Effects of Habitat For Humanity Housing on the Health of Children
   and their Mothers in the Communities of Khmer Kampuch...
Background

           According to the UN-Habitat:

“adequate shelter means more than a roof over one’s
head. It also mea...
Housing and Health background

In developing countries children diarrhea
incidence and acute lower respiratory infections...
Problem Statement


•Improving the health of children and women requires
addressing many factors, including their housing ...
5
Purpose of The study
To compare the health of children and their
mothers in Habitat for Humanity housing and
 non-Habitat ...
Specific Objectives

   To assess the impact on children’s and mothers’
    health in Habitat housing in Khmer Kampuchea
...
Description of Study Area


   In the capital city of Phnom Penh, it is estimated that
    at least 20% of the city’s pop...
9
Conceptual Framework
  Independent Variables

Habitat for Humanity                                       Dependent Variabl...
Participants and Methodology

   Household-based cross sectional analytical study

   Children ages 10 years and younger...
Data Collection Methodology
   A structured, standardized, pre-tested questionnaire in
    English and Khmer were adminis...
Data Analysis


SPSS software was utilized

Independent T test statistics

Chi-square

Logistic regression

Pearson’s...
Results
   General characteristics, including demographics, of
    non- Habitat and Habitat households


   Non-Habitat ...
Housing conditions in non-Habitat and Habitat homes

   Non-Habitat households have more occupants
    than Habitat ones,...
Discussion (continued)
   Results from questionnaire-derived and interviewer-
    observed indicate that Habitat houses a...
17
Mothers and children health in non-Habitat and Habitat homes


    Results indicate that both the mothers’ and
     child...
When children’s health was associated with potential
continuous confounders:
Households that have lived longer in the comm...
Children’s health in relation to continuous potential confounders
Characteristic                          Logistic modeled...
Discussion (continued)
   When housing conditions are associated with rate
    of incidence of certain combined symptoms,...
Mothers' and children's health in relation to
      characteristics associated with Habitat housing
                  (pot...
   The direct association of inadequate toilet
    facilities and the rate of diarrhea and
    vomiting incidence, which ...
Limitations of the Study
   Habitat program in Cambodia is relatively new: Less
    than 200 families in 3 community proj...
Thank you!




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Presentation World Toilet Summit

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Presentation World Toilet Summit

  1. 1. Effects of Habitat For Humanity Housing on the Health of Children and their Mothers in the Communities of Khmer Kampuchea Khrom, Samaki and Sen Sok in Phnom Penh, Cambodia Carmen Aurora Garcia World Toilet Summit Nov 3-6 2008 1
  2. 2. Background According to the UN-Habitat: “adequate shelter means more than a roof over one’s head. It also means adequate privacy; adequate space; physical accessibility; adequate security; security of tenure; structural stability and durability; adequate lighting, heating and ventilation; adequate basic infrastructure, such as water supply, sanitation and waste-management facilities; suitable environmental quality and health-related factors…” 2
  3. 3. Housing and Health background In developing countries children diarrhea incidence and acute lower respiratory infections are linked strongly to housing conditions. (Chaudhuri, 2004) Wolff et al (2001) Children 5 years old and below living in Habitat Houses experienced lower incidence of respiratory infection 21% to 29%; GI,10% to 14%; and malaria, 15% to 20%. than those living in traditional houses 3
  4. 4. Problem Statement •Improving the health of children and women requires addressing many factors, including their housing and sanitation condition. •Inadequate housing conditions have adverse effect to the health of children and women but there have been few studies in developing countries. 4
  5. 5. 5
  6. 6. Purpose of The study To compare the health of children and their mothers in Habitat for Humanity housing and non-Habitat housing in the communities of Khmer Kampuchea Khrom, Samaki and Sen Sok in Phnom Penh, Cambodia. 6
  7. 7. Specific Objectives  To assess the impact on children’s and mothers’ health in Habitat housing in Khmer Kampuchea Khrom, Samaki and Sen Sok communities.  To identify the specific aspects of improved housing that are most closely associated with housing-related differences in children's and mothers' health.  To identify children and their mothers’ illnesses and diseases that may be related to poor housing conditions. 7
  8. 8. Description of Study Area  In the capital city of Phnom Penh, it is estimated that at least 20% of the city’s population live in squatter settlements where more than half of them live in houses made of temporary materials.  Khmer Kampuchea Khrom, Samaki and Sen Sok Communities are 3 of the more than 19 communities opened by the city government to relocate squatter families living in the downtown area. 8
  9. 9. 9
  10. 10. Conceptual Framework Independent Variables Habitat for Humanity Dependent Variables Addressed: Improved Housing Not addressed: Training (financial management, etc.),Community Participation, Local Leadership Development, Advocacy Socio-economic Situation Health Addressed: Income, Education, Occupation Not addressed: Inequality Addressed in mothers and children: Environmental Respiratory Addressed: Drinking water source, Building materials, Gastro-intestinal Arrangement of rooms, Household size, Exposure to fuel Skin smoke, Mosquito coil, Garbage disposal, Home sanitation Not addressed: Distance to economic center, Terrain Not Addressed: Infrastructure Perception of health now vs. a year Addressed: Drainage system, Sewer system ago Not addressed: Public services (e.g., roads, public transport, public market, health center, electricity, Mental Health communication system) Social Isolation Self-esteem Behavioral Addressed: Smoking/drinking, Exercise Not addressed: Diet and, Hygiene 10
  11. 11. Participants and Methodology  Household-based cross sectional analytical study  Children ages 10 years and younger, and their mothers, who are living in Habitat-built houses and children and mothers living next door or within 100 meters in non-Habitat homes  294 respondents: 147 households living in Habitat- built houses and 147 households adjacent to them  108 in Samaki; 108 in KK and; 78 in Sen Sok 11
  12. 12. Data Collection Methodology  A structured, standardized, pre-tested questionnaire in English and Khmer were administered by 10 trained interviewers.  Samples from drinking water source were directly collected from each household and taken to the Resource Development International laboratory for testing.  The respondent were expected to be the mother whenever possible, or another adult female caregiver.  The respondent reported on recalled illness and symptoms during the last 4 weeks, and the last 2 weeks. 12
  13. 13. Data Analysis SPSS software was utilized Independent T test statistics Chi-square Logistic regression Pearson’s chi-square 13
  14. 14. Results  General characteristics, including demographics, of non- Habitat and Habitat households  Non-Habitat households reported staying in the community for an average of 4.37 years compared to 3.9 years for the Habitat households (p=.012).  Habitat for Humanity program in Phnom Penh is relatively new, having started only in 2004 14
  15. 15. Housing conditions in non-Habitat and Habitat homes  Non-Habitat households have more occupants than Habitat ones, 5.86 and 5.31 people respectively (p=.060)  Habitat households reported higher satisfaction about the condition and size of their homes compared with the non-Habitat ones (p=<.001) 15
  16. 16. Discussion (continued)  Results from questionnaire-derived and interviewer- observed indicate that Habitat houses are in better physical conditions than the non-Habitat ones.  Habitat households are generally more satisfied with their current housing conditions, reporting more adequate conditions during the rainy season and having better quality toilet facilities: Only 12.2% of Habitat households reported having inadequate toilet facilities compared with 35.% in non-Habitat. 16
  17. 17. 17
  18. 18. Mothers and children health in non-Habitat and Habitat homes  Results indicate that both the mothers’ and children’s symptom rates generally did not differ. reporting very high rates of both individual and combined symptoms  Results suggest that both groups are subjected to important unidentified health risk factors in the communities surveyed.  The communities lack adequate infrastructure and basic services, such as drainage for waste water. 18
  19. 19. When children’s health was associated with potential continuous confounders: Households that have lived longer in the community the rates of the combined symptoms of diarrhea and vomiting increases. Familyincome shows a direct association with all 3 combined symptoms. As the income increases the odds of the following combined illnesses decreases:  Cough and phlegm (p=.020)  Cough and cold (p=.004)  Diarrhea and vomiting (p=.041) 19
  20. 20. Children’s health in relation to continuous potential confounders Characteristic Logistic modeled odds ratio per unit increase P-value Child's age Cough and phlegm .992 .807 Cough and cold .888 .001 Diarrhea and vomiting .824 <.001 Number of children ≤ 10 years old in household Cough and phlegm .911 .292 Cough and cold .922 .346 Diarrhea and vomiting 1.060 .574 Hours spent with children each day Cough and phlegm .982 .249 Cough and cold 1.005 .736 Diarrhea and vomiting .997 .853 Mother's educational level Cough and phlegm .972 .777 Cough and cold .915 .371 Diarrhea and vomiting .965 .775 Years in community Cough and phlegm .947 .246 Cough and cold .998 .971 Diarrhea and vomiting 1.2226 .002 Years in this house Cough and phlegm .988 .799 Cough and cold 1.032 .504 Diarrhea and vomiting 1.229 <.001 Monthly Income Cough and phlegm .996 .020 Cough and cold .996 .004 20 Diarrhea and vomiting .995 .041
  21. 21. Discussion (continued)  When housing conditions are associated with rate of incidence of certain combined symptoms, the results show:  24% of mothers of households without toilet facilities reported diarrhea and vomiting symptoms as compared to only 8.3% of those with toilets. 21
  22. 22. Mothers' and children's health in relation to characteristics associated with Habitat housing (potential confounders) Mothers' health in relation to categorical potential confounders Symptoms No Yes X2 (df) P- Value Has toilet Cough and phlegm 9 (34.6%) 69 (25.9%) .911 (1) P=.340 Cough and cold 12 (46.2%) 88 (33.3%) 1.722 (1) P= .189 Diarrhea and vomiting 6 (24.0%) 22 (8.3%) 6.406 (1) P=.011 House size perceived adequate Cough and phlegm 23 (29.5%) 55 (25.6%) .447 (1) P=.504 Cough and cold 33 (42.9%) 67 (31.3%) 3.348 (1) P=.067 Diarrhea and vomiting 3 (3.9%) 25 (11.7%) 3.847 (1) P=.050 Housing condition perceived adequate Cough and phlegm 21 (20.6%) 57 (30.0%) 3.003 (1) .083 Cough and cold 38 (37.3%) 62 (33.0%) .535 (1) .464 Diarrhea and vomiting 9 (8.9%) 19 (10.1%) .107 (1) .743 22
  23. 23.  The direct association of inadequate toilet facilities and the rate of diarrhea and vomiting incidence, which the study establishes is consistent with the conclusion made in the study by Wolff et al (2001) that reveals that having access to safe water and owning private toilet are significantly associated to lowering the odds of acquiring some illness. 23
  24. 24. Limitations of the Study  Habitat program in Cambodia is relatively new: Less than 200 families in 3 community projects in Phnom Penh. This limited number of Habitat for Humanity houses in turn limits the confidence and power of the tests for health-related differences between Habitat and non-Habitat housing.  This study did specifically examine the physiological health-related effects of the Habitat housing, specifically gastrointestinal, respiratory and skin diseases, but did not measure other potential benefits such as increased self-esteem, stronger neighborhood/ community cohesion, and increased family economic value.  The time constraint for the research did allow the researcher to undertake a more thorough multivariate study. 24
  25. 25. Thank you! 25

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