Authors: Joseph Macarthy and Abu Conteh, SLURC
A multidisciplinary research project has been launched at the College of Medicine and Allied Health Sciences (COMAHS) Hall, New England in Freetown to foster conversation among communities and policy stakeholders about improving equity, health and wellbeing in Freetown’s informal settlements. ARISE (Accountability and Responsiveness in Informal Settlements for Equity) is a five-year consortium led by the Liverpool School of Tropical Medicine (LSTM) in partnership with institutions in the global south - Sierra Leone, Kenya, Bangladesh and India - and UK based universities, including the Institute of Development Studies, University of Sussex, University of York and University of Glasgow.
The Sierra Leone hub is being run jointly by the Sierra Leone Urban Research Centre (SLURC), College of Medicine and Allied Health Sciences (COMAHS) and affiliates of Slum/Shack Dwellers International (SDI) in Sierra Leone – the Federation of Urban and Rural Poor (FEDURP) and Centre of Dialogue on Human Settlement and Poverty Alleviation (CODOHSAPA). The partners will draw from their multidisciplinary skills and experiences in epidemiology and health systems strengthening, urban development, participatory research, community engagement etc. The partners will explore social identities, intersectionality and governance as measures for understanding the determinants of health in informal settlements and build capacities to enhance equity and access to improved healthcare services.
The Sierra Leone hub is being run jointly by the Sierra Leone Urban Research Centre (SLURC), College of Medicine and Allied Health Sciences (COMAHS) and affiliates of Slum/Shack Dwellers International (SDI) in Sierra Leone – the Federation of Urban and Rural Poor (FEDURP) and Centre of Dialogue on Human Settlement and Poverty Alleviation (CODOHSAPA). The partners will draw from their multidisciplinary skills and experiences in epidemiology and health systems strengthening, urban development, participatory research, community engagement etc. The partners will explore social identities, intersectionality and governance as measures for understanding the determinants of health in informal settlements and build capacities to enhance equity and access to improved healthcare services.
Group photo at ARISE Sierra Leone stakeholder engagement and launch
The event itself brought together stakeholders from the project’s three research sites (Dworzark, Moyiba and Cockle Bay), policy stakeholders from various government departments and non-state actors working on health systems research and advocacy. The event was launched by the Director of Research and Evaluation from Focus 1000 [1] Mr. Paul Sengeh who made a reflection on overcrowding as one of the key challenges that triggers ill health and poor living conditions in informal settlements in Freetown. He also spoke about the need to reflect on accountability as a dual process wherein the state provides services for communities, while communities themselves protect such vital services as water installations and pipes to ensure safety and improved quality of life.
The ARISE Consortium
The two principal investigators for the ARISE consortium in Sierra Leone Dr. Joseph Macarthy (SLURC) and Dr. Haja Ramatulai Wurie (COMAHS) made presentations on the unique partnership in Sierra Leone, where COMAHS focuses on health systems research, SLURC deals with urban development challenges, while CODOHSAPA and FEDURP specialize in community engagement and participatory planning.
Dr. Wurie, in her presentation summarised the vision of ARISE, which aims to enhance change by supporting informal settlement residents to amplify their voices, many of whom she said are often made vulnerable to complex socio-economic challenges, fragile ecosystems and political violence. She highlighted the country’s weak health system and the need for timely and disaggregated data on the state of health of vulnerable people, especially those living in informal settlements, and that the coming of ARISE is useful in filling that gap. She said the research work to be undertaken by ARISE not only aspires to provide useful evidence, but will improve links between communities and policy stakeholders.
Dr. Wurie, in her presentation summarised the vision of ARISE, which aims to enhance change by supporting informal settlement residents to amplify their voices, many of whom she said are often made vulnerable to complex socio-economic challenges, fragile ecosystems and political violence. She highlighted the country’s weak health system and the need for timely and disaggregated data on the state of health of vulnerable people, especially those living in informal settlements, and that the coming of ARISE is useful in filling that gap. She said the research work to be undertaken by ARISE not only aspires to provide useful evidence, but will improve links between communities and policy stakeholders.
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| Dr. Haja Ramatulai Wurie, COMAHS Team Lead for ARISE | Dr. Joseph Macarthy Executive Director of SLURC |
The Exective Director of SLURC Dr. Joseph Macarthy who presented on ARISE’s scope of work and aspirations in Sierra Leone, said the research work to be undertaken by ARISE has links to previous work by SLURC in informal setlements, and that most informal settlements have commonalities in terms of health needs, inequity, and precarious environmental conditions which require further evidence and broad based collaboration to tackle. He spoke about the need to build accountability systems around public health service provision in informal settlements, by first recognizing the current state of health and building the capacity of service providers and policy makers to respond appropriately.
He explained the scope of work through the various work packages which relate to 1) understanding social identities, and how they shape access to healthcare services; 2) exploring governance systems and how they shape inequity and 3) analysing secondary data hosted by national/international organizations to draw comparisons with empirical field data to further understand health needs of vulnerable people in the urban context. He said the work packages will be logically rolled out between communities and shared among partners within the project’s five-year cycle.
He explained the scope of work through the various work packages which relate to 1) understanding social identities, and how they shape access to healthcare services; 2) exploring governance systems and how they shape inequity and 3) analysing secondary data hosted by national/international organizations to draw comparisons with empirical field data to further understand health needs of vulnerable people in the urban context. He said the work packages will be logically rolled out between communities and shared among partners within the project’s five-year cycle.
Community Grown Solutions
The second session of the event was a stakeholder engagement facilitated by Mr. Francis Reffell, Director of CODOHSAPA, in which participants discussed accountability and how it impacts on improvements to health and wellbeing in Freetown’s informal settlements. Participants generally expressed need for communities to be empowered to understand how to address their own social needs, given that they consider themselves somewhat abandoned by political leaders. Sentiments about communities being abandoned by political leaders were expressed passionately by community chiefs, who believe that generating knowledge and resources from within are important in solving their local problems.
Issues of empowerment through knowledge co-production were reiterated by several speakers during the discussion, as communities believe that they have enough enlightenment to understand their own health and social needs. However, what is critically needed according to a community member from Moyiba, is a strong commitment to action in searching for community grown solutions.
Earlier, the welcome statement was made by the Deputy Vice Chancellor of COMAHS, University of Sierra Leone, Professor Mohamed Samai. He highlighted numerous planning challenges such as poor construction of houses and drainage, which make people vulnerable to flooding and health problems in informal settlements, and gave assurance of the university’s support for ARISE in providing evidence to aid policy processes to improve the wellbeing of people living in informal settlements.
Issues of empowerment through knowledge co-production were reiterated by several speakers during the discussion, as communities believe that they have enough enlightenment to understand their own health and social needs. However, what is critically needed according to a community member from Moyiba, is a strong commitment to action in searching for community grown solutions.
Earlier, the welcome statement was made by the Deputy Vice Chancellor of COMAHS, University of Sierra Leone, Professor Mohamed Samai. He highlighted numerous planning challenges such as poor construction of houses and drainage, which make people vulnerable to flooding and health problems in informal settlements, and gave assurance of the university’s support for ARISE in providing evidence to aid policy processes to improve the wellbeing of people living in informal settlements.
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Participants discussing accountability and health
Dr. Braima Gogra who spoke on behalf of the School of Environmental Sciences at Njala University said the university has had a good working relationship with SLURC since its inception, and that they will continue to provide support to make research evidence useful to policy processes, especially those related to environmental management. Other speakers from the Ministries of Health and Sanitation, and Planning and Economic Development spoke about the need for disaggregated data on informal settlements, the lack of which often causes misinformed planning.
The first session for the launch of the event was facilitated by the Director of Research and Training at SLURC, Braima Koroma, who also emphasised the need for integrating community knowledge and experiences with those of policy stakeholders to enhance informed policy processes to improve conditions in informal settlements.
Improving health and wellbeing in Freetown’s informal settlements is a truly multidisciplinary challenge, which is reflected in the diverse range of stakeholders involved in the ARISE launch event in Freetown.
The first session for the launch of the event was facilitated by the Director of Research and Training at SLURC, Braima Koroma, who also emphasised the need for integrating community knowledge and experiences with those of policy stakeholders to enhance informed policy processes to improve conditions in informal settlements.
Improving health and wellbeing in Freetown’s informal settlements is a truly multidisciplinary challenge, which is reflected in the diverse range of stakeholders involved in the ARISE launch event in Freetown.
[1] Focus 1000 is a local organization engaged in health systems research and policy advocacy in Sierra Leone. Its formative research during the Ebola period helped shape communication and community engagement strategies aimed at disrupting the chain of infections.