Effects of social determinants on children's health in informal settlements in Bangladesh and Kenya through an intersectionality lens: a study protocol.
Eliud Kibuchi, Proloy Barua, Ivy Chumo, Noemia Teixeira de Siqueira Filha, Penelope Phillips-Howard, Md Imran Hossain Mithu, Caroline Kabaria, Zahidul Quayyum, Lana Whittaker, Laura Dean, Ross Forsyth, Tasmiah Selim, Bachera Aktar, Varun Sai, Sureka Garimella, Samuel Saidu, Ibrahim Gandi, Lakshmi K Josyula, Blessing Mberu, Helen Elsey, Alastair H Leyland, Linsay Gray
Author Information
Eliud Kibuchi: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Glasgow, UK Eliud.Kibuchi@glasgow.ac.uk. ORCID
Proloy Barua: School of Public Health, BRAC University James P Grant School of Public Health, Dhaka, Bangladesh.
Ivy Chumo: African Population and Health Research Center, Nairobi, Kenya.
Noemia Teixeira de Siqueira Filha: Department of Health Sciences, University of York, York, UK.
Penelope Phillips-Howard: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Md Imran Hossain Mithu: School of Public Health, BRAC University James P Grant School of Public Health, Dhaka, Bangladesh. ORCID
Caroline Kabaria: African Population and Health Research Center, Nairobi, Kenya.
Zahidul Quayyum: School of Public Health, BRAC University James P Grant School of Public Health, Dhaka, Bangladesh. ORCID
Lana Whittaker: Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
Laura Dean: Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
Ross Forsyth: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Glasgow, UK.
Tasmiah Selim: School of Public Health, BRAC University James P Grant School of Public Health, Dhaka, Bangladesh.
Bachera Aktar: School of Public Health, BRAC University James P Grant School of Public Health, Dhaka, Bangladesh.
Varun Sai: The George Institute for Global Health India, New Delhi, Delhi, India.
Sureka Garimella: The George Institute for Global Health India, New Delhi, Delhi, India.
Samuel Saidu: COMAHS, Freetown, Western Area, Sierra Leone.
Ibrahim Gandi: Centre Of Dialogue On Human Settlement And Poverty Alleviation (CODOHSAPA), Freetown, Sierra Leone.
Lakshmi K Josyula: The George Institute for Global Health, Hyderabad, India.
Blessing Mberu: African Population and Health Research Center, Nairobi, Kenya.
Helen Elsey: Department of Health Sciences, University of York, York, UK. ORCID
Alastair H Leyland: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Glasgow, UK.
Linsay Gray: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Glasgow, UK.
INTRODUCTION: Several studies have shown that residents of urban informal settlements/slums are usually excluded and marginalised from formal social systems and structures of power leading to disproportionally worse health outcomes compared to other urban dwellers. To promote health equity for slum dwellers, requires an understanding of how their lived realities shape inequities especially for young children 0-4 years old (ie, under-fives) who tend to have a higher mortality compared with non-slum children. In these proposed studies, we aim to examine how key Social Determinants of Health (SDoH) factors at child and household levels combine to affect under-five health conditions, who live in slums in Bangladesh and Kenya through an intersectionality lens. METHODS AND ANALYSIS: The protocol describes how we will analyse data from the Nairobi Cross-sectional Slum Survey (NCSS 2012) for Kenya and the Urban Health Survey (UHS 2013) for Bangladesh to explore how SDoH influence under-five health outcomes in slums within an intersectionality framework. The NCSS 2012 and UHS 2013 samples will consist of 2199 and 3173 under-fives, respectively. We will apply Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy approach. Some of SDoH characteristics to be considered will include those of children, head of household, mothers and social structure characteristics of household. The primary outcomes will be whether a child had diarrhoea, cough, fever and acute respiratory infection (ARI) 2 weeks preceding surveys. ETHICS AND DISSEMINATION: The results will be disseminated in international peer-reviewed journals and presented in events organised by the Accountability and Responsiveness in Informal Settlements for Equity consortium and international conferences. Ethical approval was not required for these studies. Access to the NCSS 2012 has been given by Africa Population and Health Center and UHS 2013 is freely available.
