Integrated Health Interventions for Climate-Resilient Informal Settlements in Nairobi (HEALTHYSLUMS-NAI)

Proposal Overview

Funding Programme: Horizon Europe - Africa Initiative III

Call Identifier: HORIZON-HLTH-2025-01-DISEASE-03 / HORIZON-CL6-2025-02-COMMUNITIES-04

Thematic Area: Public Health & Green Transition (Cross-cutting)

Duration: 48 months (4 years)

Executive Summary

HEALTHYSLUMS-NAI addresses the urgent health crisis in Nairobi's informal settlements where 2.5 million residents (60% of city population) face compounding health risks from inadequate water/sanitation, climate change impacts, and infectious disease burden. Building on the successful RISE programme model (Fiji/Indonesia) and URBiNAT healthy corridors approach (Europe), this project pioneers an integrated planetary health intervention combining water-sensitive urban design, nature-based solutions, community health systems strengthening, and climate adaptation in Kibera, Mathare, and Mukuru settlements.

Problem Statement

Nairobi's informal settlements house 60-70% of the city's 4.4 million residents on just 5% of residential land. 95.4% lack adequate sanitation, and climate change exacerbates vulnerabilities through increased flooding and drought. Diarrheal diseases account for 15% child mortality; respiratory infections affect 35% of children under-5 annually.

Objectives

• OBJ 1: Co-design and implement water-sensitive urban interventions integrating decentralized wastewater treatment and green infrastructure.
• OBJ 2: Establish and strengthen integrated community health systems including trained community health promoters.
• OBJ 3: Conduct comprehensive health impact evaluation using cluster randomized controlled trial design.
• OBJ 4: Assess environmental outcomes including microbial water quality and biodiversity.
• OBJ 5: Evaluate socioeconomic impacts on women's time burden and household health expenditure.
• OBJ 6: Build African research capacity through PhD/MSc training (12 students).
• OBJ 7: Develop replication toolkit and policy briefs for scaling to 150+ informal settlements.

Methodology

Cluster randomized controlled trial with nested mixed-methods evaluation. 6 settlement clusters matched on population density and climate vulnerability. Baseline data collection, intervention implementation, and endline evaluation over 48 months.

Consortium

Lead by GCRI Kenya with 9 partners across 6 countries including University of Nairobi, Kenyatta University, APHRC, University of Cape Town, and Liverpool School of Tropical Medicine.

Innovation

First rigorous cluster RCT of integrated planetary health intervention in African informal settlements; novel environmental monitoring protocols; community co-creation model.