Between 2021 and 2022, the ARISE project team conducted data collection using diaries with 32 marginalised and vulnerable groups and a cross-sectional household survey with 1761 study participants in Korogocho and Viwandani informal settlements in Nairobi, Kenya. This brief outlines the findings from this survey.
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Earlier this year our partner, The George Institute, India, created a series of short documentaries as part of the ARISE project. These films explore the lives and experiences of garbage collectors, sanitation workers and waste pickers, and their significance in the context of sanitation and public health. The films were produced in English and local languages, and are available on YouTube.
Systems of Waste (English version)
“Systems of Waste” is a short documentary film that explores the lives of garbage collectors and sanitation workers in the city of Shimla, Himachal Pradesh, India. The film emphasises the centrality of sanitation and waste workers to the public health functions of a city and showcases the impact of informalisation of the work on the lives and wellbeing of the workers.
Systems of Waste (Hindi version)
“सिस्टम ऑफ़ वेस्ट” एक लघु वृत्तचित्र फिल्म है जो भारत के हिमाचल प्रदेश के शिमला शहर में कचरा बीनने वालों और स्वच्छता कार्यकर्ताओं के जीवन की पड़ताल करती है। फिल्म एक शहर के सार्वजनिक स्वास्थ्य कार्यों में स्वच्छता और अपशिष्ट श्रमिकों की केंद्रीयता पर जोर देती है और श्रमिकों के जीवन और सेहत पर काम के अनौपचारिकीकरण के प्रभाव को दर्शाती है।.
A Life of Waste (English version)
“Life of Waste” is a short documentary film that explores the lives of waste pickers in and around Vijayawada & Guntur, Andhra Pradesh, India. Waste pickers collect, sort and sell recyclables from waste gathered from public spaces. The film showcases that despite their contribution to solid waste management systems, they remain unrecognised and face social and economic exclusion.
A Life of Waste (Telugu version)
“వ్యర్థమైన జీవితం” అనే ఈ వాస్తవిక లఘు చలన చిత్రం, భారతదేశంలోని ఆంధ్రప్రదేశ్ లో ఉన్న విజయవాడ & గుంటూరు నగర పరిసర ప్రాంతాల్లో నివసిస్తున్న వ్యర్థాలు సేకరించే వారి జీవితాలను అన్వేషించే ఒక ప్రయత్నం. వ్యర్థాలను సేకరించేవారు బహిరంగ ప్రదేశాల నుండి సేకరించిన వ్యర్థాల నుంచి పునర్వినియోగపరచదగిన వాటిని సేకరించి, క్రమబద్ధీకరించి విక్రయిస్తారు. సాలిడ్ వేస్ట్ మేనేజ్‌మెంట్ పద్దతులకు వారి సహకారం ఉన్నప్పటికీ వారు గుర్తించబడకుండా మరియు సామాజిక మరియు ఆర్థిక బహిష్కరణ ఎదుర్కొంటున్నారని ఈ చిత్రం చూపిస్తుంది.
This visual essay by Jacob Omondi and Sarah Ouma explores the impact of introducing a physical addressing system in Mathare 4B settlement in Nairobi, Kenya, highlighting the contributions of young people and women, and how this initiative enhances healthcare delivery. Through participatory settlement profiling and visual storytelling, we illustrate how community-led efforts and the integration of physical addresses can help tackle urban challenges and improve access to essential services.
The 4B physical addressing system
Imagine living in a community where finding your way to someone’s home feels like solving a puzzle, especially during emergencies? For many residents of informal settlements the lack of a physical address isn’t just an inconvenience, it’s a barrier to life-saving services. Recognising this challenge, SDI Kenya and Muungano wa Wanavijiji, with the support of ARISE, partnered with the community in 4B to implement a physical addressing system that has transformed how services are delivered and accessed.
This system has already brought profound change, especially for community health promoters (CHPs) and waste pickers, whose daily work depends on efficient household access. For CHPs, the system has made it easier to deliver vaccines, conduct door-to-door health visits, and respond swiftly to emergencies. Vulnerable individuals are now identified and attended to without delay, ensuring that children receive timely immunisations, chronic conditions are monitored, and emergencies like childbirth are managed effectively.
For waste pickers, the addressing system has revolutionised waste management in the settlement. Groups like the Mathare River Adoption Group now use the system to organise door-to-door waste collection, achieving near-total coverage of households. This approach has drastically reduced illegal dumping into rivers, roadsides, and drainage systems, promoting cleaner streets, better recycling practices, and a healthier environment for all residents.
The benefits extend far beyond health and waste management. Ambulances now navigate the settlement with precision, cutting down critical response times in medical emergencies. Firefighters can locate and respond to outbreaks swiftly, potentially saving lives and property. Lost children are reunited with their families more quickly, and during natural disasters like floods, rescue teams can prioritise aid for the most vulnerable areas.
By introducing this system, the settlement of 4B has moved from invisibility to inclusion, becoming a model for sustainable urban development. This project highlights how community-driven innovations can restore dignity, improve accountability, and connect informal settlements to essential services
The role of youth in transforming Mathare 4B
Health is not just about surviving, it’s about thriving. Yet for communities in informal settlements like Mathare 4B, thriving often feels like an uphill battle. With uncollected waste, floods, extreme heat, limited healthcare services, and widespread poverty, residents face challenges that directly impact their well-being. Access to quality healthcare remains a distant dream for many.
In the face of these obstacles, a new generation of changemakers is emerging. Through SDI Kenya, Muungano wa Wanavijiji, and the ARISE Hub, the youth of Mathare 4B have become central to transforming their community.
Young people are driving the effort to improve both waste management and health. These young people, full of energy and creativity, bring local knowledge and leadership to the forefront. By working alongside community health promoters and waste picker groups, they address sanitation issues that contribute to poor health.
Beyond sorting and recycling waste, young people played a key role in installing the physical addressing system, which has improved service delivery and emergency response in the area. They’ve also led efforts to raise awareness about the impact of waste management on health, creating a culture of responsibility.
This approach addresses immediate needs and also creates a foundation for long-term health and safety improvements. By reducing pollution and preventing disease, the youth are able to contribute to the creation of a healthier, safer environment for everyone in Mathare 4B. In this community, the youth aren’t just participants but architects of change.
Slum Going Green and the Mathare River Adoption Group participated in a river cleanup along the Ngong River, as part of the circular economy exchange on transforming waste into a physical address system. Photo courtesy of KYCTV.
Women’s empowerment
At the core of everything SDI and Muungano wa Wanavijiji do is a deep commitment to women’s empowerment. Through ARISE, they set out to support young girls and women in Mathare and other informal settlements, helping them gain the skills and confidence to change their lives. SDI Kenya and Muungano wa Wanavijiji played a crucial role in identifying women from these settlements to undergo training, ensuring that those who needed the opportunity the most were given the chance to succeed. A powerful partnership with Buildher, an organisation that trains women to become artisans in the construction industry, brought this vision to life.
This collaboration wasn’t just about providing skills, it was also about creating real, lasting change. The young women from Mathare who joined Buildher’s programs gained hands-on experience and new opportunities to reshape their futures.
One of the most impactful outcomes was the production of the physical address number plates used in the first phase of the addressing system installation in Mathare, Kiamutisya. These women, who once faced limited opportunities, were now the ones crafting the very system that would help their community access vital services and improve daily life.Blending women’s empowerment with real, community-driven change created a ripple effect, putting women at the forefront of transformation. Working with Buildher has shown that when you invest in women, you’re not just changing their lives, but you’re lifting up the whole community.
Young women from Mathare informal settlement creating a physical address system at the Buildher warehouse. Photo courtesy of KYCTV.
Youth-led research
The journey to establish the physical address system in Mathare 4B wasn’t just about maps and numbers, it was a collective effort, fueled by the energy and passion of the community. It started with a simple yet powerful task: to walk through the settlement, map every home, and gather the stories of the people who live there. It wasn’t easy, but every step was taken with the hope of creating something that would truly serve the community.
At the heart of this process were the community co-researchers, many of them young people from Mathare, who stepped up to play a vital role. They worked hand-in-hand with village elders from Nyumba Kumi, tackling resistance and helping the community embrace this new initiative. The youth brought fresh energy, new ideas, and a deep understanding of what their neighbors needed. Together with guidance and support from SDI Kenya and Muungano wa Wanavijiji, they made sure that the information gathered was accurate, detailed, and, most importantly, meaningful.
But it wasn’t just about collecting data. It was about creating something that felt like it belonged to the community. Residents, especially the youth rolled up their sleeves and got involved in designing unique addresses for each home. This wasn’t just a system on paper; it was a reflection of who they were. Everyone’s voice mattered, and by weaving in their ideas, they built a system that felt truly theirs, one that fit their needs and reflected their identity. It was a process that sparked a sense of pride, ownership, and connection among everyone involved.
Youth conducting a profiling exercise in their settlement, to count the total number of households.
Peer learning
Peer learning is so powerful because when communities come together, they share ideas, learn from each other, and find innovative solutions to their challenges. This approach was brought to life when groups actively involved in waste management from Mathare had the chance to visit nearby settlement Kibera to learn how to tackle one of the most pressing issues in informal settlements: waste and its impact on health.
The exchange between the youth groups in Mathare and Kibera was more than just an opportunity to share knowledge, it was a transformative experience. The Mathare team observed firsthand how effective waste segregation, recycling, and composting practices can change the game when it comes to reducing health risks. One of the standout lessons was learning about the Black Soldier Fly method for managing organic waste, something that had a powerful impact on how they thought about waste as a resource, not just a problem.
But the lessons went beyond waste management. The Mathare group saw how Kibera’s community came together for more than just cleaning up the environment, they observed the power of group savings initiatives and how collective action could spark economic empowerment alongside environmental sustainability. This was more than just about waste; it was about creating a healthier, more resilient community.
With these invaluable lessons in hand, the Mathare team went home equipped with new techniques, and fresh mindset on how collaboration, innovation, and community-driven efforts can tackle the challenges that informal settlements face every day, ready to bring those ideas home and continue the work of transforming their own community.
Peer to peer exchange between Slum Going Green Kibera and youth from Mathare. Picture courtsey of KYCTV.
Launch of the physical addressing system
In November 2022, the residents of Mathare 4B gathered at Upendo Grounds to celebrate a milestone that would forever change their community, the launch of their new physical addressing system. This wasn’t just the unveiling of a project, it was the culmination of hard work, collaboration, and a shared dream to solve long-standing health challenges in the settlement. It was a moment that demonstrated the incredible power of community involvement and collective action.
The event was alive with excitement and energy, with key stakeholders, Muungano wa Wanavijiji, SDI Kenya, the Nairobi County Chief, the area member of the County Assembly, the hospital ward representative, and the area member of Parliament representative, all coming together to witness the success of a project that would bring tangible benefits to the residents of Mathare 4B.
This launch was more than just a ribbon-cutting ceremony. It was a turning point in Mathare 4B’s journey toward better infrastructure, improved service delivery, and more organised community life. The physical addressing system will now help with navigating healthcare services, from reaching patients during emergencies to facilitating door-to-door health education and vaccination campaigns. It’s a simple yet powerful tool that will make a real difference in the everyday lives of residents.
For the people of Mathare 4B, this launch was a testament to what can be achieved when a community comes together, partners with others, and works toward common goals. It wasn’t just a project, it was a victory for the whole community.
The Environmental Officer from Nairobi County Government recognises the young people who participated in the creation of the physical address system during the launch in Mathare 4B.
The different colors on the address plates—blue for sanitation facilities, yellow for churches, gray for social amenities, red for businesses, and maroon for residential houses—make it easier for people to navigate and access essential services.
Young people organise the physical address system just before the installation exercise.
Youth installing the physical address in a structure in Mathare 4B. Brown is the colour for residential structures.
About SDI Kenya and Muungano wa Wanavijiji
SDI Kenya is a non-profit organisation that aims to address urban poverty. To fulfill their mandate, SDI Kenya provides technical support to Muungano wa Wanavijiji, the largest national movement of slum dwellers in Kenya.
Founded in 1996, Muungano wa Wanavijiji is a movement that brings together groups from urban slums and other poor communities to advocate for both policy and physical changes to inadequate and challenging living conditions, organised around advocacy and savings, climate change mitigation and adaptation. SDI Kenya and Muungano wa Wanavijiji’s vision is to create inclusive cities where low-income communities have access to adequate housing and services, enabling them to live with dignity. As an affiliate of Slum Dwellers International (SDI), a global network operating in over 20 countries across Africa, Asia, and Latin America, SDI Kenya mobilizes over 28,000 of the most vulnerable women, men, and youth. These communities are brought together through dynamic savings schemes, creating a network at the settlement, city, and national levels. This network aims to drive a collective, bottom-up change agenda for inclusive and resilient cities, influencing global development agendas.
Equitable health research requires actively engaging communities in producing new knowledge to advocate for their health needs. Community-based participatory research (CBPR) relies on the coproduction of contextual and grounded knowledge between researchers, programme implementers and community partners with the aim of catalysing action for change. Improving coproduction competencies can support research quality and validity. Yet, frameworks and guidance highlighting the ideal competencies and conditions needed for all research partners to contribute meaningfully and equitably are lacking. This paper aims to advance CBPR by laying out seven core competencies and conditions that can promote power sharing in knowledge production, application and dissemination at the individual, community, organisational and systems levels.
Competencies were developed through an iterative process, that synthesised pre-existing literature and frameworks with a wide range of tacit knowledge from researchers, activists, implementation partners and community researchers from Bangladesh, India, Kenya, Sierra Leone and the UK.
The seven core competencies and conditions are: (1) capacity to interpret and respond to individual and relational identity, connection, uniqueness and inequities; (2) ability of communities and partners to work in the most suitable, inclusive and synergistic way; (3) aptitude for generating safe and inclusive spaces for multidirectional knowledge and skills exchange that goes beyond the research focus; (4) expertise in democratic leadership and/or facilitation to balance competing priorities and ensure shared decision-making; (5) capacity to analyse readiness for action, successes and areas for improvements throughout the research process; (6) ability to instigate sustainable change processes within the political dimensions of systems, policies and practices using advocacy, lobbying or activism approaches and (7) skills to interpret and disseminate findings and outputs that are understandable, respectful and promote community ownership. We present core competency and condition areas, individual and collective expertise associated with competencies, likely outcomes, examples of activities and sources of evidence.
Ozano K, Alam W, Aktar B, et al. Seven core competencies and conditions for equitable partnerships and power sharing in community-based participatory research. BMJ Global Health 2024;9:e015497.
This poster was originally presented at the 8th Annual Symposium on Health Systems Research in Nagasaki, Japan. Authors are Muhammad Riaz Hossain, Nazia Islam, Mst. Nusrat Jahan, Tasmiha Amin Oishy, Bachera Aktar and Sabina Faiz Rashid.
Inequalities in knowledge production disproportionately affect disadvantaged communities (John & Rempala, 2024). Socioeconomic, gender, and institutional hierarchies contribute to epistemological inequalities, impacting research relationships and knowledge creation (Hammett et al., 2024; Mikkonen et al., 2017). The ARISE project challenges this by using CBPR to empower communities to co-produce knowledge, particularly focusing
on health and wellbeing systems.
A poster, presented at Bintu Mansaray, Rosie Steege, Samira Sesay, Inviolata Njeri Njoroge, Ivy Chumo, Caroline Kabaria, Blessing Mberu, Partho Mukherjee, Surekha Garimella, Riaz Hossain, Sabina Rashid, Rachel Tolhurst, Neele Wiltgen Georgi, Kate Hawkins, Sally Theobald and Laura Dean, at the 8th Global Symposium on Health Systems Research.
Urban informal settlements are characterised by poor water, sanitation, and hygiene (WASH), inadequate waste management, overcrowding and viewed as problematic in health systems policy and programming. For residents, multiple intersecting inequities shape their agency and vulnerability to human rights violations. Power manifests in symbolic, structural, and direct violence for individuals experiencing urban informality and is highly interdependent and exacerbated by intersectional inequities. There is limited literature exploring experiences of WASH-related violence, yet for those living in urban informality it constitutes an everyday concern. Moving towards just health systems requires addressing epistemic injustices by addressing community concerns and priorities it demands co-production approaches that identify community capabilities and a reconceptualisation of informal settlements as sites of progressive change.
Read about the inclusive community based approach to addressing sanitation issues in Freetown informal settlements in this blog by Sullaiman Fullah, Ishmail Conteh, Dora Vangahun and Abu Conteh.
In the informal settlements of Freetown sanitation remains a huge challenge, particularly access to decent toilets. This can be due to constraints on digging land (in hilly areas) or limited space available for construction. Limited access to toilet facilities in informal settlements often leads to the unsafe disposal of human waste. As a result, it is difficult to maintain proper sanitation in these areas. Some residents share the limited toilets available while others defecate openly on the soil or in open drains leading to an increased incidence of water-borne diseases such as cholera, diarrhoea, and typhoid (Macarthy et al., 2018)[1]. Cockle Bay, a coastal informal settlement located on the Aberdeen creek of Freetown is no exception to these poor sanitation challenges. The sanitation problem has been a great concern for residents’ health and the environment. Most households use hanging toilets connected to the sea or large drainages, and poorly maintained pit latrines which are unhygienic and can overflow, particularly during the rainy season. Some residents are still practicing open defecation in the community due to a lack of access to toilet facilities exposing them to an increased risk of infectious disease outbreaks.
A hanging toilet in Cockle Bay.
ARISE and CBPR
The Community-Based Participatory Research (CBPR) approach of ARISE allows researchers to engage communities as active participants during the research, which is crucial for the successful implementation of the project. At the inception of the research project, community members were selected through a competitive, transparent, and inclusive process to act as co-researchers. Their capacity was built through training on participatory and qualitative methods (e.g. social mapping, well-being ranking, Venn diagramming, narrative and key informant interviews, and GIS mapping), and quantitative methods (health and well-being surveys). This allowed them to better understand the community issues and ensured that co-researchers and other community stakeholders were involved in every stage of the ARISE research process. The CBPR approach further led to the co-designing of small-scale interventions across the three study sites, including the construction of the Biofil toilet in Cockle Bay to address the community’s dire sanitation challenges.
Community engagement
Before construction began, the research team conducted several engagement events with co-researchers and community stakeholders. These events reaffirmed the community’s need for a safe toilet facility. During the initial engagement with co-researchers, concerns about a site for construction were raised, prompting two additional meetings to select a suitable site. In a general meeting, two potential sites were selected, but these were later nulled due to technical advice relating to their closeness to the sea, proximity to Aberdeen Bridge, and the risk of demolition by relevant government authorities. The final site was selected at Elet View. It was unanimously agreed upon by community stakeholders in consultation with community residents.
Community engagement for the selection of construction site. Photo credit: Ibrahim Bakarr Bangura.
Construction
The construction lasted for one and a half months, yielding valuable insights at each stage of the work. To ensure that deliverables were met and building standards were adhered to, the ARISE Sierra Leone Urban Research Centre (SLURC) team conducted regular monitoring of the implementation activities and evaluated each phase of the construction to assess progress and address challenges that emerged.
Affixing tiles in the toilet cubicles. Photo credit: Sullaiman Fullah
Biofil toilet in Cockle Bay
The toilet facility was designed with two digesters (5ft × 6ft) and six-compartment units to accommodate many users. Two of the cubicles (one at the front and the other at the back) are specifically designed for individuals with physical disabilities, featuring sloped ramps for wheelchair access. The remaining four rooms are designated for able-bodied users – two for men and two for women. This inclusive design promotes equity by ensuring accessibility for all and fosters a sense of community ownership and shared responsibility in maintaining the facility.
Establishment of management committee
To ensure sustainable use of the toilet facility, the SLURC research team, and community co-researchers facilitated the establishment of a women-led management committee to oversee the facility’s operations and the formulation of by-laws. The event featured an inclusive and participatory selection process to ensure proper usage, maintenance, and accountability of the toilet operations. The Biofil toilet experts subsequently trained the committee members on best practices for the use of the toilet facility. To sustain the learnings of the training, SLURC designed sanitation stickers relating to the use and maintenance of the facility which were posted outside together with the by-laws.
The management committee with Sullaiman Fullah, a researcher at SLURC. Photo credit: Emmanuel M. Kamara
Handing-over of the facility
The handing-over event gathered together the ARISE Sierra Leone team, media, community members, and community stakeholders. The Executive Director of SLURC, Dr. Joseph Mustapha Macarthy, highlighted in his statement that the installation of Biofil toilet in Cockle Bay was in response to the community’s reliance on inadequate and unhygienic facilities, such as hanging toilets and open sewage. He emphasised that the new environmentally friendly toilet aimed to improve hygiene and sanitation in the community. He proceeded by officially opening and handing over the toilet to community leaders and the management committee and called on them to ensure proper usage and maintenance of the facility. Mr. Francis Reffell, Chairman of the Centre of Dialogue on Human Settlements and Poverty Alleviation (CODOHSAPA), encouraged residents to work together to sustain the new toilet facility. Vincent Sesay, a community stakeholder, expressed his gratitude and commended SLURC, the ARISE team, and the funders for their invaluable effort in providing a decent communal toilet facility in Cockle Bay, emphasising its significance to minimising health risks from the use of unhygienic toilet facilities.
The benefits of the Biofil toilet
The ARISE Responsive Fund support for the Biofil toilet has enabled residents to have access to a hygienic and safe toilet facility in the community, which has greatly helped to mitigate health risks related to poor sanitation. For the first time, residents now use a toilet that is not only hygienic but also eco-friendly. Below are some of the benefits:
Challenges
During our initial discussions with co-researchers, they raised concerns about land issues in the community, as much of the land has been reclaimed by private individuals. This caused a huge challenge to secure an appropriate site.
The project was also implemented during the peak of the rainy season. This effected various phases, from community engagement and mobilisation to construction. In some cases, community engagement sessions were cancelled due to torrential rainfall that hindered the mobility of staff and transportation of materials to the site.
Finally, during the project we struggled with managing community expectations. Although some residents actively participated, it became clear that many others expected compensation for any work they were involved in during the implementation of the project.
Conclusion
This sanitation intervention was implemented following the ARISE core values of equity, inclusion, participation, and empowerment. These values emphasised that the voices of residents in informal urban settlements are involved in research from data collection and analysis to implementation and design of interventions. This participatory and inclusive approach addressed the urgent sanitation issues in the community and helps build trust, strengthening local capacity-building, and empowering residents to take action and protect their environment. Through community engagements and collaboration, a hygienic and eco-friendly solution has been provided to improve the quality of life of residents. The inclusive design of the facility ensures accessibility for all, and the management of the toilets promotes equity and communal responsibility. Despite challenges such as land acquisition, heavy rainfall, and community expectations, the project successfully provided a dignified, safe, and sustainable sanitation option, reducing health risks and protecting the environment. It is essential to replicate such equity-driven and participatory methods in other informal settlements to effectively address sanitation problems, improve public health, and protect the environment.
[1] Macarthy, J., Conteh, A., Sellu, S. A., & Doughty, T. (2018). Water and Sanitation challenges and impact on health in informal settlements.
Urban informality, often viewed negatively, is not solely the product of the urban poor but also reflects the failure of formal systems to adapt. Informal workers, who make up about 61% of the global workforce, operate outside formal labor laws and significantly contribute to urban development. Understanding and harnessing community capitals are vital for sustainable urban development. This qualitative study explored the community capitals framework (CCF) in an urban context, addressing the limitations of quantitative data on CCF, which often overlooks critical social factors. This study team conducted in-depth interviews with 36 informal service providers from the education, healthcare, water, sanitation, and solid waste management sectors. Additionally, four local leaders from two urban informal settlements in Nairobi, Kenya, were interviewed. The data from the transcripts were analyzed using thematic framework analysis, guided by the community capitals framework. We identified seven forms of community capital that benefit informal workers: natural, cultural, human, social, political, financial, and built. Human capital, which focuses on skills and qualities, was the most frequently utilized, followed by social capital, which centers on connections and relationships. Next in importance were financial and political capital. Although cultural capital was the least implemented, it was described as important for reflecting community knowledge and traditions. Examples of these capitals in action included solid waste workers, manual pit emptiers, education providers, health workers, and water service providers, who all contributed to urban development and well-being through waste management, sanitation, education, healthcare, and access to clean water. In conclusion, service providers use community capitals as a planning tool to understand dynamics, refine strategies, and build trust for urban development. Each capital functions like a community bank account, containing strengths and opportunities. Although cultural capital was ranked last, it warrants further research to explore its drivers. Additional research is needed to fully grasp the relationships among the various capitals and their impact on service delivery.
Ivy Chumo, Blessing Mberu, Caroline Kabaria (2024) The value of community capitals in sustainable urban development: A qualitative exploration of urban informal workers; MDPI
Some of our ARISE colleagues will be attending the 20th Annual Conference on Urban Health (ICUH 2024) in Marrakesh, Morocco. Find out more below…
ARISE session: Application of community-based participatory research approach with urban marginalised people to develop community-led initiatives for promoting climate resilience and equitable health and well-being: sharing experiences, strategies, resources and tools
Tuesday, 19 November at 3.30 pm GMT
Contributors: Dr Rachel Tolhurst, Ibrahim Gandi, Dr Jiban Karki, Wafa Alam and Smruti Jukur
Community-based participatory research (CBPR) aims to co-produce knowledge with marginalised people in order to challenge and transform material, relational and epistemic inequities. People living in urban informal settlements and other marginalised urban groups face multiple spatial, social and economic vulnerabilities to the health impacts of climate change, including barriers to accessing health promoting services. They often lack opportunities to communicate their needs to and demand rights from health systems planners and providers due to social and political distance, stereotyping and discrimination. Supporting marginalised people to analyse and communicate their own realities, and to promote trusting and respectful communication with governance stakeholders is an important strategy to tackle this exclusion and promote transformative, community-led action for climate resilience and health equity. CBPR encompasses values, processes and tools to facilitate these efforts. We will create a space for sharing, discussion and practice that aims to:
After a 10-minute introduction, participants will have the opportunity to join a 25 minute session at one of the three stations (see below) which will run twice simultaneously. In each station, presenters will share their experience of using a CBPR tool in a specific setting. Participants will be encouraged to share their own experiences. Presenters will then facilitate a session which practices or discusses using the approach.
ARISE session: Access to and uptake of healthy diets in the context of climate crisis: lessons from research in ten African and Asian cities on developing climate-resilient urban food systems
Wednesday, 20 November at 3.30 GMT
Contributors: Dr Rachel Tolhurst, Inviolata Njoroge, Mr Andrew Gerald Omoding, Dr Gloria Seruwagi, Dr Bossissi Nkuba, Dr Sia Tengbe, Dr Surekha Garimella.
The escalation of global political, economic and ecological crises and associated price surges has contributed to interdependent forms of malnutrition – undernutrition, overweight and obesity –- with enduring societal consequences. Poor and marginalised urban residents are already vulnerable to food insecurity as well as diet -related communicable and non-communicable diseases in the context of low and precarious incomes, inadequate market, road, water and sanitation and health service infrastructures, and the proliferation of unhealthy processed foods. Movement restrictions during the Covid pandemic exposed fragilities in urban food systems particularly for the urban poor and those living in informal urban settlements. Changing weather patterns are creating further vulnerabilities by increasing food production uncertainties as well as exacerbating existing infrastructural fragilities. Additional axes of vulnerability that intersect with low incomes are gender, age, disability and migrant/refugee status. Developing climate resilient urban food and health systems faces further challenges related to political settlements and related governance arrangements, including fragmented accountabilities for food production, food distribution, water and sanitation, roads and health services, between municipal and national governments.
This session shares findings from research conducted in 5 African cities through the African Cities Research Consortium (ACRC) and from research conducted through the ARISE consortium (Accountability for Urban Health Equity) in 5 cities in India and Bangladesh.
Urban SHADE and ARISE session: Community-led health initiatives for health equity and climate resilience in informal urban settlements: applications in the context of extreme weather events
Tuesday, 19 November at 5.30 pm GMT
Contributors: Dr Surekha Garimella, Kamilla Karu Gojobe, Milka Kori, Ibrahim Gandi, Inviolata Njoroge, Ms Smruti Jukur, Professor Blessing Mberu, Dr Caroline Kabaria, Dr Ivy Chumo
IPCC reports have identified that impacts of climate change will be concentrated among the most marginalised and poorest urban populations, particularly the one billion people living in informal settlements, where vulnerabilities to extreme weather events such as storms, flooding and heatwaves are already being experienced. This panel presents and discusses findings from several research consortia engaging with community led initiatives for health equity and climate resilience in informal settlements, through Community-Based Participatory Research in India, Kenya, and Sierra Leone. Community ‘co-researchers’, professional researchers and development professionals will share experiences from ARISE consortium research, which aimed to strengthen accountability for community health equity in informal urban settlements and will share how community-led initiatives are being adapted to promote climate resilience for health. Presenters will also share initial findings from Urban SHADE, which aims to strengthen health service responsiveness to extreme weather events in informal settlements India, Kenya, and Sierra Leone.
Presentations will include a consideration of how organised communities can use participatory data collection and analysis as the basis for developing their own processes for responding to extreme weather events as well as for advocating with governance stakeholders to improve responsiveness to their priorities and vulnerabilities. Community vulnerabilities are explored from an intersectional perspective, which considers how intersecting social identities create differential risks within informal settlements. Presenters will also share experiences of working with a range of governance actors relevant to the impact of extreme weather events on health, including but not limited to health services. They will draw from work including creating physical address systems, co-producing WASH improvements, developing community-based mental health interventions, creating disaster response approaches and co-producing climate resilient housing. In this 60-minute panel, 6 presenters will make an initial presentation lasting seven minutes each, after which the audience will be encouraged to ask questions and reflect on contributions of community and governance stakeholders to promoting inclusive urban development for climate-resilient, equitable health and well-being. Dr Surekha Garimella (The George Institute, India) will chair the panel as co-I for ARISE and Co-PI for Urban SHADE.
Colleagues will also attend the 8th Global Symposium on Health Systems Research (HSG 2024) in Nagasaki, Japan. Find out more about ARISE activity here.
Some of our ARISE colleagues will be attending the 8th Global Symposium on Health Systems Research (HSR 2024) in Nagasaki, Japan. Find out more below…
Urban SHADE session: Strengthening the responsiveness of health service provision to extreme weather events for urban marginalised people
Wednesday, 20 November 2024, 11.40am
Contributors: Inayat Singh Kakar,The George Institute of Global Health India; Nancy Wairimu, Muungano wa Wanavijiji; Jane Wairutu, SDI Kenya; Abu Conteh, Sierra Leone Urban Research Centre (SLURC); Desta Ali, Institute of Gender and Children’s Health Research, Sierra Leone (IGCHR); Lana Whittaker Liverpool School of Tropical Medicine (LSTM)
The greatest gains in health in the context of climate change will be achieved through reducing the risks faced by the urban poor, including by targeting informal settlements (IPCC, 2022). How to reduce health risks in these contexts through strengthened health service delivery which is responsive, equitable and people- centred is, however, currently unclear. The purpose of this session is to stimulate discussion between panellists and attendees about this challenge, focussing specifically on health service delivery in the context of extreme weather events in marginalised urban environments. We will share learning from the Urban SHADE project, which works with a range of community, government and non-government actors through community based participatory action research to strengthen health service preparedness and responsiveness in marginalised urban spaces in the context of extreme weather events in India, Kenya and Sierra Leone. We will present our findings from community consultations, participatory workshops between community members and stakeholders, climate change and health policy analysis, and initial insights from community and health service vulnerability and capacity assessments.
ARISE session: Safeguarding for just and sustainable health systems: Sharing experiences and strategies in health systems research and practice
Thursday, 21 November 2024, 11.40am
Contributors: Linet Okoth, LVCT, Kenya; Bintu Mansaray, College of Medicine and Allied Health Sciences, Sierra Leone; Hannah Berrian, UL-PIRE, Liberia; Sarah Moon, global Safeguarding Manager, Christian Blind Mission
Engagement of marginalised populations in the co-production of knowledge that challenges epistemic injustice demands rigorous and transparent safeguarding mechanisms. This session explores shares safeguarding lessons from health policy and system research projects to strengthen reflexive ‘learning health systems’ that consider ever-changing positions of power and privilege from an intersectional standpoint.
Oral presentation: Hybrid Governance of Health Service Delivery in Informal Urban Settlements in Dhaka City, Bangladesh: Systems, Actors and Challenges
Thursday, 21 November, 8am in Room 103
Presented by Bachera Aktar as part of the ‘Enhancing emergency and primary care networks: Governance and reform insights’ session.
Oral presentation: Adapting to climate change vulnerability: Insight from lived experiences and system challenges
Friday, 22 November, 9.40am in Room 109
Presented by Sabina Rashid as part of the ‘Enhancing emergency and primary care networks: Governance and reform insights’ session.
Poster: WASH-related violence in urban informal settlements in Bangladesh, Kenya, India and Sierra Leone: Co-producing knowledge for just health systems
Authors: Bintu Mansaray, Rosie Steege, Samira Sesay, Inviolata Njeri Njoroge, Ivy Chumo, Caroline Kabaria, Blessing Mberu, Partho Mukherjee, Surekha Garimella, Riaz Hossain, Sabina Rashid, Rachel Tolhurst, Neele Wiltgen Georgi, Kate Hawkins, Sally Theobald and Laura Dean
Poster: Empowering community researchers voices: Lessons from ARISE community-based participatory research in Bangladesh for translating health knowledge
Author: Muhammad Riaz Hossain, BRAC
Colleagues will also attend the 20th Annual Conference on Urban Health (ICUH 2024) in Marrakesh, Morocco. Find out more about ARISE activity here.
