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Health & Fitness

How to design universal health plan for city slums

A health facility in Mukuru kwa Reuben slum
A health facility in Mukuru kwa Reuben slum. FILE PHOTO | NMG 

Nairobi’s informal settlements of Kibera, Mukuru kwa Njenga, Mathare and Korogocho are home to many of the city’s low-income residents. Though no formal statistics exist on the distribution and number of our financially and socially disenfranchised population percentages, those in the lower two wealth quintiles make a significant number.

A recent tour of the Korogocho settlement indicates the challenges the dwellers face not just for other services, but also for healthcare needs.

Many health service providers in such areas are likely not to be professionals or licensed and services they offer are packaged with cost-cutting as the main goal. This, often, leads to a huge compromise on quality.

No single Level 4 facility exists in the area toured. Many services offered are by faith based non-profit entities.

As far as the quest for universal health care (UHC) goes, such areas and residents need to receive an affirmative action in terms of higher funding. How to design health approaches that ensure such groups benefit from our UHC strategy is important. More so given the financial and social disenfranchised nature of the group.

Unemployment is high. Among young women and girls, the economic trappings place an even higher hurdle for their escape from the poverty cycle.

With the attendant low education, the possibility of such residents falling off into crime and undesirable habits for young females, in particular, is high. This, in return, has a subsequent impact on their maternal and reproductive health outcomes over their lives.

What are the needs of communities in informal settlements and how do we decide how to allocate resources to meet them? Priorities tied to what they require are important considerations.

With the UHC team developing strategies, a priority funding for the preventative aspects would best suit informal settlements. Otherwise risk exposure to the funds would have a net loss.

A bottom-up holistic approach is the best model and attempting to meet the health needs of the community purely from a health care point of view is futile.

If any source of illness is to occur, informal settlements will serve as epicenters to the rest of the population.

Ultimately improving the housing situation followed by the infrastructure would also go a long way.

The Nairobi County health team must now second more health staff to such areas.

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