Evaluating Housing Health Hazards: Prevalence, Practices and Priorities in Delhi’s Informal Settlements

Abstract

Housing quality is crucially linked to health and sustainability goals, yet there is limited research on informal housing and settlements where housing quality is poor, and the health risks are expected to be greatest. This paper describes the investigation of housing conditions in a low-income resettlement colony in Delhi. A novel transdisciplinary methodology to evaluate multiple housing health hazards and establish intervention priorities in participation with the community was developed. Findings from housing surveys and indoor environmental monitoring were contrasted with a participatory self-assessment-revealing the widespread prevalence of hazards and suboptimal housing conditions as well as substantial differences in priorities, and thus perspectives, between participants and researchers. Focus group discussions explored the findings and built consensus on priorities. Our findings uncovered how poor housing conditions affect daily practices and thus are likely to adversely affect socioeconomic development and gender equality. We highlight limitations in current frameworks to assess housing hazards and argue that a transdisciplinary approach is vital to provide a holistic understanding and to develop effective interventions. These insights are crucial to inform inclusive solutions for adequate housing and human settlements that can support improved health and help achieve the sustainable development goals.

A framework for distributed health professions training: using participatory action research to build consensus

“…Our scoping review had enabled us to first pay attention to the existing scholarship in the field, applying what Laksov and colleagues [30] framed as a 'distanced perspective', perusing available evidence to detect similarities and differences that could direct future work. However, recognising that patterns would not seamlessly emerge from the literature to fit into a framework [31], we made an active choice as researchers [30] to involve stakeholders as participants in a PAR process so that the interpretation of the literature and application to real-life contexts would be derived from the lived experience [22] of a community of inquiry. Thus we drew on the thinking and practices of key role players in the field-the external voices -through our extensive consultative process.…”

“…[21] We adopted a participatory action research (PAR) approach based on iterative cycles (phases) of reflection, data collection and action. [22] Given our stated intention to move towards national consensus, to influence practice and policy, and to ultimately benefit health care in the country, this approach was well-suited to our needs. Healthcare has been described as a 'complex adaptive system' and we realised that PAR would allow for a process of 'feedback loops' that would maintain the momentum for change.…”

“…20 Students and staff are aware of and oriented to community needs. 21 Learning opportunities are available wherever health services are provided in the community, including home-based ca 22 Students learn through being immersed in the community. 23 Role players engage in collective celebration of accomplishments.…”

COVID-19 & informal settlements: is Stay Home safe?

“…These limiting conditions in informal settlements result in high risks of infection and injury, with children particularly vulnerable, due to malnutrition and recurrent diarrhoea resulting in stunted growth and long-term effects on cognitive development [4]. Previous research in an informal settlement in Delhi revealed how housing: was unable to provide safe indoor temperatures; had poor ventilation; experienced dampness and mould; used hazardous materials and were poorly constructed; experienced overcrowding; had poor lighting and little protection against noise; and suffered from a substantial presence of mosquitoes, pest and food infestation; and facilities for cooking, washing and sanitation were inadequate [5]. Furthermore, this research found that housing had a significant impact on the daily practices of women, as they dealt with the hazards and limiting conditions [5].…”

“…Previous research in an informal settlement in Delhi revealed how housing: was unable to provide safe indoor temperatures; had poor ventilation; experienced dampness and mould; used hazardous materials and were poorly constructed; experienced overcrowding; had poor lighting and little protection against noise; and suffered from a substantial presence of mosquitoes, pest and food infestation; and facilities for cooking, washing and sanitation were inadequate [5]. Furthermore, this research found that housing had a significant impact on the daily practices of women, as they dealt with the hazards and limiting conditions [5]. The limiting housing and environment conditions will result in health inequalities and increased levels of chronic disease and thus lead to a higher risk of severe outcomes from COVID-19.…”