Health Economics and Financing, Health Systems and Population Studies Division, icddr, b, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK.
BMC Public Health. 2024 Oct 24;24(1):2946. doi: 10.1186/s12889-024-20425-9.
Bangladesh is rapidly urbanizing and approximately half of its urban population resides in deprived slums with limited access to basic needs. However, there is a dearth of information on vulnerability levels among slum dwellers. We aimed to assess the level of vulnerability within and between slums via various socioeconomic and health indicators.
A cross-sectional survey of 810 randomly selected households was conducted in two purposively selected slums, Korail and Shyampur, in Dhaka from November to December 2021. Data was collected on various indicators, including demographics, education, employment, access to utility, and healthcare services. Principal component factor analysis was employed to identify the key indicators to construct the socioeconomic and health vulnerability index for the urban slums of Bangladesh (SEHVI-BD). Kaiser-Meyer-Olkin, Bartlett's test, and Cronbach's alpha coefficient test were used to assess indicators' suitability. The selected indicators were used to generate an index on a scale of 100, with a higher index value indicating a higher level of vulnerability. The estimated scores were used to categorize the vulnerability status into three levels: mild, moderate, and severe vulnerability. The Mann-Whitney-U test and Kruskal-Wallis test were applied between the generated index and other socioeconomic variables to validate the relationship.
A total of 27 socioeconomic and health indicators were identified that explained 60% of the variance. The indicators were then grouped into six domains on the basis of their relevance. The prevalence of severe vulnerability in the Korail slum was approximately 9% and moderate vulnerability was 30% whereas these values were approximately 58% and 37%, respectively, in the Shyampur slum. The difference in the vulnerability level between the two slums was also evident across the domains. Households in the poorest wealth quintile, with lower education levels of household heads, and having irregular income experienced higher levels of vulnerability.
The SEHVI-BD offers a critical tool for policymakers to identify and address vulnerabilities, facilitating more targeted public health interventions in urban Bangladesh and similar low-income settings. This study further emphasizes the importance of integrating comprehensive vulnerability assessments into public health policies to reduce inequalities and improve well-being, especially for the urban marginalized slum population.
孟加拉国正在快速城市化，约一半的城市人口居住在基本需求有限的贫困贫民窟中。然而，关于贫民窟居民脆弱性水平的信息却很少。我们旨在通过各种社会经济和健康指标评估贫民窟内部和之间的脆弱性水平。
2021 年 11 月至 12 月，在达卡的两个有针对性选择的贫民窟——科赖尔和沙扬普尔，对 810 户随机选择的家庭进行了横断面调查。数据收集了各种指标，包括人口统计学、教育、就业、获得公用事业和医疗保健服务的情况。采用主成分因子分析来确定构建孟加拉国城市贫民窟的社会经济和健康脆弱性指数（SEHVI-BD）的关键指标。采用 Kaiser-Meyer-Olkin、Bartlett 检验和 Cronbach 的 alpha 系数检验来评估指标的适宜性。选择的指标用于在 100 分制的范围内生成一个指数，指数值越高表示脆弱性水平越高。估计得分用于将脆弱性状态分为轻度、中度和重度三个等级。曼-惠特尼 U 检验和克鲁斯卡尔-沃利斯检验应用于生成的指数与其他社会经济变量之间，以验证关系。
确定了 27 个社会经济和健康指标，这些指标解释了 60%的方差。然后根据相关性将这些指标分为六个领域。科赖尔贫民窟严重脆弱性的患病率约为 9%，中度脆弱性约为 30%，而沙扬普尔贫民窟的这些值分别约为 58%和 37%。两个贫民窟之间脆弱性水平的差异在各个领域也很明显。最贫穷的五分之一财富家庭、户主教育水平较低和收入不稳定的家庭，脆弱性水平更高。
SEHVI-BD 为政策制定者提供了一个重要工具，可用于识别和应对脆弱性，促进孟加拉国和类似低收入环境中的城市更有针对性的公共卫生干预措施。这项研究进一步强调了将综合脆弱性评估纳入公共卫生政策的重要性，以减少不平等，提高福祉，特别是为城市边缘贫民窟人口。
