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      Drivers of vulnerability to health and wellbeing challenges in informal settlements

      , , ,
      Frontiers in Sustainable Cities
      Frontiers Media SA

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          Abstract

          Introduction

          It is widely acknowledged that vulnerable populations are hit very hard, both in the short and long term, when their health and wellbeing needs are not met. Despite the efforts at different levels to protect and promote their health and wellbeing, older persons, people with disabilities and children heads of households, continue to face significant social, economic and cultural difficulties in relation to health and wellbeing inequities. While rights to health and wellbeing are constitutionally guaranteed, and strategies can be advanced to reduce vulnerable situations, challenges persists and yet societies, communities, and individual factors that engender vulnerability are understudied and remain poorly understood. Situating our findings and understandings within CLUVA social vulnerability framework, allows us to adapt a conceptual framework for understanding vulnerability to health and wellbeing challenges across different groups in informal urban space. We used CLUVA social vulnerability framework to explore and uncover drivers of vulnerability to health and wellbeing challenges among the vulnerable and marginalized groups using the governance diaries approach.

          Methods

          This was an ethnographic study, using governance diaries with 24 participants in Korogocho and Viwandani informal settlements in Nairobi, Kenya. The governance diaries approach involved bi-weekly governance in-depth interviews (IDIs) with study participants for 4 months, complemented with observations, reflections, participant diaries and informal discussions. We used framework analysis methodology.

          Results

          We identified several interlinked drivers and grouped them as individual, community, societal and structural level factors.

          Discussion

          A comprehensive view of drivers at different levels will help actors engage in more expansive and collaborative thinking about strategies that can effectively reduce health and wellbeing challenges.

          Conclusion

          The factors identified come together to shape functioning and capabilities of vulnerable groups in informal settlements. Beyond applying a more comprehensive concept of understanding health and wellbeing challenges, It is important to understand the drivers of vulnerability to health and wellbeing challenges from the perspective of marginalized and vulnerable populations. Particularly for local urban planning, the information should blend routine data with participatory assessment within different areas and groups in the city.

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          Most cited references38

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          Using the framework method for the analysis of qualitative data in multi-disciplinary health research

          Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
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            Closing the gap in a generation: health equity through action on the social determinants of health.

            The Commission on Social Determinants of Health, created to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it, is a global collaboration of policy makers, researchers, and civil society, led by commissioners with a unique blend of political, academic, and advocacy experience. The focus of attention is on countries at all levels of income and development. The commission launched its final report on August 28, 2008. This paper summarises the key findings and recommendations; the full list is in the final report.
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              A framework for vulnerability analysis in sustainability science.

              Global environmental change and sustainability science increasingly recognize the need to address the consequences of changes taking place in the structure and function of the biosphere. These changes raise questions such as: Who and what are vulnerable to the multiple environmental changes underway, and where? Research demonstrates that vulnerability is registered not by exposure to hazards (perturbations and stresses) alone but also resides in the sensitivity and resilience of the system experiencing such hazards. This recognition requires revisions and enlargements in the basic design of vulnerability assessments, including the capacity to treat coupled human-environment systems and those linkages within and without the systems that affect their vulnerability. A vulnerability framework for the assessment of coupled human-environment systems is presented.
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                Author and article information

                Journal
                Frontiers in Sustainable Cities
                Front. Sustain. Cities
                Frontiers Media SA
                2624-9634
                February 3 2023
                February 3 2023
                : 5
                Article
                10.3389/frsc.2023.1057726
                da6c5a23-4c27-4cb7-b69e-074cff5fe3b8
                © 2023

                Free to read

                https://creativecommons.org/licenses/by/4.0/

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