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Review of drivers and barriers of water and sanitation policies for urban informal settlements in low-income and middle-income countries.

ABSTRACT: This study examined drivers and barriers of water, sanitation, and hygiene (WASH) policies in urban informal settlements in low and middle-income countries. We conducted a search of peer-reviewed and grey literature published between January 2000 and April 2018. We organized evidence into six domains of drivers and barriers: economic, spatial, social, institutional, political, and informational. Key drivers included donor prioritization and collective action, while key barriers included social exclusion, lack of land or dwelling tenure status, the political economy of decision-making, and insufficient data. Ensuring responsive water and sanitation policies for informal settlements will require inter-disciplinary collaboration and both top-down and bottom-up approaches.

SUBMITTER: Sinharoy SS

PROVIDER: S-EPMC7067261 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Review of drivers and barriers of water and sanitation policies for urban informal settlements in low-income and middle-income countries.

Sinharoy Sheela S SS Pittluck Rachel R Clasen Thomas T

Utilities policy 20191001

This study examined drivers and barriers of water, sanitation, and hygiene (WASH) policies in urban informal settlements in low and middle-income countries. We conducted a search of peer-reviewed and grey literature published between January 2000 and April 2018. We organized evidence into six domains of drivers and barriers: economic, spatial, social, institutional, political, and informational. Key drivers included donor prioritization and collective action, while key barriers included social e ...[more]

PMID: 32214692

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Project description:ObjectivesLay consultation is the process of discussing a symptom or an illness with lay social network members. This can have positive or negative consequences on health-seeking behaviours. Understanding how consultation with lay social networks works in informal urban settlements of low-income and middle-income countries (LMICs) is important to enable health and policy-makers to maximise its potential to aid healthcare delivery and minimise its negative impacts. This study explored the composition, content and consequences of lay consultation in informal urban settlements of LMICs.DesignMixed-method systematic review.Data sourcesSix key public health and social science databases, Google Scholar and reference lists of included studies were searched for potential articles.Eligibility criteriaPapers that described discussions with lay informal social network members during symptoms or illness experiences.Data analysis and synthesisQuality assessment was done using the Mixed Methods Appraisal Tool. Data were analysed and synthesised using a stepwise thematic synthesis approach involving two steps: identifying themes within individual studies and synthesising themes across studies.Results13 studies were included in the synthesis. Across the studies, three main categories of networks consulted during illness: kin, non-kin associates and significant community groups. Of these, kin networks were the most commonly consulted. The content of lay consultations were: asking for suggestions, negotiating care-seeking decisions, seeking resources and non-disclosure due to personal or social reasons. Lay consultations positively and negatively impacted access to formal healthcare and adherence to medical advice.ConclusionLay consultation is mainly sought from social networks in immediate environments in informal urban settlements of LMICs. Policy-makers and practitioners need to utilise these networks as mediators of healthcare-seeking behaviours.Prospero registration numberCRD42020205196.

Project description:Background: Climate change affects human health with those with the least resources being most vulnerable. However, little is known about the impact of climate change on human health and effective adaptation methods in informal settlements in low- and middle-income countries.Objective: The objective of this scoping review was to identify, characterize, and summarize research evidence on the impact of climate change on human health in informal settlements and the available adaptation methods and interventions.Method: A scoping review was conducted using the Arksey and O'Malley framework. The four bibliographic databases PubMed, Web of Science, Embase, and the Cochrane library were searched. Eligibility criteria were all types of peer-reviewed publications reporting on climate change or related extreme weather events (as defined by the United Nations Framework Convention on Climate Change), informal settlements (as defined by UN-Habitat), low- and middle-income countries (as defined by the World Bank) and immediate human health impacts. Review selection and characterization were performed by two independent reviewers using a predefined form.Results: Out of 1197 studies initially identified, 15 articles were retained. We found nine original research articles, and six reviews, commentaries, and editorials. The articles were reporting on the exposures flooding, temperature changes and perceptions of climate change with health outcomes broadly categorized as mental health, communicable diseases, and non-communicable diseases. Six studies had a geographical focus on Asia, four on Africa, and one on South America, the remaining four articles had no geographical focus. One article investigated an adaptation method for heat exposure. Serval other adaptation methods were proposed, though they were not investigated by the articles in this review.Conclusion: There is a paucity of original research and solid study designs. Further studies are needed to improve the understanding of the impact, the most effective adaptation methods and to inform policy making.

Project description:BackgroundThere is limited information on community health volunteer (CHV) programmes in urban informal settlements in low- and middle-income countries (LMICs). This is despite such settings accounting for a high burden of disease. Many factors intersect to influence the performance of CHVs working in urban informal settlements in LMICs. This review was conducted to identify both the programme level and contextual factors influencing performance of CHVs working in urban informal settlements in LMICs.MethodsFour databases were searched for qualitative and mixed method studies focusing on CHVs working in urban and peri-urban informal settlements in LMICs. We focused on CHV programme outcome measures at CHV individual level. A total of 13 studies met the inclusion criteria and were double read to extract relevant data. Thematic coding was conducted, and data synthesized across ten categories of both programme and contextual factors influencing CHV performance. Quality was assessed using both the Critical Appraisal Skills Programme (CASP) and the Mixed Methods Assessment Tool (MMAST); and certainty of evidence evaluated using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach.ResultsKey programme-level factors reported to enhance CHV performance in urban informal settlements in LMICs included both financial and non-financial incentives, training, the availability of supplies and resources, health system linkage, family support, and supportive supervision. At the broad contextual level, factors found to negatively influence the performance of CHVs included insecurity in terms of personal safety and the demand for financial and material support by households within the community. These factors interacted to shape CHV performance and impacted on implementation of CHV programmes in urban informal settlements.ConclusionThis review identified the influence of both programme-level and contextual factors on CHVs working in both urban and peri-urban informal settlements in LMICs. The findings suggest that programmes working in such settings should consider adequate remuneration for CHVs, integrated and holistic training, adequate supplies and resources, adequate health system linkages, family support and supportive supervision. In addition, programmes should also consider CHV personal safety issues and the community expectations.

Dataset Information

Review of drivers and barriers of water and sanitation policies for urban informal settlements in low-income and middle-income countries.

Publications

Review of drivers and barriers of water and sanitation policies for urban informal settlements in low-income and middle-income countries.

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