How does Covid-19 affect urban slums? Evidence from settlement leaders in India

Community engagement and involvement in managing the COVID-19 pandemic among urban poor in low-and middle-income countries: a systematic scoping review and stakeholders mapping

BACKGROUND

Community engagement and involvement (CEI) was crucial for the COVID-19 pandemic response, particularly among the urban poor in low-and middle-income countries (LMICs). However, no evidence synthesis explores how CEI can benefit public health emergencies.

OBJECTIVE

We conducted a systematic scoping review of the CEI with an emphasis on stakeholder identification, accountability mapping, the support system, and the engagement process among urban poor populations in LMICs during the COVID-19 pandemic.

METHODS

We searched eleven databases, including PubMed, Embase, Web of Science, and CINAHL, following the PRISMA-2020 guidelines to find articles published between November 2019 and August 2021. PROSPERO registration No: CRD42021283599. We performed the quality assessment using a mixed-method appraisal tool. We synthesized the findings using thematic framework analysis.

RESULTS

We identified 6490 records. After the title and abstract screening, 133 studies were selected for full-text review, and finally, we included 30 articles. Many stakeholders were involved in COVID-19 support, particularly for health care, livelihoods, and WASH infrastructure, and their accountability mapping by adopting an interest - influence matrix. This review emphasizes the significance of meaningful CEI in designing and implementing public health efforts for pandemic management among urban slum populations. The interest - influence matrix findings revealed that specific community volunteers, community-based organizations, and civil society organizations had high interest but less influence, indicating that it is necessary to recognize and engage them.

CONCLUSION

Motivation is crucial for those with high influence but less interest, such as corporate responsibility/conscience and private food supply agencies, for the health system's preparedness plan among urban populations.

The making of India's COVID-19 disaster: A Disaster Risk Management (DRM) Assemblage analysis

This article analyses the suite of policies and measures enacted by the Indian Union Government in response to the COVID-19 pandemic through apparatuses of disaster management. We focus on the period from the onset of the pandemic in early 2020, until mid-2021. This holistic review adopts a Disaster Risk Management (DRM) Assemblage conceptual approach to make sense of how the COVID-19 disaster was made possible and importantly how it was responded to, managed, exacerbated, and experienced as it continued to emerge. This approach is grounded in literature from critical disaster studies and geography. The analysis also draws on a wide range of other disciplines, ranging from epidemiology to anthropology and political science, as well as grey literature, newspaper reports, and official policy documents. The article is structured into three sections that investigate in turn and at different junctures the role of governmentality and disaster politics; scientific knowledge and expert advice, and socially and spatially differentiated disaster vulnerabilities in shaping the COVID-19 disaster in India. We put forward two main arguments on the basis of the literature reviewed. One is that both the impacts of the virus spread and the lockdown-responses to it affected already marginalised groups disproportionately. The other is that managing the COVID-19 pandemic through disaster management assemblage/apparatuses served to extend centralised executive authority in India. These two processes are demonstrated to be continuations of pre-pandemic trends. We conclude that evidence of a paradigm shift in India's approach to disaster management remains thin on the ground.

Vulnerability, neglect, and collectivity in Brazilian favelas: Surviving the threats of the COVID-19 pandemic and the state's necropolitics

The COVID-19 pandemic has deepened existing inequities and injustices in Brazil, seen in the disproportionately detrimental impacts on favelas. State policy responses to the pandemic have disregarded favela residents' experiences. Recommendations such as 'shelter-in-place' ignore the reality of over 11.4 million favela residents who cannot work from home or afford to stop working, nor practise physical distancing from others. This study investigates the discourse of community organisations in favelas as they respond to the threats of the COVID-19 pandemic and the state's necropolitics. Community organisations in favelas have taken action to protect their residents from the virus, unemployment and hunger. I assess organisations' (1) justification to act as a collective in their communities, and (2) stances about the government's responses to the crisis. Through content analysis of social media, websites and media appearances of eight favela organisations and collectives in São Paulo and Rio de Janeiro, this study finds three main themes through which organisations justify their actions: vulnerability, neglect, and collectivity and care. More than survival strategies, the actions of favela organisations are counter-political acts as they oppose the decrepit necropolitics of the state by collectively enduring in the Brazilian context of the COVID-19 pandemic. Understanding favela organisations' actions in response to the pandemic is fundamental. It further illuminates the impact of public health emergencies in the lives of informal settlements' residents and the governance of public health emergencies in these communities.

Care-based community communication, capacity, and agency during the COVID-19 pandemic: Evidence from the Complexo da Maré Favela, Brazil

Scholars and officials have argued that the strengthening of communities and community-led development constitute an important policy goal in the fight against emergencies such as the COVID-19 pandemic. Nevertheless, most strategies to address such crises fail to consider the significance of community-driven solutions, community-level knowledge, and actors. At the same time, researchers have recognized that communication, such as through local newspapers, promotes community development by increasing communities' social capital and cohesion. But the role of community communication in the encouragement and exercise of other levels of agency and in the development of community capacity, including to address emergencies, remains underexplored. This article investigates whether and how community journalists in a Rio de Janeiro favela have expressed and sought to develop favela residents' individual and collective agency during the COVID-19 pandemic. We do so by analyzing thematically the COVID-19 virus-related articles that appeared in a community-based newspaper, Maré Online, between March and September 2020. We also conducted semi-structured interviews with Maré Online reporters to augment our analysis and supplemented that data with participant observation of relevant virtual community-led organizing meetings and events. Our study shows how community-based journalists revealed and promoted individual and collective agency through what we term a "care-based, participatory solutions journalism," which supported favela residents' "communicative freedom" as conceptualized by Benhabib (2013). This analysis stresses the connection between communicative freedom and community capacity. It illustrates the importance of community-produced communication in development of and in community, especially when those populations are pejoratively framed in the media, public policy, and often also, research.

Health and social needs of older adults in slum communities in Ghana: a phenomenological approach used in 2021

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.

The Impact of the Pandemic on Poor Urban Neighborhoods: A Participatory Action Research Study of a "Favela" in Rio de Janeiro

The pandemic provoked by the coronavirus disease 2019 (COVID-19) devastated poor urban neighborhoods across the world, particularly in the Global South, although empirical data on this remain limited. In this article, the authors present data collected through a mixed-methods, participatory action research approach on the impacts of the pandemic in Cidade de Deus, a "favela," or poor informal settlement, in Rio de Janeiro. The authors find that the indirect consequences of COVID-19, in particular economic and mental health problems, were experienced as more severe than the direct effects of the virus itself, despite high rates of infection and mortality. The study also revealed that residents relied heavily on one another through local systems of mutual aid to address immediate crises. These findings suggest that the pandemic provoked a complex and diverse set of challenges and actions in the economic, social, physical, and mental spheres of poor urban neighborhoods.

Containing COVID-19 and the social costs on human rights in African countries

Multiple social interventions were introduced to contain the COVID-19 pandemic across Africa, limiting social engagement, school and workplace attendance, and travel. In anticipation of negative economic consequences and social impact, many governments introduced cash transfers, social pensions, food aid, and utility and tax waivers. However, people living precariously and/or under conditions of structural vulnerability were often unable to access to this support. A rapid review was undertaken on COVID-19 and the effects of interventions on human rights in African countries, examining primary studies, editorial notes, opinion papers, and literature reviews, with focus on qualitative approaches and discussions. In examining the links between health, human rights and non-pharmaceutical interventions on vulnerable populations, the review identified that: (1) people who were vulnerable were excluded from or not adequately represented in policy responses to COVID-19; (2) the precarious socio-economic conditions of these populations were not adequately addressed by dominant policy responses; and (3) only partial support was offered to those whose relationship with the state was ambiguous or conditional, so compromising human rights. Interactions between health, human rights, and underlying social and economic conditions amplified poor health and impoverishment of those who were already vulnerable. The challenge is to find a balance between stopping the spread of COVID-19 and the protection of human rights; to implement population-specific responses to supplement uniform public health responses; and to address causes (structural vulnerability) rather than symptoms. There is a need to plan rather than react to pandemics, and to co-construct interventions with rather than delivering instructions to populations. These recommendations serve as instruments to be considered when designing new policies, to incorporate a human rights perspective in responses to current and future pandemics.

Housing-related challenges during COVID-19 pandemic among urban poor in low- and middle-income countries: A systematic review and gap analysis

The abysmal health of the urban poor or slum dwellers was attributed to structural inequities such as inadequate housing, water, and sanitation. This review aimed to assess housing-related opportunities and challenges during the COVID-19 pandemic among urban poor in low-and middle-income countries. For study identification, a comprehensive search was performed in 11 databases that yielded 22 potential studies. The inadequate housing infrastructure makes the lives of the urban poor more precarious during COVID-19. Typically, the houses lacked lighting, ventilation, and overcrowding. This review reflected that it is crucial to reimagine housing policy for the urban poor with an emphasis on pandemic/epidemic guidelines.

A Systematic Review of Water, Sanitation, and Hygiene for Urban Poor in Low- and Middle-Income Countries during the COVID-19 Pandemic through a Gendered Lens

Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37-0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08-0.24), non-adherence to face masks was 0.27 (95% CI 0.0-0.81), and access to shared community toilets was 0.59 (95% CI 0.11-1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.

Pandemic management, citizens and the Indian Smart cities: Reflections from the right to the smart city and the digital divide

The technologically endowed Smart Cities take credit for managing the COVID-19 pandemic more effectively than other urban centers. However, Indian smart cities seemed unprepared for the outbreak, with reported highest cases of death and positivity rates. Thus, it becomes essential to understand why these smart cities could not handle the pandemic despite their technologically advanced infrastructures and the citizen’s role in managing it. This paper analyzes the impact of the Smart City Mission (SCM) interventions from a citizen-centric perspective and its influence on pandemic management and citizen inclusivity. The study draws from the right to the smart city framework along with stages of the digital divide. The study conducted a content analysis using secondary sources like published and unpublished papers, policy reports, and news analyses spanning the timeline of 2015-2022. The analysis infers that the lack of initiatives to link marginalized citizens with Information and Communication Technologies (ICTs) through the SCM policy led to the underutilization of the various initiatives launched during the pandemic, deepening the digital divide. The deduction from the analysis highlights that the ‘chatur citizens’ act as a solution by transitioning their formal access to ICTs into effective access enabling the marginalized communities to bridge the divide.

COVID-19 and Its Effects on the Mental Health of People Living in Urban Slums in India

The COVID-19 pandemic has had a devastating effect on the mental health of people from different backgrounds; these effects have been particularly acute among the lower-income households and in slums. There has been a steep rise in mental illness and behaviours associated with it since 2020, especially in the slums characterised by poverty, poor housing, high density and unhealthy environments. This paper aims to examine the effect of COVID-19 on the mental health of people living in the slums of Vijayawada and Visakhapatnam in the state of Andhra Pradesh in India. The results of the study confirm that more than three-fourth of people suffer from mental stress due to the spread of COVID-19 and the lockdown imposed by the government. Also, 80% of those surveyed stated that stress affected their decision-making. The study also confirms that the number of dependents, monthly income, number of living rooms, maintenance of physical distancing norms, avoidance of social gatherings, government support, health insurance and living in a rented house are significantly related to the mental stress of people living in the slums in Andhra Pradesh in India.

Microfinance loan officers before and during Covid-19: Evidence from India

The Microfinance industry has been severely affected by Covid-19. We provide detailed insights into how loan officers, the key personnel linking the lender to its borrowers, are affected in their performance and adapt their work to the pandemic. We use administrative records of an Indian Microfinance Institution and detailed panel survey data on performance, performed tasks, and work organization to document how the work environment became more challenging during the pandemic. Loan officers operate in a setting where work from home is hard to implement due to the nature of the tasks and technological constraints. The usual performance indicators appear to be mainly driven by external factors such as the nation-wide debt moratorium. Loan officers worked similar hours, but engaged less in planning activities and completed fewer of the usual tasks. Work perceptions and mental health of loan officers reflect these changes, and perceived stress was particularly high during the period of the debt moratorium.

Food security, poverty and household resilience to COVID-19 in Burkina Faso: Evidence from urban small traders' households

Analyses of the effects of the COVID-19 pandemic on food security of urban households and their resilience are increasingly receiving scholarly interest. In Burkina Faso, urban households whose primary activity is trade were the most immediately impacted by COVID-19 due to the closure of markets. The objective of this research was to analyze the effect of income loss due to COVID-19 on food security and poverty among urban small traders' households by considering their resilience capacity. A survey was performed on 503 households of small traders operating in 5 markets in Ouagadougou. Objective and subjective indicators of food security were calculated, as well as several indices of resilience capacity. A simple logit model and ordered logit model were used for the socioeconomic analysis. Three main results emerge. First, COVID-19 has increased the likelihood of households being food insecure due to their lower food consumption scores. Second, estimates show that COVID-19 has reduced households' incomes by increasing their likelihood of entering poverty. Finally, at all levels of analysis, households with adaptive capacity were able to adjust to the shock, but social security was not a mitigating factor. Implications in terms of economic policies are discussed.

Is It All the Same? Mapping and Characterizing Deprived Urban Areas Using WorldView-3 Superspectral Imagery. A Case Study in Nairobi, Kenya

In the past two decades, Earth observation (EO) data have been utilized for studying the spatial patterns of urban deprivation. Given the scope of many existing studies, it is still unclear how very-high-resolution EO data can help to improve our understanding of the multidimensionality of deprivation within settlements on a city-wide scale. In this work, we assumed that multiple facets of deprivation are reflected by varying morphological structures within deprived urban areas and can be captured by EO information. We set out by staying on the scale of an entire city, while zooming into each of the deprived areas to investigate deprivation through land cover (LC) variations. To test the generalizability of our workflow, we assembled multiple WorldView-3 datasets (multispectral and shortwave infrared) with varying numbers of bands and image features, allowing us to explore computational efficiency, complexity, and scalability while keeping the model architecture consistent. Our workflow was implemented in the city of Nairobi, Kenya, where more than sixty percent of the city population lives in deprived areas. Our results indicate that detailed LC information that characterizes deprivation can be mapped with an accuracy of over seventy percent by only using RGB-based image features. Including the near-infrared (NIR) band appears to bring significant improvements in the accuracy of all classes. Equally important, we were able to categorize deprived areas into varying profiles manifested through LC variability using a gridded mapping approach. The types of deprivation profiles varied significantly both within and between deprived areas. The results could be informative for practical interventions such as land-use planning policies for urban upgrading programs.

When Covid-19 meets conflict: politics of the pandemic response in fragile and conflict-affected states

The Covid-19 pandemic has magnified existing crises and vulnerabilities, but much remains unknown about how it has affected fragile and conflict-affected settings. This paper builds on the theory that hazards become a disaster in interaction with vulnerability and response policies, yet often lead to renewed disaster risk creation. It is based on seven case studies of countries worldwide that experienced social conflict at the advent of the pandemic, covering the period from March-August 2020. The findings show that authorities instrumentalised Covid-19 to strengthen their control and agendas. Responsibility was assumed for lockdowns, but this was not accompanied by care to mitigate their adverse effects. Social conflict shaped the response, as high levels of mistrust in authorities complicated the implementation of measures, while authorities did not support community-based coping initiatives. Whether Covid-19 will trigger or exacerbate conflict and vulnerabilities depends on pre-existing, country-specific conditions, and how a government and other actors frame the issue and respond.

A comparative analysis of urban development, economic level, and COVID-19 cases in Mexico City

The pandemic caused by the SARS-CoV-2 virus spreads more rapidly in densely populated areas. The number of confirmed cases is counted by the millions in some countries, such as USA, Brazil, and Mexico. These three countries also report the world's highest cumulative death tolls caused by the disease as of February 2021. In this study, a comparative analysis of urban development, economic level, and the number of COVID-19 cases in Mexico City, is conducted. Mexico City, the capital city of Mexico, is among the most densely populated metropolitan areas and one of the largest financial centers in the continent. Among the sixteen municipalities, in which Mexico City is divided, there exist enormous economic and urban development gaps. Based in a comparability index (CI), this study found a correlation between the number of confirmed cases of the COVID-19 disease with the population density, the per capita income, and the dwelling occupancy index in each municipality.

Dark and bright spots in the shadow of the pandemic: Rural livelihoods, social vulnerability, and local governance in India and Nepal

The global COVID-19 pandemic has brought unprecedented disruption to lives and livelihoods around the world. These disruptions have brought into sharp focus experiences of vulnerability but also, at times, evidence of resilience as people and institutions gear up to respond to the crisis. Drawing on intensive qualitative enquiry in 16 villages of Himalayan India and Nepal, this paper documents both dark and bright spots from the early days of the pandemic. We find intense experiences of fear and uncertainty, heightened food insecurity, and drastic reductions in livelihood opportunities. However, we also find a wide range of individual and collective responses as well as a patchwork of policy support mechanisms that have provided at least some measure of basic security. Local elected governments have played a critical role in coordinating responses and delivering social support, however the nature of their actions varies as a result of different institutional arrangements and state support systems in the two countries. Our findings highlight the changing nature of vulnerability in the present era, as demographic shifts, growing off-farm employment and dependence on remittances, and increasing market integration have all brought about new kinds of exposure to risk for rural populations in the context of the present disruption and beyond. Most importantly, our research shows the critical importance of strong systems of state support for protecting basic well-being in times of crises. Based on these findings, we argue that there is a need for greater knowledge of how local institutions work in tandem with a broader set of state support mechanisms to generate responses for urgent challenges; such knowledge holds the potential to develop governance systems that are better able to confront diverse shocks that households face, both now and in the future.

COVID-19 in India: Who are we leaving behind?

The COVID-19 pandemic has uncovered and intensified existing societal inequalities. People on the move and residents of urban slums and informal settlements are among some of the most affected groups in the Global South. Given the current living conditions of migrants, the WHO guidelines on how to prevent COVID-19 (such as handwashing, physical distancing and working from home) are challenging to nearly impossible in informal settlements. We use the case of India to highlight the challenges of migrants and urban slum dwellers during the COVID-19 response, and to provide human rights-based recommendations for immediate action to safeguard these vulnerable populations.