Globally, one billion people live in informal settlements, and that number is expected to triple by 2050. Studies suggests that health in informal settlements is a serious and growing concern, yet there is a paucity of research focused on health outcomes and the correlates of health in these settlements. Studies cite individual, environmental and social correlates to health in informal settlements, but they often lack empirical evidence. In particular, research suggests that high rates of violence against women (VAW) in informal settlements may be associated with detrimental effects on women's health, but few studies have investigated this link. The purpose of this study was to fill this gap by empirically exploring associations between women's experiences of intimate partner violence (IPV) and their physical and mental health. Data for this study were collected in August 2018 in Mathare Valley Informal Settlement in Nairobi, Kenya. A total of 550 randomly-selected women participated in surveys; however, analyses for this study were run on a subpopulation of the women (n = 361). Multivariate logistic regressions were used to investigate the link between psychological, sexual, and emotional IPV and women's mental and physical health. Results suggest that while some socioeconomic, demographic, and environmental variables were significantly associated with women's mental and physical health outcomes, all types of IPV emerged key correlates in this context. In particular, women's experiences of IPV were associated with lower odds of normal-high physical health component scores (based on SF-36); higher odds of gynecological and reproductive health issues, psychological distress (based on K-10), depression, suicidality, and substance use. Findings from this study suggest that policies and interventions focused on prevention and response to VAW in informal settlements may make critical contributions to improving health for women in these rapidly growing settlements.
Informal settlements (slums)—defined as residential areas lacking durable housing; sufficient living and public spaces; access to basic infrastructure, water, sanitation, and other services; and secure tenancy—are presumed to be poor health environments. Research in Kenya suggests that residents of these settlements have the worst health outcomes of any population, yet there is a paucity of research focused on the health and well-being of these residents. Even less attention is given to the role played by environment in health in these settings. The present study addresses these gaps by examining potential environmental correlates, specifically access to water and sanitation, of health-related quality of life (HRQOL) among 552 women in Mathare slum in Nairobi, Kenya. A Kiswahili version of the 36-Item Short Form Health Survey (SF-36) measured HRQOL. Results suggested that access to a toilet at all times was associated with every subscale of the mental health and general well-being domains of the SF-36. Primary water source was also associated with women’s HRQOL. Despite increasing efforts to expand sanitation and water access in informal settlements, more attention should be given to whether the interventions being introduced, which likely affect women’s psychosocial health, are appropriate for all residents, including women.
Violence against women is a serious public health and human rights concern and can take many forms. Intimate partner violence (IPV) is the subject of the majority of research focused on violence against women around the world; yet the health consequences of non-partner violence (NPV) can be just as serious. There is a critical gap in literature focused on NPV and the co-occurrence of NPV and IPV in sub-Saharan Africa, particularly in informal settlements. The unique historical, political, social, geo-spatial, physical, and built environment in informal settlements—often characterized as places with high rates of crime and violence—may be important in understanding NPV and co-occurrence of NPV and IPV in these communities, but more research is needed. The purpose of this study was to explore NPV in a large informal settlement in Nairobi, Kenya including its relationship to IPV, correlates, and common perpetrators of NPV in this setting. Data from 552 household-level surveys collected from women in a large informal settlement in Nairobi in 2018 were used in this study. Descriptive statistics and penalized maximum likelihood logistic regressions were used to examine the association between IPV and NPV, correlates, and perpetrators of NPV. Findings showed a strong, positive association between past-year IPV and NPV—highlighting a critical area for future study in IPV, NPV, and poly-victimization research. Results corroborated some findings from existing NPV research, but yielded important new information about correlates and perpetrators of NPV in informal settlements. NPV and poly-victimization have serious health consequences for women in any context, but women in informal settlements also face a number of structural economic, social, political, and environmental challenges that affect their health and wellbeing and may exacerbate the health consequences of violence perpetrated against them. Thus, more research into NPV and poly-victimization in informal settlements is critical.
Crime and violence are serious issues in informal settlements around the world. To date, there is a dearth of evidence about the causes of and effective strategies for reducing and preventing violence and crime in informal settlements in cities in the Global South. Additionally, women’s voices are often absent from research focused on violence and crime prevention and reduction in informal settlements. The purpose of this study, therefore, was (1) to identify potential causes of violence and crime in informal settlements, as perceived by women living in Mathare informal settlement in Nairobi, Kenya and (2) to highlight residents’ strategies for response and prevention. Fifty-five in-depth and walk-along interviews were conducted with women living in Mathare in 2015-2016. A modified grounded theory approach was used to guide data collection and analysis. The most common contributor to violence and crime identified by women in Mathare was idle youth, but leadership and government challenges, corruption and/or inadequacy of police, community barriers, tribalism, and lack of protective infrastructure also emerged as contributing factors. Despite facing many economic, environmental, and day-to-day challenges, women in Mathare identified violence and crime as predominant issues; thus, developing effective response and prevention strategies to these issues is paramount. Women discussed many strategies and initiatives to reduce and prevent violence and crime in informal settlements, but also identified barriers to implementing them. Findings suggest there is a need for trust-building between formal and informal sectors of the community, systems of accountability, and long-term investment to foster sustainable and effective violence and crime response and prevention in these settlements.
Around one billion people live in informal settlements, globally, including over half of Nairobi, Kenya’s three million residents. The purpose of this study was to explore women’s fear of victimization within Mathare, an informal settlement in Nairobi, Kenya and how fear of victimization influences behavior. Fifty-five in-depth interviews were conducted with women in 2016. A modified grounded theory approach guided data collection and analysis. Findings suggest fear of victimization is a serious concern in informal settlements. Women have found ways to adopt their behaviors that allow them to continue to function and protect their children despite fearing victimization, but at a potential cost to their health and well-being. Thus, there is a critical need for more research focused on social, economic, structural, community, infrastructure, technological, and individual strategies to prevent violence, enhance residents’ sense of safety, and, subsequently, minimize women’s fear of victimization in informal settlements.
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