Towards Inclusive Health Systems and Infrastructure Access: Enhancing the Well-Being of Refugees in East African Cities

Although 60% of refugees and asylum-seekers live in cities rather than camps, studies rarely consider their challenges in accessing healthcare, shelter, and infrastructure. This project analyses urban refugees’ health vulnerabilities, health-seeking practices, barriers to care, and access to water, sanitation, and other vital infrastructure.
Project status

The study focuses on Nairobi and Kampala and is a collaboration between the International Institute for Environment and Development (IIED), the Africa Population and Health Research Centre (APHRC) in Nairobi, and Young African Refugees for Integral Development (YARID) in Kampala. APHRC specialises in policy-relevant research on population, health, urbanisation and related development issues across Africa. YARID is a refugee-led organisation and its ongoing work with urban refugees will help frame the research questions to respond to their needs whilst also facilitating access to these households.

Recognising that refugees’ well-being depends not only on healthcare but also upon adequate shelter and infrastructure, the project asks how urban displaced populations (including refugees, asylum-seekers, and internally displaced persons) access healthcare, shelter, and infrastructure. Additionally, it explores whether refugees share any challenges with fellow residents of informal settlements, and examines promising strategies to foster well-being.

The research questions focus on three key areas:

1. Health and infrastructure needs:

a) What are the key health risks facing newly-arrived and longer-term refugees? Do these vary for households fleeing conflict, disaster, or other causes of displacement?

b) How do refugees access shelter and infrastructure, including water, sanitation, and energy? What is the quality of such provision? How do refugees’ shelter and infrastructure needs differ or overlap with host populations, including residents of informal settlements?

2. Health-seeking practices and barriers: What are the health-seeking practices of recent and longer-term refugees? Do they utilise the same providers and encounter any different barriers to healthcare?

3. Promoting resilience and inclusion: What strategies can support health and social inclusion amongst newcomers, longer-term refugees, and low-income host populations in cities?

The project uses a mixture of qualitative methods such as key informant interviews and focus group discussions, and quantitative surveys, to answer these research questions.

This multidisciplinary study can inform future collaborations between public health and city planning officials; civil society; and humanitarian agencies. Its findings will encourage far-sighted, inclusive responses that will better address urban humanitarian crises, benefiting both refugees and low-income host communities.

Principal Investigator: Dr Anna Walnycki, International Institute for Environment and Development 

Co-Investigator: Professor Blessing Mberu, African Population and Health Research Center

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