wow-inequalities/02-data/intermediate/wos_sample/dda4399f3b7609eaef6d1705bcbc4802-turley-ruth-and-sai/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Background
Slums are densely populated, neglected parts of cities where housing and
living conditions are exceptionally poor. In situ slum upgrading, at its
basic level, involves improving the physical environment of the existing
area, such as improving and installing basic infrastructure like water,
sanitation, solid waste collection, electricity, storm water drainage,
access roads and footpaths, and street lighting, as well as home
improvements and securing land tenure.
Objectives
To explore the effects of slum upgrading strategies involving physical
environment and infrastructure interventions on the health, quality of
life and socio-economic wellbeing of urban slum dwellers in low and
middle income countries (LMIC). Where reported, data were collected on
the perspectives of slum dwellers regarding their needs, preferences for
and satisfaction with interventions received.
Search methods
We searched for published and unpublished studies in 28 bibliographic
databases including multidisciplinary (for example Scopus) and
specialist databases covering health, social science, urban planning,
environment and LMIC topics. Snowballing techniques included searching
websites, journal handsearching, contacting authors and reference list
checking. Searches were not restricted by language or publication date.
Selection criteria
We included studies examining the impact of slum upgrading strategies
involving physical environment or infrastructure improvements (with or
without additional co-interventions) on the health, quality of life and
socio-economic wellbeing of LMIC urban slum dwellers. Randomised
controlled trials (RCTs), controlled before and after studies (CBAs) and
interrupted time series (ITS) were eligible for the main analysis.
Controlled studies with only post-intervention data (CPI) and
uncontrolled before and after (UBA) studies were included in a separate
narrative to examine consistency of results and to supplement evidence
gaps in the main analysis.
Data collection and analysis
Two authors independently extracted data and assessed risk of bias for
each study. Differences between the included study interventions and
outcomes precluded meta-analysis so the results were presented in a
narrative summary with illustrative harvest plots. The body of evidence
for outcomes within the main analysis was assessed according to GRADE as
very low, low, moderate or high quality.
Main results
We identified 10,488 unique records, with 323 screened as full text.
Five studies were included for the main analysis: one RCT with a low
risk, two CBAs with a moderate risk and two CBAs with a high risk of
bias. Three CBAs evaluated multicomponent slum upgrading strategies.
Road paving only was evaluated in one RCT and water supply in one CBA. A
total of 3453 households or observations were included within the four
studies reporting sample sizes.
Most health outcomes in the main studies related to communicable
diseases, for which the body of evidence was judged to be low quality.
One CBA with a moderate risk of bias found that diarrhoeal incidence was
reduced in households which received water connections from a private
water company (risk ratio (RR) 0.53; 95\% confidence interval (CI) 0.27
to 1.04) and the severity of diarrhoeal episodes (RR 0.48; 95\% CI 0.19
to 1.22). There was no effect for duration of diarrhoea. Road paving did
not result in changes in parasitic infections or sickness in one RCT.
After multicomponent slum upgrading, claims for a waterborne disease as
opposed to a non-waterborne disease reduced (RR 0.64; 95\% CI 0.27 to
0.98) in one CBA with a high risk of bias but there was no change in
sanitation-related mortality in a CBA with a moderate risk of bias.
The majority of socio-economic outcomes reported within the main studies
related to financial poverty, for which the body of evidence was of very
low quality. Results were mixed amongst the main studies; one RCT and
two CBAs reported no effect on the income of slum dwellers following
slum upgrading. One further CBA found significant reduction in monthly
water expenditure (mean difference (MD) -17.11 pesos; 95\% CI -32.6 to
-1.62). One RCT also showed mixed results for employment variables,
finding no effect on unemployment levels but increased weekly worked
hours (MD 4.68; 95\% CI -0.46 to 9.82) and lower risk of residents
intending to migrate for work (RR 0.78; 95\% CI 0.60 to 1.01).
There was no evidence available to assess the impact of slum upgrading
on non-communicable diseases or social capital. Maternal and perinatal
conditions, infant mortality, nutritional deficiencies, injuries,
self-reported quality of life, education and crime were evaluated in one
study each.
Nine supporting studies were included that measured varying outcomes
(6794 households or observations within eight studies reporting sample
sizes). One CPI evaluated cement flooring only while three UBAs and five
CPIs evaluated multicomponent slum upgrading strategies. All studies but
one had a high risk of bias.
The studies reinforced main study findings for diarrhoea incidence and
water-related expenditure. Findings for parasitic infections and
financial poverty were inconsistent with the main studies. In addition,
supporting studies reported a number of disparate outcomes that were not
evaluated in the main studies.
Five supporting studies included some limited information on slum
dweller perspectives. They indicated the importance of appropriate
siting of facilities, preference for private facilities, delivering
synergistic interventions together, and ensuring that infrastructure was
fit for purpose and systems were provided for cleaning, maintenance and
repair.
Authors'' conclusions
A high risk of bias within the included studies, heterogeneity and
evidence gaps prevent firm conclusions on the effect of slum upgrading
strategies on health and socio-economic wellbeing. The most common
health and socio-economic outcomes reported were communicable diseases
and indicators of financial poverty. There was a limited but consistent
body of evidence to suggest that slum upgrading may reduce the incidence
of diarrhoeal diseases and water-related expenditure. The information
available on slum dwellers'' perspectives provided some insight to
barriers and facilitators for successful implementation and maintenance
of interventions.
The availability and use of reliable, comparable outcome measures to
determine the effect of slum upgrading on health, quality of life and
socio-economic wellbeing would make a useful contribution to new
research in this important area. Given the complexity in delivering slum
upgrading, evaluations should look to incorporate process and
qualitative information alongside quantitative effectiveness data to
determine which particular interventions work (or don''t work) and for
whom.'
affiliation: 'Turley, R (Corresponding Author), Cardiff Univ, Informat Serv, SURE,
1st Floor,Heath Pk, Cardiff CF14 4YS, S Glam, Wales.
Turley, Ruth, Cardiff Univ, Informat Serv, SURE, Cardiff CF14 4YS, S Glam, Wales.
Saith, Ruhi, Oxford Policy Management, New Delhi, India.
Bhan, Nandita, Harvard Univ, Sch Publ Hlth, Dept Soc Human Dev \& Hlth, Boston,
MA 02115 USA.
Rehfuess, Eva, Univ Munich, Inst Med Informat Biometry \& Epidemiol, Munich, Germany.
Carter, Ben, Univ Birmingham, Sch Canc Sci, Canc Res UK Clin Trials Unit, Birmingham,
W Midlands, England.'
article-number: CD010067
author: Turley, Ruth and Saith, Ruhi and Bhan, Nandita and Rehfuess, Eva and Carter,
Ben
author-email: ruthturley@rocketmail.com
author_list:
- family: Turley
given: Ruth
- family: Saith
given: Ruhi
- family: Bhan
given: Nandita
- family: Rehfuess
given: Eva
- family: Carter
given: Ben
da: '2023-09-28'
doi: 10.1002/14651858.CD010067.pub2
eissn: 1361-6137
files: []
issn: 1469-493X
journal: COCHRANE DATABASE OF SYSTEMATIC REVIEWS
keywords-plus: 'IMPROVEMENT PROGRAMS; PROPERTY-RIGHTS; IMPACT; WATER; SANITATION;
DIARRHEA; SALVADOR; CHILDREN; HYGIENE; AREAS'
language: English
number: '1'
number-of-cited-references: '82'
orcid-numbers: Carter, Ben/0000-0003-0318-8865
papis_id: da2100fed31b7031686375991c5c1f2d
ref: Turley2013slumupgrading
researcherid-numbers: 'Rehfuess, Eva Annette/ABD-8167-2021
'
tags:
- relevant
- review
times-cited: '95'
title: Slum upgrading strategies involving physical environment and infrastructure
interventions and their effects on health and socio-economic outcomes (Review)
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000314315200029
usage-count-last-180-days: '3'
usage-count-since-2013: '135'
web-of-science-categories: Medicine, General \& Internal
year: '2013'