13 February 2013

Does slum upgrading work?

A new colleague at OPM Ruhi Saith is a co-author of a new Cochrane systematic review on the impact of slum upgrading programmes on health and wellbeing (full summary here).

They find only 5 studies which can demonstrate any causality, from which they find:
  • "Limited but consistent evidence to suggest that slum upgrading may reduce diarrhoea in slum dwellers and that slum dweller’s water related expenses may also be reduced
  • Mixed results for whether slum upgrading can reduce parasitic infections, educational outcomes, financial poverty and unemployment outcomes
  • Very little information on other health or social outcomes, or which types of interventions were most beneficial"
Which reminds me of two things,

first, John Snow and the 1854 Broad Street cholera epidemic, when John used a mixed methods approach based on KII*, and a pathbreaking geographic data visualization infographic** which founded the science of epidemiology using one of the first natural experiments.

second, that there is really weak evidence that area-based initiatives have any impact on employment and well-being in the UK, and so policy should target people not places

Which suggests that slum upgrading should focus on providing the public goods and infrastructure with clear evidence of impact and cost effectiveness - namely clean water and sanitation - and be more modest about expectations for impacts on other outcomes which are not primarily determined by the slum environment, such as poverty, unemployment, and low education.

*Key informant interviews. Or talking to people. Yes I am mocking your terminology, quals.
**A map. Yes you too, data monkeys.

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