Accountability in Urban Health
“More than half of the world’s people live in cities, with one in three of those living in low- and middle-income countries doing so in informal settlements, sometimes known colloquially as slums, with inadequate access to services and opportunities to shape decisions about their environment. Our research will support the people in our focal communities to claim their right to health.”
Professor Sally Theobald, Liverpool School of Tropical Medicine, Principal Investigator, ARISE
Around the world, the number of people living in cities is growing rapidly. Transforming the lives of vulnerable people in informal urban settlements is vital to accelerate progress towards the Sustainable Development Goals (SDGs). This entails tackling complex, interrelated challenges of poor health, unequal access to services, insecurity and weak accountability. Rigorous research and evidence, combined with community engagement and ownership, must inform these efforts.
The ARISE Hub – Accountability and Responsiveness in Informal Settlements for Equity – is a new research consortium, set up to enhance accountability and improve the health and wellbeing of marginalised populations living in informal urban settlements in low- and middle-income countries.
- Treat PLWDs sensitively – Many of the people that we worked with have experienced trauma. Research can evoke traumatic memories for example injuries that led to their disability or more recent experiences with COVID-19.
- Disabilities vary and require different communication strategies – People with different impairments will need to be communicated with in different ways. Researchers must be considerate of the needs of each of the different categories of marginalized people. For example, deaf people can have different levels of understanding of sign language influenced by literacy levels and the ‘hood’ which differs from one urban settlement to another. You need to understand your research participants well to know how to be able to communicate effectively.
- Support systems matter – PLWD need good, trusted support systems both at home and project level to be able to participate effectively in research studies. They may well have been taken advantage of in the past. So as a researcher it is important to identify the support system that a PLWD uses and trusts and work with it. This requires flexibility in terms of adjusting for the time it takes to engage and where this engagement will take place.
- Build trust – Research requires trusting relationships with communities and with participants themselves. Though this takes time, it can be achieved through regular feedback sessions with all relevant stakeholders, regular meetings and de-brief sessions with participants
- Listen – Regular engagement meetings with people from marginalized communities provides them with an opportunity to speak out and share their concerns, struggles and achievements. It is important to have these frequent meetings as it is helps in providing psychosocial support through speaking out challenges.
Shadowing Suvartha on her waste-picking route in Vijayawada
A photo essay by Shrutika Murthy, The George Institute for Global Health India
We have been involved in a number of processes to create guidelines on safeguarding in global health programmes. You can read more in our latest paper in BMJ Global Health.
Or you can read the findings of an international consultation on safeguarding by our colleagues Surekha Garimella and Bintu Mansaray.
We also have advice on safeguarding in the context of the COVID-19 pandemic.