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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 ElseyAlastair H Leyland, Linsay Gray

Research output: Contribution to journalArticlepeer-review

Abstract

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, underfives) 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
Original languageEnglish
Article numbere056494
Number of pages7
JournalBMJ Open
Volume12
DOIs
Publication statusPublished - 6 Jun 2022

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