EHS-COVID (66) HSG: The need for a socially just Covid-19 response in urban informal settlements

19 November, 2020

Extracts below and a comment from me. Full text here:


Covid-19 has shone a spotlight on the growing inequities experienced by people living and working within informal settlements

12th November 2020

Government responses to Covid-19 have tended to take a very biomedical approach, focusing on prevention messaging and movement restrictions. But these approaches rarely take into account the environmental and economic realities and existing privations of people living in informal settlements. These areas of cities in low- and middle-income countries are generally congested, with cramped, poor quality housing, and a lack of sufficient access to water and sanitation services...

Access to health services: Access to healthcare for pre-existing and non-Covid related needs was disrupted across all the cities, with wide reaching negative impacts. People were scared to utilise health services due to infection risk and services also struggled to cope. Some turned to private providers, incurring greater costs, whilst in some cases costs of transport to reach public facilities increased. In Kenya, elderly people were less able to use services because they needed physical support to reach them.

Learning from failures in the Covid-19 response

During the Covid-19 pandemic many communities, such as in informal settlements in Freetown Sierra Leone, rallied together to support the most vulnerable through community kitchens, and to disseminate locally appropriate messages about Covid-19 prevention through trusted networks...


Comment (NPW): For me, what is missing in this article is practical guidance on how to manage COVID-19 in informal settlements/slums, and how to maintain essential health services in such settings. Can anyone provide such guidance? We are especially grateful to frontline health workers and others who are working in extremely challenging conditions. Does anyone have contact with frontline health workers in these settings?

Best wishes, Neil

Coordinator, WHO-HIFA Collaboration: HIFA project on Essential Health Services and COVID-19

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: