Alleviating time poverty among the working poor: a pre-registered longitudinal field experiment

Poverty entails more than a scarcity of material resources—it also involves a shortage of time. To examine the causal benefits of reducing time poverty, we conducted a longitudinal field experiment over six consecutive weeks in an urban slum in Kenya with a sample of working mothers, a population who is especially likely to experience severe time poverty. Participants received vouchers for services designed to reduce their burden of unpaid labor. We compared the effect of these vouchers against equivalently valued unconditional cash transfers (UCTs) and a neutral control condition. In contrast to our pre-registered hypotheses, a pre-registered Bayesian ANCOVA indicated that the time-saving, UCT, and control conditions led to similar increases in subjective well-being, reductions in perceived stress, and decreases in relationship conflict (Cohen’s d’s ranged from 0.25 to 0.85 during the treatment weeks and from 0.21 to 0.36 at the endline). Exploratory analyses revealed that the time-saving vouchers and UCTs produced these benefits through distinct psychological pathways. We conclude by discussing the implications of these results for economic development initiatives. Protocol registration The Stage 1 protocol for this Registered Report was accepted in principle on 27/06/2019. The protocol, as accepted by Nature Human Behaviour, can be found at https://doi.org/10.6084/m9.figshare.c.4368455.

An analysis of the Gender and Social Determinants of Health in Urban Poor Areas of the Most Populated Cities of Pakistan

Background: Recent surveys, studies and reviews have highlighted the impacts of social inequities on access of women and children to health services for women and children in Pakistan. Utilising mixed methods for urban slum profiles, and facility and coverage surveys in 4431 urban poor areas of the top 10 highly populated cities of Pakistan, this paper describes and analyses the complex interactions between economic, social and gender determinants of health care access and considers health policy and program options for addressing them. Results: Findings are classified into six analytic categories of (1) access to health services, (2) female workforce participation, (3) gender friendly health services, (4) access to schools and literacy, (5) social connections, and (6) autonomy of decision making. Out of a national sample of 14,531 children in urban poor areas of 10 cities, the studies found that just over half of the children are fully immunised (54%) and 14% of children had received zero doses of vaccine. There are large shortages of health facilities and female health workforce in the slums, with significant gaps in the quality of health infrastructure, which all serve to limit both demand for, and supply of, health services for women and children. Results demonstrate low availability of schools, low levels of female literacy and autonomy over decision making, limited knowledge of the benefits of vaccination, and few social connections outside the home. All these factors interact and reinforce existing gender norms and low levels of health literacy and service access. Conclusion: The Urban Slum profiles and coverage studies provide an opportunity to introduce gender transformative strategies that include expansion of a female health workforce, development of costed urban health action plans, and an enabling policy environment to support community organisation and more equitable health service delivery access.

Nutritional support and prophylaxis of azithromycin for pregnant women to improve birth outcomes in peri-urban slums of Karachi, Pakistan—a protocol of multi-arm assessor-blinded randomized controlled trial (Mumta PW trial)

Background Maternal undernutrition is critical in the etiology of poor perinatal outcomes and accounts for 20% of small-for-gestational-age (SGA) births. High levels of food insecurity, antenatal undernourishment, and childhood undernutrition necessitate the supplementation of fortified balanced energy protein (BEP) during pregnancy in low-income settings especially with scarce literature available in this subject. Hence, this paper extensively covers the protocol of such a trial conducted in an urban slum of Karachi, Pakistan. Methods The trial is community-based, open-labelled, four-arm, and randomized controlled that will include parallel group assignments with a 1:1:1:1 allocation ratio in low-income squatter settlements in urban Karachi, Pakistan. All pregnant women (PW), if identified between > 8 and < 19 weeks of gestation based on ultrasound, will be offered routine antenatal care (ANC) counseling and voluntary participation in the trial after written informed consent. A total number of 1836 PW will be enrolled with informed consent and randomly allocated to one of the four arms receiving: (1) ANC counseling only (control group), (2) ANC counseling plus BEP supplement (intervention arm 1), (3) ANC counseling plus BEP supplement plus 2 doses azithromycin (intervention arm 2), or (4) ANC counseling plus BEP supplement plus daily single dose of nicotinamide and choline (intervention arm 3). Trial registration ClinicalTrials.govNCT04012177. Registered on July 9, 2019.

From Praxis to Theory

Research has shown that social capital plays a significant role in achieving success. For children from disadvantaged communities in India—such as the urban poor—financial and cultural constraints severely limit their ability to complete their schooling, forcing them to enter the job market as unskilled workers. This chapter presents an educational intervention called Project Disha in an urban slum by Kriti Social Initiatives, a non-profit organization in India. Project Disha is a scholarship and mentoring program that aims to teach life skills and fill the social capital gap for these disadvantaged students. Due to the pandemic, the program switched to an online mode, an already challenging situation made more so due to the extremely limited technology available to the children. With limited internet connectivity, frequent power cuts, and access only to inexpensive smartphones, Project Disha now relies on a team of volunteer mentors and creative pedagogical strategies to keep students connected, engaged, and learning.

Study Determination About Receivers of Support for Rehabilitation "The Houses Unhabitable" in Slum Area, Indonesia

Indonesia, a developing country, has launched a program with a target of 0% slum in urban areas by 2020. It has been more than ten years since this program for handling urban slums has made many improvements. One aspect of the parameter that becomes an improvement in handling urban slum areas is the improvement of uninhabitable houses. This study investigates how the quality of urban slum settlements can be improved in the aspect of houses that are not habitable, especially in terms of determining the recipient of rehabilitation assistance for houses that are unhabitable in urban areas. This study used a qualitative methodology and analysis of the literature review in 21 scientific papers on selecting houses that are not habitable assistance and related regulations. The result is that there are two processes in determining Receivers of Support for Rehabilitation "The Houses Unhabitable", first through the aspects of the criteria for houses unhabitable which are technical in the field, and selection techniques that are more academic in nature. Aspects of the criteria for houses unhabitable provide an assessment of the area and buildings. whereas the selection technique requires a selection technique capable of managing data that has many criteria.

COVID-19 Testing: Perceived Barriers Among the Urban Slum Dwellers of Dhaka, Bangladesh

Background: Urban slum dwellers are unduly affected by COVID-19, and low testing rates among them are worsening their situation. This study aimed to explore the perceived barriers to COVID-19 testing in the slums, which is crucial to its surveillance, tracking, and allocating resources to combat the pandemic. Methods: A quantitative study with a cross-sectional design was conducted among 149 urban slum dwellers (≥11 years of age), who had previously experienced COVID-19 like symptoms. They were identified from an existing slum cohort at Bauniabadh, Dhaka. Information related to their testing status and perceived barriers was acquired by a telephone survey from October to November 2020. Results: The mean age of the respondents was 34.4±15.6 years, and 58.4% of them were female. Fever (79.2%) and cough (74.5%) were the most common symptoms mentioned. Only 6.7% of the respondents had undergone COVID-19 testing. Fast relief (within 1-3 days) from symptoms (87.6%) was the most prevailing barrier to testing, seen across all age and education groups. Negative advocacy regarding the testing from family and friends (46.7%), participants uncertainty about the guidelines, site, cost, and schedule of testing (15.3%), and a general belief that ‘COVID-19 is not a disease of slum people instead, it is an affliction of the rich folk’ (20.4%), were the other cited barriers. Conclusions: The COVID-19 testing rate remained very low among the urban slum dwellers. To remove the barriers to testing, tailored behavioral change communication and augmenting the resources for testing are necessary to curb the spread in the slums.

Effectiveness of planned teaching programme on knowledge regarding dengue fever and its preventive measures among adult population in selected urban slums

Background: Dengue fever is the most critical mosquito-borne disease in the world caused by one of any of four serotypes of dengue virus. There has been a 30-fold increase in global incidence over the past fifty years. Epidemics of dengue result in human suffering, strained health services and massive economic losses.Methods: Quasi experimental one group pre-test-post-test research design was adopted to conduct the study among forty adults aged between twenty to 40 years residing in Janta Nagri, Urban slum, Lucknow, Uttar Pradesh, who matched the inclusion criteria were selected through non-probability purposive sampling technique. On day one pre-test followed by planned teaching programme was conducted and after seventh day post-test was taken. The data was analysed using descriptive and inferential statistics.Results: The results revealed that the mean post-test knowledge score was higher than mean pre-test knowledge score with standard deviation 20.15±4.02 and 7.67±3.11 respectively. The improvement of knowledge score is the mean difference of 12.5 which shows that there was a significant change in knowledge level of adult population.Conclusions: The study concluded that the planned teaching programme was effective in improving the level of knowledge regarding dengue fever and its preventive measures.

A Study on the Knowledge, Attitude and Practices towards Malaria in Urban Slum Area of Kolkata

Background: Malaria is one of the most prevalent parasitic diseases worldwide and India has fourth highest number of malaria cases and deaths in the world. Prevention of the disease through better knowledge and awareness is the appropriate way to keep the disease away and remain healthy. Thus, the present study was aimed to assess the knowledge, attitude and practices regarding malaria among residents of urban slum area of Kolkata.