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PURPOSE This study investigated knowledge and screening practices for cervical cancer among two urban poor community settings in Ibadan, Nigeria. METHODS A cross-sectional design was used. ODK tool was used to collect quantitative data among a sample size of 500 respondents. Data were analyzed using IBM SPSS version 21 for descriptive and inferential statistics. Scores for knowledge were on a scale of 0-39 points (0-18 low, 19-23 fair, and 24-39 high knowledge). RESULTS A majority of respondents (77.2%) had low knowledge of cervical cancer and were not aware (93.6%) of the Papanicolaou test (Pap smear test) or cervical cancer screening (91.2%). Very few women (10%) were aware of the human papillomavirus vaccine for the prevention of cervical cancer, 4% had been screened with the Papanicolaou test, and one woman (0.3%) with visual inspection with acetic acid. Four (1.1%) women had taken human papillomavirus vaccine before. CONCLUSION The findings of this study have underscored a necessity for increased awareness creation through health promotion interventions and strategies to alleviate low knowledge, prevention, and screening practices for cervical cancer in poor community settings in Nigeria.

Introduction:The global prevalence of anaemia in non-pregnant women is 30.2% and in India it is 56.2%.At least half the burden of anaemia is associated with iron deficiency. Women of reproductive age are at higher risk of developing iron deficiency because of losses during menstruation. Though Daily supplementation with iron and folic acid for a period of 3 months has been the standard as an approach for the prevention and treatment of iron deficiency anaemia among women of reproductive age, there has been limited success with the daily regimen in public health programmes, Intermittent use of oral iron supplements has been proposed as an effective alternative. Objectives: To compare the effectiveness of weekly and daily oral iron and folic acid therapy in improving the Hemoglobin levels among the reproductive age group women, adverse effects and compliance to both the regimens. Method:This was a comparative Randomized parallel open label trial conducted in an urban poor locality of Bengaluru conducted between January 2014 and January 2016. All the women in the reproductive age group (15-45 years) with mild to moderate anemia were included in the study. Sample size of 106 subjects was randomly allocated into the 2 groups (53 into weekly regimen and 53 into daily regimen). The subjects were supplemented with IFA tablets for 3 months according to their regimen. Results:Mean increase in Haemoglobin (Hb) in the daily group (1.92±1.1 g/dl) was significantly (P=

This paper focuses on ways to minister to diverse peoples in cities through hospitality. After surveying the Bible to better understand the origins and character of diversity, biblical examples of discovering and offering hospitality are explored. These ideas are then applied to a modern context with concrete suggestions for discovering and offering hospitality as ways to minister to diverse urban peoples. Barriers to offering hospitality are also analyzed and suggestions for overcoming them are given. Discovering and offering hospitality are both biblical and effective means for ministry to urban immigrants and the urban poor as well as a key component to developing Christian community that can bless and love the surrounding community. Churches, parachurch organizations, and mission organizations should take note of the importance of hospitality ministry among diverse peoples in cities.

الملخص: تمثل العدالة الاجتماعية وسيلة ومنهجا يقوم على أسس علمية مدروسة لرفع مستوى الحياة وإحداث تغير في طرق التفکير والعمل والمعيشة فى المجتمعات للارتقاء بالذوق العام والمشارکة في بناء مجتمع قوى قادر على الإنتاج والتطوير مع الاستفادة من إمکانيات المجتمعات المادية لذا تأتي أهمية العدالة الإجتماعية في هذا الإطار لمواجهة مشکلات الفقراء،کما تؤکد العدالة الإجتماعية على ضرورة تغطية الرعاية الصحية لتأمين المواطن ضد المرض، وفي ضوء ذلک قامت الدولة بوضع إستراتيجية متکاملة لتطوير قطاع الصحة في مصر، وتوفير الرعاية الصحية لجميع المواطنين، مما يساعد في تحقيق أهداف التنمية ورفع مستوى معيشتهم. لذلک فقد استهدفت هذه الدراسة تحديد واقع العدالة الاجتماعية وتطوير خدمات الرعاية الصحية لفقراء الحضر وتحديد الصعوبات التى تواجه تطوير خدمات الرعاية الصحية لهذة الفئة قد توصلت نتائج الدراسة الي وجود علاقة طردية بين أبعاد العدالة الاجتماعية وتطوير خدمات الرعاية الصحية لفقراء الحضر وانتهت الدراسة وانتهت الدراسة إلى بعض الاليات التى تزيد من تفعيل تطبيق العدالة الاجتماعية کمدخل فى التخطيط لتطوير خدمات الرعاية الصحية لفقراء الحضر . الکلمات المفتاحية: العدالة الاجتماعية ،التطوير, خدمات الرعاية الصحية, فقراء الحضر. Abstract: Social justice represents a method and an approach based on scientifically studied foundations to raise the standard of life and bring about a change in ways of thinking, working and living in societies to improve public taste and participate in building a strong society capable of production and development while taking advantage of the capabilities of material societies. Therefore, the importance of social justice comes in this context to face problems The poor, and social justice also emphasizes the need for health care coverage to secure the citizen against illness, and in light of this, the state has devised an integrated strategy to develop the health sector in Egypt and provide health care to all citizens, which helps in achieving development goals and raising their standard of living. Therefore, this study aimed at determining the reality of social justice, developing health care services for the urban poor, and identifying the difficulties facing the development of health care services for this group. The results of the study concluded that there is a direct relationship between the dimensions of social justice and the development of health care services for the urban poor. The study ended and the study ended with some mechanisms. Which increases the activation of the application of social justice as an input in planning to develop health care services for the urban poor.and the results of the study found a positive relationship between the dimensions of social justice and the development of health care services for the urban poor. Keywords: social justice, development, health care services, the urban poor.

The practice of allopathic medicine by informal healthcare practitioners (IHPs) is ubiquitous in India. However, a little is known about the patients' experiences and IHPs' perspectives. The core questions guided the present study were (1) why do urban poor approach IHPs for healthcare? (2) what are their experiences of availing services from IHPs? and (3) what are the perspectives of IHPs about their practice with the population they serve? A qualitative research design guided the study. The study was conducted in the Gurugram city of Haryana, India. Nine IHPs and twenty-seven patients who fit into the pre-established inclusion criteria were interviewed. The findings of the study underline the structural constrains of healthcare access to the poor in India and the mutual dependencies between IHPs and the urban poor. Three themes were emerged corresponding to the perspectives of IHPs, and five themes were generated, which describes patients' experiences and perspectives of availing treatment. The factors that attract and sustain patients to IHPs are a mixture of socio-economic aspects, which include poverty, inaccessibility, unaffordability, inefficient public healthcare facilities, and the positive behavioural and treatment attributes of the practitioners. The study implies urgent policy interventions to ensure quality healthcare to urban poor.

Pentecostals form the largest faction of evangelicalism in Chile and Latin America more widely. Their message has appealed especially to the urban poor, but this explains their success only in part. In Chile, Pentecostals have managed to withstand an overall decline of evangelicalism through a pattern of growth by fragmentation. Whereas traditional evangelical churches are struggling to retain their membership, let alone establish new branches or engage in missionary efforts, Pentecostal congregations are spreading and growing in number still. This is not so much the result of systematic missionary efforts, but of Pentecostal fragmentation and of its adaptability to the living situations of socially vulnerable classes. Based on a four-year investigation that looked into the history and geographical distribution of eleven Christian denominations in the three most populated metropolitan areas of Chile, the article offers a detailed analysis of the growth and development of Pentecostal churches among the urban poor. The example studied here is the Bajos de Mena, a poorly built and extremely dense neighbourhood of Santiago de Chile, raised up by the Chilean post-dictatorship governments to resettle poor urban dwellers from areas they previously occupied. Bajos de Mena is replete with Pentecostal churches of various types, and most of them can be explained by following the resettlement movements of their adherents and leaders. Tracing the distribution and history of Pentecostal churches in Bajos de Mena, the article offers an anthropogeographical lens to explaining the success and fragmented nature of the Pentecostal churches in certain sectors of Chilean society.

Background and Objective: With the growing concern over treatment cost in health care and the desire to improve the effectiveness and equality of healthcare financing and the quality of the care, policy-makers have turned their attention to health insurance, especially, for the poor. This study attempted to determine the willingness to pay for health insurance among the mothers who utilized the urban primary health care clinic (UPHCC) for maternal and child health. Methods: This cross-sectional study was carried out in the working areas of UPHC Project in Bangladesh following two-stage cluster sampling technique to select the participants. Data were collected from 3949 women aged 15-49 years having at least one child aged two years or less. The data on willingness to pay for health insurance was collected using the contingent valuation method with bidding style. Data analysis was done by SPSS 22.0 version. Two generalized linear models with binary logit link function and normal identity link function were developed to identify the potential predictors for willingness to pay for monthly health insurance. Results: Three-fifths (67.5%) of the respondents agreed to pay for monthly health insurance. The median monthly premium for health insurance was BDT 15.5. Multivariate analysis revealed that utilization of UPHC clinic, quality of life, family size, age, wealth index, level of education, husband and respondent’s occupation, ownership status of the house, religion and family income appeared to be potential predictors for health insurance (p

Purpose The purpose of this paper is to provide a better understanding about sources of water for the urban poor in Rajshahi city, Bangladesh. It evaluates water supply performances to identify priority areas of water supply for further improvement. The paper also illustrates whether location of slums in the city has a connection with water supply facilities or not. Design/methodology/approach The paper presents a case study of water supply for the urban slum dwellers. Based on a questionnaire survey, it evaluates performances of water supply following a holistic framework for assessing dimensions of water supply system among three slum zones of Rajshahi city. The dimensions of water supply are as follows: technical, biophysical, political, institutional, economic and social. Findings The research finds that most of the slum dwellers do not have reliable and sufficient access to water supply. The performance of water supply is location specific, and all of the slums do not have equal access to all dimensions of water supply. Overall performance of water supply is moderate, but individual performances of dimensions are unsatisfactory and unequal among the slums. Practical implications The paper suggests location-specific identification of strengths and weaknesses of water supply for the poor. It consolidates a performance evaluation method for identifying priority areas and needs of the urban poor for making Rajshahi city more inclusive and sustainable. Originality/value The paper provides an assessment of water supply performance for the urban poor in Rajshahi city, Bangladesh.

Commuters from poor households face increased challenges in their daily mobility in Sub-Saharan African cities, yet studies on their travel behavior are rare. Most poor individuals resort to walking long distances because they cannot afford motorcycles, bicycles, or even a single bus trip. Using person-trip data, this paper tries to investigate travel behavior of the urban poor through a comparative study between Maputo City and Nairobi City. The logistic regression results showed some similarities and variations among the factors affecting the travel behavior of the urban poor in Maputo City and Nairobi City. The likelihood of choosing Non-Motorized Transport (NMT) over public transport decreased with ownership of motorcycles and private cars in both cities. Surprisingly, gender had no impact on the likelihood of selecting NMT either in Maputo or Nairobi. This might indicate that men and women are equally likely to walk. Variations were observed with respect to the effect of age and residence location. For example, while the likelihood of selecting NMT is positively correlated with the residential location in Maputo, a negative relationship was observed for Nairobi. More explanations for these similarities and variations on the travel behavior are discussed in the article

This study aims to examine modern contraceptive use and unmet need of family planning of urban poor populations in Rajasthan and Uttar Pradesh as a part of IPE Global Project PAHAL (Partnerships for Affordable Healthcare Access and Longevity). Findings from the study reflect that the unmet need of family planning among the married women in the selected states was more than 15%. Women having three children reported the highest use of modern contraceptive methods and the lowest was found among the women having no child. Use of modern contraception was low among the women who were the head of the households. Working women, women belonging to richest wealth quintile, women whose husbands reported to be working and women from male headed households were less likely to have unmet need for family planning. The findings of the present study indicate a remarkably low prevalence of modern contraceptive use indicating considerable high unmet need. This can be a concern and special emphasis of the policy makers should be on this since it is well researched that modern contraceptive use and addressing unmet need are of overriding importance in reducing pregnancy related morbidity, preventing unintended pregnancies that lead to abortion and will gradually improve reproductive well-being among women.

This study assessed the impact of different hydrological scenarios on existing vulnerabilities of water and sanitation services in Chorkor and Shiabu, two coastal urban poor communities in Accra, Ghana. The hydrological scenarios were developed from the literature on climate change projections. This paper recommends adaptations for community members, service providers, and the municipality based on the impact assessment. Chorkor and Shiabu are vulnerable to an increase in rainfall because of the lack of adequate solid waste management and hydrological sound drains. Shiabu's topography and the indiscriminate sand mining along its beach make it vulnerable to an increase in sea level. Looking beyond Chorkor and Shiabu's community boundaries, the urban water utility which supplies water vendors in both communities may be severely impacted by a decrease in rainfall, which would lead to water scarcity and a shortage in hydroelectricity. Regardless of which climate change scenario emerges, many of the recommended adaptations are good water management practice, for example, increasing the number of household connections and reducing non-revenue water. Putting climate change high on the agenda has the potential to generate additional funding to help address Chorkor and Shiabu's water and sanitation problems, and climate-proof services for the future. However, the study method does not address the governance of these adaptations.

Background: Long-term suppression of SARS-CoV-2 transmission will involve strategies that recognize the heterogeneous capacity of communities to undertake public health recommendations. We highlight the epidemiological impact of barriers to adoption and the potential role of community-led coordination of support for cases and high-risk contacts in urban slums. Methods: A compartmental model representing transmission of SARS-CoV-2 in urban poor versus less socioeconomically vulnerable subpopulations was developed for Montserrado County, Liberia. Adoption of home-isolation behavior was assumed to be related to the proportion of each subpopulation residing in housing units with multiple rooms and with access to sanitation, water, and food. We evaluated the potential impact of increasing the maximum attainable proportion of adoption among urban poor following the scheduled lifting of the state of emergency. Results: Without intervention, the model estimated higher overall infection burden but fewer severe cases among urban poor versus the less socioeconomically vulnerable population. With self-isolation by mildly symptomatic individuals, median reductions in cumulative infections, severe cases, and maximum daily incidence were 7.6% (IQR: 2.2%−20.9%), 7.0% (2.0%−18.5%), and 9.9% (2.5%−31.4%), respectively, in the urban poor subpopulation and 16.8% (5.5%−29.3%), 15.0% (5.0%−26.4%), and 28.1% (9.3%−47.8%) in the less socioeconomically vulnerable population. An increase in the maximum attainable percentage of behavior adoption by the urban slum subpopulation was associated with median reductions of 19.2% (10.1%−34.0%), 21.1% (13.3%−34.2%), and 26.0% (11.5%−48.9%) relative to the status quo scenario. Conclusions: Post-lockdown recommendations that prioritize home-isolation by confirmed cases are limited by resource constraints. Investing in community-based initiatives that coordinate support for self-identified cases and their contacts could more effectively suppress COVID-19 in settings with socioeconomic vulnerabilities.

A rapidly growing research field in relation to climate change, vulnerability and human migration has been recognised by the academics and practitioners. Thus, it is also important to understand the relationship between climate-induced migration and urban consequences. This paper aims to review the recent trends of climate change and urbanization research to explore the nexus between climate-induced human mobility and subsequent impact on cities in Bangladesh. Notably, the climate-induced migration literature somewhat stagnated in theorising the concepts of ‘migration as adaptation’ and investigating the causes, drivers, factors and dynamics of decision-making in relation to migration or displacements. Little attention has been paid to the urban consequences of overwhelming migration to the cities of developing countries, such as Bangladesh. Reviewing available empirical evidence, this paper claims that Bangladesh needs a systematic transformative territorial/spatial planning approach to identify the weaknesses and strengths of particular regions as well as cities to deal with impacts of climate-induced migration. It indicates that making resilient cities would be impossible without sufficient and simultaneous considerations of rural resilience. The paper also suggests that further research and access to migration data would be a prerequisite to solve the problems.

Objective:To assess the outcome of severe wasting in infants below 6 months of age.Design:A prospective observational study conducted between January 2017 and October 2018.Setting:A medical college-affiliated hospital in Eastern Delhi, catering mainly to the urban poor population.Participants:All children with severe wasting (weight-for-length Z-score (WLZ) < −3 sd) between 1 and 6 months of age, requiring hospitalisation.Results:Out of fifty children enrolled, during hospitalisation, forty-two (84 %) recovered (WLZ > −3 sd) and discharged; the median (interquartile range (IQR)) duration of stay was 9·5 (6·5, 13·0) d. After 100 d of enrolment, sustained cure (WLZ > −2 SD) could be achieved in only fifteen (30 %) infants, while another fourteen (28 %) recovered from severe wasting, but remained in moderately wasted state (WLZ between −2 and −3 sd). Overall, there were three (6 %) deaths (all during first week of hospitalisation); three (6 %) relapses and fifteen (30 %) defaulters (5, 5, 2, 1 and 2 defaulted during hospitalisation at day 15, day 60, day 75 and day 90, respectively).Conclusions:The overall recovery rate from severe wasting in infants below 6 months of age was below the acceptable levels. In order to achieve better long-term outcome, community linkage services after discharge from hospital are required for supervised feeding, close monitoring and supportive care.

This study assesses the impact of a decrease in air quality and the risk of hospital admissions to a public hospital for chronic respiratory diseases for residents of Petaling Jaya, a city in the Greater Kuala Lumpur area in Malaysia. Data on hospital admissions for asthma, bronchitis, emphysema and other chronic obstructive pulmonary disease, weather conditions and the Malaysian Air Pollution Index, a composite indicator of air quality, were collated. An unconstrained distributed lag model to obtain risk of hospitalization for a 10 μg/m3 increase in the API. The lag cumulative effect for a 10 μg/m3 increase in the API was calculated to test for harvesting in the short term. Findings indicate that after an initial decrease in admissions (days 3 and 4), admissions increased again at day 7 and 8 and this relationship was significant. We therefore conclude that a 10 μg/m3 increase has a greater effect on admissions for respiratory health in the short term than a harvesting effect alone would suggest. These results suggest that while air quality is improving in the Greater Kuala Lumpur area, no level of air pollution can be deemed safe.

Various online learning platforms have evolved as trends in education in the field of open-distance teaching and learning. However, until now, identifying and understanding on the behavior and intention of users for online learning platform remains a vital concern as the awareness and acceptance ratio of these platforms are still low among the Malaysians, especially the urban poor. The objective of this paper is to discuss on a proposed acceptance framework of online learning platform for urban poor communities. This study aims to identify the factors that will influence the users’ behavioral intention to accept online learning platform. A pilot test was performed to consider the reliability of the factors through a survey. Thus, data for pilot testing was collected via an online survey which 35 respondents are from Klang Valley area to assess their awareness and feedback on Online Learning Platforms. The results have shown that most of the factors in the proposed acceptance framework are reliable. Therefore, the factors of the proposed acceptance framework are relevance and acceptable for future real test on a larger scale. It is hoped that the proposed acceptance framework can be beneficial in taking into concern the factors for ensuring users are intent to participate and can get advantages from the online learning platform technology.

Background: Around 80% of the African population lives in urban areas, and a rapid urbanization is observed in almost all countries. Urban poverty has been linked to several sexual and reproductive health risks, including high levels of unintended pregnancies. We aim to investigate wealth inequalities in demand for family planning satisfied with modern methods (mDFPS) among women living in urban areas from African countries.Methods: We used data from 43 national health surveys carried out since 2010 to assess wealth inequalities in mDFPS. mDFPS and the share of modern contraceptive use were stratified by groups of household wealth. We also assessed the ecological relationship between the proportion of urban population living in informal settlements and both mDFPS and inequalities in coverage.Results: mDFPS among urban women ranged from 27% (95% CI: 23–31%) in Chad to 87% (95% CI: 84–89%) in Eswatini. We found significant inequalities in mDFPS with lower coverage among the poorest women in most countries. In North Africa, inequalities in mDFPS were identified only in Sudan, where coverage ranged between 7% (95% CI: 3–15%) among the poorest and 52% (95% CI: 49–56%) among the wealthiest. The largest gap in the Eastern and Southern African was found in Angola; 6% (95% CI: 3–11%) among the poorest and 46% (95% CI: 41–51%) among the wealthiest. In West and Central Africa, large gaps were found for almost all countries, especially in Central African Republic, where mDFPS was 11% (95% CI: 7–18%) among the poorest and 47% (95% CI: 41–53%) among the wealthiest. Inequalities by type of method were also observed for urban poor, with an overall pattern of lower use of long-acting and permanent methods. Our ecological analyses showed that the higher the proportion of the population living in informal settlements, the lower the mDFPS and the higher the inequalities.Conclusion: Our results rise the need for more focus on the urban-poorer women by public policies and programs. Future interventions developed by national governments and international organizations should consider the interconnection between urbanization, poverty, and reproductive health.

Sixteenth century Istanbul contained numerous imarets that fed significant population. Apart from the imarets, food was distributed through institutions such as dervish lodges, masjids, mektebs, madrasas and tombs. Of these, dervish lodges and mektebs in particular supplied food to the urban poor as well as to their own staff. Masjids had a role in meeting need for sustenance among the people living in their vicinity, while madrasas unlike other institutions, served food mostly to their staff. Among the aforementioned institutions, dervish lodges were the ones to which philanthropists allocated the most food. Dervish lodges were thus were the most important institution in food distribution after the imarets. The support of people called “muridin and muhibbin” was particularly important in the distribution of food by the dervish lodges. Holy days and nights special significance as occasions for serving food in these lodges. Based on data in Tahrir Registers of Istanbul Waqfs dated 1546, this study discusses food waqfs, other than imarets. As this data shows, the philanthropists who donated food to the needy included people of modest means as well as those possessing enormous wealth.

Many teaching hospitals in the United States were founded on philanthropic principles and aimed to aid the urban poor and underserved. However, as times have changed, there has been a divide created between the urban poor and teaching hospitals. There is a plethora of reasons why this is the case. This paper will specifically focus on the histories of ten hospitals and medical schools and the effect that white flight, segregation, elitism, and marginalization had on healthcare institutions all over the United States. It will call for a reexamination of the values of Ivy League and Ivy Plus teaching hospitals and medical schools and for them to take an intentional look into their communities.

Building information modelling (BIM) is one of the effective ways for deciding the suitable building orientation and envelope that controls project cost, time and energy. The present paper elaborates the application of BIM for sustainable urban-poor housing. A systematic methodology is briefly discussed that considers the design challenges and suitable masonry products for achieving sustainability. The designed methodology is applied to a single-storey urban-poor house in a representative location in India. With reference to current practice, eight orientations and seven masonry options in all were analysed for achieving sustainable building design. A zero-degree orientation with the analysed suitable masonry option (recycled paper mill waste brick) resulted in reductions in the embodied energy, cost and peak cooling load of 13, 16 and 19%, respectively, over the base case.

Poorly designed policies jeopardise ecosystems and their services and the expansion of basic services to vulnerable populations. In the water and sanitation (WatSan) sector, inadequate access of the urban poor to formal and public drinking water supply and sanitation services (WSS) calls for more inclusive policies. Inclusive development (ID) has social, environmental and relational dimensions. However, there is little research on operationalising ID dimensions in WatSan policy discourse analysis. Hence, this paper addresses: How can we elaborate on indicators for inclusive WatSan policies? How can these be applied to assess the design of Brazilian WatSan policies? It examines the literature on ID and WatSan, develops and applies an analytical framework with six indicators to assess ID in WSS through policy analysis: access to minimum WSS; access to WSS even if the urban poor do not have formal housing; domestic wastewater collection/treatment; water availability; participation; and WSS subsidies for low-income people. Comparison between two Brazilian WatSan policies shows that the current WatSan law scores higher on ID than the previous law but neglects key aspects of social, environmental and relational ID dimensions. The selected indicators were useful to operationalise ID in WatSan policy discourse analysis and can boost policy design assessment elsewhere.

This study explores the factors that make an impact on the choice of cooking fuel, in our case, Liquefied Petroleum Gas (LPG) among the urban poor in the smart city, Bhubaneswar, Odisha, India. In earlier studies, multiple socio-economic and market-related factors (e.g. distribution and pricing), are discussed as determinants which ultimately determine the households cooking fuel choice. This study focuses on household characteristics that can impact the choice of cooking fuel. Primary data collection was carried out in 3036 households in three urban-slums of Bhubaneswar, Odisha, India and was used as a sample for the study. The analysis revealed that along with income and socioeconomic status, other household characteristics are also important in determining the choice of cooking fuel. A major finding of the study is that unaffordability is not the only criteria in the choice of cooking fuel. The choice of cooking fuel of a family is basically a function of external and household specific factors.

Introduction: Access to family planning (FP) services remains a challenge, particularly in informal urban settlements. The unmet need for FP in these settings is high, with a correspondingly high prevalence of unintended pregnancies that may lead to unsafe abortions. However, there is a paucity of quality data on the distribution of FP services in such settings in Uganda. This paper described the geospatial distribution of FP services in Kira Municipality, Wakiso District, Uganda.Methods: This was a cross-sectional study in which we determined the availability and distribution of FP services in Kira Municipality. Community mapping and analysis were conducted using ArcGIS (version 10.1) and ArcGIS Online. Stata version 13.1 was used for data analysis. Chi-square test was used to compare the contraceptive provision and availability among facilities from informal and formal settlements.Results: Of the 176 healthcare facilities surveyed, only 42% (n = 74) offered contraceptives in informal settlements. The majority of the facilities were privately owned small clinics (95%). At least 80% of the facilities provided three or more modern contraceptive methods, with no difference (p = 0.107) between facilities in informal and formal settlements. Only 30.7% (p = 0.001) of the facilities provided at least one long-acting contraceptive. Similarly, 20 and 12% (p = 0.001) of the facilities had implants and intrauterine devices (IUDs) on the day of the survey. Almost 25% of the facilities did not offer contraceptive services (counseling and commodities) to unmarried adolescents.Conclusions: Most facilities were small privately-owned clinics, offering at least three modern contraceptive methods. The unavailability of long-acting reversible methods in the informal settings may affect the quality of FP services due to limited choice. The inequity in service provision that disfavors the unmarried adolescent may increase unwanted/unintended pregnancies. We recommend that local governments and partners work toward filling the existing commodities gap and addressing the discrimination against unmarried adolescents in such settings.

Not much is known about the heterogeneity of risk attitudes among poor households in rich countries. This paper provides estimates from a unique data set collected among the urban poor in Atlanta, Georgia. The data set includes lab-in-the-field experiments on the relationship between risk attitudes and several household characteristics. Apart from looking at income, wealth, and education, we are particularly interested in household composition as it captures the number and kind of people who are dependant on the income of the household head. Heads of households who are less risk averse may be willing to take on the extra risk from smaller resource margins resulting from additional dependants, implying a negative relationship between household size and risk aversion. However, if the size of the household is a result of exogenous forces some heads of households may become more risk averse with more dependants. Household size can also reflect a risk management choice that involves adding non-dependant members who can provide resources and risk sharing. However, this possibility is limited to homes that are not already too crowded. We find that household size correlates positively with the risk aversion of the head, but with a large proportion of children the correlation is strongly dampened. However, this negative effect of children is conditional on the home not already being crowded. These heterogeneous findings have implications for the design of new insurance, savings, and credit programs where risk attitudes are important to the decisions to adopt.

While research on the nexus of migration and wellbeing of individuals has gained recognition in recent years, far less attention has been devoted to intra-urban mobility especially among the urban poor young populations. We assess the drivers of intra-urban mobility using a random sample of 412 migrant street children and youth in Kampala city, Uganda. This paper draws from a larger cross-sectional survey of circular migration and sexual and reproductive health choices among street children in Kampala, Uganda. We define ‘migrants’ as street children and youth with a rural-urban migration experience and ‘intra-urban mobility’ as the number of places stayed in or moved since migrating to the city, measured on a continuous scale. More than half (54.37%) of the migrant street children and youth had lived in two or more places since migrating to the city. Multivariate negative binomial regression analysis reveals migrant street children and youth’s intra-urban mobility to be associated with gender (aIRR = 0.71, 95%CI 0.53–0.96), sex work (aIRR = 1.38, 95%CI 1.01–1.88), a daily income of one USD or more (aIRR = 1.57, 95%CI 1.16–2.13) and duration of stay in the city (aIRR = 1.54, 95%CI 1.17–2.01). Other drivers of intra-urban mobility included availability of causal work, personal safety and affordability of rental costs. Our findings suggest the need for urban housing and health policies to take into account street children and youth’s intra-urban mobility and its drivers. Future research on all drivers of street children and youth’s intra-urban mobility and its linkage with their health outcomes is recommended.

What makes community health activism an ethical undertaking? I examine how, among Accredited Social Health Activists (ASHAs) in an urban poor neighborhood in Delhi, health work is underscored by relational sensibilities. By primarily situating the inquiry into the everyday lives of ASHAs, and beyond the formal trajectories of their work, I show how their care work and relational commitments exceed the forms of care foregrounded in public health program protocols. ASHAs operate through an ethics of neighborly intimacy - relational knowledge and acts, guided by ethical obligations toward their neighbors, and underscored by existing dependencies and care, and the detachments and differentiations of relationships.

Background Globally the burden of Obstructive Lung Diseases (OLD) is growing, however its effect on urban poor populations with the high prevalence of tobacco dependence is virtually unknown. The purpose of this project is to estimate the prevalence and burden of OLD in the urban, low-income populations of Ottawa, Canada. Methods The study presented in this paper was part of the PROMPT (Management and Point-of-Care for Tobacco Dependence) project; a prospective cohort study in a community-based setting (n = 80) with meaningful Patient Engagement from design to dissemination. Spirometry data, standardized questionnaires and semi-structured interviews from PROMPT were interpreted to understand the lung function, disease burden and social determinants (respectively) in this population. Results The prevalence of OLD among those who completed spirometry (N = 64) was 45–59%. Generic and disease-specific quality of life was generally poor in all PROMPT participants, even those without OLD, highlighting the higher disease burden this vulnerable population faces. Quality of life was impacted by two major themes, including i) socioeconomic status and stress and ii) social networks and related experiences of trauma. Conclusion The prevalence and disease burden of OLD is significantly higher in Ottawa’s urban poor population than what is observed in the general Canadian population who smoke, suggesting an etiological role of the social determinants of health. This urges the need for comprehensive care programs addressing up-stream factors leading to OLDs, including poor access and utilization of preventive healthcare addressing the social determinants of health. Trial registration ClinicalTrails.gov - NCT03626064, Retrospective registered: August 2018.

This article discusses the services of Health Social Security Administering Bodies (BPJS) Kesehatan. The purpose of this study is to determine the perceptions of the urban poor in the service of BPJS Kesehatan. In this study, the authors used a qualitative method with a case study model. The results showed that in society there are two perceptions of BPJS Kesehatan, namely positive perceptions and negative perceptions. Positive perceptions include: BPJS Kesehatan greatly eases payments, BPJS services are very friendly and familiar, BPJS health insurance cards are very beneficial, Negative perceptions include: less than optimal socialization, long administrative processes, and not all types of diseases are covered by BPJS. In addition, BPJS has a complicated administrative process and long queuing time, limited personnel serving, limited personnel serving, not all costs can be borne by BPJS, and it is difficult to pay installments (economy).

This chapter examines how human rights and capabilities emerge within organizations hosting music initiatives and targeting Downtown Eastside urban poor. It observes that music facilitators having considerable freedom about how to engage human rights, which are rarely specified in organizational frameworks—aims, missions, and mandates—of aid organizations that host participatory musical events, and of organizations that facilitate public music performances, for instance, performing arts companies and music academies. The chapter notes a susceptibility of jams and music therapy in aid organizations to closure. The popular music initiatives for urban poor unfold within institutional contexts of financial inequity where some music facilitators are paid very little or nothing, and certain administrators are handsomely rewarded. During the contentious urban redevelopment process of gentrification, the vulnerability of the aid organizations and their music programs, as well as the financial inequities across all organizations intensify.

The impact of restricted access to sustainable energy is the worst in vulnerable urban poor areas, and so an alternative approach to energy innovations is needed. To explore the possibilities for energy innovations, gender needs to be taken into account. This is especially relevant in the sub-Saharan African context, as most households are female-headed. This paper aims to explore the current state of gendered energy innovations by using a multivocal approach; it thus focuses on the existing body of knowledge at the gender-energy interface. The study is conducted in two parts: first, 'state of the art' is conceptualised using a multilevel approach; second, a structured literature review on gendered energy innovations is conducted in light of the structured understanding of 'state of the art'. There is definitely room for new innovations to use gender as a strategy for solving energy security problems in urban poor environments. Die impak van beperkte toegang tot volhoubare energiebronne is ergste in kwesbare arm stedelike gebiede, en gevolglik is 'n alternatiewe aanslag tot energie-innovasie, nodig. Om die moontlikhede vir energie-innovasies te ondersoek, moet geslag in ag geneem word. Dit is veral relevant in subSahara Afrika aangesien die meeste huishoudings in hierdie konteks 'n vrou as hoof het. Hierdie artikel ondersoek die huidige toestand van geslag ten opsigte van energie-innovasies deur middel van n veelduidige benadering. Dit fokus dus op die bestaande navorsing in die veld waar geslag en energie raakpunte het. Die studie is tweeledig: eerstens, word die konsep, 'state of the art', deur middel van 'n multivlak-benadering gedefinieer; tweedens word 'n gestruktureerde literatuurstudie rakende geslag in die konteks van energie-innovasies gedoen aan die hand van n gestruktureerde verstaan van 'state of the art'. Daar is beslis potensiaal vir nuwe energie-innovasies, wat geslag as n oplossingstrategie gebruik om probleme rakende energie sekuriteit in arm stedelike gebiede op te los.

Poor treatment outcomes due to nonadherence and consequent high levels of drug resistance continue to challenge efforts to combat tuberculosis (TB) in India. Mobile health‐ or mHealth‐based reminder cues have been considered in multiple health behavior modification interventions, including TB treatment nonadherence. We conducted a quasi‐experimental study in Ahmedabad, India, to examine the effectiveness of mHealth‐based reminder cues customized to meet diverse patient needs. Results from this experiment indicate that the potential of customized mHealth reminder cues may remain unrealized unless addressed in conjunction with the multifaceted drivers of TB treatment nonadherence. The perspective we present here has broad relevance for future mHealth studies, especially in interpreting challenges that arise within resource‐scarce settings of the urban poor and prevent them from adhering to recommended TB treatment regimens.

A quarter of 400 million urban Indian residents are poor. Urban poor women are as undernourished as or worse than rural women but urban averages mask this disparity. We present the spectrum of malnutrition and their determinants for more than 26,000 urban women who gave birth within 5 years from the last two rounds of Demographic Health Survey 2006 and 2016. Among urban mothers in the lowest quartile by wealth index (urban poor), 12.8% (95% CI [11.3%, 14.5%]) were short or with height < 145 cm; 20.6% (95% CI [19%, 22.3%]) were thin or with body mass index < 18.5 kg/m2; 57.4% (95% CI [55.5%, 59.3%]) had any anaemia (haemoglobin < 12 g/dL), whereas 32.4% (95% CI [30.5%, 34.3%]) had moderate to severe anaemia; and 21.1% (95% CI [19.3%, 23%]) were obese (body mass index ≥ 25 kg/m2). Decadal gains were significant for thinness reduction (17p.p.) but obesity increased by 12 p.p. Belonging to a tribal household increased odds of thinness by 1.5 (95% CI [1.06, 2.18]) times among urban poor mothers compared with other socially vulnerable groups. Secondary education reduced odds of thinness (0.61; 95% CI [0.48, 0.77]) and higher education of short stature (0.41; 95% CI [0.18, 0.940]). Consuming milk/milk products, pulses/beans/eggs/meats, and dark green leafy vegetables daily reduced the odds of short stature (0.52; 95% CI [0.35, 0.78]) and thinness (0.72; 95% CI [0.54, 0.98]). Urban poor mothers should be screened for nutritional risks due to the high prevalence of all forms of malnutrition and counselled or treated as per risk.

Globally, the novel coronavirus pandemic (COVID-19) has brought to the fore enormous challenges for policy makers, particularly, as they relate to economic and public health systems. The already weakened global economic situation will be exacerbated by future uncertainties if pragmatic and innovative policies are not put in place to control the spread of the virus and minimize the socio-economic impact of the disease. To slowdown the spread of the disease, the World Health Organization (WHO) has introduced guidelines such as social distancing to reduce physical contact between people. However, in the conventional literature, there is limited scholarly work on the practicality of these social distancing guidelines to the urban poor, particularly in the Global South. This research therefore assesses the applicability of the WHO COVID-19 social distancing guidelines to the urban poor in Ghana. Data used for the study were obtained through a review and synthesis of secondary literature primarily from databases such as JSTOR, ERIC, EBSCO and ProQuest. Other grey sources, such as news publications and data from institutional websites were also relied on for the study. The results of this study show that socio-economic conditions of the urban poor such as uncoordinated public transport systems, unorganized markets and poor access to water and sanitation undermine the applicability of the WHO social distancing guidelines in Ghana. Post COVID-19 therefore presents an important lesson for policy makers in Ghana and other countries in the Global South to respond innovatively to the living conditions of the urban poor. This will help in the effective management of future pandemics.

Dhaka is one of the densely populated megacities in developing countries with rapidly growing urban population. A significant portion of Dhaka’s population lives in informal settlements and is truly deprived of adequate water services. The study was intended to explore obstacles behind promoting sustainable water services to urban poor in Dhaka city as well as to find out opportunities in this regard. A questionnaire survey was conducted amongthe officials of 3 government organizations and 3 non-governmental organizations. In Dhaka city, water services provided by the Dhaka Water Supply and Sewerage Authority is largely groundwater dependent, and a small amount of supplied water comes from surface water sources. The study revealed that compare to rising water demands, supply is absolutely unsatisfactory to city dwellers mainly due to poor infrastructures, lack of sustainable planning and management practices, population pressure and financial constraints. The study showed that conjunctive use of surface water and rainwater, with limited extraction of ground water could be better way for providing sustainable water services to urban poor in Dhaka city. Moreover, effective coordination between government organizations & NGOs and incorporation of private sectors and local community in the service sectors can help to provide sustainable water services.J. Environ. Sci. & Natural Resources, 10(2): 1-10 2017

Aguas da Regiao de Maputo, the water utility serving the capital of Mozambique, has carried out water network expansion projects in peri-urban areas in partnership with the not-for-profit company W...

Conventional water metering has a tendency of being unreliable, inaccurate, and a source of dispute and disquiet among customers, and hence it is considered to be one primary reason why water service providers perform poorly and have very low revenue collection figures. The result of this poor performance spirals into poor management, ineffective maintenance, inaccurate billing and high non-revenue water. This study explored what a prepaid metering project in Nakuru, Kenya achieved, and to see whether or not prepayment can be considered to be an innovative way of addressing these concerns, especially how to provide better service, when providing water to the urban poor. In addition, the study investigated micro financing as tools for supporting efforts by water service providers serving the poor and whether they are an effective way of financing projects. Communal prepaid meters were installed in an existing conventional network and data on commonly used performance evaluation parameters collected through interviews, field visits, and existing literature. The results portrayed prepaid metering with positive improvements to the conventional metering. It was found that there is an opportunity in microfinance for win-win partnerships among financial institutions, water service providers and low-income customers to help them in increasing access to water services. Communal prepaid meters are now bankable and viable options for serving urban poor communities.

Background: Hygienic practices during menstruation are of considerable importance, as it has a health impact in terms of increased vulnerability to infections. Menstrual hygiene management is a special problem for adolescent girls, particularly when attending school due to limited or lack of access to safe sanitary pads and good sanitary facilities. Government of India under RMNCH+A programme, introduced priority intervention for menstrual hygiene to prevent hygiene related infections. Objectives: (1) To assess the knowledge regarding menstrual hygiene among adolescent girls. (2) To assess the menstrual hygiene practices & related infections among the adolescent girls. Methods: A cross-sectional study was conducted among 330 adolescent girls who had attained menarche and residents of an urban poor locality Yarab Nagar, which comes under the field practice area of KIMS, Bangalore. Data regarding socio demographic details and menstrual hygiene practices was obtained in a pre- designed, semi structured proforma. All the subjects were examined for any related infections from a trained female doctor. The data was analysed in Microsoft Excel using mean & percentages. Results: The mean age of the study subjects was 13.63 ± 5.76 years. Majority i.e., 306 (92.7%) of them used sanitary pads; whereas, 24 (7.3%) used old clothes as an absorbent during menstruation. Similarly, 98% cleaned the external genitalia with water during menstruation. The common infections related to menstruation were contact dermatitis (7.2%), candidiasis (5.4%) & UTI (3.5%). Conclusion: The knowledge and practice regarding menstrual hygiene was inadequate among the adolescent girls; and this inadequate hygienic practices has led to infections.

Kisumu has had a massive growth of informal settlements forming a belt around the urban core. These settlements house more than half of the city’s population. Because of the unplanned nature of these areas there has been very poor road infrastructure development, with narrow, unpaved roads constituting the road infrastructure. This situation has limited the opportunities for regular urban transport minibuses providing transport for the majority of the urban poor who live in these settlements. The coping mechanism and the development of alternative coping strategies are explored and assessed to see how effective they are in providing public transport for this majority of unserviced urban population.

In many low- and middle-income countries, conventional welfare state institutions provide social protection only for the formally employed. In contrast, the rural and urban poor are often protected...

The need for early prevention approaches to improve young people's sexual and reproductive health is gaining attention, yet little is known about the sexual experiences of early adolescents aged 10-14 years. Drawing on cross-sectional survey data collected from 365 early adolescents in a Nairobi slum, we used latent class analysis to identify subgroups based on self-reported awareness about sex and involvement in romantic and sexual activities. Multivariate regression models were fitted to examine the characteristics of each subgroup. Results revealed three subgroups: Involved (12%, high probability of being aware of sex and to have engaged in romantic/sexual activities); Observant (48%, high awareness but little own experience); and Naïve (40%, little awareness or personal experience). Being in the Involved group was associated with older age, having commenced puberty/orphanhood, and living in the least poor households. Findings suggest that while most early adolescents in this setting have not initiated romantic and sexual activities, there are distinct subgroups of who would not be captured by looking only at the prevalence of sexual intercourse. Understanding the characteristics and needs of specific subgroups may help to strengthen efforts to improve young people's sexual and reproductive health in urban poor environments.

Public health care clinics accessibility is known as an important issue for urban poverty level residences who have lower financial resources and facilities. The objectives of this study are to is over viewing and explaining the issues and challenges of public health accessibility among urban poor in three Asian countries i.e. Malaysia, Iran and India. This study used the method of literature review from online sources include: government documents, articles and publications related to poverty and health care access. All the papers were filtered for the different variables based on the model presented by the Institute of Medicine. Access concern exists in all three countries, only types and sources of the barriers are varying. Differences influence public expectations and opinion of policy makers. In general some Malaysians and Iranians do not have enough access to public health care providers in spite of a good coverage of healthcare services through public clinics in Malaysia and an acceptable coverage through health posts and health centers in Iran. India still faces so many structural, financial and personal barriers to deliver health care services through public urban health posts and urban family welfares.

During the past decade, the incomes of poor Americans have fallen or flat‐lined, housing costs have soared and public policy has failed to bridge the gap. As a result, the majority of poor renting families in America now devote at least half of their income to covering housing costs, and eviction has become a common yet consequential event in their lives. While housing is central to the lives of the urban poor, it remains marginal to the sociology of American inequality. This essay begins by charting the growing rent burden among low‐income households, and then draws on the unique contributions of Pierre Bourdieu to the study of the home to sketch an agenda for analyzing the roots and implications of the loss of affordable urban housing, a prerequisite for offering policy prescriptions. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a major health issue in the Philippines. TB-Care was introduced in 2011 to tackle pulmonary TB among the urban poor in Payatas, Quezon City, Philippines. We evaluated the efficacy of TB-Care in increasing treatment success and compliance rates. This retrospective case series reviewed 44 patients with pulmonary TB enrolled in TB-Care from 2013 to 2014. Diagnosis and treatment of pulmonary TB was made in accordance with World Health Organization guidelines. Treatment outcomes included cure, completed treatment, successfully treated, failed treatment and transferred to another facility. 14 (73.7%) out of 19 patients tested were bacteriologically cured. The average 100% compliance rate was 90.8% over six months. The programme successfully treated 39 (88.6%) patients. This was comparable to the overall national treatment success rate of 90% for Philippines and 79% for Singapore, with higher compliance rates than were previously reported in this community.

Public water companies in many countries in the global south struggle to meet the water needs of their growing urban populations, especially the urban poor. Consequently, the urban poor receive the worse form of water services mostly from unregulated water vendors and pay poverty penalty. Formalising the informal water vendors has only been mentioned in pro-poor water policies, but the reality only reveals policy rhetoric. This paper investigates the persistence of poverty penalty associated with water supply to the urban poor in Ghana from unregulated water vendors. The data used in the study were gathered through interviews with 78 water vendors (i.e. 53 fixed-point vendors and 25 mobile vendors) who were selected from two water-stressed poor urban communities and one poor urban settlement with water supply from the state utility provider. The results indicate that informal water vendors play a very important role in meeting the water needs of the urban poor. However, it was observed that the urban poor households paid a high-poverty premium for relying on these unregulated water vendors for their water needs. The paper concludes that a viable pro-poor water policy must strive to practically integrate the independent small-scale water providers in the urban water market in order to make an impact. Policy tools that can be used to integrate the private vendors into the urban water market and minimise the poverty penalty have been considered in the paper.

Background: Anemia is a major health issue affecting both developing and developed countries worldwide. In the developing countries, poverty, gender bias and lack of education about the importance of a balanced and iron-rich diet contribute to anemia. According to WHO anemia is present when the hemoglobin percentage is less than 11 gm per dl during pregnancy. The birth weight of an infant is the most important determinant of its chance of survival health growth and development. The prevalence of low birth weight (LBW) is higher in Asia than elsewhere. Low birth weight is a major determinant of mortality, morbidity and disability in infancy and childhood and has a long term impact on health outcomes in adult life. The purpose of this study was to assess the relationship between maternal hemoglobin concentration with neonatal birth weight.Methods: This was a descriptive study. Details were collected from ante-natal records of women, attending 10 numbers of Maternal and Child health clinics run by Tata Steel Family Initiatives Foundation for urban poor community in and around Jamshedpur. This study was done over a period of 7 months from May 2018 to November 2018. Data was collected retrospectively after women had delivered. A sample size of 511 women was taken as a part of the survey.Results: Analysis of the data shows that anemia was associated with a significantly increase risk of low birth weight (

Kenyan water utilities face a challenge of balancing the financial objective of commercial viability with the social objective of service expansion. To achieve this, they employ service differentiation in which different categories of consumers receive different levels of service. Although service differentiation has achieved results, it reflects a prioritization of financial objectives over social objectives and raises three particular concerns. First, service differentiation reflects a withdrawal of the utility from core service provision responsibilities. Second, it results in inequitable service provision. Finally, it may lock low-income consumers into a low level of service.

The existing resettlement infrastructure for informal settlements in Manila, Philippines provide an opportunity to facilitate future climate change adaptation in the city. This research assesses the feasibility of using resettlement as climate change adaptation (CCA) in Manila using the 5 Principles for climate-related resettlement developed by Tadgell, Doberstein and Mortsch (2017 forthcoming). Data from key informant interviews (n=27) with resettlement, CCA, and DRR professionals, addresses the topic in three phases. First, it investigates the role of resettlement in existing CCA and DRR projects to understand if movement from environmental hazards is already occurring. Next, the research gathers interviewee perspectives on the applicability of the 5 Principles in relation to Manila's existing resettlement landscape, and identifies any amendments or foreseen challenges to them. Finally, it explores the perceptions of resettlement, DRR, and CCA actors on the feasibility of employing resettlement as CCA in Manila, including any challenges that may impede the strategy. The findings suggest that existing resettlement infrastructure could be enhanced to provide effective CCA as identified by the 5 Principles, such as initiatives with in-city relocation sites and vertical housing. Poverty is the greatest challenge to implementing any successful adaptation strategy, including resettlement. Thus, poverty reduction should the foundation of CCA planning for some urban poor communities in Manila.