Sauti Mashinani Lab Research Projects

Climate change and related extreme weather events (EWEs) such as heatwave, cold spells, floods, heavy downpours, drought, and landslides are expected to have a profound impact on health and well-being. Residents of informal settlements are especially vulnerable to the effects of changes in climate and face serious barriers to adaptation due to political, economic, and social marginalization. Yet, there is a paucity of research focused on the effects that climate and EWEs may have on residents’ health and wellbeing and, importantly, on residents’ resilience in the face of climate change and an increase of EWEs.

The purpose of this study is to carry out a qualitative exploration of women’s resilience in the face of EWEs in informal settlements. This study is being carried out alongside a larger, longitudinal investigation of direct and indirect pathways between climate and women’s mental health and experiences of violence in informal settlements in Kenya (R21).

Findings from this study will enhance the impact of the larger study by adding rich detail about residents’ resilience and coping strategies that are not well-captured in quantitative data, and help expose critical points for supportive programming and climate change response in informal settlement communities.

Globally, 30% of women have experienced intimate partner violence (IPV). Prevention and response to IPV is critical; yet few interventions have been adapted for residents of informal settlements. Currently, 56% of the 3 million residents in Nairobi, the capital city of Kenya, live in informal settlements, and this population is likely to double by 2050.

Research carried out in informal settlements in Nairobi report that up to 85% of women have experienced IPV in their lifetime and up to 66% have experienced IPV in the past year. Women experiencing IPV are more likely to also experience depression, anxiety, and post- traumatic stress. In 2014, Kenya identified reduction of and response to violence against women (VAW) as a priority health area in national policies and strategic plans; yet, no screening or response protocols have been adopted in clinics in informal settlements for IPV survivors.

The purpose of this study is to explore potential facilitators and barriers to screening and intervention for IPV and related mental health challenges in healthcare settings in informal settlements in Kenya; combine an IPV intervention (Wings of Hope: WINGS) with a World Health Organization (WHO) mental health response intervention (Problem Management Plus: PM+) and adapt the combined (WINGS+PM+) intervention for use in public healthcare settings in informal settlements in Nairobi; and 3) pilot test the adapted WINGS+PM+ intervention through a randomized control trial with women experiencing IPV to assess safety, feasibility, and acceptability.

Climate vulnerable communities—defined as those most susceptible to or with fewer resources to cope with adverse effects of climate change, including climate variability and extremes—and marginalized populations (e.g., women, children, people living with disabilities) in the Global South, are crucial to developing action-oriented solutions to address climate change and related health inequities. This principle is at the heart of the Anga Center in East Africa, where our central mission is to improve climate justice, health equity, and community well-being by exploring climate-related health impacts and interventions to address them.

With a commitment to community engagement and empowerment, Anga aims to support climate-vulnerable communities and early career researchers in East Africa with infrastructure, technical skills, training and capacity-building, multi-directional knowledge sharing, and opportunities to envision and create the future of climate change and health research, intervention, and policy. 

The Anga Center consists of three cores, including the Administrative Core, the Capacity-Building Core, and the Community Collaborative Core and a pilot Research Project focused on developing and testing localized, impact-based early warning systems for climate vulnerable communities in Uganda, Tanzania, and Kenya.

A multinational, multistage, transdisciplinary team of researchers, community team members, collaborative boards, and stakeholders across Uganda, Tanzania, and Kenya will work together to achieve the mission of the Center. Anga has a network of partners and supporters including the Africa Institute for Brain and Mental Health (AFRIMEB) in Kenya, Mzumbe University in Tanzania, Makerere University in Uganda, Drexel University in the US, Columbia University in the US, the Trans-African Hydro-Meteorological Observatory (TAHMO), the Kenyan Meteorological Department (KMD), the Uganda National Meteorological Authority (UNMA), and the Tanzania Meteorological Authority (TMA). 

Climate change and related weather events are expected to impact intimate partner violence (IPV). Women in informal settlements in lower- and middle-income countries (LMICs) are more likely to be experiencing IPV, less likely to have access to services, and more vulnerable to the effects of climate change and related extreme weather events (EWEs). Despite the potential impacts of climate change on IPV, strategies to adapt to climate change in these settlements, i.e., reducing the consequences of mounting climate challenges, have overlooked violence-related outcomes. In particular, there is a paucity of interventions to help residents of informal settlements experiencing IPV to adapt to or minimize the impact of climate change on their safety and well-being.

The purpose of this study is to develop and test the preliminary efficacy of a smartphone-delivered climate adaptation safety and harm reduction intervention for women experiencing IPV in informal settlements in Kenya using ecological momentary intervention (EMI) and ecological momentary assessment (EMA). Guided by the African Institute of Mental and Brain Health (AFRIMEB), we will adapt an evidence-based safety and harm reduction intervention for integration into the EMA application and test the feasibility and preliminary efficacy of the adapted intervention through a randomized control trial.

The goal of this study is to provide women with a low-cost, accessible, smartphone-based tool that empowers them to develop, utilize, and revise personal safety and harm reduction strategies that are specifically responsive to climate-related IPV. Findings could support a low-cost, sustainable, and easily adaptable climate adaptation and IPV response application and implementation model for informal settlements or other under-resourced settings, globally.