By Helen Elsey, Ak Narayan Poudel, Tim Ensor, Tolib Mirzoev, James Nicholas Newell, Joseph Paul Hicks, Christopher Cartwright, David Wong, Caroline Tait, Sushil Baral, Radheshyam Bhattarai, Sudeepa Khanal, Rajeev Dhungel, Subash Gajurel, Shraddha Manandhar, Saidur Mashreky, Junnatul Ferdoush, Rumana Huque, Tarana Ferdous, Shammi Nasreen, Hoang Van Minh, Duong Minh Duc, Bao Ngoc, Dana Thomson, and Hilary Wallace.
As rapid urbanisation transforms the sociodemographic structures within cities, standard survey methods, which have remained unchanged for many years, under-represent the urban poorest. This leads to an overly positive picture of urban health, distorting appropriate allocation of resources between rural and urban and within urban areas. Here, we present a protocol for our study which (i) tests novel methods to improve representation of urban populations in household surveys and measure mental health and injuries, (ii) explores urban poverty and compares measures of poverty and ‘slumness’ and (iii) works with city authorities to understand, and potentially improve, utilisation of data on urban health for planning more equitable services.
Methods and analysis
We will conduct household surveys in Kathmandu, Hanoi and Dhaka to test novel methods: (i) gridded population sampling; (ii) enumeration using open-access online maps and (iii) one-stage versus two-stage cluster sampling. We will test reliability of an observational tool to categorise neighbourhoods as slum areas. Within the survey, we will assess the appropriateness of a short set of questions to measure depression and injuries. Questionnaire data will also be used to compare asset-based, consumption-based and income-based measures of poverty. Participatory methods will identify perceptions of wealth in two communities in each city. The analysis will combine quantitative and qualitative findings to recommend appropriate measures of poverty in urban areas. We will conduct qualitative interviews and establish communities of practice with government staff in each city on use of data for planning. Framework approach will be used to analyse qualitative data allowing comparison across city settings.