Understanding the slum–health conundrum in sub-Saharan Africa: a proposal for a rights-based approach to health promotion in slums

Abstract

Sub-Saharan Africa is the world’s least urbanized region but is ironically also the region with the largest proportion of urban slum dwellers. However, there exists limited understanding of the impact of slums on health in the region. To address this knowledge gap, we conducted a systematic search in PubMed, Google, and Google Scholar to identify and review studies examining the slum–health relationship in sub-Saharan African cities. Subsequently, we performed thematic analysis of 40 studies to identify themes that explain the health impact of slums in the region. The majority of studies characterize slums as health-damaging settings, where poverty and unfavorable environmental conditions pose threats to public health and safety. Only a handful of studies suggest a beneficial relationship between slums and health, in such areas as affordable housing provision, employment generation, and community cohesion. We argue that the literature’s overwhelming emphasis on the environmental risks of slums feeds into a neoliberal urban agenda that seeks to clear slums at the expense of their beneficial contributions to health. Accordingly, we advocate a shift in policy discourse, from static characterization of slums as health risks to a health-promotion agenda that emphasizes the housing and service rights of slum populations.

The Most Important Social Determinants of Slum Dwellers’ Health: A Scoping Review

“…The oldest study was published in 2012, and the most recent study was published in 2019. Among the studies reviewed, 10 were cross-sectional studies [17,21,22,24,26,31,32,35,37,42], 6 were literature reviews [2,14,18,19,34,39], 5 were secondary analyses, 4 used mixed methods, and 8 studies were designed using other methods, as listed in Table 2. Eight studies were conducted in India [15,17,19,24,26,37,41,42], 7 studies were conducted in Bangladesh, 2 studies were conducted in Jordan, and the rest of the studies were carried out in various other countries (Table 2).…”

“…Physical structure of housing, lack of strength, durability, and safety of buildings due to the use of brittle, non-durable, and flammable materials [2,12,13,23,34]; Indoor air pollution and poor ventilation [2,35]; The presence of small rooms in houses [13,14]; Unhygienic toilets [13]; Lack of security and fear of destruction due to illegal construction [13,14]; Contamination with rodents and insects [14]; Adverse social-psychological residential environment [12,18,29,34]; The use of pathogenic and toxic substances in the construction of houses such as asbestos and lead [14]; House seizure (rent, private property, etc.) [36].…”

Tenant management under COVID-19 pandemic season among informal settlement rental housing in Ghana

“…According to Abu-Salia et al (2015), these phenomena have led to homelessness, loss of job, crime and poverty among slum dwellers. While past studies have failed to recognise the need to study tenant management among informal settlements, it has the potential of increasing COVID-19 cases as suggested by Wasdani and Prasad (2020) and Alaazi and Aganah (2019). This provides justification for the need to evaluate tenant management in COVID-19 pandemic season as a means of contributing to housing support and care studies during pandemic seasons.…”

Housing, planning and urban health: Historical and current perspectives from South Africa

“…The global literature commonly refers to informal settlements or slums as unhealthy, overcrowded or illegal and emphasises that these three aspects are related (Alaazi and Aganah 2019). These public health concerns remain a prominent motivation for slum clearance programmes across the globe.…”