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Attafuah PYA, Everink IH, Lohrmann C, Abuosi A, Schols JM. Health and social needs of older adults in slum communities in Ghana: a phenomenological approach used in 2021. Arch Public Health 2023; 81:74. [PMID: 37106445 PMCID: PMC10134515 DOI: 10.1186/s13690-023-01056-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/08/2023] [Indexed: 04/29/2023] Open
Abstract
Slum-dwellers lack several essential amenities (such as water, sanitation, and electricity) which make them more vulnerable than non-slum dwellers. As there is limited to no access to health and social care services in slums, the slum environment is expected to be an even more dangerous environment for older adults, negatively impacting their quality of life (QoL). To provide an overview of the perceived (unmet) health and social care needs and how it affects the QoL, this study aims to explore the self-perceived health and social needs of older adults in urban slums in Ghana. Using a phenomenological approach, 25 semi-structured interviews were conducted between May and June 2021, in the homes of older adults in two slums in Ghana. After coding and analysing the transcripts, five main themes emerged: (a) perception of health; (b) (de)motivators of health service use; (c) perception of social care, (d) social needs, and (e) influence of phenomena on QoL. It appeared that older adults believed that spiritual powers were causing illnesses and influenced their use of formal health services. Other factors such as expired insurance cards and the attitude of healthcare workers served as demotivators for using health services.Perceived health needs were mainly current disease conditions (arthritis, diabetes, hypertension, vision/hearing challenges), challenges with health insurance, the behaviour of some health professionals, the proximity of health facilities, and unnecessary queues at major health facilities. Unmet social needs identified by this study were a sense of neglect by family (need for companionship), requiring assistance with activities of daily living, and the need for financial support. Participants had more health needs than social needs. Health providers do not usually prioritize the care of slum-dwelling older adults. Most participants still have challenges with the National Health Insurance Scheme (NHIS). Their social needs were mainly related to financial difficulties and help with some activities of daily living. Participants expressed that they desired companionship (especially the widowed or divorced ones) and the lack of it made them feel lonely and neglected. Home visits by health professionals to older adults should be encouraged to monitor their health condition and advocate for family members to keep older adults company. Healthcare providers should exhibit positive attitudes and educate older patients on the advantages of formal health services use, as well as the need to seek early treatment as this will influence their QoL to a large extent.
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Affiliation(s)
- Priscilla Yeye Adumoah Attafuah
- School of Nursing and Midwifery, University of Ghana, Legon, Ghana.
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
| | - Irma Hj Everink
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Christa Lohrmann
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Aaron Abuosi
- Health Services Management Department, University of Ghana Business School, Legon, Ghana
| | - Jos Mga Schols
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Department of Family Medicine and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Gajanan Prabhune A, Manjunath U, Satheesh SS. A Literature Review on Perceptions and Practices Related to Healthcare and Nutrition Amongst the Residents of Urban Slums Across India. Cureus 2023; 15:e36654. [PMID: 37113376 PMCID: PMC10129044 DOI: 10.7759/cureus.36654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 03/28/2023] Open
Abstract
Urban regions are home to more than a billion people worldwide; by 2030, more than half of the world's population is projected to reside there. Many rural residents relocate to urban regions in pursuit of employment, better living conditions, and access to healthcare facilities. The study's primary objective is to collate the findings related to perceptions, knowledge, attitude, and practices from studies across the urban slums in India related to healthcare and nutrition. A systematic search of articles was conducted on the National Library of Medicine PubMed Portal Google Scholar, and J-Stor databases for published studies across the indexed journals. Academic social media sites like Academia.edu and Researchgate.org were also searched for grey literature. The inclusion criteria include studies conducted in Urban slums from 2010 to 2022, conducted amongst the Indian population within the Indian Geography, and focusing on documenting perceptions, knowledge, attitude, and practices. Exclusion criteria were cross-sectional surveys with quantitative questionnaires focusing on the prevalence of diseases and the burden of risk factors, literature reviews, systematic reviews, frameworks for implementation of specific interventions, and experimental study designs. A total of 18 qualitative observational studies were included in the review and the findings related to knowledge, attitudes, and practices identified from the literature were summarized. The literature indicated adequate knowledge about nutrition and healthcare, and the barriers towards transitioning knowledge to practice were related to lack of resources, priorities around employment and income, and the attitudes towards change-making were usually based on convenience to access cost of service and availability of the services. The review recommends further investment in research to understand the perceptions, patterns of nutrition, and health-seeking behaviours. Also, there is a pressing need to use the evidence for developing policies in line with the expectations of poor urban communities.
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Curtis AJ, Maisha F, Ajayakumar J, Bempah S, Ali A, Morris JG. The Use of Spatial Video to Map Dynamic and Challenging Environments: A Case Study of Cholera Risk in the Mujoga Relief Camp, D.R.C. Trop Med Infect Dis 2022; 7:tropicalmed7100257. [PMID: 36287998 PMCID: PMC9609570 DOI: 10.3390/tropicalmed7100257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/26/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
In this paper, we provide an overview of how spatial video data collection enriched with contextual mapping can be used as a universal tool to investigate sub-neighborhood scale health risks, including cholera, in challenging environments. To illustrate the method’s flexibility, we consider the life cycle of the Mujoga relief camp set up after the Nyiragongo volcanic eruption in the Democratic Republic of Congo on 22 May 2021. More specifically we investigate how these methods have captured the deteriorating conditions in a camp which is also experiencing lab-confirmed cholera cases. Spatial video data are collected every month from June 2021 to March 2022. These coordinate-tagged images are used to make monthly camp maps, which are then returned to the field teams for added contextual insights. At the same time, a zoom-based geonarrative is used to discuss the camp’s changes, including the cessation of free water supplies and the visible deterioration of toilet facilities. The paper concludes by highlighting the next data science advances to be made with SV mapping, including machine learning to automatically identify and map risks, and how these are already being applied in Mujoga.
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Affiliation(s)
- Andrew J. Curtis
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Correspondence: ; Tel.: +1-(626)-429-9476
| | - Felicien Maisha
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32601, USA
| | - Jayakrishnan Ajayakumar
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Sandra Bempah
- Department of Geography, Kent State University, Kent, OH 44242, USA
| | - Afsar Ali
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32601, USA
- Department of Environmental & Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32601, USA
| | - J. Glenn Morris
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32601, USA
- College of Medicine, University of Florida, Gainesville, FL 32601, USA
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Slums, Space, and State of Health-A Link between Settlement Morphology and Health Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062022. [PMID: 32204347 PMCID: PMC7143924 DOI: 10.3390/ijerph17062022] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/06/2020] [Accepted: 03/13/2020] [Indexed: 12/31/2022]
Abstract
Approximately 1 billion slum dwellers worldwide are exposed to increased health risks due to their spatial environment. Recent studies have therefore called for the spatial environment to be introduced as a separate dimension in medical studies. Hence, this study investigates how and on which spatial scale relationships between the settlement morphology and the health status of the inhabitants can be identified. To this end, we summarize the current literature on the identification of slums from a geographical perspective and review the current literature on slums and health of the last five years (376 studies) focusing on the considered scales in the studies. We show that the majority of medical studies are restricted to certain geographical regions. It is desirable that the number of studies be adapted to the number of the respective population. On the basis of these studies, we develop a framework to investigate the relationship between space and health. Finally, we apply our methodology to investigate the relationship between the prevalence of slums and different health metrics using data of the global burden of diseases for different prefectures in Brazil on a subnational level.
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George CE, Norman G, Wadugodapitya A, Rao SV, Nalige S, Radhakrishnan V, Behar S, de Witte L. Health issues in a Bangalore slum: findings from a household survey using a mobile screening toolkit in Devarajeevanahalli. BMC Public Health 2019; 19:456. [PMID: 31035969 PMCID: PMC6489349 DOI: 10.1186/s12889-019-6756-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/08/2019] [Indexed: 12/13/2022] Open
Abstract
Background Slums are home to nearly one billion people in the world and are expanding at an exponential rate. Devarjeevanahalli is a large notified slum in Bangalore, South India which is characterised by poverty, overcrowding, hazardous living environment and social complexities. The poor living conditions not only affect the health of the people living there but also poses distinctive challenges to conducting health surveys. The purpose of this paper is to report the findings of a household survey that was done to study the health condition of people living in a slum. Methods A community-based cross-sectional survey was designed to determine the prevalence of health conditions using a mobile screening toolkit-THULSI (Toolkit for Healthy Urban Life in Slums Initiative). Devarjeevanahalli slum was chosen purposively as it is fairly representative of any slum in a big city in India. Sample size was calculated as 1100 households and demographic parameters at the household level and parameters related to priority health conditions (hypertension, diabetes mellitus, anaemia and malnutrition) at the individual level were studied. Six zones within the slum were purposively selected and all the contiguous households were selected. The last of the six zones was partially surveyed as the desired sample size was achieved. Results A total of 1186 households were surveyed and 3693 people were screened. More than three fourth (70.4%) of the population were below poverty line. Only one third had a regular job and the average daily income was 5.3$ and 2.6$ in men and women respectively. The prevalence of hypertension (35.5%), diabetes (16.6%) and anaemia (70.9%) was high in the screened slum population. Most of the people (56.5% of hypertensives and 34.4% diabetics) were screened for the first time. Almost half of the children under the age of five years were stunted. Conclusions Poor income security and huge burden of health issues were reported among adults and children in the household health screening in a large notified slum in South India. Most people were unaware of their disease condition prior to the screening. Relatively simple technological solutions enabled the local health team to screen the slum population despite many challenges. Electronic supplementary material The online version of this article (10.1186/s12889-019-6756-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Carolin Elizabeth George
- Division of Community Health and Family Medicine, Bangalore Baptist Hospital, Bellary Road, Hebbal, Bangalore, 560024, India.
| | - Gift Norman
- Division of Community Health and Family Medicine, Bangalore Baptist Hospital, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Avanti Wadugodapitya
- Zuyd University of Applied Sciences, Nieuw Eyckholt 300, 6419, DJ, Heerlen, The Netherlands
| | - Shyam Vasudeva Rao
- E Health Enablers Innovations Pvt. Ltd, Binnamangala, Stage 1, Indiranagar, Bangalore, India
| | - Shailendra Nalige
- E Health Enablers Innovations Pvt. Ltd, Binnamangala, Stage 1, Indiranagar, Bangalore, India
| | | | - Sapna Behar
- Icarus Nova, No 7, Rogers Road, Richards Town, Bangalore, India
| | - Luc de Witte
- Centre for Assistive Technology and Connected Healthcare, University of Sheffield, Portobello, Sheffield, UK
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