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Slum upgrading strategies involving physical environment and infrastructure interventions and their effects on health and socio-economic outcomes

  1. Ruth Turley1,*,
  2. Ruhi Saith2,
  3. Nandita Bhan3,
  4. Eva Rehfuess4,
  5. Ben Carter5

Editorial Group: Cochrane Public Health Group

Published Online: 31 JAN 2013

Assessed as up-to-date: 9 AUG 2012

DOI: 10.1002/14651858.CD010067.pub2


How to Cite

Turley R, Saith R, Bhan N, Rehfuess E, Carter B. Slum upgrading strategies involving physical environment and infrastructure interventions and their effects on health and socio-economic outcomes. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD010067. DOI: 10.1002/14651858.CD010067.pub2.

Author Information

  1. 1

    Information Services, Cardiff University, Support Unit for Research Evidence (SURE), Cardiff, Wales, UK

  2. 2

    New Delhi, Oxford Policy Management, New Delhi, India

  3. 3

    Harvard School of Public Health, Department of Society, Human Development and Health, Boston, USA

  4. 4

    Ludwig-Maximilians-University Munich, Institute for Medical Informatics, Biometry and Epidemiology, Munich, Germany

  5. 5

    Birmingham University, Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, Birmingham, UK

*Ruth Turley, Support Unit for Research Evidence (SURE), Information Services, Cardiff University, 1st Floor, Neuadd Meirionnydd, Heath Park, Cardiff, Wales, CF14 4YS, UK. ruthturley@rocketmail.com. TurleyRL@cf.ac.uk.

Publication History

  1. Publication Status: New
  2. Published Online: 31 JAN 2013

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Summary of findings    [Explanations]

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms

 
Summary of findings for the main comparison. Summary of findings - health and quality of life

What are the effects of slum upgrading strategies on the health and quality of life of slum dwellers?

Patient or population: Slum dwellers

Settings: Urban/peri-urban slums from low and middle income countries

Intervention: Slum upgrading involving physical environment and infrastructure interventions

GRADE is used to describe the quality of the body of main evidence. Main studies are those eligible for the main synthesis of findings (RCTs, ITS, CBA). Supporting studies are UBAs and CPIs that cannot determine causality and are reported only as supplemental information, to explore consistency with main study findings or summarise the limited 'best available evidence' where main studies do not evaluate a relevant outcome .

OutcomesImpact of InterventionNo of Participants
(main studies)
Quality of the body of main evidence for each outcome category
(GRADE)

Communicable diseasesFour main studies evaluated different outcomes related to communicable diseases and observed mixed effects of slum upgrading.

One CBA found a reduction in diarrhoea episodes (RR = 0.53; 95% CI 0.27 1.04; P = 0.07) and severity (RR = 0.48; 95% CI 0.17 to 1.22; P = 0.12) but not duration of diarrhoea. One CBA indicated that private water supply reduces the relative risk of making an insurance claim for a waterborne illness (RR = 0.64; 95% CI 0.41 to 0.98; P = 0.04).

 

There was no significant effect of road paving on the incidence of parasite and fungus infections or sickness in 1 RCT, or of multicomponent slum upgrading on mortality caused by diseases related to lack of sanitation in one CBA.
973 observations, 4 main studies.⊕⊕⊝⊝
low*

Supplemental information

Four supporting studies found associations between slum upgrading interventions and reduced incidence of communicable diseases in intervention groups compared to control / baseline. All four studies reinforced the main study finding, by observing lower diarrhoeal incidence in intervention groups. Two studies also observed lower incidence of parasitic infections which is inconsistent with main study findings.


Maternal and perinatal conditions and infant mortalityOne main CBA study reported no effect of slum upgrading (multi-component) on infant mortality.306 observations, 1 main study⊕⊕⊝⊝
low*

Supplemental information

One supporting study reported either a decrease or no change in maternal and perinatal conditions following slum upgrading depending on the indicator measured.


Nutritional deficienciesNo studies were identified for the main analysis that examined the effect of slum upgrading on nutritional deficiencies.N/A

 
N/A

Two further studies reported slum upgrading was associated with either lower incidence of nutritional deficiencies or no difference, depending on the indicator measured.


Non-communicable diseasesNo main studies examining the effect of slum upgrading on specific non-communicable diseases were identified for the main analysis of results.N/A

 
N/A

Supplemental information

One supporting study found evidence for an association between slum upgrading (providing homes with cement floors) and improved maternal mental health.


InjuriesOne CBA study, reported no effect of slum upgrading (multi-component) on the proportion of deaths due to homicides.306 observations, 1 main study⊕⊕⊝⊝
Very low**

Supplemental information

No eligible supporting studies were identified examining associations between slum upgrading and injuries.


General health measuresNo main studies reported other general health measures.N/AN/A

Supplemental information:

Four further supporting studies examined a range of general health measures (e.g. self reported ill health or sickness, and average monthly medical spending). Across the different measures, slum upgrading interventions were associated with outcomes that were either beneficial,adverse or showed no difference,


Quality of lifeOne main study reported no effect of slum upgrading (road paving) on residents satisfaction with living in the city. 897 observations, 1 main study⊕⊕⊝⊝
low***

Supplemental information

One supporting study found a statistically significant association between providing cement flooring to households and satisfaction with quality of life.


GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

* Lowest body of evidence included is from CBAs with no downgrading

** CBA evidence downgraded once due to limitations with directness of evidence (applicability of homicides to broader injury measures)

*** RCT evidence downgraded twice due to 'very serious' limitations with directness of evidence (narrow focus of intervention and QoL measures in relation to other slum upgrading strategies and broader QoL outcomes)

 Summary of findings 2 Summary of findings - socio-economic outcomes

 

Background

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms
 

Description of the issue

Slums are densely populated and neglected parts of cities where housing and living conditions are exceptionally poor. Varying in nature, from central city tenements to spontaneous squatter settlements at the edge of cities, slums are the product of unplanned urbanisation and are responsible for a number of socio-economic and health problems for their residents (UN HABITAT 2003a). Conditions of living within slums can differ between countries and even between residents within the same country or city. Some settlements may have few employment prospects for residents, whereas others may provide a wealth of formal or informal income-earning opportunities. Rapid population growth, rural-urban migration and the failure of urban governance are considered the key contributory factors for the development of slums (WHO 2005).

This review focused on slums, and the impact of strategies to upgrade them, in low and middle income countries (LMIC). Home to over 90% of slum dwellers today, a significant proportion of slums and the related socio-economic and health burdens occur in these LMIC regions (United Nations 2007a). Efforts to improve slum conditions in these resource-constrained settings may also be met with further challenges of extreme poverty, rapid population growth and urbanization.

It is expected that nearly 60% of the world's population will be urban dwellers within two decades. Urban population growth is most rapid in LMICs, where cities gain an average of five million residents every month. Rapid and unplanned growth of urban centres is occurring in the context of unfavourable economic conditions, inadequate urban planning policies and regulatory frameworks unresponsive to the transformation in progress. As a result, the number and size of informal settlements or slums are growing rapidly (United Nations 2007b).

The United Nations Human Settlements Programme (UN-Habitat), the global agency for promoting socially and environmentally sustainable towns and cities, provides a working definition of slums that focuses on both physical living conditions and legal aspects. According to UN-Habitat, a slum household is defined as a group of individuals living under the same roof in an urban area and who lack one or more of the following:

  1. access to improved water (access to sufficient amount of water for family use, at an affordable price, available to household members without being subject to extreme effort);
  2. access to improved sanitation (access to an excreta disposal system, either in the form of a private toilet or a public toilet shared with a reasonable number of people);
  3. security of tenure (evidence of documentation to prove secure tenure status or de facto or perceived protection from evictions);
  4. durability of housing (permanent and adequate structure in non-hazardous location);
  5. sufficient living area (not more than three people sharing the same habitable room) (UN HABITAT 2003a).

In addition, slums may lack other municipal services (storm drainage, street lighting, paved footpaths, emergency access roads, electricity and energy for cooking and heating) and suffer from a paucity of educational, social and health services and institutions (childcare facilities, schools, playgrounds, health clinics) (UN HABITAT 2003a).

Evidence for the association between key characteristics of slums and ill health (UN HABITAT 2003a) has been discussed by several authors (Kyobutngi 2008; Riley 2007; Sclar 2005; Unger 2007). Poor access to safe water and sanitation can often lead to water scarcity or contamination, increased rat density and open sewers. These living conditions among slum dwellers can lead to high risks of communicable diseases such as diarrhoeal diseases, cholera, malaria, dengue and leptospirosis. Poor structural quality of housing (such as damp housing) or homes located in hazardous areas can make slum dwellers susceptible to respiratory illnesses like tuberculosis (TB) or asthma and injuries from land or mud slides, flooding or fire. Overcrowding in slums also provides enhanced opportunity for transmission of diseases such as TB and other respiratory conditions. Furthermore, lack of secure tenure can inhibit residents' access to health care or social services in the neighbourhoods. Appendix 1 provides an overview of the adverse health outcomes associated with slum defining characteristics, reproduced from Unger 2007.

Although the proximate physical environment of slum dwellers is a major factor in the transmission of communicable diseases, it is only one of a number of key influences on health and wellbeing. The major trends shaping urban living conditions are complex. Existing frameworks to describe the determinants of urban health posit that fundamental distal, or 'upstream', factors (such as population size, climate, geography, political orders, economy, religion and culture) underlie and influence health and wellbeing via multiple pathways. These in turn influence an array of interlinking proximate physical and social factors, interceded by the individual’s behaviour, knowledge and healthcare seeking behaviour (see Northridge 2003 and Galea 2005).

 

Description of the intervention

Advocated by John Turner in the 1970s, slum upgrading, in its most basic form, involves improvements in the physical environment of the existing area, for example improving or installing basic infrastructure services such as water, sanitation, solid waste collection, electricity, storm water drainage, access roads, footpaths and street lighting. Interventions may also include home improvements and securing land tenure. Over time the concept of upgrading has evolved to include integration of social, economic, organizational and environmental intervention components (Wekesa 2011). Through partnerships with slum residents, community groups, non-governmental organisations (NGOs), businesses and municipal authorities or local governments, the goal of slum upgrading programs is to provide basic services; strengthen the capacity of governance institutions to support upgrading projects in slums; improve the livelihoods of people living and working in informal settlements; and empower communities to improve their wellbeing (WHO 2005).

This review examines the impact of slum upgrading programmes on health and social wellbeing. A broad range of slum upgrading approaches and their interlinkages with health and socio-economic outcomes have been depicted in the logic model (Figure 1). These have been grouped into proximal interventions within the living environment (physical environment, social environment, service access, health promotion and behavioural interventions) and distal strategies that enable structures and systems to implement these proximal environment interventions (policies, laws and regulations, financial investment, community action, or a combination of these factors). The logic model also demonstrates that strategies may be delivered by governments (global, national, state or local), the private sector, civil society, or by a combination of these actors and stakeholders.

 FigureFigure 1. Logic model to outline slum upgrading interventions.

The number, breadth and diversity of slum upgrading interventions outlined in the logic model are too broad to be assessed in a single systematic review. This review, therefore, has focused on upgrading interventions involving physical environment and infrastructure improvements, with or without the integration of wider slum upgrading approaches (for example policy, legal, financial, community action, social or service interventions). Where such studies deliver multicomponent strategies, the nature of the full package of interventions were examined.

This review did not set out to examine the issue of preventing future unplanned growth of slums, nor to evaluate the impact of slum clearance or relocating slum dwellers to new housing. While these remain key areas of relevance to the health and wellbeing of the urban poor, and critical issues worthy of investigation, they are outside the scope of this review and will require examination through separate reviews.

 

How the intervention might work

 

Potential effects of slum upgrading

The complex picture of urban health influences suggests that slum upgrading strategies have the potential to effect various interwoven health and socio-economic outcomes. Interventions may directly influence physical and mental health through a reduction in the risks of disease transmission, injuries and stressors; or indirectly through economic development and modification of key socio-economic factors. Interventions may also have varying impact at the individual, household or community level. For example, installing private latrines in homes may improve the health within the household, but if the latrines are not connected to an effective sewerage system in the neighbourhood the community may still be exposed to waste and its associated health risks.

A World Health Organization (WHO) literature review assessing the evidence for associations between slum life, health and health inequity demonstrated that overcrowding has been linked with stress and violence (including intimate partner violence) (WHO 2005). Thus, in addition to checking the spread of communicable diseases, reduced overcrowding may lead to declines in injuries and mental health problems. The WHO review also points to links between poverty and mental illness, child malnutrition, stunting and wasting plus health risk behaviours (for example drug and tobacco use) (WHO 2005).

Existing evidence suggests water and sanitation improvements could improve both health and socio-economic wellbeing. Systematic reviews (not limited to slum settings) report reductions in rates of diarrhoeal diseases following improved water supply (Clasen 2006; Waddington 2009) and excreta disposal (Clasen 2010). In addition to health gains and reduced health costs, a recent WHO cost-benefit analysis of water and sanitation access at the global level demonstrated clear reductions in days lost with respect to formal and informal employment, school attendance, or other productive activities in the household, as a result of time saved from illness and accessing safe water and sanitation (Hutton 2004). A further impact evaluation concluded that improvements in water supply enhance household economy as residents are able to reallocate the time saved in collecting water to income-generating activities (Aiga 2002).

Land titling has often been included within slum upgrading strategies. It is increasingly being considered one of the most effective forms of encouraging economic growth in poor communities. De Moura 2009 suggested that land titling leads to a reduction in child labour force participation; and Field 2006 indicated that securing tenure can lead to significant increases in the value of housing and, in turn, increases banks' willingness to use housing as collateral for loans.

 

Potential moderators of slum upgrading

The effects of slum upgrading strategies may be moderated by upstream influences on urban slum strategies, such as governance, crime and mafia influence, culture, religion and gender roles. For example, Field 2006 noted that criminal organizations may present significant barriers to project implementation by controlling access to water supplies. Land mafias that acquire, develop and sell slum land in illegal ways for profit may also hinder slum improvement strategies.

Key organisations such as Cities Alliance, a global alliance of cities and their development partners, advocate community participation in the planning and delivery of interventions as being a key aspect of successful slum upgrading. Women's participation is particularly advocated as slum dwelling women are likely to have useful skills honed from running the household and specific needs due to cultural norms that often do not give them the same legal rights or status as a man (Cities Alliance 2011).

Thus, wider slum upgrading programmes targeting policy, organizational, community engagement, financial, social environment and health and social care access aspects may enhance the impact of slum upgrading strategies on slum dwellers' health and socio-economic wellbeing. The short and long-term effects of the slum upgrading programmes will also be mediated by process variables, such as the uptake and completion of the programme; its reach, longevity or sustainability; and slum dwellers' satisfaction and acceptance of the intervention. 

Given the complex nature of the suggested interlinking outcomes and mediators described, it was important that this systematic review adopted a holistic approach to examining the key effects of slum upgrading.

 

Why it is important to do this review

Efforts to improve the living conditions of slum dwellers, particularly within LMICs, peaked during the 1980s and was followed by a period of disjointed activities (UN HABITAT 2003a). Renewed concern, political will and slum upgrading activities were fuelled, however, following the United Nations Millennium Declaration in 2000 which included aims to significantly improve the lives of at least 100 million slum dwellers by the year 2020.   

The 2010 Millennium Development Goals progress report showed that whilst these efforts were considerable, slum improvements failed to keep pace with the growing ranks of the urban poor (United Nations 2010). More recently there have been signs of progress, the share of slum dwellers in urban areas declined from 39% in 2000 to 33% in 2012, but major inequalities remain (United Nations 2012).

To ensure that valuable resources are invested in the most effective and efficient ways and are tailored to appropriate settings, it is important that slum upgrading strategies be based on the best available evidence. Evidence on the effectiveness of strategies to reduce the ill effects of urban slums has, to date, not been examined in a systematic review. Whilst several systematic reviews have evaluated the impact of water and sanitation interventions on health outcomes (Clasen 2006; Clasen 2010; Waddington 2009), these have not focused on the complex setting of slums and do not cover the range of slum upgrading interventions that exist beyond water and sanitation. Furthermore, they are restricted to targeted health outcomes (for example diarrhoea incidence).

Scoping searches by the author team found that the evidence base for slum upgrading is widely dispersed across different disciplines and grey literature sources. Moreover, single studies may not be adequate to capture the broad spectra of relevant health and social outcomes, or diverse slum upgradation approaches. A comprehensive review of slum upgrading programmes can collate all relevant research and provide a broader picture on effectiveness across different settings, interventions and outcomes whilst considering the reliability and validity of the results and measures. Systematically reviewing this literature can provide a documented account of reliable evidence and research gaps, and serve as an important investment in global knowledge to guide urban planning and sectoral reforms.

This review examined slum upgrading strategies involving physical environmental or infrastructure changes with or without additional wider upgrading approaches (for example policy, legal, financial, community action, social or service interventions). Within such strategies, the authors sought to identify key intervention components that may result in the greatest improvements in the health and socio-economic wellbeing of slum dwellers and highlight any potential adverse effects .

 

Objectives

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms

The main objectives of this systematic review were:

  • to examine the effectiveness of slum upgrading strategies involving physical environment and infrastructure interventions for improving the health and quality of life of slum dwellers.

Secondary research objectives were: 

  • to examine the effectiveness of slum upgrading strategies involving physical environment and infrastructure interventions for improving the socio-economic wellbeing of slum dwellers;
  • to identify slum dwellers' perceived needs, preferences for slum upgrading and satisfaction with the interventions they receive;
  • to identify potential adverse impacts slum upgrading may have on slum dwellers' health and wellbeing;
  • to define and identify programme characteristics and components which increase the health and wellbeing of slum dwellers;
  • to identify external contexts that may boost or hinder intervention effects.

 

Methods

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms
 

Criteria for considering studies for this review

 

Types of studies

Slum upgrading programmes have been evaluated using a wide variety of approaches and designs. Whilst prone to less bias, randomised controlled trials (RCTs) are difficult to design and implement due to ethical, resource and practical implications. Common methodologies often include longitudinal impact studies using experimental or quasi-experimental designs, and evaluations often utilise qualitative data collection (Field 2006). Further, appropriate controls may be difficult to identify due to the varying characteristics between and within slums, and evaluations are often commissioned during or after the implementation phase (Vaessen 2010). To overcome these challenges, the following study designs were considered for the synthesis of the main findings:

  • RCTs including, cluster RCTs;
  • quasi-RCTs, cluster quasi-RCTs;
  • controlled before and after studies (CBAs), cluster CBAs;
  • interrupted time series (ITS).

In these studies, control groups could include slums or areas within slums which did not receive an intervention, or received a different intervention, for example an alternative slum upgrading strategy or a relocation or clearance programme.

In addition, the following study designs were included as supporting studies:

  • uncontrolled before and after studies (UBAs);
  • non-randomised, controlled studies with only post-intervention outcome data (CPIs).

Supporting studies can indicate associations between interventions and outcomes but not whether interventions caused the effect. They were included as supplemental information, and described in a separate narrative to the main study findings, to explore consistency with the main study findings or summarise the limited 'best available evidence' where main studies did not evaluate a relevant outcome. Whilst these study designs are prone to a higher level of bias, in the absence of studies with greater internal validity they can provide an evidence map of rich data on the settings and contexts, intervention characteristics, processes and indicative findings. A similar approach has been employed in a previously conducted review of specialist outreach clinics in primary care and rural hospital settings that is published in The Cochrane Library (Gruen 2004).

Qualitative data regarding slum dwellers' needs, preferences and satisfaction with slum upgrading strategies were also included if conducted in parallel with a quantitative study described above. Stand-alone qualitative research studies not linked to quantitative or mixed methods studies were excluded. Non-comparative case reports or cross-sectional studies were also excluded.

 

Types of participants

Populations living in urban or peri-urban slums in LMICs (as defined by the World Bank) were eligible. The population was not restricted by age, gender, social hierarchy (for example caste, class) or any other criterion. Slums were identified on the basis of at least one of the following two criteria.

A. The authors described the setting using the term ‘slum’, an alternative synonym(s), or named a slum community (please see  Table 1 for further information). If the authors referred to slum upgrading within the publication but did not specifically identify the settings as slums, they were contacted for further clarification.

B. Sufficient detail was provided to determine that the setting is an urban area within an LMIC and that the households lack two of or more of the following five indicators used by UN-HABITAT to identify slum households (United Nations 2010):

  • access to improved water;
  • access to improved sanitation;
  • security of tenure;
  • durability of housing;
  • sufficient living area.

Further details outlining the criteria for classifying the elements as improved are provided in Appendix 2. UN-Habitat requires just one criterion to be met in order for a household to be identified as a slum household. However, a more conservative approach was taken for this review because in many urban cities living area may be insufficient for both middle classes and slum populations (UN HABITAT 2003b). Urban refugee camps or settlements clearly meeting at least two of the UN-Habitat criteria for slums were considered to be eligible settings. 

 

Types of interventions

The review examined slum upgrading programmes involving at least one or more physical environment or infrastructure change to the slum environment in situ; with or without the inclusion of policy, financial, legal, behavioural, educational, social environment, or health and social service interventions.

Examples of potential physical environment interventions include the following.

  • Water and sanitation: improved access to sanitation (e.g. private latrines), access to adequate water quality and quantity for drinking and other needs (e.g. piped water into dwelling), drainage and flood protection.
  • Energy infrastructure e.g. gas or electricity supply, improved cook stoves.
  • Transportation infrastructure e.g. building road networks, emergency access roads, public transportation, paved sidewalks and footpaths, installing street lighting.
  • Mitigation of environmental hazards (flood, landslide and waste) via ground stabilisation, water drainage, sewerage systems, waste disposal and collection.
  • Waste management e.g. kerbside waste collection.
  • Housing improvements e.g. improved flooring.

Where packages of interventions were provided (for example multicomponent physical environment strategies or a combination of physical and wider slum improvement programmes), the full nature of the included components was recorded. No minimum duration was required for a slum upgrading intervention. The following interventions were not eligible:  

  • behavioural, educational, social or health service interventions without accompanying physical environment or infrastructure change in slums;
  • interventions to prevent slum formation;
  • slum clearance or relocation to housing outside of the slum neighbourhood.

 

Types of outcome measures

The review examined a range of primary and secondary outcomes of interest. Studies were included in the review if they reported either a health, quality of life or socio-economic outcome as described below.

 

Primary outcomes

 
Health and quality of life

The primary outcomes for this review are shown below. They may be measured objectively or subjectively (self-reported).

  • Mortality and morbidity related to:
    • communicable diseases;
    • non-communicable diseases;
    • injuries.
  • Quality of life (QoL): example measures could include validated instruments such as health-related quality of life or self reports of subjective wellbeing such as life satisfaction or happiness).

 

Secondary outcomes

 
Socio-economic wellbeing

As slum upgrading projects frequently comprise a combination of physical, social, economic, organizational and environmental interventions, they also have the potential to impact a broad range of socio-economic outcomes. These factors are intrinsically linked with urban health (see How the intervention might work). Therefore, studies were included in the review if they reported at least one of the following socio-economic outcomes.

  • Financial poverty:

    • household income;
    • household assets;
    • time or proportion of income spent on water or fuel collection;
    • households above or below poverty threshold.

  • Employment and occupation.
  • Crime and violence.
  • Education.
  • Social capital: example measures could include membership of formal or informal clubs, societies; contact with social groups including families, religious groups, friends; presence and reliance on networks of support; shared norms and values within a community; trust in neighbours, family members, government and community members such as politicians and police; and civic participation and shared decision making.

 
Slum dwellers' views and preferences

Where reported, data regarding slum dweller perspectives and experiences were collected from eligible effectiveness studies examining the outcomes described above. The following information was sought:

  • slum dwellers' diagnoses of their own needs and preferences for interventions and improvements to their living environment;
  • slum dwellers' perceptions and views regarding the delivery, acceptability and impact of the intervention received;
  • adverse effects reported by slum dwellers e.g. whether families felt their cultural patterns were impaired as a result of upgrading interventions or upgraded homes were no longer affordable.

 

Search methods for identification of studies

A comprehensive search for both published and unpublished research studies was performed across a broad range of information sources to reflect the cross-disciplinary nature of the topic. Articles from all languages were considered and no restrictions were made regarding publication dates. An initial literature search was performed between May 2011 and July 2011, followed by an update search between April 2012 and May 2012.

 

Electronic searches

 
Databases

A comprehensive search strategy for the database SCOPUS was developed that combined two concept groups of search terms: setting (slums) and interventions (upgrading). Studies were sifted manually for study designs and outcomes once the search was completed. The SCOPUS strategy was then adapted to the other databases listed below using database-specific subject headings, where available.


Health and Biomedical

  • MEDLINE and MEDLINE in Process (1947 to April 2012), via Ovid)
  • EMBASE (1947 to April 2012, via Ovid)
  • British Nursing Index (1994 to May 2012, via ProQuest)
  • Cochrane Public Health Group Specialized Register (inception to April 2012)
  • Cochrane Central Register of Controlled Trials (CENTRAL) (inception to May 2012)
  • CINAHL (via EBSCOhost) (1981 to May 2012)
  • PsycINFO (1806 to April 2012)
  • Science Citation Index (1899 to April 2012, via ISI Web of Knowledge)

Multidisciplinary

  • Scopus (1960 to May 2012)

Social Science

  • ASSIA (1987 to April 2012)
  • Sociological Abstracts (1963 to May 2012)
  • Social Science Citation Index (1956 to April 2012, via ISI Web of Knowledge)

Architecture, Urban Planning, Environment

  • Avery (1930s to May 2012)
  • EI Compendex (inception to May 2012 via Engineering village)
  • Georef (1666 to May 2011)
  • Greenfile (inception to May 2012 via EBSCO)
  • Planex (inception to May 2012 via UKMFA)
  • ICONDA (1976 to April 2012 via Ovid)
  • REPIDISCA (1982 to April 2012)

LMIC-relevant

  • ELDIS (inception to May 2012)
  • IndMed (1985 to May 2012)
  • MedCarib (inception to April 2012)
  • Global Health Library (inception to May 2012). Search all sources to cover: 


    • Regional Indexes, AIM (AFRO), LILACS (AMRO/PAHO), IMEMR (EMRO), IMSEAR (SEARO), WPRIM (WPRO), WHOLIS (KMS), SciELO

Grey literature, Unpublished Research 

  • HMIC (1979 to April 2012 via Ovid)
  • Current Controlled trials (unpublished studies) (inception to May 2012)
  • 3ie impact database (inception to May 2012)
  • IDEAS (inception to April 2012)
  • JOLIS (inception to April 2012)



During the update search, the sensitivity of the original search strategy was slightly increased by including additional search terms relating to improved cookstoves, mitigation of environmental hazards and home flooring. These extra search terms were incorporated in databases that allowed complex search strategies (SCOPUS, MEDLINE, EMBASE, HMIC, ICONDA and Psycinfo) and rerun for the entire search period. Remaining update searches covered January 2011 to April, May 2012. Georef was not available for the update search.

The final SCOPUS search strategy is shown in Appendix 3 and all search strategies used in the original and updated search are presented in Appendix 4.

 
Websites

The following websites were searched for grey literature:

  • Asian Development Bank;
  • Care International;
  • Centers for Disease Control and Prevention;
  • Cities Alliance;
  • Comic Relief;
  • International Council for Research and Innovation in Building and Construction (CIBD);
  • J-PAL;
  • Office of Evaluation and Oversight (OVE) of the Inter-American Development Bank;
  • Oxfam;
  • Red Cross;
  • Slum Dwellers International;
  • The Society for the Promotion of Area Resource Centres (SPARC);
  • UK Department for International Development (DFID);
  • UN-HABITAT;
  • US Agency for International Development (USAID), including its Environmental Health Project (EHP);
  • Water Aid;
  • World Bank;
  • World Health Organization.

OVE was not included in the original literature search but was searched for publications of any date during the update literature search.

 

Searching other resources

The journal titles of all included articles were handsearched for the previous five years with the exception of Social Science and Medicine, which was searched for just the last six months due to the large volume of issues published by the journal.

Additionally, reference lists from included studies were scanned for further relevant articles, and individual experts and organisations were contacted to obtain relevant published, unpublished or ongoing studies. 

 

Data collection and analysis

 

Selection of studies

Search results were downloaded and screened using reference management software. Initially one review author sifted the titles and abstracts to exclude duplicate records and clearly ineligible articles (that is studies in high income countries, not slum settings, or purely descriptive articles). If there was any uncertainty as to whether records were potentially relevant they were retained for further screening.

The remaining titles and abstracts were then sifted by two independent review authors. Where available, full texts of all remaining potentially relevant or unclear papers were obtained and reviewed against the inclusion criteria using a checklist, by two independent review authors working in duplicate. Disagreements were resolved by discussion and, where required, a third review author.

 

Data extraction and management

Data were extracted by two review authors, independently in duplicate, using a data extraction form adapted from the Cochrane Public Health Group 'Guide for Developing a Cochrane Protocol' (CPHG 2011). Any disagreements in data extraction were resolved by discussion, and using a third review author if required.

If key data were missing from reports, attempts were made to contact the investigators to obtain the information. Where multiple reports of the same study were published, the most recent paper formed the primary reference and data were maximally extracted to cover all relevant outcomes and methods reported across the studies.

Data extraction also recorded information on a range of important characteristics to reflect the array of distal and proximal influences on slum health and socio-economic wellbeing as well as factors such as the fidelity of intervention delivery. Where possible, details were collected regarding: the population, setting (including origin of slum, defining characteristics, whether squatter settlement or legal but dilapidated, and whether conditions were improving or worsening), interventions, process variables, outputs (for example fidelity and sustainability of intervention), and barriers and facilitators to implementation.

 

Assessment of risk of bias in included studies

Two independent review authors assessed the quality of included studies in duplicate using checklists based on the ‘Graphical Appraisal Tool for Epidemiological studies' (GATE) (Jackson 2006) and adapted by the National Institute for Health and Clinical Excellence (NICE) for public health interventions (NICE 2009). Disagreements between review authors were agreed on by discussion and a third review author if required.

These checklists were used to inform risk of bias (RoB) tables based on the Cochrane Effective Practice and Organisation of Care Group (EPOC) RoB tool. The tables were completed to summarise the internal validity of all included studies. An additional domain (taken from the NICE tool) was added to capture details of any measures that non-randomised studies applied to minimise selection bias. Studies were reported as having high, unclear, or low risk of bias in each of the domains shown below.

  1. Random sequence generation (selection bias).
  2. Allocation concealment (selection bias).
  3. Selection of exposure (and comparison groups) for non-randomised studies (selection bias).
  4. Baseline outcome measurements similar (selection bias).
  5. Baseline characteristic measurements similar (selection bias).
  6. Incomplete outcome data (attrition bias).
  7. Knowledge of interventions adequately prevented (performance and detection bias).
  8. Study adequately protected against contamination (performance bias).
  9. Selective outcome reporting (reporting bias).
  10. Other bias.

Questions answered with 'not reported' or 'not applicable' in the NICE checklist were completed as 'unclear bias' or 'high risk of bias' in the EPOC RoB tables, respectively. Where EPOC RoB domains were not applicable to a particular study design (mainly CPI and UBA studies) a description was added in the notes section of the RoB tool to indicate this.

Completion of the NICE checklists and EPOC RoB tables provided summary scores for a study's internal validity. Grades ranged from '++' (good internal validity, low risk of bias), '+' (mixed or unclear risk of bias), to '-' (poor internal validity, high risk of bias). If any of the EPOC RoB domains applicable to a particular study were reported as having a high risk of bias, the study was graded as '-', that is an overall high risk of bias. The NICE checklists also resulted in summary scores for external validity, that is the extent to which the findings for the study participants are generalisable to the population they were chosen from (NICE 2009). Scores were either '++' (good), '+' (mixed or unclear), or '-' (poor). Appropriate NICE checklists were also completed for qualitative components of included studies using the same grading system for internal validity (NICE 2009).

Risk of bias is discussed in the section Risk of bias in included studies while RoB tables are presented in Characteristics of included studies and results of NICE checklists in Additional tables.

 

Measures of treatment effect

Continuous outcomes (mean differences (MDs)) were reported as found in the primary research. Where appropriate and feasible, dichotomous outcomes were presented as relative risk ratios (RRs) with their associated CIs. For regression based studies, RRs were estimated according to methods outlined in the Campbell International Development Group guidelines (CIDG 2011). Standard errors were estimated based on reported t statistics (following Keef 2004).

 

Unit of analysis issues

 

Clustered studies

Studies that allocated interventions to communities (clusters) but did not account for the community effect during analysis were to be reported and reanalysed, inflating the standard error to account for the correlated nature of the data. Where this was not feasible, only the point estimate was reported (without the P value or CI).

 

Multiple time-points per outcome

Outcomes were extracted for multiple timepoints where reported by the included studies.

 

Dealing with missing data

Investigators were contacted when study designs or outcomes were unclear or had not been reported.

 

Data synthesis

Meta-analysis was only considered for studies eligible for the main analysis of findings (that is RCTs, CCTs, CBAs and ITS). However, diversity of interventions and outcomes prohibited any pooling of studies. Therefore, a narrative synthesis was performed separately for both main and supporting study findings.

Drawing on methods described by Ogilvie 2008, harvest plots were developed to visually convey findings, appropriateness of the study design, confidence in the estimate of effect and risk of bias of the included studies. Studies are represented by bars plotted onto a grid, marked with the first three letters of the primary author's surname and placed according to the direction of effect. Outcome measures varied considerably between studies, thus study results were grouped into broad outcome categories. For example, diarrhoea, parasitic infections and dengue fever were all plotted within the communicable diseases group. Where possible, one bar was used for each study within one outcome group. In some cases, the same study measured two or more individual outcomes that fitted under the same broad outcome heading. Where the direction and statistical significance of the effects were the same, one bar was used for all outcome indicators. Where a study's results differed for each indicator, separate bars were used to illustrate the uncertainty.  

The height of the bar reflects the appropriateness of the study design in relation to its ability to eliminate selection bias and detect whether the intervention has a causal effect on the outcome of interest (highest represents most appropriate). RCTs are considered the gold standard study design to eliminate selection bias as known and unknown differences in intervention and control groups can be evenly distributed. Therefore, the highest bar is used for RCTs.

Study designs that allow a causal effect to be plausibly interpreted are marked by the second highest bar. This is assigned to CBA or ITS designs as well as controlled post-intervention only studies (CPI) that statistically aimed to eliminate selection bias by a combination of analytical methods (for example propensity score matching, adjusting for confounders). UBAs and all other CPI study designs were assigned the lowest height bar, as a causal effect of the intervention rather than some other factor cannot be confidently interpreted. See Summary of main results.

All outcomes were represented in summary of findings tables by organising them into broad categories (see  Summary of findings for the main comparison;  Summary of findings 2). Health and QoL outcomes were grouped into the following broad categories: communicable diseases; maternal and perinatal diseases and infant mortality; nutritional deficiencies; non-communicable diseases; injuries; general health measures; and QoL. Socio-economic outcomes were grouped into financial poverty; employment; education; crime and violence; and social capital. The GRADE approach (Grading of Recommendations Assessment, Development and Evaluation) (Guyatt 2008) was used to assess the quality of the body of evidence from all main studies within each broad outcome category. According to GRADE, the body of evidence for each outcome group was judged as either:

  • high quality, further research is very unlikely to change our confidence in the estimate of effect;
  • moderate quality, further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate;
  • low quality, further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; or
  • very low quality, further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.

For each broad outcome, the corresponding results of supporting studies were also briefly described as supplementary information.

Qualitative data were extracted in duplicate within the same data extraction forms described above. Perspectives were sought for three key topics: slum dweller living conditions in unimproved areas and their perceived needs; views regarding intervention effects (whether beneficial or adverse) and factors thought to enhance or mediate impact; acceptability of the intervention including perceived barriers and facilitators of their use and implementation. Due to a lack of available studies including slum dwellers' perspectives, paucity of richness in the data and the dissimilar nature of the information available, a narrative description of the findings within each paper was presented in accordance with Noyes 2011 and NICE 2009. One review author organised individual study findings into broad descriptive themes which were listed in a summary table and accompanied by a brief description of the study finding associated with each theme (see  Table 2). A second review author reviewed the narrative description of studies and checked that themes in the summary table were appropriate. The table highlighted that, on the whole, themes were disparate, precluding further thematic analysis across studies.

 

Subgroup analysis and investigation of heterogeneity

Given the paucity of available main studies and the high degree of study heterogeneity, it was not possible to conduct planned subgroup analyses regarding: the composition of the intervention (singular versus multiple component); and use of community engagement in the design, delivery, or maintenance of interventions (engagement versus non-engagement).

Instead, harvest plots were developed to visually explore potential trends in studies with these characteristics.

 

Results

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms
 

Description of studies

See: Characteristics of included studies; Characteristics of excluded studies; Characteristics of ongoing studies.

 

Results of the search

The combined literature search, completed in May 2012, yielded 10,488 unique titles and abstracts. After initial screening to remove clearly irrelevant records, 1160 abstracts were screened by two independent review authors; 323 were considered potentially eligible and assessed in full text by two independent review authors. On completion of the selection process 21 publications reporting five main studies and nine supporting studies were included. See Figure 2 for a flow diagram of the selection processes.

 FigureFigure 2. Original literature search.

 

Included studies

Please see: Characteristics of included studies.

Main studies are those eligible for the main synthesis of findings (RCTs, ITS, CBA). Five main studies were identified for inclusion: one cluster-RCT (Gonzalez-Navarro 2010) and four cluster-CBAs (Butala 2010; Galiani 2007; Soares 2005; Taylor 1987) using difference in difference analyses and adjustment for confounders. Taylor 1987 was the only study not to use robust standard errors to account for the effect of clustering or to provide sufficient information to allow reanalysis. A graphical overview of the intervention components and outcomes examined by the main studies is provided in Figure 3. A total of 3453 households or observations were included in the four studies that reported a sample size, while the number of observations within studies varied depending on the outcome measured. One further study did not report a clear sample size (Taylor 1987).

 FigureFigure 3. Main studies - overview of intervention components and outcomes.

In brief, three CBAs compared the impact of broad slum upgrading strategies, involving physical upgrading and wider living environment strategies, to no intervention (Butala 2010; Soares 2005; Taylor 1987). Outcomes differed between studies. Butala 2010 examined effects on waterborne illnesses, whereas Taylor 1987 examined effect on mean household income and Soares 2005 measured mortality (infant, homicide and sanitation-related), income and illiteracy. Two further studies evaluated the impact of single physical interventions: one RCT (Gonzalez-Navarro 2010) evaluated the impact of road paving on parasite or fungus infections, sickness and quality of life; and one CBA examined the effect of water supply on diarrhoea and water expenditure (Galiani 2007). Due to the lack of similar interventions and common outcomes between the studies, a meta-analysis was not possible.

Supporting studies are UBAs and CPIs that cannot determine causality and are reported only as supplemental information to explore consistency with the main study findings or summarise the limited 'best available evidence' where the main studies do not evaluate a relevant outcome. Nine supporting studies were included: six CPI studies (Aiga 2002; Cattaneo 2009; De Leon 1986; Moitra 1987; Moraes 2004; Parikh in press) and three UBA studies (Abelson 1996; Joshi 2002; Milone 1993). A total of 6794 households or observations were included in the four studies reporting sample sizes, while the number of observations within studies varied depending on the outcome measured. One further study did not report the sample size (Moitra 1987). Except for three (Aiga 2002; De Leon 1986; Joshi 2002), the majority of studies were clustered yet four studies did not adjust for the clustering effect (Abelson 1996; Milone 1993; Moitra 1987; Moraes 2004). Cattaneo 2009 selected controls using propensity score matching and adjusted for confounders whilst two studies controlled for potential confounders (Aiga 2002; Moraes 2004). A graphical overview of the intervention components and outcomes examined by the supporting studies is provided in Figure 4.

 FigureFigure 4. Supporting studies - overview of intervention components and outcomes.

One study evaluated a single physical upgrading intervention entitled Piso Firme. This project replaced dirt floors with cement floors in slum households (Cattaneo 2009). The remaining studies examined multiple physical environment interventions with additional health or social components (Abelson 1996; De Leon 1986; Joshi 2002; Moitra 1987) and four studies assessed multicomponent physical upgrading only (Aiga 2002; Cattaneo 2009; Milone 1993; Moraes 2004). Outcomes differed considerably between studies, focusing mostly on measures of communicable diseases and financial poverty.

 

Actors and how communities were chosen to receive the intervention

The majority of studies were 'natural experiments' whereby researchers did not manipulate allocation or delivery of the intervention, and comparison groups were frequently established post hoc. One RCT was able to incorporate randomisation into a government road paving intervention, offering an objective system of assigning the intervention where budgetary constraints prevented treatment of all the communities identified as in need (Gonzalez-Navarro 2010).

Included studies reported an array of actors who contributed to intervention delivery. Amongst the main studies two projects were state-led government programmes, road paving (Gonzalez-Navarro 2010) and Favela-Barrio, which also received funding from the Inter-American Development Bank (IADB) (Soares 2005). The majority of interventions described in the supporting studies were government-led, such as the Piso Firme cement flooring project (Cattaneo 2009) and Barrio-Escopa (De Leon 1986). Global agencies commonly provided financial assistance, including the World Bank (Aiga 2002), Asian Development Bank (Milone 1993), UK government overseas departments (Abelson 1996) and the United Nations (De Leon 1986).

Partnerships between different combinations of government, civil society, private industry, NGOs and charitable trusts were also described in both the main and supporting studies (Butala 2010; Galiani 2007; Joshi 2002; Parikh in press).

 

Intervention duration

The time needed to implement interventions was not reported in the majority of studies. Where information was provided, descriptions were usually limited to time periods in which programmes were rolled out across slums, without clearly stating how long the interventions took to complete within each slum.

 

Community engagement

Three main studies (Butala 2010; Galiani 2007; Taylor 1987) and three supporting studies (Aiga 2002; Joshi 2002; Parikh in press) reported community involvement, either in the form of slum residents paying for the intervention delivery or the fees for the resulting infrastructure such as water supply (see Figure 3 and Figure 4).

Only one main study described slum residents being involved in the selection of slum upgrading projects (Soares 2005). However, one project involved varying levels of community engagement between neighbourhoods, with marginal consultation in planning and some involvement during implementation. Some slums residents were consulted about the location of roads and walkways, and to a lesser degree regarding the location of water standpipes and sanitary facilities (Taylor 1987). Galiani 2007 reported greater involvement with the community – whereby slum neighbourhoods requested the private water service and provided the labour for implementing the intervention, in addition to paying the water company fees for the services provided thereafter.

Community consultation was also included in the interventions of three supporting studies (Abelson 1996; Joshi 2002; Moitra 1987). Slum dwellers provided labour for interventions in one main study intervention (Galiani 2007) and two supporting studies (Cattaneo 2009; De Leon 1986).

Joshi 2002 also described significant community involvement in the delivery of the interventions, including consultation on needs, establishment of community based organisations to monitor delivery of the interventions and contributions to the costs of the programme via a community management organisation (CMO). Community management was also present in a further study of multicomponent slum upgrading (Abelson 1996).

Joshi 2002 was the only study that specifically stated that gender dimensions were considered in the planning of the intervention. The Integrated Slum Development (ISD) Programme was required to proactively impact on women. Therefore, tailoring and embroidery courses were provided in addition to a women’s CMO which sustained ISD in the slum and gave them technical and managerial skills and credibility within slums as leaders.

 

Excluded studies

A common reason for excluding publications was ineligible study design. Many papers were descriptive overviews or discussion papers of slum upgrading, or non-comparative cross-sectional reports and stand-alone qualitative studies. Furthermore, a large number of papers did not address a relevant topic, that is the study setting(s) was not identifiable as a slum neighbourhood or the intervention was not a slum upgrading strategy involving physical environment and infrastructure interventions.

 

Risk of bias in included studies

Please see  Table 3 and  Table 4 for a summary of the NICE validity assessments. A more detailed description is provided in RoB tables within the Characteristics of included studies section. Risk of bias ranged from low to high for the main studies. One RCT (Gonzalez-Navarro 2010) was assigned a low risk of bias (++), two CBAs (Galiani 2007; Soares 2005) were judged to be have mixed or unclear bias (+) and two CBAs were considered to have a high risk of bias (-) (Butala 2010; Taylor 1987).

Only one supporting study was judged to have a mixed or unclear risk of bias (Cattaneo 2009), the remaining eight studies were all judged to have a high risk of bias (Abelson 1996; Aiga 2002; De Leon 1986; Joshi 2002; Milone 1993; Moitra 1987; Moraes 2004; Parikh in press).

 

Allocation

To establish whether an intervention is responsible for the effect on outcomes of interest, the results need to be compared to the 'counterfactual', that is the outcomes that would have been observed had the intervention participants not received the intervention. Because the counterfactual cannot be directly observed, outcomes in intervention groups are compared to reference control groups with similar characteristics so that the only difference between groups is the intervention itself. Selection bias, whereby systematic differences are present between the participants in the comparison groups, is an important threat to internal validity of studies. As a result, observed differences in the outcomes may be explained by pre-existing differences between the groups rather than the intervention itself (NICE 2009). Reducing the risk of selection bias in evaluations of slum upgrading can be challenging, as identifying suitable control groups is particularly difficult due to the high degree of variability between and within slum settings. While concealed random allocation within an RCT design is considered the most reliable approach to eliminating selection bias, most of the included studies represented real-life projects where the intervention itself had been carried out as part of the country’s existing program for upgradation. Thus randomisation to either intervention or control was not always feasible.

It should be acknowledged that in any non-randomised study, even when experimental and control groups appear comparable at baseline, there is still a risk of bias due to residual confounding as all methods to control for confounding are imperfect (Higgins 2011). However, studies can use a range of statistical techniques to minimise selection bias and establish plausible counterfactuals. These can include analyses to adjust for unobserved differences between comparison groups such as difference in differences (DiD), instrumental variables and regression discontinuity designs, or adjusting for observed differences such as matching control and intervention individuals or groups according to similar characteristics, adjusting for potential confounders in multiple regression analyses, and propensity score matching (Craig 2012). Combining analytical methods for addressing observed and unobserved variables can strengthen causal inference (Craig 2012).

Within the five main studies, one RCT was identified as having a low risk of selection bias due to its random allocation and use of DiD analysis (Gonzalez-Navarro 2010). Three CBAs (Butala 2010; Galiani 2007; Soares 2005) were graded as having a mixed risk of selection bias, as they were not randomised but employed a DiD approach to minimise selection bias and adjusted for potential confounders. In addition, Soares 2005 utilised propensity score matching. One further CBA was graded as having a high risk of selection bias as it did not report analytical techniques to address observed or unobserved characteristics, and the authors noted significant differences between key variables measured. The author reported difficulties in identifying comparable control slums as the only unimproved 'control sites' were those considered by the city’s planners to be unsuitable for permanent residential use due to their hazardous location (Taylor 1987).

Just one of the six controlled supporting studies used propensity score matching in addition to adjusted multivariate regression and was graded as having a mixed risk of selection bias (Cattaneo 2009). The remaining five CPI studies were graded as having a high risk of selection bias due to the lack of matching analyses or ability to compare baseline measures to check the comparability of comparison groups. This included two studies that described attempts to identify similar communities and controlled for potential confounders (Aiga 2002; Moraes 2004) and three studies that did not discuss comparability between groups (De Leon 1986; Moitra 1987; Parikh in press).

 

Blinding

 

Detection bias

The process of blinding is a technique used to minimise risks that the participants, investigators and outcome assessors' knowledge of the intervention could cause systematic differences in the way in which outcomes are assessed, collected or analysed (Higgins 2011). This is relevant to all included controlled studies from both the main analysis of results and the supporting studies. Given the nature of the interventions to the physical living environment, it would not be possible to blind the slum residents from the upgrading taking place. Generally, it was difficult to blind slum dwellers or field workers from the interventions that took place. Just two studies described methods to minimise detection bias. One RCT ensured participants were not informed of the study objectives during household interviews with field workers as a way to minimise bias (Gonzalez-Navarro 2010). One supporting study blinded microscopists examining stool samples to the intervention status of the community from whom the samples had been collected (Moraes 2004).

 

Performance bias

Performance bias occurs if there are systematic differences between study groups in their exposure to factors other than the interventions of interest (Higgins 2002). For example, in healthcare studies if patients are aware they are receiving the study placebo they may use other forms of care. Blinding is the main approach to minimising risk of performance bias but this was generally not possible to achieve.

It is important, however, that any concurrent interventions outside the programme being studied are recorded to ensure that the intervention and control groups are similar except for the intervention being studied. One supporting CPI study noted the presence of other social programs in the communities but controlled for these confounders within its multivariate analyses (Cattaneo 2009).

 

Incomplete outcome data

Most of the eight studies with baseline and follow-up measures did not report attrition of participants from the study or whether an intention-to-treat analysis was performed. This is particularly pertinent for determining whether systematic differences between comparison groups occurred due to withdrawals or attrition from the study.

One RCT analysed data only for households that were interviewed at both baseline and follow-up (and not those who moved out of or into the area in the study period) and it was determined that attrition in the panel was random (Gonzalez-Navarro 2010). One CBA (Galiani 2007) redefined and transferred observations from the control group to the treatment group based on the knowledge that the intervention programme (water expansion) had reached one of the control communities during the study period and some participants gained access to the water service prior to the follow-up data collection.

 

Selective reporting

Selective reporting was difficult to judge in most studies due to the lack of published protocols. There were, however, concerns regarding one CBA (Taylor 1987) and three supporting studies (Milone 1993; Moitra 1987; Parikh in press), which scored poorly in this area due to the lack of reporting of raw data or numerical values for results that were described narratively or graphically.

 

Other potential sources of bias

 

Length of follow-up

Whilst studies generally reported the timing of the baseline and follow-up surveys, they lacked sufficient detail on the length of follow-up after intervention delivery. Thus it was difficult to judge whether or not a sufficient follow-up period was utilised in order for the impact of interventions to be fully recognised. Although relatively short follow-up periods may detect changes in communicable diseases, the length of follow-up is especially pertinent to non-communicable diseases, mortality and socio-economic outcomes, which could take a longer time for effects to take place. Of the main studies, it was possible to determine that Galiani 2007 had follow-up periods of between five to 10 months after intervention completion, which may have been sufficient to detect an impact on diarrhoeal diseases and water-related expenses. Taylor 1987 had a longer follow-up period of between two and four years, which would be appropriate for detecting income changes. The follow-up period in Gonzalez-Navarro 2010 varied depending on the intervention site, ranging from 0 months to 17 months (seven sites were completed in 2007, five sites in 2008, and five sites just before follow-up measures were recorded). Follow-up after intervention completion was unclear in the two remaining main studies (Butala 2010; Soares 2005). Only three of the supporting studies described follow-up outcome measures of between two and four years after intervention completion (Cattaneo 2009; De Leon 1986; Joshi 2002). The remaining studies did not clearly report the follow-up period following the intervention delivery (Abelson 1996; Aiga 2002; Milone 1993; Moitra 1987; Moraes 2004; Parikh in press).

 

Fidelity of the intervention

The fidelity of the interventions delivered was also poorly reported. There was scarce information concerning whether interventions were delivered as intended, reached the target populations, or the equity of that reach. Therefore it was not possible to assess the impact of the intervention in the context of how successfully it was implemented.

Of the main studies, three did not report information on fidelity (Butala 2010; Galiani 2007; Taylor 1987). Data was analysed in the road paving project for 17 out of the intended 28 communities that the project reached, with no further information provided on the fidelity or maintenance of the treated communities (Gonzalez-Navarro 2010). The multicomponent slum upgrading programme evaluated by Soares 2005 was found to significantly increase access to sewerage, water and rubbish collection, though it was not reported whether this achieved full access to all participants surveyed.

Three supporting studies did not consider the degree to which the intervention or its components were delivered as intended (the fidelity of the intervention) (Moitra 1987; Moraes 2004; Parikh in press). Factors such as uptake of the services, the successful implementation of the intervention, and maintenance and sustainability of the intervention components were not explored, or whether fidelity differed within or between comparison groups. Moitra 1987 did report some information regarding sustainability, stating infrastructure improvements were not maintained. Results showed a positive association with the intervention and employment, but not for health (those reporting being ‘well’) or education outcomes. It is possible that the poor maintenance of the intervention may explain the lack of improved outcomes. Results from the study should, however, be viewed cautiously due to the high risk of bias, with lack of causality and lack of accounting for clustering.

Some supporting studies provided limited information on the fidelity of at least some of the component interventions within their packages of slum upgrading strategies. Aiga 2002 did not formally evaluate fidelity but described residents in the intervention enjoying water nearly 24 hrs per day. The study did not discuss the fidelity of the additional interventions delivered as part of the zonal improvement programme (ZIP), which may also have been factors responsible for the outcomes observed. Milone 1993 revealed qualitatively that a number of the components delivered within the multicomponent physical upgrading programme were not successfully installed, maintained or used. This included drains either not being delivered or being inappropriately installed or not working, or poor siting of facilities resulting in lack of use. It was noted that the study did not report that the community were consulted and engaged in the planning of the interventions, and this may be a contributory factor to the poor implementation and maintenance. The study by Joshi 2002, however, had several levels of community engagement (consulted at design stage) and the CMO helped oversee implementation and collected extensive data on the uptake of the various components of the Integrated Slum networking programme, which demonstrated reasonably successful uptake and delivery of services with 95% of slum dwellers receiving a regular water supply and 100% provided with a toilet and electricity connection. Abelson 1996 described successful implementation of secure land tenure and waste disposal practice following multiple slum upgrading, however access to tap water and private latrines was not achieved and communal latrines were not properly maintained. It is possible that the poor maintenance of the intervention may explain the lack of improved health outcomes (sickness or chronic illness).Results from the study should be viewed cautiously, however, due to the high risk of bias, with lack of causality and lack of accounting for clustering. One supporting study of a single slum upgrading intervention (Piso Firme project to provide cement flooring) succeeded in prompting households to install cement floors for almost all their household floor space (Cattaneo 2009).

 

Consideration of all intervention components

Two supporting studies emphasised one aspect of a slum upgrading strategy being implemented without detailed consideration of co-interventions. Aiga 2002 studied the impact of improvement of water supply on diarrhoea and household economy. However, closer examination of the article revealed that water improvements were taking place in the context of a multicomponent ZIP including water connections, private toilets, electric power supplies to every housing unit, paved roadways and secure tenure. Similarly, Moraes 2004 aimed to examine the impact of drains or drains and sewerage but it was apparent that paved paths and tenure were also provided as part of the intervention.

 

Clustered studies

Individuals within a particular group tend to be more similar to each other than to members of other groups (Higgins 2011). Failure to adjust for this can result in overestimating the precision of effect estimates. Four main studies allocated the intervention to slum communities (that is clusters) rather than individual slum dwellers and used appropriate analyses (Butala 2010; Galiani 2007; Gonzalez-Navarro 2010; Soares 2005). One further main study (Taylor 1987) was also clustered but did not adjust for clustering.

Six of the nine supporting studies were clustered and analysed results by individuals, yet only one study adjusted for clustering effect in its analysis of results (Cattaneo 2009) whilst the remaining five did not (Abelson 1996; De Leon 1986; Milone 1993; Moitra 1987; Moraes 2004).

 

Reliability of outcome measures

The reliability of outcome measures used across studies varied. Most studies relied on self-reporting by participants, which is subject to recall and reporting bias.

Recall of up to two weeks is considered a generally reliable period in reporting disease morbidity before significant bias sets in (Waddington 2009) though recent research indicates that shorter recall periods of three days in children and four days in adults would be likely to yield more accurate data (Feiken 2010). Two of the main studies used recall periods of four weeks or more for self-reported outcomes (Galiani 2007; Gonzalez-Navarro 2010) and two did not report the length of recall (Soares 2005; Taylor 1987). Several supporting studies also used recall periods that were unclear, or greater than four weeks (De Leon 1986; Joshi 2002; Milone 1993; Moitra 1987; Parikh in press). Among the studies reviewed, the most reliable outcome measures were utilised in the supporting studies Cattaneo 2009 and Moraes 2004. Both collected stool samples to measure the prevalence of intestinal parasites. A two-week calendar designed for use by illiterate adults and bearing a photo of each child aged < 5 years was used to avoid recall bias. In addition, Moraes 2004, described rigorous methods to assess self-reported diarrhoea, by measuring episodes every two weeks over the period of a year, using diarrhoea calendars and quality checking data obtained. The presence of geohelminth infections was confirmed using microbiological assessment of collected stool samples.

Butala 2010, a CBA, was the only study that used health insurance claims to measure health, expressed as a ratio of waterborne compared to non-waterborne diseases. This outcome measure was considered unreliable because assumptions about the changes in the proportion of waterborne illnesses relies on no significant change in non-waterborne illnesses. The criteria used by researchers to code illness claims were not reported, and findings may not be representative of the most disadvantaged slum residents, who may not be able to afford health insurance.

 

Sample sizes

Only one study reported a power calculation to identify the required sample size for detecting significant effects (Aiga 2002).

 

Conflicts of interest

Two studies posed potential conflicts of interest from the authors being associated with the deliverer or designers of the intervention. Dr Parikh examined the ‘Slum Networking Programme’, an intervention created and designed by the author’s father. Joshi 2002 evaluated the Integrated Slum Development programme, founded and implemented by an organisation the author is a director for (SAATH). Staff from SAATH were also responsible for the data collection during the household interventions.

 

Effects of interventions

See:  Summary of findings for the main comparison Summary of findings - health and quality of life;  Summary of findings 2 Summary of findings - socio-economic outcomes

 

Main review findings

One cluster RCT (Gonzalez-Navarro 2010) and four cluster CBAs (Butala 2010; Galiani 2007; Soares 2005; Taylor 1987) were identified. Three studies compared the impact of broad slum upgrading strategies involving physical upgrading plus wider living environment interventions to no intervention (control) (Butala 2010; Soares 2005; Taylor 1987). Two further studies evaluated single physical upgrading interventions: road paving (Gonzalez-Navarro 2010) and water supply (Galiani 2007).

 

Multicomponent upgrading programmes compared to no intervention

 
Primary outcomes – health and quality of life

See  Table 5.

 
Communicable diseases

One clustered CBA, using difference in difference (DiD) analysis, examined the change over time in the probability of making a claim for a waterborne disease as opposed to a non-waterborne disease. Waterborne illnesses were identified from health insurance claims, which were coded according to whether the diagnosis of illness reflected a disease that was waterborne or not. Both a broad model (whereby mosquito-borne illnesses were coded as waterborne) and a conservative model (mosquito-borne considered non-waterborne) were tested. The estimated relative risk ratio (RR) indicated that the slum upgrading intervention resulted in a significant decrease in waterborne illness claims as opposed to non-waterborne illness claims for both the broad model (RR 0.62; 95% CI 0.61 to 0.64; P = 0.04) and conservative model (RR 0.64; 95% CI 0.41 to 0.98; P = 0.04) (Butala 2010).

One clustered CBA, using DiD analysis, examined the impact of phase one of a multicomponent upgrading project (Favela-Bairro project) on mortality rates within slum neighbourhoods. After controlling for baseline infrastructure facilities (water, sanitation, garbage), household income and average years schooling; DiD estimates showed that the proportion of treated households over time did not decrease the proportion of deaths caused by diseases related to lack of sanitation (DiD β -0.007; 95% CI -0.02 to -0.01) (Soares 2005).

 
Infant mortality and Injuries

Multicomponent slum upgrading did not reduce the proportion of infant deaths (DiD β 0.03; 95% CI -0.02 to 0.07) or homicides (DiD β -0.01; 95% CI -0.04 to 0.03) in intervention areas compared to control areas (Soares 2005).

 
Secondary outcomes - socio-economic

See  Table 6.

 
Financial poverty

No statistically significant impact was found for Favela-Bairro on head of household income (DID β -0.105; 95% CI -0.31 to 0.31) (Soares 2005). A second CBA with a high risk of bias also observed no significant differences in mean total household income at three-year follow-up. The study did not report whether clustering or potential inflation increases over the study period were accounted for (Taylor 1987). 

Education

Multicomponent slum upgrading was not shown to effect the illiteracy rate of the head of the household (DID β 0.007; 95% CI -0.03 to 0.06) (Soares 2005).

Crime

Multicomponent slum upgrading did not lead to a reduction in homicides (DiD β -0.01; 95% CI -0.04 to 0.03) in intervention areas compared to control areas (Soares 2005).

 

Privatised water service only compared to no intervention

 
Primary outcomes – health and quality of life
 
Communicable diseases - diarrhoea

Galiani 2007 reported limited evidence (at the 10% significance level) that the incidence of diarrhoea and severity of infections was lower in intervention slums following improved water supply by a private water company. The relative risk (RR) was calculated as 0.53 (95% CI 0.26 to 1.04; P = 0.07) for 2-week diarrhoeal episodes and 0.48 (95% CI 0.19 to 1.22; P = 0.12) for severity of the infection, comparing intervention to control. There was no significant difference in duration of diarrhoea episodes between intervention and control following improved water supply mean difference (MD -0.12 days; 95% CI -2.8 to 0.43; P = 0.16) (Galiani 2007).

 
Secondary outcomes - socio-economic
 
Financial poverty - annual water-related expenditure

Galiani 2007 reported that after controlling for changes in household income, there was evidence that monthly water related expenditure was reduced in the intervention group compared to the control group, MD of -19.72 pesos (95% CI -35.4 to -4.04; P = 0.01), which persisted after including costs associated with the intervention (MD -17.11 pesos: 95% CI -32.6 to -1.62; P = 0.03).

 

Road paving only compared to no intervention

One cluster RCT looked at the impact of paving street projects (a neighbouring set of unpaved urban blocks connecting to the city’s pavement grid). As only 17 of the 28 planned street paving projects were completed in time for the follow-up survey, instrumental variable regression results are presented below (Gonzalez-Navarro 2010).

 
Primary outcomes – health and quality of life
 
Communicable diseases

Health outcomes were unchanged by the street paving intervention; this was observed for both the proportion of intervention residents reporting sickness (defined as vomiting, diarrhoea, bronchitis, stomach pain, flu, fever or coughing) within the last month compared to residents in unpaved streets (RR 0.98; 95% CI 0.85 to 1.14; P = 0.83); and participants reporting parasites or fungus infections in the last year (RR 1.06; 95% CI 0.70 to 1.61; P = 0.79) (Gonzalez-Navarro 2010).

 
Quality of life

Following road paving, residents' satisfaction with living in their city did not differ between intervention and control groups (MD 0.01; 95% CI -0.10 to 0.12; P = 0.92). At baseline, satisfaction was relatively high in both groups (rated as 3 on a 4-point scale, whereby 3 is satisfied and 4 is very satisfied) (Gonzalez-Navarro 2010).

 
Secondary outcomes – socio-economic
 
Financial poverty

Street paving did not result in a statistically significant change in the log monthly labour income (MD 0.05; 95% CI -0.13 to 0.23; P = 0.67) (Gonzalez-Navarro 2010).

 
Employment

Unemployment was unchanged by the road paving intervention (RR 1.05; 95% CI 0.39 to 2.83; P = 0.92). Household heads in paved streets were more likely to use a motor transport to travel to work than household heads in unpaved streets (RR 1.43; 95% CI 1.13 to 1.83; P < 0.001) and there was also limited evidence at the 10% level of improved labour market expectations (intervention households were less likely to have plans to migrate for work reasons than those in unpaved streets (RR 0.78; 95% CI 0.60 to 1.01; P = 0.06) and an increase in weekly worked hours (MD = 4.68; 95% CI -0.46 to 9.82; P = 0.07) (Gonzalez-Navarro 2010).

 
Education

Paving streets did not result in changes in education variables for children aged 5 to 17: estimated RRs for school enrolment and absenteeism in the last month were 1.03 (95% CI 0.96 to 1.12; P = 0.38) and 1.49 (95% CI 0.75 to 2.93; P = 0.25) respectively (Gonzalez-Navarro 2010).

 
Crime and violence

Crime outcomes were not affected by road paving. There was no strong evidence that burglary or vehicles stolen in the past 12 months were more likely following the intervention (RR 1.83; 95% CI 0.84 to 4.02; P = 0.13 and RR 1.07; 95% CI 0.25 to 4.57; P = 0.92, respectively). Furthermore household members from paved streets were not more likely to feel safe walking the street at night than household members on unpaved streets (RR 1.08; 95% CI 0.88 to 1.32; P = 0.48) (Gonzalez-Navarro 2010).

 

Supporting information studies

Studies in this section are included as supporting studies only as their design lacks the ability to deduce causal effects of the intervention. Nine studies examined the impact of varying physical environment and infrastructure upgrading strategies within CPIs (Aiga 2002; Cattaneo 2009; De Leon 1986; Moitra 1987; Moraes 2004; Parikh in press) or UBAs (Abelson 1996; Joshi 2002; Milone 1993). Six studies were clustered ( Abelson 1996; Cattaneo 2009; Milone 1993; Moitra 1987; Moraes 2004; Parikh in press,). One CPI employed analytical methods of matching and regression adjustment to minimise selection bias and tentatively allow plausible causal inference (Cattaneo 2009).

One study evaluated a single physical upgrading intervention examining the effect of providing cement flooring via the Piso Firme project (Cattaneo 2009). Eight studies examined multicomponent slum upgrading programmes consisting of physical upgrading interventions only (Aiga 2002, Moraes 2004, Milone 1993; Parikh in press) or physical upgrading with additional co-interventions at the living environment level (Abelson 1996; Joshi 2002; Moitra 1987).

 

Consistency of supporting studies with findings of main studies

Some health, quality of life and socio-economic outcomes were examined in both main and supporting studies. The degree to which the supporting studies reinforced the findings of main studies was variable, though findings for reduced diarrhoea incidence and reductions in water supply expenditure were consistent. Details for each shared outcome are given below. 

 
Health and quality of life outcomes assessed in both main and supporting studies

Diarrhoeal and parasitic infections were the most common communicable diseases evaluated by main studies. These outcomes were also measured in supporting studies. See  Table 7 for individual supporting study results.

 
Communicable diseases - diarrheoa

One main study, a CBA with a mixed risk of bias, showed that slum upgrading reduced diarrhoea incidence (Galiani 2007). Supporting studies provided additional evidence to strengthen this finding, demonstrating associations between multicomponent slum upgrading (Aiga 2002; Milone 1993; Moraes 2004) or single interventions (cement flooring - Cattaneo 2009) and less diarrhoea. Lower diarrhoeal incidence among children under five years was associated with the presence of the multicomponent slum upgrading (RR 0.29; 95% CI 0.20 0.42; P < 0.0001) in one CPI (Aiga 2002). Two further studies (one CPI, one UBA) also showed associations between multicomponent upgrading and reduced diarrhoeal incidence, but the precision and statistical significance of effect estimates could not be determined as the analysis did not account for clustering (Moraes 2004) or provide sufficient information (Milone 1993).

One further CPI found that a single intervention (cement floors via the Piso Firme programme) was associated with lower diarrhoea incidence in the previous month, comparing intervention children to controls (estimated RR 0.87; 95% CI 0.77 to 0.98; P = 0.05).

One main study found that water supply did not improve either the severity or duration of diarrhoea (Galiani 2007). These outcomes were not examined by supporting studies.

Results should be interpreted carefully as the study designs identify associations between interventions and observed outcomes but not whether the intervention caused the results.

Communicable diseases - intestinal infections

One RCT reported that slum upgrading (road paving) did not reduce the incidence of parasitic infections (Gonzalez-Navarro 2010). Two supporting studies (Cattaneo 2009, Moraes 2004) added some uncertainty regarding the effect of slum upgrading on parasitic infections, finding associations between multicomponent interventions and lower incidence of infection. One CPI with a moderate risk of bias found that a single intervention (cement flooring as part of the Piso Firme project) was associated with a 19.2% reduction in the presence of parasites present in a child’s stool sample, when compared to control children (RR 0.84; 95% CI 0.71 to 1.0; P = 0.05). Results should be interpreted carefully as the study designs identify associations between interventions and observed outcomes but not whether the intervention caused the results.

A further CPI study with a high risk of bias, examined the effect of multi-component slum upgrading (involving either provision of drains or drains and sewerage) on three species of intestinal infections (Ascaris, Trichuris and Hookworm) (Moraes 2004). Both interventions were associated with lower incidence of the three species when compared to the control group, with the lowest risk observed in the drain and sewers group. The precision and statistical significance of the effect estimates could not be determined as the study did not account for clustering. There was no difference between the study groups regarding the intensity of infection (eggs per gram stool) in those with Ascaris. Trichuris had a significantly higher intensity in the control than in the intervention groups, and contrary to expectation Hookworm intensity was highest in the drains and sewerage intervention group (Moraes 2004). Intensity of infection was not evaluated in main studies.

 
Quality of life

Only one main study evaluated outcomes related to quality of life, finding that satisfaction with living in the city was unchanged by a road paving intervention (Gonzalez-Navarro 2010). One further CPI with a moderate risk of bias, showed inconsistent results with this finding. Offering cement flooring as part of the Piso Firme programme was associated with an 18.7% increase in the proportion of mothers satisfied with their quality of life, compared to control mothers ( RR 1.19; 95% CI 1.11 to 1.27; P < 0.001) (Cattaneo 2009).

 
Socio-economic outcomes assessed in both main and supporting studies

Income, water expenditure, unemployment, literacy and school participation were examined in both main studies and supporting studies. See  Table 8 for the individual supporting study results.

 
Financial poverty

Main studies found consistent results for reductions in water-related expenditure (Galiani 2007) but lack of an effect on household income from either road paving (Gonzalez-Navarro 2010) or multicomponent interventions (Soares 2005; Taylor 1987).

The results of one CPI reinforced main study findings that water expenses are reduced following multicomponent slum upgrading (Aiga 2002). Mean water expenditure and mean proportion of income spent on water was lower in the intervention group who received improved water supply as part of multicomponent slum upgrading, than the control group (109 peso/household/months in the intervention slum compared to 234 peso/household/month in control slum, P < 0.01; and 2.8% in the intervention slum compared to 10.1% in the control slum, P < 0.05, respectively) (Aiga 2002).

The results of the majority of supporting studies however, did not agree with main study findings related to household income, adding some uncertainty to the findings. One CPI with a moderate risk of bias, found no significant association between provision of cement floors (Piso Firme) and improved household income per capita. In contrast, five studies (three CPIs and two UBAs) found that multicomponent physical slum upgrading was associated with improved income (Abelson 1996; Aiga 2002; Joshi 2002; Moraes 2004; Parikh in press).

 
Employment

There was limited evidence from the main analysis for the effect of slum upgrading on employment. Only one main study evaluated employment outcomes, finding that road paving did not improve levels of unemployment, with limited evidence of increased labour expectations and weekly worked hours (Gonzalez-Navarro 2010). Supporting studies contributed to the uncertainty, finding inconsistent results across studies. One UBA with a high risk of bias found that adult employment rates did not change following a multicomponent upgrading intervention in comparison to baseline (RR of 1.01) (Abelson 1996). A further CPI with a high risk of bias showed an association between lower levels of unemployment and multicomponent slum upgrading when compared to the control group. The relative risk of 0.53 was estimated from frequency percentages, but insufficient information was available to determine the precision or statistical significance of the effect estimate (Moitra 1987).

 
Education

Only two main studies considered education, finding no effect of slum upgrading on different education outcomes: literacy of head of household (Soares 2005), school enrolment (Gonzalez-Navarro 2010) and school absentism (Gonzalez-Navarro 2010).

Supporting studies added uncertainty to the findings, either disagreeing with main studies or displaying inconsistent results across studies. Results for literacy were mixed amongst supporting studies. Literacy levels were slightly higher in groups receiving multi-component slum upgrading versus no intervention, in one UBA (Abelson 1996) and two CPIs (Moitra 1987; Parikh in press) with a high degree of bias. The precision and significance of two studies could not be determined because they did not account for clustering (Abelson 1996) or did not report numerical results (Parikh in press). Multicomponent slum upgrading was not associated with changes in literacy in one UBA (Joshi 2002). There was also no change in literacy between intervention and control groups in the slums situated in South Africa, unlike the improvements observed in the study slums situated in India (Parikh in press).

Gonzalez-Navarro 2010 found no effect of slum upgrading (road paving) on children's school participation. However, two UBA supporting studies disagreed; reporting that multicomponent slum upgrading was associated with an increase in school-going children when compared to baseline (RR 1.34; 95% CI 1.07 to 1.60; P = 0.01) (Joshi 2002) and in the proportion of children going to pre-school (RR of 1.94) (Abelson 1996). In addition, one CPI study examined education differences in slums with varying community sanitation interventions. Mean schooling of household head was greater in both the sewerage and drainage group (MD of 1.4) and drainage only group (MD of 1.6) compared to the control group (Moraes 2004). As clustering was not accounted for precision of these results are not presented. Results should also be interpreted carefully, as the study designs identify associations between interventions and observed outcomes but not whether the intervention caused the results.

 

Relevant outcomes only assessed in supporting studies

Several relevant outcomes were evaluated in supporting studies that were not examined by main studies. Whilst it is not possible to determine causal effects within these supporting studies, the findings summarised below represent the best available evidence for the specified outcomes. Results of individual studies are presented in  Table 7 (health outcomes) and  Table 8 (socio-economic outcomes).

 
Health outcomes only assessed in supporting studies
 
Communicable diseases - skin diseases and dengue fever

Two supporting studies examined skin diseases (Cattaneo 2009; Milone 1993). One UBA study with a high degree of bias found a lower relative risk of having a skin disease 'seldom or often' when outcomes, immediately after the delivery of multicomponent slum upgrading or at final follow-up one year later, were compared to baseline (RR 0.77 and 0.38 respectively) (Milone 1993). However, there was not sufficient information available to determine the precision and statistical significance of the effect estimate. Cattaneo 2009 found no difference in skin diseases between intervention and slum sites. Milone 1993 did not find any change in dengue fever, which was only measured at cycle II (once the intervention had been delivered) and at final follow-up a year later.

 
Maternal and perinatal outcomes

Infant mortality was the only maternal and perinatal outcome examined in the main analysis (Gonzalez-Navarro 2010). One UBA study also evaluated perinatal outcomes but was unable to reinforce main analysis findings as the study reported different measures. The study observed that following multicomponent slum upgrading there was no difference in the probability of delivery problems amongst births (RR of 0.98) but there were fewer post-natal consultations (RR of 0.32) (Abelson 1996). The precision and significance of the effect estimates could not be determined as the study did not adjust for clustering.

 
Non-communicable diseases - mental health

Mental health outcomes were only evaluated in supporting studies. One CPI found that offering cement flooring (Piso Firme project) was associated with fewer symptoms of maternal depression (CES-D scale MD -2.37; 95% CI-3.46 to -7.02; P < 0.001) and stress (perceived stress scale MD -1.74; 95% CI -2.50 to -5.16; P < 0.001) (Cattaneo 2009).

 
Nutritional deficiencies

While nutritional deficiencies were not examined in the main studies, two supporting studies measured different indicators (Abelson 1996; Cattaneo 2009). One UBA study with a high risk of bias found no difference in the proportion of households that were undercaloried following a multicomponent slum upgrading (estimated RR of 0.96) but found a small decrease in the proportion of children who were underweight (RR of 0.68) (Abelson 1996). Clustering was not accounted for therefore the precision of the effect could not be determined.

One CPI with a moderate risk of bias found limited evidence that lower incidence of anaemia in children under six years old was associated with the offering cement floors (Piso Firme project) (RR 0.81; 95% CI 0.70 to 0.92; P < 0.001), but not for height-for-age and weight-for-height z scores (MDs of 0.00 and -0.01, respectively) (Cattaneo 2009).

 
Cognitive development

Cognitive development was not examined in main studies but was evaluated in one CPI study of cement floor provision. The intervention was associated with significantly higher MacArthur Communicative Development Test scores (MD 5.57; 95% CI 2.35 to 16.49; P = 0.01) and Picture Peabody Vocabulary Test percentile scores (MD 3.08; 95% CI 0.31 to 9.13; P = 0.03) (Cattaneo 2009).

 
General health measures

Supporting studies examined a range of outcomes relating to general ill-health, with inconsistent results. Two CPIs observed fewer reports of ill-health (Moitra 1987; Parikh in press) in intervention groups compared to controls, one CPI found no difference (Cattaneo 2009) and one study found that the proportion of reported 'persons sick' increased (from 1.5% to 4.5%) or those 'chronically ill' from 1.4% to 3.2% (Abelson 1996). Results should be viewed cautiously. The precision and significance of the effect estimate could not be determined in three studies, either because clustering was not accounted for (Abelson 1996) or numerical results and sample sizes were not reported (Moitra 1987; Parikh in press). Abelson 1996 reasoned that the increase in ill-health over time may be due to improved health reporting. Cattaneo 2009 did not expect differences in child respiratory diseases or 'other diseases' between beneficiaries of cement flooring and non-beneficiaries. The analysis was performed as a robustness check to explore the possibility that other public programmes in the study area were falsifying the results of the study.

 
Socio-economic outcomes only assessed in supporting studies
 
Financial poverty - households living below the poverty threshold

Income or water-related expenditure, or both, were evaluated in main and supporting studies. In addition, two supporting studies with a high risk of bias measured changes in households living under the poverty threshold. Aiga 2002, a CPI study, found that households in the slum receiving multicomponent upgradrading were less likely than controls to be living under the poverty threshold (RR 0.47; 95% CI 0.37 to 0.59; P < 0.001 based on income levels). Milone 1993 also observed that the risk of households living below the poverty threshold (set at the 40th percentile expenditure level) was lower following slum upgrading compared to before (RR of 0.74, precision and statistical significance could not be determined from the information reported). Results should be interpreted carefully, as the study designs identify associations between interventions and observed outcomes but are not able to examine causality.

 
Employment - occupation type

Employment rates were evaluated by both main (Gonzalez-Navarro 2010) and supporting studies (Abelson 1996; Moitra 1987). However, occupation type was only evaluated in one UBA study with a high risk of bias (Joshi 2002). The study found the proportion of workers engaged in casual and unskilled occupations decreased following multi-component slum upgrading (RR 0.5; 95% CI 0.28 to 0.88; P = 0.02). Other occupation types such as skilled workers, vendors, government or private, were unchanged (Joshi 2002).

 
Social capital

Social capital was not examined in the main studies. One CPI study with a high risk of bias measured an indicator of social capital (De Leon 1986) during its evaluation of a multicomponent physical upgrading programme. The study found the proportion of residents agreeing that there had been an improvement in resident social interaction and citizen participation was higher in slums receiving the intervention than no intervention (RR 1.14; 95% CI 1 to 1.31; P = 0.05). Results should also be interpreted carefully, as the study designs identify associations between interventions and observed outcomes but not whether the intervention caused the results.

 

Slum dweller perspectives

Three of the included supporting studies qualitatively examined slum dwellers' views and experiences (Aiga 2002; Milone 1993; Parikh in press). Qualitative studies were assessed in duplicate using NICE/GATE checklists. Methods were poorly reported, therefore the qualitative aspect of the studies were judged as 'not reported, unable to assess validity'. Two further supporting studies collected slum dwellers perspectives quantitatively (De Leon 1986; Joshi 2002).

As summarised in  Table 2, themes varied considerably between studies and there were just five themes common to more than one study.

Further details of the views and opinions of slum dwellers reported within the included studies is described below.

 

Qualitative findings of slum dweller perspectives

 

Aiga 2002

Aiga 2002 captured views regarding the delivery of water supply as part of a multicomponent programme and described living conditions in unimproved control slums or intervention slums prior to receipt of the programme.

 
Conditions of slums without upgrading and residents diagnosis of their own needs

In the control group, waiting and filling time for collecting water from the three public water faucets was very long, particularly during the morning. Upgraded-slum residents reported that water collection at public water faucets used to be one of the major problems prior to intervention, highlighting constraints on income generating activities. Most households collected water from three public water faucets. Water delivery services were utilised by 39% of households used at a price four times as expensive as the unit price of water itself, to overcome long water collection waiting times (Aiga 2002).

Poor availability of water in the control slum constrained water consumption and finances, due to the expense of acquiring water and depriving residents of job opportunities. Focus group discussion revealed that households who could not afford water delivery services nominated one household member to forgo employment and just be in charge of water collection. A total of 68.6% of the 122 household members in charge of water collection expressed their willingness to work for additional income when water supply is improved (Aiga 2002).

 
Factors perceived to mediate or enhance impacts of the intervention on the outcomes of interest

All participants in the intervention focus group discussions unanimously agreed that the financial burden of water had been reduced by the improvement of water supply (Aiga 2002). 

 

Milone 1993

Milone 1993 captured  perspectives of residents who received multicomponent slum upgrading programme, and residents from unimproved control slums.

 
Acceptability of the intervention components

Cemented footpaths and roads were highly appreciated, more than drains or other components. Residents deemed drains to be very essential. Toilets were judged as the second most important component by kampung residents. Some communities wanted paths and roads widened so that more and larger vehicles could enter. Some residents believed that footpaths “made the kampung more beautiful and neater” (Milone 1993).

There was a consistent theme that residents preferred private facilities. The authors reported that the public bath, laundry and latrine facilities were introduced too late in the project. During that time, there had been increasing opportunities for kampung residents to obtain low interest SIP loans or aid from other programs to install a slab toilet in their own yard or home. There was also declining use of public taps during the study period because increasingly kampung residents with higher incomes began installing piped water in homes or in household yards (Milone 1993).

 
Barriers and facilitators to use or implementation of intervention

Siting of facilities was an important factor in whether or not services were used. Several examples were described of facilities not being located where they were needed most, or in areas that were impractical or inconsiderate of gender and social class sensitivities. For example, bath, laundry and latrine facilities could be on the other side of a swamp which flooded during the rainy season; or water taps situated too far away for a woman or girl to carry water home, requiring them to pay male vendors. Some shared facilities were housed in an affluent family’s yard, since only the more affluent had large enough and titled land to denote a portion. Poorer residents were often ashamed to use the public facilities as it denoted poverty (Milone 1993).

Solid waste disposal boxes were unsuccessful because the cities did not have the capacity to collect rubbish on a regular basis. This was partly because a subproject had not yet been implemented (Milone 1993).

Residents deemed drains to be an essential part of the intervention, yet numerous problems with the installed drains were reported. This included co0mplaints that drains were not deep enough, connected to discharge pipes from kitchens and baths, or were found on only one side of the path instead of both. In some sites, drains could not function optimally because they were not yet connected to the larger diameter city drains. Furthermore, some reported drains along some streets were installed higher than the level of the floor of the house, thus when it rained houses were flooded (Milone 1993).

Strategies for maintaining the taps or keeping the drains and public latrines clean were not established. Thus a majority of residents objected to having the public baths, laundry and latrine facilities nearby due to the bad odour. The private water company (PAM) complained that not enough fees were collected to cover the water they dispersed, so several public taps were closed down. User groups had not held together because members could not pay PAM fees on a sustained basis (Milone 1993). 

Latrines were only used by the absolute poor when they were sited in a secluded public area. In kampungs where drains were kept clean it was due to effective leadership of the kepala Rukka Warga (community), kepala Rukka Tetanga (neighbourhoods within), and policy setting by the Lurah (leadership of the overall village). Community self-investment also appeared to enhance the implementation of interventions, such as residents making improvements to new footpaths in front or alongside their property (Milone 1993).

 
Factors perceived to mediate or enhance impacts of the intervention on the outcomes of interest

Residents said footpaths and roads improved access to the rest of the city, and made efficient and quicker transport possible. This improved and quickened access to market, schools and work all year round. Otherwise during the rainy season, unpaved muddy, and often flooded kampung paths were difficult to manoeuver. In some instances this component facilitated the establishment of small sidewalk enterprises (Milone 1993).

Paved paths were perceived to increase security, as residents invested in electric lighting along footpath edges at their own expense. In some kampungs paths were valued as safe pedestrian thoroughfares, to the extent that residents constructed barriers to prevent vehicle entry. Flag holders in several kampungs were constructed along the paths for national celebrations and greater efforts were put into constructing kampung gates, reflecting heightened community identity (Milone 1993).

 

Parikh in-press

Parikh in press collected opinions from both control slums and communities receiving SNP intervention, in the main study and in a subsample of 20 residents.

 
Diagnosis of own needs

Slum dwellers gave top priority to investments in water and sanitation infrastructure, in preference to housing health, education and employment (Parikh in press).

 
Factors perceived to mediate or enhance impacts of the intervention on the outcomes of interest

Many women in Sanjaynagar said that no longer having to carry buckets of water had reduced their back problems, and indicated improvements in quality of life and gender dimensions. They stated that bathing everyday made their bodies feel “furt” (energetic) and that girls who previously had to spend time disposing waste water because the boys would not do this work, could now wake up late and sleep more (Parikh in press).

Respondents perceived water and sanitation as a factor influencing income due to freed time, fewer days lost to illness and less medical expenses. The effect on education was highlighted: “Children go to school now. Previously there was no time to send children to school. If women go out of their houses to fetch water who will get the children ready to go to school?” (Parikh in press). Discussions revealed that the provision of physical infrastructure was reported as the most important reason for making investments in upgrading of their shelter, followed by better social standing and security of tenure. (Parikh in press).

In the subsample study, intervention residents reported that owning a TV, as a result of electricity provision and increased income, had improved communication with the outside world: “Ignorance is now reducing and TV shows like Discovery channel shows us things that we have never dreamt or seen before.” (Parikh in press).

 

Quantitative findings of slum dweller perspectives

 

De Leon 1986

 
Conditions of slums without upgrading and residents diagnosis of their own needs

Tenure was valued with 21% of the control (no intervention) group stating that certificate of lot ownership should be given to improve slum improvement project activities (De Leon 1986).

 
Factors perceived to mediate or enhance impacts of the intervention on the outcomes of interest

Prior to a multicomponent slum upgrading programme, 90% of slum residents felt that the government was not concerned about residents' housing problems. Yet after the slum upgrading project, 80.4% of intervention residents in comparison to 60% of control residents were satisfied that the housing upgrading aspect of the programme was proof of the government's concern. In addition, roads were perceived to improve safety, with residents expressing preferences for straight pathways to facilitate neighbourhood vigilance (De Leon 1986).

 

Joshi 2002

Joshi 2002 captured views of slum residents included in a UBA study of a broad slum upgrading strategy including physical environment upgrading and other interventions within the living environment.

 
Residents diagnosis of own needs

Prior to the intervention, the majority of residents listed water and drainage facilities (85.54%) as their first priorities of housing needs, above health and education. Following water and drainage facilities most residents listed education facilities (27/62, 43.55%) and health facilities (30.65%) as their next priority (Joshi 2002).

 
Factors perceived to mediate or enhance impacts of the intervention on the outcomes of interest

On average, women saved almost two hours every day due to regular household water supply. The majority of men, women and boys stated that the main benefit of the regular water supply was the time saved; girls equally listed hygiene and time saved, whereas elders listed hygiene improvements as the main benefit (Joshi 2002).

 

Potential adverse effects

Adverse health or socio-economic outcomes were observed in three supporting studies that suffered from a high risk of bias and were not designed to infer causal effects. One UBA study observed increases in general health measures following a multicomponent slum upgrading strategy with wider health and social co-interventions. The proportion of persons sick increased from 1.5% to 4.5% (estimated RR of 3.0) and persons chronically ill from 1.4% to 3.2%. The authors reason this may be due to improved health reporting (Abelson 1996). An increase in the intensity of hookworm infections was observed in the fullest community sanitation neighbourhoods (drainage and sewers) than in drainage only or control groups (Moraes 2004). Out of a wide range of education outcomes, Joshi 2002 observed a small increase in female illiteracy (RR 1.34; 95% CI 0.99 to 1.80; P = 0.05).

Residential mobility of slum residents is a potential adverse effect of slum upgrading if rent and housing costs become unaffordable, or home owners move out to capitalise on the ability to charge higher rent. There were mixed reports of out-migration and its causes amongst five included studies. Three main studies found that moving out of the community was not associated with presence of the intervention (Gonzalez-Navarro 2010; Taylor 1987) or changes in housing values (Soares 2005).

Two supporting studies narratively discussed residential mobility. Moitra 1987 observed that rent increased in improved bustees, and there was a gradual change in occupancy pattern with self-employed workers replaced by higher earning white collar workers. Abelson 1996 however indicated that outmovers were residents who took advantage of increased wealth rather than those pushed out by high rents.

 

Discussion

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms
 

Summary of main results

 

What are the effects of slum upgrading strategies involving physical environment and infrastructure interventions on the health and quality of life of slum dwellers?

See  Summary of findings for the main comparison and Figure 5.

 FigureFigure 5. Harvest plot to show health and QoL findings across main and supporting studies.

The majority of available health-related evidence examined the effect of slum upgrading on different measures of communicable diseases.

According to GRADE, the quality of the body of research for effects on communicable diseases was low, with the majority of evidence coming from CBA studies, and one RCT with unreliable health outcome measures. The outcome measures and corresponding results varied across studies (see Data synthesis for a description of GRADE and summary of findings tables).

There is limited but consistent evidence to suggest that slum upgrading interventions improve diarrhoeal incidence. One main study with a mixed risk of bias found evidence that diarrhoeal incidence decreased in households which received water connections from a private water company in comparison to control households (RR 0.53; 95% CI 0.26 to 1.04; P = 0.07) (Galiani 2007). Four supporting studies with high risk of bias reinforced this result, reporting that lower diarrhoea incidence was associated with receiving a single cement flooring intervention (Cattaneo 2009) or multicomponent slum upgrading (Aiga 2002; Milone 1993; Moraes 2004). Galiani 2007 also found limited evidence for a reduction in severity of diarrhoeal episodes (RR 0.48; 95% CI 0.19 to 1.22; P = 0.12) and no effect on duration of diarrhoea.

There were mixed and inconclusive results for parasitic infections. One RCT with a low risk of bias but unreliable recall period, found no improvement in the likelihood of slum dwellers reporting a parasite or fungus infection in the past year following road paving (Gonzalez-Navarro 2010). Two supporting studies with a mixed or high risk of bias) disagreed with this finding. When compared to controls, a lower incidence of parasitic infections was observed in single cement floor intervention groups (Cattaneo 2009) or multicomponent slum upgrading (Moraes 2004)..

The available evidence for other communicable diseases is insufficient. Results for broader indicators of communicable diseases were inconsistent. There was no effect on mortality caused by lack of sanitation, but this was only evaluated in one CBA study with a mixed risk of bias (Soares 2005). There was limited evidence of reductions in waterborne illesses from one CBA study with a high risk of bias. (Butala 2010)Skin diseases were examined in two supporting studies with inconsistent results (Cattaneo 2009; Milone 1993) and dengue fever in one supporting study (Milone 1993).

There is also insufficient evidence available to assess the impact of slum upgrading on other types of health outcomes. The limited evidence identified is described below.

The body of evidence for maternal and peri-natal conditions was sparse and considered to be low quality according to GRADE. Soares 2005, a CBA with mixed risk of bias, reported no effect of slum upgrading (multicomponent) on infant mortality. One UBA with a high risk of bias was unable to reinforce these findings as it examined different perinatal outcomes (Abelson 1996) .

No main studies were identified that examined nutritional deficiencies or non-communicable diseases such as mental health. Two supporting studies with a moderate and a high risk of bias, found inconsistent results for different indicators of nutritional deficiencies (anaemia, height-for-age and weight-for-height z scores, children underweight, and under-caloried households) (Abelson 1996; Cattaneo 2009). Similarly, only one supporting study with a moderate risk of bias examined mental health effects (Cattaneo 2009). The study observed fewer symptoms of depression (CES-D scale MD -2.37; 95% CI-3.46 to -7.02; P < 0.001) and stress (perceived stress scale MD -1.74; 95% CI -2.50 to -5.16; P < 0.001) in intervention households provided with cement floors.

There was no effect of road paving on homicides according to one CBA with a mixed risk of bias (Soares 2005). However, the quality of the body of evidence available for injuries was graded as very low, because of the serious limitations in the applicability of the outcome and intervention to wider types of injuries and slum upgrading approaches.

Whilst no effect of slum upgrading was identified for residents satisfaction with living in the city in one RCT with a low risk of bias (Gonzalez-Navarro 2010, the quality of the body of evidence available for injuries was graded as low, because of the 'very serious' limitations in the applicability of the intervention (road paving) and outcome measure to wider slum upgrading interventions and quality of life.

 

What are the effects of slum upgrading strategies involving physical environment and infrastructure interventions on the socio-economic wellbeing of slum dwellers?

See  Summary of findings 2 and Figure 6.

 FigureFigure 6. Harvest plot to show socioeconomic findings across main and supporting studies. Note that outcome measures within each broad category varied, and should be considered alongside the narrative synthesis.

The majority of available socioeconomic evidence examined the effect of slum upgrading on financial poverty.

Apart from beneficial effects on water-related expenditure observed in one main study, three main studies reported that financial poverty (indicated by household income) was unchanged by slum upgrading. In contrast, supporting studies generally found associations between slum upgrading and improvements in financial poverty. Results for financial poverty should be viewed cautiously, as the quality of the body of evidence according to GRADE was judged to be very low. This was because the CBA evidence was downgraded due to the wide confidence intervals indicating a lack of precision in effect estimates (see Data synthesis for a description of GRADE and summary of findings tables).

One CBA  with a moderate risk of bias reported improved private water supply significantly reduced monthly water expenditure (including costs associated with the intervention) (MD -17.11 pesos; 95% CI -32.6 to -1.62; P = 0.03) (Galiani 2007). This was reinforced by one supporting study that observed an multicomponent slum upgrading was associated with reduced water expenditure (Aiga 2002). Three main studies (1 RCT with a low risk of bias, 1 CBA with a mixed risk of bias and 1 CBA with a high risk of bias) reported no effect on slum dwellers' income following slum upgrading (Gonzalez-Navarro 2010; Soares 2005; Taylor 1987).  Six further supporting studies with a high risk of bias, added some uncertainty by consistently disagreeing with this finding. They reported slum upgrading was associated with improvements in income per capita (Aiga 2002; Moraes 2004), household monthly income (Abelson 1996), lower proportions of households below poverty thresholds or earning very low incomes (Aiga 2002; Joshi 2002; Milone 1993), disposable income (Parikh in press).

There was insufficient evidence available to assess the impact of slum upgrading on other socioeconomic outcomes. The limited evidence identified is described below.

One RCT with a low risk of bias found no effect of slum upgrading on unemployment, but did report limited evidence that fewer residents intended to migrate for work (RR 0.78; 95% CI 0.60 to 1.01; P = 0.06) and weekly worked hours increased (MD 4.68; 95% CI -0.46 to 9.82; P = 0.07) (Gonzalez-Navarro 2010). The quality of the body of evidence was graded as low, because of the serious limitations in the applicability of the intervention (road paving) compared to broader slum upgrading strategies and the wide confidence intervals observed for the estimate of effect. Three further supporting studies with a high risk of bias reported mixed results; observing either lower or similar unemployment levels between interventions and control groups (Abelson 1996; Moitra 1987) and a decrease in the proportion of workers engaged in casual or unskilled occupations (Joshi 2002).

The quality of the body of evidence for crime and violence was graded as low because of the serious limitations in the applicability of the intervention to broader slum upgrading strategies and the wide confidence intervals observed for the estimate of effect. Gonzalez-Navarro 2010, an RCT with a low risk of bias, found no evidence for an effect of slum upgrading (road paving) on the proportion of residents feeling safe walking the street at night or the proportions of households reporting burglaries or  vehicles stolen. No supporting information studies examined these outcomes.

The quality of the body of evidence for the effect of slum upgrading on education outcomes was judged to be low according to GRADE. Two main studies found no effect of slum upgrading on different education outcomes. One RCT with a low risk of bias reported no effect of road paving on the proportion of children enrolled in school or school absenteeism (Gonzalez-Navarro 2010) and one CBA found no effect of multicomponent slum upgrading on illiteracy rate of head of slum households (Soares 2005). The results across five supporting studies were inconsistent, adding uncertainty to the findings. (Abelson 1996; Joshi 2002; Moitra 1987; Moraes 2004; Parikh in press).

No main studies were identified that examined the effect of slum upgrading on social capital. This was evaluated in just one supporting study with a high risk of bias, which found limited evidence of an association between slum upgrading and improvements in perceived resident social interaction and citizen participation (De Leon 1986).

 

What are potential adverse impacts slum upgrading may have on slum dwellers health and wellbeing?

There is no strong evidence to suggest slum upgrading has adverse impacts on slum dwellers health and socioeconomic wellbeing. No main studies reported any adverse effects. However the harvest plots (Figure 5) highlight two supporting studies indicated adverse results for two health outcomes; intensity of hookworm eggs per gram stool (Moraes 2004) and increased proportion of 'ill-health' (Abelson 1996). .These observations should be viewed cautiously as the study designs are not able to infer causality. . One UBA study observed small increases in general ill-health measures following a multicomponent slum upgrading yet this may be as a result of increased reporting of illnesses following improved access to health services (Abelson 1996). Furthermore, the study did not account for clustering so it is unclear whether the finding was statistically significant. Reasons for the observed increase in the intensity of hookworm infections was not discussed by Moraes 2004, however the results should be viewed cautiously as there were no increases in intensity of Ascaris or Trichuris, and the prevalence of all three infections were lower in slums receiving the interventions.

One potential unintended consequence, residential mobility, is a particular policy concern of slum upgrading. Former residents may rent or sell their properties, to capitalize on the increased security and home value, particularly if land titling is included as part of the upgrading strategy. Relocating may also become the only option, if slum residents are unable to afford their new financial responsibilities such as taxes, maintenance and legal expenses and tenants may face increases in rent charges (Cadavid 2010). This poses several implications, namely that the intervention no longer targets the most disadvantaged populations it was intended to reach. Out-migration also has significant potential to affect community cohesion as long-term residents move away to affordable shelter and new residents who can afford the cost of living, move in. This may create further complications if upgrading interventions rely on community participation or cohesive community organisations to be responsible for the maintenance of the interventions provided (Kellet 1992). 

There was only limited evidence available that explored residential mobility and affordability of upgraded slums. Three main studies found that moving out of the community was not associated with presence of the intervention (Gonzalez-Navarro 2010, Taylor 1987) or changes in housing values (Soares 2005). Two supporting studies narratively discussed residential mobility. Moitra 1987 observed that rent increased in improved bustees, and there was a gradual change in occupancy pattern with self-employed workers replaced by higher earning white collar workers. Abelson 1996 however indicated that outmovers were residents who took advantaged of increased wealth rather than those pushed out by high rents.

Further research outside of the scope of this review specifically examined whether slum rehabilitation (in situ clearance and rebuilding of slums) results in residential mobility. The author found that on average 10% of original slum occupants moved away. The reason for mobility was found to be due to upgrading slums not being matched to the needs of the resident, and the high cost of living (Cadavid 2010). Outmigration rates reported in two included studies were 16.8% (Joshi 2002) and 21.5% (Gonzalez-Navarro 2010).

 

What are slum dwellers perceived needs, preferences for slum upgrading and satisfaction with the interventions they receive?

Views regarding slum dwellers needs, preferences and satisfaction with interventions were not captured within main studies, but were discussed in four supporting studies. Due to the lack of available methodogical information, it was not possible to assess the reliability of the perspectives reported. Water, sanitation and drainage improvements were rated as higher priorities for residents above health and education services (Joshi 2002; Milone 1993; Parikh in press). The needs of the residents and the values attributed to them changed as water and sanitation improved. Once implemented, water and sanitation was perceived to improve health, health behaviour and quality of life, and income. Residents mentioned less days lost to illness, fewer back problems from carrying water, increases in feeling energetic and saving time from water collection that was directed to income generating opportunities (Aiga 2002; Parikh in press). Tenure was valued in one study, with 21% of control participants stating that certificate of lot ownership should be given to improve slum upgrading project activities (De Leon 1986).

In the limited information available on the nature of services,  private facilities appeared to be preferred by residents to communal facilities for water, bathing and toilets. Siting public facilities away from areas of most need, impractical locations, or in ways that social class and gender dimensions were described as barriers to the use of services (Milone 1993).

Cemented footpaths and roads were highly appreciated, where residents thought these led to improved access to market, schools and work, and increased safety (Milone 1993) and were viewed as increasing safety (Abelson 1996).

Milone 1993 also reported resident dissatisfaction with a number of intervention components due to their location, incomplete service design (for example solid waste disposal boxes were provided but no system for collecting them) and lack of maintenance of drains or public latrines.

 

What programme characteristics and components increase health and wellbeing of slum dwellers?

Conclusions on whether particular characteristics and components have less or more impact on the health and wellbeing of slum dwellers, or operate synergistically, could not be drawn from the available main studies due to study heterogeneity and the lack of information regarding integrity and follow-up. For these reasons it was not appropriate to perform subgroup meta-analyses intended at the protocol stage. Instead harvest plots were developed to visually compare results between single and multicomponent interventions and those with and without community involvement. No trends were observed according to the type of intervention (these harvest plots are available from the review authors).

Views and opinions of slum dwellers collected in only five supporting studies (Aiga 2002; De Leon 1986; Joshi 2002; Milone 1993; Parikh in press) offer potential reasons for why slum upgrading strategies may improve health and wellbeing. Slum dwellers discussed water, sanitation and roads or footpaths in particular.

Slum dwellers described how improved water and sanitation benefited their hygiene (Joshi 2002), quality of life (residents in Parikh in press stated girls who previously had to spend time disposing waste water could now wake up late and sleep more) and health (Parikh in press). Access to safe water and sanitation was described as freeing time (Aiga 2002; Joshi 2002; Parikh in press) for example from collecting water (Aiga 2002) and as a result of fewer days lost to illness (Parikh in press). The additional time allowed for productive activities such as school (Parikh in press) or income generating opportunities (Aiga 2002). Slum dwellers described less costs for medical expenses as a result of less illness (Parikh in press), and the financial burden of accessing water was reduced by improvement of water supply (Aiga 2002). Participants even stated that payment for services may actively encourage slum residents to work for income in order to pay fees.

Improvements to roads and footpaths were valued by residents in two studies (De Leon 1986; Milone 1993). Milone 1993 described how this increased access to the rest of the city, and made efficient and quicker transport possible to market, schools and to work all year round. In some instances road or pavements facilitated the establishment of small sidewalk enterprises. Residents often said that paved paths increased security, as residents at their own expense strung up electric lighting along the footpath edges (Milone 1993) and slum dwellers in one study expressed preferences for straight pathways to facilitate neighbourhood vigilance (De Leon 1986).

Considering slum upgrading strategies in general, slum dwellers views suggested that provision of physical infrastructure demonstrated that the government was concerned about their housing problems (De Leon 1986) and was also reported as the most important reason for residents making investments in upgrading of their shelter.

 

What external contexts may boost or hinder intervention effects?

The logic model in Figure 1 demonstrates the strategies that take place upstream of interventions to directly change the living conditions of slums.

There is insufficient evidence available to form conclusions on what external contexts may boost or hinder intervention effects. The identified studies were highly heterogeneous and lacked detailed information regarding external contexts.

Limited information was available in the eligible studies on the policy and planning environment that the implemented slum upgrading interventions were operating within. Two of the four main studies were government-led (mostly municipal) projects demonstrating political commitment to slum upgrading (Gonzalez-Navarro 2010; Soares 2005.). This was also present in all nine supporting studies (Abelson 1996; Aiga 2002; Cattaneo 2009; De Leon 1986; Milone 1993; Moitra 1987; Moraes 2004; Parikh in press). However, supportive public policies such as use of local labour for public works to create job opportunities or policies to improve delivery strategies through training and capacity building or increasing urban planning manpower were not reported in either main or supporting studies.

Due to the limitations of the available evidence described above, it was not possible to draw conclusions on whether particular intervention actors boost or hinder programme delivery and outcomes. There was also insufficient evidence available to assess whether community participation or different funding models boosted intervention effects. For these reasons it was not possible to perform intended subgroup meta-analyses to explore the impact engagement with the community has on the intervention effectiveness. However harvest plots (available from the authors) were developed to visually compare results of interventions involving some level of community intervention to those that do not. The plots show the lack of consistent outcomes across the studies and consequently does not demonstrate any trends in results according to type of intervention. Engagement of the community is widely recommended by development experts in intervention programs to ensure that the needs of slum residents are met, and assist with the fidelity and sustainability of the intervention. Within the included studies, most community participation was in the form of residents paying for at least part of the services they received or providing labour. Just one main study (Soares 2005) and three supporting studies described how communities were consulted during intervention design, or were responsible for managing delivery and maintenance of interventions, or both (Abelson 1996; De Leon 1986; Joshi 2002).

It is generally acknowledged that some of the underlying structures affecting both the living environment and upstream interventions include religious, political, and economic structures and institutions. These have not been described sufficiently in any of the included studies. However, Galiani 2007 demonstrate how economic and political environments can, relatively quickly, impact on slum upgrading interventions even after the actual program delivery has ended. The authors describe that Argentina suffered a macro-economic crisis in the years that followed the private water expansion of services in shantytowns. Conflict between the government and water privatisation services followed as the government blocked previously agreed tariff increases, and private companies reacted by interrupting their investments. Eventually the water concession was cancelled, and water provision contracts were transferred to a newly creased public company.

 

Overall completeness and applicability of evidence

 

Completeness of the evidence

 
Outcomes examined in the papers

The harvest plots provide a visual presentation of the interventions and outcomes covered by main and supporting studies (see Figure 5 and Figure 6). The most commonly examined health outcome was communicable diseases, namely diarrhoeal diseases. There was insufficient evidence available to assess the impact of slum upgrading on other communicable diseases such as parasitic infections, and other maternal or perinatal conditions, nutritional deficiencies and other non-communicable diseases. There was also insufficient evidence to assess the impact of slum upgrading on slum residents quality of life.

Similarly, among socioeconomic outcomes, indicators of financial poverty were most commonly investigated across studies. Various indicators were used including mean income per capita, proportion of residents under the poverty threshold, and water-related expenditures. There was insufficient available to assess the impact of slum upgrading on education, employment, crime and violence and social capital.

As described in the background section How the intervention might work, slum upgrading has the potential to not only directly influence health outcomes by reducing routes of disease transmission, but also to impact upon a broader range of social determinants of health and wellbeing. Given the complexity of designing and delivering slum upgrading interventions, it is important that impact evaluations take a holistic approach to the array of important policy-relevant outcomes that may be affected, in order to demonstrate that the investment, time and resources required, are outweighed by their effect on improving the lives of slum dwellers, and their integration into society.

 
Intervention components of the included studies

Across all included studies, three groups of slum upgrading interventions incorporating improvements to the physical environment and infrastructure, were found.

  1. Single-component physical environment and infrastructure intervention within slums were investigated in two of the five main studies regarding improved water supply (Galiani 2007) and road paving (Gonzalez-Navarro 2010). One further supporting study evaluated cement floors (Cattaneo 2009).
  2. Broad slum upgrading strategies involving multicomponent physical environment and infrastructure interventions plus other interventions within the living environment (such as health and social service provision or health behaviour, education) were investigated in two of the five main studies (Butala 2010; Taylor 1987) and four supporting studies (Abelson 1996; De Leon 1986; Joshi 2002; Moitra 1987).
  3. Multicomponent physical environment and infrastructure interventions without other living environment interventions were evaluated in one main study (Soares 2005) and four supporting studies (Aiga 2002; Milone 1993; Moraes 2004; Parikh in press).

The combination of intervention components differed across studies, even when the programmes shared the same name (please see Figure 3 for characteristics of main studies and Figure 4 for supporting studies). The lack of available main studies with a low risk of bias and the heterogeneous nature of the interventions, settings and outcomes did not permit any conclusions on which components may have been most beneficial.

Water, sanitation, drainage and road infrastructure were common features of slum upgrading strategies in both main and supporting studies.

Within the five main studies waste management, energy improvements and improved housing interventions were poorly covered, though self-improvements to homes were observed in two mainstudies of multicomponent slum upgrading (Gonzalez-Navarro 2010; Taylor 1987) Regarding co-interventions, micro-credit loans were included within the programme of one main study (Butala 2010). Health education co-components were included in the slum upgrading programmes of two main studies (Butala 2010; Taylor 1987) and secure tenure in one study (Butala 2010). Social environment interventions such as crime reduction interventions were not examined by any main studies.

A similar pattern of slum upgrading interventions were observed in the nine supporting studies. Considering physical upgrading; waste management, energy improvements and improved housing interventions were poorly covered, though self-improvements to homes were observed in four studies (Abelson 1996; Joshi 2002; Moitra 1987; Parikh in press). Regarding wider co-interventions, provision of health clinics or schools were evaluated in three supporting studies (Abelson 1996; Joshi 2002; Moitra 1987), and health education component in one study (De Leon 1986). Slum upgrading interventions included secure tenure or time-bound guarantees from threat of eviction were described in over half of the supporting studies (Abelson 1996; Aiga 2002; De Leon 1986; Joshi 2002; Moraes 2004; Parikh in press). The inclusion of income generation projects or microcredit loans were investigated in four supporting studies (Abelson 1996; De Leon 1986; Joshi 2002; Moitra 1987). Health and social service components were described in three supporting studies (Abelson 1996; De Leon 1986; Moitra 1987) but, as with the main studies, social environment interventions such as crime reduction interventions were include in supporting study programmes.

A range of terminologies were used to describe the implemented projects, including slum upgrading (Butala 2010), slum improvement (Abelson 1996; Moitra 1987), Kampung Improvement Programme (KIP – Milone 1993; Taylor 1987), Zonal Improvement Programme (ZIP, Aiga 2002), Barrio Escopa pilot project (De Leon 1986), Small Town Urban Development Project (STUDP - Milone 1993), and Favela-Bairro (Soares 2005). Two projects employed Slum Networking Programmes (SNP), Parikh in press evaluated just  SNP in five communities, whereas Joshi 2002 delivered a wider ‘Integrated Slum Development’ Programme, with SNP forming the physical upgrading element.

 
External contexts

Limited information was available in the eligible studies on the policy and planning environment that the implemented slum upgrading interventions were operating within.  Interventions in two of the five main studies were government-led (mostly municipal) projects demonstrating political commitment to slum upgrading (Gonzalez-Navarro 2010; Soares 2005) and all nine supporting studies (Abelson 1996; Aiga 2002; Cattaneo 2009; De Leon 1986; Milone 1993; Moitra 1987; Moraes 2004; Parikh in press). Supportive public policies such as use of local labour for public works to create job opportunities or policies to improve delivery strategies through training and capacity building or increasing urban planning manpower were not reported in either main or supporting studies.

Just one main study (Soares 2005) and three supporting studies included interventions reported to involve community engagement, either by consultation during intervention design, or through delivery or maintenance of interventions (Abelson 1996 De Leon 1986 Joshi 2002).

Information regarding underlying contexts such as religious, political, and economic structures was not described sufficiently in any of the included studies.

 
Were the interventions sustained?

Firm conclusions on the sustainability of completed interventions are not possible, due to the lack of available information. Only one main study (Butala 2010), a CBA, described anecdotal evidence suggesting that a majority of ancillary health interventions did not persist after construction of the basic infrastructure as per the slum upgrading programme.

The remaining information was reported in four supporting studies. Milone 1993 did not quantitatively examine sustainability but described the lack of maintenance of the multi-component physical upgrading, for example drains were not kept clear, water taps were not maintained so that if they broke they were not fixed, and water fees were not always paid so taps were turned off. Joshi 2002 reported that building capacities and sustaining motivation of co-coordinators and local workers had proved challenging. Key facilitators for maintaining these partnerships included structures to facilitate collaborative initiatives, proactive integration of partners differing aims, acceptance of different working styles, recognition of efforts put in by all partners, sustainable processes that enhance partnership and meeting partners objectives. Moitra 1987 discussed that earlier improvements were nullified because of lack of adequate arrangements for operation and maintenance. The author believed that this was due to the government becoming the owner of the areas through land rights acquisition, which meant that maintenance fell on an organisation ill-equipped to handle it. The author proposed that residents should take responsibility for day to day maintenance (such as clearing drains) but that there’s no formal system of community participation in the urban areas. De Leon 1986 described how almost all lot boundaries established within an upgrading programme kept their original positions, pathways were well maintained. However pocket parks were reduced in size by 20% at follow-up.

There was some evidence in the included studies that the slum upgrading programmes also resulted in self-initiated improvements by the slum community. Two main studies (Gonzalez-Navarro 2010; Taylor 1987) and four supporting studies (Abelson 1996; Joshi 2002; Moitra 1987; Parikh in press) reported that slum dwellers made improvements to their homes, and one supporting studies reported community enhancement of footpaths (Milone 1993).

 
Were the outcomes sustained?

While the majority of main studies followed up outcomes a number of years after baseline measures, two studies did not clarify when the slum upgrading intervention was completed, making it difficult to judge the length of follow-up post-intervention delivery (Butala 2010; Soares 2005). Information in three of the five main studies showed that, Galiani 2007 and Gonzalez-Navarro 2010 measured outcomes over a relatively short period (between five to 10 months and between 19 and 1 month, respectively), whereas Taylor 1987 measured outcomes between three and five years after the intervention (the exact follow-up period is not clearly reported).

It is not possible to detect whether the impact of the interventions had diminished or been maintained during the follow-up period, as short and long-term measures were not common across these studies. Three supporting studies reported relatively long follow-up periods between two to four years after the intervention (Cattaneo 2009; De Leon 1986; Joshi 2002) but again did not measure outcomes at more than one timepoint within the studies, or measure the same outcomes across these studies.

 
Did sustained intervention relate to sustained outcome?

There is insufficient information provided on the sustainability of interventions or outcomes to evaluate whether sustained intervention related to sustained outcomes.

 

Applicability of the evidence to other slum communities

As previously discussed, the study intervention components and outcomes are heterogeneous, preventing conclusion on which specific intervention had the noted effects or whether there was synergy between components. However the diversity in the population settings and intervention strategies does increase the likelihood that the evidence can be generalized to wider slum settings.

Main studies were conducted in Asian countries including India (Butala 2010) and Indonesia (Taylor 1987), and Latin America including Argentina Galiani 2007), Mexico (Gonzalez-Navarro 2010) and Brazil (Soares 2005). A predominant number of support studies examined interventions in slums in Asian countries. Four of these were situated in India (Abelson 1996; Joshi 2002; Moitra 1987; Parikh in press), two in the Phillipines (Aiga 2002; De Leon 1986) and one in Indonesia (Milone 1993). Two further supporting studies were conducted in Latin America, including Mexico (Cattaneo 2009) and Brazil (Moraes 2004). The evidence base inadequately represented Africa and the Caribbean nations with only one study from Cape Town (Parikh in press) and none from the Caribbean.

Existing slum conditions prior to or without intervention showed most slum settings lacked secure tenure, water and sanitation services. Studies did not consistently report conditions with respect to drainage facilities, housing materials, overcrowding, roads and energy infrastructure and waste management conditions. Correspondence was required with the authors of two studies authors to ascertain whether the setting could be considered as slums (Cattaneo 2009; Gonzalez-Navarro 2010).

The majority of studies included squatter communities without secure tenure, though often slums had been in existence for several years. Two studies included participants that were in recognised residential areas, and mostly owned their homes or property title (Cattaneo 2009; Gonzalez-Navarro 2010). Taylor 1987 additionally reported that the proportion of households with secure land tenure at baseline was low in control slums (24%), and higher in reference and intervention groups (32% and 48% respectively). The percentage owning house tenure was considerably higher in all three groups, ranging from 60 to 72%. Two studies did not provide information on the tenure of the communities (Galiani 2007; Parikh in press).

Parikh in press did not describe the setting conditions of the included slums prior to the intervention. Of the remaining studies, water and sanitation provision was poor in all studies, except for Moraes 2004 which reported that many houses had some form of water supply. Only two studies reported information on housing durability, with Gonzalez-Navarro 2010 finding the majority had cement walls and floors, whereas conditions were poor in the included slum settings of Taylor 1987, with only 23% to 36% of households within the study groups having homes built of permanent material. Energy infrastructure was generally not described, though two studies reported good access to electricity (Cattaneo 2009; Moraes 2004). Drainage facilities, overcrowding, and road infrastructure was also poorly reported amongst the studies.

Thus whilst further detail would have been desired about the history and conditions of the included slums, the included settings could be applicable to urban slums in LMIC countries, and particularly relevant to slum communities in Asia.  Of the main studies, one RCT was considered to have high external validity (Gonzalez-Navarro 2010), and three CBAs mixed generalisability (Butala 2010; Galiani 2007; Soares 2005). It should be noted however that Gonzalez-Navarro 2010 evaluated a single intervention, road paving, thus the results may have limited applicability to broader multicomponent slum upgrading interventions. Taylor 1987 was judged to have poor or unclear external validity as it did not report how the neighbourhoods chosen for the study were chosen, or whether the participants included were representative of the neighbourhoods included.

Supporting studies were judged to have either high (Moraes 2004; Joshi 2002) to moderate (Abelson 1996; Aiga 2002; Cattaneo 2009; De Leon 1986; Milone 1993; Moitra 1987; Parikh in press) external validity. Studies generally described the source area well, though were less successful in describing whether the study area was representative of the source area, or how selected participants in the study area represented the eligible slum population of interest.

 

Quality of the evidence

Risk of bias tables are presented in Characteristics of included studies. The internal validity of included studies according to the NICE/GATE checklist are also presented in  Table 3 and  Table 4.

Within the main studies, one RCT was considered to have a low risk of bias (Gonzalez-Navarro 2010). Four CBAs were also included, two of which were judged to have a mixed or unclear risk of bias (Galiani 2007; Soares 2005) and two had a high risk of bias (Butala 2010; Taylor 1987).

A significant challenge with the evaluation of slum upgrading projects is the identification of comparable control groups, which was compounded by the failure in most studies to incorporate evaluation processes during the initial stages of project design. Therefore researchers often had to examine the effect of intervention once regions had already been upgraded, and identify control groups post hoc.To reduce the risk of selection bias such limitations were likely to introduce, the majority of main studies utilised difference in difference analyses (Butala 2010; Galiani 2007; Gonzalez-Navarro 2010; Soares 2005), propensity score matching (Soares 2005) and multivariate analyses that controlled for confounders (Galiani 2007; Gonzalez-Navarro 2010; Soares 2005).

With the exception of Cattaneo 2009 all supporting studies were judged to have a high risk of bias. The studies were mostly CPI designs that lacked baseline data (Aiga 2002; Cattaneo 2009; De Leon 1986; Moitra 1987; Moraes 2004; Parikh in press) and were highly susceptible to selection bias. Propensity score matching was utilised by Cattaneo 2009 and effect estimates were controlled for potential confounders in three studies (Aiga 2002; Cattaneo 2009; Moraes 2004) to try to minimise such bias.

The majority of studies were clustered. Whilst most main studies used appropriate statistical analyses to account for this, the majority of supporting studies did not and risked wrongly detecting statistically significant effect estimates by underestimating standard errors.

In general, both main and supporting studies suffered from potential detection bias (as blinding was not possible), reliance on existing data sources that tended to use unreliable outcome measures based on self-reporting over recall periods longer than two weeks, and poor reporting of intervention fidelity and power of the sample size.

 

Potential biases in the review process

This review may suffer from certain biases in the review process, encountered during identification of relevant studies.

Firstly, the topic crosses multiple disciplines such as health, urban planning and architecture, environmental, and the social sciences. The review authors hence felt it necessary to search both large multidisciplinary (for example SCOPUS) and topic-specific bibliographic databases to attempt to capture potentially specialised literature (such as Planex, Georef, and Sociological Abstracts). Scoping searches during review protocol development, had revealed a lack of clear and standard terminology within the topic, due to the range of disciplines and countries covered in this review. This is reflected in the list of terms used to describe slum settings in  Table 1 together with the programme names identified in the included studies to describe the intervention (for example Slum Networking Programme, Kampung Improvement Programme, Zonal Improvement Programme, Integrated Slum Development, and Water Expansion). The review search strategy utilised a broad structure, combining just two search concepts for setting and intervention terms, to minimise the risk of missing eligible study designs or outcomes in the search. Within these concepts, an extensive list of terms and synonyms were utilised, employing truncation and adjacency operators to cast a wide net across the literature. Several bibliographic databases only allowed a limited number of terms to be searched, presenting the risk that relevant studies could have been missed.

A second challenge in identifying relevant research was the large amount of potentially relevant literature, only available as grey or unpublished literature, and therefore not indexed in the bibliographic databases described above. Again, steps were taken to address this by searching grey literature databases such as HMIC, IDEAS and 3ie impact evaluation database, a wide range of key organisation websites, reference list checking and suggestions from experts. Five of the 14 included studies were identified through these snowballing techniques.

A third obstacle faced in the review process, was the difficulty in obtaining potentially relevant studies. The full text of 27 potentially relevant abstracts could not be retrieved, despite using the library resources available to the team or requests to the British Library. It is likely that these records would not meet the inclusion criteria, yet as most provided very limited information in the abstract, or did not provide an abstract it was not possible to confidently exclude them from the literature review. Based on the information available, it is likely that just five records would have potential relevance, however only two of these records reported an abstract, and no records suggested that they met all study review criteria.

 

Agreements and disagreements with other studies or reviews

To our knowledge, there is no existing systematic review that has been conducted on the topic of the health or socioeconomic impacts of multicomponent slum upgrading strategies. 

There are several reviews (not limited to slum settings) that support our review findings that interventions including water and sanitation improvements could increase both health and socio-economic wellbeing. The reports reveal reductions in diarrhoeal diseases following improved water supply (Clasen 2006; Waddington 2009) and excreta disposal (Clasen 2010). In addition to health gains and reduced health costs, a recent World Health Organization (WHO) cost-benefit analysis of water and sanitation access at the global level, demonstrated clear reductions in days lost with respect to formal or informal employment, school attendance, or other productive activities in the household, as a result of time saved from illness and time saved accessing safe water and sanitation (Hutton 2004).

Slum Networking Programmes (SNP) were described in two of the included studies (Joshi 2002; Parikh in press). Within these low quality studies, moderate improvements in health, household income, education and occupation were observed, and the authors reached conclusions generally favouring the interventions. A discussion paper presenting results from a cross-sectional survey conducted in slums receiving SNP in Indore and newspaper archive material from these regions, presents a less positive picture (Verma 2000). The survey revealed that poor implementation of SNP features, only 34% had toilet connections and only 16% had private water supply. Streets were often waterlogged and there was virtually no evidence of soft landscaping. The author commented on a number of failed assumptions that were made within the SNP concept, such as believing all slum households could and would connect toilets to underground drainage once provided, to ensure all community sewage finds its way into piped sewerage. The contrasting outlook of SNP between the included intervention studies and this cross-sectional survey highlight the importance of incorporating sufficient process evaluations as part of the impact evaluation, in order to assess whether slum residents are satisfied with the intervention received, identify barriers and facilitators, and assess whether the outcomes reported represent that maximal result that could be achieved if the intervention was delivered in the way it was intended.

Due to the heterogeneity of the included interventions and outcome measures, it was not possible to reach clear conclusions regarding which aspects of slum upgrading strategies were responsible for the observed effects. However, studies of sole land titling interventions suggest that tenure security results in significant improvements on residential investment in housing (Field 2005), hours of employment (Field 2007) and reduction in the household demand for child labour (De Moura 2009; Field 2007). Whilst the evidence suggests that secure tenure could be an important aspect to include in slum upgrading strategies, the local context of the area receiving the intervention should be considered. Taylor 1987 described that tenure security was not considered for inclusion by the Government implementing the slum upgrading programme, as it realised that the tenure regularisation process in Indonesia would be very time-consuming. Instead they intended to implement land tenure at a later stage, believing that due the existing complexities in land tenure the system would be stable enough to discourage eviction. 

 

Authors' conclusions

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms

 

Implications for practice

Within the limited evidence base available, results suggest that the incidence of diarrhoea is reduced following slum upgrading. There were mixed results for whether slum upgrading improved occurence of parasitic infections, or broader indicators of communicable diseases. There was insufficient evidence available to make firm conclusions on the impact of slum upgrading on other health outcomes (including non-communicable and injuries) or quality of life outcomes. Regarding socio-economic outcomes, the included studies demonstrated mixed effects of slum upgrading on measures of financial poverty and employment outcomes. There was also insufficient evidence available to assess the impact of upgrading on education, social capital, crime and violence.

The heterogeneity of interventions and outcomes prevent conclusions on which interventions, or combination of components is linked to the greatest improvements in health or socioeconomic wellbeing. Within the included studies, water supply, sanitation, drainage, roads and paved footpaths were the most commonly delivered strategies. 

Limited qualitative and views based quantitative data within the studies suggest that slum communities value infrastructure upgrading (namely water and sanitation interventions) as top priorities for slum improvement; above health, education or financial interventions. Once the physical living environment had been improved residents valued health and education facilities.

Information provided in several studies also suggested that slum dwellers are keen to contribute to the improvement of their living conditions. It was observed that slum residents were willing to pay for the services they receive, and contribute to the design, planning, and delivery of the intervention. Furthermore, several studies also observed residents making investments to their homes and community outside of the intervention delivered. A consistent theme amongst the studies was the desire for slum households to work for income and belief in education, if time was freed by improved conditions. These factors may present opportunities to build upon for improving the cost recovery of slum upgrading.

Information available on the fidelity and sustainability of interventions was scarce within the included studies. The available qualitative data however indicated the importance of appropriate siting of facilities, preference for private facilities, timing delivery of synergistic interventions together and ensuring infrastructure is fit for purpose and systems are provided for cleaning, maintenance and repair. Engaging with communities during the design and implementation may help to ensure interventions are utilised and maintained as intended by addressing gender, cultural and social stigma.

A common limitation of the included studies was the lack of involvement of independent researchers at the start of the intervention. As a consequence, studies were faced with difficulties in accurate collection of outcomes, confounders and details regarding intervention processes and fidelity. This was often addressed by measuring only post-intervention data for comparison groups or making use of existing health insurance claim data and household surveys, or both. Whilst these provided pragmatic solutions, study validity was limited by the quality of the available data. It is essential that rigorous process and impact evaluations are routinely incorporated during the planning and commissioning of slum upgrading programmes, to enable further refinement of interventions that build upon lessons learned.

 
Implications for research

A number of evidence gaps were identified by the systematic review. In particular, there is a lack of research for the effect of physical slum upgrading on non-communicable diseases, maternal and perinatal conditions, injuries, quality of life, employment, education, social capital and crime. With regards to the interventions examined, further research is required on the impact of energy infrastructure, waste management and improvements to homes in slum communities. Additional studies are needed to examine whether the combination of physical upgrading and other interventions designed to improve health /social services, health education and behaviour, or the social environment, have a greater impact on the outcomes of interest.  

Rigorous studies with a low risk of bias are required to draw firm conclusions on the impact of slum upgrading strategies. The potential for studies to reduce bias is greatest when evaluations are planned at the same time as the design and delivery of the intervention and independent researchers are involved in intervention allocation and data collection. This is demonstrated by the one RCT (Gonzalez-Navarro 2010) included in the review and a further RCT of in situ slum upgrading currently in progress (Cooper 2007). However, it is acknowledged that large-scale multicomponent slum upgrading interventions can be difficult to manipulate experimentally and RCTs would often be impractical or unethical. As is the case with the majority of included studies, many interventions are evaluated under 'natural experiment' conditions. Whether RCTs or other types of impact evaluations are performed, the following study features are recommended in order to strengthen the evidence base on slum upgrading:

Comparison groups

Wherever possible, a control group should be utilised to help demonstrate that changes in the slums are brought about by the effect of the intervention. Choice of control group should be carefully considered to ensure comparison groups are as similar as possible. In particular it is important to understand whether the reasons why the control group has not received the intervention, is reflective of important differences in the setting characteristics.

Outcomes

The existing evidence base would be strengthened by using objective measures where possible to accurately assess outcomes (for example collecting stool samples to examine intestinal infections). If self-reported outcomes are collected, they should use a reliable recall period (up to two weeks). Measures of financial poverty such as household income should consider and adjust for changes in inflation over time.

Measuring outcomes at several time points would allow assessment of secular trends and conclusions to be drawn on whether short term effects of interventions are sustained, continue to improve or worsen over time.

Studies that allocate interventions by clusters but analyse outcomes by individuals should ensure appropriate analyses are used to allow for clustering effect, or report the intracluster coefficient and effective sample size to enable reanalysis of data.

Reporting standards

It is important that studies clearly define the population and setting of interest to maximise the likelihood that studies are identified during the literature search, and enable reviewers to examine heterogeneity between studies and assess 'what works for whom'. Full details of the intervention should also be provided (see process evaluations below).

To assist the synthesis of primary research in systematic reviews, studies should report sufficient detail to allow estimation of effect sizes and assessment of internal validity. This should include the number of participants or clusters within comparison groups, power calculations indicating how large a sample size is required to detect expected effects, and measures of variance for effect estimates (such as standard deviations, standard errors and confidence intervals).

Addressing selection bias

Given the heterogeneous nature of slum settings and the difficulties in identifying control groups, steps to address selection bias are needed. This is particularly pertinent for non-randomised or 'natural experiment' studies. There are a number of different statistical approaches that can be utilised to minimise selection bias. These can include analyses to adjust for unobserved differences between comparison groups (such as difference in differences, instrumental variables and regression discontinuity designs) or observed differences (such as matching control and intervention individuals or groups according to similar characteristics, adjusting for potential confounders in multiple regression analyses, and propensity score matching) (Craig 2012). Recent guidance by the Medical Research Council recommends combining analytical methods for addressing observed and unobserved variables in order to strengthen causal inference (Craig 2012).

Process evaluations and qualitative studies

Slum upgrading interventions and the settings in which they are delivered can be complex, as demonstrated in Figure 1. Programmes can involve multiple interacting components and delivery to heterogeous settings with variable living conditions and subsequent infrastructure needs. Successful slum upgrading may also require different behaviours from different organisations at local and national levels, such as government, business, civil society and local residents.

Quantitative effectiveness studies should therefore seek to incorporate process evaluations and qualitative investigation of slum dwellers views and experiences to enhance understanding of what interventions work, for whom and why and how best to deliver facilities. In order to achieve this, data should be gathered on all intervention components, the context in which they were delivered, and whether services were provided as intended (fidelity of intervention) in addition to information regarding the resources and time required to deliver a programme. Views and perspectives of providers and slum residents should also be captured to provide insight regarding acceptability, barriers and facilitators.

This would provide valuable implementation information to help decision makers determine which interventions and combinations are most appropriate for the needs of their community, how they should be delivered, and what likely barriers and facilitators will need addressing for the effective delivery of interventions.

 

Acknowledgements

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms

The author team would like to thank Professor Laurie Anderson for her support and mentorship throughout the design and writing of the review protocol. We would also like to thank the Cochrane Public Health Group for their continued support and in particular for the guidance provided by Professor Elizabeth Waters, Dr Rebecca Armstrong, and Jodie Doyle. Thanks are also extended to Dr Helen Morgan for reviewing the search strategy and Dr Alison Weightman for conducting some data analysis and contributing to the completion of the report.

The author team acknowledges, with thanks, the support and guidance of the review advisory group for their content expertise and suggestions during the design of the review protocol. This includes Dr Richard Tomlinson, Dr Neelima Risbud, Dr Gabriela Charnes, Mojgan Sami, Dr Rima Nakkash, and Dr Maria Elena Ducci. We also thank staff at 3ie for reviewing the protocol and for their suggestions.

 

Data and analyses

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms

This review has no analyses.

 

Appendices

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms
 

Appendix 1. Adverse health outcomes associated with slum defining characteristics


CharacteristicPhysical or Legal DefinitionPhysical/Legal OutcomeAdverse Health Outcomes

Insecure residential statusHouseholds without:

  • formal title deeds to either land or residence
  • enforceable agreements as a proof of tenure
  • Eviction
  • Exposure to toxic/chemical waste and pollution
  • Low service utilization


 
  • Poor access to health care services traffic injuries
  • Acute poisoning, respiratory diseases, cancer
  • Intentional injuries, STDs/HIV, unwanted pregnancy, substance abuse–related diseases

Poor structural quality of housing

 
Households residing in hazardous sites:

  • geologically hazardous (landslide, earthquake/flood areas)
  • industrial pollution
  • unprotected hazards (e.g., dumps, railroads, power lines)


Households living in temporary and/or dilapidated structures:

  • inferior building materials (cardboard, corrugated tin, mud, low-grade concrete/bricks)
  • substandard construction (e.g., inadequate foundation or support structures, insecure joints/connections
  • Land and mud slides
  • Flooding
  • Fire
  • Vertical, multistory housing construction
  • Residence in or near dumps; spontaneous combustion of garbage


 
  • Unintentional injuries
  • Leptospirosis, diarrhoeal diseases, cholera, malaria, dengue, hepatitis, drowning
  • Falling injuries
  • Burn injuries

OvercrowdingHouseholds with more than two persons per room or less than five square meters per person
  • Enhanced opportunity for disease transmission
  • Tuberculosis and other respiratory illnesses, meningitis, scabies, skin infections, bacterial pharyngitis, rheumatic heart disease

Inadequate access to safe waterLess than 50% of households have access to a:

  • household connection
  • access to public stand pipe
  • rainwater collection


 
  • Contaminated water source
  • Water scarcity
  • Diarrheal diseases, cholera, typhoid, hepatitis
  • Scabies, bacterial skin infections, acute glomerulonephritis

Inadequate access to sanitation and other infrastructureLess than 50% of households have improved sanitation:

  • public sewer
  • pour-flush latrine
  • ventilated improved pit latrine
  • Increased rat density
  • Open or broken sewers
  • Suboptimal schools
  • Inadequate/inappropriate health care service
  • Typhus, leptospirosis, diarrhoeal diseases, cholera, malaria, dengue, hookworm, hepatitis, chronic respiratory diseases, growth retardation
  • Under-utilization of services, maternal health complications, vaccine-preventable diseases, perinatal diseases, rheumatic heart disease, suicide
  • Poor access to health education
  • Drug-resistant infections, poorly controlled hypertension, diabetes, and other chronic illnesses



Reproduced from Unger 2007 according to the Creative Commons Attribution License (CCAL).

 

Appendix 2. Physical and legal characteristics of slums

UN Habitat have devised a working definition of slums in order to monitor progress. This systematic review will adopt these criteria in order to identify studies for inclusion in the review , for studies that do not specify whether the setting(s) receiving the intervention is a slum. The table below examples of each criteria, and is adapted from the 2010 updated chapter 1 of the Global Report on Human Settlements 2003 (UN 2010) and the WHO/UNICEF Joint Monitoring Programme to highlight different degrees of improved/unimproved water and sanitation access in relation to shared and private facilities (WHO/UNICEF JMP).


 Examples of Improved accessExamples of unimproved access

Access to improved waterImproved: piped water into dwelling, plot or yard

Other Improved: public tap/standpipe; tube well/borehole; protected dug well; protected spring; and rainwater collection. Bottled water is only considered an improved water source when water from an improved source is used for cooking and personal hygiene)
Unprotected dug well; unprotected spring; cart with small tank/drum; bottled water;  tanker-truck; and surface water (river, dam, lake, pond, stream, canal, irrigation channels).

Access to improved sanitation

 
Flush or pour-flush to piped sewer system, septic tank or pit latrine; ventilated improved pit latrine; pit latrine with slab; and composting toilet.

Only facilities that are not shared or not public are considered improved.
Shared sanitation facilities: Sanitation facilities of an otherwise acceptable type shared between two or more households.

Unimproved sanitation facilities: flush or pour–flush to elsewhere (e.g. street, yard or plot, open sewer, ditch);pit latrine without slab or open pit; bucket; hanging toilet or hanging latrine; no facilities or bush or field.

Sufficient-living areaNo more than three people share the same habitable (minimum of four square meters) room.More than three people share the same habitable room.

Durability of housing

 
A house built on a non-hazardous location and has a structure permanent and able to protect its inhabitants from the extremes of climatic conditions, such as rain, heat, cold and humidity.House built on a hazardous location and/or with a non permanent structure unable to protect inhabitants from extremes of climatic conditions.

Security of tenureEvidence of documentation that can be used as proof of secure tenure status or when there is either de facto or perceived protection against forced evictions.No protection against forced evictions.



 

Appendix 3. SCOPUS search strategy

Key

TITLE-ABS-KEY: searches the title, abstract, index keywords and authors keywords

*: truncates the word:  e.g. favela* will retrieve favela or favelas

“…”: Searches for the exact phrase, i.e. terms contained within quotation marks will be identified if adjacent to each other in the record.

W/n: Restricts to n words between the two words, in any order. E.g. squatter w/2 settlement will retrieve records with the terms squatter and settlement appearing in any order, with up to two unspecified words between them.

Describing slum settings or populations

#1        (TITLE-ABS-KEY(slum OR slums OR shanty OR shanties OR shantyhouse* OR barrio OR barrios OR favela* OR kampung OR tugurio* OR ghetto OR ghettos OR bidon OR bidons OR bidonville*))

#2        (TITLE-ABS-KEY((informal W/2 shack*) OR (informal W/2 housing) OR (informal W/2 settlement*) OR (irregular W/2 settlement*) OR (illegal W/2 settlement*) OR (informal W/2 tenement*) OR (irregular W/2 tenement*) OR (squatter W/2 settlement*) OR (squatter W/2 area*) OR (illegal W/2 tenement*)))

#3        (TITLE-ABS-KEY("public squalor" OR "public squalor" OR "squalid housing" OR "squalid accommodation" OR "human settlement development" OR "urban poor"))

#4        (TITLE-ABS-KEY("cardboard cit*" OR "tenement district*" OR "tenement hous*" OR "rundown neighborhood*" OR "rundown neighbourhood*" OR "rundown settlement*"))

#5        (TITLE-ABS-KEY(lahbach OR elendsviertel OR brarek OR foundouks OR tanake OR aashwa* OR truschobi OR taudis OR morro OR loteamento OR comunidade OR ahata OR katra OR watta OR jhopadpatti OR umjondolo OR mabanda OR kijiji OR barraca* OR conventillos))

#6        (TITLE-ABS-KEY("kartonsko naselje" OR "habitat precaire" OR "habitat spontane" OR "quartier irregulier" OR "asentamiento irregular" OR "colonia popular" OR "villa* miseria" OR "ciudad perdida" OR "edina achouaia" OR "mudal safi" OR "pelli gewal"))

#7        (TITLE-ABS-KEY(bustee* OR gecekondu* OR chawls* OR basti OR masseque* OR "squatter cit*" OR "katchi abadi*" OR dharavi OR kibera OR "cite soleil" OR khayelitsha OR "orangi town"))

#8        (TITLE-ABS-KEY("informal shack*" OR "irregular shack*" OR "illegal shack*" OR "shack dweller*" OR "shackdweller*" OR "shack town*" OR "skid row" OR "urban blight" OR squatter camp* OR shack settlement* OR arrabal OR asentamiento* OR campamento* OR cantegril* OR comuna OR comunas OR " Pueblos jóvene*" OR barriada* OR "Poblacion callampa" OR tugurio OR precario OR chacarita OR tent cit* OR informal cit* OR imijondolo* OR migrant camp* OR migrant settlement* OR refugee camp* OR refugee settlement*))

#9        #1 or #2 or #3 or #4 or #5 or #6 or #7 or #8

Describing interventions

#10      (TITLE-ABS-KEY(improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat*))

#11      (TITLE-ABS-KEY("flood protect*" OR "ground stabili*" OR "slope stabili*" OR (mitigat* W/2 landslide) OR (drain* W/2 stormwater*) OR (drain* W/2 surface) OR (drain* W/2 system*) OR (drain* W/2 water*) OR (sewage W/2 collect*) OR (sewage W/2 dispos*) OR (sewage W/2 manag*) OR (sewage W/2 remov*) OR (sewage W/2 service*) OR (sewage W/2 system*) OR (sewage W/2 treatment*) OR (sewer* W/2 collect*) OR (sewer* W/2 dispos*) OR (sewer* W/2 expansion) OR (sewer* W/2 manag*) OR (sewer* W/2 prov*) OR (sewer* W/2 remov*) OR (sewer* W/2 service*) OR (sewer* W/2 suppl*) OR (sewer* W/2 system*) OR (sewer* W/2 treatment*) OR (trash W/2 collect*) OR (trash W/2 dispos*) OR (trash W/2 dispos*) OR (trash W/2 manag*) OR (trash W/2 remov*) OR (trash W/2 service*) OR (waste W/2 scheme*) OR (manag* W/2 stormwater*) OR (manag* W/2 surface water)))

#12      (TITLE-ABS-KEY(electric W/2 cooker*) OR (electric W/2 cookstove*) OR (electric W/2 stove*) OR (electric W/2 stoves) OR (electric* W/2 provid*) OR (electric* W/2 provis*) OR (electric* W/2 suppl*) OR (garbage W/2 service*) OR (gas W/2 cooker*) OR (gas W/2 cookstove*) OR (gas W/2 stove*) OR (gas W/2 stoves) OR (improv* W/2 cooker*) OR (improv* W/2 cookstove*) OR (improv* W/2 stove*) OR (improv* W/2 stoves) OR (lpg W/2 cooker*) OR (lpg W/2 cookstove*) OR (lpg W/2 stove*) OR (lpg W/2 stoves))

#13      (TITLE-ABS-KEY((water W/2 suppl*) OR (water W/2 prov*) OR (water W/2 expansion) OR (water W/2 access) OR (water W/2 service*) OR (sanitation W/2 suppl*) OR (sanitation W/2 prov*) OR (sanitation W/2 expansion) OR (sanitation W/2 access) OR (sanitation W/2 service*) OR (sewerage W/2 suppl*) OR (sewerage W/2 prov*) OR (sewerage W/2 expansion) OR (water W/2 access) OR (sewerage W/2 service*) OR (water W/2 system*) OR (sanitation W/2 system*) OR (sewerage W/2 system*)))

#14      (TITLE-ABS-KEY("rain water collection" OR "piped water" OR "public tap*" OR "tube well*" OR standpipe* OR "protected spring" OR "protected dug well" OR "deliver* water" OR "septic tank*" OR toilet* OR "safe water" OR borewell* OR "bore well*" OR "drinking water"))

#15      (TITLE-ABS-KEY("sewer system*" OR "buil* road*" OR "new road*" OR "road* buil*" OR "access road*" OR "drainage system" OR "underground sewerage" OR "street light*" OR "pave* road*" OR "pave* footpath*" OR "pave* sidewalk" OR pavement* OR (infrastructure W/2 develop*)))

#16      (TITLE-ABS-KEY((waste W/2 collect*) OR (waste W/2 service*) OR (waste W/2 manag*) OR (waste W/2 dispos*) OR (garbage W/2 collect*) OR (disposal W/2 scheme) OR (disposal W/2 service*) OR (garbage W/2 manag*) OR (garbage W/2 dispos*) OR (garbage W/2 collect*) OR (refuse W/2 manag*) OR (refuse W/2 dispos*) OR (refuse W/2 collect*) OR (waste W/2 remov*) OR (refuse W/2 remov*) OR (garbage W/2 remov*)))

#17      (TITLE-ABS-KEY((storm W/2 drain*) OR (environment* W/2 hazard*) OR (mitigat* W/2 hazard*) OR electricity OR gas OR "power supply" OR "energy supply" OR utilities))

#18      (TITLE-ABS-KEY("Housing strateg*" OR "housing polic*" OR "housing project*" OR "housing program*" OR "new* buil*" OR "social housing*" OR "SI project*" OR "urban management" OR manpower OR capacity OR political accountability OR "scal* up" OR home OR homes OR dwelling*))

#19      (TITLE-ABS-KEY((secur* W/2 tenure*) OR (land W/2 titl*) OR (property W/2 titl*) OR (property W/2 rights) OR (land W/2 tenur*) OR (land W/2 rights) OR "development rights"))

#20      (TITLE-ABS-KEY("Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*"))

#21      (TITLE-ABS-KEY(kip OR "permanent hous*" OR "formal hous*" OR "hous* building" OR "new hous*"))

#22      (TITLE-ABS-KEY(subsid* OR investment* OR partnership* OR microcredit OR credit OR "village bank*" OR microcredit* OR mortgage* OR "social fund*" OR microfinance OR loan OR loans OR "monetary support" OR "monetary assis*" OR "financ* support" OR "financ* assist"))

#23      #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22

 

Appendix 4. Search history

 

Original search (May to July 2011)

ASSIA, AVERY and Sociological abstracts

((KW= (slum or slums OR shanty OR shanties OR shantyhouse* OR favela* OR kampung OR tugurio* OR bidon OR bidons OR bidonville* OR ghetto OR ghettos OR "informal shack*" OR "irregular shack*" OR "illegal shack*" OR "shack dweller*" OR shackdweller OR "shack town*" OR "skid row" OR "urban blight" OR bustee* OR gecekondu* OR chawls* OR basti OR masseque* OR "squatter cit*" OR "katchi abadi*" OR dharavi OR kibera OR cite soleil OR khayelitsha OR "orangi town" OR "kartonsko naselje" OR "habitat precaire" OR "habitat spontane" OR "quartier irregulier" OR "asentamiento irregular" OR "colonia popular" OR "villa miseria" OR "ciudad perdida" OR "edina achouaia" OR "mudal safi" OR "pelli gewal" OR lahbach OR elendsviertel OR brarek OR foundouks OR tanake OR aashwa’i OR truschobi OR taudis OR morro OR loteamento OR comunidade OR ahata OR katra OR watta OR jhopadpatti OR umjondolo OR mabanda OR kijiji OR barraca OR conventillos)) and((KW=(kip or housing or home or homes OR "Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*" OR improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat* OR road* OR drainage OR "street light*" OR sidewalk OR pavement* OR infrastructure OR subsidy OR subsidi* OR investment* OR partnership* OR microcredit OR credit OR "village bank*" OR microcredit* OR mortgage* OR microfinance OR loan OR loans OR "storm drain*" OR electricity OR gas OR "power supply" OR "energy supply" OR utilities OR "public tap*" OR "tube well*" OR standpipe* OR "dug well" OR "septic tank*" OR toilet* OR "scal* up" or water OR sanitation OR sewerage)) or(KW=((waste or garbage or refuse) NEAR (collect* or manag* or service* or system* or dispos*))))

BNI

1.            poverty areas/                 

2.            urban environment/                                      

3.            (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.            

4.            (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.                                   

5.            (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.                 

6.            (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.                                     

7.            (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.                                          

8.            (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement*).ti,ab.                                      

9.            (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.                                      

10.          ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.                                            

11.          or/1-10                                                

12.          ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.                                              

13.          (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.                                     

14.          (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.                             

15.          (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.                                                

16.          ((waste or garbage or refuse) adj2 (collect* or service* or manag* dispos* or scheme* or remov*)).ti,ab.                                           

17.          (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.                                   

18.          (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.                                           

19.          ((water or sanitation or sewerage) adj2 (suppl* or prov* or expan* or access or service* or system$1)).ti,ab.                                    

20.          (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.                                    

21.          ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.                             

22.          (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling*).ti,ab.                                              

23.          "Water Quality and Supply"/                                      

24.          or/12-23                                              

25.          11 and 24 

CENTRAL

#1      (poverty) and ("urban population" or "urban health" or urbanization):ti,ab,kw 

#2      "Poverty Areas":ti,ab,kw          

#3      (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*) :ti,ab,kw   

#4      ("informal shack*" or "irregular shack*" or "illegal shack*" or "shack dweller*" or shackdweller or "shack town*" or "skid row" or "urban blight squatter camp*" or "shack settlement*" or arrabal or asentamiento* or campamento* or cantegril* or comuna or comunas or "Pueblos jovene*" or barriada* or "Poblacion callampa" or tugurio or precario or chacarita or "tent cit*" or "informal cit*" or imijondolo*) :ti,ab,kw      

#5      (bustee* or gecekondu* or chawls* or basti or masseque* or "squatter cit*" or "katchi abadi*" or dharavi or kibera or "cite soleil" or khayelitsha or "orangi town"):ti,ab,kw

#6      (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos) :ti,ab,kw         

#7      ("public squalor" or "public squalor" or "squalid housing" or "squalid accommodation" or "human settlement development" or "urban poor"):ti,ab,kw           

#8      ((informal NEAR/2 shack*) or (informal NEAR/2 settlement*) or (irregular NEAR/2 settlement*) or (illegal NEAR/2 settlement*) or (informal NEAR/2 tenement*) or (irregular NEAR/2 tenement*) or (squatter NEAR/2 settlement*) or (squatter NEAR/2 area*) or (illegal NEAR/2 tenement*)):ti,ab,kw     

#9      ("kartonsko naselje" or "habitat precaire" or "habitat spontane" or "quartier irregulier" or "asentamiento irregular" or "colonia popular" or "villa miseria" or "ciudad perdida" or "edina achouaia" or "mudal safi" or "pelli gewal") :ti,ab,kw           

#10    ("cardboard cit*" or "tenement district*" or "tenement hous*" or "rundown neighborhood*" or "rundown neighbourhood*" or "rundown settlement*") :ti,ab,kw  

#11    (#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10)       

#12    ((secur* or land or propert) NEAR/2 (tenur* or rights or titl*)):ti,ab,kw

#13    ("Communit* involv*" or "participatory model*" or "participat* communit*" or "communit* manag*" or "communit* organi*" or "communit* group*"):ti,ab,kw 

#14    (kip or "permanent hous*" or "formal hous*" or "hous* building" or "new hous*"):ti,ab,kw      

#15    (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*):ti,ab,kw  

#16    ((waste or garbage or refuse) NEAR/2 (collect* OR service* OR "manag* dispos*" OR scheme* or remov*)):ti,ab,kw          

#17    ("sewer system*" or "buil* road*" or "new road*" or "road* buil*" or "access road*" or "drainage system" or "underground sewerage" or "street light*" or "pave* road*" or "pave* footpath*" or "pave* sidewalk" or pavement* or (infrastructure NEAR/2 develop*)):ti,ab,kw      

18      ("rain water collection" or "piped water" or "public tap*" or "tube well*" or standpipe* or "protected spring" or "dug well" or "deliver* water" or "septic tank*" or toilet* or "safe water" or borewell* or "bore well*" or "drinking water"):ti,ab,kw 

#19    ((water or sanitation or sewerage) NEAR/2 (suppl* OR prov* or expan* OR access or service* OR system$1)):ti,ab,kw      

#20    (subsid* or investment* or partnership* or microcredit or credit or "village bank*" or microcredit* or mortgage* or "social fund*" or microfinance or loan or loans or "monetary support" or "monetary assis*" or "financ* support" or "financ* assist*"):ti,ab,kw   

#21    ((storm NEAR/2 drain*) or (environment* NEAR/2 hazard*) or (mitigat* NEAR/2 hazard*) or electricity or gas or "power supply" or "energy supply" or utilities):ti,ab,kw        

#22    ("Housing strateg*" or "housing polic*" or "housing project*" or "housing program*" or "new* buil*" or "social housing*" or "SI project*" or "urban management" or manpower or capacity or "political accountability" or "scal* up" or home or homes or dwelling*):ti,ab,kw     

#23    ("water purification") or ("water supply") or ("urban renewal") or ("waste management") or ("urban renewal") or ("consumer participation"):ti,ab,kw      

#24    (#12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22 OR #23)          

#25    (#11 AND #24) 

CINAHL and Greenfile

S14  S12 and S13 

S13  S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 

S12  S9 or S10 or S11 

S11  TX(slum or slums) 

S10  TX (shanty OR shanties OR shantyhouse* OR favela* OR kampung) 

S9  TX ("informal settlement*" or "illegal settlement*" or "squatter settlement*") 

S8  TX (kip or housing or home or homes) 

S7  TX ("Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*") 

S6  TX (improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat*) 

S5  TX (road* OR drainage OR "street light*" OR sidewalk OR pavement* OR infrastructure) 

S4  TX (subsidy OR subsidi* OR investment* OR partnership* OR microcredit OR credit OR "village bank*" OR microcredit* OR mortgage* OR microfinance OR loan OR loans) 

 S3  TX ("storm drain*" OR electricity OR gas OR "power supply" OR "energy supply" OR utilities ) 

 S2  TX((waste or garbage or refuse) AND (collect* or manag* or service* or system* or dispos*)) 

 S1  TX ("public tap*" OR "tube well*" OR standpipe* OR "dug well" OR "septic tank*" OR toilet* OR "scal* up" or water OR sanitation OR sewerage) 

Current Controlled Trials Search Results

 (slum OR slums OR kampung* OR informal settlement OR urban poor OR squatter)

Ei compendex

( (((slum OR slums OR kampung* OR favela* OR bidon* OR tugurio* OR {informal settlement*} OR {illegal settlement*} OR {squatter settlement*} OR {shack settlement*} OR {shack dwell*})) WN KY) AND (1884-2011 WN YR)) AND (( (((kip OR housing OR home OR homes OR {Communit* involv*} OR {participatory model*} OR {participat* communit*} OR {communit* manag*} OR {communit* organi*} OR {communit* group*} OR improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat* OR road* OR drainage OR {street light*} OR sidewalk OR pavement* OR infrastructure OR subsidy OR subsidi* OR investment* OR partnership* OR microcredit OR credit OR {village bank*} OR microcredit* OR mortgage* OR microfinance OR loan OR loans OR {storm drain*} OR electricity OR gas OR {power supply} OR {energy supply} OR utilities OR {public tap*} OR {tube well*} OR standpipe* OR {dug well} OR {septic tank*} OR toilet* OR {scal* up} OR water OR sanitation OR sewerage)) WN KY) AND (1884-2011 WN YR)) OR ( ((((waste OR garbage OR refuse) AND (collect* OR manag* OR service* OR system* OR dispos*))) WN ALL) AND (1884-2011 WN YR))) 

ELDIS

Slum*, Barrio, Kampung*, Favela

EMBASE

1. (poverty/ or lowest income group/) and (urban population/ or urban area/ or urbanization/)

2. urban slum/

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement* or immigrant camp$1 or immigrant settlement$ or migrant camp$1 or migrant settlement$ or refugee camp$1 or refugee settlement$1).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect* or service* or manag* dispos* or scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl* or prov* or expan* or access or service* or system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling*).ti,ab.

23. water supply/ or sanitation/

24. or/12-23

25. 11 and 24 

Georef

1. urban environment/ and developing countries/

2. slum.ti,ab.

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement*).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect* or service* or manag* dispos* or scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl* or prov* or expan* or access or service* or system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling*).ti,ab.

23. waste disposal/ or water supply/ or drinking water/

24. or/12-23

25. 11 and 24

Global Health Library

Across all sources:

 (slum or slums or urban poor or informal settlement* or kampung* or squatter settlement* OR refugee camp*) AND (water OR sanitation OR improv* OR upgrad* OR develop* OR infrastructure* OR tenure* OR invest*)

HMIC

1. poverty/ and (urban areas/ or urban expansion/ or urban health/)

2. poverty/ and (urban areas/ or urban expansion/ or urban health/)

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement*).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect* or service*OR manag* dispos* or scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl*OR prov* or expan*OR access or service*OR system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling*).ti,ab.

23. Water supply distribution systems/ or exp Water supply/ or exp Water supply services/ or exp Surface water drainage/ or exp Waste water drainage/ or sanitation/ or urban renewal/ or urban regeneration/

24. or/12-23

25. 11 and 24 

ICONDA

1. slum.de.

2. informal settlements.de.

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement*).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect* or service* or manag* dispos* or scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl*OR prov* or expan* or access or service* or system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up).ti,ab.

23. (upgrading or upgrading program or upgrading slums).de.

24. or/12-23

25. 11 and 24

IDEAS

(slum | slums | favela | kampung) (upgrading | improving | redevelop | transform | water | sanitation).

IndMed

(slums) or (slum) or (kampung) or (barrio) or (kampungs)

Medcarib

(slum or slums or urban poor or informal settlement* or kampung* or squatter settlement* or barrio)

MEDLINE and MEDLINE in Process

1. poverty/ and (urban population/ or urban health/ or urbanization/)

2. Poverty Areas/

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement* or immigrant camp$1 or immigrant settlement$ or migrant camp$1 or migrant settlement$ or refugee camp$1 or refugee settlement$1).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect*OR service*OR manag* dispos*OR scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl* OR prov* or expan*OR access or service*OR system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling*).ti,ab.

23. water purification/ or water supply/ or urban renewal/ or waste management/ or urban renewal/ or consumer participation/

24. or/12-23

25. 11 and 24

 

PsycINFO

1. poverty/ and urban environment/

2. Poverty Areas/

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement*).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect* or service* or manag* dispos* or scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl*OR prov* or expan* or access or service* or system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling*).ti,ab.

23. water safety/ or housing/ or waste disposal/ or water quality/ or drinking water/ or housing.mp. or water safety/ [mp=title, abstract, heading word, table of contents, key concepts, original title, tests & measures]

24. or/12-23

25. 11 and 24

Planex

slum OR slums OR favela* OR Kampung* OR "informal settlement*"

REPIDISCA

(slum or slums or "urban poor" or "informal settlement*" or kampung* or "squatter settlement*" or barrio) AND (water OR sanitation OR improv* OR upgrad* OR develop* OR infrastructure* OR tenure* OR investment)

SCOPUS

((TITLE-ABS-KEY((secur* W/2 tenure*) OR (land W/2 titl*) OR (property W/2 titl*) OR (property W/2 rights) OR (land W/2 tenur*) OR (land W/2 rights) OR "development rights")) OR (TITLE-ABS-KEY("Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*")) OR (TITLE-ABS-KEY(kip OR "permanent hous*" OR "formal hous*" OR "hous* building" OR "new hous*")) OR (TITLE-ABS-KEY(improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat*)) OR (TITLE-ABS-KEY((waste W/2 collect*) OR (waste W/2 service*) OR (waste W/2 manag*) OR (waste W/2 dispos*) OR (garbage W/2 collect*) OR (disposal W/2 scheme) OR (disposal W/2 service*) OR (garbage W/2 manag*) OR (garbage W/2 dispos*) OR (garbage W/2 collect*) OR (refuse W/2 manag*) OR (refuse W/2 dispos*) OR (refuse W/2 collect*) OR (waste W/2 remov*) OR (refuse W/2 remov*) OR (garbage W/2 remov*))) OR (TITLE-ABS-KEY("sewer system*" OR "buil* road*" OR "new road*" OR "road* buil*" OR "access road*" OR "drainage system" OR "underground sewerage" OR "street light*" OR "pave* road*" OR "pave* footpath*" OR "pave* sidewalk" OR pavement* OR (infrastructure W/2 develop*))) OR (TITLE-ABS-KEY("rain water collection" OR "piped water" OR "public tap*" OR "tube well*" OR standpipe* OR "protected spring" OR "protected dug well" OR "deliver* water" OR "septic tank*" OR toilet* OR "safe water" OR borewell* OR "bore well*" OR "drinking water")) OR (TITLE-ABS-KEY((water W/2 suppl*) OR (water W/2 prov*) OR (water W/2 expansion) OR (water W/2 access) OR (water W/2 service*) OR (sanitation W/2 suppl*) OR (sanitation W/2 prov*) OR (sanitation W/2 expansion) OR (sanitation W/2 access) OR (sanitation W/2 service*) OR (sewerage W/2 suppl*) OR (sewerage W/2 prov*) OR (sewerage W/2 expansion) OR (water W/2 access) OR (sewerage W/2 service*) OR (water W/2 system*) OR (sanitation W/2 system*) OR (sewerage W/2 system*))) OR (TITLE-ABS-KEY(subsid* OR investment* OR partnership* OR microcredit OR credit OR "village bank*" OR microcredit* OR mortgage* OR "social fund*" OR microfinance OR loan OR loans OR "monetary support" OR "monetary assis*" OR "financ* support" OR "financ* assist")) OR (TITLE-ABS-KEY((storm W/2 drain*) OR (environment* W/2 hazard*) OR (mitigat* W/2 hazard*) OR electricity OR gas OR "power supply" OR "energy supply" OR utilities)) OR (TITLE-ABS-KEY("Housing strateg*" OR "housing polic*" OR "housing project*" OR "housing program*" OR "new* buil*" OR "social housing*" OR "SI project*" OR "urban management" OR manpower OR capacity OR political accountability OR "scal* up" OR home OR homes OR dwelling*))) AND ((TITLE-ABS-KEY(slum OR slums OR shanty OR shanties OR shantyhouse* OR barrio OR barrios OR favela* OR kampung OR tugurio* OR ghetto OR ghettos OR bidon OR bidons OR bidonville*)) OR (TITLE-ABS-KEY("informal shack*" OR "irregular shack*" OR "illegal shack*" OR "shack dweller*" OR "shackdweller*" OR "shack town*" OR "skid row" OR "urban blight" OR squatter camp* OR shack settlement*or arrabal OR asentamiento*or campamento* OR cantegril* OR comuna OR comunas OR " Pueblos jóvene*" OR barriada* OR "Poblacion callampa" OR tugurio OR precario OR chacarita OR tent cit*or informal cit*or imijondolo*)) OR (TITLE-ABS-KEY(bustee* OR gecekondu* OR chawls* OR basti OR masseque* OR "squatter cit*" OR "katchi abadi*" OR dharavi OR kibera OR "cite soleil" OR khayelitsha OR "orangi town")) OR (TITLE-ABS-KEY("kartonsko naselje" OR "habitat precaire" OR "habitat spontane" OR "quartier irregulier" OR "asentamiento irregular" OR "colonia popular" OR "villa* miseria" OR "ciudad perdida" OR "edina achouaia" OR "mudal safi" OR "pelli gewal")) OR (TITLE-ABS-KEY(lahbach OR elendsviertel OR brarek OR foundouks OR tanake OR aashwa* OR truschobi OR taudis OR morro OR loteamento OR comunidade OR ahata OR katra OR watta OR jhopadpatti OR umjondolo OR mabanda OR kijiji OR barraca* OR conventillos)) OR (TITLE-ABS-KEY("cardboard cit*" OR "tenement district*" OR "tenement hous*" OR "rundown neighborhood*" OR "rundown neighbourhood*" OR "rundown settlement*")) OR (TITLE-ABS-KEY("public squalor" OR "public squalor" OR "squalid housing" OR "squalid accommodation" OR "human settlement development" OR "urban poor")) OR (TITLE-ABS-KEY((informal W/2 shack*) OR (informal W/2 settlement*) OR (irregular W/2 settlement*) OR (illegal W/2 settlement*) OR (informal W/2 tenement*) OR (irregular W/2 tenement*) OR (squatter W/2 settlement*) OR (squatter W/2 area*) OR (illegal W/2 tenement*))))

Web of Science (SSCI and SCI)

# 6          #5 OR #4

# 5          #3 AND #1

# 4          #3 AND #2

# 3          TS=((informal OR illegal OR informal) SAME (settlement*)) OR TS=(slum OR slums OR shanty OR shanties OR shantyhouse* OR barrio OR barrios OR favela* OR kampung)

# 2          TS=(road* OR drainage OR "street light*" OR sidewalk OR pavement* OR infrastructure) OR TS=(improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat*) OR TS=("Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*") OR TS=((informal OR illegal OR informal) SAME (settlement*))

# 1          TS=(kip or housing or home* OR "public tap*" OR "tube well*" OR standpipe* OR "dug well" OR "septic tank*" OR toilet* OR "scal* up") OR TS=(water OR sanitation OR sewerage) OR TS=(waste or garbage or refuse) OR TS=("storm drain*" OR electricity OR gas OR "power supply" OR "energy supply" OR utilities ) OR TS=(subsid* OR investment* OR partnership* OR microcredit OR credit OR village bank* OR microcredit* OR mortgage* OR social fund* OR microfinance OR loan OR loans)

Databases=SCI-EXPANDED, SSCI Timespan=1955-2011  

3ie impact database

The following individual terms were searched: slum, slums, urban poor, informal settlement, informal settlements, kampung, squatter, barrio, favela.

 

Update searches - April 2012

ASSIA, AVERY, BNI and Sociological abstracts (via Proquest)

S14         s13 and s12

S13         S9 or s10 or s11

 S12        S1 or S2 or S3 or S4 or s5 or s6 or s7 or s8

 S11        ALL(slum or slums)

 S10        ALL(shanty OR shanties OR shantyhouse* OR favela* OR kampung)

S9           ALL("informal settlement*" or "illegal settlement*" or "squatter settlement*")

S8           ALL(kip or housing or home or homes)

S7           ALL("Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*")

S6           ALL(improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat*)

 S5          ALL(road* OR drainage OR "street light*" OR sidewalk OR pavement* OR infrastructure)

 S4          ALL(subsidy OR subsidi* OR investment* OR partnership* OR microcredit OR credit OR "village bank*" OR microcredit* OR mortgage* OR microfinance OR loan OR loans)

 S3          ALL("storm drain*" OR electricity OR gas OR "power supply" OR "energy supply" OR utilities)

 S2          ALL((waste or garbage or refuse) AND (collect* or manag* or service* or system* or dispos*))

S1           ALL("public tap*" OR "tube well*" OR standpipe* OR "dug well" OR "septic tank*" OR toilet* OR "scal* up" or water OR sanitation OR sewerage )

CENTRAL

#1      (poverty) and ("urban population" or "urban health" or urbanization):ti,ab,kw 

#2      "Poverty Areas":ti,ab,kw          

#3      (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*) :ti,ab,kw   

#4      ("informal shack*" or "irregular shack*" or "illegal shack*" or "shack dweller*" or shackdweller or "shack town*" or "skid row" or "urban blight squatter camp*" or "shack settlement*" or arrabal or asentamiento* or campamento* or cantegril* or comuna or comunas or "Pueblos jovene*" or barriada* or "Poblacion callampa" or tugurio or precario or chacarita or "tent cit*" or "informal cit*" or imijondolo*) :ti,ab,kw      

#5      (bustee* or gecekondu* or chawls* or basti or masseque* or "squatter cit*" or "katchi abadi*" or dharavi or kibera or "cite soleil" or khayelitsha or "orangi town"):ti,ab,kw

#6      (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos) :ti,ab,kw         

#7      ("public squalor" or "public squalor" or "squalid housing" or "squalid accommodation" or "human settlement development" or "urban poor"):ti,ab,kw           

#8      ((informal NEAR/2 shack*) or (informal NEAR/2 settlement*) or (irregular NEAR/2 settlement*) or (illegal NEAR/2 settlement*) or (informal NEAR/2 tenement*) or (irregular NEAR/2 tenement*) or (squatter NEAR/2 settlement*) or (squatter NEAR/2 area*) or (illegal NEAR/2 tenement*)):ti,ab,kw     

#9      ("kartonsko naselje" or "habitat precaire" or "habitat spontane" or "quartier irregulier" or "asentamiento irregular" or "colonia popular" or "villa miseria" or "ciudad perdida" or "edina achouaia" or "mudal safi" or "pelli gewal") :ti,ab,kw           

#10    ("cardboard cit*" or "tenement district*" or "tenement hous*" or "rundown neighborhood*" or "rundown neighbourhood*" or "rundown settlement*") :ti,ab,kw  

#11    (#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10)       

#12    ((secur* or land or propert) NEAR/2 (tenur* or rights or titl*)):ti,ab,kw

#13    ("Communit* involv*" or "participatory model*" or "participat* communit*" or "communit* manag*" or "communit* organi*" or "communit* group*"):ti,ab,kw 

#14    (kip or "permanent hous*" or "formal hous*" or "hous* building" or "new hous*"):ti,ab,kw      

#15    (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*):ti,ab,kw  

#16    ((waste or garbage or refuse) NEAR/2 (collect* OR service* OR "manag* dispos*" OR scheme* or remov*)):ti,ab,kw          

#17    ("sewer system*" or "buil* road*" or "new road*" or "road* buil*" or "access road*" or "drainage system" or "underground sewerage" or "street light*" or "pave* road*" or "pave* footpath*" or "pave* sidewalk" or pavement* or (infrastructure NEAR/2 develop*)):ti,ab,kw      

18      ("rain water collection" or "piped water" or "public tap*" or "tube well*" or standpipe* or "protected spring" or "dug well" or "deliver* water" or "septic tank*" or toilet* or "safe water" or borewell* or "bore well*" or "drinking water"):ti,ab,kw 

#19    ((water or sanitation or sewerage) NEAR/2 (suppl* OR prov* or expan* OR access or service* OR system$1)):ti,ab,kw      

#20    (subsid* or investment* or partnership* or microcredit or credit or "village bank*" or microcredit* or mortgage* or "social fund*" or microfinance or loan or loans or "monetary support" or "monetary assis*" or "financ* support" or "financ* assist*"):ti,ab,kw   

#21    ((storm NEAR/2 drain*) or (environment* NEAR/2 hazard*) or (mitigat* NEAR/2 hazard*) or electricity or gas or "power supply" or "energy supply" or utilities):ti,ab,kw        

#22    ("Housing strateg*" or "housing polic*" or "housing project*" or "housing program*" or "new* buil*" or "social housing*" or "SI project*" or "urban management" or manpower or capacity or "political accountability" or "scal* up" or home or homes or dwelling*):ti,ab,kw     

#23    ("water purification") or ("water supply") or ("urban renewal") or ("waste management") or ("urban renewal") or ("consumer participation"):ti,ab,kw      

#24    (#12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22 OR #23)          

#25    (#11 AND #24) 

CINAHL (via EBSCOhost)

S14  S12 and S13 

S13  S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 

S12  S9 or S10 or S11 

S11  TI ( slum or slums ) OR SU ( slum or slums ) OR AB ( slum or slums ) OR KW ( slum or slums ) 

S10 TI ( (shanty OR shanties OR shantyhouse* OR favela* OR kampung) ) OR AB ( (shanty OR shanties OR shantyhouse* OR favela* OR kampung) ) OR MW ( (shanty OR shanties OR shantyhouse* OR favela* OR kampung) ) 

S9 TI ( ("informal settlement*" or "illegal settlement*" or "squatter settlement*") ) OR AB ( ("informal settlement*" or "illegal settlement*" or "squatter settlement*") ) OR MW ( ("informal settlement*" or "illegal settlement*" or "squatter settlement*") ) 

S8  TX (kip or housing or home or homes) 

S7  TX ("Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*") 

S6  TX (improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat*) 

S5  TX (road* OR drainage OR "street light*" OR sidewalk OR pavement* OR infrastructure) 

S4  TX (subsidy OR subsidi* OR investment* OR partnership* OR microcredit OR credit OR "village bank*" OR microcredit* OR mortgage* OR microfinance OR loan OR loans) 

 S3  TX ("storm drain*" OR electricity OR gas OR "power supply" OR "energy supply" OR utilities ) 

 S2  TX((waste or garbage or refuse) AND (collect* or manag* or service* or system* or dispos*)) 

 S1  TX ("public tap*" OR "tube well*" OR standpipe* OR "dug well" OR "septic tank*" OR toilet* OR "scal* up" or water OR sanitation OR sewerage)

Cochrane Public Health Specialised Register

Searched titles and abstracts with the following keywords: slum, slums, squatters, barrio, barrios, favela, favelas, shanty

Current Controlled Trials Search Results

 (slum OR slums OR kampung* OR informal settlement OR urban poor OR squatter)

 Ei compendex

( (((slum OR slums OR kampung* OR favela* OR bidon* OR tugurio* OR {informal settlement*} OR {illegal settlement*} OR {squatter settlement*} OR {shack settlement*} OR {shack dwell*})) WN KY) AND (1884-2011 WN YR)) AND (( (((kip OR housing OR home OR homes OR {Communit* involv*} OR {participatory model*} OR {participat* communit*} OR {communit* manag*} OR {communit* organi*} OR {communit* group*} OR improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat* OR road* OR drainage OR {street light*} OR sidewalk OR pavement* OR infrastructure OR subsidy OR subsidi* OR investment* OR partnership* OR microcredit OR credit OR {village bank*} OR microcredit* OR mortgage* OR microfinance OR loan OR loans OR {storm drain*} OR electricity OR gas OR {power supply} OR {energy supply} OR utilities OR {public tap*} OR {tube well*} OR standpipe* OR {dug well} OR {septic tank*} OR toilet* OR {scal* up} OR water OR sanitation OR sewerage)) WN KY) AND (1884-2011 WN YR)) OR ( ((((waste OR garbage OR refuse) AND (collect* OR manag* OR service* OR system* OR dispos*))) WN ALL) AND (1884-2011 WN YR)))

ELDIS

Slum*, Barrio, Kampung*, Favela

EMBASE

1. (poverty/ or lowest income group/) and (urban population/ or urban area/ or urbanization/)

2. urban slum/

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement* or immigrant camp$1 or immigrant settlement$ or migrant camp$1 or migrant settlement$ or refugee camp$1 or refugee settlement$1).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect* or service* or manag* dispos* or scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl* or prov* or expan* or access or service* or system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling*).ti,ab.

23. water supply/ or sanitation/

24. ((electric adj2 cooker*) or (electric adj2 cookstove*) or (electric adj2 stove*) or (electric adj2 stoves) or (electric* adj2 provid*) or (electric* adj2 provis*) or (electric* adj2 suppl*) or (garbage adj2 service*) or (gas adj2 cooker*) or (gas adj2 cookstove*) or (gas adj2 stove*) or (gas adj2 stoves) or (improv* adj2 cooker*) or (improv* adj2 cookstove*) or (improv* adj2 stove*) or (improv* adj2 stoves) or (lpg adj2 cooker*) or (lpg adj2 cookstove*) or (lpg adj2 stove*) or (lpg adj2 stoves)).ti,ab.

25. (floor or floors or flooring or flood protect* or ground stabili* or slope stabili* or (mitigat* adj2 landslide) or (drain* adj2 stormwater*) or (drain* adj2 surface) or (drain* adj2 system*) or (drain* adj2 water*) or (sewage adj2 collect*) or (sewage adj2 dispos*) or (sewage adj2 manag*) or (sewage adj2 remov*) or (sewage adj2 service*) or (sewage adj2 system*) or (sewage adj2 treatment*) or (sewer* adj2 collect*) or (sewer* adj2 dispos*) or (sewer* adj2 expansion) or (sewer* adj2 manag*) or (sewer* adj2 prov*) or (sewer* adj2 remov*) or (sewer* adj2 service*) or (sewer* adj2 suppl*) or (sewer* adj2 system*) or (sewer* adj2 treatment*) or (trash adj2 collect*) or (trash adj2 dispos*) or (trash adj2 dispos*) or (trash adj2 manag*) or (trash adj2 remov*) or (trash adj2 service*) or (waste adj2 scheme*) or (manag* adj2 stormwater*) or (manag* adj2 surface water)).ti,ab.

26. or/12-25

27. 11 and 26

Georef

No access for update search

Global Health Library

Across all sources:

 (slum or slums or urban poor or informal settlement* or kampung* or squatter settlement* OR refugee camp*) AND (water OR sanitation OR improv* OR upgrad* OR develop* OR infrastructure* OR tenure* OR invest*)

Greenfile (via EBSCOhost)

S14  S12 and S13 

S13  S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 

S12  S9 or S10 or S11 

S11  TI ( slum or slums ) OR SU ( slum or slums ) OR AB ( slum or slums ) OR KW ( slum or slums ) 

S10  TX (shanty OR shanties OR shantyhouse* OR favela* OR kampung) 

S9  TX ("informal settlement*" or "illegal settlement*" or "squatter settlement*") 

S8  TX (kip or housing or home or homes) 

S7  TX ("Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*") 

S6  TX (improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat*) 

S5  TX (road* OR drainage OR "street light*" OR sidewalk OR pavement* OR infrastructure) 

S4  TX (subsidy OR subsidi* OR investment* OR partnership* OR microcredit OR credit OR "village bank*" OR microcredit* OR mortgage* OR microfinance OR loan OR loans) 

 S3  TX ("storm drain*" OR electricity OR gas OR "power supply" OR "energy supply" OR utilities ) 

 S2  TX((waste or garbage or refuse) AND (collect* or manag* or service* or system* or dispos*)) 

 S1  TX ("public tap*" OR "tube well*" OR standpipe* OR "dug well" OR "septic tank*" OR toilet* OR "scal* up" or water OR sanitation OR sewerage)

HMIC

1. poverty/ and (urban areas/ or urban expansion/ or urban health/)

2. poverty/ and (urban areas/ or urban expansion/ or urban health/)

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement* or immigrant camp$1 or immigrant settlement$ or migrant camp$1 or migrant settlement$ or refugee camp$1 or refugee settlement$1).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect* or service*OR manag* dispos* or scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl* or prov* or expan* or access or service* or system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling*).ti,ab.

23. Water supply distribution systems/ or exp Water supply/ or exp Water supply services/ or exp Surface water drainage/ or exp Waste water drainage/ or sanitation/ or urban renewal/ or urban regeneration/

24. (floor or floors or flooring or flood protect* or ground stabili* or slope stabili* or (mitigat* adj2 landslide) or (drain* adj2 stormwater*) or (drain* adj2 surface) or (drain* adj2 system*) or (drain* adj2 water*) or (sewage adj2 collect*) or (sewage adj2 dispos*) or (sewage adj2 manag*) or (sewage adj2 remov*) or (sewage adj2 service*) or (sewage adj2 system*) or (sewage adj2 treatment*) or (sewer* adj2 collect*) or (sewer* adj2 dispos*) or (sewer* adj2 expansion) or (sewer* adj2 manag*) or (sewer* adj2 prov*) or (sewer* adj2 remov*) or (sewer* adj2 service*) or (sewer* adj2 suppl*) or (sewer* adj2 system*) or (sewer* adj2 treatment*) or (trash adj2 collect*) or (trash adj2 dispos*) or (trash adj2 dispos*) or (trash adj2 manag*) or (trash adj2 remov*) or (trash adj2 service*) or (waste adj2 scheme*) or (manag* adj2 stormwater*) or (manag* adj2 surface water)).ti,ab.

25. ((electric adj2 cooker*) or (electric adj2 cookstove*) or (electric adj2 stove*) or (electric adj2 stoves) or (electric* adj2 provid*) or (electric* adj2 provis*) or (electric* adj2 suppl*) or (garbage adj2 service*) or (gas adj2 cooker*) or (gas adj2 cookstove*) or (gas adj2 stove*) or (gas adj2 stoves) or (improv* adj2 cooker*) or (improv* adj2 cookstove*) or (improv* adj2 stove*) or (improv* adj2 stoves) or (lpg adj2 cooker*) or (lpg adj2 cookstove*) or (lpg adj2 stove*) or (lpg adj2 stoves)).ti,ab.

26. or/12-25

27. 11 and 26

ICONDA

1. slum.de.

2. informal settlements.de.

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement* or immigrant camp$1 or immigrant settlement$ or migrant camp$1 or migrant settlement$ or refugee camp$1 or refugee settlement$1).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect* or service* or manag* dispos* or scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl*OR prov* or expan* or access or service* or system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up).ti,ab.

23. (upgrading or upgrading program or upgrading slums).de.

24. (floor or floors or flooring or flood protect* or ground stabili* or slope stabili* or (mitigat* adj2 landslide) or (drain* adj2 stormwater*) or (drain* adj2 surface) or (drain* adj2 system*) or (drain* adj2 water*) or (sewage adj2 collect*) or (sewage adj2 dispos*) or (sewage adj2 manag*) or (sewage adj2 remov*) or (sewage adj2 service*) or (sewage adj2 system*) or (sewage adj2 treatment*) or (sewer* adj2 collect*) or (sewer* adj2 dispos*) or (sewer* adj2 expansion) or (sewer* adj2 manag*) or (sewer* adj2 prov*) or (sewer* adj2 remov*) or (sewer* adj2 service*) or (sewer* adj2 suppl*) or (sewer* adj2 system*) or (sewer* adj2 treatment*) or (trash adj2 collect*) or (trash adj2 dispos*) or (trash adj2 dispos*) or (trash adj2 manag*) or (trash adj2 remov*) or (trash adj2 service*) or (waste adj2 scheme*) or (manag* adj2 stormwater*) or (manag* adj2 surface water)).ti,ab.

25. ((electric adj2 cooker*) or (electric adj2 cookstove*) or (electric adj2 stove*) or (electric adj2 stoves) or (electric* adj2 provid*) or (electric* adj2 provis*) or (electric* adj2 suppl*) or (garbage adj2 service*) or (gas adj2 cooker*) or (gas adj2 cookstove*) or (gas adj2 stove*) or (gas adj2 stoves) or (improv* adj2 cooker*) or (improv* adj2 cookstove*) or (improv* adj2 stove*) or (improv* adj2 stoves) or (lpg adj2 cooker*) or (lpg adj2 cookstove*) or (lpg adj2 stove*) or (lpg adj2 stoves)).ti,ab.

26. or/12-25

27. 26 and 11

IDEAS

(slum | slums | favela | kampung) (upgrading | improving | redevelop | transform | water | sanitation).

IndMed

(slums) or (slum) or (kampung) or (barrio) or (kampungs)

Jolis

Keywords anywhere "slum or slums or kampung$ or favela$" AND Keywords anywhere "upgrad$ or improv$"

Medcarib

(slum or slums or urban poor or informal settlement* or kampung* or squatter settlement* or barrio)

MEDLINE and MEDLINE in Process

1. poverty/ and (urban population/ or urban health/ or urbanization/)

2. Poverty Areas/

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement* or immigrant camp$1 or immigrant settlement$ or migrant camp$1 or migrant settlement$ or refugee camp$1 or refugee settlement$1).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect*OR service*OR manag* dispos*OR scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl* or prov* or expan* or access or service* or system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling* or floor or floors or flooring).ti,ab.

23. water purification/ or water supply/ or urban renewal/ or waste management/ or urban renewal/ or consumer participation/

24. (flood protect* or ground stabili* or slope stabili* or (mitigat* adj2 landslide) or (drain* adj2 stormwater*) or (drain* adj2 surface) or (drain* adj2 system*) or (drain* adj2 water*) or (sewage adj2 collect*) or (sewage adj2 dispos*) or (sewage adj2 manag*) or (sewage adj2 remov*) or (sewage adj2 service*) or (sewage adj2 system*) or (sewage adj2 treatment*) or (sewer* adj2 collect*) or (sewer* adj2 dispos*) or (sewer* adj2 expansion) or (sewer* adj2 manag*) or (sewer* adj2 prov*) or (sewer* adj2 remov*) or (sewer* adj2 service*) or (sewer* adj2 suppl*) or (sewer* adj2 system*) or (sewer* adj2 treatment*) or (trash adj2 collect*) or (trash adj2 dispos*) or (trash adj2 dispos*) or (trash adj2 manag*) or (trash adj2 remov*) or (trash adj2 service*) or (waste adj2 scheme*) or (manag* adj2 stormwater*) or (manag* adj2 surface water)).ti,ab.

25. ((electric adj2 cooker*) or (electric adj2 cookstove*) or (electric adj2 stove*) or (electric adj2 stoves) or (electric* adj2 provid*) or (electric* adj2 provis*) or (electric* adj2 suppl*) or (garbage adj2 service*) or (gas adj2 cooker*) or (gas adj2 cookstove*) or (gas adj2 stove*) or (gas adj2 stoves) or (improv* adj2 cooker*) or (improv* adj2 cookstove*) or (improv* adj2 stove*) or (improv* adj2 stoves) or (lpg adj2 cooker*) or (lpg adj2 cookstove*) or (lpg adj2 stove*) or (lpg adj2 stoves)).ti,ab.

26. or/12-25

27. 11 and 26

PsycINFO

1. poverty/ and urban environment/

2. Poverty Areas/

3. (slum or slums or shanty or shanties or shantyhouse* or barrio or barrios or favela* or kampung or tugurio* or ghetto or ghettos or bidon or bidons or bidonville*).ti,ab.

4. (informal shack* or irregular shack* or illegal shack* or shack dweller* or shackdweller or shack town* or skid row or urban blight squatter camp* or shack settlement* or arrabal or asentamiento*or campamento* or cantegril* or comuna or comunas or Pueblos jovene* or barriada* or Poblacion callampa or tugurio or precario or chacarita or tent cit* or informal cit* or imijondolo*).ti,ab.

5. (bustee* or gecekondu* or chawls* or basti or masseque* or squatter cit* or katchi abadi* or dharavi or kibera or cite soleil or khayelitsha or orangi town).ti,ab.

6. (kartonsko naselje or habitat precaire or habitat spontane or quartier irregulier or asentamiento irregular or colonia popular or villa miseria or ciudad perdida or edina achouaia or mudal safi or pelli gewal).ti,ab.

7. (lahbach or elendsviertel or brarek or foundouks or tanake or aashwa or truschobi or taudis or morro or loteamento or comunidade or ahata or katra or watta or jhopadpatti or umjondolo or mabanda or kijiji or barraca or conventillos).ti,ab.

8. (cardboard cit* or tenement district* or tenement hous* or rundown neighborhood* or rundown neighbourhood* or rundown settlement* or immigrant camp$1 or immigrant settlement$ or migrant camp$1 or migrant settlement$ or refugee camp$1 or refugee settlement$1).ti,ab.

9. (public squalor or public squalor or squalid housing or squalid accommodation or human settlement development or urban poor).ti,ab.

10. ((informal adj2 shack*) or (informal adj2 settlement*) or (irregular adj2 settlement*) or (illegal adj2 settlement*) or (informal adj2 tenement*) or (irregular adj2 tenement*) or (squatter adj2 settlement*) or (squatter adj2 area*) or (illegal adj2 tenement*)).ti,ab.

11. or/1-10

12. ((secur* or land or propert) adj2 (tenur* or rights or titl*)).ti,ab.

13. (Communit* involv* or participatory model* or participat* communit* or communit* manag* or communit* organi* or communit* group*).ti,ab.

14. (kip or permanent hous* or formal hous* or hous* building or new hous*).ti,ab.

15. (improv* or upgrad* or transform* or retransform* or redevelop* or renewal or rehabilit* or regenerat*).ti,ab.

16. ((waste or garbage or refuse) adj2 (collect* or service* or manag* dispos* or scheme* or remov*)).ti,ab.

17. (sewer system* or buil* road* or new road* or road* buil* or access road* or drainage system or underground sewerage or street light* or pave* road* or pave* footpath* or pave* sidewalk or pavement* or (infrastructure adj2 develop*)).ti,ab.

18. (rain water collection or piped water or public tap* or tube well* or standpipe* or protected spring or dug well or deliver* water or septic tank* or toilet* or safe water or borewell* or bore well* or drinking water).ti,ab.

19. ((water or sanitation or sewerage) adj2 (suppl*OR prov* or expan* or access or service* or system$1)).ti,ab.

20. (subsid* or investment* or partnership* or microcredit or credit or village bank* or microcredit* or mortgage* or social fund* or microfinance or loan or loans or monetary support or monetary assis* or financ* support or financ* assist*).ti,ab.

21. ((storm adj2 drain*) or (environment* adj2 hazard*) or (mitigat* adj2 hazard*) or electricity or gas or power supply or energy supply or utilities).ti,ab.

22. (Housing strateg* or housing polic* or housing project* or housing program* or new* buil* or social housing* or SI project* or urban management or manpower or capacity or political accountability or scal* up or home or homes or dwelling*).ti,ab.

23. water safety/ or housing/ or waste disposal/ or water quality/ or drinking water/ or housing.mp. or water safety/ [mp=title, abstract, heading word, table of contents, key concepts, original title, tests & measures]

24. ((electric adj2 cooker*) or (electric adj2 cookstove*) or (electric adj2 stove*) or (electric adj2 stoves) or (electric* adj2 provid*) or (electric* adj2 provis*) or (electric* adj2 suppl*) or (garbage adj2 service*) or (gas adj2 cooker*) or (gas adj2 cookstove*) or (gas adj2 stove*) or (gas adj2 stoves) or (improv* adj2 cooker*) or (improv* adj2 cookstove*) or (improv* adj2 stove*) or (improv* adj2 stoves) or (lpg adj2 cooker*) or (lpg adj2 cookstove*) or (lpg adj2 stove*) or (lpg adj2 stoves)).ti,ab.

25. (floor or floors or flooring or flood protect* or ground stabili* or slope stabili* or (mitigat* adj2 landslide) or (drain* adj2 stormwater*) or (drain* adj2 surface) or (drain* adj2 system*) or (drain* adj2 water*) or (sewage adj2 collect*) or (sewage adj2 dispos*) or (sewage adj2 manag*) or (sewage adj2 remov*) or (sewage adj2 service*) or (sewage adj2 system*) or (sewage adj2 treatment*) or (sewer* adj2 collect*) or (sewer* adj2 dispos*) or (sewer* adj2 expansion) or (sewer* adj2 manag*) or (sewer* adj2 prov*) or (sewer* adj2 remov*) or (sewer* adj2 service*) or (sewer* adj2 suppl*) or (sewer* adj2 system*) or (sewer* adj2 treatment*) or (trash adj2 collect*) or (trash adj2 dispos*) or (trash adj2 dispos*) or (trash adj2 manag*) or (trash adj2 remov*) or (trash adj2 service*) or (waste adj2 scheme*) or (manag* adj2 stormwater*) or (manag* adj2 surface water)).ti,ab.

26. or/12-25

27. 11 and 26

Planex

slum OR slums OR favela* OR Kampung* OR "informal settlement*"

SCOPUS

#1        (TITLE-ABS-KEY(slum OR slums OR shanty OR shanties OR shantyhouse* OR barrio OR barrios OR favela* OR kampung OR tugurio* OR ghetto OR ghettos OR bidon OR bidons OR bidonville*))

#2        (TITLE-ABS-KEY((informal W/2 shack*) OR (informal W/2 housing) OR (informal W/2 settlement*) OR (irregular W/2 settlement*) OR (illegal W/2 settlement*) OR (informal W/2 tenement*) OR (irregular W/2 tenement*) OR (squatter W/2 settlement*) OR (squatter W/2 area*) OR (illegal W/2 tenement*)))

#3        (TITLE-ABS-KEY("public squalor" OR "public squalor" OR "squalid housing" OR "squalid accommodation" OR "human settlement development" OR "urban poor"))

#4        (TITLE-ABS-KEY("cardboard cit*" OR "tenement district*" OR "tenement hous*" OR "rundown neighborhood*" OR "rundown neighbourhood*" OR "rundown settlement*"))

#5        (TITLE-ABS-KEY(lahbach OR elendsviertel OR brarek OR foundouks OR tanake OR aashwa* OR truschobi OR taudis OR morro OR loteamento OR comunidade OR ahata OR katra OR watta OR jhopadpatti OR umjondolo OR mabanda OR kijiji OR barraca* OR conventillos))

#6        (TITLE-ABS-KEY("kartonsko naselje" OR "habitat precaire" OR "habitat spontane" OR "quartier irregulier" OR "asentamiento irregular" OR "colonia popular" OR "villa* miseria" OR "ciudad perdida" OR "edina achouaia" OR "mudal safi" OR "pelli gewal"))

#7        (TITLE-ABS-KEY(bustee* OR gecekondu* OR chawls* OR basti OR masseque* OR "squatter cit*" OR "katchi abadi*" OR dharavi OR kibera OR "cite soleil" OR khayelitsha OR "orangi town"))

#8        (TITLE-ABS-KEY("informal shack*" OR "irregular shack*" OR "illegal shack*" OR "shack dweller*" OR "shackdweller*" OR "shack town*" OR "skid row" OR "urban blight" OR squatter camp* OR shack settlement* OR arrabal OR asentamiento* OR campamento* OR cantegril* OR comuna OR comunas OR " Pueblos jóvene*" OR barriada* OR "Poblacion callampa" OR tugurio OR precario OR chacarita OR tent cit* OR informal cit* OR imijondolo* OR migrant camp* OR migrant settlement* OR refugee camp* OR refugee settlement*))

#9        #1 or #2 or #3 or #4 or #5 or #6 or #7 or #8

#10      (TITLE-ABS-KEY(improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat*))

#11      (TITLE-ABS-KEY("flood protect*" OR "ground stabili*" OR "slope stabili*" OR (mitigat* W/2 landslide) OR (drain* W/2 stormwater*) OR (drain* W/2 surface) OR (drain* W/2 system*) OR (drain* W/2 water*) OR (sewage W/2 collect*) OR (sewage W/2 dispos*) OR (sewage W/2 manag*) OR (sewage W/2 remov*) OR (sewage W/2 service*) OR (sewage W/2 system*) OR (sewage W/2 treatment*) OR (sewer* W/2 collect*) OR (sewer* W/2 dispos*) OR (sewer* W/2 expansion) OR (sewer* W/2 manag*) OR (sewer* W/2 prov*) OR (sewer* W/2 remov*) OR (sewer* W/2 service*) OR (sewer* W/2 suppl*) OR (sewer* W/2 system*) OR (sewer* W/2 treatment*) OR (trash W/2 collect*) OR (trash W/2 dispos*) OR (trash W/2 dispos*) OR (trash W/2 manag*) OR (trash W/2 remov*) OR (trash W/2 service*) OR (waste W/2 scheme*) OR (manag* W/2 stormwater*) OR (manag* W/2 surface water)))

#12      (TITLE-ABS-KEY(electric W/2 cooker*) OR (electric W/2 cookstove*) OR (electric W/2 stove*) OR (electric W/2 stoves) OR (electric* W/2 provid*) OR (electric* W/2 provis*) OR (electric* W/2 suppl*) OR (garbage W/2 service*) OR (gas W/2 cooker*) OR (gas W/2 cookstove*) OR (gas W/2 stove*) OR (gas W/2 stoves) OR (improv* W/2 cooker*) OR (improv* W/2 cookstove*) OR (improv* W/2 stove*) OR (improv* W/2 stoves) OR (lpg W/2 cooker*) OR (lpg W/2 cookstove*) OR (lpg W/2 stove*) OR (lpg W/2 stoves))

#13      (TITLE-ABS-KEY((water W/2 suppl*) OR (water W/2 prov*) OR (water W/2 expansion) OR (water W/2 access) OR (water W/2 service*) OR (sanitation W/2 suppl*) OR (sanitation W/2 prov*) OR (sanitation W/2 expansion) OR (sanitation W/2 access) OR (sanitation W/2 service*) OR (sewerage W/2 suppl*) OR (sewerage W/2 prov*) OR (sewerage W/2 expansion) OR (water W/2 access) OR (sewerage W/2 service*) OR (water W/2 system*) OR (sanitation W/2 system*) OR (sewerage W/2 system*)))

#14      (TITLE-ABS-KEY("rain water collection" OR "piped water" OR "public tap*" OR "tube well*" OR standpipe* OR "protected spring" OR "protected dug well" OR "deliver* water" OR "septic tank*" OR toilet* OR "safe water" OR borewell* OR "bore well*" OR "drinking water"))

#15      (TITLE-ABS-KEY("sewer system*" OR "buil* road*" OR "new road*" OR "road* buil*" OR "access road*" OR "drainage system" OR "underground sewerage" OR "street light*" OR "pave* road*" OR "pave* footpath*" OR "pave* sidewalk" OR pavement* OR (infrastructure W/2 develop*)))

#16      (TITLE-ABS-KEY((waste W/2 collect*) OR (waste W/2 service*) OR (waste W/2 manag*) OR (waste W/2 dispos*) OR (garbage W/2 collect*) OR (disposal W/2 scheme) OR (disposal W/2 service*) OR (garbage W/2 manag*) OR (garbage W/2 dispos*) OR (garbage W/2 collect*) OR (refuse W/2 manag*) OR (refuse W/2 dispos*) OR (refuse W/2 collect*) OR (waste W/2 remov*) OR (refuse W/2 remov*) OR (garbage W/2 remov*)))

#17      (TITLE-ABS-KEY((storm W/2 drain*) OR (environment* W/2 hazard*) OR (mitigat* W/2 hazard*) OR electricity OR gas OR "power supply" OR "energy supply" OR utilities))

#18      (TITLE-ABS-KEY("Housing strateg*" OR "housing polic*" OR "housing project*" OR "housing program*" OR "new* buil*" OR "social housing*" OR "SI project*" OR "urban management" OR manpower OR capacity OR political accountability OR "scal* up" OR home OR homes OR dwelling*))

#19      (TITLE-ABS-KEY((secur* W/2 tenure*) OR (land W/2 titl*) OR (property W/2 titl*) OR (property W/2 rights) OR (land W/2 tenur*) OR (land W/2 rights) OR "development rights"))

#20      (TITLE-ABS-KEY("Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*"))

#21      (TITLE-ABS-KEY(kip OR "permanent hous*" OR "formal hous*" OR "hous* building" OR "new hous*"))

#22      (TITLE-ABS-KEY(subsid* OR investment* OR partnership* OR microcredit OR credit OR "village bank*" OR microcredit* OR mortgage* OR "social fund*" OR microfinance OR loan OR loans OR "monetary support" OR "monetary assis*" OR "financ* support" OR "financ* assist"))

#23      #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22

REPIDISCA

(slum or slums or "urban poor" or "informal settlement*" or kampung* or "squatter settlement*" or barrio) AND (water OR sanitation OR improv* OR upgrad* OR develop* OR infrastructure* OR tenure* OR investment)

Web of Science (SSCI and SCI)

# 6          #5 OR #4

# 5          #3 AND #1

# 4          #3 AND #2

# 3          TS=((informal OR illegal OR informal) SAME (settlement*)) OR TS=(slum OR slums OR shanty OR shanties OR shantyhouse* OR barrio OR barrios OR favela* OR kampung)

# 2          TS=(road* OR drainage OR "street light*" OR sidewalk OR pavement* OR infrastructure) OR TS=(improv* OR upgrad* OR transform* OR retransform* OR redevelop* OR renewal OR rehabilit* OR regenerat*) OR TS=("Communit* involv*" OR "participatory model*" OR "participat* communit*" OR "communit* manag*" OR "communit* organi*" OR "communit* group*") OR TS=((informal OR illegal OR informal) SAME (settlement*))

# 1          TS=(kip or housing or home* OR "public tap*" OR "tube well*" OR standpipe* OR "dug well" OR "septic tank*" OR toilet* OR "scal* up") OR TS=(water OR sanitation OR sewerage) OR TS=(waste or garbage or refuse) OR TS=("storm drain*" OR electricity OR gas OR "power supply" OR "energy supply" OR utilities ) OR TS=(subsid* OR investment* OR partnership* OR microcredit OR credit OR village bank* OR microcredit* OR mortgage* OR social fund* OR microfinance OR loan OR loans)

3ie impact database

The following individual terms were searched: slum, slums, urban poor, informal settlement, informal settlements, kampung, squatter, barrio, favela. In addition, database records were browsed.

 

Appendix 5. Glossary


CBA Controlled Before and After Study

CIConfidence Interval

CIDGCampbell International Developing Group

CMOCommunity Management Organisation

CPIControlled post intervention only study

DiDDifference in difference analysis 

EPOCEffective Practice and Organisation of Care Cochrane Group

GATEGraphical Appraisal Tool for Epidemiological Studies

IADBInter-American Development Bank

ISDIntegrated Slum Development

KIPKampung Improvement Programme

LMICLow and Middle Income Countries

NGONon-Governmental Organisation

NICENational Institute for Health and Clinical Excellence

QoLQuality of Life

PSMPropensity Score matching 

RCTRandomised Controlled Trial 

RRRelative risk 

RsRupees

RpsRupiahs

SNPSlum Networking Programme

STUDPSmall Towns Urban Development Project

UBAUncontrolled before and after study 

WHOWorld Health Organization

ZIPZonal Improvement Programme



 

Contributions of authors

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms

RT was responsible for drafting the report with assistance from RS, NB, BC and ER. Literature searching, study selection, data extraction and risk of bias assessement was conducted by RT, RS and NB. RT developed the Harvest Plots, GRADE and Summary of Findings table, with methodological guidance and contributions from ER. BC provided statistical advice and contributed to writing the data collection and analysis section.

 

Declarations of interest

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms

None

 

Sources of support

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms
 

Internal sources

  • No sources of support supplied

 

External sources

  • International Initiative for Impact Evaluation (3ie), UK.
    3ie have provided grant funding for the design and completion of the review
  • Jawaharlal Nehru Institute of Advanced Study, Jawaharlal Nehru University, India.
    Support was provided during Ruhi Saith's fellowship with the Institute.
  • Victorian Health Promotion Foundation (VicHealth), Australia.
    VicHealth provided funding to support the editorial process for this Cochrane Public Health Group review

 

Differences between protocol and review

  1. Top of page
  2. Summary of findings    [Explanations]
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. Contributions of authors
  13. Declarations of interest
  14. Sources of support
  15. Differences between protocol and review
  16. Index terms

To further increase the coverage of the literature searches, three additional bibliographic databases were searched for the review - British Nursing Index, CENTRAL and PsycINFO. In addition, during the update search the sensitivity of the original search strategy was slightly increased by including additional search terms relating to improved cookstoves, mitigation of environmental hazards and home flooring. These extra search terms were incorporated in databases that allowed complex search strategies (SCOPUS, MEDLINE, EMBASE, HMIC, ICONDA and PsycINFO) and rerun for the entire search period.

It was intended that RCTs would be quality assessed using the Cochrane risk of bias tool, and supplemented with the NICE/GATE checklist. All remaining studies were to be assessed using the NICE/GATE checklist only. However to ensure a consistent approach in dealing with the breadth of study designs identified, it was deemed more appropriate for all studies to be quality assessed using the EPOC Cochrane risk of bias tool (which also incorporates items relevant to CBAs) and supplement the tool with the NICE/GATE checklist which identifies methodological issues relevant to a wider range of study designs.

It was intended that views and perspectives of slum dwellers would be collected and summarised from qualitative studies embedded within included studies. However two studies out of the five studies including views information collected quantitatively through survey questions. It was felt that, as the information still captured slum dwellers views, it was important to include this information in the results of slum dwellers views. It is clearly marked where information is collected from quantitative or qualitative methods.

The protocol originally planned to synthesise only the primary outcomes (health and quality of life) into a summary of finding (SoF) table. However, it became apparent that the narrative-based SoF format that the team designed could also be used to provide a concise overview of (secondary) socioeconomic outcomes.

* Indicates the major publication for the study

References

References to studies included in this review

  1. Top of page
  2. AbstractRésumé scientifique
  3. Summary of findings
  4. Background
  5. Objectives
  6. Methods
  7. Results
  8. Discussion
  9. Authors' conclusions
  10. Acknowledgements
  11. Data and analyses
  12. Appendices
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Differences between protocol and review
  17. Characteristics of studies
  18. References to studies included in this review
  19. References to studies excluded from this review
  20. References to ongoing studies
  21. Additional references
Abelson 1996 {published data only}
  • Abelson P. Evaluation of slum improvements. Case study in Visakhaptnam, India. Cities 13;2:97-108.
Aiga 2002 {published data only}
  • Aiga H, Arai Y, Marui E, Umenai T. Impact of Improvement of water supply on reduction of diarrheal incidence in a squatter area of Manila. Environmental Health and Preventive Medicine 1999;4:111-6.
  • Aiga H, Umenai T. Impact of improvement of water supply on household economy in a squatter area of Manila. Social Science and Medicine 2002;55:627-41.
Butala 2010 {published data only}
  • Butala NM, VanRooyen MJ, Patel RB. Improved health outcomes in urban slums through infrastructure upgrading. Social Science and Medicine 2010;71:935-40.
Cattaneo 2009 {published data only}
  • Cattaneo MD, Galiani S, Gertler PJ, Martinez S, Titiunik R. Housing, health and happiness. American Economic Journal: Economic Policy 2009;1(1):75-105.
  • Cattaneo MD, Galiani S, Gertler PJ, Martinez S, Titiunik R. Housing, health and happiness. American Economic Journal: Economic Policy February 2009;1(1):75-105.
De Leon 1986 {published data only}
  • De Leon LT. Barrio Escopa. Journal of Architectural and Planning Research 1986;3(2):93-116.
Galiani 2007 {published data only}
  • Galiani S, Gonzalez-Rozada M, Schargrodsky E. Water expansions in Shantytowns: Health and Savings. Water expansions in shantytowns: Health and savings. Washington: Inter-American Development Bank, 2007.
Gonzalez-Navarro 2010 {published data only}
  • Gonzalez-Navarro M, Quintana-Domeque C. Roads to Development: Experimental Evidence from Urban Road Pavement. Social Science Research Network Working Paper February 23 2010. [DOI: http://dx.doi.org/10.2139/ssrn.1558631; : Available at SSRN: http://ssrn.com/abstract=1558631]
  • Gonzalez-Navarro M, Quintana-Domeque C. Slum upgrading: evidence from an urban road pavement experiment in Mexico. Proceedings of the International Conference on Infrastructure Economics and Development February 22 2010;C92, C93, H41, O15, O12:1-60. [: http://www.eea-esem.com/files/papers/EEA/2010/1819/pavement_experiment.pdf]
  • Gonzalez-Navarro M, Quintana-Domeque C. Urban Infrastructure and economic development: experimental evidence from street pavement. Institute for the Study of Labor (IZA) November 2010;Discussion Paper No. 5346:0-51. [: http://ftp.iza.org/dp5346.pdf]
Joshi 2002 {published data only}
  • Joshi R. Integrated Slum Development in the slums of of Pravinagar-Guptanagar, Ahmedabad. In: Amitabh Kundu, Darshini Mahadevia (Eds) editor(s). Poverty and Vulnerability in a Globalising Metropolis. Delhi, India: Manak, 2002. [: http://www.ashanet.org/dallas/projects/saath/IntegratedSlumDevelopment.htm]
Milone 1993 {published data only}
  • Milone P. Kampung improvement in the small and medium sized cities of central Java. Review of Urban and Regional Development Studies 1993;5(1):74-94.
Moitra 1987 {published data only}
  • Moitra MK, Samajdar S. Evaluation of the slum improvement program of Calcutta Bustees. In: Skinner RJ,  Taylor JL,  Wegelin EA editor(s). Shelter upgrading for the urban poor:evaluation of Third World experience. Manila: Island Publishing House, 1987.
Moraes 2004 {published data only}
  • Moraes LRS, Cairncross S. Environmental interventions and the pattern of geohelminth infections in Salvador, Brazil. Parasitology 2004;129:223-32.
  • Moraes LRS, Cancio JA, Cairncross S. Impact of drainage and sewerage on intestinal nematode infections in poor urban areas in Salvador, Brazil. Transactions of the Royal Society of Tropical Medicine and Hygiene 2004;98(197):204.
  • Moraes LRS, Cancio JA, Cairncross S, Huttly S. Impact of drainage and sewerage on diarrhoea in poor urban areas in Salvador, Brazil. Transactions of the Royal Society of Tropical Medicine and Hygiene 2003;97:153-8.
Parikh in press {published data only}
  • Parikh P, McRobie A. Engineering as a tool for improving human habitat. International Journal of Management and Decision Making 2009;10(3/4):270-81.
  • Parikh P, Parikh M, McRobie A. The role of infrastructure in improving human settlements. Proceedings of the ICE - Urban Design and Planning 5 June 2012;Paper 1000038:1-18. [DOI: http://dx.doi.org/10.1680/udap.10.00038]
Soares 2005 {published data only}
  • Soares F, Soares Y. The socio-economic impact of Favela-Bairro: What do the data say?. Office of Evaluation and Oversight. Washington: Inter-American Development Bank, August 2005.
Taylor 1987 {published data only}
  • Taylor JL. Evaluation of the Jakarta kampung improvement programme. In: Skinner RJ,  Taylor JL,  Wegelin EA editor(s). Shelter upgrading for the urban poor:evaluation of Third World experience. Manila: Island Publishing House, 1987.

References to studies excluded from this review

  1. Top of page
  2. AbstractRésumé scientifique
  3. Summary of findings
  4. Background
  5. Objectives
  6. Methods
  7. Results
  8. Discussion
  9. Authors' conclusions
  10. Acknowledgements
  11. Data and analyses
  12. Appendices
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Differences between protocol and review
  17. Characteristics of studies
  18. References to studies included in this review
  19. References to studies excluded from this review
  20. References to ongoing studies
  21. Additional references
Choudhary 2002 {published data only}
  • Choudhary R. Building for the future: Influence of housing on intelligence quotients of children in an urban slum. Health Policy and Planning 2002;17(4):420-4.
Chowdhury 2006 {published data only}
  • Chowdhury FJ, Amin ATMN. Environmental assessment in slum improvement programs: Some evidence from a study on infrastructure projects in two Dhaka slums. Environmental Impact Assessment Review 2006;26(6):530-52.
Dasgupta 2006 {published data only}
  • Dasgupta B, Lall SV. Assessing benefits of slum upgrading programs in second-best settings. World Bank Policy Research Working Paper 3993 August 2006:1-40. [: http://www-wds.worldbank.org/servlet/WDSContentServer/WDSP/IB/2006/08/09/000016406_20060809113021/Rendered/PDF/wps3993.pdf]
De Moura 2009 {published data only}
  • De Moura M, da Silveira Bueno D, Leony L. How land title affects child labor?. The World Bank, Policy Research Working Paper, 5010 July 2009; Vol. Impact Evaluation Series No.37.
Field 2003 {published data only}
  • Field E. Fertility Responses to Urban Titling Programs: The Roles of Ownership Security and the Distribution of Household Assets. Harvard University Working Paper 2003.
Field 2007 {published data only}
  • Field E. Entitled to work: Urban property rights and labor supply in Peru. Quarterly Journal of Economics 2007;122(4):1561-602.
Galdo 2005 {published data only}
  • Galdo V, Briceno B. Evaluating the Impact on Child Mortality of a Water Supply Project and Sewerage Expansion in Quito: Is Water Enough?. Inter-American Development Bank 2005; Vol. 105.
Galiani 2005 {published data only}
  • Galiani S, Gertler PJ, Schargrodsky E. Water For Life: The impact of the privatization of water services on child mortality. Journal of Political Economy 2005;113(1):83-120.
Gamper-Rabindran 2008 {published data only}
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Genser 2008 {published data only}
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Parikh 2007 {published data only}
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Perlman 2008 {published data only}
  • Perlman JE. Parsing the Urban Poverty Puzzle: A Multi-generational Panel Study in Rio de Janeiro's Favelas, 1968 - 2008. Working Paper // World Institute for Development Economics Research 2008; Vol. No 2010, 27. [: https://www.econstor.eu/dspace/bitstream/10419/54113/1/636508854.pdf]
Rakodi 1988 {published data only}
  • Rakodi C. Upgrading in Chawama, Lusaka: displacement or differentiation?. Urban Studies 1988;25(4):297-318.
Ruprah 2008 {published data only}
  • Ruprah I. An Impact Evaluation of a Neighbourhood Crime Prevention Program: Does Safer Commune Make Chileans Safer?. Inter-American Development Bank Office of Evaluation and Oversight. Working Paper: OVE/WP-09/08 November 2008.
Takeuchi 2008 {published data only}
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Tironi 2009 {published data only}

References to ongoing studies

  1. Top of page
  2. AbstractRésumé scientifique
  3. Summary of findings
  4. Background
  5. Objectives
  6. Methods
  7. Results
  8. Discussion
  9. Authors' conclusions
  10. Acknowledgements
  11. Data and analyses
  12. Appendices
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Differences between protocol and review
  17. Characteristics of studies
  18. References to studies included in this review
  19. References to studies excluded from this review
  20. References to ongoing studies
  21. Additional references
Cooper 2007 {published data only}
  • Cooper R, Galiani S, Gerter P, Martinez S, Ross A, Undurraga R. Slum Housing Upgrading in El Salvador & Uruguay [in process 2007 -]. Poverty Action Lab. Translating Research into Action. [: http://www.povertyactionlab.org/evaluation/slum-housing-upgrading-el-salvador-uruguay]

Additional references

  1. Top of page
  2. AbstractRésumé scientifique
  3. Summary of findings
  4. Background
  5. Objectives
  6. Methods
  7. Results
  8. Discussion
  9. Authors' conclusions
  10. Acknowledgements
  11. Data and analyses
  12. Appendices
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Differences between protocol and review
  17. Characteristics of studies
  18. References to studies included in this review
  19. References to studies excluded from this review
  20. References to ongoing studies
  21. Additional references
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