Abstract
Introduction: Rapid urbanisation in Nairobi has led to the growth of informal settlements, characterised by overcrowding, poor infrastructure, and limited access to basic services. Often invisible in formal systems, these areas face weak accountability and restricted service access, worsening health and wellbeing. This paper evaluates the impact of a community-led Physical Address System (PAS) in improving visibility, access, and support for residents in the settlement of Kiamutisya in Mathare, Nairobi.
Methods: Drawing on community-led data collection, the PAS introduced a unique address for each physical structure in Kiamutisya to support service delivery and emergency response, addressing the invisibility that residents face. We held three Ripple Effect Mapping (REM) workshops with community leaders, community health promoters and Accountability and Responsiveness in Informal Settlements for Equity (ARISE) Hub co-researchers. REM is a participatory evaluation method that captures the impacts of an intervention, both intended and unintended, from the perspective of the community. Data was coded using NVivo 12 and analysed thematically.
Results: The PAS evaluation found direct impacts like better service delivery by community health promoters, and indirect benefits including stronger community identity, improved safety, and government engagement. It also noted ethical risks like data misuse and resident stigmatization. Key recommendations for policymakers and planners include using physical addresses to enhance service delivery and emergency response, formally integrating addresses into planning systems, and fostering community participation to improve equity in challenging urban environments.
Conclusions: This study underscores the potential of community health systems to address structural vulnerabilities and build resilience in informal settlements. The PAS demonstrates the value of participatory approaches in creating sustainable, scalable models for urban health, reinforcing the critical role of communities as active agents in advancing health and well-being.
Methods: Drawing on community-led data collection, the PAS introduced a unique address for each physical structure in Kiamutisya to support service delivery and emergency response, addressing the invisibility that residents face. We held three Ripple Effect Mapping (REM) workshops with community leaders, community health promoters and Accountability and Responsiveness in Informal Settlements for Equity (ARISE) Hub co-researchers. REM is a participatory evaluation method that captures the impacts of an intervention, both intended and unintended, from the perspective of the community. Data was coded using NVivo 12 and analysed thematically.
Results: The PAS evaluation found direct impacts like better service delivery by community health promoters, and indirect benefits including stronger community identity, improved safety, and government engagement. It also noted ethical risks like data misuse and resident stigmatization. Key recommendations for policymakers and planners include using physical addresses to enhance service delivery and emergency response, formally integrating addresses into planning systems, and fostering community participation to improve equity in challenging urban environments.
Conclusions: This study underscores the potential of community health systems to address structural vulnerabilities and build resilience in informal settlements. The PAS demonstrates the value of participatory approaches in creating sustainable, scalable models for urban health, reinforcing the critical role of communities as active agents in advancing health and well-being.
| Original language | English |
|---|---|
| Number of pages | 12 |
| Journal | Journal of Community Systems for Health |
| Volume | 2 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 23 Jun 2025 |
