO usage was low (<20 % households). Milk (39 %), green leafy vegetables (25 %) and fruits (25 %) intake were below recommendations. Mean HDDS was 7.87. Prevalence of overweight/obesity was high (66.7 %). Lipid profile showed mean HDL-C levels lower than recommendations for females. Community based awareness programs for prevention of non-communicable diseases should incorporate healthy diet and lifestyle practices with emphasis on quantity and quality of nutrient intake. This must be considered as an integral part of chronic disease prevention strategy for underprivileged communities in urban India.

Purchase of drinking water is associated with increased child morbidity and mortality among urban slum-dwelling families in Indonesia.

PubMed

Semba, Richard D; de Pee, Saskia; Kraemer, Klaus; Sun, Kai; Thorne-Lyman, Andrew; Moench-Pfanner, Regina; Sari, Mayang; Akhter, Nasima; Bloem, Martin W

2009-07-01

In developing countries, poor families in urban slums often do not receive municipal services including water. The objectives of our study were to characterize families who purchased drinking water and to examine the relation between purchasing drinking water and child morbidity and mortality in urban slums of Indonesia, using data collected between 1999 and 2003. Of 143,126 families, 46.8% purchased inexpensive drinking water from street vendors, 47.4% did not purchase water, i.e., had running or spring/well water within household, and 5.8% purchased more expensive water in the previous 7 days. Families that purchased inexpensive drinking water had less educated parents, a more crowded household, a father who smoked, and lower socioeconomic level compared with the other families. Among children of families that purchased inexpensive drinking water, did not purchase drinking water, or purchased more expensive water, the prevalence was, respectively, for diarrhea in last 7 days (11.2%, 8.1%, 7.7%), underweight (28.9%, 24.1%, 24.1%), stunting (35.6%, 30.5%, 30.5%), wasting (12.0%, 10.5%, 10.9%), family history of infant mortality (8.0%, 5.6%, 5.1%), and of under-five child mortality (10.4%, 7.1%, 6.4%) (all P<0.0001). Use of inexpensive drinking water was associated with under-five child mortality (Odds Ratio [O.R.] 1.32, 95% Confidence Interval [C.I.] 1.20-1.45, P<0.0001) and diarrhea (O.R. 1.43, 95% C.I. 1.29-1.60, P<0.0001) in multivariate logistic regression models, adjusting for potential confounders. Purchase of inexpensive drinking water was common and associated with greater child malnutrition, diarrhea, and infant and under-five child mortality in the family. Greater efforts must be made to ensure access to safe drinking water, a basic human right and target of the Millennium Development Goals, in urban slums.

What influences where they seek care? Caregivers’ preferences for under-five child healthcare services in urban slums of Malawi: A discrete choice experiment

PubMed Central

Guda Obse, Amarech; Darker, Catherine; Biesma, Regien

2018-01-01

Access to and utilisation of quality healthcare promotes positive child health outcomes. However, to be optimally utilised, the healthcare system needs to be responsive to the expectations of the population it serves. Health systems in many sub-Saharan African countries, including Malawi, have historically focused on promoting access to health services by the rural poor. However, in the context of increasing urbanisation and consequent proliferation of urban slums, promoting health of children under five years of age in these settings is a public health imperative. We conducted a discrete choice experiment to determine the relative importance of health facility factors in seeking healthcare for childhood illnesses in urban slums of Malawi. Caregivers of children under five years of age were presented with choice cards that depicted two hypothetical health facilities using six health facility attributes: availability of medicines and supplies, thoroughness of physical examination of the child, attitude of health workers, cost, distance, and waiting time. Caregivers were asked to indicate the health facility they would prefer to use. A mixed logit model was used to estimate the relative importance of and willingness to pay (WTP) for health facility attributes. Attributes with greatest influence on choice were: availability of medicines and supplies (β = 0.842, p<0.001) and thorough examination of the child (β = 0.479, p <0.001) with WTP of MK3698.32 ($11) (95% CI: $8–$13) and MK2049.13 ($6) (95% CI: $3–$9) respectively. Respondents were willing to pay 1.8 and 2.4 times more for medicine availability over thorough examination and positive attitude of health workers respectively. Therefore, strengthening health service delivery system through investment in sustained availability of essential medicines and supplies, sufficient and competent health workforce with positive attitude and clinical discipline to undertake thorough examination, and reductions in waiting times have the potential to improve child healthcare utilization in the urban slums. PMID:29351299

What influences where they seek care? Caregivers' preferences for under-five child healthcare services in urban slums of Malawi: A discrete choice experiment.

PubMed

Lungu, Edgar Arnold; Guda Obse, Amarech; Darker, Catherine; Biesma, Regien

2018-01-01

Access to and utilisation of quality healthcare promotes positive child health outcomes. However, to be optimally utilised, the healthcare system needs to be responsive to the expectations of the population it serves. Health systems in many sub-Saharan African countries, including Malawi, have historically focused on promoting access to health services by the rural poor. However, in the context of increasing urbanisation and consequent proliferation of urban slums, promoting health of children under five years of age in these settings is a public health imperative. We conducted a discrete choice experiment to determine the relative importance of health facility factors in seeking healthcare for childhood illnesses in urban slums of Malawi. Caregivers of children under five years of age were presented with choice cards that depicted two hypothetical health facilities using six health facility attributes: availability of medicines and supplies, thoroughness of physical examination of the child, attitude of health workers, cost, distance, and waiting time. Caregivers were asked to indicate the health facility they would prefer to use. A mixed logit model was used to estimate the relative importance of and willingness to pay (WTP) for health facility attributes. Attributes with greatest influence on choice were: availability of medicines and supplies (β = 0.842, p<0.001) and thorough examination of the child (β = 0.479, p <0.001) with WTP of MK3698.32 ($11) (95% CI: $8-$13) and MK2049.13 ($6) (95% CI: $3-$9) respectively. Respondents were willing to pay 1.8 and 2.4 times more for medicine availability over thorough examination and positive attitude of health workers respectively. Therefore, strengthening health service delivery system through investment in sustained availability of essential medicines and supplies, sufficient and competent health workforce with positive attitude and clinical discipline to undertake thorough examination, and reductions in waiting times have the potential to improve child healthcare utilization in the urban slums.

Seasonal variations and shared latrine cleaning practices in the slums of Kampala city, Uganda.

PubMed

Kwiringira, Japheth; Atekyereza, Peter; Niwagaba, Charles; Kabumbuli, Robert; Rwabukwali, Charles; Kulabako, Robinah; Günther, Isabel

2016-04-27

The effect of seasons on health outcomes is a reflection on the status of public health and the state of development in a given society. Evidence shows that in Sub-Saharan Africa, most infectious diseases flourish during the wet months of the year; while human activities in a context of constrained choices in life exacerbate the effects of seasons on human health. The paper argues that, the wet season and when human activities are at their peak, sanitation is most dire poor slum populations. A shared latrine cleaning observation was undertaken over a period of 6 months in the slums of Kampala city. Data was collected through facility observations, user group meetings, Focus group discussions and, key informant interviews. The photos of the observed sanitation facilities were taken and assessed for facility cleanliness or dirt. Shared latrine pictures, observations, Focus Group Discussion, community meetings and key informant interviews were analysed and subjected to an analysis over the wet, dry and human activity cycles before a facility was categorised as either 'dirty' or 'clean'. Human activity cycles also referred to as socio-economic seasons were, school days, holidays, weekends and market days. These have been called 'impure' seasons, while the 'pure' seasons were the wet and dry months: improved and unimproved facilities were negatively affected by the wet seasons and the peak seasons of human activity. Wet seasons were associated with, mud and stagnant water, flooding pits and a repugnant smell from the latrine cubicle which made cleaning difficult. During the dry season, latrines became relatively cleaner than during the wet season. The presence of many child(ren) users during school days as well as the influx of market goers for the roadside weekly markets compromised the cleaning outcomes for these shared sanitation facilities. Shared latrine cleaning in slums is impacted by seasonal variations related to weather conditions and human activity. The wet seasons made the already bad sanitation situation worse. The seasonal fluctuations in the state of shared slum sanitation relate to a wider malaise in the population and an implied capacity deficit among urban authorities. Poor sanitation in slums is part of a broader urban mismanagement conundrum pointing towards the urgent need for multiple interventions aimed at improving the general urban living conditions well beyond sanitation.

Performance of a community-based health and nutrition-education intervention in the management of diarrhoea in a slum of Delhi, India.

PubMed

Pahwa, Smriti; Kumar, Geeta Trilok; Toteja, G S

2010-12-01

Diarrhoeal infections are the fifth leading cause of death worldwide and continue to take a high toll on child health. Mushrooming of slums due to continuous urbanization has made diarrhoea one of the biggest public-health challenges in metropolitan cities in India. The objective of the study was to carry out a community-based health and nutrition-education intervention, focusing on several factors influencing child health with special emphasis on diarrhoea, in a slum of Delhi, India. Mothers (n=370) of children, aged >12-71 months, identified by a door-to-door survey from a large urban slum, were enrolled in the study in two groups, i.e. control and intervention. To ensure minimal group interaction, enrollment for the control and intervention groups was done purposively from two extreme ends of the slum cluster. Baseline assessment of knowledge, attitudes, and practices on diarrhoea-related issues, such as oral rehydration therapy (ORT), oral rehydration salt (ORS), and continuation of breastfeeding during diarrhoea, was carried out using a pretested questionnaire. Thereafter, mothers (n=195) from the intervention area were provided health and nutrition education through fortnightly contacts achieved by two approaches developed for the study--'personal discussion sessions' and 'lane approach'. The mothers (n=175) from the control area were not contacted. After the intervention, there was a significant (p=0.000) improvement in acquaintance to the term 'ORS' (65-98%), along with its method of reconstitution from packets (13-69%); preparation of home-made sugar-salt solution (10-74%); role of both in the prevention of dehydration (30-74%) and importance of their daily preparation (74-96%); and continuation of breastfeeding during diarrhoea (47-90%) in the intervention area. Sensitivity about age-specific feeding of ORS also improved significantly (p=0.000) from 13% to 88%. The reported usage of ORS packets and sugar-salt solution improved significantly from 12% to 65% (p=0.000) and 12% to 75% (p=0.005) respectively. The results showed that health and nutrition-education intervention improved the knowledge and attitudes of mothers. The results indicate a need for intensive programmes, especially directed towards urban slums to further improve the usage of oral rehydration therapy.

Unhealthy Fat in Street and Snack Foods in Low-Socioeconomic Settings in India: A Case Study of the Food Environments of Rural Villages and an Urban Slum.

PubMed

Gupta, Vidhu; Downs, Shauna M; Ghosh-Jerath, Suparna; Lock, Karen; Singh, Archna

2016-04-01

To describe the food environment in rural villages and an urban slum setting in India with reference to commercially available unbranded packaged snacks and street foods sold by vendors, and to analyze the type and quantity of fat in these foods. Cross-sectional. Two low-income villages in Haryana and an urban slum in Delhi. Street vendors (n = 44) were surveyed and the nutritional content of snacks (n = 49) sold by vendors was analyzed. Vendors' awareness and perception of fats and oils, as well as the type of snacks sold, along with the content and quality of fat present in the snacks. Descriptive statistics of vendor survey and gas chromatography to measure fatty acid content in snacks. A variety of snacks were sold, including those in unlabeled transparent packages and open glass jars. Mean fat content in snacks was 28.8 g per 100-g serving in rural settings and 29.6 g per 100-g serving in urban settings. Sampled oils contained high levels of saturated fats (25% to 69% total fatty acids) and trans fats (0.1% to 30% of total fatty acids). Interventions need to target the manufacturers of oils and fats used in freshly prepared products to improve the quality of foods available in the food environment of low-socioeconomic groups in India. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

A spatial epidemiological analysis of self-rated mental health in the slums of Dhaka

PubMed Central

2011-01-01

Background The deprived physical environments present in slums are well-known to have adverse health effects on their residents. However, little is known about the health effects of the social environments in slums. Moreover, neighbourhood quantitative spatial analyses of the mental health status of slum residents are still rare. The aim of this paper is to study self-rated mental health data in several slums of Dhaka, Bangladesh, by accounting for neighbourhood social and physical associations using spatial statistics. We hypothesised that mental health would show a significant spatial pattern in different population groups, and that the spatial patterns would relate to spatially-correlated health-determining factors (HDF). Methods We applied a spatial epidemiological approach, including non-spatial ANOVA/ANCOVA, as well as global and local univariate and bivariate Moran's I statistics. The WHO-5 Well-being Index was used as a measure of self-rated mental health. Results We found that poor mental health (WHO-5 scores < 13) among the adult population (age ≥15) was prevalent in all slum settlements. We detected spatially autocorrelated WHO-5 scores (i.e., spatial clusters of poor and good mental health among different population groups). Further, we detected spatial associations between mental health and housing quality, sanitation, income generation, environmental health knowledge, education, age, gender, flood non-affectedness, and selected properties of the natural environment. Conclusions Spatial patterns of mental health were detected and could be partly explained by spatially correlated HDF. We thereby showed that the socio-physical neighbourhood was significantly associated with health status, i.e., mental health at one location was spatially dependent on the mental health and HDF prevalent at neighbouring locations. Furthermore, the spatial patterns point to severe health disparities both within and between the slums. In addition to examining health outcomes, the methodology used here is also applicable to residuals of regression models, such as helping to avoid violating the assumption of data independence that underlies many statistical approaches. We assume that similar spatial structures can be found in other studies focussing on neighbourhood effects on health, and therefore argue for a more widespread incorporation of spatial statistics in epidemiological studies. PMID:21599932

Resilience in the face of post-election violence in Kenya: the mediating role of social networks on wellbeing among older people in the Korogocho informal settlement, Nairobi.

PubMed

Bennett, Rachel; Chepngeno-Langat, Gloria; Evandrou, Maria; Falkingham, Jane

2015-03-01

Older people in slum settings are a vulnerable sub-group during crises, yet have received minimal attention in the development discourse. This paper examines the protective role of different types of social networks for older slum dwellers' wellbeing during adversity by investigating the relationship between social networks, the Kenyan 2007/08 post-election violence, and dimensions of wellbeing namely self-rated health, life satisfaction and happiness amongst older people in the Korogocho slum, Nairobi. The analyses are based on conditional change logistic regression models using data from a unique longitudinal survey of the health and wellbeing of older people. The results show that maintaining or increasing formal local networks reduced the detrimental effects of the post-election violence for older people's wellbeing, whilst household environment and informal local and non-local networks did not influence the relationship. Consequently, the paper provides evidence that supporting inclusive community organisations which are accessible to older people can be valuable in promoting the resilience of this population group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Empowering low-income community in Kampong settlement by exploring people's activities in surrounding environment

NASA Astrophysics Data System (ADS)

Bawole, Paulus; Sutanto, Haryati B.

2017-11-01

Urban Kampong is a spontaneous settlement growing in several big cities within developing countries including Indonesia. This settlement is developed by low-income people without any plan. Therefore there is no specific housing pattern in the settlement. The characteristics of the settlements is dominated by Javanese traditional roof typology and narrow path with minimal public open spaces. People's creativity in building their houses often uses second hand building materials that make their houses look specific. Besides, infrastructure facilities within Kampong Settlement are very poor. Because the poor living in Urban Kampong have to adjust their live with minimum infrastructure facilities available, they have to be creative in using all facilities available. Through the creativities of low-income people living in Urban Kampong the research will show how the inhabitants can be empowered by exploring inhabitant's creativities and consequently the environmental quality within Urban Kampong can be improved as well.

Barriers to formal emergency obstetric care services' utilization.

PubMed

Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

2011-06-01

Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be put in place to enhance security in the slums at night.

Agricultural production and stability of settlement systems in Upper Mesopotamia during the Early Bronze Age (third millennium BCE)

NASA Astrophysics Data System (ADS)

Kalayci, Tuna

This study investigates the relationship between rainfall variation and rain-fed agricultural production in Upper Mesopotamia with a specific focus on Early Bronze Age urban settlements. In return, the variation in production is used to explore stability of urban settlement systems. The organization of the flow of agricultural goods is the key to sustaining the total settlement system. The vulnerability of a settlement system increases due to the increased demand for more output from agricultural lands. This demand is the key for the success of urbanization project. However, without estimating how many foodstuffs were available at the end of a production cycle, further discussions on the forces that shaped and sustained urban settlement systems will be lacking. While large scale fluctuations in the flow of agricultural products between settlements are not the only determinants of hierarchical structures, the total available agricultural yield for each urban settlement in a hierarchy must have influenced settlement relations. As for the methodology, first, Early Bronze Age precipitation levels are estimated by using modern day associations between the eastern Mediterranean coastal areas and the inner regions of Upper Mesopotamia. Next, these levels are integrated into a remote-sensing based biological growth model. Also, a CORONA satellite imagery based archaeological survey is conducted in order to map the Early Bronze Age settlement system in its entirety as well as the ancient markers of agricultural intensification. Finally, ancient agricultural production landscapes are modeled in a GIS. The study takes a critical position towards the traditionally held assumption that large urban settlements (cities) in Upper Mesopotamia were in a state of constant demand for food. The results from this study also suggest that when variations in ancient precipitation levels are translated into the variations in production levels, the impact of climatic aridification on ancient settlement systems becomes less visible in the archaeological record.

Socio-demographic determinants and prevalence of Tuberculosis knowledge in three slum populations of Uganda.

PubMed

Obuku, Ekwaro A; Meynell, Clea; Kiboss-Kyeyune, Jemimah; Blankley, Simon; Atuhairwe, Christine; Nabankema, Evelyn; Lab, Morris; Jeffrey, Nikki; Ndungutse, David

2012-07-23

Knowledge of tuberculosis has been shown to influence health seeking behaviour; and urban slum dwellers are at a higher risk of acquiring tuberculosis than the general population. The study aim was to assess knowledge of tuberculosis and identify the associated socio-demographic determinants, in order to inform tailored interventions for advocacy, communication and social mobilisation in three urban-slum communities of Uganda. A cross-sectional survey of 1361 adults between April and October 2011. Data was analyzed by descriptive statistics. Adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) of potential determinants of tuberculosis (TB) knowledge were estimated by multivariable ordinal logistic regression using Stata 11.2 software. We found low knowledge of TB cause (26.7%); symptoms (46.8%), transmission (54.3%), prevention (34%) and free treatment (35%). Knowledge about TB treatment (69.4) and cure (85.1) was relatively high. Independent determinants of poor knowledge of TB in the multivariable analysis included (aOR, 95% CI) lack of formal education (0.56; 0.38 - 0.83, P = 0.004), unemployment (0.67; 0.49 - 0.90, P = 0.010) and never testing for HIV (0.69; 0.51 - 0.92, P < 0.012). Whilst, older age (1.73; 1.30 - 2.29, P < 0.001) and residing in Lira (2.02; 1.50 - 2.72, P < 0.001) were independent determinants of higher knowledge of TB. This study revealed deficiencies in the public health knowledge about TB symptoms, diagnosis and treatment among urban-slum dwellers in Uganda. Tuberculosis control programmes in similar settings should consider innovative strategies for TB education, advocacy, communication and social mobilisation to reach the youth, unemployed and less-educated; as well as those who have never tested for HIV.

A population-based survey of prevalence of diabetes and correlates in an urban slum community in Nairobi, Kenya.

PubMed

Ayah, Richard; Joshi, Mark D; Wanjiru, Rosemary; Njau, Elijah K; Otieno, C Fredrick; Njeru, Erastus K; Mutai, Kenneth K

2013-04-20

Urban slum populations in Africa continue to grow faster than national populations. Health strategies that focus on non-communicable diseases (NCD) in this segment of the population are generally lacking. We determined the prevalence of diabetes and associated cardiovascular disease (CVD) risk factors correlates in Kibera, Nairobi's largest slum. We conducted a population-based household survey utilising cluster sampling with probability proportional to size. Households were selected using a random walk method and consenting residents aged 18 years and above were recruited. The WHO STEPS instrument was administered. A random capillary blood sugar (RCBS) was obtained; known persons with diabetes and subjects with a RCBS >11.1 had an 8 hours fasting blood sugar (FBS) drawn. Diabetes was defined as a RCBS of  ≥ 11.1 mmol/l and a FBS of  ≥ 7.0 mmol/l, or a prior diagnosis or receiving diabetes drug treatment. Out of 2061 enrolled; 50.9% were males, mean age was 33.4 years and 87% had a minimum of primary education. Only 10.6% had ever had a blood sugar measurement. Age adjusted prevalence of diabetes was 5.3% (95% CI 4.2-6.4) and prevalence increased with age peaking at 10.5% (95% CI 6.8-14.3%) in the 45-54 year age category. Diabetes mellitus (DM) correlates were: 13.1% smoking, 74.9% alcohol consumption, 75.7% high level of physical activity; 16.3% obese and 29% overweight with higher rates in women.Among persons with diabetes the odds of obesity, elevated waist circumference and hypertension were three, two and three fold respectively compared to those without diabetes. Cardiovascular risk factors among subjects with diabetes were high and mirrored that of the entire sample; however they had a significantly higher use of tobacco. This previously unstudied urban slum has a high prevalence of DM yet low screening rates. Key correlates include cigarette smoking and high alcohol consumption. However high levels of physical activity were also reported. Findings have important implications for NCD prevention and care. For this rapidly growing youthful urban slum population policy makers need to focus their attention on strategies that address not just communicable diseases but non communicable diseases as well.

Risk factors of hypertension among adults aged 35-64 years living in an urban slum Nairobi, Kenya.

PubMed

Olack, Beatrice; Wabwire-Mangen, Fred; Smeeth, Liam; Montgomery, Joel M; Kiwanuka, Noah; Breiman, Robert F

2015-12-17

Hypertension is an emerging public health problem in Sub Saharan Africa (SSA) and urbanization is considered to favor its emergence. Given a paucity of information on hypertension and associated risk factors among urban slum dwellers in SSA, we aimed to characterize the distribution of risk factors for hypertension and investigate their association with hypertension in an urban slum in Kenya. We conducted a community based cross-sectional survey among adults 35 years and older living in Kibera slum Nairobi, Kenya. Trained interviewers collected data on socio demographic characteristics and self reported health behaviours using modified World Health Organization stepwise surveillance questionnaire for chronic disease risk factors. Anthropometric and blood pressure measurements were performed following standard procedures. Multiple logistic regression was used for analysis and odds ratios with 95 % confidence intervals were calculated to identify risk factors associated with hypertension. A total of 1528 adults were surveyed with a mean age of 46.7 years. The age-standardized prevalence of hypertension was 29.4 % (95 % CI 27.0-31.7). Among the 418 participants classified as hypertensive, over one third (39.0 %) were unaware they had hypertension. Prevalence of current smoking and alcohol consumption was 8.5 and 13.1 % respectively. Over one quarter 26.2 % participants were classified as overweight (Body Mass Index [BMI] ≥25 to ≤29.9 kg/m(2)), and 17 % classified as obese (BMI ≥30 kg/m(2)). Overweight, obesity, current smoking, some level of education, highest wealth index, moderate physical activity, older age and being widowed were each independently associated with hypertension. When fit in a multivariable logistic regression model, being a widow [AOR = 1.7; (95 % CI, 1.1-2.6)], belonging to the highest wealth index [AOR = 1.6; (95 % CI, 1.1-2.5)], obesity [AOR = 1.8; 95 % CI, 1.1-3.1)] and moderate physical activity [AOR = 1.9; (95 % CI, 1.2-3.0)], all remained significantly associated with hypertension. Hypertension in the slum is a public health problem affecting at least one in three adults aged 35-64 years. Age, marital status, wealth index, physical inactivity and body mass index are important risk factors associated with hypertension. Prevention measures targeting the modifiable risk factors associated with hypertension are warranted to curb hypertension and its progressive effects.

Sociocultural factors influencing breastfeeding practices in two slums in Nairobi, Kenya.

PubMed

Wanjohi, Milka; Griffiths, Paula; Wekesah, Frederick; Muriuki, Peter; Muhia, Nelson; Musoke, Rachel N; Fouts, Hillary N; Madise, Nyovani J; Kimani-Murage, Elizabeth W

2016-01-01

Despite numerous interventions promoting optimal breastfeeding practices in Kenya, pockets of suboptimal breastfeeding practices are documented in Kenya's urban slums. This paper describes cultural and social beliefs and practices that influence breastfeeding in two urban slums in Nairobi, Kenya. Qualitative data were collected in Korogocho and Viwandani slums through 10 focus group discussions and 19 in-depth interviews with pregnant, breastfeeding women and community health volunteers and 11 key-informant interviews with community leaders. Interviews were audiotaped, transcribed verbatim, coded in NVIVO and analyzed thematically. Social and cultural beliefs and practices that result to suboptimal breastfeeding practices were highlighted including; considering colostrum as 'dirty' or 'curdled milk', a curse 'bad omen' associated with breastfeeding while engaging in extra marital affairs, a fear of the 'evil eye' (malevolent glare which is believed to be a curse associated with witchcraft) when breastfeeding in public and breastfeeding being associated with sagging breasts. Positive social and cultural beliefs were also identified including the association of breast milk with intellectual development and good child health. The beliefs and practices were learnt mainly from spouses, close relatives and peers. Interventions promoting behavior change with regards to breastfeeding should focus on dispelling the beliefs and practices that result to suboptimal breastfeeding practices and to build on the positive ones, while involving spouses and other family members as they are important sources of information on breastfeeding. ISRCTN83692672: December 2013 (retrospectively registered).

24 CFR 511.80 - Performance review.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Performance review. 511.80 Section... DEVELOPMENT SLUM CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATION GRANT PROGRAM Grantee Performance: Review, Reporting and Corrective or Remedial Actions § 511.80 Performance review. (a) General. HUD will review the...

24 CFR 511.80 - Performance review.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Performance review. 511.80 Section... DEVELOPMENT SLUM CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATON GRANT PROGRAM Grantee Performance: Review, Reporting and Corrective or Remedial Actions § 511.80 Performance review. (a) General. HUD will review the...

24 CFR 511.80 - Performance review.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false Performance review. 511.80 Section... DEVELOPMENT SLUM CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATION GRANT PROGRAM Grantee Performance: Review, Reporting and Corrective or Remedial Actions § 511.80 Performance review. (a) General. HUD will review the...

24 CFR 511.80 - Performance review.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Performance review. 511.80 Section... DEVELOPMENT SLUM CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATON GRANT PROGRAM Grantee Performance: Review, Reporting and Corrective or Remedial Actions § 511.80 Performance review. (a) General. HUD will review the...

24 CFR 511.80 - Performance review.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Performance review. 511.80 Section... DEVELOPMENT SLUM CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATION GRANT PROGRAM Grantee Performance: Review, Reporting and Corrective or Remedial Actions § 511.80 Performance review. (a) General. HUD will review the...

Gender differentials and old age survival in the Nairobi slums, Kenya.

PubMed

Bennett, Rachel; Chepngeno-Langat, Gloria; Evandrou, Maria; Falkingham, Jane

2016-08-01

This paper examines gender differentials in survival amongst older people (50+ years) in the Nairobi slums and to the best of our knowledge is the first study of its kind in an urban African setting. The results provide evidence contrary to the expected paradox of poorer self-rated health yet better survival amongst older women. Older women in the Nairobi slums have poorer self-rated health and poorer circumstances across other factors, including disability and socio-economic status. Further, older women in the slums do not have better survival. The conventional female advantage in mortality only becomes apparent after accounting for the cumulative influence of individual characteristics, social networks, health and socio-economic status, suggesting the female advantage in unadjusted old-age mortality does not apply to contexts where women experience significant disadvantage across multiple life domains. This highlights the urgent need to redress the support, status and opportunities available for women across the life course in contexts such as the Nairobi slums. In addition, a greater number of factors differentiate mortality risk amongst men than amongst women, suggesting inequality amongst slum dwelling older men and highlighting the need for gender sensitive interventions which account for the particular needs of both genders in old age. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The influence of urbanisation on measures of Plasmodium falciparum infection prevalence in East Africa

PubMed Central

Omumbo, J.A.; Guerra, C.A.; Hay, S.I.; Snow, R.W.

2011-01-01

There is a growing interest in the effects of urbanisation in Africa on Plasmodium falciparum risks and disease outcomes. We undertook a review of published and unpublished literature to identify parasite survey data from communities in East Africa. Data were selected to represent the most reliable and contemporary estimates of infection prevalence and were categorised by urban or rural status using a number of approaches. We identified 329 spatially distinct surveys undertaken since 1980 in the sub-region of which 37 were undertaken in urban settlements and 292 in rural settlements. Overall rural settlements reported significantly higher parasite prevalence among children aged 0–14 than urban settlements (on average 10% higher infection rates; p < 0.05). No urban settlements recorded parasite prevalence in excess of 75%. In areas of East Africa where climatic conditions are likely to support higher parasite transmission, the rural–urban difference was most marked. There was a significant trend towards documenting higher classes of parasite prevalence in rural compared to urban settlements (p < 0.05) and the mean difference between rural and urban samples was 18% (p < 0.001). These results further highlight the need to better define urban extents in Africa in order to capture the non-climatic determinants of infection and disease risk and provide a more informed approach to describing the burden of disease across the continent. PMID:15589793

Socio-economic factors explain differences in public health-related variables among women in Bangladesh: a cross-sectional study.

PubMed

Khan, Md Mobarak H; Kraemer, Alexander

2008-07-23

Worldwide one billion people are living in slum communities and experts projected that this number would double by 2030. Slum populations, which are increasing at an alarming rate in Bangladesh mainly due to rural-urban migration, are often neglected and characterized by poverty, poor housing, overcrowding, poor environment, and high prevalence of communicable diseases. Unfortunately, comparisons between women living in slums and those not living in slums are very limited in Bangladesh. The objectives of the study were to examine the association of living in slums (dichotomized as slum versus non-slum) with selected public health-related variables among women, first without adjusting for the influence of other factors and then in the presence of socio-economic variables. Secondary data was used in this study. 120 women living in slums (as cases) and 480 age-matched women living in other areas (as controls) were extracted from the Bangladesh Demographic and Health Survey 2004. Many socio-economic and demographic variables were analysed. SPSS was used to perform simple as well as multiple analyses. P-values based on t-test and Wald test were also reported to show the significance level. Unadjusted results indicated that a significantly higher percent of women living in slums came from country side, had a poorer status by household characteristics, had less access to mass media, and had less education than women not living in slums. Mean BMI, knowledge of AIDS indicated by ever heard about AIDS, knowledge of avoiding AIDS by condom use, receiving adequate antenatal visits (4 or more) during the last pregnancy, and safe delivery practices assisted by skilled sources were significantly lower among women living in slums than those women living in other areas. However, all the unadjusted significant associations with the variable slum were greatly attenuated and became insignificant (expect safe delivery practices) when some socio-economic variables namely childhood place of residence, a composite variable of household characteristics, a composite variable of mass media access, and education were inserted into the multiple regression models. Taken together, childhood place of residence, the composite variable of mass media access, and education were the strongest predictors for the health related outcomes. Reporting unadjusted findings of public health variables in women from slums versus non-slums can be misleading due to confounding factors. Our findings suggest that an association of childhood place of residence, mass media access and public health education should be considered before making any inference based on slum versus non-slum comparisons.

The adequacy of antenatal care services among slum residents in Addis Ababa, Ethiopia.

PubMed

Bayou, Yibeltal T; Mashalla, Yohana S; Thupayagale-Tshweneagae, Gloria

2016-06-15

There are recent efforts made to eliminate inequalities in the utilisation of basic health care services. More emphasis is given for improvement of health in developing countries including maternal and child health. However, disparities for the fast-growing population of urban poor are masked by the urban averages. The aim of this paper is to report on the findings of antenatal care adequacy among slum residents in Addis Ababa, Ethiopia. This was a quantitative and cross-sectional community based study design which employed a stratified two-stage cluster sampling technique to determine the sample. Data was collected using structured questionnaire administered to 870 women aged 15-49 years. Weighted 'backward selection' logistic regression models were employed to identify predictors of adequacy of antenatal care. Majority of slum residents did not have adequate antenatal care services with only 50.3, 20.2 and 11.0 % of the slum resident women initiated antenatal care early, received adequate antenatal care service contents and had overall adequate antenatal care services respectively. Educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.7 times more likely to receive overall adequate care compared to those with no formal education. Similarly, clients of private healthcare facilities were 2.2 times respectively more likely to receive overall adequate antenatal care compared to those clients of public healthcare facilities. In order to improve ANC adequacy in the study area, the policy-making, planning, and implementation processes should address the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.

[Relationships between settlement morphology transition and residents commuting energy consumption].

PubMed

Zhou, Jian; Xiao, Rong-Bo; Sun, Xiang

2013-07-01

Settlement morphology transition is triggered by rapid urbanization and urban expansion, but its relationships with residents commuting energy consumption remains ambiguous. It is of significance to understand the controlling mechanisms of sustainable public management policies on the energy consumption and greenhouse gases emission during the process of urban settlement morphology transition. Taking the Xiamen City of East China as a case, and by using the integrated land use and transportation modeling system TRANUS, a scenario analysis was made to study the effects of urban settlement morphology transition on the urban spatial distribution of population, jobs, and land use, and on the residents commuting energy consumption and greenhouse gasses emission under different scenarios. The results showed that under the Business As Usual (BAU) scenario, the energy consumption of the residents at the morning peak travel time was 54.35 tce, and the CO2 emission was 119.12 t. As compared with those under BAU scenario, both the energy consumption and the CO2 emission under the Transition of Settlement Morphology (TSM) scenario increased by 12%, and, with the implementation of the appropriate policies such as land use, transportation, and economy, the energy consumption and CO2 emission under the Transition of Settlement Morphology with Policies (TSMP) scenario reduced by 7%, indicating that urban public management policies could effectively control the growth of residents commuting energy consumption and greenhouse gases emission during the period of urban settlement morphology transition.

24 CFR 511.74 - Audit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM... financial management systems used by grantees and, where applicable, State recipients shall provide for...

Impact Monitoring of the National Scale Up of Zinc Treatment for Childhood Diarrhea in Bangladesh: Repeat Ecologic Surveys

PubMed Central

Larson, Charles P.; Saha, Unnati Rani; Nazrul, Hazera

2009-01-01

Background Zinc treatment of childhood diarrhea has the potential to save 400,000 under-five lives per year in lesser developed countries. In 2004 the World Health Organization (WHO)/UNICEF revised their clinical management of childhood diarrhea guidelines to include zinc. The aim of this study was to monitor the impact of the first national campaign to scale up zinc treatment of childhood diarrhea in Bangladesh. Methods/Findings Between September 2006 to October 2008 seven repeated ecologic surveys were carried out in four representative population strata: mega-city urban slum and urban nonslum, municipal, and rural. Households of approximately 3,200 children with an active or recent case of diarrhea were enrolled in each survey round. Caretaker awareness of zinc as a treatment for childhood diarrhea by 10 mo following the mass media launch was attained in 90%, 74%, 66%, and 50% of urban nonslum, municipal, urban slum, and rural populations, respectively. By 23 mo into the campaign, approximately 25% of urban nonslum, 20% of municipal and urban slum, and 10% of rural under-five children were receiving zinc for the treatment of diarrhea. The scale-up campaign had no adverse effect on the use of oral rehydration salt (ORS). Conclusions Long-term monitoring of scale-up programs identifies important gaps in coverage and provides the information necessary to document that intended outcomes are being attained and unintended consequences avoided. The scale-up of zinc treatment of childhood diarrhea rapidly attained widespread awareness, but actual use has lagged behind. Disparities in zinc coverage favoring higher income, urban households were identified, but these were gradually diminished over the two years of follow-up monitoring. The scale up campaign has not had any adverse effect on the use of ORS. Please see later in the article for the Editors' Summary PMID:19888335

Diarrhoea in slum children: observation from a large diarrhoeal disease hospital in Dhaka, Bangladesh.

PubMed

Ferdous, Farzana; Das, Sumon Kumar; Ahmed, Shahnawaz; Farzana, Fahmida Dil; Malek, Mohammad Abdul; Das, Jui; Latham, Jonathan Ross; Faruque, Abu Syed Golam; Chisti, Mohammod Jobayer

2014-10-01

To determine and compare socio-demographic, nutritional and clinical characteristics of children under five with diarrhoea living in slums with those of children who do not live in slums of Dhaka, Bangladesh. From 1993 to 2012, a total of 28 948 under fives children with diarrhoea attended the Dhaka Hospital of icddr,b. Data were extracted from the hospital-based Diarrhoea Disease Surveillance System, which comprised 17 548 under fives children from slum and non-slum areas of the city. Maternal illiteracy [aOR = 1.57; 95% confidence interval (1.36, 1.81), P-value <0.001], paternal illiteracy [1.37 (1.21, 1.56) <0.001], mother's employment [1.59 (1.37, 1.85) <0.001], consumption of untreated water [2.73 (2.26, 3.30) <0.001], use of non-sanitary toilets [3.48 (3.09, 3.93) <0.001], 1st wealth quintile background [3.32 (2.88, 3.84) <0.001], presence of fever [1.14 (1.00, 1.29) 0.047], some or severe dehydration [1.21 (1.06, 1.40) 0.007], stunting [1.14 (1.01, 1.29) 0.030] and infection with Vibrio cholerae [1.21 (1.01, 1.45) 0.039] were significantly associated with slum-dwelling children after controlling for co-variates. Measles immunisation [0.52 (0.47, 0.59) P < 0.001] and vitamin A supplementation rates [0.36 (0.31, 0.41) P < 0.001] amongst children 12-59 months were lower for slum dwellers than other children in univarate analysis only. Slum-dwelling children are more malnourished, have lower immunisation rates (measles vaccination and vitamin A supplementation) and higher rates of measles, are more susceptible to diarrhoeal illness due to V. cholerae and suffer from severe dehydration more often than children from non-slum areas. Improved health and nutrition strategies should give priority to children living in urban slums. © 2014 John Wiley & Sons Ltd.

Comparing causes of death between formal and informal neighborhoods in urban Africa: evidence from Ouagadougou Health and Demographic Surveillance System

PubMed Central

Soura, Abdramane Bassiahi; Lankoande, Bruno; Millogo, Roch; Bangha, Martin

2014-01-01

Background The probable coexistence of two or more epidemiological profiles in urban Africa is poorly documented. In particular, very few studies have focused on the comparison of cause-specific mortality between two types of neighborhoods that characterize contemporary southern cities: formal neighborhoods, that is, structured or delineated settlements (planned estates) that have full access to public utilities (electricity and water services), and the informal neighborhoods, that is, spontaneous and unplanned peri-urban settlements where people live in slum-like conditions, often with little or no access to public utilities. Objective To compare the causes of death between the formal and informal neighborhoods covered by the Ouagadougou Health and Demographic Surveillance Systems (HDSS). Design The data used come from the INDEPTH pooled dataset which includes the contribution of Ouagadougou HDSS and are compiled for the INDEPTH Network Data repository. The data were collected between 2009 and 2011 using verbal autopsy (VA) questionnaires completed by four fieldworkers well trained in the conduction of VAs. The VA data were then interpreted using the InterVA-4 program (version 4.02) to arrive at the causes of death. Results Communicable diseases are the leading cause of death among children (aged between 29 days and 14 years) in both formal and informal neighborhoods, contributing more than 75% to the mortality rate. Mortality rates from non-communicable diseases (NCDs) are very low before age 15 but are the leading causes from age 50, especially in formal neighborhoods. Mortality from injuries is very low, with no significant difference between the two neighborhoods. Conclusions The fact that mortality from NCDs is higher among adults in formal neighborhoods seems consistent with the idea of a correlation between modern life and epidemiological transition. However, NCDs do affect informal neighborhoods as well. They consist mainly of cardiovascular diseases and neoplasms most of which are preventable and/or manageable through a change in lifestyle. A prevention program would certainly reduce the burden of these chronic diseases among adults and the elderly with a significant economic impact for families. PMID:25377335

Topological patterns in street networks of self-organized urban settlements

NASA Astrophysics Data System (ADS)

Buhl, J.; Gautrais, J.; Reeves, N.; Solé, R. V.; Valverde, S.; Kuntz, P.; Theraulaz, G.

2006-02-01

Many urban settlements result from a spatially distributed, decentralized building process. Here we analyze the topological patterns of organization of a large collection of such settlements using the approach of complex networks. The global efficiency (based on the inverse of shortest-path lengths), robustness to disconnections and cost (in terms of length) of these graphs is studied and their possible origins analyzed. A wide range of patterns is found, from tree-like settlements (highly vulnerable to random failures) to meshed urban patterns. The latter are shown to be more robust and efficient.

Use of population-based surveillance to determine the incidence of rotavirus gastroenteritis in an urban slum and a rural setting in Kenya.

PubMed

Breiman, Robert F; Cosmas, Leonard; Audi, Allan; Mwiti, William; Njuguna, Henry; Bigogo, Godfrey M; Olack, Beatrice; Ochieng, John B; Wamola, Newton; Montgomery, Joel M; Williamson, John; Parashar, Umesh D; Burton, Deron C; Tate, Jacqueline E; Feikin, Daniel R

2014-01-01

Rotavirus gastroenteritis is a major cause of mortality among children <2 years of age. Disease burden data are important for introducing and sustaining new rotavirus vaccines in immunization programs. We analyzed population-based infectious disease surveillance data from 2007 to 2010 from Kenyan sites in rural and urban slum areas. Stool specimens were collected from patients of all ages presenting to study clinics with diarrheal disease and tested for rotavirus by enzyme immunoassay. Incidence rates were adjusted using data on healthcare utilization (from biweekly home visits) and proportion of stools collected at study clinics from patients meeting case definitions. Rotavirus was detected in 285 (9.0%) of 3174 stools tested, including 122 (11.9%) from children <5 years of age and 162 (7.6%) from participants ≥5 years of age. Adjusted incidence rates for infants were 13,419 and 12,135 per 100,000 person-years of observation in rural and urban areas, respectively. Adjusted incidence rates were high in adults across age ranges. The rates suggest that annually, among children <5 years of age, there are >54,500 cases of rotavirus-associated gastroenteritis in rural Nyanza Province and >16,750 cases in Nairobi urban slums. Community-based surveillance in urban and rural Kenya suggests that rotavirus plays an important role as a cause of acute gastroenteritis in adults, as well as in children. In addition to substantially preventing illness and complications from diarrheal disease in children, rotavirus infant immunization has the potential of indirectly preventing diarrheal disease in older children and adults, assuming children are the predominant sources of transmission.

The perspectives of clients and unqualified allopathic practitioners on the management of delivery care in urban slums, Dhaka, Bangladesh - a mixed method study

PubMed Central

2010-01-01

Background BRAC is implementing a program to improve maternal and newborn health among the urban poor in the slums of Bangladesh (Mansohi), funded by the Bill & Melinda Gates Foundation. Formative research has demonstrated that unqualified allopathic practitioners (UAPs) are commonly assisting home-delivery. The objective of this study was to explore the role of unqualified allopathic practitioners during home delivery in urban slums of Dhaka. Methods This cross-sectional study was conducted between September 2008 and June 2009 in Kamrangirchar slum in Dhaka, Bangladesh, using both qualitative and quantitative research methods. Through a door-to-door household survey, quantitative data were collected from 463 women with a home birth and/or trial of labor at home. We also conducted seven in-depth interviews with the UAPs to explore their practices. Results About one-third (32%) of the 463 women interviewed sought delivery care from a UAP. We did not find an association between socio-demographic characteristics and care-seeking from a UAP, except for education of women. Compared to women with three or more pregnancies, the highest odds ratio was found in the primi-gravidity group [odds ratio (OR): 3.46; 95% confidence interval (CI): 1.65-7.25)], followed by women with two pregnancies (OR: 2.54; 95% CI: 1.36-4.77) to use a UAP. Of women who reported at least one delivery-related complication, 45.2% received care from the UAPs. Of 149 cases where the UAP was involved with delivery care, 133 (89.3%) received medicine to start or increase labor with only 6% (9 of 149) referred by a UAP to any health facility. The qualitative findings showed that UAPs provided a variety of medicines to manage excessive bleeding immediately after childbirth. Conclusion There is demand among slum women for delivery-related care from UAPs during home births in Bangladesh. Some UAPs' practices are contrary to current World Health Organization recommendations and could be harmful. Programs need to develop interventions to address these practices to improve perinatal care outcomes. PMID:20822521

The land-use of Bandung, its density, overcrowded area and public facility toward a compact city

NASA Astrophysics Data System (ADS)

Paramita, B.

2016-04-01

The concept of a compact city has been introduced since 1973. It is a utopian vision largely driven by a desire to see more efficient uses of resources. In 1980s, the reconfiguration of the physical urban form of metropolitan areas was increasingly debated by both theorists and practitioners. Recently, the concept of a compact city has been more focused on developed countries in which the population tends to decrease. However, in Asia, except Japan which contains many dense cities, it has become a concept which promotes relatively high residential density with mixed land uses, though rather only in population and density. This paper addresses the land-use of Bandung that having the density over 14,000 people/km2, which has been so much potential toward a compact city. Somehow, unprepared ness of urban planning and regulation, the city seemed overwrought to serve its inhabitants. This condition is shown from the demographic condition, especially population density in Bandung based on its sub areas of the city (SWK). The stack of public facilities in a certain district has led the concentration of density and activity, which finally raising the slum and overcrowded settlement. Finally, this paper explores the implications of land use management and describes challenges faced and possible approaches, especially in land-use management strategies to be implemented in Bandung.

Blood donation practices and willingness to donate among residents of an urban slum in Lagos Nigeria.

PubMed

Sekoni, A O; Balogun, M R; Odukoya, O O; Inem, V; Onigbogi, O O

2014-03-01

This study was carried out to assess the blood donation practices and willingness to donate among residents of an urban slum. Cross sectional descriptive study design with a qualitative and quantitative component. Multistage sampling was used to select 400 respondents for the questionnaire interview while three FGD sessions were conducted guide among three groups of participants namely youths, men and women. The information collected was analyzed manually (FGD) and with Epi info version 3.5.3. Majority of the questionnaire respondents were female, married, traders, had at least secondary school education, with mean age of 37.6 years. Only 12.0% had donated in the past, the main reason given by non donors was that they had never been asked to donate; this was also a key finding in the FGD. Willingness to donate was positively associated with being a male, single and Christian, age was a significant predictor of previous donation while more of the previous donors were still willing to donate, more for family/friends (p=0.036) than voluntarily (p=0.001) this view was supported by the participants at the FGD. Members of this urban slum had poor practice of blood donation,had positive attitude and were willing to donate, there is need to mobilise and organise outreach blood donation programs to convert attitude into actual practice.

Water and sanitation hygiene knowledge attitude practice in urban slum settings.

PubMed

Joshi, Ashish; Prasad, Satish; Kasav, Jyoti B; Segan, Mehak; Singh, Awnish K

2013-11-18

Access to improved drinking water, sanitation and hygiene is one of the prime concerns around the globe. This study aimed at assessing water and sanitation hygiene-related attitude and practices, and quality of water in urban slums of south Delhi, India. This pilot cross sectional study was performed during July 2013 across four urban slums of South Delhi. A convenient sample of 40 participants was enrolled. A modified version of previously validated questionnaire was used to gather information on socio-demographics, existing water and sanitation facilities and water treatment practices. Water quality testing was additionally performed using hydrogen sulphide (H2S) vials. Average age of participants was 36 years (SD=10). 83% of the participants perceived gastrointestinal tract infection as the most important health problem. 75% of the participants did not use any method for drinking water treatment. 45% of the participants consumed water from privately-owned tube well/ bore well. Water shortage lasted two days or more (50%) at a stretch with severe scarcity occurring twice a year (40%). Females aged 15 years and above were largely responsible (93%) for fetching water from water source. 45% of the participants had toilets within their households. 53% of drinking water samples collected from storage containers showed positive bacteriological contamination. There is an urgent need to develop family centered educational programs that would enhance awareness about water treatment methods that are cost effective and easily accessible.

[Rural-urban migration in Tucuman: its impact on the deterioration of the environment].

PubMed

Cusa, A T

1994-01-01

The author looks at rural-urban migration in Latin America as a whole, and in Argentina and the province of Tucuman in particular. She describes the negative effect this migration has had on the Argentine city of San Miguel de Tucuman, in that it has given rise to the growth of urban poverty and slum areas. (SUMMARY IN ENG)

Biotic and abiotic effects of human settlements in the wildland-urban interface

Treesearch

Avi Bar-Massada; Volker C. Radeloff; Susan I. Stewart

2014-01-01

The wildland-urban interface (WUI) is the area in which human settlements adjoin or intermix with ecosystems. Although research on the WUI has been focused on wildfire risk to settlements, we argue here that there is a need to quantify the extent of areas in which human settlements interact with adjoining ecosystems, regardless of their ability to support fire spread....

Climate Change and Flooding in an Ecologically Fragile Zone of Nigerian Coastal Areas: A Case Study of Ilaje Settlement in Lagos, Nigeria

NASA Astrophysics Data System (ADS)

Oni, A. F.

2017-12-01

Climate change exacerbates the environmental condition directly or indirectly. The frequency of climate-related disasters worldwide has been on the increase with their amplitude growing. The consequences of climate-related disaster are not limited to loss of lives and properties alone, but also serious repercussions on post-disaster reconstruction, as well as the cost implications for resilience of the infrastructure and natural environment. In developing countries, the low-income group whose income is below the world poverty line is the most vulnerable to the dangers of climate change. To worsen the case, the political and economic strength of these countries in terms of economic resources, technological development and urban planning management necessary for adapting to climate change are relatively weak. This study takes an inventory of the study area environment to establish its environmental state in terms of the extent of its vulnerability and economic strength. It was found that the study area is vulnerable being a coastal area and could be described as a slum settlement. Also, information on frequency and extent of flooding in association with change in temperature was collected. The results show that the frequency of flood occurrence within the period has increased and the increase was attributed to rise in sea level alongside a significant increase in temperature within the period of study. The implications of the findings on loss of lives/properties and continuous decline in the area economic strength as it relates to resilience of the area was discussed. The study suggests an effective urban land use management and control, as well as redevelopment of resilient infrastructure in the area. The study concludes that the increase in temperature for the period as an indicator of climate change causes rise in sea level and the subsequent increase in flooding occurrence. Key Words: Ecologically Fragile Zone, Climate Change, Flooding and Vulnerability.

The Marine Air Ground Task Force Expeditionary Family (MAGTF) of Fighting Vehicles (MEFFV) - Assault Variant Design: Recommendations for Urban Battle

DTIC Science & Technology

2003-01-01

contemporary problems. Merely supplying the basic need for food is a struggle as Oliver Argenti , an urban food specialist with the United Nation’s Food and...An_Urbanizing_World.htm#intro>, accessed 4 January 2003. 17 Brockerhoff, np. 18 Olivio Argenti , “Feeding an Increasingly Urban World,” Food and...2003. 19 Argenti , np. 10 “squatters” reside in urban slums with no potable water supply and no adequate sewage, spreading disease amongst them

Unhealthy Fat in Street and Snack Foods in Low-Socioeconomic Settings in India: A Case Study of the Food Environments of Rural Villages and an Urban Slum

PubMed Central

Gupta, Vidhu; Downs, Shauna M.; Ghosh-Jerath, Suparna; Lock, Karen; Singh, Archna

2016-01-01

Objective To describe the food environment in rural villages and an urban slum setting in India with reference to commercially available unbranded packaged snacks and street foods sold by vendors, and to analyze the type and quantity of fat in these foods. Design Cross-sectional. Setting Two low-income villages in Haryana and an urban slum in Delhi. Participants Street vendors (n = 44) were surveyed and the nutritional content of snacks (n = 49) sold by vendors was analyzed. Main Outcome Measures Vendors' awareness and perception of fats and oils, as well as the type of snacks sold, along with the content and quality of fat present in the snacks. Analysis Descriptive statistics of vendor survey and gas chromatography to measure fatty acid content in snacks. Results A variety of snacks were sold, including those in unlabeled transparent packages and open glass jars. Mean fat content in snacks was 28.8 g per 100-g serving in rural settings and 29.6 g per 100-g serving in urban settings. Sampled oils contained high levels of saturated fats (25% to 69% total fatty acids) and trans fats (0.1% to 30% of total fatty acids). Conclusions and Implications Interventions need to target the manufacturers of oils and fats used in freshly prepared products to improve the quality of foods available in the food environment of low-socioeconomic groups in India. PMID:26872553

Examining the relationship between social support availability, urban center size, and self-perceived mental health of recent immigrants to Canada: a mixed-methods analysis.

PubMed

Chadwick, Kathryn A; Collins, Patricia A

2015-03-01

The experiences of settlement in a new country (e.g., securing housing and employment, language barriers) pose numerous challenges for recent immigrants that can impede their health and well-being. Lack of social support upon arrival and during settlement may help to explain why immigrant mental health status declines over time. While most urban centers in Canada offer some settlement services, little is known about how the availability of social supports, and the health statuses of recent immigrants, varies by city size. The objective of this mixed-methods study was to examine the relationship between self-perceived mental health (SPMH), social support availability, and urban center size, for recent immigrants to Canada. The quantitative component involved analysis of 2009-2010 Canadian Community Health Survey data, selecting for only recent immigrants and for those living in either large or small urban centers. The qualitative component involved in-depth interviews with managers of settlement service organizations located in three large and three small urban centers in Canada. The quantitative analysis revealed that social support availability is positively associated with higher SPMH status, and is higher in small urban centers. In support of these findings, our interviews revealed that settlement service organizations operating in small urban centers offer more intensive social supports; interviewees attributed this difference to personal relationships in small cities, and the ease with which they can connect to other agencies to provide clients with necessary supports. Logistic regression analysis revealed, however, that recent immigrants in small urban centers are twice as likely to report low SPMH compared to those living in large urban centers. Thus, while the scope and nature of settlements services appears to vary by city size in Canada, more research is needed to understand what effect settlement services have on the health status of recent immigrants to Canada, especially in smaller urban centers. Copyright © 2015. Published by Elsevier Ltd.

Impact of nutrition education on health of the mother and newborn belonging to the poor urban slum community.

PubMed

Sur, D; Mukhopadhyay, S P; Biswas, R

1997-07-01

To find the nutritional knowledge among mothers of one child of the poor community and to relate status of education to the nutritional health of them and the newborn and to get a thorough knowledge on the impact of nutritional education, a comprehensive study was undertaken in an urban slum area. Nutritional grading was done through scoring system. There were 47 mothers (24.1%) out of 195 having normal nutritional grade and 37 mothers (19%) having severe nutritional grade. There were 80 mothers having 'no knowledge' on maternal nutrition. 'Adequate knowledge' was found in 31 cases. Mothers (n = 80) of 'no knowledge' delivered babies of average weight 2.3 kg whereas 'adequate knowledge' mothers gave birth to babies of average weight 2.9 kg.

HIV/AIDS among youth in urban informal (slum) settlements in Kenya: What are the correlates of and motivations for HIV testing?

PubMed Central

2011-01-01

Background Although HIV counseling and testing (HCT) is widely considered an integral component of HIV prevention and treatment strategies, few studies have examined HCT behavior among youth in sub-Saharan Africa-a group at substantial risk for HIV infection. In this paper we examine: the correlates of HIV testing, including whether associations differ based on the context under which a person gets tested; and the motivations for getting (or not getting) an HIV test. Methods Drawing on data collected in 2007 from 4028 (51% male) youth (12-22 years) living in Korogocho and Viwandani slum settlements in Nairobi (Kenya), we explored the correlates of and motivations for HIV testing using the Health Belief Model (HBM) as a theoretical framework. Multinomial and binary logistic regression analyses were employed to examine correlates of HIV testing. Bivariate analyses were employed to assess reasons for or against testing. Results Nineteen percent of males and 35% of females had been tested. Among tested youth, 74% of males and 43% of females had requested for their most recent HIV test while 7% of males and 32% of females reported that they were required to take their most recent HIV test (i.e., the test was mandatory). About 60% of females who had ever had sex received an HIV test because they were pregnant. We found modest support for the HBM in explaining variation in testing behavior. In particular, we found that perceived risk for HIV infection may drive HIV testing among youth. For example, about half of youth who had ever had sex but had never been tested reported that they had not been tested because they were not at risk. Conclusions Targeted interventions to help young people correctly assess their level of risk and to increase awareness of the potential value of HIV testing may help enhance uptake of testing services. Given the relative success of Prevention of Mother-to-Child Transmission (PMTCT) services in increasing HIV testing rates among females, routine provider-initiated testing and counseling among all clients visiting medical facilities may provide an important avenue to increase HIV status awareness among the general population and especially among males. PMID:21888666

Disclosure and help seeking behavior of women exposed to physical spousal violence in Dhaka slums.

PubMed

Parvin, Kausar; Sultana, Naznin; Naved, Ruchira Tabassum

2016-05-10

Despite high prevalence of intimate partner violence (IPV) and its adverse social and health consequences, the rate of help seeking for IPV is generally low. Although the level of IPV is much higher in urban slums of Bangladesh, the level and nature of help seeking of the victims are unknown. This paper aims to address this gap in the literature. Using a cross-sectional survey conducted between August 2011-February 2012, we explored disclosure of violence, help seeking behavior, and their correlates among randomly selected currently married women aged 15-29 in Dhaka slums (n = 2604). About 60 % of the currently married women reported past year spousal physical violence, but only 21 % disclosed and 19 % sought any help. High acceptance of violence was the main reason for not seeking help. Help was most commonly sought from informal sources (89 %). Any education, frequent and severe physical abuse, and presence of children increased the likelihood of disclosure and help seeking. Most survivors from slum who disclosed also sought help. Despite widespread physical abuse, many survivors never sought help. Wide acceptance of violence hampering help seeking needs to be challenged. Increasing disclosure would also enhance help seeking. Awareness rising regarding rights of women to live a violence free life is essential. Although many services are available in the urban area, information about these services needs to be available to women. Promoting education is important in increasing both disclosure and service uptake.

Determinants of childhood mortality in slums of Karachi, Pakistan.

PubMed

D'souza, R M; Bryant, J H

1999-01-01

Pakistan has an infant mortality rate (IMR) of 90.5/1000 live births, and the country's child mortality level of 117.5 is worse than in other South Asian countries. Rapid population growth combined with rural-to-urban migration has led to the creation of urban slums in which morbidity levels are usually higher than in rural populations. A study was conducted in January 1993 in 6 slums of Karachi where the Aga Khan University has operated primary health care programs since 1985. Researchers recorded the deaths of 347 children under age 5 years old due to diarrhea and acute respiratory infections (ARI) during 1989-93. 235 mothers of these children were interviewed. The following are discussed as risk factors for under-5 child mortality: the use of traditional healers, poor nutritional status, incomplete or no immunization, the quick change of healers, inappropriate child care arrangements, mother's literacy, who decides about outside treatment, short birth interval, bottle feeding, and nuclear family structure. Maternal autonomy, appropriate health-seeking behavior, and child-rearing processes identified in the study point to the need for intervention strategies which go beyond the usual primary health care initiatives and involve communities in developing social support systems for mothers.

Social Determinants, Suboptimal Health Behavior, and Morbidity in Urban Slum Population: An Indian Perspective

PubMed Central

Mohan, Palipudi VenkataTrinadaKrishna; Bansal, Rajkumar K.

2008-01-01

Improving the health of urban residents, particularly those living in slum areas, requires an integrated approach. Appropriate interventions must be based on a well-grounded understanding of health determinants. Social factors are as important as physical factors in determining health status and suggest alternative interventions. Employment, stress, social exclusion, social support, substance use, nutrition, transport, and conditions during childhood are among the most important social determinants of health status identified by the International Center for Health and Society. This paper uses social determinants of health approach to understand morbidity outcomes for people residing in the slums of Surat City, India. To quantify suboptimal health behavior and identify the determinants of health status for this population survey data on household characteristics, health-seeking behavior, socioeconomic status, food and personal habits, social life, and physical activity has been used. After controlling for socioeconomic and demographic factors, logistic regression analysis reveals that social exclusion, stress, and lack of social support are significantly associated with morbidity. Thus, understanding of social determinants of health by policy makers is important as the health sector has a crucial role in addressing disparities in social determinants. PMID:18404392

Characterizing Urban Heat Islands of Global Settlements Using MODIS and Nighttime Lights Products

NASA Technical Reports Server (NTRS)

Zhang, Ping; Imhoff, Marc L.; Wolfe, Robert E.; Bounoua, Lahouari

2010-01-01

Impervious surface area (ISA) from the National Geophysical Data Center (NGDC) and land surface temperature (LST) from MODIS averaged over three annual cycles (2003-2005) are used in a spatial analysis to assess the urban heat island (UHI) signature on LST amplitude and its relationship to development intensity, size, and ecological setting for more than 3000 urban settlements over the globe. Development intensity zones based on fractional ISA are defined for each urban area emanating outward from the urban core to the nearby non-urban rural areas and used to stratify sampling for LST. Sampling is further constrained by biome type and elevation data to insure objective inter-comparisons between zones and between cities in different biomes. We find that the ecological context and settlement size significantly influence the amplitude of summer daytime UHI. Globally, an average of 3.8 C UHI is found in cities built in biomes dominated by forests; 1.9 C UHI in cities embedded in grass/shrub biomes, and only a weak UHI or sometimes an Urban Heat Sink (UHS) in cities in and and semi-arid biomes. Overall, the amplitude of the UHI is negatively correlated (R = -0.66) to the difference in vegetation density between urban and rural zones represented by MODIS Normalized Difference Vegetation Index (NDVI). Globally averaged, the daytime UHI amplitude for all settlement is 2.6 C in summer and 1.4 C in winter. Globally, the average summer daytime UHI is 4.7 C for settlements larger than 500 square kilometers, compared to 2.5 C for settlements smaller than 50 square kilometers and larger than 10 square kilometers. The stratification of cities by size indicates that the aggregated amount of ISA is the primary driver of UHI amplitude with variations between ecological contexts and latitudinal zones. More than 60% of the total LST variances is explained by ISA for urban settlements within forests at mid-to-high latitudes. This percentage will increase to more than 80% when only USA settlements are examined.

Women's perceptions and reflections of male partners and couple dynamics in family planning adoption in selected urban slums in Nigeria: a qualitative exploration.

PubMed

Aransiola, Joshua Oyeniyi; Akinyemi, Akanni Ibukun; Fatusi, Adesegun Olayiwola

2014-08-23

Nigeria is one of the countries where significant progress has not been recorded in contraceptive uptake despite decades of family planning programs while there are indications that slum dwellers may differ significantly from other urban dwellers in their sexual and reproductive behavior, including family planning uptake. This study therefore examined local notions regarding male partners' involvement in family planning (FP) adoption by women in two selected urban slums areas in Nigeria - Ibadan (Southwest region) and Kaduna (Northwest region). Specifically, the study investigated women's narratives about FP, perceived barriers from male partners regarding FP adoption by the women and how women negotiate male partners' cooperation for FP use. Sixteen FGD sessions were conducted with selected groups of men and women, stratified by sex, age group, and FP experience using a vignette to generate discussions. Sessions were facilitated by experienced social scientists and audio-taped, with note-taker also present. The transcribed data were analyzed with Atlas.ti software version 7. Inductive approach was employed to analyze the data. Reasons given for FP attitudes and use are presented in a network format while critical discourse analysis was also used in generating relevant tables. The finding shows that women in the selected communities expressed desire for FP adoption. Three main reasons largely accounted for the desire to use FP: perceived need to space childbirth, family's financial condition and the potential adverse effect of high fertility on the woman's health. Male partners' support for the use of FP by women was perceived to be low, which is due to misconceptions about FP and traditional pro-natalistic beliefs and tendencies. Mechanisms by which women negotiate their male-partner's cooperation for FP adoption include seeking the support of the partner's significant others and advice from older women. To significantly improve family planning adoption rates among urban slum dwellers in Nigeria, there is the need to specifically and specially target men alongside their female partners as well as other stakeholders who have significant influences at family and community level.

Disparities in the use of mobile phone for seeking childbirth services among women in the urban areas: Bangladesh Urban Health Survey.

PubMed

Bishwajit, Ghose; Hoque, Md Rakibul; Yaya, Sanni

2017-12-29

In Bangladesh, similar to its other South Asian counterparts, shortage of health workers along with inadequate infrastructure constitute some of the major obstacles for the equitable provision of reproductive healthcare services, particularly among the marginalized and underserved neighbourhoods. However, given the rapidly expanding broadband communication and mobile phone market in the country, the application of eHealth and mHealth technologies offer a window of opportunities to minimise the impact of socioeconomic barriers and promote the utilization of maternal healthcare services thereby. In the present study we aimed to investigate 1) the prevalence of usage of mobile phones for seeking childbirth services, 2) neighbourhood and socioeconomic disparities in the use, and 3) association between using mobile phones and the uptake of postnatal care among mothers and neonates. Data for the present study came from Bangladesh Urban Health Survey 2013. Study subjects were 9014 married women aged between 15 and 49 years. The overall rate of use of mobile phone was highest in City Corporation non-Slum areas (16.2%) and lowest in City Corporation Slum areas (7.4%). The odds of using mobile for seeking childbirth services were significantly higher among those who were living in non-slum areas, and lower among those who never attended school and lived in poorer households. Results also indicated that women in the slum areas who used mobile phone for childbirth service seeking, were 4.3 times [OR = 4.250;95% CI = 1.856-9.734] more likely to receive postnatal care for themselves, and those from outside the city-corporation areas were 2.7 times [OR = 2.707;95% CI = 1.712-4.279] more likely to receive postnatal care for the newborn. Neighbourhood, educational and economic factors were significantly associated with the mobile phone utilization status among urban women. Promoting access to better education and sustainable income earning should be regarded as an integral part to the expansion of mHealth for maternal healthcare seeking behaviour.

Health & Demographic Surveillance System Profile: The Nairobi Urban Health and Demographic Surveillance System (NUHDSS).

PubMed

Beguy, Donatien; Elung'ata, Patricia; Mberu, Blessing; Oduor, Clement; Wamukoya, Marylene; Nganyi, Bonface; Ezeh, Alex

2015-04-01

The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was the first urban-based longitudinal health and demographic surveillance platform in sub-Saharan Africa (SSA). The NUHDSS was established in 2002 to provide a platform to investigate the long-term social, economic and health consequences of urban residence, and to serve as a primary research tool for intervention and impact evaluation studies focusing on the needs of the urban poor in SSA. Since its inception, the NUHDSS has successfully followed every year a population of about 65,000 individuals in 24,000 households in two slum communities--Korogocho and Viwandani--in Nairobi, Kenya. Data collected include key demographic and health information (births, deaths including verbal autopsy, in- and out-migration, immunization) and other information that characterizes living conditions in the slums (livelihood opportunities, household amenities and possessions, type of housing etc.). In addition to the routine data, it has provided a robust platform for nesting several studies examining the challenges of rapid urbanization in SSA and associated health and poverty dynamics. NUHDSS data are shared through internal and external collaborations, in accordance with the Centre's guidelines for publications, data sharing. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Challenging urban health: towards an improved local government response to migration, informal settlements, and HIV in Johannesburg, South Africa

PubMed Central

Vearey, Joanna

2011-01-01

This article is a review of the PhD thesis undertaken by Joanna Vearey that explores local government responses to the urban health challenges of migration, informal settlements, and HIV in Johannesburg, South Africa. Urbanisation in South Africa is a result of natural urban growth and (to a lesser extent) in-migration from within the country and across borders. This has led to the development of informal settlements within and on the periphery of urban areas. The highest HIV prevalence nationally is found within urban informal settlements. South African local government has a ‘developmental mandate’ that calls for government to work with citizens to develop sustainable interventions to address their social, economic, and material needs. Through a mixed-methods approach, four studies were undertaken within inner-city Johannesburg and a peripheral urban informal settlement. Two cross-sectional surveys – one at a household level and one with migrant antiretroviral clients – were supplemented with semi-structured interviews with multiple stakeholders involved with urban health and HIV in Johannesburg, and participatory photography and film projects undertaken with urban migrant communities. The findings show that local government requires support in developing and implementing appropriate intersectoral responses to address urban health. Existing urban health frameworks do not deal adequately with the complex health and development challenges identified; it is essential that urban public health practitioners and other development professionals in South Africa engage with the complexities of the urban environment. A revised, participatory approach to urban health – ‘concept mapping’ – is suggested which requires a recommitment to intersectoral action, ‘healthy urban governance’ and public health advocacy. PMID:21686331

Intestinal parasitic infections in children presenting with diarrhoea in outpatient and inpatient settings in an informal settlement of Nairobi, Kenya.

PubMed

Mbae, Cecilia Kathure; Nokes, David James; Mulinge, Erastus; Nyambura, Joyce; Waruru, Anthony; Kariuki, Samuel

2013-05-27

The distribution of and factors associated with intestinal parasitic infections are poorly defined in high risk vulnerable populations such as urban slums in tropical sub-Saharan Africa. In a cross sectional study, children aged 5 years and below who presented with diarrhoea were recruited from selected outpatient clinics in Mukuru informal settlement, and from Mbagathi District hospital, Nairobi, over a period of two years (2010-2011). Stool samples were examined for the presence of parasites using direct, formal-ether concentration method and the Modified Ziehl Neelsen staining technique. Overall, 541/2112 (25.6%) were positive for at least one intestinal parasite, with the common parasites being; Entamoeba histolytica, 225 (36.7%),Cryptosporidium spp. 187, (30.5%), Giardia lamblia, 98 (16%).The prevalence of intestinal parasites infection was higher among children from outpatient clinics 432/1577(27.4%) than among those admitted in hospital 109/535 (20.1%) p < 0.001. Infections with E. histolytica, and G. lamblia were higher among outpatients than inpatients (13.8% vs 1.3% p < 0.001 and 5.8% vs 1.3% p < 0.049) respectively, while infection with Cryptosporidium spp. was higher among inpatients than outpatients (15.3% vs 6.7%) respectively p < 0.001. Other parasites isolated among outpatients included Isospora belli, 19 (1.2%), Ascaris lumbricoides, 26 (1.6%), and Hymenolepis nana 12 (0.8%), with the remainder detected in less than ten samples each. HIV-infected participants were more likely to be infected with any parasite than uninfected participants, Adjusted Odds Ratio (AOR), 2.04, 95% CI, 1.55-2.67, p < 0.001), and with Cryptosporidium spp. (AOR, 2.96, 95% CI 2.07-4.21, p < 0.001).The inpatients were less likely to be infected with E. histolytica than outpatients (AOR, 0.11, 95% CI, 0.51-0.24, p < 0.001), but more likely for inpatients to be infected with Cryptosporidium spp. than outpatients (AOR, 1.91, 95% CI, 1.33-2.73, p < 0.001). Mixed parasitic infections were seen in 65 (12.0%) of the 541 infected stool samples. Intestinal parasitic infections are common in urban informal settlements' environment. Routine examinations of stool samples and treatment could benefit both the HIV infected and uninfected children in outpatient and inpatient settings.

Bringing sexual and reproductive health in the urban contexts to the forefront of the development agenda: the case for prioritizing the urban poor.

PubMed

Mberu, Blessing; Mumah, Joyce; Kabiru, Caroline; Brinton, Jessica

2014-09-01

Estimates suggest that over 90 % of population increase in the least developed countries over the next four decades will occur in urban areas. These increases will be driven both by natural population growth and rural-urban migration. Moreover, despite its status as the world's least urbanized region, the urban population in the sub-Saharan Africa region is projected to increase from under 40 % currently to over 60 % by 2050. Currently, approximately 70 % of all urban residents in the region live in slums or slum-like conditions. Sexual and reproductive health (SRH) risks for the urban poor are severe and include high rates of unwanted pregnancies, sexually transmitted infections, and poor maternal and child health outcomes. However, the links between poverty, urbanization, and reproductive health priorities are still not a major focus in the broader development agenda. Building on theoretical and empirical data, we show that SRH in urban contexts is critical to the development of healthy productive urban populations and, ultimately, the improvement of quality of life. We posit that a strategic focus on the sexual and reproductive health of urban residents will enable developing country governments achieve international goals and national targets by reducing health risks among a large and rapidly growing segment of the population. To that end, we identify key research, policy and program recommendations and strategies required for bringing sexual and reproductive health in urban contexts to the forefront of the development agenda.

Height and relative leg length as indicators of the quality of the environment among Mozambican juveniles and adolescents.

PubMed

Padez, Cristina; Varela-Silva, Maria Inês; Bogin, Barry

2009-01-01

The growth status of Mozambique adolescents was assessed to test the hypothesis that relative leg length is a more sensitive indicator of the quality of the environment than the total height. The sample comprised 690 boys and 727 girls, aged between 9 and 17 years, from Maputo. It is divided between those living in the Centre of Maputo and those living in the slums on the periphery of the city. Height, weight, and sitting height were measured and the sitting height ratio was calculated. The hypothesis that relative leg length is more sensitive than total stature as an indicator of environmental quality is not uniformly confirmed. Overall, mean stature is greater for the centre group than the slum group, but relative leg length as measured by the sitting height ratio does not differ. Compared with African-American references (NHANES II), all centre girls, 9- to 14-year-old slum girls, all slum boys, and the oldest centre boys show relatively shorter legs. These findings show that within the Mozambique sample, relative leg length is not sensitive enough to distinguish the quality of the living environment. Mozambique was a colony of Portugal until 1975. Civil unrest and warfare characterized the late Colonial period and the postindependence period until a peace settlement was concluded in 1992. It is possible that all socioeconomic status groups within the country suffered sufficiently to reduce relative leg length compared with the better-off African-American reference sample. Possible genetic influences on relative leg length are also discussed.

24 CFR 30.100 - Settlement of a civil money penalty action.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Settlement of a civil money penalty... Housing and Urban Development CIVIL MONEY PENALTIES: CERTAIN PROHIBITED CONDUCT Procedures § 30.100 Settlement of a civil money penalty action. The officials listed at subpart B of this part, or their...

24 CFR 30.100 - Settlement of a civil money penalty action.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Settlement of a civil money penalty... Housing and Urban Development CIVIL MONEY PENALTIES: CERTAIN PROHIBITED CONDUCT Procedures § 30.100 Settlement of a civil money penalty action. The officials listed at subpart B of this part, or their...

24 CFR 30.100 - Settlement of a civil money penalty action.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Settlement of a civil money penalty... Housing and Urban Development CIVIL MONEY PENALTIES: CERTAIN PROHIBITED CONDUCT Procedures § 30.100 Settlement of a civil money penalty action. The officials listed at subpart B of this part, or their...

24 CFR 30.100 - Settlement of a civil money penalty action.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Settlement of a civil money penalty... Housing and Urban Development CIVIL MONEY PENALTIES: CERTAIN PROHIBITED CONDUCT Procedures § 30.100 Settlement of a civil money penalty action. The officials listed at subpart B of this part, or their...

24 CFR 30.100 - Settlement of a civil money penalty action.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Settlement of a civil money penalty... Housing and Urban Development CIVIL MONEY PENALTIES: CERTAIN PROHIBITED CONDUCT Procedures § 30.100 Settlement of a civil money penalty action. The officials listed at subpart B of this part, or their...

Impediments to the adoption of alternative sewerage in South African urban informal settlements.

PubMed

Ashipala, N; Armitage, N P

2011-01-01

In recent decades South Africa has witnessed a substantial growth in its urban population. This growth has been accompanied by the mushrooming of informal settlements (shantytowns) flanking more formal development. The lack of adequate urban drainage in many of these informal settlements has resulted in extremely polluted environments which add to the disease burden of the poor people who live there. In many instances, informal settlements in South Africa are established on marginal land that is inherently difficult to service using conventional gravity sewerage. International experience has shown that various alternative wastewater collection systems may present more appropriate ways of providing water-borne sewerage in areas that are difficult to service by conventional means. Alternative sewerage schemes have however had a poor record of success in South African informal settlements - primarily stemming from the implementing agencies' failure to adequately address various social and institutional factors. In this paper, a review of South African experiences with simplified sewerage, settled sewerage and vacuum sewerage in urban informal settlements is used to highlight the key constraints that currently impede the application of these technologies.

Mapping the refugee’s settlements in Thessaloniki during the first thirty years of the 20th Century.

NASA Astrophysics Data System (ADS)

Savvaidis, P.

2013-01-01

During the Balkan wars and particularly after the national disaster of Asia Minor, Thessaloniki had to lodge many tenths of thousands of refugees. Then the town authorities created settlements for their hosting. These settlements were rapidly transformed to urban quarters of the town leading to an extension of the town to any direction, particularly to the NW and SE directions without any urban planning. These settlements and later on urban quarters were mapped in different Charts of the town during the 20th Century. The study of these maps is the subject of this paper.(in Greeks)

Urban Inequality, Social Exclusion and Schooling in Dhaka, Bangladesh

ERIC Educational Resources Information Center

Cameron, Stuart James

2017-01-01

This paper asks whether education is a viable route to better livelihoods and social inclusion for children living in poor urban areas in Dhaka, Bangladesh. It uses qualitative interviews with 36 students aged 11-16, living in slum and middle-class areas, and also draws on data from a larger, mixed-methods study to provide context. Many children…

Risk factors for differential outcome following directly observed treatment (DOT) of slum and non-slum tuberculosis patients: a retrospective cohort study.

PubMed

Snyder, Robert E; Marlow, Mariel A; Phuphanich, Melissa E; Riley, Lee W; Maciel, Ethel Leonor Noia

2016-09-20

Brazil's National Tuberculosis Control Program seeks to improve tuberculosis (TB) treatment in vulnerable populations. Slum residents are more vulnerable to TB due to a variety of factors, including their overcrowded living conditions, substandard infrastructure, and limited access to healthcare compared to their non-slum dwelling counterparts. Directly observed treatment (DOT) has been suggested to improve TB treatment outcomes among vulnerable populations, but the program's differential effectiveness among urban slum and non-slum residents is not known. We retrospectively compared the impact of DOT on TB treatment outcome in residents of slum and non-slum census tracts in Rio de Janeiro reported to the Brazilian Notifiable Disease Database in 2010. Patient residential addresses were geocoded to census tracts from the 2010 Brazilian Census, which were identified as slum (aglomerados subnormais -AGSN) and non-slum (non-AGSN) by the Census Bureau. Homeless and incarcerated cases as well as those geocoded outside the city's limits were excluded from analysis. In 2010, 6,601 TB cases were geocoded within Rio de Janeiro; 1,874 (27.4 %) were residents of AGSN, and 4,794 (72.6 %) did not reside in an AGSN area. DOT coverage among AGSN cases was 35.2 % (n = 638), while the coverage in non-AGSN cases was 26.2 % (n = 1,234). Clinical characteristics, treatment, follow-up, cure, death and abandonment were similar in both AGSN and non-AGSN TB patients. After adjusting for covariates, AGSN TB cases on DOT had 1.67 (95 % CI: 1.17, 2.4) times the risk of cure, 0.61 (95 % CI: 0.41, 0.90) times the risk of abandonment, and 0.1 (95 % CI: 0.01, 0.77) times the risk of death from TB compared to non-AGSN TB cases not on DOT. While DOT coverage was low among TB cases in both AGSN and non-AGSN communities, it had a greater impact on TB cure rate in AGSN than in non-AGSN populations in the city of Rio de Janeiro.

Spatial adaptation as the Madurese migrant resilience form at urban informal sector workers settlement: a case study of Kotalama settlement - Malang

NASA Astrophysics Data System (ADS)

Asikin, Damayanti; Antariksa; Dwi Wulandari, Lisa; Indira Rukmi, Wara

2017-12-01

Migration is the movement of the population that will bring the change of society's behavior because of the adjustments occuring at the destination of migrant area. The availability of houses in urban area is not a proportional comparison to the increasing of limited housing space, thus it encourages urban migrants to adapt to the existing conditions. Adaptation will be closely linked to the resilience of migrants in the process of interacting with their environment. The theory of urban settlement architecture continues to grow constantly, so the used paradigm should be interdisciplinary. Thereby, the understanding of adaptation, which is used will concern to various aspects of physical and non-physical environment, and it is viewed as a process and product of human interactions with the environment holistically. Malang city is one of the migration destinations of Madurese people since 1930s, and Kotalama Malang settlement is the settlement that holds the largest Madurese migrant working in informal sector, which has been developed since 1950s. This study was conducted to determine the spatial adaptation of Madurese migrants in urban settlement area as a resilience form towards their settlement environment. The qualitative descriptive method with the discourse analysis approach of searching the data through the observation and the in-depth interview of key person were used to know the adaptation process that happened. The study result indicated that spatial adaptation as a process and product on meso and micro scale conducted by Madurese migrants was the form of resilience towards their settlement environment.

Seroepidemiology of leptospirosis in dogs from rural and slum communities of Los Rios Region, Chile.

PubMed

Lelu, Maud; Muñoz-Zanzi, Claudia; Higgins, Brooke; Galloway, Renee

2015-02-12

Leptospirosis is a zoonotic disease of global importance and often neglected as a public health problem due to lack of awareness, under-diagnosis and under-reporting. Animals serve as a source of transmission through the shedding of Leptospira in their urine. Because of their proximity to humans, dogs may play a role in human infections. In order to assess and mitigate leptospirosis in dogs and the risk of transmission to humans it is important to understand the epidemiology of leptospirosis under natural conditions. This study aimed to characterize leptospirosis in owned dogs from three distinct community types. Blood, dog and household data were collected from 265 dogs in 190 households from 12 communities representing farms, rural villages, and urban slums in the Los Rios region, Chile. Serologic profiles with a 20-serovar microagglutination test panel were obtained. Binomial and multinomial logistic regression models were used to evaluate the associations between spatial, ecological, socio-economic variables and overall seropositivity as well as seropositivity to serogroup Canicola. Results from 247 dogs with no history of vaccination were used. Overall seroprevalence was 25.1% (62/247) with significant differences by community type: 10.9% (9/82) in dogs from farms, 22.3% (21/94) from rural villages, and 45.1% (32/71) from urban slums (p <0.001). This trend by community type was also observed for dogs with evidence of seropositivity to the Canicola serogroup. Factors associated with seropositive dogs included dog density and precipitation two-weeks prior to sampling. Presence of Leptospira positive puddles collected from the peri-domestic household environment was also associated with increased seropositivity. Results suggest that leptospirosis is actively maintained in the dog population in this study region with notably distinct patterns by community type. Dog populations from rural villages, and urban slums in particular, showed evidence of high levels of transmission probably as a result of the combined effects of dog living conditions as well as community-level ecological and environmental factors.

Awareness and eye health-seeking practices for cataract among urban slum population of Delhi: The North India eye disease awareness study.

PubMed

Misra, Vasundhra; Vashist, Praveen; Singh, Senjam Suraj; Malhotra, Sumit; Gupta, Vivek; Dwivedi, S N; Gupta, Sanjeev K

2017-12-01

The objective of the study was to assess the awareness and health-seeking practices related to cataract in urban slums of Delhi. This study design was a population-based cross-sectional study. Participants aged 18-60 years were recruited from randomly selected five slums of South Delhi. They were interviewed using a semi-structured interview schedule on awareness and eye health-seeking practices related to cataract. The practices were recorded if the respondents themselves or any other member of the family was diagnosed with cataract in previous 2 years. A total of 1552 respondents participated in the study, of which, 89.9% had heard of cataract but only (42%) were aware of any symptom of cataract. The common symptoms of cataract reported by the participants were white opacity in eyes (25.9%) and loss of vision (20.6%). Surgery as a treatment of cataract was known to only 559 (40.1%) participants. Awareness about surgery as treatment of cataract was significantly higher among people aged 45-60 years (adjusted odds ratio = 2.89, 95% confidence interval = 2.11-3.97) and in educated people (adjusted OR = 3.69 95% CI = 2.37-5.73). Out of 84 respondents who had been diagnosed with cataract, the health-seeking practices were observed by 70 (83.3%) participants. Among them, 51 (72.9%) had undergone surgery and another 19 (27.1%) had been advised to wait for surgery. Most of the operated patients 48 (94.1%) attended the postoperative follow-up. The study findings suggest the majority of participants have heard of cataract, but there is low awareness of its symptoms and treatment, and good eye health-seeking practices observed for cataract in urban slum population. Gaps in awareness observed can be filled up by implementing proper eye health education programs.

Socio-demographic determinants and prevalence of Tuberculosis knowledge in three slum populations of Uganda

PubMed Central

2012-01-01

Background Knowledge of tuberculosis has been shown to influence health seeking behaviour; and urban slum dwellers are at a higher risk of acquiring tuberculosis than the general population. The study aim was to assess knowledge of tuberculosis and identify the associated socio-demographic determinants, in order to inform tailored interventions for advocacy, communication and social mobilisation in three urban-slum communities of Uganda. Methods A cross-sectional survey of 1361 adults between April and October 2011. Data was analyzed by descriptive statistics. Adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) of potential determinants of tuberculosis (TB) knowledge were estimated by multivariable ordinal logistic regression using Stata 11.2 software. Results We found low knowledge of TB cause (26.7%); symptoms (46.8%), transmission (54.3%), prevention (34%) and free treatment (35%). Knowledge about TB treatment (69.4) and cure (85.1) was relatively high. Independent determinants of poor knowledge of TB in the multivariable analysis included (aOR, 95% CI) lack of formal education (0.56; 0.38 – 0.83, P = 0.004), unemployment (0.67; 0.49 – 0.90, P = 0.010) and never testing for HIV (0.69; 0.51 – 0.92, P < 0.012). Whilst, older age (1.73; 1.30 – 2.29, P < 0.001) and residing in Lira (2.02; 1.50 – 2.72, P < 0.001) were independent determinants of higher knowledge of TB. Conclusion This study revealed deficiencies in the public health knowledge about TB symptoms, diagnosis and treatment among urban-slum dwellers in Uganda. Tuberculosis control programmes in similar settings should consider innovative strategies for TB education, advocacy, communication and social mobilisation to reach the youth, unemployed and less-educated; as well as those who have never tested for HIV. PMID:22824498

Retention of female volunteer community health workers in Dhaka urban slums: a case-control study.

PubMed

Alam, Khurshid; Tasneem, Sakiba; Oliveras, Elizabeth

2012-09-01

Volunteer community health workers (CHWs) are one approach to addressing the health workforce shortage in developing countries. BRAC, a large NGO in Bangladesh, is a pioneer in using female volunteer CHWs as core workers in its successful health programmes. After 25 years of implementing the CHW model in rural areas, BRAC is now using CHWs in urban slums of Dhaka through Manoshi, a community-based maternal and child health project. However, high dropout rates among CHWs in the slums suggested a need to better understand factors associated with their retention, and consequently recommend strategies for increasing their retention. This mixed-method study included a case-control design to assess factors relating to the retention of volunteer CHWs, and focus group discussions (FGDs) to explore solutions to problems. In total, 542 current and 146 dropout CHWs participated in the survey. Six FGDs were held with groups of current and groups of dropout CHWs. Financial incentives were the main factor linked to CHW retention. CHWs who joined with the expectation of income were almost twice as likely to remain as CHWs. This finding was reinforced by the inverse association between wealth quintile of the CHWs and retention; the poorest CHWs were significantly more likely to stay in the programme than the richest. However, social prestige, community approval and household responsibilities were important non-financial factors associated with CHW retention. Restructuring and expansion of existing financial incentives to better compensate CHWs were recommended by CHWs to improve their retention. Factors found to be important in this study are similar to those from earlier studies in rural areas. While the data indicate that financial incentives are the most commonly discussed factor regarding CHW retention in urban slums, the results also suggest other avenues that could be strengthened to improve their retention.

Profile of sterilized women in urban slums and evaluation of motivational strategies.

PubMed

Vaidya, V G; Sahasrabudhe, B G; Jogi, J A; Mitkar, R P

2003-01-01

A study undertaken in hard core pockets having C.P.R. >50% of urban slums to sensitize target couples for encouraging spacing methods and sterilizations showed 55.4% coverage of 1820 unprotected eligible couples. This coverage is attributed to involvement of Aganwadi workers, Mahila Mandals and home visits. The motivational strategies such as sensitization of Mahila Mondals, provision of MCH services and inter personal communications were found to be effective. The reasons for non-acceptance, such as desire to have male and female child in 17.8%, post insertion bleeding due to Cu-T in 13.9% and refusal by male partners in 13.36% were noted in eligible couples. These reasons could be removed by continued inter personal communications. Illiteracy rate of 76.30% in living children of sterilized women indicates need of implementing literacy programme.

A comparison of social and spatial determinants of health between formal and informal settlements in a large metropolitan setting in Brazil.

PubMed

Snyder, Robert E; Jaimes, Guillermo; Riley, Lee W; Faerstein, Eduardo; Corburn, Jason

2014-06-01

Urban informal settlements are often under-recognized in national and regional surveys. A lack of quality intra-urban data frequently contributes to a one-size-fits-all public health intervention and clinical strategies that rarely address the variegated socioeconomic disparities across and within different informal settlements in a city. The 2010 Brazilian census gathered detailed population and place-based data across the country's informal settlements. Here, we examined key socio-demographic and infrastructure characteristics that are associated with health outcomes in Rio de Janeiro with the census tract as the unit of analysis. Many of the city's residents (1.39 million people, 22 % of the population) live in informal settlements. Residents of census tracts in Rio de Janeiro's urban informal areas are younger, (median age of 26 versus 35 years in formal settlements), and have less access to adequate water (96 versus 99 % of informal households), sanitation (86 versus 96 %), and electricity (67 versus 92 %). Average per household income in informal settlement census tracts is less than one third that of non-informal tracts (US\\$708 versus US\\$2362). Even among informal settlements in different planning areas in the same city, there is marked variation in these characteristics. Public health interventions, clinical management, and urban planning policies aiming to improve the living conditions of the people residing in informal settlements, including government strategies currently underway, must consider the differences that exist between and within informal settlements that shape place-based physical and social determinants of health.

Drinking Water Supply, Sanitation, and Hygiene Promotion Interventions in Two Slum Communities in Central Uganda.

PubMed

Musoke, David; Ndejjo, Rawlance; Halage, Abdullah Ali; Kasasa, Simon; Ssempebwa, John C; Carpenter, David O

2018-01-01

Poor water, sanitation, and hygiene (WASH) continue to contribute to the high prevalence of diarrhoeal diseases in low-income countries such as Uganda particularly in slums. We implemented a 3-year WASH project in two urban slums in Uganda with a focus on safe drinking water and improvement in sanitation. The project implemented community and school interventions in addition to capacity building initiatives. Community interventions included home improvement campaigns, clean-up exercises, water quality assessment, promotion of drinking safe water through household point-of-use chlorination, promotion of hand washing, and support towards solid waste management. In schools, the project supported health clubs and provided them with "talking compound" messages. The capacity building initiatives undertaken included training of youth and community health workers. Project evaluation revealed several improvements in WASH status of the slums including increase in piped water usage from 38% to 86%, reduction in use of unprotected water sources from 30% to 2%, reduction in indiscriminate disposal of solid waste from 18% to 2%, and increase in satisfaction with solid waste management services from 40% to 92%. Such proactive and sustainable community interventions have the potential to not only improve lives of slum inhabitants in developing countries but also create lasting impact.

Drinking Water Supply, Sanitation, and Hygiene Promotion Interventions in Two Slum Communities in Central Uganda

PubMed Central

Halage, Abdullah Ali; Kasasa, Simon; Ssempebwa, John C.; Carpenter, David O.

2018-01-01

Poor water, sanitation, and hygiene (WASH) continue to contribute to the high prevalence of diarrhoeal diseases in low-income countries such as Uganda particularly in slums. We implemented a 3-year WASH project in two urban slums in Uganda with a focus on safe drinking water and improvement in sanitation. The project implemented community and school interventions in addition to capacity building initiatives. Community interventions included home improvement campaigns, clean-up exercises, water quality assessment, promotion of drinking safe water through household point-of-use chlorination, promotion of hand washing, and support towards solid waste management. In schools, the project supported health clubs and provided them with “talking compound” messages. The capacity building initiatives undertaken included training of youth and community health workers. Project evaluation revealed several improvements in WASH status of the slums including increase in piped water usage from 38% to 86%, reduction in use of unprotected water sources from 30% to 2%, reduction in indiscriminate disposal of solid waste from 18% to 2%, and increase in satisfaction with solid waste management services from 40% to 92%. Such proactive and sustainable community interventions have the potential to not only improve lives of slum inhabitants in developing countries but also create lasting impact. PMID:29623096

'SMS' for mental health—feasibility and acceptability of using text messages for mental health promotion among young women from urban low income settings in India.

PubMed

Chandra, Prabha S; Sowmya, H R; Mehrotra, Seema; Duggal, Mona

2014-10-01

The current study assesses the acceptability and feasibility of mobile text messages for promoting positive mental health and as a helpline among young women in urban slums of Bangalore. Forty girls in the age range of 16-18 years from urban slums received messages every day for a month. They could call or message back or give a 'missed call' to the same number whenever they had emotional problems or felt like talking to a counselor. The received responses in the form of return texts, missed calls and return phone calls were recorded. Feedback about the feasibility and acceptability of the mobile messages was collected after a month. 25 out of 40 (62.5%) participants called back, asking for mental health services and to say they felt good about the messages. 23 of 40 (57.5%) messaged back regarding their feelings. 62% reported that they felt supported with the mental health messages. Male family members of nearly half of the participants called back to check the authenticity of the source. Most women did not face any problems because of the messages. This pilot qualitative study indicates that mobile text messages are a feasible and culturally acceptable method for mental health promotion and prevention among young women from urban slums in India. Issues such as consent from the woman and family, ensuring confidentiality and providing authentic and reliable support services, need to be taken into account before attempting to scale up such a service, particularly in vulnerable groups. Copyright © 2014 Elsevier B.V. All rights reserved.

Linear growth increased in young children in an urban slum of Haiti: a randomized controlled trial of a lipid-based nutrient supplement.

PubMed

Iannotti, Lora L; Dulience, Sherlie Jean Louis; Green, Jamie; Joseph, Saminetha; François, Judith; Anténor, Marie-Lucie; Lesorogol, Carolyn; Mounce, Jacqueline; Nickerson, Nathan M

2014-01-01

Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children. We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children. Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally. Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm. A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.

Characterizing Urban Heat Islands of Global Settlements Using MODIS and Nighttime Lights Products

NASA Technical Reports Server (NTRS)

Zhang, Ping; Imhoff, Marc L.; Wolfe, Robert E.; Bounoua, Lahouari

2010-01-01

Impervious surface area (ISA) from the National Geophysical Data Center (NGDC) and land surface temperature (LST) from the Moderate Resolution Imaging Spectroradiometer (MODIS) averaged over three annual cycles (2003-2005) are used in a spatial analysis to assess the urban heat island (UHI) signature on LST amplitude and its relationship with development intensity, size, and ecological setting for more than 3000 urban settlements globally. Development intensity zones based on fractional ISA are defined for each urban area emanating outward from the urban core to the nearby nonurban rural areas and used to stratify sampling for LST. Sampling is further constrained by biome type and elevation data to ensure objective intercomparisons between zones and between cities in different biomes. We find that the ecological context and settlement size significantly influence the amplitude of summer daytime UHI. Globally, an average of 3.8 C UHI is found in cities built in biomes dominated by forests; 1.9 C UHI in cities embedded in grass shrubs biomes; and only a weak UHI or sometimes an urban heat sink (UHS) in cities in arid and semi-arid biomes. Overall, the amplitude of the UHI is negatively correlated (R = -0.66) with the difference in vegetation density between urban and rural zones represented by the MODIS normalized difference vegetation index (NDVI). Globally averaged, the daytime UHI amplitude for all settlements is 2.6 C in summer and 1.4 C in winter. Globally, the average summer daytime UHI is 4.7 C for settlements larger than 500 square kilometers compared with 2.5 C for settlements smaller than 50 square kilometers and larger than 10 square kilometers. The stratification of cities by size indicates that the aggregated amount of ISA is the primary driver of UHI amplitude, with variations between ecological contexts and latitudinal zones. More than 60% of the total LST variance is explained by ISA for urban settlements within forests at mid to high latitudes. This percentage will increase to more than 80% when only settlements in the US are examined.

Provider characteristics among staff providing care to sexually transmitted infection self-medicating patients in retail pharmacies in Kibera slum, Nairobi, Kenya.

PubMed

Kwena, Zachary; Sharma, Anjali; Wamae, Njeri; Muga, Charles; Bukusi, Elizabeth

2008-05-01

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

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

24 CFR 200.156 - Settlement of claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Settlement of claims. 200.156 Section 200.156 Housing and Urban Development Regulations Relating to Housing and Urban Development... by the mortgagee's payment of cash or surrender of debentures at par plus accrued interest to the...

24 CFR 180.445 - Settlement negotiations before a settlement judge.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Settlement negotiations before a... Proceedings Prior to Hearing § 180.445 Settlement negotiations before a settlement judge. (a) Appointment of... of the Office of Hearings and Appeals to appoint another ALJ to conduct settlement negotiations. The...

24 CFR 180.445 - Settlement negotiations before a settlement judge.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Settlement negotiations before a... Proceedings Prior to Hearing § 180.445 Settlement negotiations before a settlement judge. (a) Appointment of... of the Office of Hearings and Appeals to appoint another ALJ to conduct settlement negotiations. The...

24 CFR 180.445 - Settlement negotiations before a settlement judge.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Settlement negotiations before a... Proceedings Prior to Hearing § 180.445 Settlement negotiations before a settlement judge. (a) Appointment of... of the Office of Hearings and Appeals to appoint another ALJ to conduct settlement negotiations. The...

24 CFR 180.445 - Settlement negotiations before a settlement judge.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Settlement negotiations before a... Proceedings Prior to Hearing § 180.445 Settlement negotiations before a settlement judge. (a) Appointment of... of the Office of Hearings and Appeals to appoint another ALJ to conduct settlement negotiations. The...

24 CFR 180.445 - Settlement negotiations before a settlement judge.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Settlement negotiations before a... Proceedings Prior to Hearing § 180.445 Settlement negotiations before a settlement judge. (a) Appointment of... of the Office of Hearings and Appeals to appoint another ALJ to conduct settlement negotiations. The...

"I Want to Help Girls Like Me": An Exploration of the Educational Aspirations of Teenage Girls in Kolkata Slums

ERIC Educational Resources Information Center

Ipe, Rebecca

2016-01-01

This qualitative study used participatory visual research in order to develop an understanding of the educational experiences of urban poor adolescent girls in Kolkata and to elicit their capabilities. The sample comprised urban poor girls who were undergoing formal education at a religious, philanthropic primary school in Kolkata. Findings from…

Water and the city (Henry Darcy Medal Lecture)

NASA Astrophysics Data System (ADS)

Rosso, Renzo

2010-05-01

Total world population is about six billion, half living in cities, one third living in slums. This figure has doubled from 1960, when urban population was less than one billion out of the total figure of 3 billion; no more than one fifth was estimated to live in slums at that time. Demography experts predict that population will be around 9 billion in 2050, two thirds (6 billion) living in urban areas, and no reasonable prediction is available for slums. History shows that water is a key factor of urbanization: springs and rivers played a fundamental role in determining where one could settle, and where we are settled now. Water availability is expected to be a major control of man's life in the next future of planet Earth. The daily municipal water withdrawal ranges from 80 to 150 liters per person in China, India and Brazil cities; can they pretend to get more than 600 liters as a US citizen currently does? The impact of natural disasters such as storms and floods is strongly linked to increasing vulnerability associated with urbanization. Are state-of-the-art mitigation policies effective in reducing this impact in both terms of human casualties and economic damage? These and similar questions are fundamental to address hydrological science and engineering hydrology in next years. This talk will approach some open problems arising from the impact of increasing urbanization on the water cycle and, mostly, the associated feedback on human life. These include the need for an insight of nonstationarity, transients and feedback control of hydrological processes; the merging of the space-time scales of hydrological processes with the spatial scales of the city, and the temporal scale of lifestyles; and the way for water scientist and engineers to be involved in the design of cities and the search for life styles coherent with a sustainable development approach.

Prevalence of primary headaches in an urban slum in Enugu South East Nigeria: a door-to-door survey.

PubMed

Ezeala-Adikaibe, Birinus A; Onyekonwu, Chinwe; Okudo, Grace; Onodugo, Obinna; Ekenze, Stella; Orjioke, Casmir; Chime, Peter; Ezeanosike, Obum; Mbadiwe, Nkiru; Chikani, Mark; Okwara, Celestine; Ulasi, Ifeoma; Ijoma, Uchenna

2014-01-01

This study aims to determine the prevalence of primary headache disorders using the second edition of international classification of headache disorders among urban slum dwellers. Headache is a common neurological disorder and one of the most common reasons for visiting the neurology clinics in Nigeria. Low socioeconomic status has been linked with primary headaches. Factors that may precipitate and sustain headaches are common in Africa especially in urban slums. There are limited population based data on the prevalence of headache from Nigeria and other African countries. A 3 phase cross-sectional descriptive study was done to survey at least 40% of the adult population (Igbos) living in an urban slum using the International Classification of Headache Disorders 2nd Edition (ICHD-I) criteria using a validated Igbo language adaptation (translation and back-translation into Igbo language) of a World Health Organization protocol for screening neurological disorders in the community. The lifetime prevalence of headache of any type was 66.7% (95% confidence interval [CI] 64.2-69.2), significantly higher in females (70.2% [95% CI 67.0-73.4]) than in males (62.3% [95% CI 58.5-66.1]; P = .0.002). The prevalence of primary headaches was also significantly lower in males than in females (44.9% [95% CI 45.5-53.3] vs 53.2% (95% CI 49.3-57.1), P = .002). Female (52.1%) drinkers had a statistically higher prevalence of primary headaches than male drinkers (43.6%; P = .004). The prevalence of migraine was 6.4% (95% CI 5.1-7.7); 7.5% (95% CI 5.6-9.4) in females and 5% (95% CI 3.3-6.7) in males (P = .058). Migraine with aura was similar in both males and females. Migraine without aura was significantly higher in females (5.7%) than males (3.1%) (P = .022). Tension-type headache (TTH) had an overall prevalence of 13.8% (95% CI 11.3-16.3), males 12.2% (95% CI 9.7-14.7), and females 15.1% (95% CI 12.6-17.6; P = .118.) The peak decade for all primary headaches was 20-29 years for males (49.8%) and 60-69 years for females (57.5%). Headache is a common health problem in an urban slum in Enugu south east Nigeria where 66.7% of participants had experienced headache in their lifetime, and 49.4% had experienced primary headaches. The prevalence of migraine and TTH were 6.4% (5% in males and 7.5% in females) and 13.8% (12.2% in males and 15.1% in females), respectively. The peak ages of migraine and tension-type headache were 30-39 and 60-69 years, respectively. The prevalence of primary headaches was significantly higher among subjects who used alcohol significantly. © 2014 American Headache Society.

Menstrual pattern, sexual behaviors, and contraceptive use among postpartum women in Nairobi urban slums.

PubMed

Ndugwa, Robert P; Cleland, John; Madise, Nyovani J; Fotso, Jean-Christophe; Zulu, Eliya M

2011-06-01

Postpartum months provide a challenging period for poor women. This study examined patterns of menstrual resumption, sexual behaviors and contraceptive use among urban poor postpartum women. Women were eligible for this study if they had a birth after the period September 2006 and were residents of two Nairobi slums of Korogocho and Viwandani. The two communities are under continuous demographic surveillance. A monthly calendar type questionnaire was administered retrospectively to cover the period since birth to the interview date and data on sexual behavior, menstrual resumption, breastfeeding patterns, and contraception were collected. The results show that sexual resumption occurs earlier than menses and postpartum contraceptive use. Out of all postpartum months where women were exposed to the risk of another pregnancy, about 28% were months where no contraceptive method was used. Menstrual resumption acts as a trigger for initiating contraceptive use with a peak of contraceptive initiation occurring shortly after the first month when menses are reported. There was no variation in contraceptive method choice between women who initiate use before and after menstrual resumption. Overall, poor postpartum women in marginalized areas such as slums experience an appreciable risk of unintended pregnancy. Postnatal visits and other subsequent health system contacts provide opportunities for reaching postpartum women with a need for family planning services.

The Role of HIV in the Household Introduction and Transmission of Influenza in an Urban Slum, Nairobi, Kenya, 2008-2011.

PubMed

Judd, Michael C; Emukule, Gideon O; Njuguna, Henry; McMorrow, Meredith L; Arunga, Geoffrey O; Katz, Mark A; Montgomery, Joel M; Wong, Joshua M; Breiman, Robert F; Mott, Joshua A

2015-09-01

Little is known about how human immunodeficiency virus (HIV) infection affects influenza transmission within homes in sub-Saharan Africa. We used respiratory illness surveillance and HIV testing data gathered in Kibera, an urban slum in Nairobi, Kenya, to examine the impact of HIV status on (1) introducing influenza to the home and (2) transmitting influenza to household contacts. While HIV status did not affect the likelihood of being an influenza index case, household contacts of HIV-infected influenza index cases had twice the risk of developing secondary influenza-like illness than contacts of HIV-negative index cases. HIV-infected influenza index cases may facilitate transmission of influenza within the home. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Counter-intuitive influence of Himalayan river morphodynamics on Indus Civilisation urban settlements.

PubMed

Singh, Ajit; Thomsen, Kristina J; Sinha, Rajiv; Buylaert, Jan-Pieter; Carter, Andrew; Mark, Darren F; Mason, Philippa J; Densmore, Alexander L; Murray, Andrew S; Jain, Mayank; Paul, Debajyoti; Gupta, Sanjeev

2017-11-28

Urbanism in the Bronze-age Indus Civilisation (~4.6-3.9 thousand years before the present, ka) has been linked to water resources provided by large Himalayan river systems, although the largest concentrations of urban-scale Indus settlements are located far from extant Himalayan rivers. Here we analyse the sedimentary architecture, chronology and provenance of a major palaeochannel associated with many of these settlements. We show that the palaeochannel is a former course of the Sutlej River, the third largest of the present-day Himalayan rivers. Using optically stimulated luminescence dating of sand grains, we demonstrate that flow of the Sutlej in this course terminated considerably earlier than Indus occupation, with diversion to its present course complete shortly after ~8 ka. Indus urban settlements thus developed along an abandoned river valley rather than an active Himalayan river. Confinement of the Sutlej to its present incised course after ~8 ka likely reduced its propensity to re-route frequently thus enabling long-term stability for Indus settlements sited along the relict palaeochannel.

Beneficiary level factors influencing Janani Suraksha Yojana utilization in urban slum population of trans-Yamuna area of Delhi.

PubMed

Vikram, K; Sharma, A K; Kannan, A T

2013-09-01

Janani Suraksha Yojana (JSY), a conditional cash transfer scheme introduced to improve the institutional delivery rates and thereby reduce the maternal and infant mortality was implemented in all States and Union Territories of India from 2007. The present study was carried out to identify the beneficiary level factors of utilization of JSY scheme in urban slums and resettlement colonies of trans-Yamuna area of Delhi. A cross-sectional community based survey was done of mothers of infants in the selected areas of the two districts by stratified random sampling on a population proportionate basis. Socio-demographic factors, antenatal services availed and distance of nearest health facility were studied. Outcome variable, a beneficiary, was a woman who had ever interacted with the ASHA of her area during the antenatal period of previous pregnancy and had child birth in an institution. Descriptive tables were drawn; univariate analysis followed by multiple logistic regression was applied for identifying the predictors for availing the benefits. Of the 469 mothers interviewed, 333 (71%) had institutional delivery, 128 (27.3%) had benefited from JSY scheme and 68 (14.5%) had received cash benefits of JSY. Belonging to Hindu religion and having had more than 6 antenatal check ups were the significant predictors of availing the benefits of JSY. There is a need to improve the awareness among urban slum population about the utilization of JSY scheme. Targeting difficult to access areas with special measures and encouraging more antenatal visits were essential, prerequisites to improve the impact of JSY.

Slum upgrading strategies involving physical environment and infrastructure interventions and their effects on health and socio-economic outcomes.

PubMed

Turley, Ruth; Saith, Ruhi; Bhan, Nandita; Rehfuess, Eva; Carter, Ben

2013-01-31

Slums are densely populated, neglected parts of cities where housing and living conditions are exceptionally poor. In situ slum upgrading, at its basic level, involves improving the physical environment of the existing area, such as improving and installing basic infrastructure like water, sanitation, solid waste collection, electricity, storm water drainage, access roads and footpaths, and street lighting, as well as home improvements and securing land tenure. To explore the effects of slum upgrading strategies involving physical environment and infrastructure interventions on the health, quality of life and socio-economic wellbeing of urban slum dwellers in low and middle income countries (LMIC). Where reported, data were collected on the perspectives of slum dwellers regarding their needs, preferences for and satisfaction with interventions received. We searched for published and unpublished studies in 28 bibliographic databases including multidisciplinary (for example Scopus) and specialist databases covering health, social science, urban planning, environment and LMIC topics. Snowballing techniques included searching websites, journal handsearching, contacting authors and reference list checking. Searches were not restricted by language or publication date. We included studies examining the impact of slum upgrading strategies involving physical environment or infrastructure improvements (with or without additional co-interventions) on the health, quality of life and socio-economic wellbeing of LMIC urban slum dwellers. Randomised controlled trials (RCTs), controlled before and after studies (CBAs) and interrupted time series (ITS) were eligible for the main analysis. Controlled studies with only post-intervention data (CPI) and uncontrolled before and after (UBA) studies were included in a separate narrative to examine consistency of results and to supplement evidence gaps in the main analysis. Two authors independently extracted data and assessed risk of bias for each study. Differences between the included study interventions and outcomes precluded meta-analysis so the results were presented in a narrative summary with illustrative harvest plots. The body of evidence for outcomes within the main analysis was assessed according to GRADE as very low, low, moderate or high quality. We identified 10,488 unique records, with 323 screened as full text. Five studies were included for the main analysis: one RCT with a low risk, two CBAs with a moderate risk and two CBAs with a high risk of bias. Three CBAs evaluated multicomponent slum upgrading strategies. Road paving only was evaluated in one RCT and water supply in one CBA. A total of 3453 households or observations were included within the four studies reporting sample sizes.Most health outcomes in the main studies related to communicable diseases, for which the body of evidence was judged to be low quality. One CBA with a moderate risk of bias found that diarrhoeal incidence was reduced in households which received water connections from a private water company (risk ratio (RR) 0.53; 95% confidence interval (CI) 0.27 to 1.04) and the severity of diarrhoeal episodes (RR 0.48; 95% CI 0.19 to 1.22). There was no effect for duration of diarrhoea. Road paving did not result in changes in parasitic infections or sickness in one RCT. After multicomponent slum upgrading, claims for a waterborne disease as opposed to a non-waterborne disease reduced (RR 0.64; 95% CI 0.27 to 0.98) in one CBA with a high risk of bias but there was no change in sanitation-related mortality in a CBA with a moderate risk of bias.The majority of socio-economic outcomes reported within the main studies related to financial poverty, for which the body of evidence was of very low quality. Results were mixed amongst the main studies; one RCT and two CBAs reported no effect on the income of slum dwellers following slum upgrading. One further CBA found significant reduction in monthly water expenditure (mean difference (MD) -17.11 pesos; 95% CI -32.6 to -1.62). One RCT also showed mixed results for employment variables, finding no effect on unemployment levels but increased weekly worked hours (MD 4.68; 95% CI -0.46 to 9.82) and lower risk of residents intending to migrate for work (RR 0.78; 95% CI 0.60 to 1.01).There was no evidence available to assess the impact of slum upgrading on non-communicable diseases or social capital. Maternal and perinatal conditions, infant mortality, nutritional deficiencies, injuries, self-reported quality of life, education and crime were evaluated in one study each.Nine supporting studies were included that measured varying outcomes (6794 households or observations within eight studies reporting sample sizes). One CPI evaluated cement flooring only while three UBAs and five CPIs evaluated multicomponent slum upgrading strategies. All studies but one had a high risk of bias.The studies reinforced main study findings for diarrhoea incidence and water-related expenditure. Findings for parasitic infections and financial poverty were inconsistent with the main studies. In addition, supporting studies reported a number of disparate outcomes that were not evaluated in the main studies.Five supporting studies included some limited information on slum dweller perspectives. They indicated the importance of appropriate siting of facilities, preference for private facilities, delivering synergistic interventions together, and ensuring that infrastructure was fit for purpose and systems were provided for cleaning, maintenance and repair. A high risk of bias within the included studies, heterogeneity and evidence gaps prevent firm conclusions on the effect of slum upgrading strategies on health and socio-economic wellbeing. The most common health and socio-economic outcomes reported were communicable diseases and indicators of financial poverty. There was a limited but consistent body of evidence to suggest that slum upgrading may reduce the incidence of diarrhoeal diseases and water-related expenditure. The information available on slum dwellers' perspectives provided some insight to barriers and facilitators for successful implementation and maintenance of interventions.The availability and use of reliable, comparable outcome measures to determine the effect of slum upgrading on health, quality of life and socio-economic wellbeing would make a useful contribution to new research in this important area. Given the complexity in delivering slum upgrading, evaluations should look to incorporate process and qualitative information alongside quantitative effectiveness data to determine which particular interventions work (or don't work) and for whom.

24 CFR 14.320 - Settlement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Settlement. 14.320 Section 14.320... Applications § 14.320 Settlement. The applicant and agency counsel may agree on a proposed settlement of the award before final action on the application, either in connection with a settlement of the underlying...

Dispersion and oviposition of Aedes albopictus in a Brazilian slum: Initial evidence of Asian tiger mosquito domiciliation in urban environments.

PubMed

Ayllón, Tania; Câmara, Daniel Cardoso Portela; Morone, Fernanda Cristina; Gonçalves, Larissa da Silva; Saito Monteiro de Barros, Fábio; Brasil, Patrícia; Carvalho, Marilia Sá; Honório, Nildimar Alves

2018-01-01

Aedes albopictus, originally considered as a secondary vector for arbovirus transmission, especially in areas where this species co-exist with Aedes aegypti, has been described in most regions of the world. Dispersion and domiciliation of Ae. albopictus in a complex of densely urbanized slums in Rio de Janeiro, Southeastern Brazil, was evidenced. In this study, we tested the hypotheses that 1) Ae. albopictus distribution in urban slums is negatively related to distance from vegetation, and 2) these vectors have taken on a domestic life style with a portion of the population feeding, ovipositing, and resting indoors. To do this, we developed an integrated surveillance proposal, aiming to detect the presence and abundance of Aedes mosquitoes. The study, based on a febrile syndrome surveillance system in a cohort of infants living in the slum complex, was performed on a weekly basis between February 2014 and April 2017. A total of 8,418 adult mosquitoes (3,052 Ae. aegypti, 44 Ae. albopictus, 16 Ae. scapularis, 4 Ae. fluviatilis and 5,302 Culex quinquefasciatus) were collected by direct aspiration and 46,047 Aedes spp. eggs were collected by oviposition traps. The Asian tiger mosquito, Ae. albopictus, was aspirated in its adult form (n = 44), and immature forms of this species (n = 12) were identified from the eggs collected by the ovitraps. In most collection sites, co-occurrence of Ae. aegypti and Ae. albopictus was observed. Key-sites, such as junkyards, thrift stores, factories, tire repair shops and garages, had the higher abundance of Ae. albopictus, followed by schools and households. We collected Ae. albopictus at up to 400 meters to the nearest vegetation cover. The log transformed (n+1) number of females Ae. albopictus captured at each collection point was inversely related to the distance to the nearest vegetation border. These results show that Ae. albopictus, a competent vector for important arboviruses and more commonly found in areas with higher vegetation coverage, is present and spread in neglected and densely urbanized areas, being collected at a long distance from the typical encounter areas for this species. Besides, as Ae. albopictus can easily move between sylvatic and urban environment, the entomological monitoring of Ae. albopictus should be an integral part of mosquito surveillance and control. Finally, key-sites, characterized by high human influx and presence of potential Aedes breeding sites, should be included in entomological monitoring.

Dispersion and oviposition of Aedes albopictus in a Brazilian slum: Initial evidence of Asian tiger mosquito domiciliation in urban environments

PubMed Central

Câmara, Daniel Cardoso Portela; Morone, Fernanda Cristina; Gonçalves, Larissa da Silva; Saito Monteiro de Barros, Fábio; Brasil, Patrícia; Carvalho, Marilia Sá; Honório, Nildimar Alves

2018-01-01

Aedes albopictus, originally considered as a secondary vector for arbovirus transmission, especially in areas where this species co-exist with Aedes aegypti, has been described in most regions of the world. Dispersion and domiciliation of Ae. albopictus in a complex of densely urbanized slums in Rio de Janeiro, Southeastern Brazil, was evidenced. In this study, we tested the hypotheses that 1) Ae. albopictus distribution in urban slums is negatively related to distance from vegetation, and 2) these vectors have taken on a domestic life style with a portion of the population feeding, ovipositing, and resting indoors. To do this, we developed an integrated surveillance proposal, aiming to detect the presence and abundance of Aedes mosquitoes. The study, based on a febrile syndrome surveillance system in a cohort of infants living in the slum complex, was performed on a weekly basis between February 2014 and April 2017. A total of 8,418 adult mosquitoes (3,052 Ae. aegypti, 44 Ae. albopictus, 16 Ae. scapularis, 4 Ae. fluviatilis and 5,302 Culex quinquefasciatus) were collected by direct aspiration and 46,047 Aedes spp. eggs were collected by oviposition traps. The Asian tiger mosquito, Ae. albopictus, was aspirated in its adult form (n = 44), and immature forms of this species (n = 12) were identified from the eggs collected by the ovitraps. In most collection sites, co-occurrence of Ae. aegypti and Ae. albopictus was observed. Key-sites, such as junkyards, thrift stores, factories, tire repair shops and garages, had the higher abundance of Ae. albopictus, followed by schools and households. We collected Ae. albopictus at up to 400 meters to the nearest vegetation cover. The log transformed (n+1) number of females Ae. albopictus captured at each collection point was inversely related to the distance to the nearest vegetation border. These results show that Ae. albopictus, a competent vector for important arboviruses and more commonly found in areas with higher vegetation coverage, is present and spread in neglected and densely urbanized areas, being collected at a long distance from the typical encounter areas for this species. Besides, as Ae. albopictus can easily move between sylvatic and urban environment, the entomological monitoring of Ae. albopictus should be an integral part of mosquito surveillance and control. Finally, key-sites, characterized by high human influx and presence of potential Aedes breeding sites, should be included in entomological monitoring. PMID:29684029

The Settlements Growth in Mijen District, Suburb of Semarang

NASA Astrophysics Data System (ADS)

Pigawati, B.; Yuliastuti, N.; Mardiansjah, F. H.

2018-02-01

Semarang is one of metropolitan cities in Indonesia. As common in metropolitan cities, Semarang has problems regarding the availability of urban space, especially for settlements. This is related to the increase of population in Semarang. The selection of settlements should consider the suitability of space usage. This study aimed to analyze the growth of Semarang settlements in 2006-2015, distribution patterns, characteristics, directions and factors affecting growth. The location of the research is Mijen District located in Suburb of Semarang. This research used a quantitative descriptive spatial approach by using remote sensing technique and Geographic Information System (GIS). The results showed that some of the growth sites of settlements in Mijen District, the suburb of Semarang are located in areas which not suitable for settlements. There are several types of settlement patterns in Mijen District. Accessibility is the major factor driving the growth of settlements. An integrated development policy is needed to maintain a sustainable balance of urban settlement development.

Quantification of microbial risks to human health caused by waterborne viruses and bacteria in an urban slum.

PubMed

Katukiza, A Y; Ronteltap, M; van der Steen, P; Foppen, J W A; Lens, P N L

2014-02-01

To determine the magnitude of microbial risks from waterborne viruses and bacteria in Bwaise III in Kampala (Uganda), a typical slum in Sub-Saharan Africa. A quantitative microbial risk assessment (QMRA) was carried out to determine the magnitude of microbial risks from waterborne pathogens through various exposure pathways in Bwaise III in Kampala (Uganda). This was based on the concentration of Escherichia coli O157:H7, Salmonella spp., rotavirus (RV) and human adenoviruses F and G (HAdV) in spring water, tap water, surface water, grey water and contaminated soil samples. The total disease burden was 680 disability-adjusted life years (DALYs) per 1000 persons per year. The highest disease burden contribution was caused by exposure to surface water open drainage channels (39%) followed by exposure to grey water in tertiary drains (24%), storage containers (22%), unprotected springs (8%), contaminated soil (7%) and tap water (0.02%). The highest percentage of the mean estimated infections was caused by E. coli O157:H7 (41%) followed by HAdV (32%), RV (20%) and Salmonella spp. (7%). In addition, the highest infection risk was 1 caused by HAdV in surface water at the slum outlet, while the lowest infection risk was 2.71 × 10(-6) caused by E. coli O157:H7 in tap water. The results show that the slum environment is polluted, and the disease burden from each of the exposure routes in Bwaise III slum, with the exception of tap water, was much higher than the WHO reference level of tolerable risk of 1 × 10(-6) DALYs per person per year. The findings of this study provide guidance to governments, local authorities and nongovernment organizations in making decisions on measures to reduce infection risk and the disease burden by 10(2) to 10(5) depending on the source of exposure to achieve the desired health impacts. The infection risk may be reduced by sustainable management of human excreta and grey water, coupled with risk communication during hygiene awareness campaigns at household and community level. The data also provide a basis to make strategic investments to improve sanitary conditions in urban slums. © 2013 The Society for Applied Microbiology.

Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: study protocol for a cluster randomised controlled trial

PubMed Central

2013-01-01

Background Nutrition in the first 1,000 days of life (during pregnancy and the first two years) is critical for child growth and survival. Poor maternal, infant and young child nutrition (MIYCN) practices are widely documented in Kenya, with potential detrimental effects on child growth and survival. This is particularly a problem in slums, where most urban residents live. For example, exclusive breastfeeding for the first six months is only about two per cent. Innovative strategies to reach slum residents are therefore needed. Strategies like the Baby Friendly Hospital Initiative have proven effective in some settings but their effectiveness in resource-limited settings, including slums where many women do not deliver in hospital, is questionable. We propose to test the effectiveness of a home-based intervention on infant feeding practices, nutrition and health outcomes of infants born in two slums in Nairobi, Kenya. Methods/Design The study, employing a cluster-randomised study design, will be conducted in two slums in Nairobi: Korogocho and Viwandani where 14 community units (defined by the Government’s health care system) will form the unit of randomization. A total of 780 pregnant women and their respective child will be recruited into the study. The mother-child pair will be followed up until the child is one year old. Recruitment will last approximately one year and three months from September 2012 to December 2013. The mothers will receive regular, personalised, home-based counselling by trained Community Health Workers on MIYCN. Regular assessment of knowledge, attitudes and practices on MIYCN will be done, coupled with assessments of nutritional status of the mother-child pairs and diarrhea morbidity for the children. Statistical methods will include analysis of covariance and multinomial logistic regression. Additionally, cost-effectiveness analysis will be done. The study is funded by the Wellcome Trust and will run from March 2012 to February 2015. Discussion Interventions aimed at promoting optimal breastfeeding and complementary feeding practices are considered to have high impact and could prevent a fifth of the under-five deaths in countries with high mortality rates. This study will inform policy and practice in Kenya and similar settings regarding delivery mechanisms for such high-impact interventions, particularly among urban poor populations. Trial registration ISRCTN83692672 PMID:24370263

Nutritional status of school-age children - A scenario of urban slums in India

PubMed Central

2012-01-01

Background One of the greatest problems for India is undernutrition among children. The country is still struggling with this problem. Malnutrition, the condition resulting from faulty nutrition, weakens the immune system and causes significant growth and cognitive delay. Growth assessment is the measurement that best defines the health and nutritional status of children, while also providing an indirect measurement of well-being for the entire population. Methods A cross-sectional study, in which we explored nutritional status in school-age slum children and analyze factors associated with malnutrition with the help of a pre-designed and pre-tested questionnaire, anthropometric measurements and clinical examination from December 2010 to April 2011 in urban slums of Bareilly, Uttar-Pradesh (UP), India. Result The mean height and weight of boys and girls in the study group was lower than the CDC 2000 (Centers for Disease Control and Prevention) standards in all age groups. Regarding nutritional status, prevalence of stunting and underweight was highest in age group 11 yrs to 13 yrs whereas prevalence of wasting was highest in age group 5 yrs to 7 yrs. Except refractive errors all illnesses are more common among girls, but this gender difference is statistically significant only for anemia and rickets. The risk of malnutrition was significantly higher among children living in joint families, children whose mother's education was [less than or equal to] 6th standard and children with working mothers. Conclusions Most of the school-age slum children in our study had a poor nutritional status. Interventions such as skills-based nutrition education, fortification of food items, effective infection control, training of public healthcare workers and delivery of integrated programs are recommended. PMID:22958757

Occupation and urbanization of Roraima State, Brazil.

PubMed

Diniz, A

1997-01-01

The author examines settlement patterns and urbanization of the remote area of Roraima State, Brazil. "A survey conducted in the capital city, Boa Vista, provides information on migration histories and migrants' characteristics.... Current views of urbanization of the Amazon [region] are focused on the displacement factor that development and state geopolitics have upon rural settlements...." The author also suggests that more attention needs to be paid to the characteristics of migrants in the urban areas. (EXCERPT)

Political Primitivism, Differential Socialization, and Lower-Class Leftist Radicalism

ERIC Educational Resources Information Center

Portes, Alejandro

1971-01-01

Examines hypotheses linking lower class leftist radicalism to the political primitivism caused by lack of education, lack of media exposure, infrequent participation in organizations, and personal isolation--on the basis of data from 382 Chilean urban slum dwellers. (RJ)

Do Low-Cost Private School Leavers in the Informal Settlement Have a Good Chance of Admission to a Government Secondary school? A Study from Kibera in Kenya

ERIC Educational Resources Information Center

Ohba, Asayo

2013-01-01

There are growing numbers of low-cost private schools in urban informal settlements in developing countries. It has been argued that these institutions may constitute alternatives for government schools, as they are able to meet the educational needs of children in urban informal settlements. This study explores the question of whether low-cost…

Urban health in Johannesburg: the importance of place in understanding intra-urban inequalities in a context of migration and HIV.

PubMed

Vearey, Joanna; Palmary, Ingrid; Thomas, Liz; Nunez, Lorena; Drimie, Scott

2010-07-01

Developing country urban contexts present multiple challenges to those responsible for ensuring the good health of urban populations. These include urban growth, migration, informal settlements, intra-urban inequalities and - in some cases - high HIV prevalence. Using Johannesburg as a case study, this paper explores the complexities of the urban context by comparing the social determinants of urban health between migrant groups residing in the inner-city and a peripheral urban informal settlement. It is argued that any attempt to improve the health of urban populations in the context of migration and HIV requires understanding that 'place matters'. 2010 Elsevier Ltd. All rights reserved.

Determinants for participation in a public health insurance program among residents of urban slums in Nairobi, Kenya: results from a cross-sectional survey.

PubMed

Kimani, James K; Ettarh, Remare; Kyobutungi, Catherine; Mberu, Blessing; Muindi, Kanyiva

2012-03-19

The government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. This paper examines the determinants associated with participation in the NHIF among residents of urban slums in Nairobi city. The study used data from the Nairobi Urban Health and Demographic Surveillance System in two slums in Nairobi city, where a total of about 60,000 individuals living in approximately 23,000 households are under surveillance. Descriptive statistics and multivariate logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with participation in the NHIF program. Only 10% of the respondents were participating in the NHIF program, while less than 1% (0.8%) had private insurance coverage. The majority of the respondents (89%) did not have any type of insurance coverage. Females were more likely to participate in the NHIF program (OR = 2.4; p < 0.001), while respondents who were formerly in a union (OR = 0.5; p < 0.05) and who were never in a union (OR = 0.6; p < 0.05) were less likely to have public insurance coverage. Respondents working in the formal employment sector (OR = 4.1; p < 0.001) were more likely to be enrolled in the NHIF program compared to those in the informal sector. Membership in microfinance institutions such as savings and credit cooperative organizations (SACCOs) and community-based savings and credit groups were important determinants of access to health insurance. The proportion of slum residents without any type of insurance is high, which underscores the need for a social health insurance program to ensure equitable access to health care among the poor and vulnerable segments of the population. As the Kenyan government moves toward transforming the NHIF into a universal health program, it is important to harness the unique opportunities offered by both the formal and informal microfinance institutions in improving health care capacity by considering them as viable financing options within a comprehensive national health financing policy framework.

24 CFR 3800.60 - Settlements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Settlements. 3800.60 Section 3800... DEVELOPMENT INVESTIGATIONS IN CONSUMER REGULATORY PROGRAMS § 3800.60 Settlements. (a) At any time during an investigation, the Department and the parties subject to an investigation may conduct settlement negotiations...

Drug susceptibility profiles of pulmonary Mycobacterium tuberculosis isolates from patients in informal urban settlements in Nairobi, Kenya.

PubMed

Kerubo, Glennah; Amukoye, Evans; Niemann, Stefan; Kariuki, Samuel

2016-10-19

Anti-tuberculosis drug resistance is an emerging health problem in Kenya and especially in slums. Slum environments create a conducive environment for the spread of tuberculosis (TB) due to high population density and lack of basic amenities such as decent housing, access to clean water, lack of drainage and basic sanitation. Furthermore, ineffective health services in crowded and poorer populations, poor patient compliance, a large pool of untreated cases, delayed diagnosis and inappropriate treatment regimens are likely to favour selection and spread of drug resistant Mycobacterium tuberculosis (Mtb) strains in such settings, however, precise data on this problem are only sparsely available. To address this question, this study aimed at determining drug resistance patterns of Mtb strains obtained from pulmonary TB patients who sought health care in randomly selected informal settings. This is a cross-sectional study conducted between September 2014 and March 2015, sputum samples were collected from 223 consenting adult patients and subjected to primary isolation and drug susceptibility testing. Socio-demographic data was collected and all data analysed using SPSS v20. Drug susceptibility testing against first line drugs was successfully carried out on 184 isolates. Resistance to at-least one drug was observed in 33 % of the isolates. The highest prevalence of resistance to any drug was identified against isoniazid,(INH) (23.9 %) followed by Ethambutol (EMB) (13.6 %). The highest proportion of mono resistance was observed against INH, 25 (13.6 %). Multidrug resistance (MDR) was observed in 4.4 % of the new cases. There was no significant difference in the proportion of any resistance by sex, age or previous treatment. Levels of drug resistance have reached an alarming level in this population. Capacity of laboratories to conduct TB culture and DST should be strengthened in order to adequately manage TB patients and stop further creation and spread of MDR TB.

The role of a decision-support smartphone application in enhancing community health volunteers’ effectiveness to improve maternal and newborn outcomes in Nairobi, Kenya: quasi-experimental research protocol

PubMed Central

Bakibinga, Pauline; Kamande, Eva; Omuya, Milka; Ziraba, Abdhalah K; Kyobutungi, Catherine

2017-01-01

Introduction Improving maternal and newborn survival remains major aspirations for many countries in the Global South. Slum settlements, a result of rapid urbanisation in many developing countries including Kenya, exhibit high levels of maternal and neonatal mortality. There are limited referral mechanisms for sick neonates and their mothers from the community to healthcare facilities with ability to provide adequate care. In this study, we specifically plan to develop and assess the added value of having community health volunteers (CHVs) use smartphones to identify and track mothers and children in a bid to reduce pregnancy-related complications and newborn deaths in the urban slums of Kamukunji subcounty in Nairobi, Kenya. Methods and analysis This is a quasi-experimental study. We are implementing an innovative, mHealth application known as mobile Partnership for Maternal, Newborn and Child Health (mPAMANECH) which uses dynamic mobile phone and web-portal solutions to enable CHVs make timely decisions on the best course of action in their management of mothers and newborns at community level. The application is based on existing guidelines and protocols in use by CHVs. Currently, CHVs conduct weekly home visits and make decisions from memory or using unwieldy manual tools, and thus prone to making errors. mPAMANECH has an in-built algorithm that makes it easier, faster and more likely for CHVs to make the right management decision. We are working with a network of selected CHVs and maternity centres to pilot test the tool. To measure the impact of the intervention, baseline and end-line surveys will be conducted. Data will be obtained through qualitative and quantitative methods. Ethics and dissemination Ethical approval for the study was obtained from the African Medical Research Foundation. Key messages from the results will be packaged and disseminated through meetings, conference presentations, reports, fact sheets and academic publications to facilitate uptake by policy-makers. PMID:28729309

Use of illicit drugs by adolescents and young adults of an urban settlement in Brazil.

PubMed

Guimarães, Rafael Alves; Souza, Márcia Maria de; Caetano, Karlla Antonieta Amorim; Teles, Sheila Araujo; Matos, Marcos André de

2018-02-01

To estimate the prevalence and factors associated with illicit drug use by adolescents and young adults of a formal urban settlement. Cross-sectional study including adolescents and young adults 12-24 years of an urban settlement in the Midwest Region of Brazil. Data were collected using a structured questionnaire and analyzed using Stata, version 12.0. We used Poisson regression model to estimate the factors associated with illicit drug use. Of the total participants (n=105), 27.6% (95CI 20.0-36.9%) had used illicit drugs such as marijuana, cocaine, crack, LSD and inhalants. The consumption of these substances was associated with male gender, use of body piercing and/or tattoos, licit drug use and self-report of signs and/or symptoms of sexually transmitted infections. High prevalence of illicit drug use was found in the individuals investigated, ratifying the presence of risk factors to the vulnerability of the settlers to use these substances in the urban settlement population.

Ethnic Groups in Urban Areas; Community Formation and Growth: A Selected Bibliography. Council of Planning Librarians Exchange Bibliography Series, Number 202.

ERIC Educational Resources Information Center

Thompson, Bryan; Vance, Mary, Ed.

This bibliography deals with ethnic settlement patterns in urban areas. The emphasis is on factors that determine initial settlement, subsequent intraurban migration and community growth, and their relationship with the more general questions of urban structure and growth. The selection is by no means exhaustive, and was not compiled in any…

A controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children: research protocol for the Maputo Sanitation (MapSan) study, Mozambique

PubMed Central

Brown, Joe; Cumming, Oliver; Bartram, Jamie; Cairncross, Sandy; Ensink, Jeroen; Holcomb, David; Knee, Jackie; Kolsky, Peter; Liang, Kaida; Liang, Song; Nala, Rassul; Norman, Guy; Rheingans, Richard; Stewart, Jill; Zavale, Olimpio; Zuin, Valentina; Schmidt, Wolf-Peter

2015-01-01

Introduction Access to safe sanitation in low-income, informal settlements of Sub-Saharan Africa has not significantly improved since 1990. The combination of a high faecal-related disease burden and inadequate infrastructure suggests that investment in expanding sanitation access in densely populated urban slums can yield important public health gains. No rigorous, controlled intervention studies have evaluated the health effects of decentralised (non-sewerage) sanitation in an informal urban setting, despite the role that such technologies will likely play in scaling up access. Methods and analysis We have designed a controlled, before-and-after (CBA) trial to estimate the health impacts of an urban sanitation intervention in informal neighbourhoods of Maputo, Mozambique, including an assessment of whether exposures and health outcomes vary by localised population density. The intervention consists of private pour-flush latrines (to septic tank) shared by multiple households in compounds or household clusters. We will measure objective health outcomes in approximately 760 children (380 children with household access to interventions, 380 matched controls using existing shared private latrines in poor sanitary conditions), at 2 time points: immediately before the intervention and at follow-up after 12 months. The primary outcome is combined prevalence of selected enteric infections among children under 5 years of age. Secondary outcome measures include soil-transmitted helminth (STH) reinfection in children following baseline deworming and prevalence of reported diarrhoeal disease. We will use exposure assessment, faecal source tracking, and microbial transmission modelling to examine whether and how routes of exposure for diarrhoeagenic pathogens and STHs change following introduction of effective sanitation. Ethics Study protocols have been reviewed and approved by human subjects review boards at the London School of Hygiene and Tropical Medicine, the Georgia Institute of Technology, the University of North Carolina at Chapel Hill, and the Ministry of Health, Republic of Mozambique. Trial registration number NCT02362932. PMID:26088809

Child health interventions in urban slums: are we neglecting the importance of nutrition?

PubMed

Wray, J D

1986-12-01

During the early part of the twentieth century, there were dramatic falls in the mortality rates in many cities in the West. The reasons for this improvement are of considerable relevance today because the conditions which prevailed at that time in cities such as New York are comparable to those prevailing in many slums of the Third World today. Some early studies linked the improvements in health, as measured by mortality rates, to a better level of nutrition. The importance of nutrition is now widely accepted and there are many studies which show the association between nutrient intake and both mortality and morbidity, and in particular between breast feeding and infant mortality rates. It is sometimes assumed that, because nutrition indicators for city populations have improved, there is no longer a major problem of malnutrition in urban areas. However, it is likely that the figures hide disparities through aggregation, and studies in slums rather than cities as a whole give a much less encouraging picture. Poverty is at the root of many of the nutritional and associated health problems, but the children who will be born over the coming decades cannot afford to wait for a new economic order to provide the solution. Through the promotion of breast feeding, education, growth monitoring and food supplementation, necessary help can be targeted at this vulnerable population.

Challenges to achieving sustainable sanitation in informal settlements of Kigali, Rwanda.

PubMed

Tsinda, Aime; Abbott, Pamela; Pedley, Steve; Charles, Katrina; Adogo, Jane; Okurut, Kenan; Chenoweth, Jonathan

2013-12-10

Like most cities in developing countries, Kigali is experiencing rapid urbanisation leading to an increase in the urban population and rapid growth in the size and number of informal settlements. More than 60% of the city's population resides in these settlements, where they experience inadequate and poor quality urban services including sanitation. This article discusses the issues and constraints related to the provision of sustainable sanitation in the informal settlements in Kigali. Two informal settlements (Gatsata and Kimisagara) were selected for the study, which used a mixed method approach for data collection. The research found that residents experienced multiple problems because of poor sanitation and that the main barrier to improved sanitation was cost. Findings from this study can be used by the city authorities in the planning of effective sanitation intervention strategies for communities in informal settlements.

Multidimensional Measurement of Household Water Poverty in a Mumbai Slum: Looking Beyond Water Quality.

PubMed

Subbaraman, Ramnath; Nolan, Laura; Sawant, Kiran; Shitole, Shrutika; Shitole, Tejal; Nanarkar, Mahesh; Patil-Deshmukh, Anita; Bloom, David E

2015-01-01

A focus on bacterial contamination has limited many studies of water service delivery in slums, with diarrheal illness being the presumed outcome of interest. We conducted a mixed methods study in a slum of 12,000 people in Mumbai, India to measure deficiencies in a broader array of water service delivery indicators and their adverse life impacts on the slum's residents. Six focus group discussions and 40 individual qualitative interviews were conducted using purposeful sampling. Quantitative data on water indicators-quantity, access, price, reliability, and equity-were collected via a structured survey of 521 households selected using population-based random sampling. In addition to negatively affecting health, the qualitative findings reveal that water service delivery failures have a constellation of other adverse life impacts-on household economy, employment, education, quality of life, social cohesion, and people's sense of political inclusion. In a multivariate logistic regression analysis, price of water is the factor most strongly associated with use of inadequate water quantity (≤20 liters per capita per day). Water service delivery failures and their adverse impacts vary based on whether households fetch water or have informal water vendors deliver it to their homes. Deficiencies in water service delivery are associated with many non-health-related adverse impacts on slum households. Failure to evaluate non-health outcomes may underestimate the deprivation resulting from inadequate water service delivery. Based on these findings, we outline a multidimensional definition of household "water poverty" that encourages policymakers and researchers to look beyond evaluation of water quality and health. Use of multidimensional water metrics by governments, slum communities, and researchers may help to ensure that water supplies are designed to advance a broad array of health, economic, and social outcomes for the urban poor.

Documenting a long-term development model in the slums of Delhi.

PubMed

Morrow, Martha; Armstrong, Greg; Dayal, Prarthna; Kermode, Michelle

2016-04-28

Achieving development outcomes requires the inclusion of marginalised populations that have the least opportunity to participate in and benefit from development. Slum dwellers often see little of the 'urban advantage', suffering more from infectious diseases, increasing food costs, poor access to education and health care, inadequate water and sanitation, and informal employment. A recent Cochrane Review of the impact of slum upgrading strategies found a dearth of unbiased studies, making it difficult to draw firm conclusions. The Review calls for greater use of process data, and qualitative alongside quantitative methods of evaluation. India is a lower middle income nation with large gender disparities and around 65 million slum inhabitants. The Asha Community Health and Development Society, a non-governmental organisation based in Delhi, has delivered a multi-sectoral program across 71 slums since 1988. This article reports on a mixed-method study to document measureable health and social impacts, along with Asha's ethos and processes. Several observational visits were made to 12 Asha slums where informal discussions were had with staff and residents (n = 50). Asha data records were analysed for change over time (and differences with greater Delhi) in selected indicators (maternal-child health, education, child sex ratio) using descriptive statistics. 34 semi-structured individual/small group interviews and 14 focus group discussions were held with staff, residents, volunteers, elected officials, civil servants, bankers, diplomats, school principals, slumlords and loan recipients (n = 147). Key indicators of health and social equity improved over time and compared favourably with those for greater Delhi. The Asha model emphasises rights, responsibilities, equity and non-violence. It employs strategies characterised by long-term involvement, systematic protocols and monitoring, development of civil society (especially women's and children's groups) to advocate for rights under the law, and links with foreign volunteers and fund-raisers. Stakeholders agreed that changes in community norms and living conditions were at least partly attributable to the Asha model. While lacking a control group or complete baseline data, evidence suggested substantial improvements in slum conditions and social equity. The Asha model offers some lessons for slum (and broader) development.

Measurement of overweight and obesity an urban slum setting in sub-Saharan Africa: a comparison of four anthropometric indices.

PubMed

Haregu, Tilahun Nigatu; Oti, Samuel; Egondi, Thaddaeus; Kyobutungi, Catherine

2016-01-01

As a result of both genetic and environmental factors, the body composition and topography of African populations are presumed to be different from western populations. Accordingly, globally accepted anthropometric markers may perform differently in African populations. In the era of rapid emergence of cardio-vascular diseases in sub-Saharan Africa, evidence about the performance of these markers in African settings is essential. The aim of this study was to investigate the inter-relationships among the four main anthropometric indices in measuring overweight and obesity in an urban poor African setting. Data from a cardiovascular disease risk factor assessment study in urban slums of Nairobi were analyzed. In the major study, data were collected from 5190 study participants. We considered four anthropometric markers of overweight and obesity: Body Mass Index, Waist Circumference, Waist to Hip Ratio, and Waist to Height Ratio. Pairwise correlations and kappa statistics were used to assess the relationship and agreement among these markers, respectively. Discordances between the indices were also analyzed. The weighted prevalence of above normal body composition was 21.6 % by body mass index, 28.9 % by waist circumference, 45.5 % by waist to hip ratio, and 38.9 % by waist to height ratio. The overall inter-index correlation was +0.44. Waist to hip ratio generally had lower correlation with the other anthropometric indices. High level of discordance exists between body mass index and waist to hip ratio. Combining the four indices shows that 791 (16.1 %) respondents had above normal body composition in all four indices. Waist circumference better predicted hypertension and hyperglycemia while waist to height ratio better predicted hypercholesterolemia. There exists a moderate level of correlation and a remarkable level of discordance among the four anthropometric indices with regard to the ascertainment of abnormal body composition in an urban slum setting in Africa. Waist circumference is a better predictor of cardio-metabolic risk.

Prevalence of reproductive tract infections and their determinants in married women residing in an urban slum of North-East Delhi, India.

PubMed

Bhilwar, Meenakshi; Lal, Panna; Sharma, Nandini; Bhalla, Preena; Kumar, Ashok

2015-08-01

Reproductive tract infections (RTIs) have adverse implications on the health of the women. Community-based studies in India have shown a high prevalence of RTIs but here is a lack of sizeable literature from urban slums and resettlement areas. The objective was to document the prevalence and determinants of RTIs in married women (15-49 years) residing in an urban slum in Delhi, India. The study was conducted in an urban resettlement colony of Gokulpuri in the North-East district of Delhi. Systematic random sampling method was adopted to choose the study subjects, that is, married and non-pregnant women in the reproductive age group (15-49 years) residing in the study area. Data were collected using a pretested semi-structured questionnaire, through the house to house visits. The diagnosis of RTIs was made as per the World Health Organization syndromic approach. Data were analyzed in SPSS version 16 (Chicago, IL, USA). A total of 802 women were interviewed. The mean age of study subjects was 30.79 ± 7 years. A total of 352 (43.9%) women currently had symptoms of RTIs. The most frequently reported symptoms included abdominal pain (68.2%), back pain (69.6%), and vaginal discharge (59.3%). Older women (≥25 years) (odds ratio [OR] 2.2, 95% confidence interval [CI]; 1.4-3.5), those belonging to the lower socioeconomic status (OR 2.1, 95% CI; 1.5-2.9), those using cloth during menses (OR 2.6, 95% CI; 1.6-4.3), those having more than three pregnancies (OR 1.8, 95% CI; 1.2-2.6) and those using an intrauterine contraceptive device (OR 11.8, 95% CI; 4.3-32.0) had higher odds of having RTIs. A high case load was found based on the syndromic approach. Generating community awareness, ensuring proper menstrual hygiene, and improving the socioeconomic status would help in reducing the cases of RTI.

'Jago Grahak Jago': A cross-sectional study to assess awareness about food adulteration in an urban slum.

PubMed

Ishwar, Shailesh; Dudeja, Puja; Shankar, Pooja; Swain, Santosh; Mukherji, Sandip

2018-01-01

Food adulteration includes various forms of practices, including mixing, substituting, concealing the quality of food, etc. One of the main causes for rampant adulteration is ignorance of consumer regarding their right and responsibilities resulting in faulty buying practices. Hence, the present study was done to assess the knowledge about adulteration among consumers in an urban slum. A community-based cross-sectional study was done among residents of an urban slum over a period of 2 months. Adults responsible for purchasing groceries for the household were included. A sample size of 100 was taken and pilot-tested questionnaire was administered. All of them were made aware about adulteration. The mean age of the study subjects was 40.2 ± 11.7 years. Only 7% of the study subjects were illiterate. Good practices like checking of Food Safety and Standards Authority of India (FSSAI) logo (90%), Agmark logo (76%) and nutrition label (65%) are lacking among the majority. The most prominent source of knowledge about adulteration is mass media especially television (65%). Almost 40% of the study subjects are unaware about the consumer empowering initiative ' Jago Grahak Jago '. Factors which had a strong positive relationship with good practices like checking of nutrition label, FSSAI logo, Agmark logo, seal and expiry date are age, education status and socio-economic status ( p value ≤ 0.05). Majority of study subjects are unaware about adulteration. ' Jago Grahak Jago ' initiative which empowers the consumers has to be instilled in the minds of consumers. Awareness and motivation will lead to empowerment and end the menace of food adulteration.

Child malnutrition and mortality among families not utilizing adequately iodized salt in Indonesia.

PubMed

Semba, Richard D; de Pee, Saskia; Hess, Sonja Y; Sun, Kai; Sari, Mayang; Bloem, Martin W

2008-02-01

Salt iodization is the main strategy for reducing iodine deficiency disorders worldwide. Characteristics of families not using iodized salt need to be known to expand coverage. The objective was to determine whether families who do not use iodized salt have a higher prevalence of child malnutrition and mortality and to identify factors associated with not using iodized salt. Use of adequately iodized salt (>or =30 ppm), measured by rapid test kits, was assessed between January 1999 and September 2003 in 145 522 and 445 546 families in urban slums and rural areas, respectively, in Indonesia. Adequately iodized salt was used by 66.6% and 67.2% of families from urban slums and rural areas, respectively. Among families who used adequately iodized salt, mortality in neonates, infants, and children aged <5 y was 3.3% compared with 4.2%, 5.5% compared with 7.1%, and 6.9% compared with 9.1%, respectively (P < 0.0001 for all), in urban slums; among families who did not use adequately iodized salt, the respective values were 4.2% compared with 6.3%, 7.1% compared with 11.2%, and 8.5% compared with 13.3% (P < 0.0001 for all) in rural areas. Families not using adequately iodized salt were more likely to have children who were stunted, underweight, and wasted. In multivariate analyses that controlled for potential confounders, low maternal education was the strongest factor associated with not using adequately iodized salt. In Indonesia, nonuse of adequately iodized salt is associated with a higher prevalence of child malnutrition and mortality in neonates, infants, and children aged <5 y. Stronger efforts are needed to expand salt iodization in Indonesia.

Intestinal parasitic infections: Current status and associated risk factors among school aged children in an archetypal African urban slum in Nigeria.

PubMed

Gyang, Vincent P; Chuang, Ting-Wu; Liao, Chien-Wei; Lee, Yueh-Lun; Akinwale, Olaoluwa P; Orok, Akwaowo; Ajibaye, Olusola; Babasola, Ajayi J; Cheng, Po-Ching; Chou, Chia-Mei; Huang, Ying-Chieh; Sonko, Pasaiko; Fan, Chia-Kwung

2017-06-22

Intestinal parasitic infections (IPIs) among school aged children (SAC) in Nigeria remains endemic, hence the need for regular surveillance to attract the attention of policy makers. This cross-sectional study investigated the current prevalence and factors associated with intestinal parasitic infections among school aged children in an urban slum of Lagos City, Nigeria. Single stool samples from 384 school aged children (188 boys and 196 girls) were examined by employing Merthiolate-iodine-formaldehyde concentration (MIFC) and Kato-Katz methods. Demographic characteristics and risk factors were obtained by questionnaires investigation. The overall prevalence was 86.2% in school children, out of them 39.1% had polyparasitism. IPIs showed the highest to the lowest prevalence of 62% (238/384), 25% (97/384), 12.3% (47/384), 11.8% (45/384), 9.9% (38/384), 8.4% (32/384), 3.4% (13/384), and 0.5% (2/384) found in Ascaris lumbricoides, Entamoeba histolytica/dispar, Giardia duodenalis, Endolimax nana, Entamoeba coli, Trichuris trichiura, Blastocystis hominis, and hookworm infections, respectively. MIFC technique showed superiority to Kato-Katz technique in the detection of IPIs (p < 0.0001). Drinking untreated water was a significant risk factor for these school aged children in acquiring protozoan infections after multivariate adjustment (OR = 1.86, 95% CI = 1.08-3.20, p = 0.02). Intestinal parasitic infections are very severe among school aged children in the urban slums, thus regular mass de-worming programs, health education, and the provision of safe drinking water is recommended to combat IPIs among the school aged children. Copyright © 2017. Published by Elsevier B.V.

24 CFR 1720.180 - Settlements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Settlements. 1720.180 Section 1720... Proceedings General Provisions § 1720.180 Settlements. Parties may propose in writing, at any time during the course of a proceeding, offers of settlement which shall be submitted to the Secretary. If determined to...

24 CFR 200.1525 - Settlement agreements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Settlement agreements. 200.1525... Lender Quality Assurance Enforcement § 200.1525 Settlement agreements. (a) HUD staff, as authorized, may negotiate a settlement agreement with a MAP lender before or after the issuance of a warning letter or...

24 CFR 7.43 - Settlement agreements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Settlement agreements. 7.43 Section... and Compliance § 7.43 Settlement agreements. (a) The Department shall make reasonable efforts to... and/or their designees; and (4) Otherwise comply with 29 CFR part 1614. (b) Any settlement agreement...

24 CFR 200.1525 - Settlement agreements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Settlement agreements. 200.1525... Lender Quality Assurance Enforcement § 200.1525 Settlement agreements. (a) HUD staff, as authorized, may negotiate a settlement agreement with a MAP lender before or after the issuance of a warning letter or...

24 CFR 7.43 - Settlement agreements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Settlement agreements. 7.43 Section... and Compliance § 7.43 Settlement agreements. (a) The Department shall make reasonable efforts to... and/or their designees; and (4) Otherwise comply with 29 CFR part 1614. (b) Any settlement agreement...

24 CFR 200.1525 - Settlement agreements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Settlement agreements. 200.1525... Lender Quality Assurance Enforcement § 200.1525 Settlement agreements. (a) HUD staff, as authorized, may negotiate a settlement agreement with a MAP lender before or after the issuance of a warning letter or...

24 CFR 7.43 - Settlement agreements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Settlement agreements. 7.43 Section... and Compliance § 7.43 Settlement agreements. (a) The Department shall make reasonable efforts to... and/or their designees; and (4) Otherwise comply with 29 CFR part 1614. (b) Any settlement agreement...

24 CFR 200.1525 - Settlement agreements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Settlement agreements. 200.1525... Lender Quality Assurance Enforcement § 200.1525 Settlement agreements. (a) HUD staff, as authorized, may negotiate a settlement agreement with a MAP lender before or after the issuance of a warning letter or...

Exploring the context in which different close-to-community sexual and reproductive health service providers operate in Bangladesh: a qualitative study.

PubMed

Mahmud, Ilias; Chowdhury, Sadia; Siddiqi, Bulbul Ashraf; Theobald, Sally; Ormel, Hermen; Biswas, Salauddin; Jahangir, Yamin Tauseef; Sarker, Malabika; Rashid, Sabina Faiz

2015-09-01

A range of formal and informal close-to-community (CTC) health service providers operate in an increasingly urbanized Bangladesh. Informal CTC health service providers play a key role in Bangladesh's pluralistic health system, yet the reasons for their popularity and their interactions with formal providers and the community are poorly understood. This paper aims to understand the factors shaping poor urban and rural women's choice of service provider for their sexual and reproductive health (SRH)-related problems and the interrelationships between these providers and communities. Building this evidence base is important, as the number and range of CTC providers continue to expand in both urban slums and rural communities in Bangladesh. This has implications for policy and future programme interventions addressing the poor women's SRH needs. Data was generated through 24 in-depth interviews with menstrual regulation clients, 12 focus group discussions with married men and women in communities and 24 semi-structured interviews with formal and informal CTC SRH service providers. Data was collected between July and September 2013 from three urban slums and one rural site in Dhaka and Sylhet, Bangladesh. Atlas.ti software was used to manage data analysis and coding, and a thematic analysis was undertaken. Poor women living in urban slums and rural areas visit a diverse range of CTC providers for SRH-related problems. Key factors influencing their choice of provider include the following: availability, accessibility, expenses and perceived quality of care, the latter being shaped by notions of trust, respect and familiarity. Informal providers are usually the first point of contact even for those clients who subsequently access SRH services from formal providers. Despite existing informal interactions between both types of providers and a shared understanding that this can be beneficial for clients, there is no effective link or partnership between these providers for referral, coordination and communication regarding SRH services. Training informal CTC providers and developing strategies to enable better links and coordination between this community-embedded cadre and the formal health sector has the potential to reduce service cost and improve availability of quality SRH (and other) care at the community level.

Prevalence of induced abortions and contraceptive use among married women in an urban slum of Delhi, India.

PubMed

Bhilwar, Meenakshi; Lal, Panna; Sharma, Nandini; Bhalla, Preena; Kumar, Ashok

2017-01-01

To document abortion practices and contraceptive use among women of reproductive age in an urban slum of Delhi. Data were collected as part of a cross-sectional study conducted in an urban resettlement colony in the North East District of Delhi between November 2010 and December 2011. Systematic random sampling was used to enroll 200 married women aged 15-49 years from each of the four blocks of the colony. Participants were interviewed and data were entered into a pretested semi-structured questionnaire. Among 802 participants, 284 (35.4%) reported at least one spontaneous or induced abortion, and 196 (24.4%) reported induced abortions. Unsupervised medical termination was reported by 78 (27.5%) of the 284 women. Overall, only 207 (25.8%) women practiced any type of contraception. The predominant decision maker regarding contraception was the husband for 95 (45.9%) women and the mother-in-law for 78 (37.7%). There is a need for focused community-based education to address specific issues, particularly regarding the dangers of unsafe abortion and choosing a method of contraception in consultation with a healthcare practitioner. © 2016 International Federation of Gynecology and Obstetrics.

Family planning choice behaviour in urban slums of Bangladesh: an econometric approach.

PubMed

Barkat, A; Rahman, M U; Bose, M L

1997-03-01

Bangladesh's urban population is projected to account for 26% of the country's total population by the year 2000 and 37% by 2015. A 1991 Bangladesh census report found that about 21 million of the total 111.5 million population were living in urban areas. 1551 currently-married women of reproductive age in 1551 households sampled from a representative sample of 91 slums in the metropolitan areas of Dhaka, Chittagong, and Khulna participated in a study of family planning behavior choice. 673 of the women were practicing family planning. The authors describe the construction of the econometric model used for analysis. Economic status as indicated by household income was found to considerably influence people's decisions concerning family planning practices. Higher women's educational status is also positively correlated with family planning practice. Husband's educational status has a less significant effect upon family planning practice. The change of a person from non-Muslim to Muslim has an insignificant, though positive, impact upon family planning practice. The more a woman feels empowered, being over age 19 years, the greater the number of living children, and the lower the level of preference for sons, the more likely a woman is to practice family planning.

Challenges to Achieving Sustainable Sanitation in Informal Settlements of Kigali, Rwanda

PubMed Central

Tsinda, Aime; Abbott, Pamela; Pedley, Steve; Charles, Katrina; Adogo, Jane; Okurut, Kenan; Chenoweth, Jonathan

2013-01-01

Like most cities in developing countries, Kigali is experiencing rapid urbanisation leading to an increase in the urban population and rapid growth in the size and number of informal settlements. More than 60% of the city’s population resides in these settlements, where they experience inadequate and poor quality urban services including sanitation. This article discusses the issues and constraints related to the provision of sustainable sanitation in the informal settlements in Kigali. Two informal settlements (Gatsata and Kimisagara) were selected for the study, which used a mixed method approach for data collection. The research found that residents experienced multiple problems because of poor sanitation and that the main barrier to improved sanitation was cost. Findings from this study can be used by the city authorities in the planning of effective sanitation intervention strategies for communities in informal settlements. PMID:24336021

Social conditions and urban health inequities: realities, challenges and opportunities to transform the urban landscape through research and action.

PubMed

de Snyder, V Nelly Salgado; Friel, Sharon; Fotso, Jean Christophe; Khadr, Zeinab; Meresman, Sergio; Monge, Patricia; Patil-Deshmukh, Anita

2011-12-01

The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. Additionally, the persistence of certain conditions, such as poverty, ethnic heterogeneity, and high population turnover, contributes to a lowered ability of individuals and communities to control crime, vandalism, and violence. The social vulnerability in health is not a "natural" or predefined condition but occurs because of the unequal social context that surrounds the daily life of the disadvantaged, and often, socially excluded groups. Social exclusion of individuals and groups is a major threat to development, whether to the community social cohesion and economic prosperity or to the individual self-realization through lack of recognition and acceptance, powerlessness, economic vulnerability, ill health, diminished life experiences, and limited life prospects. In contrast, social inclusion is seen to be vital to the material, psychosocial, and political aspects of empowerment that underpin social well-being and equitable health. Successful experiences of cooperation and networking between slum-based organizations, grassroots groups, local and international NGOs, and city government are important mechanisms that can be replicated in urban settings of different low- and middle-income countries. With increasing urbanization, it is imperative to design health programs for the urban poor that take full advantage of the social resources and resourcefulness of their own communities.

24 CFR 28.45 - Settlements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Settlements. 28.45 Section 28.45... IMPLEMENTATION OF THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 28.45 Settlements. (a) HUD and the respondent may enter into a settlement agreement at any time prior to the issuing of a notice of final...

The potential of volunteered geographic information to investigate peri-urbanization in the conservation zone of Mexico City.

PubMed

Heider, Katharina; Lopez, Juan Miguel Rodriguez; Scheffran, Jürgen

2018-03-14

Due to the availability of Web 2.0 technologies, volunteered geographic information (VGI) is on the rise. This new type of data is available on many topics and on different scales. Thus, it has become interesting for research. This article deals with the collective potential of VGI and remote sensing to detect peri-urbanization in the conservation zone of Mexico City. On the one hand, remote sensing identifies horizontal urban expansion, and on the other hand, VGI of ecological complaints provides data about informal settlements. This enables the combination of top-down approaches (remote sensing) and bottom-up approaches (ecological complaints). Within the analysis, we identify areas of high urbanization as well as complaint densities and bring them together in a multi-scale analysis using Geographic Information Systems (GIS). Furthermore, we investigate the influence of settlement patterns and main roads on the peri-urbanization process in Mexico City using OpenStreetMap. Peri-urbanization is detected especially in the transition zone between the urban and rural (conservation) area and near main roads as well as settlements.

The Pre-History of Urban Scaling

PubMed Central

Ortman, Scott G.; Cabaniss, Andrew H. F.; Sturm, Jennie O.; Bettencourt, Luís M. A.

2014-01-01

Cities are increasingly the fundamental socio-economic units of human societies worldwide, but we still lack a unified characterization of urbanization that captures the social processes realized by cities across time and space. This is especially important for understanding the role of cities in the history of human civilization and for determining whether studies of ancient cities are relevant for contemporary science and policy. As a step in this direction, we develop a theory of settlement scaling in archaeology, deriving the relationship between population and settled area from a consideration of the interplay between social and infrastructural networks. We then test these models on settlement data from the Pre-Hispanic Basin of Mexico to show that this ancient settlement system displays spatial scaling properties analogous to those observed in modern cities. Our data derive from over 1,500 settlements occupied over two millennia and spanning four major cultural periods characterized by different levels of agricultural productivity, political centralization and market development. We show that, in agreement with theory, total settlement area increases with population size, on average, according to a scale invariant relation with an exponent in the range . As a consequence, we are able to infer aggregate socio-economic properties of ancient societies from archaeological measures of settlement organization. Our findings, from an urban settlement system that evolved independently from its old-world counterparts, suggest that principles of settlement organization are very general and may apply to the entire range of human history. PMID:24533062

The pre-history of urban scaling.

PubMed

Ortman, Scott G; Cabaniss, Andrew H F; Sturm, Jennie O; Bettencourt, Luís M A

2014-01-01

Cities are increasingly the fundamental socio-economic units of human societies worldwide, but we still lack a unified characterization of urbanization that captures the social processes realized by cities across time and space. This is especially important for understanding the role of cities in the history of human civilization and for determining whether studies of ancient cities are relevant for contemporary science and policy. As a step in this direction, we develop a theory of settlement scaling in archaeology, deriving the relationship between population and settled area from a consideration of the interplay between social and infrastructural networks. We then test these models on settlement data from the Pre-Hispanic Basin of Mexico to show that this ancient settlement system displays spatial scaling properties analogous to those observed in modern cities. Our data derive from over 1,500 settlements occupied over two millennia and spanning four major cultural periods characterized by different levels of agricultural productivity, political centralization and market development. We show that, in agreement with theory, total settlement area increases with population size, on average, according to a scale invariant relation with an exponent in the range [Formula: see text]. As a consequence, we are able to infer aggregate socio-economic properties of ancient societies from archaeological measures of settlement organization. Our findings, from an urban settlement system that evolved independently from its old-world counterparts, suggest that principles of settlement organization are very general and may apply to the entire range of human history.

Gecekondu Settlements in Turkey: Rural-Urban Migration in the Developing European Periphery

ERIC Educational Resources Information Center

Tas, Halil I.; Lightfoot, Dale R.

2005-01-01

Squatter settlements or "shanty towns" are often viewed as a problem confined to poorer countries of the developing world. Turkey is centered neither in the impoverished Third World nor the industrialized West, but has experienced rapid urban growth and related modernizing social tensions attendant with its headlong pitch into the…

Working with Urban Youth: Experiences from Medellin, Colombia.

ERIC Educational Resources Information Center

Hearn, Lydia

1994-01-01

In the slums of Medellin, Colombia, a program seeks to improve children's physical health, intellectual development, and self-concept through such activities as carpentry, breadmaking, and sports and literature clubs. These activities help develop ethical and moral values, planning and organizing skills, and a future orientation. (SK)

Value of Military Experience in Recuiting the Disadvantaged Worker

ERIC Educational Resources Information Center

Singer, Daniel D.; Domitrz, Joseph

1974-01-01

A study of Vietnam veterans residing in urban slums and ghettos indicates that minority group potential employees with military experience possess greater employment motivation than their nonveteran peers, although they may need appropriate management support in order to make a satisfactory work adjustment. (Author/SA)

An observation on the quality of interfaces in order to understand the complexity and coherence of informal settlement: A study on Tamansari Kampung in Bandung

NASA Astrophysics Data System (ADS)

Sawira, S.; Rahman, T.

2018-05-01

Self-organized settlements are formed within the limited capacity of the inhabitants with or without the Government’s interventions. This pattern is mostly found in the informal settlements, where occupants are the planners who are guided by their needs, limited resources and vernacular knowledge about place making. Understanding the process of its development and transformation could be a way of unfolding the complexity it offers to a formal urban setting. To identify the patterns of adaptation process, a study of morphological elements (i.e. house form, streets) could be a possible way. A case study of an informal settlement (Kampung of Tamansari, Bandung in Indonesia) has been taken to dissect these elements. Two of important components of the study area: house forms and streets created the first layer of urban fabric. High population density demanded layers of needs and activities which eventually guided the multifunctional characteristics of streets and house forms. Thus, streets create dialogue with the complex built forms-often known as interface is the key element to understand the underneath order of Tamansari. Here interface can be divided into two categories depending on their scale – small and large. Small scale interfaces are comprised of small elements such as, extended platform, fence, steps, low height wall, blank wall and elements to set above, set forth, set over in house forms. These components help to create and define semipublic spaces in the settlement. These spaces could be visually and physically interactive or no interactive which result into active or inactive spaces respectively. Small scale interfaces are common features of the settlement, whereas large scale interfaces are placed at strategic locations and act as active spaces. Connecting bridges, open spaces and contours often create special dialogue within and beyond the study area. Interfaces cater diversity in the settlement by creating hierarchy of spaces. Sense of belonging and scope of personalization of the inhabitants are integral parts of alleyways and thus they create a complex yet coherent urban fabric. Apart from the physical elements, the settlement embodies some intangible assets like social bonding, trust, kinship, empathy and sense of belonging that add value to the spatial quality which is a distinctive character of Tamansari kampung. Informal settlements are certainly complex in nature, as it is an outcome of multiple people working to accommodate multidimensional needs. Whereas in a formal system, approach to cater for need is guided by a set of rules developed by a set of professionals end up in creating prototypes irrespective of necessity, affordability and cultural diversity. Cities throughout the world, are experiencing rapid urbanization creating different urban issues. Therefore, it is highly necessary to address different need and affordability of users and come up with suitable urban solutions. Understanding Tamansari Kampung as an informal settlement will enrich the knowledge and expertise to work in complex urban settings.

Channelling urban modernity to sustainable pro-poor tourism development in Indonesia

NASA Astrophysics Data System (ADS)

Prasetyanti, R.

2017-06-01

Sustainable urban planning and development requires not only a fast-growing economic growth and modernity, but also social equity and environmental sustainability. Meanwhile, the global goals of sustainable development have fascinatingly set a promising urban development future by enhancing ecology based pro-poor policy program. Apparently, pro-poor development agenda has led to the notion of pro-poor tourism as part of urban development strategies on poverty alleviation. This research presents Jakarta Hidden Tour and Kampung Warna-warni as certain cases of pro-poor tourism in Indonesia. By the emergence of criticism on “pro-growth” paradigm, the critical analysis of this research focuses on the scenario of sustainable pro-poor tourism through eco-cultural based Kampung-Tour development. In accordance, debates and dilemma have been continuously arising as pros and cons regarding the ethical issues of poverty alleviation based Kampung-Tour development. Nevertheless, this paper tries to redefine Slum Kampung as potential; the writer wildly offers a concept of poverty alleviation by reinventing pro-poor tourism strategy; revitalizing slum site to eco-cultural based pro-poor tourism development as an embodiment of a sustainable urban development. By holding system thinking analysis as research method, sustainable pro-poor tourism highlights the urgency community based tourism and eco-tourism so that poverty alleviation based tourism can be tangibly perceived by the poor. In this sense, good local governance and public private partnership must be enhanced, it is due to, like any other development projects; sustainable pro-poor tourism needs a strong political commitment to alleviate urban poverty, as well as to pursue a better future of sustainable nation.

A pilot-scale microwave technology for sludge sanitization and drying.

PubMed

Mawioo, Peter M; Garcia, Hector A; Hooijmans, Christine M; Velkushanova, Konstantina; Simonič, Marjana; Mijatović, Ivan; Brdjanovic, Damir

2017-12-01

Large volumes of sludge are produced from onsite sanitation systems in densely populated areas (e.g. slums and emergency settlements) and wastewater treatment facilities that contain high amounts of pathogens. There is a need for technological options which can effectively treat the rapidly accumulating sludge under these conditions. This study explored a pilot-scale microwave (MW) based reactor as a possible alternative for rapid sludge treatment. The reactor performance was examined by conducting a series of batch tests using centrifuged waste activated sludge (C-WAS), non-centrifuged waste activated sludge (WAS), faecal sludge (FS), and septic tank sludge (SS). Four kilograms of each sludge type were subjected to MW treatment at a power of 3.4kW for various time durations ranging from 30 to 240min. During the treatment the temperature change, bacteria inactivation (E. coli, coliforms, Staphylococcus aureus, and enterococcus faecalis) and sludge weight/volume reduction were measured. Calorific values (CV) of the dried sludge and the nutrient content (total nitrogen (TN) and total phosphorus (TP)) in both the dried sludge and the condensate were also determined. It was found that MW treatment was successful to achieve a complete bacterial inactivation and a sludge weight/volume reduction above 60%. Besides, the dried sludge and condensate had high energy (≥16MJ/kg) and nutrient contents (solids; TN≥28mg/g TS and TP≥15mg/g TS; condensate TN≥49mg/L TS and TP≥0.2mg/L), having the potential to be used as biofuel, soil conditioner, fertilizer, etc. The MW reactor can be applied for the rapid treatment of sludge in areas such as slums and emergency settlements. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Breaking new ground in mapping human settlements from space - The Global Urban Footprint

NASA Astrophysics Data System (ADS)

Esch, Thomas; Heldens, Wieke; Hirner, Andreas; Keil, Manfred; Marconcini, Mattia; Roth, Achim; Zeidler, Julian; Dech, Stefan; Strano, Emanuele

2017-12-01

Today, approximately 7.2 billion people inhabit the Earth and by 2050 this number will have risen to around nine billion, of which about 70% will be living in cities. The population growth and the related global urbanization pose one of the major challenges to a sustainable future. Hence, it is essential to understand drivers, dynamics, and impacts of the human settlements development. A key component in this context is the availability of an up-to-date and spatially consistent map of the location and distribution of human settlements. It is here that the Global Urban Footprint (GUF) raster map can make a valuable contribution. The new global GUF binary settlement mask shows a so far unprecedented spatial resolution of 0.4″ (∼ 12m) that provides - for the first time - a complete picture of the entirety of urban and rural settlements. The GUF has been derived by means of a fully automated processing framework - the Urban Footprint Processor (UFP) - that was used to analyze a global coverage of more than 180,000 TanDEM-X and TerraSAR-X radar images with 3 m ground resolution collected in 2011-2012. The UFP consists of five main technical modules for data management, feature extraction, unsupervised classification, mosaicking and post-editing. Various quality assessment studies to determine the absolute GUF accuracy based on ground truth data on the one hand and the relative accuracies compared to established settlements maps on the other hand, clearly indicate the added value of the new global GUF layer, in particular with respect to the representation of rural settlement patterns. The Kappa coefficient of agreement compared to absolute ground truth data, for instance, shows GUF accuracies which are frequently twice as high as those of established low resolution maps. Generally, the GUF layer achieves an overall absolute accuracy of about 85%, with observed minima around 65% and maxima around 98%. The GUF will be provided open and free for any scientific use in the full resolution and for any non-profit (but also non-scientific) use in a generalized version of 2.8″ (∼ 84m). Therewith, the new GUF layer can be expected to break new ground with respect to the analysis of global urbanization and peri-urbanization patterns, population estimation, vulnerability assessment, or the modeling of diseases and phenomena of global change in general.

Marie Russo: An Oral History of the Italian Settlement House

ERIC Educational Resources Information Center

Beard, Kathryn H.

2010-01-01

The Settlement House Movement in the United States was a response by progressive reformers to meet the needs of urban poor and immigrant families in the early years of the 20th century. Some settlements were outreach services of churches. There are limited accounts of the experiences of the individuals who used the settlement houses. This study…

Urban lymphatic filariasis in the metropolis of Dar es Salaam, Tanzania

PubMed Central

2013-01-01

Background The last decades have seen a considerable increase in urbanization in Sub-Saharan Africa, and it is estimated that over 50% of the population will live in urban areas by 2040. Rapid growth of cities combined with limited economic resources often result in informal settlements and slums with favorable conditions for proliferation of vectors of lymphatic filariasis (LF). In Dar es Salaam, which has grown more than 30 times in population during the past 55 years (4.4 million inhabitants in 2012), previous surveys have indicated high prevalences of LF. This study investigated epidemiological aspects of LF in Dar es Salaam, as a background for planning and implementation of control. Methods Six sites with varying distance from the city center (3–30 km) and covering different population densities, socioeconomic characteristics, and water, sewerage and sanitary facilities were selected for the study. Pupils from one public primary school at each site were screened for circulating filarial antigen (CFA; marker of adult worm infection) and antibodies to Bm14 (marker of exposure to transmission). Community members were examined for CFA, microfilariae and chronic manifestations. Structured questionnaires were administered to pupils and heads of community households, and vector surveys were carried out in selected households. Results The study indicated that a tremendous decrease in the burden of LF infection had occurred, despite haphazard urbanisation. Contributing factors may be urban malaria control targeting Anopheles vectors, short survival time of the numerous Culex quinquefasciatus vectors in the urban environment, widespread use of bed nets and other mosquito proofing measures, and mass drug administration (MDA) in 2006 and 2007. Although the level of ongoing transmission was low, the burden of chronic LF disease was still high. Conclusions The development has so far been promising, but continued efforts are necessary to ensure elimination of LF as a public health problem. These will include improving the awareness of people about the role of mosquitoes in transmission of LF, more thorough implementation of environmental sanitation to reduce Cx. quinquefasciatus breeding, continued MDA to high-risk areas, and set-up of programmes for management of chronic LF disease. PMID:24289718

Impact of flooding on feeding practices of infants and young children in Dhaka, Bangladesh Slums: what are the coping strategies?

PubMed

Goudet, Sophie M; Griffiths, Paula L; Bogin, Barry A; Selim, Nasima

2011-04-01

Previous research has shown that urban slums are hostile environments for the growth of infants and young children (IYC). Flooding is a hazard commonly found in Dhaka slums (Bangladesh) which negatively impacts IYC's nutritional and health status. This paper aims 1) to identify the impact of flooding on IYC's feeding practices, and 2) to explore the coping strategies developed by caregivers. Qualitative data (participant observation and semi-structured interviews) and quantitative data (household questionnaire and anthropometric measurements) collected in slums in Dhaka (n=18 mothers, n=5 community health workers, and n=55 children) were analysed. The subjects of the interviews were mothers and Bangladesh Rural Advancement Committee (BRAC) community health workers living and working in the slums. Research findings showed that breastfeeding and complementary feeding practices for IYC were poor and inappropriate due to lack of knowledge, time, and resources in normal times and worse during flooding. One coping strategy developed by mothers purposely to protect their IYC's nutritional status was to decrease their personal food intake. Our research findings suggest that mothers perceived the negative impact of flooding on their IYC's nutritional health but did not have the means to prevent it. They could only maintain their health through coping strategies which had other negative consequences. The results suggests a holistic approach combining 1) provision of relief for nutritionally vulnerable groups during flooding, 2) support to mothers in their working role, 3) breastfeeding counseling and support to lactating mothers with difficulties, and 4) preventing malnutrition in under 2 year old children. © 2010 Blackwell Publishing Ltd.

If I do not have enough water, then how could I bring additional water for toilet cleaning?! Addressing water scarcity to promote hygienic use of shared toilets in Dhaka, Bangladesh.

PubMed

Saxton, Ronald E; Yeasmin, Farzana; Alam, Mahbub-Ul; Al-Masud, Abdullah; Dutta, Notan Chandra; Yeasmin, Dalia; Luby, Stephen P; Unicomb, Leanne; Winch, Peter J

2017-09-01

Provision of toilets is necessary but not sufficient to impact health as poor maintenance may impair toilet function and discourage their consistent use. Water in urban slums is both scarce and a prerequisite for toilet maintenance behaviours. We describe the development of behaviour change communications and selection of low-cost water storage hardware to facilitate adequate flushing among users of shared toilets. We conducted nine focus group discussions and six ranking exercises with adult users of shared toilets (50 females, 35 males), then designed and implemented three pilot interventions to facilitate regular flushing and improve hygienic conditions of shared toilets. We conducted follow-up assessments 1 and 2 months post-pilot including nine in-depth interviews and three focus group discussions with adult residents (23 females, 15 males) and three landlords in the pilot communities. Periodic water scarcity was common in the study communities. Residents felt embarrassed to carry water for flushing. Reserving water adjacent to the shared toilet enabled slum residents to flush regularly. Signs depicting rules for toilet use empowered residents and landlords to communicate these expectations for flushing to transient tenants. Residents in the pilot reported improvements in cleanliness and reduced odour inside toilet cubicles. Our pilot demonstrates the potential efficacy of low-cost water storage and behaviour change communications to improve maintenance of and user satisfaction with shared toilets in urban slum settings. © 2017 John Wiley & Sons Ltd.

Diverting the Radicalization Track

ERIC Educational Resources Information Center

Cohen, Jared A.

2009-01-01

The struggle against violent extremism is the most significant national-security challenge of the 21st century. It is the challenge that makes all the threats Americans face that much more dangerous. The ungoverned spaces, urban slums, and impoverished regions of the Middle East, Asia, and Africa, along with the poorly integrated immigrant…

Soil resources, land cover changes and rural areas: towards a spatial mismatch?

PubMed

Ferrara, Agostino; Salvati, Luca; Sabbi, Alberto; Colantoni, Andrea

2014-04-15

The present study analyzes the impact of long-term urban expansion on soil depletion in Emilia-Romagna, an agricultural-specialized region of northern Italy. Using settlement density maps at three points in time (1945, 1971 and 2001) dense and diffused urbanization trends were assessed and correlated with soil quality. Non-urbanized land decreased from 11.8% in 1945 to 6.3% in 2001. Urbanization dynamics between 1945 and 1971 reflect the increase of dense settlements around pre-existing urban centers. To the contrary, a discontinuous, low- and medium-density urban expansion along the road network and in the most fertile lowland areas was observed between 1971 and 2001. Overall, urbanization consumed soils with progressively higher quality. However, a diverging trend was observed in the two investigated time intervals: soil with high quality was occupied by compact and dense settlements during 1945-1971 and by discontinuous, medium- and low-density settlements during 1971-2001. These findings document the polarization in areas with low and high soil capital and may reflect disparities in agricultural production and increasing environmental degradation. Moreover, the analysis shows a diverging trend between land and soil consumption patterns suggesting that the edification of pervious land is an unreliable indicator of soil quality depletion. Taken together, the results of this study illustrate the (increasing) spatial mismatch between agricultural land and high-quality soils as a consequence of urbanization-driven landscape transformations and may inform measures to contain soil depletion driven by economic growth. Copyright © 2014 Elsevier B.V. All rights reserved.

Sustainability of population growth: a case study of urban settlements in Israel.

PubMed

Portnov, B A; Pearlmutter, D

1997-01-01

"One of the most sensitive criteria for gauging the degree of socio-economic prosperity of an urban settlement is the ability to sustain stable rates of population growth by attracting newcomers and retaining existing population. The present paper argues that after reaching a particular size (on the average, 20-30,000 residents), urban localities in Israel tend to experience substantial changes in components of their annual population growth. Starting with this inflection point, the growth of settlements gradually becomes less dependent on natural causes (birth and death rates) than on the ability to attract newcomers and retain current residents. On the basis of this conclusion, a strategy of ¿redirecting priorities' to developing the peripheral regions of the country is suggested." excerpt

A world of cities and the end of TB

PubMed Central

Prasad, Amit; Ross, Alex; Rosenberg, Paul; Dye, Christopher

2016-01-01

The WHO's End TB Strategy aims to reduce TB deaths by 95% and incidence by 90% between 2015 and 2035. As the world rapidly urbanizes, more people could have access to better infrastructure and services to help combat poverty and infectious diseases, including TB. And yet large numbers of people now live in overcrowded slums, with poor access to urban health services, amplifying the burden of TB. An alignment of the Sustainable Development Goals (SDGs) for health and for urban development provides an opportunity to accelerate the overall decline in infection and disease, and to create cities free of TB. PMID:26884491

Unmasking inequalities: Sub-national maternal and child mortality data from two urban slums in Lagos, Nigeria tells the story.

PubMed

Anastasi, Erin; Ekanem, Ekanem; Hill, Olivia; Adebayo Oluwakemi, Agnes; Abayomi, Oluwatosin; Bernasconi, Andrea

2017-01-01

Nigeria has one of the highest maternal mortality ratios in the world as well as high perinatal mortality. Unfortunately, the country does not have the resources to assess this critical indicator with the conventional health information system and measuring its progress toward the goal of ending preventable maternal deaths is almost impossible. Médecins Sans Frontières (MSF) conducted a cross-sectional study to assess maternal and perinatal mortality in Makoko Riverine and Badia East, two of the most vulnerable slums of Lagos. The study was a cross-sectional, community-based household survey. Nearly 4,000 households were surveyed. The sisterhood method was utilized to estimate maternal mortality and the preceding births technique was used to estimate newborn and child mortality. Questions regarding health seeking behavior were posed to female interviewees and self-reported data were collected. Data was collected from 3963 respondents for a total of 7018 sisters ever married. The maternal mortality ratio was calculated at 1,050/100,000 live births (95% CI: 894-1215), and the lifetime risk of maternal death at 1:18. The neonatal mortality rate was extracted from 1967 pregnancies reported and was estimated at 28.4/1,000; infant mortality at 43.8/1,000 and under-five mortality at 103/1,000. Living in Badia, giving birth at home and belonging to the Egun ethnic group were associated with higher perinatal mortality. Half of the last pregnancies were reportedly delivered in private health facilities. Proximity to home was the main influencing factor (32.4%) associated with delivery at the health facility. The maternal mortality ratio found in these urban slum populations within Lagos is extremely high, compared to the figure estimated for Lagos State of 545 per 100,000 live births. Urgent attention is required to address these neglected and vulnerable neighborhoods. Efforts should be invested in obtaining data from poor, marginalized, and hard-to-reach populations in order to identify pockets of marginalization needing additional resources and tailored approaches to guarantee equitable treatment and timely access to quality health services for vulnerable groups. This study demonstrates the importance of sub-regional, disaggregated data to identify and redress inequities that exist among poor, remote, vulnerable populations-as in the urban slums of Lagos.

Unmasking inequalities: Sub-national maternal and child mortality data from two urban slums in Lagos, Nigeria tells the story

PubMed Central

Adebayo Oluwakemi, Agnes; Abayomi, Oluwatosin

2017-01-01

Introduction Nigeria has one of the highest maternal mortality ratios in the world as well as high perinatal mortality. Unfortunately, the country does not have the resources to assess this critical indicator with the conventional health information system and measuring its progress toward the goal of ending preventable maternal deaths is almost impossible. Médecins Sans Frontières (MSF) conducted a cross-sectional study to assess maternal and perinatal mortality in Makoko Riverine and Badia East, two of the most vulnerable slums of Lagos. Materials and methods The study was a cross-sectional, community-based household survey. Nearly 4,000 households were surveyed. The sisterhood method was utilized to estimate maternal mortality and the preceding births technique was used to estimate newborn and child mortality. Questions regarding health seeking behavior were posed to female interviewees and self-reported data were collected. Results Data was collected from 3963 respondents for a total of 7018 sisters ever married. The maternal mortality ratio was calculated at 1,050/100,000 live births (95% CI: 894–1215), and the lifetime risk of maternal death at 1:18. The neonatal mortality rate was extracted from 1967 pregnancies reported and was estimated at 28.4/1,000; infant mortality at 43.8/1,000 and under-five mortality at 103/1,000. Living in Badia, giving birth at home and belonging to the Egun ethnic group were associated with higher perinatal mortality. Half of the last pregnancies were reportedly delivered in private health facilities. Proximity to home was the main influencing factor (32.4%) associated with delivery at the health facility. Discussion The maternal mortality ratio found in these urban slum populations within Lagos is extremely high, compared to the figure estimated for Lagos State of 545 per 100,000 live births. Urgent attention is required to address these neglected and vulnerable neighborhoods. Efforts should be invested in obtaining data from poor, marginalized, and hard-to-reach populations in order to identify pockets of marginalization needing additional resources and tailored approaches to guarantee equitable treatment and timely access to quality health services for vulnerable groups. This study demonstrates the importance of sub-regional, disaggregated data to identify and redress inequities that exist among poor, remote, vulnerable populations—as in the urban slums of Lagos. PMID:28489890

Retention of female volunteer community health workers in Dhaka urban slums: a prospective cohort study.

PubMed

Alam, Khurshid; Oliveras, Elizabeth

2014-05-20

Volunteer community health workers (CHWs) are a key approach to improving community-based maternal and child health services in developing countries. BRAC, a large Bangladeshi non-governmental organization (NGO), has employed female volunteer CHWs in its community-based health programs since 1977, recently including its Manoshi project, a community-based maternal and child health intervention in the urban slums of Bangladesh. A case-control study conducted in response to high dropout rates in the first year of the project showed that financial incentives, social prestige, community approval and household responsibilities were related to early retention in the project. In our present prospective cohort study, we aimed to better understand the factors associated with retention of volunteer CHWs once the project was more mature. We used a prospective cohort study design to examine the factors affecting retention of volunteer CHWs who remained in the project after the initial start-up period. We surveyed a random sample of 542 CHWs who were working for BRAC Manoshi in December 2008. In December 2009, we revisited this cohort of CHWs and interviewed those who had dropped out about the main reasons for their dropping out. We used a multivariable generalized linear model regression analysis with a log link to estimate the relative risk (RR) of independent factors on retention. Of the 542 CHWs originally enrolled, 120 had dropped out by the end of one year, mainly because they left the slums. CHWs who received positive community appraisal (adjusted RR = 1.45, 95% confidence interval (CI) = 1.10 to 1.91) or were associated with other NGOs (adjusted RR = 1.13, 95% CI = 1.04 to 1.23) were more likely to have been retained in the project. Although refresher training was also associated with increased retention (adjusted RR = 2.25, 95% CI = 1.08 to 4.71) in this study, too few CHWs had not attended refresher training regularly to make it a meaningful predictor of retention that could be applied in the project setting. Factors that affect retention of CHWs may change over time, with some factors that are important in the early years of a project losing importance as the project matures. Community health programs operating in fragile urban slums should consider changing factors over program duration for better retention of volunteer CHWs.

Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study.

PubMed

Nahar, Shamsun; Banu, Morsheda; Nasreen, Hashima E

2011-01-30

Recognizing the burden of maternal mortality in urban slums, in 2007 BRAC (formally known as Bangladesh Rural Advancement Committee) has established a woman-focused development intervention, Manoshi (the Bangla abbreviation of mother, neonate and child), in urban slums of Bangladesh. The intervention emphasizes strengthening the continuum of maternal, newborn and child care through community, delivery centre (DC) and timely referral of the obstetric complications to the emergency obstetric care (EmOC) facilities. This study aimed to assess whether Manoshi DCs reduces delays in accessing EmOC. This cross-sectional study was conducted during October 2008 to January 2009 in the slums of Dhaka city among 450 obstetric complicated cases referred either from DCs of Manoshi or from their home to the EmOC facilities. Trained female interviewers interviewed at their homestead with structured questionnaire. Pearson's chi-square test, t-test and Mann-Whitney test were performed. The median time for making the decision to seek care was significantly longer among women who were referred from home than referred from DCs (9.7 hours vs. 5.0 hours, p < 0.001). The median time to reach a facility and to receive treatment was found to be similar in both groups. Time taken to decide to seek care was significantly shorter in the case of life-threatening complications among those who were referred from DC than home (0.9 hours vs.2.3 hours, p = 0.002). Financial assistance from Manoshi significantly reduced the first delay in accessing EmOC services for life-threatening complications referred from DC (p = 0.006). Reasons for first delay include fear of medical intervention, inability to judge maternal condition, traditional beliefs and financial constraints. Role of gender was found to be an important issue in decision making. First delay was significantly higher among elderly women, multiparity, non life-threatening complications and who were not involved in income-generating activities. Manoshi program reduces the first delay for life-threatening conditions but not non-life-threatening complications even though providing financial assistance. Programme should give more emphasis on raising awareness through couple/family-based education about maternal complications and dispel fear of clinical care to accelerate seeking EmOC.

Patterns of illness disclosure among Indian slum dwellers: a qualitative study.

PubMed

Das, Moumita; Angeli, Federica; Krumeich, Anja J S M; van Schayck, Onno C P

2018-01-16

Slum dwellers display specific traits when it comes to disclosing their illnesses to professionals. The resulting actions lead to poor health-seeking behaviour and underutilisation of existing formal health facilities. The ways that slum people use to communicate their feelings about illness, the type of confidants that they choose, and the supportive and unsupportive social and cultural interactions to which they are exposed have not yet been studied in the Indian context, which constitutes an important knowledge gap for Indian policymakers and practitioners alike. To that end, this study examines the patterns of illness disclosure in Indian slums and the underpinning factors which shape the slum dwellers' disclosing attitude. In-depth, semi-structured interviews were conducted among 105 men and 113 women who experienced illness in the year prior to the study period. Respondents were selected from four urban slums in two Indian cities, Bangalore and Kolkata. Findings indicate that women have more confidants at different social levels, while men have a limited network of disclosures which is culturally and socially mediated. Gender role limitations, exclusion from peer groups and unsupportive local situations are the major cause of disclosure delay or non-disclosure among men, while the main concerns for women are a lack of proper knowledge about illness, unsupportive responses received from other people on certain occasions, the fear of social stigma, material loss and the burden of the local situation. Prompt sharing of illness among men is linked with prevention intention and coping with biological problems, whereas factors determining disclosure for women relate to ensuring emotional and instrumental safety, preventing collateral damage of illness, and preventing and managing biological complications. The findings reveal that patterns of disclosure are not determined by the acknowledgment of illness but largely depend on the interplay between individual agency, disclosure consequences and the socio cultural environment. The results of this study can contribute significantly to mitigating the pivotal knowledge gap between health policymakers, practitioners and patients, leading to the formulation of policies that maximise the utilisation of health facilities in slums.

Dietary diversity of formal and informal residents in Johannesburg, South Africa

PubMed Central

2013-01-01

Background This paper considers the question of dietary diversity as a proxy for nutrition insecurity in communities living in the inner city and the urban informal periphery in Johannesburg. It argues that the issue of nutrition insecurity demands urgent and immediate attention by policy makers. Methods A cross-sectional survey was undertaken for households from urban informal (n = 195) and urban formal (n = 292) areas in Johannesburg, South Africa. Foods consumed by the respondents the previous day were used to calculate a Dietary Diversity Score; a score < 4 was considered low. Results Statistical comparisons of means between groups revealed that respondents from informal settlements consumed mostly cereals and meat/poultry/fish, while respondents in formal settlements consumed a more varied diet. Significantly more respondents living in informal settlements consumed a diet of low diversity (68.1%) versus those in formal settlements (15.4%). When grouped in quintiles, two-thirds of respondents from informal settlements fell in the lowest two, versus 15.4% living in formal settlements. Households who experienced periods of food shortages during the previous 12 months had a lower mean DDS than those from food secure households (4.00 ± 1.6 versus 4.36 ± 1.7; p = 0.026). Conclusions Respondents in the informal settlements were more nutritionally vulnerable. Achieving nutrition security requires policies, strategies and plans to include specific nutrition considerations. PMID:24088249

Influence of parental factors on adolescents' transition to first sexual intercourse in Nairobi, Kenya: a longitudinal study.

PubMed

Okigbo, Chinelo C; Kabiru, Caroline W; Mumah, Joyce N; Mojola, Sanyu A; Beguy, Donatien

2015-08-21

Several studies have demonstrated a link between young people's sexual behavior and levels of parental monitoring, parent-child communication, and parental discipline in Western countries. However, little is known about this association in African settings, especially among young people living in high poverty settings such as urban slums. The objective of the study was to assess the influence of parental factors (monitoring, communication, and discipline) on the transition to first sexual intercourse among unmarried adolescents living in urban slums in Kenya. Longitudinal data collected from young people living in two slums in Nairobi, Kenya were used. The sample was restricted to unmarried adolescents aged 12-19 years at Wave 1 (weighted n = 1927). Parental factors at Wave 1 were used to predict adolescents' transition to first sexual intercourse by Wave 2. Relevant covariates including the adolescents' age, sex, residence, school enrollment, religiosity, delinquency, and peer models for risk behavior were controlled for. Multivariate logistic regression models were used to assess the associations of interest. All analyses were conducted using Stata version 13. Approximately 6% of our sample transitioned to first sexual intercourse within the one-year study period; there was no sex difference in the transition rate. In the multivariate analyses, male adolescents who reported communication with their mothers were less likely to transition to first sexual intercourse compared to those who did not (p < 0.05). This association persisted even after controlling for relevant covariates (OR: ≤0.33; p < 0.05). However, parental monitoring, discipline, and communication with their fathers did not predict transition to first sexual intercourse for male adolescents. For female adolescents, parental monitoring, discipline, and communication with fathers predicted transition to first sexual intercourse; however, only communication with fathers remained statistically significant after controlling for relevant covariates (OR: 0.30; 95% C.I.: 0.13-0.68). This study provides evidence that cross-gender communication with parents is associated with a delay in the onset of sexual intercourse among slum-dwelling adolescents. Targeted adolescent sexual and reproductive health programmatic interventions that include parents may have significant impacts on delaying sexual debut, and possibly reducing sexual risk behaviors, among young people in high-risk settings such as slums.

[Migration, climate and health].

PubMed

Tellier, Siri; Carballo, Manuel; Calballo, Manuel

2009-10-26

Many tentative connections have been postulated between migration and climate. This article points to rural-urban migration, particularly into low elevation urban slums prone to flooding as an issue needing urgent attention by health professionals. It also notes the no-man's land in which environmental refugees find themselves and the consequences this may have. Finally, it points to the urgent need to reform health systems in both developing and developed countries to adapt to rapidly changing disease patterns and to become more responsive to them.

Low-smoke chulha in Indian slums: study protocol for a randomised controlled trial.

PubMed

Thakur, Megha; Boudewijns, Esther A; Babu, Giridhara R; Winkens, Bjorn; de Witte, Luc P; Gruiskens, Jeroen; Sushama, Preeti; Ghergu, Cristian T; van Schayck, Onno C P

2017-05-16

Biomass fuel is used as a primary cooking source by more than half of the world's population, contributing to a high burden of disease. Although cleaner fuels are available, some households continue using solid fuels because of financial constraints and absence of infrastructure, especially in non-notified slums. The present study documents a randomised controlled study investigating the efficacy of improved cookstove on the personal exposure to air pollution and the respiratory health of women and children in an Indian slum. The improved cookstove was based on co-creation of a low-smoke chulha with local communities in order to support adaption and sustained uptake. The study will be conducted in a non-notified slum called Ashrayanagar in Bangalore, India. The study design will be a 1:1 randomised controlled intervention trial, including 250 households. The intervention group will receive an improved cookstove (low-smoke chulha) and the control group will continue using either the traditional cookstove (chulha) or a combination of the traditional stove and the kerosene/diesel stove. Follow-up time is 1 year. Outcomes include change in lung function (FEV 1/ FVC), incidence of pneumonia, change in personal PM 2.5 and CO exposure, incidence of respiratory symptoms (cough, phlegm, wheeze and shortness of breath), prevalence of other related symptoms (headache and burning eyes), change in behaviour and adoption of the stove. Ethical clearance was obtained from the Institutional Ethics Committee of the Indian Institute of Public Health Hyderabad- Bengaluru Campus. The findings from this study aim to provide insight into the effects of improved cookstoves in urban slums. Results can give evidence for the decrease of indoor air pollution and the improvement of respiratory health for children and women. The trial was registered with clinicaltrials.gov on 21 June 2016 with the identifier NCT02821650 ; A Study to Test the Impact of an Improved Chulha on the Respiratory Health of Women and Children in Indian Slums.

A worldwide model for boundaries of urban settlements.

PubMed

Oliveira, Erneson A; Furtado, Vasco; Andrade, José S; Makse, Hernán A

2018-05-01

The shape of urban settlements plays a fundamental role in their sustainable planning. Properly defining the boundaries of cities is challenging and remains an open problem in the science of cities. Here, we propose a worldwide model to define urban settlements beyond their administrative boundaries through a bottom-up approach that takes into account geographical biases intrinsically associated with most societies around the world, and reflected in their different regional growing dynamics. The generality of the model allows one to study the scaling laws of cities at all geographical levels: countries, continents and the entire world. Our definition of cities is robust and holds to one of the most famous results in social sciences: Zipf's law. According to our results, the largest cities in the world are not in line with what was recently reported by the United Nations. For example, we find that the largest city in the world is an agglomeration of several small settlements close to each other, connecting three large settlements: Alexandria, Cairo and Luxor. Our definition of cities opens the doors to the study of the economy of cities in a systematic way independently of arbitrary definitions that employ administrative boundaries.

Acceptability of the rainwater harvesting system to the slum dwellers of Dhaka City.

PubMed

Islam, M M; Chou, F N-F; Kabir, M R

2010-01-01

Urban area like Dhaka City, in Bangladesh, has scarcity of safe drinking water which is one of the prominent basic needs for human kind. This study explored the acceptability of harvested rainwater in a densely populated city like Dhaka, using a simple and low cost technology. A total of 200 random people from four slums of water-scarce Dhaka City were surveyed to determine the dwellers' perception on rainwater and its acceptability as a source of drinking water. The questionnaire was aimed at finding the socio-economic condition and the information on family housing, sanitation, health, existing water supply condition, knowledge about rainwater, willingness to accept rainwater as a drinking source etc. A Yield before Spillage (YBS) model was developed to know the actual rainwater availability and storage conditions which were used to justify the effective tank size. Cost-benefit analysis and feasibility analysis were performed using the survey results and the research findings. The survey result and overall study found that the low cost rainwater harvesting technique was acceptable to the slum dwellers as only the potential alternative source of safe drinking water.

Soil-Transmitted Helminths in Pre-School-Aged and School-Aged Children in an Urban Slum: A Cross-Sectional Study of Prevalence, Distribution, and Associated Exposures

PubMed Central

Davis, Stephanie M.; Worrell, Caitlin M.; Wiegand, Ryan E.; Odero, Kennedy O.; Suchdev, Parminder S.; Ruth, Laird J.; Lopez, Gerard; Cosmas, Leonard; Neatherlin, John; Njenga, Sammy M.; Montgomery, Joel M.; Fox, LeAnne M.

2014-01-01

Soil-transmitted helminths (STHs) are controlled by regular mass drug administration. Current practice targets school-age children (SAC) preferentially over pre-school age children (PSAC) and treats large areas as having uniform prevalence. We assessed infection prevalence in SAC and PSAC and spatial infection heterogeneity, using a cross-sectional study in two slum villages in Kibera, Nairobi. Nairobi has low reported STH prevalence. The SAC and PSAC were randomly selected from the International Emerging Infections Program's surveillance platform. Data included residence location and three stools tested by Kato-Katz for STHs. Prevalences among 692 analyzable children were any STH: PSAC 40.5%, SAC 40.7%; Ascaris: PSAC 24.1%, SAC 22.7%; Trichuris: PSAC 24.0%, SAC 28.8%; hookworm < 0.1%. The STH infection prevalence ranged from 22% to 71% between sub-village sectors. The PSAC have similar STH prevalences to SAC and should receive deworming. Small areas can contain heterogeneous prevalences; determinants of STH infection should be characterized and slums should be assessed separately in STH mapping. PMID:25157123

Prevalence and predictors of hypertension among residents aged 20-59 years of a slum-resettlement colony in Delhi, India.

PubMed

Panesar, Sanjeet; Chaturvedi, Sanjay; Saini, N K; Avasthi, Rajnish; Singh, Abhishek

2013-01-01

Slum-resettlement communities are increasingly adopting urban lifestyles. The aim of this study was to assess the prevalence and identify correlates of hypertension among residents aged 20-59 years of a slum-resettlement colony. A community-based cross-sectional study was done from 2010 to 2012 in NandNagri, a slum-resettlement area in east Delhi. 310 participants aged 20-59 years were enrolled through multistage systematic random sampling. Each study subject was interviewed and examined for raised blood pressure; data on risk factors including smoking, alcohol intake, physical activity and salt consumption were also collected. Data were analysed by use of univariate and multivariate regression. The overall prevalence of hypertension was 17.4% and 35% participants were prehypertensive. On multiple logistic regression, age 40-49 years (P = 0.020) and 50-59 years (P = 0.012), clerical/professional occupation (P = 0.004), abnormal waist circumference (≥90 cm in males and ≥ 80 cm in females; P = 0.001), positive family history of hypertension in both parents (P = 0.013) and above-average daily salt intake (P = 0.000) were significantly associated with hypertension. These findings indicate that hypertension is a significant health problem in the study population. Many study participants diagnosed with prehypertension are at risk of developing hypertension, thus immediate public-health interventions are indicated.

Serological Evidence of Hantavirus Infection in Apparently Healthy People from Rural and Slum Communities in Southern Chile

PubMed Central

Muñoz-Zanzi, Claudia; Saavedra, Farides; Otth, Carola; Domancich, Ljubica; Hott, Melissa; Padula, Paula

2015-01-01

Hantavirus disease in America has been recognizable because of its rapid progression in clinical cases, occurrence in previously healthy young adults, and high case fatality rate. Hantavirus disease has been proposed now to define the diversity of clinical manifestations. Since 1995, a total of 902 cases of hantavirus pulmonary syndrome have been reported in Chile, caused by Andes virus (ANDV), with overall fatality of 32%. This report describes the sero-epidemiology of hantavirus in apparently healthy people in rural and urban slum communities from southern Chile. Ten of 934 samples yielded a positive result resulting in a seroprevalence of 1.07% (95% confidence intervals: 0.05%–2.0%). A higher proportion of positive samples was found among individuals from rural villages (1.3%) and slums (1.5%) compared with farms (0.5%). Seropositivity was associated with age (p = 0.011), low education level (p = 0.006) and occupations linked to the household (homemaker, retired, or student) (p = 0.016). No evidence of infection was found in 38 sigmodontinae rodents trapped in the peri-domestic environment. Our findings highlight that exposure risk was associated with less documented risk factors, such as women in slum and rural villages, and the occurrence of infection that may have presented as flu-like illness that did not require medical attention or was misdiagnosed. PMID:25912713

Factors influencing the decision to drop out of health insurance enrolment among urban slum dwellers in Ghana.

PubMed

Atinga, Roger A; Abiiro, Gilbert Abotisem; Kuganab-Lem, Robert Bella

2015-03-01

To identify the factors influencing dropout from Ghana's health insurance scheme among populations living in slum communities. Cross-sectional data were collected from residents of 22 slums in the Accra Metropolitan Assembly. Cluster and systematic random sampling techniques were used to select and interview 600 individuals who had dropped out from the scheme 6 months prior to the study. Descriptive statistics and multivariate logistic regression models were computed to account for sample characteristics and reasons associated with the decision to dropout. The proportion of dropouts in the sample increased from the range of 6.8% in 2008 to 34.8% in 2012. Non-affordability of premium was the predominant reason followed by rare illness episodes, limited benefits of the scheme and poor service quality. Low-income earners and those with low education were significantly more likely to report premium non-affordability. Rare illness was a common reason among younger respondents, informal sector workers and respondents with higher education. All subgroups of age, education, occupation and income reported nominal benefits of the scheme as a reason for dropout. Interventions targeted at removing bottlenecks to health insurance enrolment are salient to maximising the size of the insurance pool. Strengthening service quality and extending the premium exemption to cover low-income families in slum communities is a valuable strategy to achieve universal health coverage. © 2014 John Wiley & Sons Ltd.

An analysis of factors contributing to household water security problems and threats in different settlement categories of Ngamiland, Botswana

NASA Astrophysics Data System (ADS)

Kujinga, Krasposy; Vanderpost, Cornelis; Mmopelwa, Gagoitseope; Wolski, Piotr

Globally, water security is negatively affected by factors that include climatic and hydrological conditions, population growth, rural-urban migration, increased per-capita water use, pollution and over-abstraction of groundwater. While Botswana has made strides in providing safe and clean water to its population since independence in 1966, over the years, a combination of factors have contributed to water security problems in different settlement categories of the country (i.e., primary, secondary, tertiary and ungazetted settlements) in general and in the district of Ngamiland in particular. To study water security problems differentiated by settlement category, this study employed quantitative data collection methods (i.e. household structured questionnaires) and qualitative data collection methods (i.e. key informant interviews, observation, focus group discussions and informal interviews), complemented by a review of relevant literature. Water security in all settlements is affected by status of the settlement, i.e. gazetted or ungazetted, climatic and hydrological factors and water governance challenges. In large villages such as Maun, factors threatening water security include population growth, urbanization, management challenges, old water supply and distribution infrastructure, increased demand for individual connections and changing lifestyles. Small gazetted and ungazetted settlements encounter problems related to limited sources of water supply as well as salinity of groundwater resources. In order to enhance water security in different settlement categories, Botswana has to develop a comprehensive water resources management strategy underpinned by integrated water resources management principles aimed at addressing factors contributing to water security problems. The strategy has to be settlement category specific. Large villages have to address factors related to demographic changes, urbanization, management challenges, water supply infrastructure and the introducing of water demand management activities. Households in small villages need provision of water from more sustainable sources while ungazetted settlements need better access to clean water.

Migration, settlement change and health in post-apartheid South Africa: triangulating health and demographic surveillance with national census data.

PubMed

Collinson, Mark A; Tollman, Stephen M; Kahn, Kathleen

2007-08-01

World population growth will be increasingly concentrated in the urban areas of the developing world; however, some scholars caution against the oversimplification of African urbanization noting that there may be "counter-urbanization" and a prevailing pattern of circular rural-urban migration. The aim of the paper is to examine the ongoing urban transition in South Africa in the post-apartheid period, and to consider the health and social policy implications of prevailing migration patterns. Two data sets were analysed, namely the South African national census of 2001 and the Agincourt health and demographic surveillance system. A settlement-type transition matrix was constructed on the national data to show how patterns of settlement have changed in a five-year period. Using the sub-district data, permanent and temporary migration was characterized, providing migration rates by age and sex, and showing the distribution of origins and destinations. The comparison of national and sub-district data highlight the following features: urban population growth, particularly in metropolitan areas, resulting from permanent and temporary migration; prevailing patterns of temporary, circular migration, and a changing gender balance in this form of migration; stepwise urbanization; and return migration from urban to rural areas. Policy concerns include: rural poverty exacerbated by labour migration; explosive conditions for the transmission of HIV; labour migrants returning to die in rural areas; and the challenges for health information created by chronically ill migrants returning to rural areas to convalesce. Lastly, suggestions are made on how to address the dearth of relevant population information for policy-making in the fields of migration, settlement change and health.

WHO WINS THE GAME, SUCCESSFUL PROGRAMS FOR THE DISADVANTAGED.

ERIC Educational Resources Information Center

HAUBRICH, VERNON F.

THE BACKGROUND OF THE FAILURE OF RURAL AND URBAN SLUM SCHOOLS TO PROVIDE SUCCESSFUL PROGRAMS FOR DISADVANTAGED YOUTH IS REVIEWED. A DISCUSSION OF THE SOCIAL-PSYCHOLOGICAL CONDITIONS FOR SUCCESSFUL EFFORTS SHOWS THE IMPORTANCE OF THE INVOLVEMENT OF THE TEACHER, THE PARENT, AND THE COMMUNITY IN THESE PROGRAMS. IT IS FELT THAT ACTIVE TEACHER…

Unveiling the Mirror: Afro-Brazilian Identity and the Emergence of the Community School Movement.

ERIC Educational Resources Information Center

Jones de Almeida, Adjoa Florencia

2003-01-01

Afro-Brazilian residents of urban favelas (outlying, unincorporated slums) have established community schools in response to lack of public schools. A study of three such community schools in Salvador, Bahia, focused on social justice issues, school efforts to rescue a Black identity denied by Brazil's official "racial democracy"…

Mobile Creches: Pioneering Early Childhood Care and Development in India

ERIC Educational Resources Information Center

Young Children, 2007

2007-01-01

Mobile Creche ("creche" means "day nursery") was founded on one woman's determination to change life for India's most vulnerable children. Within its first decade, Mobile Creches' network of child care centers spread from construction sites to urban slums and from the capital city of Delhi to the commercial and cultural centers…

Race and the Third World City. An International Urbanization Survey Report to the Ford Foundation.

ERIC Educational Resources Information Center

Tinker, Hugh

This survey paper attempts to demonstrate that there is a functional interaction between race and the city. Given the basic features of slums, squatter colonies, rapid immigration, patchy industrialization and chronic unemployment, together with political instability (induced both internally and externally), the author attempts to show that race…

Quality of diabetic care in an urban slum area of Mysore: A community based study.

PubMed

Madhu, B; Srinath, K M; Chandresh, Swathi; Ashok, N C; Basavanagowdappa, H; Rama, H V

2016-01-01

Community based cross sectional study was conducted in an urban slum of Mysore. Data was collected between July and August 2011. Known diabetics residing in this area were included in the study. Socio-demographic information of diabetic patients, history, physicians advice and the extent of compliance of patients towards treatment were assessed. Descriptive statistics, like percentages were calculated. Study comprised of 104 patients. Mean fasting and post prandial blood glucose was 163±70mg/dl and 239±89mg/dl respectively. Common co-morbid conditions were hypertension and obesity. Key process indicators of care, indicated that adherence to medication advice was maximum and less than one fourth of them had an annual Hba1c and lipid profile examinations. To prevent long term complications associated with diabetes, doctors must adhere to the guidelines. There is a need to improve the health system, in terms of developing facilities to provide annual eye examination, annual lipid profile, urea, creatinine testing for diabetic patient. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Nutritional status of pavement dweller children of Calcutta City.

PubMed

Ray, S K; Mishra, R; Biswas, R; Kumar, S; Halder, A; Chatterjee, T

1999-01-01

Pavement dwelling is likely to aggravate malnutrition among its residents due to extreme poverty, lack of dwelling and access to food and their exposure to polluted environment. Paucity of information about nutritional status of street children compared to that among urban slum dwellers, squatters or rural/tribal population is quite evident. The present study revealed the magnitude of Protein Energy Malnutrition (PEM) and few associated factors among a sample of 435 underfives belonging to pavement dweller families and selected randomly from clusters of such families, from each of the five geographical sectors of Calcutta city. Overall prevalence of PEM was found almost similar (about 70%) to that among other 'urban poor' children viz. slum dwellers etc., but about 16% of them were found severely undernourished (Grade III & V of IAP classification of PEM). About 35% and 70% of street dweller children had wasting and stunting respectively. Severe PEM (Grade III & IV) was more prevalent among 12-23 months old, girl child, those belonged to illiterate parents and housewife mothers rather than wage earners. It also did increase with increase of birth rate of decrease of birth interval.

Settlement Dynamics and Hierarchy from Agent Decision-Making: a Method Derived from Entropy Maximization.

PubMed

Altaweel, Mark

2015-01-01

This paper presents an agent-based complex system simulation of settlement structure change using methods derived from entropy maximization modeling. The approach is applied to model the movement of people and goods in urban settings to study how settlement size hierarchy develops. While entropy maximization is well known for assessing settlement structure change over different spatiotemporal settings, approaches have rarely attempted to develop and apply this methodology to understand how individual and household decisions may affect settlement size distributions. A new method developed in this paper allows individual decision-makers to chose where to settle based on social-environmental factors, evaluate settlements based on geography and relative benefits, while retaining concepts derived from entropy maximization with settlement size affected by movement ability and site attractiveness feedbacks. To demonstrate the applicability of the theoretical and methodological approach, case study settlement patterns from the Middle Bronze (MBA) and Iron Ages (IA) in the Iraqi North Jazirah Survey (NJS) are used. Results indicate clear differences in settlement factors and household choices in simulations that lead to settlement size hierarchies comparable to the two evaluated periods. Conflict and socio-political cohesion, both their presence and absence, are suggested to have major roles in affecting the observed settlement hierarchy. More broadly, the model is made applicable for different empirically based settings, while being generalized to incorporate data uncertainty, making the model useful for understanding urbanism from top-down and bottom-up perspectives.

Gender in metropolitan development strategies: the case of Durban.

PubMed

Todes, A

1995-10-01

The author describes her experiences with the Durban Development Forum (DDF) and the strategies used in the Durban Functional Region (DFR) of South Africa. Policies are generally concerned with low income people, spatial distribution, and the organization of development and only partially concerned with gender issues. This paper discusses general urban development strategies in South Africa, gives an overview of the position of women in the DFR, and the strategies of the DDF. Prior to 1994 urban development plans focused on righting the inequalities and inefficiencies of apartheid cities, promotion of local economic development, and development implementation that was highly political and excluded major inputs from Black people. The DDF was formed in 1993 and aimed to be inclusive of all population groups in development planning. A set of principles were developed to guide development based on consensus decision making. Women's groups were included from the beginning, but little research was and is available on specific conditions and needs of different groups of women. Durban experienced since the 1980s a rise in the number of women in the labor force, a rise in female migrants to the DFR, and movement into "more insecure, poorly serviced newer settlements." Under apartheid, low income housing for Blacks was situated on peripheral areas or more distant locations that were away from employment in commerce and service industries in the central city. Women in urban slums survived with few sanitation amenities and limited access to an adequate water supply or electricity. Most development policy in the DFR ignored gender differences and gender power relations and focused on improving land, housing, and amenities for the poor in the central city. Although the general approach to improve infrastructure and facilities and to remove obstacles to development may have benefits for low income women, there are in fact mixed benefits for women.

The Burden of Common Infectious Disease Syndromes at the Clinic and Household Level from Population-Based Surveillance in Rural and Urban Kenya

PubMed Central

Feikin, Daniel R.; Olack, Beatrice; Bigogo, Godfrey M.; Audi, Allan; Cosmas, Leonard; Aura, Barrack; Burke, Heather; Njenga, M. Kariuki; Williamson, John; Breiman, Robert F.

2011-01-01

Background Characterizing infectious disease burden in Africa is important for prioritizing and targeting limited resources for curative and preventive services and monitoring the impact of interventions. Methods From June 1, 2006 to May 31, 2008, we estimated rates of acute lower respiratory tract illness (ALRI), diarrhea and acute febrile illness (AFI) among >50,000 persons participating in population-based surveillance in impoverished, rural western Kenya (Asembo) and an informal settlement in Nairobi, Kenya (Kibera). Field workers visited households every two weeks, collecting recent illness information and performing limited exams. Participants could access free high-quality care in a designated referral clinic in each site. Incidence and longitudinal prevalence were calculated and compared using Poisson regression. Results Incidence rates resulting in clinic visitation were the following: ALRI — 0.36 and 0.51 episodes per year for children <5 years and 0.067 and 0.026 for persons ≥5 years in Asembo and Kibera, respectively; diarrhea — 0.40 and 0.71 episodes per year for children <5 years and 0.09 and 0.062 for persons ≥5 years in Asembo and Kibera, respectively; AFI — 0.17 and 0.09 episodes per year for children <5 years and 0.03 and 0.015 for persons ≥5 years in Asembo and Kibera, respectively. Annually, based on household visits, children <5 years in Asembo and Kibera had 60 and 27 cough days, 10 and 8 diarrhea days, and 37 and 11 fever days, respectively. Household-based rates were higher than clinic rates for diarrhea and AFI, this difference being several-fold greater in the rural than urban site. Conclusions Individuals in poor Kenyan communities still suffer from a high burden of infectious diseases, which likely hampers their development. Urban slum and rural disease incidence and clinic utilization are sufficiently disparate in Africa to warrant data from both settings for estimating burden and focusing interventions. PMID:21267459

The burden of common infectious disease syndromes at the clinic and household level from population-based surveillance in rural and urban Kenya.

PubMed

Feikin, Daniel R; Olack, Beatrice; Bigogo, Godfrey M; Audi, Allan; Cosmas, Leonard; Aura, Barrack; Burke, Heather; Njenga, M Kariuki; Williamson, John; Breiman, Robert F

2011-01-18

Characterizing infectious disease burden in Africa is important for prioritizing and targeting limited resources for curative and preventive services and monitoring the impact of interventions. From June 1, 2006 to May 31, 2008, we estimated rates of acute lower respiratory tract illness (ALRI), diarrhea and acute febrile illness (AFI) among >50,000 persons participating in population-based surveillance in impoverished, rural western Kenya (Asembo) and an informal settlement in Nairobi, Kenya (Kibera). Field workers visited households every two weeks, collecting recent illness information and performing limited exams. Participants could access free high-quality care in a designated referral clinic in each site. Incidence and longitudinal prevalence were calculated and compared using Poisson regression. INCIDENCE RATES RESULTING IN CLINIC VISITATION WERE THE FOLLOWING: ALRI--0.36 and 0.51 episodes per year for children <5 years and 0.067 and 0.026 for persons ≥ 5 years in Asembo and Kibera, respectively; diarrhea--0.40 and 0.71 episodes per year for children <5 years and 0.09 and 0.062 for persons ≥ 5 years in Asembo and Kibera, respectively; AFI--0.17 and 0.09 episodes per year for children <5 years and 0.03 and 0.015 for persons ≥ 5 years in Asembo and Kibera, respectively. Annually, based on household visits, children <5 years in Asembo and Kibera had 60 and 27 cough days, 10 and 8 diarrhea days, and 37 and 11 fever days, respectively. Household-based rates were higher than clinic rates for diarrhea and AFI, this difference being several-fold greater in the rural than urban site. Individuals in poor Kenyan communities still suffer from a high burden of infectious diseases, which likely hampers their development. Urban slum and rural disease incidence and clinic utilization are sufficiently disparate in Africa to warrant data from both settings for estimating burden and focusing interventions.

Natural hazards and climate change in Dhaka: future trends, social adaptation and informal dynamics

NASA Astrophysics Data System (ADS)

Thiele-Eich, I.; Aßheuer, T.; Simmer, C.; Braun, B.

2009-04-01

Similar to many megacities in the world, Dhaka is regularly threatened by natural hazards. Risks associated with floods and cyclones in particular are expected to increase in the years to come because of global climate change and rapid urbanization. Greater Dhaka is expected to grow from 13.5 million inhabitants in 2007 to 22 million inhabitants by 2025. The vast majority of this growth will take place in informal settlements. Due to the setting of Greater Dhaka in a deltaic plain, the sprawl of slums is primarily taking place in wetlands, swamps and other flood-prone areas. Slum dwellers and informal businesses are vulnerable, but have somehow learned to cope with seasonal floods and developed specific adaptation strategies. An increase of precipitation extremes and tropical cyclones, however, would put considerable stress on the adaptability of the social and economic system. DhakaHazard, a joint research project of the Department of Meteorology at the University of Bonn and the Department of Geography at the University of Cologne, takes up these issues in an interdisciplinary approach. The project, which begun in November 2008, aims to achieve two main objectives: To link analyses of informal social and economic adaptation strategies to models on future climate change and weather extremes. To estimate more accurately the future frequency and magnitude of weather extremes and floods which are crucial for the future adaptability of informal systems. To fulfill these objectives, scientists at the Meteorological Institute are studying the evolution of natural hazards in Bangladesh, while researchers at the Department of Geography are undertaking the task of assessing these hazards from a social point of view. More specifically, the meteorologists are identifying global and regional weather conditions resulting in flooding of the Greater Dhaka region, while possible variations in flood-inducing weather patterns are analyzed by evaluating their frequency and magnitude. Findings are then applied to future global climate scenario runs to obtain a first estimate of trends for the frequency and magnitude of weather extremes and their impact on spatial and temporal characteristics of floods in the Greater Dhaka region. From this estimate, a prediction method for the spatial patterns of flooding within the Dhaka area will be developed. The social part of the project analyzes the vulnerability and resilience of economic and social systems within high-risk areas by utilizing methods such as e.g. quantitative household surveys in Dhaka and qualitative expert interviews. Geographers are hoping to identify adaptation and recovery strategies of slum dwellers and informal businesses (e.g. brickfields, tanneries), analyze the role of social capital as well as formal and informal institutions for building up resilience, and analyze possibilities and limits of adaptation strategies under conditions of further urban growth and climate change. By paying attention to the important behavioral patterns of the informal sector, a meteorological early warning system can then be developed to make better use of weather predictions to mitigate weather-related risks for Greater Dhaka. If successful, this project poses as an exemplary intersection of social science and natural hazards research.

Multidimensional Measurement of Household Water Poverty in a Mumbai Slum: Looking Beyond Water Quality

PubMed Central

Subbaraman, Ramnath; Nolan, Laura; Sawant, Kiran; Shitole, Shrutika; Shitole, Tejal; Nanarkar, Mahesh; Patil-Deshmukh, Anita; Bloom, David E.

2015-01-01

Objective A focus on bacterial contamination has limited many studies of water service delivery in slums, with diarrheal illness being the presumed outcome of interest. We conducted a mixed methods study in a slum of 12,000 people in Mumbai, India to measure deficiencies in a broader array of water service delivery indicators and their adverse life impacts on the slum’s residents. Methods Six focus group discussions and 40 individual qualitative interviews were conducted using purposeful sampling. Quantitative data on water indicators—quantity, access, price, reliability, and equity—were collected via a structured survey of 521 households selected using population-based random sampling. Results In addition to negatively affecting health, the qualitative findings reveal that water service delivery failures have a constellation of other adverse life impacts—on household economy, employment, education, quality of life, social cohesion, and people’s sense of political inclusion. In a multivariate logistic regression analysis, price of water is the factor most strongly associated with use of inadequate water quantity (≤20 liters per capita per day). Water service delivery failures and their adverse impacts vary based on whether households fetch water or have informal water vendors deliver it to their homes. Conclusions Deficiencies in water service delivery are associated with many non-health-related adverse impacts on slum households. Failure to evaluate non-health outcomes may underestimate the deprivation resulting from inadequate water service delivery. Based on these findings, we outline a multidimensional definition of household “water poverty” that encourages policymakers and researchers to look beyond evaluation of water quality and health. Use of multidimensional water metrics by governments, slum communities, and researchers may help to ensure that water supplies are designed to advance a broad array of health, economic, and social outcomes for the urban poor. PMID:26196295

Access to health in city slum dwellers: The case of Sodom and Gomorrah in Accra, Ghana.

PubMed

Owusu-Ansah, Frances E; Tagbor, Harry; Togbe, Mabel Afi

2016-03-29

Rapid rural-urban migration of people to cities is a reality around the globe that has increased city slum dwellers. Sodom and Gomorrah is a city slum located in the heart of Accra, Ghana. Like other slums, it lacks basic amenities necessary for dwellers' quality of life. This study describes residents' access to health and factors associated with the use of healthcarefacilities. Questionnaires were administered in systematically selected shacks across the entire slum. Data on demographic characteristics, existent health facilities and number of users, health-insured residents and knowledge of common diseases were collected. Majority of the residents were from the northern parts of Ghana, relative to the south and a few of them come from other parts of West Africa. Seventy-one percent of residents had never visited a health facility in the last 5 years. When necessary, they access health care from drug stores (61.1%) or hospitals (33.1%). Residents' age, educational status, income, health knowledge and membership of National Health Insurance Scheme were significantly (p < 0.05) associated with the use of healthcare facilities. Younger residents and those without National Health Insurance Scheme membership, formal education, no knowledge of common illnesses and regular income were significantly less likely to use a healthcare facility. For most residents, neither distance (73.2%) nor transportation to health facilities was a problem (74.1%). Conditions of profound environmental hazards, overcrowding, poor-quality housing and lack of health care in Sodom and Gomorrah pose grave threats to the health of the inhabitants. Multisectoral interventions and resource mobilisation championed by the Ministry of Local Government and Rural Development are needed to alter the trend.

Cost and sustainability of a successful package of interventions to improve vaccination coverage for children in urban slums of Bangladesh.

PubMed

Hayford, K; Uddin, M J; Koehlmoos, T P; Bishai, D M

2014-04-25

To estimate the incremental economic costs and explore satisfaction with a highly effective intervention for improving immunization coverage among slum populations in Dhaka, Bangladesh. A package of interventions based on extended clinic hours, vaccinator training, active surveillance, and community participation was piloted in two slum areas of Dhaka, and resulted in an increase in valid fully immunized children (FIC) from 43% pre-intervention to 99% post-intervention. Cost data and stakeholder perspectives were collected January-February 2010 via document review and 10 key stakeholders interviews to estimate the financial and opportunity costs of the intervention, including uncompensated time, training and supervision costs. The total economic cost of the 1-year intervention was $18,300, comprised of external management and supervision (73%), training (11%), coordination costs (1%), uncompensated staff time and clinic costs (2%), and communications, supplies and other costs (13%). An estimated 874 additional children were correctly and fully immunized due to the intervention, at an average cost of $20.95 per valid FIC. Key stakeholders ranked extended clinic hours and vaccinator training as the most important components of the intervention. External supervision was viewed as the most important factor for the intervention's success but also the costliest. All stakeholders would like to reinstate the intervention because it was effective, but additional funding would be needed to make the intervention sustainable. Targeting slum populations with an intensive immunization intervention was highly effective but would nearly triple the amount spent on immunization per FIC in slum areas. Those committed to increasing vaccination coverage for hard-to-reach children need to be prepared for substantially higher costs to achieve results. Copyright © 2014. Published by Elsevier Ltd.

Projected Regional Climate in 2025 Due to Urban Growth

NASA Technical Reports Server (NTRS)

Shepherd, J. Marshall; Manyin, Michael; Messen, Dmitry

2005-01-01

By 2025, 60 to 80 percent of the world s population will live in urban environments. Additionally, the following facts published by the United Nations further illustrates how cities will evolve in the future. Urban areas in the developing world are growing very rapidly. The urban growth rate will continue to be particularly rapid in the urban areas of less developed regions, averaging 2.4 per cent per year during 2000-2030, consistent with a doubling time of 29 years. The urbanization process will continue worldwide. The concentration of population in cities is expected to continue so that, by 2030, 84 percent of the inhabitants of more developed countries will be urban dwellers. Urbanization impacts the whole hierarchy of human settlements. In 2000,24.8 per cent of the world population lived in urban settlements with fewer than 500,000 inhabitants and by 2015 that proportion will likely rise to 27.1 per cent.

An epidemiological study of emotional and behavioral disorders among children in an urban slum.

PubMed

Bele, Samir D; Bodhare, Trupti N; Valsangkar, Sameer; Saraf, Abhay

2013-01-01

Although mental health research in India has gained momentum in recent years and several epidemiological studies have begun to quantify psychiatric morbidities, there are few community-based epidemiological studies focusing specifically on prevalence and associated risk factors of emotional and behavioral disorders among children. A cross-sectional study was conducted in an urban slum of Karimnagar, Andhra Pradesh among 370 children selected by simple random sampling. Strength and difficulty questionnaire (SDQ) was used to estimate the prevalence of emotional and behavioral disorder. A semi-structured questionnaire was used to evaluate the social predictors of the condition, health-seeking behavior, and its impact on educational status of the children. Maternal depression was evaluated using patient health questionnaire (PHQ-9). Eighty-three (22.43%) children had an abnormal score on at least one domain of SDQ. Logistic regression analysis indicated that male gender (odds ration (OR) = 5.51), under-nutrition (OR = 2.74), low socioeconomic status (OR = 3.73), nuclear family (OR = 1.89), working status of the mother (OR = 2.71), younger age of the mother at the birth of the child (OR = 3.09), disciplinary method (OR = 2.31), financial problem at home (OR = 13.32), alcoholic father (OR = 11.65), conflicts in family (OR = 7.29), and depression among mother (OR = 3.95) were significant predictors. There was a significant impact on educational performance (p = 0.008) and parents had little awareness regarding the condition. The high frequency of emotional and behavioral problems, its impact on educational performance of the children, associated adverse social factors, poor knowledge, and treatment-seeking behavior of the parents in an urban slum warrants immediate attention. The interrelation of all these factors can be utilized to plan a continuum of comprehensive services that focus on prevention, early identification, and effective intervention strategies with community involvement.

Fecal total iron concentration is inversely associated with fecal Lactobacillus in preschool children.

PubMed

Kalipatnapu, Sasank; Kuppuswamy, Sivaraman; Venugopal, Giriprasad; Kaliaperumal, Venkatesh; Ramadass, Balamurugan

2017-08-01

Iron deficiency is associated with stunting and poor performance in children. Oral iron supplementation is widely promoted to correct iron deficiency. However, excess iron may be toxic to beneficial luminal gut bacteria and could support growth of pathobionts. The aim of this study is to analyze the fecal total iron concentration and fecal Lactobacillus levels in a cohort of stunted and normal children. The study was undertaken in two different locations. One of them is a rural area, and the other is a semi-urban-slum area; both areas are located in the Vellore district of Tamilnadu state. Twenty children (10 stunted and 10 normal growth) aged 2 to 5 years from each area were recruited. Both groups were nearly identical demographically. Fecal samples were collected. Fecal total iron was estimated, and fecal DNA was extracted and subjected to 16S rDNA-targeted real-time PCR to determine the relative predominance of Lactobacillus and Escherichia coli. The fecal total iron concentration in rural children (3656 μg/g wet wt. of feces) was significantly higher when compared with semi-urban-slum children (114.9 μg/g wet wt. of feces, P < 0.005). Inversely, fecal Lactobacillus in rural children (median 3.18 × 10 -3 relative difference compared with total bacteria) was significantly lower when compared with semi-urban-slum children (median 59.33 × 10 -3 , p < 0.005). There was no significant change observed between normal and stunted children. E. coli levels remained unaffected. The present study documents an inverse relationship between fecal iron concentration and fecal Lactobacillus concentration in children belonging to two different localities independent of their nutritional status. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Women's housing conditions in Bangladesh.

PubMed

Shefali, M K

1996-01-01

This news article describes women's housing conditions, housing policy, and pilot programs to house poor women in Bangladesh. Although Bangladesh has a constitution that reinforces the equal status of women, in practice, men dominate and patrilineal customs determine inheritance and property rights. Religious affiliation also determines land tenure and inheritance. Muslim women can inherit 12.5% of their husband's property if there are children. 25% is inherited if wives are without children. Hindu women without sons can inherit their husband's property, but not parental property. Many families refuse to release property to women without a fight. Women, regardless of ownership of land, rarely control or use their land. The custom of requiring men to maintain wives during the marriage, and daughters until marriage, creates obstacles to women's decision making about property. Without collateral and other security women are unable to secure bank loans. Many women are also constrained by the requirement of male consent or guarantees for bank transactions. Banks do not have a gender responsive criteria for selecting loan recipients. The government does not provide sufficient housing to satisfy the growing housing needs due to population growth. Some housing is available from slum landlords. A National Housing Policy was formulated in 1993. Priority would be given to the housing needs of low income women in urban areas and women-headed households with income below the poverty line. The policy does not address the underlying factors that prevent equal access to housing for women. The government prepared a Human Settlement and Urban Development proposal for the Habitat II conference. The plan did not address gender issues. Special efforts are being made by nongovernmental groups to meet the housing needs of professional women and for some disadvantaged women.

The potential use of natural resources in urban informal settlements as substitutes for financial capital during flooding emergencies

NASA Astrophysics Data System (ADS)

Dalu, Mwazvita T. B.; Shackleton, Charlie M.

2018-04-01

Rapid and widespread land cover change and the subsequent loss of the buffering capacity provided by healthy ecosystems against natural hazards has resulted in increased vulnerability to natural hazards. There is an insufficient understanding of the natural resources contribution to the resilience of poor urban communities living in informal settlements and the financial implications thereof. Thus, household strategies used to recover from the October 2012 flood shock were investigated within the informal settlements of three small South African towns using questionnaires. Within the vulnerability paradigm and the sustainable livelihood framework, the study also quantified and evaluated the relative contribution of natural resources to recovery strategies and the impacts on household financial capital. We found that natural resources contributed up to 70% to recovery of households from the flood shock, most of this being to reconstruct housing structures after the flood. Factors such as household head education level, household income, kinship level, the extent of property damage and the cost associated with property rehabilitation significantly influenced the uptake of natural resources in recovery from floods, and this was variable among settlements and towns. The main findings showed that natural resources reduced household vulnerability of urban informal settlements by providing an emergency-net function that substitutes financial capital. Their inclusion in disaster management plans and responses has the potential to contribute to the sustainable livelihoods of the urban poor in the Eastern Cape, South Africa.

A Study on Consciousness of Adolescent Girls About Their Body Image

PubMed Central

Dixit, Swati; Agarwal, GG; Singh, JV; Kant, Surya; Singh, Neelam

2011-01-01

Background: Perceived body image is an important potential predictor of nutritional status. Body image misconception during adolescence is unexplored field in Indian girls. Objectives: To study the consciousness of adolescent girls about their body image. Materials and Methods: This multistage observational study was conducted on 586 adolescent girls of age 10–19 years in Lucknow district (151 from rural, 150 from slum, and 286 from urban area) of Uttar Pradesh, India. Information on desired and actual body size was collected with the help of predesigned questionnaire. Results: 20.5% of studied girls show aspiration to become thin, who already perceived their body image as too thin. 73.4% adolescent girls were satisfied with their body image, while 26.6% were dissatisfied. The dissatisfaction was higher among girls of urban (30.2%) and slum (40.0%) areas in comparison to rural (22.5%) area. Percentage of satisfied girls was less in the 13–15 years (69.9%) age groups in comparison to 10–12 years (76.5%) and 16–19 years (76.4%). Among girls satisfied with their body image, 32.8% girls were found underweight, and 38.4% were stunted. Underweight girls (42.1%) and stunted girls (64.9%) were higher in number within satisfied girls of slum area. Among all of these adolescent girls, 32.8% of girls had overestimated their weight, while only 4.9% of girls had underestimated their weight. Conclusions: This study concludes that desire to become thin is higher in adolescent girls, even in those who already perceived their body image as too thin. PMID:22090673

Prevalence of pulmonary tuberculosis among adults in selected slums of Delhi city.

PubMed

Sarin, Rohit; Vohra, Vikram; Khalid, U K; Sharma, Prem Prakash; Chadha, Vineet; Sharada, M A

2018-04-01

A survey was carried out to estimate the point prevalence of bacteriologically positive pulmonary tuberculosis (PTB) among persons ≥15 years of age residing in Jhuggi-Jhopri (JJ) colonies - urban slums in Delhi, India implementing Directly Observed Treatment strategy since 1998. Among 12 JJ colonies selected by simple random sampling, persons having persistent cough for ≥2 weeks at the time of the survey or cough of any duration along with history of contact/currently on ant-TB treatment/known HIV positive were subjected to sputum examination - 2 specimens, by smear microscopy for Acid Fast Bacilli and culture for Mycobacterium tuberculosis. Persons with at least one specimen positive were labelled as bacteriologically confirmed PTB. Prevalence was estimated after imputing missing values to correct bias introduced by incompleteness of data and corrected for non-screening by X-ray by a multiplication factor derived from recently conducted surveys. Of 40,756 persons registered, 40,529 (99.4%) were screened. Of them, 691 (2%) were eligible for sputum examination. Spot specimens were collected from 659 (99.2%) and early morning sputum specimens from 647 (98.1%). Using screening by interview alone, prevalence of bacteriologically positive PTB in persons ≥15 years of age was estimated at 160.4 (123.7-197.1) per 100,000 populations and210.0 (CI: 162.5-258.2) after correcting for non-screening by X-ray. Observed prevalence suggests further strengthening of TB control program in urban slums. Copyright © 2017 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Induced Abortion Practices in an Urban Indian Slum: Exploring Reasons, Pathways and Experiences.

PubMed

Behera, Deepanjali; Bharat, Shalini; Chandrakant Gawde, Nilesh

2015-09-01

To explore the context, experiences and pathways of seeking abortion care among married women in a minority dominated urban slum community in Mumbai city of India. A mixed-method study was conducted using a systematic random sampling method to select 282 respondents from the slum community. One fifth of these womenreported undergoing at least one induced abortion over past five years. A quantitative survey was conducted among these women (n = 57) using structured face-to-face interviews. Additionally, in-depths interviews involving 11 respondents, 2 community health workers and 2 key informants from the community were conducted for further exploration of qualitative data. The rate of induced abortion was 115.6 per 1000 pregnancies in the study area with an abortion ratio of 162.79 per 1000 live births. Frequent pregnancies with low birth spacing and abortions were reported among the women due to restricted contraception use based on religious beliefs. Limited supportfrom husband and family compelled the women to seek abortion services, mostly secretly, from private, unskilled providers and unregistered health facilities. Friends and neighbors were main sources of advice and link to abortion services. Lack of safe abortion facilities within accessible distance furtherintensifies the risk of unsafe abortions. Low contraception usage based on rigid cultural beliefs and scarcely accessible abortion services were the root causes of extensive unsafe abortions.Contraception awareness and counseling with involvement of influential community leaders as well as safe abortion services need to be strengthened to protect these deprived women from risks of unwanted pregnancies and unsafe abortions.

Gut Microbiota Differences in Children From Distinct Socioeconomic Levels Living in the Same Urban Area in Brazil.

PubMed

Mello, Carolina S; Carmo-Rodrigues, Mirian S; Filho, Humberto B A; Melli, Lígia C F L; Tahan, Soraia; Pignatari, Antônio C C; de Morais, Mauro B

2016-11-01

To compare gut microbiota in impoverished children versus children of high socioeconomic status living in the same urban area in Brazil. A cross-sectional study was conducted to evaluate 100 children living in a slum and 30 children from a private school, ages between 5 and 11 years old, in Sao Paulo State, Brazil. To characterize the groups, data based on socioeconomic status, sanitation, and housing conditions were collected. Anthropometric measurements and neonatal data were obtained from both groups. Gut microbiota were quantified in fecal samples by real-time polymerase chain reaction. The children in the private school group had higher rates of cesarean delivery and premature birth than the children in the slum group. Staphylococcus aureus (90% vs 48.0%) and Clostridium difficile (100% vs 43.0%) were more commonly found in the children from the private school than in the impoverished children (P < 0.0001). C perfringens was most frequently identified in the group of children from the slum (92.0% vs 80%; P = 0.064). Higher counts of total eubacteria, Firmicutes and Bacteroidetes phyla organisms, Escherichia coli, Lactobacillus spp., and Methanobrevibacter smithii were found in the children living in poverty, whereas higher counts of Salmonella spp., C difficile, and C perfringens were observed in the children living in satisfactory housing conditions (P < 0.05). Important differences were observed between the gut microbiota of children living under distinct socioeconomic and environmental conditions within the same city. Our findings suggest that children of high socioeconomic status have less favorable gut microbiota than do children who live in poverty.

Circumstances leading to intimate partner violence against women married as children: a qualitative study in Urban Slums of Lahore, Pakistan.

PubMed

Nasrullah, Muazzam; Zakar, Rubeena; Zakar, Muhammad Zakria; Abbas, Safdar; Safdar, Rabia

2015-08-25

Child marriage (<18 years) is prevalent in Pakistan which is associated with negative health outcomes including intimate partner violence (IPV). Our aim is to describe the types and circumstances of IPV against women who were married as children in urban slums of Lahore, Pakistan. Women of reproductive age (15-49 years) who were married prior to 18 years, for at least 5 years were recruited from most populous slum areas of Lahore, Pakistan. Themes for the interview guide were developed using published literature and everyday observations of the researchers. Interviews were conducted by trained interviewers in Urdu language and were translated into English. The interviews were tape-recorded, transcribed, analyzed and categorized into themes. All 19 participants were married between 11 and 17 years. Most respondents were uneducated, poor and were working as housemaids. Majority of participants experienced verbal abuse, and threatened, attempted and completed physical violence by their husbands. A sizeable number of women reported unwanted sexual encounters by their husbands. Family affairs particularly issues with in-laws, poor house management, lack of proper care of children, bringing insufficient dowry, financial problems, an act against the will of husband, and inability to give birth to a male child were some of the reasons narrated by the participants which led to IPV against women. Women married as children are vulnerable to IPV. Concerted efforts are needed from all sectors of society including academia, public health experts, policy makers and civil society to end the child marriage practice in Pakistan.

Using the LCZ framework for change detection and urban growth monitoring

NASA Astrophysics Data System (ADS)

Danylo, Olha; See, Linda; Gomez, Adriana; Schnabel, Georg; Fritz, Steffen

2017-04-01

The world's population reached 7.3 billion in 2015 and it is projected to increase further to 9.7 billion by 2050. Population growth is strongly linked to city expansion, as many people are moving from rural to urban areas. In order to enhance inclusive and sustainable urbanization, we need an efficient workflow for assessing the corresponding SDG (Sustainable Development Goal) targets. In this study we investigate how the Local Climate Zone (LCZ) classification framework can be used for monitoring sustainable urbanization and assess the availability of adequate and safe housing. The original LCZ classification system consists of 10 urban classes, which can be characterized by urban structure, the type of roads and buildings, the density of the built-up area, etc. The other seven classes in the classification scheme include natural land cover classes that do not contain any buildings (e.g., forest, low vegetation, bare land, water, etc). As a case study area we have chosen the cities of Johannesburg and Pretoria in South Africa. According to the 2011 Census, the population of Gauteng province (which includes both Johannesburg and Pretoria) increased by 32.55% compared to 2001 Census and reached 12 million in 2011. A large number of people live in slums and informal housing, which makes this area relevant for such an analysis. Using available satellite images for different years, we classified the case-study areas into the main LCZ classes, including the lightweight lowrise building zone, which corresponds to informal housing. We estimated the land use efficiency as the ratio of the land consumption rate to the population growth rate to illustrate how the LCZ framework can be applied to the assessment of urban growth and to help understand the trajectories of the changes in the urban environment. We show that a low value of this ratio does not necessarily indicate sustainable city expansion, but may instead signal a growing population density in the slum areas.

Nontraditional Settlement Patterns and Typhoon Hazard on Contemporary Majuro Atoll, Republic of the Marshall Islands

PubMed

Spennemann

1996-05-01

Low-lying islands and atolls are particularly prone to storm surges created by tropical depressions and typhoons. This paper presents a case study of traditional and contemporary settlement patterns of Majuro, the capital of the Republic of the Marshall Islands, and discusses its vulnerability to such storm surges. The paper shows that the application of traditional knowledge extends to the realm of urban planning and that, in fact, ignoring this traditional knowledge as expressed in pre-World War II settlement patterns, exposes urban development to increased flood hazards, a risk which may exact a price too high in life and property.

Migration, settlement change and health in post-apartheid South Africa: Triangulating health and demographic surveillance with national census data1

PubMed Central

COLLINSON, MARK A.; TOLLMAN, STEPHEN M.; KAHN, KATHLEEN

2010-01-01

Background World population growth will be increasingly concentrated in the urban areas of the developing world; however, some scholars caution against the oversimplification of African urbanization noting that there may be “counter-urbanization” and a prevailing pattern of circular rural–urban migration. The aim of the paper is to examine the ongoing urban transition in South Africa in the post-apartheid period, and to consider the health and social policy implications of prevailing migration patterns. Methods Two data sets were analysed, namely the South African national census of 2001 and the Agincourt health and demographic surveillance system. A settlement-type transition matrix was constructed on the national data to show how patterns of settlement have changed in a five-year period. Using the sub-district data, permanent and temporary migration was characterized, providing migration rates by age and sex, and showing the distribution of origins and destinations. Findings The comparison of national and sub-district data highlight the following features: urban population growth, particularly in metropolitan areas, resulting from permanent and temporary migration; prevailing patterns of temporary, circular migration, and a changing gender balance in this form of migration; stepwise urbanization; and return migration from urban to rural areas. Conclusions Policy concerns include: rural poverty exacerbated by labour migration; explosive conditions for the transmission of HIV; labour migrants returning to die in rural areas; and the challenges for health information created by chronically ill migrants returning to rural areas to convalesce. Lastly, suggestions are made on how to address the dearth of relevant population information for policy-making in the fields of migration, settlement change and health. PMID:17676507

The Mother-Infant Relationship and Infant Attachment in a South African Peri-Urban Settlement

ERIC Educational Resources Information Center

Tomlinson, Mark; Cooper, Peter; Murray, Lynne

2005-01-01

A sample of 147 mother-infant dyads was recruited from a peri-urban settlement outside Cape Town and seen at 2- and 18-months postpartum. At 18 months, 61.9% of the infants were rated as securely attached (B); 4.1% as avoidant (A); 8.2% as resistant (C); and 25.8% disorganized (D). Postpartum depression at 2 months, and indices of poor parenting…

Uptake and linkage into care over one year of providing HIV testing and counselling through community and health facility testing modalities in urban informal settlement of Kibera, Nairobi Kenya.

PubMed

Muhula, Samuel; Memiah, Peter; Mbau, Lilian; Oruko, Happiness; Baker, Bebora; Ikiara, Geoffrey; Mungai, Margaret; Ndirangu, Meshack; Achwoka, Dunstan; Ilako, Festus

2016-05-04

We examine the uptake of HIV Testing and Counselling (HTC) and linkage into care over one year of providing HTC through community and health facility testing modalities among people living in Kibera informal urban settlement in Nairobi Kenya. We analyzed program data on health facility-based HIV testing and counselling and community- based testing and counselling approaches for the period starting October 2013 to September 2014. Univariate and bivariate analysis methods were used to compare the two approaches with regard to uptake of HTC and subsequent linkage to care. The exact Confidence Intervals (CI) to the proportions were approximated using simple normal approximation to binomial distribution method. Majority of the 18,591 clients were tested through health facility-based testing approaches 72.5 % (n = 13485) vs those tested through community-based testing comprised 27.5 % (n = 5106). More clients tested at health facilities were reached through Provider Initiated Testing and Counselling PITC 81.7 % (n = 11015) while 18.3 % were reached through Voluntary Counselling and Testing (VCT)/Client Initiated Testing and Counselling (CITC) services. All clients who tested positive during health facility-based testing were successfully linked to care either at the project sites or sites of client choice while not all who tested positive during community based testing were linked to care. The HIV prevalence among all those who were tested for HIV in the program was 5.2 % (n = 52, 95 % CI: 3.9 %-6.8 %). Key study limitation included use of aggregate data to report uptake of HTC through the two testing approaches and not being able to estimate the population in the catchment area likely to test for HIV. Health facility-based HTC approach achieved more clients tested for HIV, and this method also resulted in identifying greater numbers of people who were HIV positive in Kibera slum within one year period of testing for HIV compared to community-based HTC approach. Linking HIV positive clients to care proved much easier during health facility- based HTC compared to community- based HTC.

Dermatophyte infections in primary school children in Kibera slums of Nairobi.

PubMed

Chepchirchir, A; Bii, C; Ndinya-Achola, J O

2009-02-01

To determine the prevalence and aetiology of dermatophyte infections in relation to social economic factors in primary school children in Kibera. A cross-sectional descriptive study. City council sponsored schools namely Olympic, Kibera, Ayany and Mbagathi way all in Kibera, the largest of the informal settlement within Nairobi which is home to between 700,000-1,000,000 inhabitamts. The study was conducted between September 2006 and February 2007. A total of 422 primary school children from the ages of five years to 15 years were selected for the study. The prevalence of dermatophytoses was 11.2% with tinea capitis being the most common type while the grey patch form being the dominant clinical manifestation. There was a significant difference (p = 0.001) in dermatophytoses in different schools with Olympic primary school registering the highest prevalence (22.6%). The highest infection rate occurred among six to eight years age bracket in both sexes compared to other age brackets (p = 0.002). The genera of fungi associated with dermatophytoses were isolated indicating the number in each species as follows; T. violecium (35), T. mentagrophytes(3), T. terestre(3), T. schoenleinii(2), and T. interdigitale(1), M. canis(2), M. equinum(1) and E. flocossum(1). T. violecium was the predominant species isolated, at 35/48 (71%) followed by T. mentagrophytes and T. terrestre at 3/48 (6%) each. The study indicates high prevalence of 11.2% dermatophyte infection among the school children in Kibera. Factors contributing to the high frequency and chronic occurrences of ring worm in this area may include poor living environment, children interaction patterns and poor health seeking behaviour. There is need for health education and public awareness campaigns among the communities in urban informal settlements on healthy seeking behaviors and hygiene in order to reduce transmission and severe clinical manifestations.

Determining risk for severe leptospirosis by molecular analysis of environmental surface waters for pathogenic Leptospira.

PubMed

Ganoza, Christian A; Matthias, Michael A; Collins-Richards, Devon; Brouwer, Kimberly C; Cunningham, Calaveras B; Segura, Eddy R; Gilman, Robert H; Gotuzzo, Eduardo; Vinetz, Joseph M

2006-08-01

Although previous data indicate that the overall incidence of human leptospirosis in the Peruvian Amazon is similar in urban and rural sites, severe leptospirosis has been observed only in the urban context. As a potential explanation for this epidemiological observation, we tested the hypothesis that concentrations of more virulent Leptospira would be higher in urban than in rural environmental surface waters. A quantitative real-time PCR assay was used to compare levels of Leptospira in urban and rural environmental surface waters in sites in the Peruvian Amazon region of Iquitos. Molecular taxonomic analysis of a 1,200-bp segment of the leptospiral 16S ribosomal RNA gene was used to identify Leptospira to the species level. Pathogenic Leptospira species were found only in urban slum water sources (Fisher's exact test; p = 0.013). The concentration of pathogen-related Leptospira was higher in urban than rural water sources (approximately 10(3) leptospires/ml versus 0.5 x 10(2) leptospires/ml; F = 8.406, p < 0.05). Identical 16S rRNA gene sequences from Leptospira interrogans serovar Icterohaemorrhagiae were found in urban slum market area gutter water and in human isolates, suggesting a specific mode of transmission from rats to humans. In a prospective, population-based study of patients presenting with acute febrile illness, isolation of L. interrogans-related leptospires from humans was significantly associated with urban acquisition (75% of urban isolates); human isolates of other leptospiral species were associated with rural acquisition (78% of rural isolates) (chi-square analysis; p < 0.01). This distribution of human leptospiral isolates mirrored the distribution of leptospiral 16S ribosomal gene sequences in urban and rural water sources. Our findings data support the hypothesis that urban severe leptospirosis in the Peruvian Amazon is associated with higher concentrations of more pathogenic leptospires at sites of exposure and transmission. This combined quantitative and molecular taxonomical risk assessment of environmental surface waters is globally applicable for assessing risk for leptospiral infection and severe disease in leptospirosis-endemic regions.

Determining Risk for Severe Leptospirosis by Molecular Analysis of Environmental Surface Waters for Pathogenic Leptospira

PubMed Central

Collins-Richards, Devon; Brouwer, Kimberly C; Cunningham, Calaveras B; Segura, Eddy R; Gilman, Robert H; Gotuzzo, Eduardo; Vinetz, Joseph M

2006-01-01

Background Although previous data indicate that the overall incidence of human leptospirosis in the Peruvian Amazon is similar in urban and rural sites, severe leptospirosis has been observed only in the urban context. As a potential explanation for this epidemiological observation, we tested the hypothesis that concentrations of more virulent Leptospira would be higher in urban than in rural environmental surface waters. Methods and Findings A quantitative real-time PCR assay was used to compare levels of Leptospira in urban and rural environmental surface waters in sites in the Peruvian Amazon region of Iquitos. Molecular taxonomic analysis of a 1,200-bp segment of the leptospiral 16S ribosomal RNA gene was used to identify Leptospira to the species level. Pathogenic Leptospira species were found only in urban slum water sources (Fisher's exact test; p = 0.013). The concentration of pathogen-related Leptospira was higher in urban than rural water sources (~103 leptospires/ml versus 0.5 × 102 leptospires/ml; F = 8.406, p < 0.05). Identical 16S rRNA gene sequences from Leptospira interrogans serovar Icterohaemorrhagiae were found in urban slum market area gutter water and in human isolates, suggesting a specific mode of transmission from rats to humans. In a prospective, population-based study of patients presenting with acute febrile illness, isolation of L. interrogans-related leptospires from humans was significantly associated with urban acquisition (75% of urban isolates); human isolates of other leptospiral species were associated with rural acquisition (78% of rural isolates) (chi-square analysis; p < 0.01). This distribution of human leptospiral isolates mirrored the distribution of leptospiral 16S ribosomal gene sequences in urban and rural water sources. Conclusions Our findings data support the hypothesis that urban severe leptospirosis in the Peruvian Amazon is associated with higher concentrations of more pathogenic leptospires at sites of exposure and transmission. This combined quantitative and molecular taxonomical risk assessment of environmental surface waters is globally applicable for assessing risk for leptospiral infection and severe disease in leptospirosis-endemic regions. PMID:16933963

Training to Work with the Disadvantaged Rural, Tribal and Urban Slum Child.

ERIC Educational Resources Information Center

D'Silva, Loretta; And Others

1984-01-01

Describes a comprehensive list of skills, personal qualities, and competencies considered essential for a child-care worker in India. This list was created by interviewing 30 training instructors from 10 agencies. It was found that these skills could be developed in the field worker through field-based, on-the-job training. (Author/CB)

Eight Case Studies of Communication Patterns in a Black, Urban Slum.

ERIC Educational Resources Information Center

Ryan, Michael

The Kerner Commission was critical six years ago in its assessment of media coverage of black problems, and eight case studies conducted in Philadelphia indicate that news media may not yet be effectively meeting the needs of some blacks. In January 1974 interviews were held with eight residents in a section of north Philadelphia characterized in…

The Sexual Lives of Muslim Girls in the "Bustees" of Kolkata, India

ERIC Educational Resources Information Center

Chakraborty, Kabita

2010-01-01

This paper aims to understand why and how young Muslim women pursue sexual relationships in the urban bustees (slums) of Kolkata, West Bengal, India. I discuss how girls in heterosexual romantic relationships decide where, when and how to have sex, and the importance of class discourses and popular Bollywood culture in this decision-making…

Some Learning Disabilities of Socially Disadvantaged Puerto Rican and Negro Children.

ERIC Educational Resources Information Center

Cohen, S. Alan

The findings of several tests are used to describe some learning disabilities and patterns common in lower-class Puerto Rican and Negro children. In particular, perceptual dysfunction is pointed to as a major causal factor in the reading problems of the disadvantaged. In one urban slum school, 40 percent of first graders showed serious dysfunction…

The role of a decision-support smartphone application in enhancing community health volunteers' effectiveness to improve maternal and newborn outcomes in Nairobi, Kenya: quasi-experimental research protocol.

PubMed

Bakibinga, Pauline; Kamande, Eva; Omuya, Milka; Ziraba, Abdhalah K; Kyobutungi, Catherine

2017-07-20

Improving maternal and newborn survival remains major aspirations for many countries in the Global South. Slum settlements, a result of rapid urbanisation in many developing countries including Kenya, exhibit high levels of maternal and neonatal mortality. There are limited referral mechanisms for sick neonates and their mothers from the community to healthcare facilities with ability to provide adequate care. In this study, we specifically plan to develop and assess the added value of having community health volunteers (CHVs) use smartphones to identify and track mothers and children in a bid to reduce pregnancy-related complications and newborn deaths in the urban slums of Kamukunji subcounty in Nairobi, Kenya. This is a quasi-experimental study. We are implementing an innovative, mHealth application known as mobile Partnership for Maternal, Newborn and Child Health (mPAMANECH) which uses dynamic mobile phone and web-portal solutions to enable CHVs make timely decisions on the best course of action in their management of mothers and newborns at community level. The application is based on existing guidelines and protocols in use by CHVs. Currently, CHVs conduct weekly home visits and make decisions from memory or using unwieldy manual tools, and thus prone to making errors. mPAMANECH has an in-built algorithm that makes it easier, faster and more likely for CHVs to make the right management decision. We are working with a network of selected CHVs and maternity centres to pilot test the tool. To measure the impact of the intervention, baseline and end-line surveys will be conducted. Data will be obtained through qualitative and quantitative methods. Ethical approval for the study was obtained from the African Medical Research Foundation. Key messages from the results will be packaged and disseminated through meetings, conference presentations, reports, fact sheets and academic publications to facilitate uptake by policy-makers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Mapping the Urban Side of the Earth- the new GUF+ Layer

NASA Astrophysics Data System (ADS)

Gorelick, N.; Marconcini, M.; Üreyen, S.; Zeidler, J.; Svaton, V.; Esch, T.

2017-12-01

From the beginning of the years 2000, it is estimated that more than half of the global population is living in cities and the dynamic trend of urbanization is growing at an unprecedented speed. In such framework, how does expanding population affect the surrounding landscape? Are urban areas making good use of limited space or is rapid urbanization threatening the planet's sustainability? What is the impact of urbanization on vulnerability to natural disasters? To try answering these and other challenging questions, a key information is to reliably know the location and characteristics (e.g. shape, extent, greenness) of human settlements worldwide. In this context, yet from the last decade different global maps outlining urban areas have started being produced. Here, DLR's Global Urban Footprint (GUF) layer, generated on the basis of very high resolution radar imagery, represents one of the most accurate and largely employed datasets. However, in order to overcome still existing limitations of the GUF layer, often originating from specifics of the underlying radar imagery, DLR developed a novel methodology that for the first time exploits mass multitemporal collections of optical and radar satellite imagery. The new approach has been employed for generating the GUF+ 2015 layer, a global map of settlement areas derived at 10m spatial resolution based overall on a joint analysis of hundreds of thousands of Landsat and Sentinel-1 scenes (processed with the support of Google Earth Engine) collected in the years 2014-2015. The GUF+2015 outperforms all other existing global human settlements maps and allows - among others - to considerably improve the detection of very small settlements in rural regions and better outline scattered peri-urban areas. Nevertheless, this is not an arrival but rather a starting point for generating a suite of additional products (GUF+ suite) supposed to support a 360° analysis of global urbanization - e.g. with data on the imperviousness/greenness and the spatiotemporal development of the built-up area over the last decades.

Capacitacion de educadores para areas marginales--I: Caracteristicas y necesidades educativas de los ninos, jovenes y adultos en las poblaciones menos favorecidas, rurales y urbanas. Tercera edicion (Preparation of Educators for Marginal Areas--I: Educational Needs and Characteristics of Children, Youth and Adults in Disadvantaged Populations, Rural and Urban. Third Edition).

ERIC Educational Resources Information Center

Tedesco, Juan Carlos

Forty percent of the families in Latin America have an income which does not provide essential necessities. Two-thirds of poor families live in the countryside, while the remainder reside in urban slums. The key variable in explaining poverty is education. Without education these families have irregular, unstable, and low paying employment…

24 CFR 266.656 - Recovery of costs after final claim settlement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Recovery of costs after final claim... Contract Rights and Obligations Claim Procedures § 266.656 Recovery of costs after final claim settlement. If, after final claim settlement, the HFA recovers additional sums as the result of the sale of the...

24 CFR 266.656 - Recovery of costs after final claim settlement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Recovery of costs after final claim... Contract Rights and Obligations Claim Procedures § 266.656 Recovery of costs after final claim settlement. If, after final claim settlement, the HFA recovers additional sums as the result of the sale of the...

24 CFR 266.656 - Recovery of costs after final claim settlement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Recovery of costs after final claim... Contract Rights and Obligations Claim Procedures § 266.656 Recovery of costs after final claim settlement. If, after final claim settlement, the HFA recovers additional sums as the result of the sale of the...

24 CFR 266.656 - Recovery of costs after final claim settlement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Recovery of costs after final claim... Contract Rights and Obligations Claim Procedures § 266.656 Recovery of costs after final claim settlement. If, after final claim settlement, the HFA recovers additional sums as the result of the sale of the...

24 CFR 266.656 - Recovery of costs after final claim settlement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Recovery of costs after final claim... Contract Rights and Obligations Claim Procedures § 266.656 Recovery of costs after final claim settlement. If, after final claim settlement, the HFA recovers additional sums as the result of the sale of the...

Analysis of arable land loss and its impact on rural sustainability in Southern Jiangsu Province of China.

PubMed

Liu, Y S; Wang, J Y; Long, H L

2010-01-01

Rapid urbanization and industrialization in southern Jiangsu Province have consumed a huge amount of arable land. Through comparative analysis of land cover maps derived from TM images in 1990, 2000 and 2006, we identified the trend of arable land loss. It is found that most arable land is lost to urbanization and rural settlements development. Urban settlements, rural settlements, and industrial park-mine-transport land increased, respectively, by 87 997 ha (174.65%), 81 041 ha (104.52%), and 12 692 ha (397.99%) from 1990 to 2006. Most of the source (e.g., change from) land covers are rice paddy fields and dryland. These two covers contributed to newly urbanized areas by 37.12% and 73.52% during 1990-2000, and 46.39% and 38.86% during 2000-2006. However, the loss of arable land is weakly correlated with ecological service value, per capita net income of farmers, but positively with grain yield for some counties. Most areas in the study site have a low arable land depletion rate and a high potential for sustainable development. More attention should be directed at those counties that have a high depletion rate but a low potential for sustainable development. Rural settlements should be controlled and rationalized through legislative measures to achieve harmonious development between urban and rural areas, and sustainable development for rural areas with a minimal impact on the ecoenvironment. 2009 Elsevier Ltd. All rights reserved.

Food insecurity in households in informal settlements in urban South Africa.

PubMed

Naicker, N; Mathee, A; Teare, J

2015-04-01

Food insecurity in the urban poor is a major public health challenge. The Health, Environment and Development study assessed trends in food insecurity and food consumption over a period of 7 years in an informal settlement in Johannesburg, South Africa (SA). Annual cross-sectional surveys were conducted in the informal settlement (Hospital Hill). The degree of household food insecurity decreased significantly from 2006 (85%) to 2012 (70%). There was a spike in 2009 (91%), possibly owing to global food price increases. Childhood food insecurity followed the same trend as household food insecurity. During the first 3 study years, consumption of protein, vegetables and fruit decreased by 10-20%, but had returned to previous levels by 2012. In this study, although declining, food insecurity remains unacceptably high. Hunger relief and poverty alleviation need to be more aggressively implemented in order to improve the quality of life in poor urban communities in SA.

Investigating the Use of 3d Geovisualizations for Urban Design in Informal Settlement Upgrading in South Africa

NASA Astrophysics Data System (ADS)

Rautenbach, V.; Coetzee, S.; Çöltekin, A.

2016-06-01

Informal settlements are a common occurrence in South Africa, and to improve in-situ circumstances of communities living in informal settlements, upgrades and urban design processes are necessary. Spatial data and maps are essential throughout these processes to understand the current environment, plan new developments, and communicate the planned developments. All stakeholders need to understand maps to actively participate in the process. However, previous research demonstrated that map literacy was relatively low for many planning professionals in South Africa, which might hinder effective planning. Because 3D visualizations resemble the real environment more than traditional maps, many researchers posited that they would be easier to interpret. Thus, our goal is to investigate the effectiveness of 3D geovisualizations for urban design in informal settlement upgrading in South Africa. We consider all involved processes: 3D modelling, visualization design, and cognitive processes during map reading. We found that procedural modelling is a feasible alternative to time-consuming manual modelling, and can produce high quality models. When investigating the visualization design, the visual characteristics of 3D models and relevance of a subset of visual variables for urban design activities of informal settlement upgrades were qualitatively assessed. The results of three qualitative user experiments contributed to understanding the impact of various levels of complexity in 3D city models and map literacy of future geoinformatics and planning professionals when using 2D maps and 3D models. The research results can assist planners in designing suitable 3D models that can be used throughout all phases of the process.

Risk factors of stunting among children living in an urban slum of Bangladesh: findings of a prospective cohort study.

PubMed

Islam, M Munirul; Sanin, Kazi Istiaque; Mahfuz, Mustafa; Ahmed, A M Shamsir; Mondal, Dinesh; Haque, Rashidul; Ahmed, Tahmeed

2018-01-30

Bangladesh is one of the 20 countries with highest burden of stunting globally. A large portion (around 2.2 million) of the population dwells in the slum areas under severe vulnerable conditions. Children residing in the slums are disproportionately affected with higher burden of undernutrition particularly stunting. In this paper, findings of a prospective cohort study which is part of a larger multi-country study are presented. Two hundred and sixty five children were enrolled and followed since their birth till 24 months of age. Anthropometric measurements, dietary intake and morbidity information were collected monthly. Data from 9 to 12, 15-18 and 21-24 months were collated to analyze and report findings for 12, 18 and 24 months of age. Generalized estimating equation models were constructed to determine risk factors of stunting between 12 and 24 months of age. Approximately, 18% of children were already stunted (LAZ < -2SD) at birth and the proportion increased to 48% at 24 months of age. Exclusive breastfeeding prevalence was only 9.4% following the WHO definition at 6 months. Dietary energy intake as well as intakes of carbohydrate, fat and protein were suboptimal for majority of the children. However, in regression analysis, LAZ at birth (AOR = 0.40, 95% CI: 0.26, 0.61), household with poor asset index (AOR = 2.81, 95% CI: 1.43, 5.52; ref.: average asset index), being male children (AOR = 1.75, 95% CI: 1.04, 2.95; ref.: female) and age (AOR = 2.34, 95% CI: 1.56, 3.52 at 24 months, AOR = 2.13, 95% CI: 1.55, 2.92 at 18 months; ref.: 12 months of age) were the significant predictors of stunting among this population. As the mechanism of stunting begins even before a child is born, strategies must be focused on life course approach and preventive measurement should be initiated during pregnancy. Alongside, government and policymakers have to develop sustainable strategies to improve various social and environmental factors those are closely interrelated with chronic undernutrition particularly concentrating on urban slum areas.

Inequalities in maternity care and newborn outcomes: one-year surveillance of births in vulnerable slum communities in Mumbai

PubMed Central

More, Neena Shah; Bapat, Ujwala; Das, Sushmita; Barnett, Sarah; Costello, Anthony; Fernandez, Armida; Osrin, David

2009-01-01

Background Aggregate urban health statistics mask inequalities. We described maternity care in vulnerable slum communities in Mumbai, and examined differences in care and outcomes between more and less deprived groups. Methods We collected information through a birth surveillance system covering a population of over 280 000 in 48 vulnerable slum localities. Resident women identified births in their own localities and mothers and families were interviewed at 6 weeks after delivery. We analysed data on 5687 births over one year to September 2006. Socioeconomic status was classified using quartiles of standardized asset scores. Results Women in higher socioeconomic quartile groups were less likely to have married and conceived in their teens (Odds ratio 0.74, 95% confidence interval 0.69–0.79, and 0.82, 0.78–0.87, respectively). There was a socioeconomic gradient away from public sector maternity care with increasing socioeconomic status (0.75, 0.70–0.79 for antenatal care and 0.66, 0.61–0.71 for institutional delivery). Women in the least poor group were five times less likely to deliver at home (0.17, 0.10–0.27) as women in the poorest group and about four times less likely to deliver in the public sector (0.27, 0.21–0.35). Rising socioeconomic status was associated with a lower prevalence of low birth weight (0.91, 0.85–0.97). Stillbirth rates did not vary, but neonatal mortality rates fell non-significantly as socioeconomic status increased (0.88, 0.71–1.08). Conclusion Analyses of this type have usually been applied across the population spectrum from richest to poorest, and we were struck by the regularly stepped picture of inequalities within the urban poor, a group that might inadvertently be considered relatively homogeneous. The poorest slum residents are more dependent upon public sector health care, but the regular progression towards the private sector raises questions about its quality and regulation. It also underlines the need for healthcare provision strategies to take account of both sectors. PMID:19497130

Retention of female volunteer community health workers in Dhaka urban slums: a prospective cohort study

PubMed Central

2014-01-01

Background Volunteer community health workers (CHWs) are a key approach to improving community-based maternal and child health services in developing countries. BRAC, a large Bangladeshi non-governmental organization (NGO), has employed female volunteer CHWs in its community-based health programs since 1977, recently including its Manoshi project, a community-based maternal and child health intervention in the urban slums of Bangladesh. A case–control study conducted in response to high dropout rates in the first year of the project showed that financial incentives, social prestige, community approval and household responsibilities were related to early retention in the project. In our present prospective cohort study, we aimed to better understand the factors associated with retention of volunteer CHWs once the project was more mature. Methods We used a prospective cohort study design to examine the factors affecting retention of volunteer CHWs who remained in the project after the initial start-up period. We surveyed a random sample of 542 CHWs who were working for BRAC Manoshi in December 2008. In December 2009, we revisited this cohort of CHWs and interviewed those who had dropped out about the main reasons for their dropping out. We used a multivariable generalized linear model regression analysis with a log link to estimate the relative risk (RR) of independent factors on retention. Results Of the 542 CHWs originally enrolled, 120 had dropped out by the end of one year, mainly because they left the slums. CHWs who received positive community appraisal (adjusted RR = 1.45, 95% confidence interval (CI) = 1.10 to 1.91) or were associated with other NGOs (adjusted RR = 1.13, 95% CI = 1.04 to 1.23) were more likely to have been retained in the project. Although refresher training was also associated with increased retention (adjusted RR = 2.25, 95% CI = 1.08 to 4.71) in this study, too few CHWs had not attended refresher training regularly to make it a meaningful predictor of retention that could be applied in the project setting. Conclusion Factors that affect retention of CHWs may change over time, with some factors that are important in the early years of a project losing importance as the project matures. Community health programs operating in fragile urban slums should consider changing factors over program duration for better retention of volunteer CHWs. PMID:24886046

Soil-transmitted helminths in pre-school-aged and school-aged children in an urban slum: a cross-sectional study of prevalence, distribution, and associated exposures.

PubMed

Davis, Stephanie M; Worrell, Caitlin M; Wiegand, Ryan E; Odero, Kennedy O; Suchdev, Parminder S; Ruth, Laird J; Lopez, Gerard; Cosmas, Leonard; Neatherlin, John; Njenga, Sammy M; Montgomery, Joel M; Fox, LeAnne M

2014-11-01

Soil-transmitted helminths (STHs) are controlled by regular mass drug administration. Current practice targets school-age children (SAC) preferentially over pre-school age children (PSAC) and treats large areas as having uniform prevalence. We assessed infection prevalence in SAC and PSAC and spatial infection heterogeneity, using a cross-sectional study in two slum villages in Kibera, Nairobi. Nairobi has low reported STH prevalence. The SAC and PSAC were randomly selected from the International Emerging Infections Program's surveillance platform. Data included residence location and three stools tested by Kato-Katz for STHs. Prevalences among 692 analyzable children were any STH: PSAC 40.5%, SAC 40.7%; Ascaris: PSAC 24.1%, SAC 22.7%; Trichuris: PSAC 24.0%, SAC 28.8%; hookworm < 0.1%. The STH infection prevalence ranged from 22% to 71% between sub-village sectors. The PSAC have similar STH prevalences to SAC and should receive deworming. Small areas can contain heterogeneous prevalences; determinants of STH infection should be characterized and slums should be assessed separately in STH mapping. © The American Society of Tropical Medicine and Hygiene.

A cross-sectional, randomized cluster sample survey of household vulnerability to extreme heat among slum dwellers in ahmedabad, india.

PubMed

Tran, Kathy V; Azhar, Gulrez S; Nair, Rajesh; Knowlton, Kim; Jaiswal, Anjali; Sheffield, Perry; Mavalankar, Dileep; Hess, Jeremy

2013-06-18

Extreme heat is a significant public health concern in India; extreme heat hazards are projected to increase in frequency and severity with climate change. Few of the factors driving population heat vulnerability are documented, though poverty is a presumed risk factor. To facilitate public health preparedness, an assessment of factors affecting vulnerability among slum dwellers was conducted in summer 2011 in Ahmedabad, Gujarat, India. Indicators of heat exposure, susceptibility to heat illness, and adaptive capacity, all of which feed into heat vulnerability, was assessed through a cross-sectional household survey using randomized multistage cluster sampling. Associations between heat-related morbidity and vulnerability factors were identified using multivariate logistic regression with generalized estimating equations to account for clustering effects. Age, preexisting medical conditions, work location, and access to health information and resources were associated with self-reported heat illness. Several of these variables were unique to this study. As sociodemographics, occupational heat exposure, and access to resources were shown to increase vulnerability, future interventions (e.g., health education) might target specific populations among Ahmedabad urban slum dwellers to reduce vulnerability to extreme heat. Surveillance and evaluations of future interventions may also be worthwhile.

Socio-Cultural Impacts in the Formation of Urban Village

NASA Astrophysics Data System (ADS)

Marpaung, B. O. Y.

2017-03-01

In Indonesia, a group of village people tends to move from one place to another and develops a living space to create a settlement. This research is conducted by taking an example of a particular ethnic group that leaves the forestry area to a new place in the city. After some time, this group of people creates a similar or adapted socio-cultural system adapted from their origin place. The purpose of this research is to examine the socio-cultural aspects that significantly influence the emergence of urban village. This influence is interpreted as social and cultural relations with the establishment of space and significance of urban village. By focusing on this issue, this research will trace the process of how a new and unplanned settlement could emerge. The process and elements are indispensable from social and cultural factors. Essentially, the shape of bulit space is a non-physical manifestation of local people, which is established from time to time. In this case, the research’s challenge lies on the circumstance in Indonesia where society and culture influence the emergence of urban village. Physical appearance can be identified as a tipology of settlement and morphology of urban village.

Unintended pregnancy and subsequent use of modern contraceptive among slum and non-slum women in Nairobi, Kenya

PubMed Central

2014-01-01

Background In spite of major gains in contraceptive prevalence over the last few decades, many women in most parts of the developing world who would like to delay or avoid pregnancy do not use any method of contraception. This paper seeks to: a) examine whether experiencing an unintended pregnancy is associated with future use of contraception controlling for a number factors including poverty at the household and community levels; and b) investigate the mechanisms through which experiencing an unintended pregnancy leads to uptake of contraception. Methods Quantitative and qualitative data from a cross-sectional research project conducted in 2009/10 in two slum settlements and two non-slum settings of Nairobi, Kenya are used. The quantitative component of the project was based on a random sample of 1,259 women aged 15–49 years. Logistic regression models were used to assess the effect of unintended pregnancy on future contraceptive use. The qualitative component of the project successfully interviewed a total of 80 women randomly selected from survey participants who had reported having at least one unintended pregnancy. Results Women whose last pregnancy was unintended were more likely to be using a modern method of contraception, compared to their peers whose last pregnancy was intended, especially among the wealthier group as shown in the interaction model. Among poor women, unintended pregnancy was not associated with subsequent use of contraception. The qualitative investigation with women who had an unplanned pregnancy reveals that experiencing an unintended pregnancy seems to have served as a “wake-up call”, resulting in greater attention to personal risks, including increased interest in pregnancy prevention. For some women, unintended pregnancy was a consequence of strong opposition by their partners to family planning, while others reported they started using contraceptives following their unintended pregnancy, but discontinued after experiencing side effects. Conclusion This study provides quantitative and qualitative evidence that women who have had an unintended pregnancy are “ready for change”. Family planning programs may use the contacts with antenatal, delivery and post-delivery care system as an opportunity to identify women whose pregnancy is unplanned, and target them with information and services. PMID:25012817

Unintended pregnancy and subsequent use of modern contraceptive among slum and non-slum women in Nairobi, Kenya.

PubMed

Fotso, Jean Christophe; Izugbara, Chimaraoke; Saliku, Teresa; Ochako, Rhoune

2014-07-10

In spite of major gains in contraceptive prevalence over the last few decades, many women in most parts of the developing world who would like to delay or avoid pregnancy do not use any method of contraception. This paper seeks to: a) examine whether experiencing an unintended pregnancy is associated with future use of contraception controlling for a number factors including poverty at the household and community levels; and b) investigate the mechanisms through which experiencing an unintended pregnancy leads to uptake of contraception. Quantitative and qualitative data from a cross-sectional research project conducted in 2009/10 in two slum settlements and two non-slum settings of Nairobi, Kenya are used. The quantitative component of the project was based on a random sample of 1,259 women aged 15-49 years. Logistic regression models were used to assess the effect of unintended pregnancy on future contraceptive use. The qualitative component of the project successfully interviewed a total of 80 women randomly selected from survey participants who had reported having at least one unintended pregnancy. Women whose last pregnancy was unintended were more likely to be using a modern method of contraception, compared to their peers whose last pregnancy was intended, especially among the wealthier group as shown in the interaction model. Among poor women, unintended pregnancy was not associated with subsequent use of contraception. The qualitative investigation with women who had an unplanned pregnancy reveals that experiencing an unintended pregnancy seems to have served as a "wake-up call", resulting in greater attention to personal risks, including increased interest in pregnancy prevention. For some women, unintended pregnancy was a consequence of strong opposition by their partners to family planning, while others reported they started using contraceptives following their unintended pregnancy, but discontinued after experiencing side effects. This study provides quantitative and qualitative evidence that women who have had an unintended pregnancy are "ready for change". Family planning programs may use the contacts with antenatal, delivery and post-delivery care system as an opportunity to identify women whose pregnancy is unplanned, and target them with information and services.