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Introduction: Provision of ANC services has a positive impact on pregnancy as it enables identification of risk factors, early diagnosis and treatment of complications. It is also used by primary care physicians as a means to educate women about nutrition, breastfeeding, family planning, spacing after childbirth and promote healthy lifestyle. Objectives: 1) To assess the pattern of utilization of maternal health care services 2) To study the association between socio-demographic factors and maternal health Care service utilization. Materials and Methods: A Community-based, Cross-sectional study was done among 320 mothers who were residing in urban slums of Kurnool, were selected by Simple Random Sampling Method, Data were collected between April 2023 to July 2023 using Semi-structured questionnaire. Data were analysed using SPSS-Version25. Results: Majority of mothers (72.5%) had antenatal registration done in first trimester.75.9% of mothers had > 4 ANC visits, 24.1% of mothers had < 4 ANC visits. 98.4% of mothers-had received 2 TT injections.76.9% of mothers had consumed > 100 Iron and Folic acid tablets, 23.1% had consumed < 100 Iron and folic acid tablets. 91.6% of mothers-delivered in Government hospital, 8.4% delivered in Private Hospital. Statistically significant relationship was found between education and employment status of mother, economic status of family with utilization of MCH services. Conclusion: Socioeconomic development that prioritises maternal education and women’s empowerment can lead to better utilisation of MCH services, which in turn will improve and enhance the use of MCH services. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Oral cancer represents a significant global health burden, disproportionately affecting vulnerable populations in developing countries like India. Urban slums, characterized by socioeconomic challenges and limited access to healthcare, are particularly susceptible. This study aimed to examine the association between tobacco use, a well-established risk factor, and the incidence of oral cancer among women residing in these underserved communities. Methods: A case-control study was conducted, involving 300 women from urban slums: 150 cases diagnosed with oral cancer within the past year and 150 controls without a history of the disease. Data were collected through structured interviews, encompassing tobacco use habits (type, frequency, and duration), sociodemographic factors, and oral hygiene practices. Statistical analyses, including Chi-square tests and logistic regression, were employed to assess the association between tobacco use and oral cancer risk. Results: The study revealed a strong association between tobacco use and oral cancer among women in urban slums. The prevalence of tobacco use, particularly smokeless tobacco, was significantly higher in cases compared to controls. Smokeless tobacco use and smoking emerged as independent risk factors for oral cancer. Lower educational attainment was also identified as an independent risk factor, underscoring the influence of socioeconomic disadvantages on disease susceptibility. Conclusion: This study provides compelling evidence linking tobacco use to a heightened risk of oral cancer among women in urban slums. The findings underscore the urgent need for targeted interventions, including health education, access to cessation programs, and addressing socioeconomic disparities, to mitigate the burden of oral cancer in this vulnerable population. The study highlights the importance of culturally sensitive and effective preventive measures to combat oral cancer in underserved communities. [ABSTRACT FROM AUTHOR]

Background: In India, Non-Degree Allopathic Providers (NDAPs), who do not have formal training in allopathic medicine, play a prominent role in basic healthcare delivery in both rural areas and urban informal settlements. Often recognized as providers of 'first contact' care for minor acute ailments, there is little information regarding the roles they play in providing services for non-communicable diseases (NCDs). In this study, we explore the roles played by NDAPs in diagnosing and managing two NCDs—diabetes and hypertension—in urban informal settlements of the Mumbai Metropolitan Region. Methods: This is a qualitative study involving data collection with 25 NDAPs (19 males and 6 females). Data was collected between December 2022 and September 2023. Data was coded inductively, and an iterative process of coding was followed to derive key themes. These themes were further refined through reflections within the author group. The qualitative software NVivo Version 10.3 was used to facilitate the analysis process. Results: All NDAPs we spoke to noted an increase in diabetes and hypertension patients in the urban informal settlements they worked in. All of them provided medication for 'quick relief' to patients from the bothersome symptoms of the two diseases. But in some cases, NDAPs also reported acting as counsellors, patient navigators, and local supervisors of therapy initiated by other doctors. Generally, risk-averse, NDAPs were cautious about how much of the diagnosis and treatment process they participated in. Those with informal and formal connections with private, qualified allopathic providers involved themselves more extensively in the management of the two NCDs. NDAPs had limited ties with the public health system and preferred sending patients to other private doctors if they felt a case was beyond their purview. Conclusion: The informal health sector in India is currently offering a range of services to address the needs of patients with NCDs. Our study suggests that the strong presence of this sector in resource-constrained communities can be leveraged by the public health system to enable community-level screening for NCDs, facilitate access to specialist care, improve treatment adherence, and promote wellness initiatives. In light of the changing epidemiological burden, our study underscores that despite the contentious nature of practices in the informal health sector, overlooking this group of providers is no longer an option for health policies. [ABSTRACT FROM AUTHOR]

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

Abstract Understanding the dynamics of movements between different demographic events is essential for informing effective population management strategies. This study aims to characterize the trajectories of demographic and other vital events within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). Thus, it intends to unravel patterns and trends that can guide the development of targeted policies and interventions to address the population’s evolving needs. Using a continuous-time homogeneous multi-state Markov model, longitudinal data from 223,350 individuals in Korogocho and Viwandani urban slums, we study the enumeration, births, deaths, and migrations among urban poor in Nairobi, shedding light on population dynamics and movements over time, disaggregated by gender. Findings indicate a positive net migration in population per thousand in 2002, dropping in 2004, with Viwandani consistently showing higher birth rates than Korogocho. Males generally have higher death rates than females. Females from Viwandani are 39.0% more likely to exit after enumeration compared to Korogocho, while males are 35.6% more likely to move from enumeration to exit compared to males from Korogocho. Both genders from Viwandani have a decreased likelihood of moving from birth to death compared to Korogocho. Our findings provide unique insights into migration in urban Kenya, the frequency and movement to different demographic events and any gender differences that warrant strategic policies for effective population and health planning in Africa. These findings can inform the design of effective health interventions that are often affected by migration and population growth.

Abstract Background Bangladesh is rapidly urbanizing and approximately half of its urban population resides in deprived slums with limited access to basic needs. However, there is a dearth of information on vulnerability levels among slum dwellers. We aimed to assess the level of vulnerability within and between slums via various socioeconomic and health indicators. Methods A cross-sectional survey of 810 randomly selected households was conducted in two purposively selected slums, Korail and Shyampur, in Dhaka from November to December 2021. Data was collected on various indicators, including demographics, education, employment, access to utility, and healthcare services. Principal component factor analysis was employed to identify the key indicators to construct the socioeconomic and health vulnerability index for the urban slums of Bangladesh (SEHVI-BD). Kaiser-Meyer-Olkin, Bartlett’s test, and Cronbach’s alpha coefficient test were used to assess indicators’ suitability. The selected indicators were used to generate an index on a scale of 100, with a higher index value indicating a higher level of vulnerability. The estimated scores were used to categorize the vulnerability status into three levels: mild, moderate, and severe vulnerability. The Mann-Whitney-U test and Kruskal-Wallis test were applied between the generated index and other socioeconomic variables to validate the relationship. Results A total of 27 socioeconomic and health indicators were identified that explained 60% of the variance. The indicators were then grouped into six domains on the basis of their relevance. The prevalence of severe vulnerability in the Korail slum was approximately 9% and moderate vulnerability was 30% whereas these values were approximately 58% and 37%, respectively, in the Shyampur slum. The difference in the vulnerability level between the two slums was also evident across the domains. Households in the poorest wealth quintile, with lower education levels of household heads, and having irregular income experienced higher levels of vulnerability. Conclusions The SEHVI-BD offers a critical tool for policymakers to identify and address vulnerabilities, facilitating more targeted public health interventions in urban Bangladesh and similar low-income settings. This study further emphasizes the importance of integrating comprehensive vulnerability assessments into public health policies to reduce inequalities and improve well-being, especially for the urban marginalized slum population.

Background Immunisation services does not reach over one third of urban poor children. There is clear cut difference of children completely immunised in the low as compared to high standard of living index in urban areas. This difference is more marked in low performing states like Rajasthan and this difference as compared to better performing states like Kerala. Such inter-state differentials indicate the importance of extra focus on low performing states like Rajasthan. Methodology A cross-sectional study was conducted among 550 children aged 12–23 months in an urban slum of a district in southern Rajasthan. Along with the immunisation coverage, determinants associated with incomplete immunisation was assessed. The child’s immunisation was ascertained using the immunisation cards/Mamta cards or in whom cards not available WHO recall method was used. The Chi-square test was used to find out statistical significance. Results Of 550 children studied, 417 (75.8%) were fully immunised, 117 (21.3%) were partially immunised and 16 of them were non immunised (2.9%). When the determinants of incomplete immunisation were assessed, all were found statistically significant. Conclusion The present study concluded that immunisation coverage is lower than that of the target. The factors thought to have influenced immunisation such as religion, family composition, education of mother and gender of child were discovered to be statistically significant.

ABSTRACT: Background: Immunisation services does not reach over one third of urban poor children. There is clear cut difference of children completely immunised in the low as compared to high standard of living index in urban areas. This difference is more marked in low performing states like Rajasthan and this difference as compared to better performing states like Kerala. Such inter-state differentials indicate the importance of extra focus on low performing states like Rajasthan. Methodology: A cross-sectional study was conducted among 550 children aged 12–23 months in an urban slum of a district in southern Rajasthan. Along with the immunisation coverage, determinants associated with incomplete immunisation was assessed. The child's immunisation was ascertained using the immunisation cards/Mamta cards or in whom cards not available WHO recall method was used. The Chi-square test was used to find out statistical significance. Results: Of 550 children studied, 417 (75.8%) were fully immunised, 117 (21.3%) were partially immunised and 16 of them were non immunised (2.9%). When the determinants of incomplete immunisation were assessed, all were found statistically significant. Conclusion: The present study concluded that immunisation coverage is lower than that of the target. The factors thought to have influenced immunisation such as religion, family composition, education of mother and gender of child were discovered to be statistically significant. [ABSTRACT FROM AUTHOR]

This study explores the impact of migration on the access and utilisation of sexual and reproductive health services by women living in an informal settlement in Dhaka, Bangladesh. A total of 16 in-depth interviews were conducted in March and April of 2019 with women (18–49 years old) who had migrated from rural areas to Dhaka. They reported continued economic insecurity while receiving minimal support from the state. All women reported financial and infrastructural barriers to accessing formal sexual and reproductive health services and tended to seek resources and support through social networks within the slum and from informal health services. Compared with more recent migrants, women who had migrated and resided in the slums for longer found it easier to utilise social networks and resources for sexual and reproductive health. Women had more agency in experimenting with contraceptives but had less power in making decisions during pregnancy and when seeking health care. Menstrual health was a neglected aspect of public health. The study indicates that public health policy targeting the urban poor needs to address the unique challenges faced by migrant women in informal settlements to rectify inequities in health services that leave significant portions of the urban poor population behind. [ABSTRACT FROM AUTHOR]

This paper explores politics and political participation from the voices and perspectives of migrant slum dwellers in Agbogbloshie, the most populous migrant slum in Accra. Using in-depth interviews, the paper found that residents' conception of politics is couched in a pejorative sense as they view politics as a "dirty and deceitful game." While most migrants see politics as contested elections in which political elites struggle for power, they participate in politics mainly by voting in periodic elections. The main driver of migrants' political participation is the need to vote for political parties and governments that protect them against forced eviction. [ABSTRACT FROM AUTHOR]

Children living in urban slums in India are exposed to chronic stressors that increase their risk of developing mental disorders, but they remain a neglected group. Effective mental health interventions are needed; however, it is necessary to understand how mental health symptoms and needs are perceived and prioritized locally to tailor interventions for this population. We used an existing rapid ethnographic assessment approach to identify mental health problems from the perspective of children living in Indian slums, including local descriptions, perceived causes, impact, and coping behavior. Local Hindi-speaking interviewers conducted 77 free-list interviews and 33 key informant interviews with children and adults (N = 107) from two slums in New Delhi. Results identified a range of internalizing and externalizing symptoms consistent with depression, anxiety, and conduct problems in children. Findings included both common cross-cultural experiences and symptoms as well as uniquely described symptoms (e.g., "madness or anger," "pain in the heart and mind") not typically included on western standardized measures of psychopathology. Mental health problems appeared to be highly interconnected, with experiences such as harassment and fighting often described as both causes and impacts of mental health symptoms in children. Community perspectives indicated that even in the face of several unmet basic needs, mental health problems were important to the community and counseling interventions were likely to be acceptable. We discuss implications for adapting mental health interventions and assessing their effectiveness to reduce the burden of mental illness among children living in urban slums in India. [ABSTRACT FROM AUTHOR]

Urban slums are human habitats with poor habitation qualities that are vulnerable to infectious diseases and public health crises. Low coverage from formal healthcare services providers created opportunity for informal providers to thrive in urban slums. This study examined the nature of relationship between informal and formal healthcare services providers in urban slums and explored opportunities for strengthening collaborations between them. Reconnaissance research method, a qualitative research approach for exploring under-researched terrains, guided the interview of 104 slum healthcare stakeholders across eight purposively selected slums in Enugu and Onitsha cities, in southeastern-Nigeria. Findings show that informal healthcare service providers are dominant in urban slums, and many of them cooperate and compete with formal providers. Supervision of informal providers in slums is inadequate, and the formal providers report that the informal providers find acceptance, despite their lack of adequate training and professionalism. Authorities governing health systems in slums are encouraged to establish a mechanism to profile informal providers, delineate the scope of services, and bridge the gap through the creation of referral channels. Subsequent studies may explore what character any mechanism created to institutionalize the collaboration toward improving healthcare services delivery should take and what challenges could undermine it. [ABSTRACT FROM AUTHOR]

Urban inequalities are exacerbated due to rapid urbanisation. This is also evident within slums in low- and middle-income countries, where high levels of heterogeneity amongst the slum population lead to differential experiences in Water, Sanitation, and Hygiene (WASH) and housing access. This scoping review provides evidence of the interconnection of WASH and housing and presents barriers to access and the consequences thereof for slum dwellers. It does so while considering the social stratification amongst urban slum dwellers and their lived experiences. A systematic search of journal articles was conducted in November 2022 in PubMed, Scopus, and Web of Science. A total of 33 papers were identified which were full text reviewed and data extracted. Infrastructure, social and cultural, socio-economic, governance and policy and environmental barriers emerged as general themes. Barriers to WASH and housing were more frequently described concerning women and girls due to gender norms within WASH and the home. Barriers to WASH lead to compromised health, socio-economic burdens, and adverse social impacts, thus causing residents of slums to navigate their WASH mobility spatially and over time. Insights from this review underscore the need for an intersectional approach to understanding access inequalities to WASH and housing.

Abstract Background India is experiencing a rising burden of chronic disease multimorbidity due to an aging population and epidemiological transition. Older adults residing in urban slums are especially vulnerable due to challenges in managing multimorbidity amid deprived living conditions. This study aimed to assess the prevalence of multimorbidity, associated health literacy, and quality of life impact in this population. Methods A community-based cross-sectional study was conducted among 800 adults aged ≥ 65 years in an urban slum in Gujarat, India. Data on sociodemographics, physical and mental health conditions, health literacy (HLS-SF-47), quality of life (Short Form-12 scale), and social determinants of health were collected. Multimorbidity is ≥ 2 physical or mental health conditions in one person. Results The prevalence of multimorbidity was 62.5% (500/800). Multimorbidity was significantly associated with lower physical component summary (PCS) and mental component summary (MCS) scores on the SF-12 (p

Abstract Background Illicit drug and high-risk alcohol use among adolescents leads to poor health outcomes. We enrolled adolescents from urban slums in Kampala, Uganda, to assess baseline prevalence and factors associated with illicit drug and high-risk alcohol consumption. Methods We conducted a cross-sectional study using data collected in a cohort that enrolled 14-19-year-old male and female participants from 25 March 2019 to 30 March 2020. Data was collected on social demographics, sexual behavior, and reproductive health using interviewer-administered questionnaires. The main outcomes were illicit drug use and high-risk alcohol use. Data on alcohol use was collected using the Alcohol Use Disorder Identification Test (AUDIT); results were dichotomized. Factors associated with each outcome were analyzed using multivariable logistic regression. Results We enrolled 490 participants (60.6% female) with a median age of 18 (IQR 17–18) years, 84.9% had less than secondary education, 48.4% had their sexual debut before 15 years, 47.1% reported paid sex in the past 3 months and 22.8% had a sexually transmitted infection (chlamydia, gonorrhea, and active syphilis) baseline characteristics associated with illicit drug use in the past 3 months were male gender (aOR 12.45; 95% CI 7.21–21.50) being married (aOR 2.26; 95%CI 1.03–4.94) 10 or more paying sexual partners (aOR 2.45; 95%CI 1.05–5.69) and high-risk alcohol use (aOR 3.94; 95%CI 2.10–7.40), baseline characteristics associated with high-risk alcohol use were male gender (aOR 0.29; 95% CI 0.13–0.63) emotional violence from sexual partners (aOR 2.35; 95%CI 1.32–418) illicit drug users com (aOR 3.94; 95% CI 2.10–7.40). Conclusion Illicit drug and high-risk alcohol use are prevalent among male adolescents and adolescents involved in high-risk sexual behavior living in the urban slums of Kampala.

Purpose: This study evaluates the recent trends in ocular morbidities and vision-related practices in “out-of-school” children in urban slums of Gurugram in North India. Methods: In this observational study, a validated questionnaire was administered to 161 students from two nonformal slum schools. Sociocultural, demographic data, vision-related practices, and visual acuity with subjective refraction of the children were recorded. Results: A total of 80 boys and 81 girls (9.17 ± 2.58 years) participated in this study. About 40% of the children were from lower socioeconomic status. The visual acuity recorded for all the children, except three children, was 6/6 in both eyes. One child had a pre-phthisical eye with no light perception, following a childhood trauma, with the other eye having 6/6 vision. Two children had refractive errors (myopia and compound myopic astigmatism), with a best corrected visual acuity (BCVA) of 6/6. Thirteen children (8%) had Bitot’s spots and 67 (35.4%) had allergic conjunctivitis. Eight (5%) children complained of dry eye–related symptoms like redness and watering of eyes, while 19 (11.8%) had diffuse headache. Average number of years spent in school for these children was less than 1.7 years (range: 1 month–6 years). Only 10.5% of the children gave the history of watching television more than 30 h/week. Significant association was found between the income of father and use of digital devices in children below 10 years (P = 0.003) and children playing outdoors (P = 0.001). There was a significant association noted for age and use of digital devices (P = 0.037). Conclusion: The prevalence of refractive errors in “out-of-school” children of urban slum was much less than the national average. Almost one in three children suffered from eye allergies, while 8% children had Bitot’s spots. The data about the prevalence of ocular comorbidities in underserved areas like urban slums can be used to update and strategize eye health-care delivery models for out-of-school children.

Background: India is experiencing a rising burden of chronic disease multimorbidity due to an aging population and epidemiological transition. Older adults residing in urban slums are especially vulnerable due to challenges in managing multimorbidity amid deprived living conditions. This study aimed to assess the prevalence of multimorbidity, associated health literacy, and quality of life impact in this population. Methods: A community-based cross-sectional study was conducted among 800 adults aged ≥ 65 years in an urban slum in Gujarat, India. Data on sociodemographics, physical and mental health conditions, health literacy (HLS-SF-47), quality of life (Short Form-12 scale), and social determinants of health were collected. Multimorbidity is ≥ 2 physical or mental health conditions in one person. Results: The prevalence of multimorbidity was 62.5% (500/800). Multimorbidity was significantly associated with lower physical component summary (PCS) and mental component summary (MCS) scores on the SF-12 (p < 0.001). After adjusting for sociodemographic variables, the odds ratio of 0.81 indicates that for every 1 unit increase in the health literacy score, the odds of having multimorbidity decrease by 19%. Older age within the older adult cohort (per year increase) was associated with greater odds of multimorbidity (AOR 1.05, 95% CI 1.02–1.09). Physical inactivity (AOR 1.68, 95% CI 1.027–2.77) and lack of social support (AOR 1.57, 95% CI 1.01–2.45) also increased the likelihood of multimorbidity. Conclusion: There is a substantial burden of multimorbidity among urban slum dwellers aged ≥ 65 years in India, strongly linked to modifiable risk factors like poor health literacy and social determinants of health. Targeted interventions are essential to alleviate this disproportionate burden among urban slum older adults. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluates the recent trends in ocular morbidities and vision-related practices in "out-of-school" children in urban slums of Gurugram in North India. Methods: In this observational study, a validated questionnaire was administered to 161 students from two nonformal slum schools. Sociocultural, demographic data, vision-related practices, and visual acuity with subjective refraction of the children were recorded. Results: A total of 80 boys and 81 girls (9.17 ± 2.58 years) participated in this study. About 40% of the children were from lower socioeconomic status. The visual acuity recorded for all the children, except three children, was 6/6 in both eyes. One child had a pre-phthisical eye with no light perception, following a childhood trauma, with the other eye having 6/6 vision. Two children had refractive errors (myopia and compound myopic astigmatism), with a best corrected visual acuity (BCVA) of 6/6. Thirteen children (8%) had Bitot's spots and 67 (35.4%) had allergic conjunctivitis. Eight (5%) children complained of dry eye- related symptoms like redness and watering of eyes, while 19 (11.8%) had diffuse headache. Average number of years spent in school for these children was less than 1.7 years (range: 1 month-6 years). Only 10.5% of the children gave the history of watching television more than 30 h/week. Significant association was found between the income of father and use of digital devices in children below 10 years (P = 0.003) and children playing outdoors (P = 0.001). There was a significant association noted for age and use of digital devices (P = 0.037). Conclusion: The prevalence of refractive errors in "out-of-school" children of urban slum was much less than the national average. Almost one in three children suffered from eye allergies, while 8% children had Bitot's spots. The data about the prevalence of ocular comorbidities in underserved areas like urban slums can be used to update and strategize eye health-care delivery models for out-of-school children. [ABSTRACT FROM AUTHOR]

This research seeks to find out the economic empowerment of women living in the Nagpur city sl- ums by engaging with the Self-Help Groups(SHG). Since the women in these disadvantaged societies still struggle to overcome some socio-economic barriers, SHGs are now accepted means of empowering women to improve their livelihood. As part of this research, quantitative questionnaires are used alongside qualitative interview to assess the role of SHGs in improving women's income earning capacities, skills acquisition, and access to finances. The study also shows that women's economic status is probably improved through formation of SHGs because; they are able to access credit facilities, engage in any type of business and bargain for better prices. Further, socio-cultural benefits for the formation of SHGs as identified in the study are that it builds up the confidence levels of the women, empowers the women in decision-making, strengthens the social obligations and group unity of the females. The findings highlight the need to improve policy support and organizational environment for the development of SHGs and their scale. Finally, this research establishes that SHGs act as a useful means through which economic enfranchisement might be achieved; the present study's findings could therefore be useful to policymakers, development workers and community mobilisers who are interested in the upliftment of women living in urban slums. [ABSTRACT FROM AUTHOR]

Background: Illicit drug and high-risk alcohol use among adolescents leads to poor health outcomes. We enrolled adolescents from urban slums in Kampala, Uganda, to assess baseline prevalence and factors associated with illicit drug and high-risk alcohol consumption. Methods: We conducted a cross-sectional study using data collected in a cohort that enrolled 14-19-year-old male and female participants from 25 March 2019 to 30 March 2020. Data was collected on social demographics, sexual behavior, and reproductive health using interviewer-administered questionnaires. The main outcomes were illicit drug use and high-risk alcohol use. Data on alcohol use was collected using the Alcohol Use Disorder Identification Test (AUDIT); results were dichotomized. Factors associated with each outcome were analyzed using multivariable logistic regression. Results: We enrolled 490 participants (60.6% female) with a median age of 18 (IQR 17–18) years, 84.9% had less than secondary education, 48.4% had their sexual debut before 15 years, 47.1% reported paid sex in the past 3 months and 22.8% had a sexually transmitted infection (chlamydia, gonorrhea, and active syphilis) baseline characteristics associated with illicit drug use in the past 3 months were male gender (aOR 12.45; 95% CI 7.21–21.50) being married (aOR 2.26; 95%CI 1.03–4.94) 10 or more paying sexual partners (aOR 2.45; 95%CI 1.05–5.69) and high-risk alcohol use (aOR 3.94; 95%CI 2.10–7.40), baseline characteristics associated with high-risk alcohol use were male gender (aOR 0.29; 95% CI 0.13–0.63) emotional violence from sexual partners (aOR 2.35; 95%CI 1.32–418) illicit drug users com (aOR 3.94; 95% CI 2.10–7.40). Conclusion: Illicit drug and high-risk alcohol use are prevalent among male adolescents and adolescents involved in high-risk sexual behavior living in the urban slums of Kampala. [ABSTRACT FROM AUTHOR]

Background Urban slums are hotspots of infectious diseases like COVID-19 as was seen in the waves of 2020 and 2021. One of the primary reasons why slums are disproportionately affected is their location in inaccessible and uninhabitable zones, crowded and poorly ventilated living spaces, unsanitary conditions and common facilities (water taps, common toilets, etc.). Staying at home during pandemics is hardly an option for slum dwellers as it often means giving up work and even basic necessities. Methodology This paper aims to understand the habitat vulnerabilities of slums in the two Indian megacities of Pune and Surat which were the worst hit during both waves. The study is done at the level of wards, which is the smallest administrative boundary, taking the habitat vulnerability (congestion and access to basic services). To identify the explanatory variables which increase the vulnerability of slums to infectious diseases, literature study is done on the triggering factors which affect habitat vulnerability derived from common characteristics and definitions of slum. Results The aim of the research is to categorize the slums into 3 levels of risk zones and map them subsequently. Conclusion This study will help in formulating a model to prioritize the allocation of sparse resources in developing countries to tackle the habitat vulnerabilities of the slum dwellers especially during health emergencies of contagious diseases like COVID-19.

Background: Economic violence prevails to be one of the unexplored domains of intimate partner violence. Objective: To explore the perceived forms of economic violence and its health impacts among married women in Puducherry. Methodology: A community-based exploratory study was conducted in urban slums in Puducherry. All married women aged 18 to 65 years belonging to low socio-economic status residing in two selected slums were included by purposive sampling. A total of seven focus group discussions were conducted till the point of saturation and manual content analysis done. Results: Four major themes emerged, namely: experiences of economic abuse, health impacts of economic abuse, perceived factors influencing economic abuse, and suggested preventive measures for economic abuse. Conclusion: Economic abuse against women in India exists in multiple dimensions. It has profound consequences on the physical and psychological health of women. [ABSTRACT FROM AUTHOR]

Background: With increasing urbanization, number of urban slums is also rising. The health facilities and indicators in urban slums are poor as compared to other urban population. The present study presents an analysis of the health problems, utilization of health services and vulnerability of urban slums. Aims & Objectives: To map the slums in urban areas and assess the vulnerability of households. Methodology: The study was conducted in all urban slums of five cities of Nainital and Udham Singh Nagar districts namely Haldwani, Ramnagar, Rudrapur, Jaspur and Kashipur. Group discussions involving community members, ward surveys by ASHA workers and household level vulnerability assessment were done using standard format according to "Guidelines and Tools for Vulnerability Mapping and Assessment of Urban Health, 2017". Results: Most urban slum dwellers are daily wage laborers with major population suffering mainly from diabetes, hypertension, respiratory infection. Lack of drugs and diagnostic facilities are the major concerns. Infrastructure needs strengthening in most of the slums. Around three fourth of population belonged to vulnerable group with remaining in highly vulnerable group. Conclusion: There are social problems in urban slums like illiteracy, lack of awareness, unemployment which worsen the health problems. So, a holistic approach is needed for the solution. [ABSTRACT FROM AUTHOR]

Currently, 24.5% of the population of Bima City lack access to sanitation. The issue is predominantly concentrated in densely populated urban slums along the riverbanks, influenced by the cultural and societal context of Indonesian society. From 2021 to 2022, a comprehensive mixed-method study was conducted in three urban slums, applying the Integrated Framework for Sanitation Services (IFSS) to explore individual aspects within a socio-cultural context. Combining quantitative and qualitative methods, the research involved a household questionnaire survey and in-depth interviews (IDI). The study revealed that individual aspects are shaped by perceptions of the convenience of open defecation and latrine use as well as experiences with shared latrines, driving the adoption of private latrines. Challenges such as financial constraints and limited construction capabilities in urban slum communities often hinder latrine construction, though cultural and traditional values (adat) in the Bima community in urban slums help to alleviate these obstacles. A recommendation is made to enhance the monitoring of sanitation adoption progress, focusing on the sanitation system’s functioning and adherence to the sanitation hierarchy. Despite awareness of the importance of safe disposal, its impact on sanitation behavior in Bima City’s urban slums has been constrained, underscoring the imperative for effective behavior change communication strategies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the factors associated with knowledge and practices related to menstrual hygiene management among adolescent girls in urban slums in Jaipur, India. Material and Methods: A cross-sectional study among 417 adolescent girls was conducted. Descriptive statistics, Chi-square, and bivariate and multivariate logistic regression methods were used to analyze the data and determine the associated factors. Findings: Only 48.7% of girls had a correct understanding of menstruation. In addition, 55.1% of the menstruating girls had faced health problems related to mensuration in the last 6 months; however, only 47.6% visited a health facility for treatment. Educational status of the girl (AOR = 1.89, 95% CI = 0.88-4.06), mother's education (AOR = 2.19, 95% CI = 1.30-3.67) and income (AOR = 1.89, 95% CI = 0.67-3.95), father's income (AOR = 1.42, 95% CI = 0.76-2.95), and counseling by field health workers (AOR = 2.08, 95% CI = 1.23-3.51) were found to be associated with knowledge about menstruation. Girl's education (AOR = 1.49, 95% CI = 0.74-2.95), mother's education (AOR = 1.46, 95% CI = 0.7-2.84) and income (AOR = 1.314, 95% CI = 0.44-2.02), father's education (AOR = 1.64, 95% CI = 0.55-3.08) and income (AOR = 2.0, 95% CI = 0.86-3.28), and counseling by field health workers (AOR = 1.48, 95% CI = 0.76-2.64) were found to be associated with the type of absorbents used. Conclusion: The findings from the study show that the awareness about mensuration and utilization of health services among adolescent girls is low. There is a need to create an enabling environment for girls to access knowledge and health services related to menstruation by creating awareness at the community level, strengthening outreach by field health workers, and ensuring privacy in healthcare facilities. [ABSTRACT FROM AUTHOR]

Background Urban slums are hotspots of infectious diseases like COVID-19 as was seen in the waves of 2020 and 2021. One of the primary reasons why slums are disproportionately affected is their location in inaccessible and uninhabitable zones, crowded and poorly ventilated living spaces, unsanitary conditions and common facilities (water taps, common toilets, etc.). Staying at home during pandemics is hardly an option for slum dwellers as it often means giving up work and even basic necessities. Methodology This paper aims to understand the habitat vulnerabilities of slums in the two Indian megacities of Pune and Surat which were the worst hit during both waves. The study is done at the level of wards, which is the smallest administrative boundary, taking the habitat vulnerability (congestion and access to basic services). To identify the explanatory variables which increase the vulnerability of slums to infectious diseases, literature study is done on the triggering factors which affect habitat vulnerability derived from common characteristics and definitions of slum. Results The aim of the research is to categorize the slums into 3 levels of risk zones and map them subsequently. Conclusion This study will help in formulating a model to prioritize the allocation of sparse resources in developing countries to tackle the habitat vulnerabilities of the slum dwellers especially during health emergencies of contagious diseases like COVID-19.

This research output established that a significant proportion of the global population lives in low-income communities mostly in the Global South. These communities face severe water scarcity and persistent sanitation challenges. It emerged that greywater reuse has the potential to improve the access to sufficient clean water in low-income communities. The study sought to ascertain user perceptions and acceptance of treated greywater reuse in low-income communities. To anchor this research, a comprehensive consultation of literature was done, and key sources of data were drawn from various secondary sources of data such as bibliographic databases. This was followed by the snowballing of obtained papers. The research employed a narrative review approach in methodology. The findings of this study indicate that people living in low-income communities have a positive perception regarding reusing treated greywater. Furthermore, it was established that the majority of persons living in low-income communities accept reuse for non-potable purposes including vegetable irrigation, laundry, toilet flushing, and car washing. HIGHLIGHTS Low-income communities lack sufficient clean water and improved sanitation.; Greywater reuse has the potential to improve water supply in low-income communities.; A significant percentage of persons living in low-income communities accept reusing treated greywater for both potable and non-potable purposes.;

Urban inequalities are exacerbated due to rapid urbanisation. This is also evident within slums in low- and middle-income countries, where high levels of heterogeneity amongst the slum population lead to differential experiences in Water, Sanitation, and Hygiene (WASH) and housing access. This scoping review provides evidence of the interconnection of WASH and housing and presents barriers to access and the consequences thereof for slum dwellers. It does so while considering the social stratification amongst urban slum dwellers and their lived experiences. A systematic search of journal articles was conducted in November 2022 in PubMed, Scopus, and Web of Science. A total of 33 papers were identified which were full text reviewed and data extracted. Infrastructure, social and cultural, socio-economic, governance and policy and environmental barriers emerged as general themes. Barriers to WASH and housing were more frequently described concerning women and girls due to gender norms within WASH and the home. Barriers to WASH lead to compromised health, socio-economic burdens, and adverse social impacts, thus causing residents of slums to navigate their WASH mobility spatially and over time. Insights from this review underscore the need for an intersectional approach to understanding access inequalities to WASH and housing. [ABSTRACT FROM AUTHOR]

Abstract Background It is assumed that the health conditions of urban women are superior to their rural counterparts. However, evidence from Asia and Africa, show that poor urban women and their families have worse access to antenatal care and facility childbirth compared to the rural women. The maternal, newborn, and child mortality rates as high as or higher than those in rural areas. In Uganda, maternal and newborn health data reflect similar trend. The aim of the study was to understand factors that influence use of maternal and newborn healthcare in two urban slums of Kampala, Uganda. Methods A qualitative study was conducted in urban slums of Kampala, Uganda and conducted 60 in-depth interviews with women who had given birth in the 12 months prior to data collection and traditional birth attendants, 23 key informant interviews with healthcare providers, coordinator of emergency ambulances/emergency medical technicians and the Kampala Capital City Authority health team, and 15 focus group discussions with partners of women who gave birth 12 months prior to data collection and community leaders. Data were thematically coded and analyzed using NVivo version 10 software. Results The main determinants that influenced access to and use of maternal and newborn health care in the slum communities included knowledge about when to seek care, decision-making power, financial ability, prior experience with the healthcare system, and the quality of care provided. Private facilities were perceived to be of higher quality, however women primarily sought care at public health facilities due to financial constraints. Reports of disrespectful treatment, neglect, and financial bribes by providers were common and linked to negative childbirth experiences. The lack of adequate infrastructure and basic medical equipment and medicine impacted patient experiences and provider ability to deliver quality care. Conclusions Despite availability of healthcare, urban women and their families are burdened by the financial costs of health care. Disrespectful and abusive treatment at hands of healthcare providers is common translating to negative healthcare experiences for women. There is a need to invest in quality of care through financial assistance programs, infrastructure improvements, and higher standards of provider accountability are needed.

Background: The NFHS-5 found that 35.5% (Urban areas-30%) of children under five years were stunted and 32.1% were overweight (1). ICDS being a centrally sponsored scheme, is functioning nationwide in tribal, rural and urban slums; with a potential to improve nutritional outcome as well as overall development of the child. Children dwelling in urban slums are at a higher risk of being undernourished. As per the NFHS 2015-16 survey, only 40.2% of children from urban areas are receiving ICDS services. The anganwadi workers(AWW) identify and encourage the beneficiaries to attend anganwadi regularly and avail the services. Objective: The aim of this study was to understand the reasons for a lower enrolment of children in anganwadi. Methodology: The study was conducted in an urban slum in Mumbai with a population of 1.2lakh. We conducted force field analysis among the AWWs in 3 groups of 6-7 each. The factors mentioned in individual sheets and those represented in diagram were analysed manually. Results: The force field analysis revealed that the motivating factors for attending anganwadi regularly were closer distance from home, attractive toys/activities, special food on certain days, interactive teachers, meeting friends, siblings going to school. On the contrary, reasons for poor/nil attendance were infrastructural challenges like restricted space, no water and electricity, rented anganwadis; availability of private/municipality preschools nearby; working parents; ration made available at doorsteps during COVID and disinterest in the variety of food provided. Conclusion: Need-based revamping of Anganwadis in urban slums is needed to improve the attendance of children and in turn ensure good nutrition and development of children in slums.

This study aims at (re)focusing research attention on the improvement of welfare, achieving sustainable micro cyber-risk management, and the reduction of persistent insurance exclusion among retail e-payment agents (REAs) or branchless banking agents operating globally and in Lagos slums. With the active collaboration of REAs and micro-insurers, we designed and introduced the first hypothetical POS-related micro cyber-risk insurance (PRMCRI) to sustainably manage identified cyber-risks of REAs. Using a contingent valuation survey and logistic regression, this study also investigates REAs' perceptions and factors having statistically significant effects on their willingness to pay (WTP) for PRMCRI. Our findings revealed that WTP for PRMCRI is only slightly sensitive to premium price. REAs' perceptions of inflation, interest rates, deployment/administration of PRMCRI on mobile-technology platforms, and the effectiveness of regulatory consumer protection all positively affected their WTP for PRMCRI. Age, marital status, education, religion, and gender had no statistically significant effect on the WTP for PRMCRI. The practical value and actionable implication of the PRMCRI were further evinced, as 65.93 percent of the 455 surveyed REAs affirmed their WTP for the product. Ultimately, we hope that the introduced PRMCRI and its associated empirical/policy dynamics will champion a novel and seminal path for global micro cyber-insurance markets, future studies, and policies. [ABSTRACT FROM AUTHOR]

Background Vaccination against coronavirus disease 2019 (COVID-19) is a cost-effective mitigation strategy against the pandemic. As the COVID-19 vaccine becomes more available, low uptake is now a global threat and understanding the underpinnings in local contexts is a priority for intervention development. We aimed to evaluate behavioural determinants of COVID-19 vaccine acceptance that could inform engagement strategies to improve vaccine uptake in Makoko, an urban slum in Lagos, Nigeria. Methods A population-based case–control study utilized the barrier analysis (BA) approach to evaluate the beliefs and behaviours of 45 'doers' and 45 'non-doers'. The standardized BA tabulation sheet was used to assess differences in the proportions between the two groups to identify significant factors that could be addressed through a behaviour change strategy. Results Perceived social norms (family, friend, healthcare workers) that approve the vaccine and expected vaccine protection against diseases among doers were determinants of behaviour. Perceived poor accessibility, safety concerns, lack of trust, low vaccine efficacy and low susceptibility to the infection were the most important determinants of behaviour among non-doers. Conclusions Measures to improve COVID-19 vaccine acceptance in Makoko should include improvement in accessibility and exposing myths and misinformation through clear, concise and evidence-based community education delivered by trusted persons such as healthcare workers and religious leaders. [ABSTRACT FROM AUTHOR]

Abstract Slum-dwellers lack several essential amenities (such as water, sanitation, and electricity) which make them more vulnerable than non-slum dwellers. As there is limited to no access to health and social care services in slums, the slum environment is expected to be an even more dangerous environment for older adults, negatively impacting their quality of life (QoL). To provide an overview of the perceived (unmet) health and social care needs and how it affects the QoL, this study aims to explore the self-perceived health and social needs of older adults in urban slums in Ghana. Using a phenomenological approach, 25 semi-structured interviews were conducted between May and June 2021, in the homes of older adults in two slums in Ghana. After coding and analysing the transcripts, five main themes emerged: (a) perception of health; (b) (de)motivators of health service use; (c) perception of social care, (d) social needs, and (e) influence of phenomena on QoL. It appeared that older adults believed that spiritual powers were causing illnesses and influenced their use of formal health services. Other factors such as expired insurance cards and the attitude of healthcare workers served as demotivators for using health services. Perceived health needs were mainly current disease conditions (arthritis, diabetes, hypertension, vision/hearing challenges), challenges with health insurance, the behaviour of some health professionals, the proximity of health facilities, and unnecessary queues at major health facilities. Unmet social needs identified by this study were a sense of neglect by family (need for companionship), requiring assistance with activities of daily living, and the need for financial support. Participants had more health needs than social needs. Health providers do not usually prioritize the care of slum-dwelling older adults. Most participants still have challenges with the National Health Insurance Scheme (NHIS). Their social needs were mainly related to financial difficulties and help with some activities of daily living. Participants expressed that they desired companionship (especially the widowed or divorced ones) and the lack of it made them feel lonely and neglected. Home visits by health professionals to older adults should be encouraged to monitor their health condition and advocate for family members to keep older adults company. Healthcare providers should exhibit positive attitudes and educate older patients on the advantages of formal health services use, as well as the need to seek early treatment as this will influence their QoL to a large extent.

Background: The COVID-19 pandemic has brought an unprecedented adverse impact on women's health. Evidence from the literature suggests that violence against women has increased multifold. Gender-based violence in urban slums has worsened due to a lack of water and sanitation services, overcrowding, deteriorating conditions and a lack of institutional frameworks to address gender inequities. Methods: The SAMBHAV (Synchronized Action for Marginalized to Improve Behaviors and Vulnerabilities) initiative was launched between June 2020 to December 2020 by collaborating with the Uttar Pradesh state government, UNICEF and UNDP. The program intended to reach 6000 families in 30 UPS (Urban Poor settlements) of 13 city wards. These 30 UPS were divided into 5 clusters. The survey was conducted in 760 households, 397 taken from randomly selected 15 interventions and 363 households from 15 control UPS. This paper utilized data from a baseline assessment of gender and decision-making from a household survey conducted in the selected UPS during July 03–15, 2020. A sample size of 360 completed interviews was calculated for intervention and control areas to measure changes attributable to the SAMBHAV intervention in the behaviours and service utilization (pre- and post-intervention). Results: The data analysis showed a significant difference (p-value < 0.001) between respondents regarding women's freedom to move alone in the control and intervention area. It also reflected a significant difference between control and intervention areas as the respondents in the intervention area chose to work for the cause of gender-based violence. Conclusion: The SAMBHAV initiative brought an intersectional lens to gender issues. The community volunteers were trained to approach issues based on gender-based violence with the local public, and various conferences and meetings were organized to sensitize the community. The initiative's overall impact was that it built momentum around the issue of applying the concept of intersectionality for gender issues and building resilience in the community. There is still a need to bring multi-layered and more aggressive approaches to reduce the prevalence of gender-based violence in the community.

Aim: The study aims to assess the practice of using unsafe drinking water and sanitary practices among the population dwelling in slum settings of Bhubaneswar city, Odisha, India. Subjects and Methods: A cross-sectional study was conducted among 288 households in the Bhubaneswar slums of Chandrasekharpur, Neeladri Vihar, and Trinatha basti. A questionnaire was administered face to face. Descriptive statistics were used to define the participants’ sociodemographic characteristics, household information, drinking water, latrine characteristics, and waste disposal. Results: The majority (59.7%) resided in kutcha households in notified slum areas, and 89.6% were reportedly illiterate. About 92.7% resided in a deplorable condition, relying on piped water (79.5%) from the community sources and 20.5% used it for drinking and household purposes. Around 83% of the respondents stated they did not treat water before consumption. Bathroom facilities were found to be inadequate, and 74.3% used pit latrines. The majority of household wastes (83%) were managed by directly letting them to the drainage system untreated. As a consequence, 91% reported breeding of flies and mosquitoes near their household premises and 70.5% stated having fever in the past 6 months. Conclusion: Despite the government’s initiatives to improve water, sanitation, and hygiene (WASH) strategies, an extensive gap in practice was observed. As a result, Bhubaneswar municipality must strictly enforce policy and regulatory guidelines concerning WASH to improve the sanitation practices, particularly in the areas of drinking water and household waste management.

Abstract Background Inequalities in child feeding practices are evident in urban slums in developing nations. Our study identified the determinants of complementary feeding (CF) practices in the informal settings of Pune, India, a district close to the business capital of India. Methods Employing a cross-sectional study design, 1066 mother–children dyads were surveyed. Five indicators defined by the WHO were used to study complementary feeding practices. Determinants of complementary feeding practices were identified using multivariate analyses. Results Timely initiation of CF was reported by 42%. Minimum acceptable diet (MAD), minimum meal frequency (MMF), and Diet Diversity Score > 4 were achieved by 14.9%, 76.5%, and 16.4%, respectively. Continued breastfeeding (CBF) at 2 years, and feeding processed foods were practiced by 94% and 50%, respectively. Among the maternal characteristics, a mother’s age > 30 years at pregnancy was less likely to achieve DD [AOR: 0.195 (CI 0.047–0.809)] and MAD [AOR: 0.231 (CI 0.056–0.960)]. Mothers with lower education were less likely to meet MMF [AOR: 0.302 (0.113–0.807)], MAD [AOR: 0.505 (CI 0.295–0.867)] and to introduce formula feeds (FF) [AOR: 0.417 (0.193- 0.899)]. Among obstetric characteristics, birth spacing

Background: Elder abuse is still underreported and unacknowledged despite being a serious social concern linked to significantly higher rates of hospital admission and mortality. Abuse has a profound effect on the victims' physical, mental, and overall quality of life. Abuse can worsen an elderly person's preexisting chronic and incapacitating disease, increasing their dependence, vulnerability, and marginalization. Objective: The objective of this study is to evaluate the prevalence and pattern of abuse and identify various factors associated with it among community-dwelling elderly people in slums of Siliguri Municipal Corporation. Materials and Methods: A community-based cross-sectional study was conducted among 300 elderly people (60 years and above) in slums of Siliguri Municipal Corporation. A predesigned, pretested, and semi-structured questionnaire was used for data collection. The prevalence and pattern of elder abuse were determined by simple descriptive statistics and binary logistic regression was used to find out the correlates of abuse. Results: Abuse was present in 12% of the study population. The elderly above 80 years and females had higher odds of abuse. With respect to the existing property, results showed that ownership of agricultural land is a risk factor of abuse. Most of the study population thought that disrespect accounts for elder abuse, followed by neglect, and verbal abuse. The main perpetrators were daughters-in-law, followed by sons, and spouses. Conclusion: The prevalence of geriatric abuse was found to be quite high in the present study. The higher age group and lesser socioeconomic position are just a couple of the causes. Therefore, the continuous issues that make life difficult for the elderly must be addressed.

Abstract Background Urban slums are home to a significant number of marginalized individuals and are often excluded from public services. This study explores the determinants of willingness and uptake of COVID-19 vaccines in urban slums in Pakistan. Methods The study uses a cross-sectional survey of 1760 respondents from five urban slums in twin cities of Rawalpindi and Islamabad carried out between June 16 and 26, 2021. Pairwise means comparison tests and multivariate logistic regressions were applied to check the associations of socio-demographic factors and COVID-19 related factors with willingness to get vaccinated and vaccination uptake. Results Only 6% of the sample was fully vaccinated while 16% were partially vaccinated at the time of survey. Willingness to receive vaccination was associated with higher education (aOR: 1.583, CI: 1.031, 2.431), being employed (aOR: 1.916, CI: 1.423, 2.580), prior infection in the family (but not self) (aOR: 1.646, CI: 1.032, 2.625), family vaccination (aOR: 3.065, CI: 2.326, 4.038), knowing of and living close to a vaccination center (aOR: 2.851, CI: 1.646, 4.939), and being worried about COVID-19 (aOR: 2.117, CI: 1.662, 2.695). Vaccine uptake was influenced by the same factors as willingness, except worriedness about COVID-19. Both willingness and vaccination were the lowest in the two informal settlements that are the furthest from public facilities. Conclusions We found low lived experience with COVID-19 infection in urban slums, with moderate willingness to vaccinate and low vaccination uptake. Interventions that seek to vaccinate individuals against COVID-19 must account for urban poor settlement populations and overcome structural barriers such as distance from vaccination services, perhaps by bringing such services to these communities.

Abstract Background Tobacco in any form kills millions of people every year. Tobacco addiction among youth shows an increasing trend while smokeless type is becoming more common. This study aimed to describe the lifestyle of chewing smokeless tobacco among a group of high-risk youth population in Sri Lanka. Methods A descriptive cross-sectional study was conducted among a sample of 1431 youths aged between 15 to 24 years residing in urban slums in Colombo Sri Lanka, using a cluster sampling technique combined with probability proportionate to size technique. Data were collected using an interviewer-administered questionnaire. Chewing smokeless tobacco was assessed using betel quid chewing and commercially prepared tobacco and areca nut packet chewing. Current chewer was defined as who had the practice of chewing during past 30 days. Results The mean age of the study sample was 17.53 (95% CI: 17.40–17.65). Of the 1431 respondents, 57% were males and 43% were females. The prevalence of current smokeless tobacco chewers was 44.9% and among them 90.8% were males and 9.8% were females. Around 31.3% did not have smokeless tobacco chewing practice (Male-5.9%, Female-64.9%). Among the current smokeless tobacco chewers 21.5% chew both types of smokeless tobacco products and all of them were males. Male gender (OR 17.9; 11.4 -27.9) and ever smoking lifestyle (OR 4.4; 2.9–6.6) were significant determinants of current smokeless tobacco chewing lifestyle. Conclusion and recommendations The study shows a high prevalence of smokeless tobacco use by youth aged between 15 to 24 years who were residing in urban slum areas in the district of Colombo, in Sri Lanka, highlighting this target group for early intervention to reduce the uptake and promote the quitting of this practice.

Water-sensitive design (WSD) is created to manage water sensitivity, such as rainwater management and water supply. Manado City is strategically located in North Sulawesi Province, Indonesia, which is growing rapidly but has slum areas and is prone to flooding. Slums do not meet standards, including water management. The application of WSD to residential areas in urban areas affects the utilization of rainwater flows and the availability of alternative water sources. Previous studies did not look at the potential for implementing WSD to increase the settlement quality in slum areas. This study aims to identify the potential for implementing WSD in the urban slum area of Manado city by considering the existing situation and conditions. Furthermore, this study reviews the physical, non-physical, and supporting aspects for the potential implementation. Three locations of Manado city slums were reviewed as case studies. For data collection, this study uses the interview method through structured questionnaires, area observations, and secondary data. The physical aspect reviews the rainwater drainage system fed by greywater and the water supply including groundwater and refilled water. The non-physical aspect reviews incomes, ownership of houses, and limited land. The study results show that the application of WSD is very potential given the location conditions, but some challenges need to be considered according to the characteristics of the location. [ABSTRACT FROM AUTHOR]

Reciprocity and negativity in social relationships are fundamental topics of social research rarely examined in sub‐Saharan Africa. Since the number and quality of relationships is associated with individual outcomes, these ties are particularly important in impoverished areas. We conducted a multi‐method study of the conditions associated with problematic networks and difficult people, including face‐to‐face surveys in Agbogbloshie (Accra, Ghana) and Kangemi (Nairobi, Kenya). While one quarter of all relationships were perceived to be difficult, results reveal significant differences between the two communities in terms of the composition of personal networks and the factors associated with difficulty at both relational and network levels of analysis. Kenyan networks are more difficult when there is an imbalance of assistance provided by the respondent (exploitation), while any imbalance (inequality) is problematic in Ghanaian networks. These findings underscore the importance of independent analyses of negative ties and difficult networks, contributing to a community‐based understanding of poverty in urban slums. [ABSTRACT FROM AUTHOR]

Background: It is assumed that the health conditions of urban women are superior to their rural counterparts. However, evidence from Asia and Africa, show that poor urban women and their families have worse access to antenatal care and facility childbirth compared to the rural women. The maternal, newborn, and child mortality rates as high as or higher than those in rural areas. In Uganda, maternal and newborn health data reflect similar trend. The aim of the study was to understand factors that influence use of maternal and newborn healthcare in two urban slums of Kampala, Uganda. Methods: A qualitative study was conducted in urban slums of Kampala, Uganda and conducted 60 in-depth interviews with women who had given birth in the 12 months prior to data collection and traditional birth attendants, 23 key informant interviews with healthcare providers, coordinator of emergency ambulances/emergency medical technicians and the Kampala Capital City Authority health team, and 15 focus group discussions with partners of women who gave birth 12 months prior to data collection and community leaders. Data were thematically coded and analyzed using NVivo version 10 software. Results: The main determinants that influenced access to and use of maternal and newborn health care in the slum communities included knowledge about when to seek care, decision-making power, financial ability, prior experience with the healthcare system, and the quality of care provided. Private facilities were perceived to be of higher quality, however women primarily sought care at public health facilities due to financial constraints. Reports of disrespectful treatment, neglect, and financial bribes by providers were common and linked to negative childbirth experiences. The lack of adequate infrastructure and basic medical equipment and medicine impacted patient experiences and provider ability to deliver quality care. Conclusions: Despite availability of healthcare, urban women and their families are burdened by the financial costs of health care. Disrespectful and abusive treatment at hands of healthcare providers is common translating to negative healthcare experiences for women. There is a need to invest in quality of care through financial assistance programs, infrastructure improvements, and higher standards of provider accountability are needed. [ABSTRACT FROM AUTHOR]

This paper deals with COVID-19-hit Kenyan slums and the numerous interventions civil society organizations implemented during the first waves of the pandemic since it was initially detected in March 2020. As part of a comprehensive project using mixed methodology, including desk research and key informant interviews, community-based organizations and non-governmental organizations, together with other stakeholders of their collaborative networks, were investigated regarding the roles that they played, the projects they carried out, and the interventions they were involved in in the mitigation of the negative impacts of COVID-19. This paper investigates how COVID-19 actually hit Kenyan slums and how it affected civil society organizations during the pandemic. [ABSTRACT FROM AUTHOR]