Search Results (286)

Vocational training can lead to higher employment rates and improved incomes, particularly for young women in low-resource settings like Kampala’s slums. Despite these benefits, further research is needed to understand the full impact and mechanisms of vocational training on youth in low-resource environments. In 2022, a focus group project, part of a larger study, involved 60 women aged 18 to 24, recruited from three Youth Support Centers operated by the Uganda Youth Development Link (UYDEL) in Kampala. Six focus groups (about 10 women in each group) were held to explore urban stress and how vocational training might mitigate social and environmental stressors and improve mental health. Data analysis conducted using NVivo software identified five key themes: economic benefits, skill development, building confidence and self-esteem, improved social and behavioral well-being, and enhanced lifestyle and quality of life. This formative research underscores that vocational training benefits young women, highlighting outcomes such as job acquisition, financial empowerment, and skill development. Additionally, self-esteem and confidence development emphasize the training’s role in fostering mental health and agency and addressing gender inequality. These findings underscore the value of vocational training in enhancing the mental health and overall well-being of young women and suggest areas for future research for how to best optimize and scale these programs in low-resource settings. Full article

For the majority of its existence, Addis Ababa has had predominantly low-quality housing with inadequate water and sanitation services. However, in 2004, the government-led condominium housing development project started changing the availability and quality of these services. Our team has performed a systematic review of articles dealing with this housing development project and related water and wastewater issues. The results of the review show that over 208,000 condominium housing units with modern water and sanitation infrastructure were built between 2005 and 2021. The condominium housing units have a significantly higher per capita water consumption of 60.5 L/d compared to 17 L/d for the city’s old low-quality Kebele houses. The city has had to more than double the pre-2005 water supply and expand its very limited wastewater treatment capacity from a mere 7500 m³/d to more than 185,000 m³/d in response to the new demand. Overall, both the IHDP and private housing development have increased the quality of life for over 30% of Addis Ababa’s residents by providing modern cooking, bathing, and toilet facilities. Despite this, water supply interruptions are persistent and require a sustainable solution. Full article

Background: Caesarean section (CS) is a critical intervention, yet stark inequities in access persist across low- and middle-income countries (LMICs). Over the last decade, governments have introduced policies to eliminate or subsidize user fees; however, the collective impact of these initiatives on utilization, equity, and financial protection has not been fully synthesized. Methods: We conducted a systematic review in line with PRISMA 2020 guidelines. Searches were conducted in PubMed, Dimensions, Google Scholar, Scopus, Web of Science, and government portals for studies published between 1 January 2009 and 30 May 2025. Eligible studies evaluated government-initiated financing reforms, including full user-fee exemptions, partial subsidies, vouchers, insurance schemes, and provider-payment restructuring. Two reviewers independently applied the PICOS criteria, extracted data using a 15-item template, and assessed the study quality. Given heterogeneity, results were synthesized narratively. Results: Thirty-seven studies from 28 LMICs were included. Most (70%) evaluated fee exemptions. Mixed-methods and cross-sectional designs predominated, while only six studies employed interrupted time series designs. Twenty-two evaluations (59%) reported increased CS uptake, ranging from a 1.4-fold rise in Senegal to a threefold increase in Kano State, Nigeria. Similar surges were also observed in non-African contexts such as Iran and Georgia, where reforms included incentives for vaginal delivery or punitive tariffs to curb overuse. Fourteen of 26 fee-exemption studies documented pro-rich or pro-urban drift, while catastrophic expenditure persisted for 12–43% of households, despite the implementation of “free” policies. Median out-of-pocket costs ranged from USD 14 in Burkina Faso to nearly USD 300 in Dakar’s slums. Only one study linked reforms to a reduction in neonatal mortality (a 30% decrease in Mali/Benin), while none demonstrated an impact on maternal mortality. Qualitative evidence highlighted hidden costs, delayed reimbursements, and weak accountability. At the same time, China and Bangladesh demonstrated how demographic reforms or voucher schemes could inadvertently lead to CS overuse or expose gaps in service readiness. Conclusions: Government-led financing reforms consistently increased CS volumes but fell short of ensuring equity, financial protection, or sustained quality. Effective initiatives combined fee removal with investments in surgical capacity, timely reimbursement, and transparent accountability. Future CS policies must integrate real-time monitoring of equity and quality and adopt robust quasi-experimental designs to enable mid-course correction. Full article

Today, due to the widening of the wealth gap, the intensification of climate change, and the acceleration of both population growth and population aging, our cities are being tested by multiple economic, environmental, and social challenges, including, but not limited to, urban sprawl, urban gentrification, marginalization, housing crisis, tent city, urban flooding, urban heat island, environmental migrants, urban slums, tent cities, urban aging, and empty nesters [...] Full article

The National Adaptation Plan of Bangladesh identifies eleven climate-stressed zones, placing nearly 100 million people at high risk of climate-related hazards. Vulnerable groups such as the poor, floating populations, daily laborers, and slum dwellers are particularly affected. However, there is a lack of data on climate-sensitive diseases and related hospital visits in these areas. This study explored the prevalence of such diseases using the Delphi method through focus group discussions with 493 healthcare professionals from 153 hospitals in 156 upazilas across 21 districts and ten zones. Participants were selected by district Civil Surgeons. Key climate-sensitive diseases identified included malnutrition, diarrhea, pneumonia, respiratory infections, typhoid, skin diseases, hypertension, cholera, mental health disorders, hepatitis, heat stroke, and dengue. Seasonal surges in hospital visits were noted, influenced by factors like extreme heat, air pollution, floods, water contamination, poor sanitation, salinity, and disease vectors. Some diseases were zone-specific, while others were widespread. Regions with fewer hospital visits often had higher disease burdens, indicating under-reporting or lack of access. The findings highlight the need for area-specific adaptation strategies and updates to the Health National Adaptation Plan. Strengthening resilience through targeted investment and preventive measures is crucial to reducing health risks from climate change. Full article

In pursuit of the Sustainable Development Goals (SDGs)’s objective of eliminating slum cities, the government of Indonesia has initiated a survey-based slum mapping program. Unfortunately, recent observations have highlighted considerable inconsistencies in the mapping process. These inconsistencies can be attributed to various factors, including variations in the expertise of surveyors and the intricacies of the indicators employed to characterize slum conditions. Consequently, reliable data is lacking, which poses a significant barrier to effective monitoring of slum upgrading programs. Remote sensing (RS)-based approaches, particularly those employing deep learning (DL) techniques, have emerged as a highly effective and accurate method for identifying slum areas. However, the reliance on RS alone is likely to encounter challenges in complex urban environments. A substantial body of research has previously identified the merits of integrating land surface data with RS. Therefore, this study seeks to combine remote sensing imagery (RSI) with street view imagery (SVI) for the purpose of slum mapping and compare its accuracy with a field survey conducted in 2024. The city of Bandung is a pertinent case study, as it is facing a considerable increase in population density. These slums collectively encompass approximately one-tenth of Bandung City’s population as of 2020. The present investigation evaluates the mapping results obtained from four distinct deep learning (DL) networks: The first category comprises FCN, which utilizes RSI exclusively, and FCN-DK, which also employs RSI as its sole input. The second category consists of two networks that integrate RSI and SVI, namely FCN and FCN-DK. The findings indicate that the integration of RSI and SVI enhances the precision of slum mapping in Bandung City, particularly when employing the FCN-DK network, achieving an accuracy of 86.25%. The results of the mapping process employing a combination of the FCN-DK network, which utilizes the RSI and SVI, indicate the presence of 2294 light slum points and 29 medium slum points. It should be noted that the outcomes are contingent upon the methodological approach employed, the accessibility of the dataset, and the training data that mirrors the distribution of slums in 2020 and the specific degree of its integration within the FCN network. The FCN-DK model, which integrates RSI and SVI, demonstrates enhanced performance in comparison to the other models examined in this study. Full article

The efficient and precise identification of urban slums is a significant challenge for urban planning and sustainable development, as their morphological diversity and complex spatial distribution make it difficult to use traditional remote sensing inversion methods. Current deep learning (DL) methods mainly face challenges such as limited receptive fields and insufficient sensitivity to spatial locations when integrating multi-source remote sensing data, and high-quality datasets that integrate multi-spectral and geoscientific indicators to support them are scarce. In response to these issues, this study proposes a DL model (coordinate-attentive U²-DeepLab network [CAU²DNet]) that integrates multi-source remote sensing data. The model integrates the multi-scale feature extraction capability of U²-Net with the global receptive field advantage of DeepLabV3+ through a dual-branch architecture. Thereafter, the spatial semantic perception capability is enhanced by introducing the CoordAttention mechanism, and ConvNextV2 is adopted to optimize the backbone network of the DeepLabV3+ branch, thereby improving the modeling capability of low-resolution geoscientific features. The two branches adopt a decision-level fusion mechanism for feature fusion, which means that the results of each are weighted and summed using learnable weights to obtain the final output feature map. Furthermore, this study constructs the São Paulo slums dataset for model training due to the lack of a multi-spectral slum dataset. This dataset covers 7978 samples of 512 × 512 pixels, integrating high-resolution RGB images, Normalized Difference Vegetation Index (NDVI)/Modified Normalized Difference Water Index (MNDWI) geoscientific indicators, and POI infrastructure data, which can significantly enrich multi-source slum remote sensing data. Experiments have shown that CAU²DNet achieves an intersection over union (IoU) of 0.6372 and an F1 score of 77.97% on the São Paulo slums dataset, indicating a significant improvement in accuracy over the baseline model. The ablation experiments verify that the improvements made in this study have resulted in a 16.12% increase in precision. Moreover, CAU²DNet also achieved the best results in all metrics during the cross-domain testing on the WHU building dataset, further confirming the model’s generalizability. Full article

Background—Against childhood lead poisoning, removing lead exposure is the main measure, but how to do it effectively has not been fully established. Our objective was to determine the impact of several interventions (education, housing remediation, and relocation) on children’s blood lead levels. Methods—A historical cohort of childhood lead poisoning was drawn in Marseille, France, from 2011 to 2018. A generalized mixed model was developed to study the kinetics of blood lead levels. Results—We included 151 children, with 56% living in legal substandard housing and others living in slums. Medical follow-up (median: 612 days) included 492 blood samples. In legal substandard housing, blood lead level decrease was significantly associated with every intervention. In slums, blood lead level decrease was significantly associated with housing relocation and education, although to a lesser extent. Conclusions—Every intervention contributed to reducing blood lead levels in substandard housing. Educational intervention is rapidly implemented. Housing remediation follows a long-lasting but effective legal procedure. Some families get housing relocation, depending on their financial resources or whether they are eligible for social housing. In slums, access to legal housing is the most effective against environmental exposure and education has a wider impact on health literacy. Full article

Objective: Malnutrition remains a global challenge to child development, with urban slums in India experiencing high rates of protein deficiency. This study aimed to evaluate the effectiveness of a low-cost, fish bycatch-derived protein supplement in supporting catch-up growth among malnourished children. Methods: Using the Sustainable Community Partnership and Empowerment (SCOPE) model, we implemented a 90-day intervention with daily 10 g of Advanced Protein Powder (APP), produced from underutilized fish bycatch. Forty-six malnourished children (aged 3–6) from Bengaluru slums were randomized into a Control group receiving caloric support or an APP supplement group. Growth indicators, cognition, and caregiver perspectives were assessed. Results: Children receiving the APP supplement showed a significant increase in the weight-for-age percentile (underweight), rising by 7.59%, compared to 0.59% in the Control group (p = 0.02185). Muscle growth, measured by mid-upper arm circumference, also improved significantly in the APP Group (p < 0.05). In the first month, APP supplementation led to a significant height gain of 1.86 cm (p < 0.001), whereas the Control group showed no change (p > 0.05). Additionally, APP supplementation enhanced cognitive function, visual processing, short-term memory, and planning ability, with sustained effects at six months (p < 0.05). Caregivers reported noticeable improvements in children’s vitality, appetite, focus, and engagement in social and learning activities. Conclusions: Bycatch-derived protein supplementation, implemented through the SCOPE model, enhanced physical growth, behavior, and cognition in malnourished children in urban slums. Future studies should investigate the long-term effects, scalability, and adaptability of this sustainable solution for addressing child malnutrition. Full article

Morro do Banco, a slum in Rio de Janeiro, Brazil, is home to a community composed mainly of Brazilian and Venezuelan nationals, where littering is a persistent issue. This study investigates the causes of littering and examines the differences in perceptions and littering behaviours between residents, addressing a research gap in multicultural slums. A face-to-face survey was conducted with 150 residents, complemented by interviews with community members and professionals from urban cleaning and waste management services. Visual observations were also made. The results indicate that littering is primarily linked to a lack of containers for waste disposal and collection, as well as residents’ failure to dispose of waste at the designated times. There is a notable absence of awareness campaigns aimed at addressing the problem. While both communities recognise the littering issue, Venezuelan residents are less aware of public services and report observing lower levels of littering than Brazilian residents. Furthermore, Brazilians tend to place more responsibility on local authorities, while Venezuelans attribute responsibility to the central government. Venezuelans also express less support for oversight actions involving penalties compared to Brazilians. These findings highlight the need for targeted awareness campaigns and inclusive policies to effectively tackle littering in multicultural slums. Full article

Rodent-borne diseases threaten global public health, impacting the urban poor. Despite widespread application of rodenticide in rodent/rodent-borne disease control programs, empirical evidence demonstrating their effectiveness is lacking. This review proposed guidelines for designing and implementing empirical studies on rodenticides as public health measures. The recommendations include: (i) the importance of the type of quasi-experimental design adopted, and how it creates robust evidence; (ii) how urban slums present both challenges for control and ideal settings for studies; (iii) partnering with pest control authorities and community engagement for long-term viability; (iv) leveraging zoonotic systems with direct/environmental transmission, reliable diagnosis, and high prevalence for effectivity assessment; (v) pairing human cohort studies to observe epidemiological links; (vi) systematic data collection and management protocols; (vii) short- and long-term goals for critical evaluation and course-correction; (viii) focus on mechanistic approach; (ix) the need for standardized reporting of the findings. Full article

Rapid urbanization has led to significant demographic shifts and environmental challenges worldwide, with a growing portion of the urban population living in slums. This study investigates the impact of an urban slum upgrading program on pro-environmental behaviors and health-oriented mindsets among residents in Surakarta City, Indonesia. Specifically, it aims to reveal how pro-environmental behaviors, house satisfaction, health-oriented behaviors, and sustainability beliefs manifest within this unique socio-cultural setting. A representative survey was conducted among 327 residents of newly renovated urban slum housing. Additionally, cluster analysis with the Silhouette method was performed to identify distinct demographic and social ‘personalities’ characterized by pro-environmental and health-oriented mindsets within the heterogeneous population across three observed districts. The findings show that while strong beliefs in sustainability are common, there is a gap in translating these beliefs into action, as evidenced by low engagement with recycling and waste-burning avoidance. Furthermore, four clusters with unique profiles emerged: (1) residents dissatisfied with housing but proactive in sustainability (23.3%); (2) health-focused residents satisfied with housing but less engaged in sustainability (5.8%); (3) residents content with housing but low on health awareness and moderate in sustainability beliefs (46.8%); and (4) residents with strong sustainability beliefs but minimal pro-environmental actions (24.1%). This study offers valuable insights for policymakers to guide urban slum upgrading programs with targeted interventions addressing the unique characteristics among the residents. These findings are vital for creating a sustainable urban environment and preventing upgraded areas from reverting to slum conditions. Full article

Refugee camps are typically designed as temporary sustainable settlements, prioritizing logistics over cultural considerations, which can lead to environments being misaligned with the lived experiences of displaced populations. This study addresses the challenge of traditional humanitarian camp designs that prioritize logistical efficiency over cultural and socio-cultural needs, leading to environments that do not align with the lived experiences of displaced populations. Focusing on the Zaatari Syrian Refugee Camp in Jordan, the research employs a structured questionnaire distributed among 102 households to investigate how refugees have reconfigured the camp’s original grid layout into more cohesive clustered patterns, informed by the principles of defensible space theory. Key findings reveal that refugees actively transform public courtyards into semi-private spaces, driven by cultural imperatives and safety needs. Statistical analyses confirm significant correlations between clustering behaviors and the attributes of defensible space, particularly the zones of influence and boundary demarcation, enhancing community resilience and accessibility. However, the study finds a limited predictive power overall, indicating that while these adaptations are significant, factors such as natural surveillance and territorial behavior do not exhibit strong influences on clustering dynamics. These findings have important implications for humanitarian planning and design. They highlight the necessity for more culturally sensitive and flexible approaches that prioritize refugee agencies and communal identity in camp layouts. This research advocates for a hybrid planning approach that integrates socio-cultural values, promoting resilience and quality of life among refugees. By aligning spatial designs with the social and cultural realities of refugee communities, humanitarian actors can enhance the effectiveness of their interventions, ultimately contributing to more sustainable and inclusive urban environments as part of broader goals related to urban planning and development. Future research is encouraged to explore these practices in diverse refugee contexts, providing further validation of these findings and enhancing the applicability of these design principles in global humanitarian efforts. Full article

The informal city, also known as the clandestine city and usually associated with the phenomenon of urban self-organisation, is a reality that cuts across all societies today and occurs in the most diverse regions of the globe, which raises the following question: Why do such different cultures, in such different geographies, adopt a common idea of an ‘informal city’ to live in? Despite the dramatic human condition that characterises slums and informal settlements, it is challenging to understand how these settlements can be adopted as a living space for so many and such diverse populations, admitting the interpretation that it is a utopia and an urban idealisation. Informal urbanisation processes occur outside the system and on the fringes of the practice of ‘institutional urban planning’, as a necessary and immediate response to the absence of public land policies, housing market failures or situations arising from social and economic crises. The object of this study is to find out to what extent the configuration of space, the territorialisation model and the morphology of the informal city, characterised by an entropic urbanism, correspond to an urban organisational structure that occurs when it is up to society to provide its own habitat and urban environment. Full article

Objective: With rapid urbanization in countries like India, understanding the nutritional status and needs of urban populations, particularly among underprivileged groups such as people living in slums, is crucial. This study investigates the prevalence, characteristics, and determinants of child malnutrition in the urban slums of the Kolkata Municipal Corporation (KMC) and Siliguri Municipal Corporation (SMC) in West Bengal, India. Methods: A cross-sectional study was conducted among 736 children aged 6–59 months. Data were collected using structured interviews to gather socioeconomic, demographic, and dietary information, alongside anthropometric measurements. The analysis employed the Composite Index of Anthropometric Failure (CIAF), and multiple linear regression (MLR) models to identify key factors influencing malnutrition. Results: The findings revealed a high prevalence of stunting (24.1%), underweight (22.3%), and wasting (15.4%) among children aged 6–59 months, with significant variations observed between the two study sites. Key predictors of anthropometric malnutrition include low household income, incidence of recent illness, low maternal nutrition, and delayed initiation of breastfeeding. Conclusions: Addressing child malnutrition in urban slums requires integrated strategies encompassing income-generation opportunities, health-sensitive urban planning, and focused maternal and child health interventions. Full article