Drivers of vulnerability to health and wellbeing challenges in informal settlements

Abstract

IntroductionIt 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.MethodsThis 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.ResultsWe identified several interlinked drivers and grouped them as individual, community, societal and structural level factors.DiscussionA 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.ConclusionThe 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.

Enhancing Well-being in Nairobi and Wajir Counties through Targeted Interventions: A Holistic Approach to Sustainable Development in Kenya's Devolved Units

“…Chumo [29] Drivers of vulnerability to health and well-being challenges in informal settlements in Nairobi found that several interlinked drivers and grouped them as individual, community, societal and structural level factors.…”

“…By prioritizing education and healthcare equity, Wajir can foster human capital development, empower communities, and lay the groundwork for sustainable development and enhanced happiness. Reviewed local studies have also echoed these policy implications in the context of promoting sustainable development in both counties [27][28][29][30].…”

Social inclusion of persons with disability in employment: what would it take to socially support employed persons with disability in the labor market?

“…For this reason, some employers have considered their talents and employed them at their workplace. From our position, we believe that there is a need for social support to employed PWDs at the workplace, even when they have talents, more so in the informal settlements where government social rehabilitation services are inexistent or inadequate (17,32). Despite the talents and the fortune of being employed, PWDs often condemn and hurt themselves since they cannot accept their imperfection and often feel ashamed, anxious, incapable, unfortunate, miserable, inattentive, and meaningless (31).…”

“…Under such circumstances, many residents have unmet needs ( 16 ), therefore leaving communities including PWDs to find ways of fulfilling their own needs by seeking employment opportunities. Due to vulnerabilities of PWDs ( 17 ), some employers accommodate them in the workplace; yet, no study has uncovered social support of PWDs in informal settlements from the employers’ perspectives.…”

“…The theory is applicable to our study because PWDs need social support for their effective functioning. Notably, they often receive negative treatment such as being labelled based on their disability status ( 31 ) and are vulnerable to a greater risk of becoming victims of crime ( 17 ) and social and psychological problems ( 31 ). PWDs have also been perceived as dependent, incompetent, unproductive, ill, burdensome, unattractive, hypersensitive, helpless, passive, and childish, and as such, they have many unmet needs ( 16 ).…”