Slum Sanitation and the Social Determinants of Women’s Health in Nairobi, Kenya

Inadequate urban sanitation disproportionately impacts the social determinants of women's health in informal settlements or slums. The impacts on women's health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls' health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements.