Authors: Blessed Phiri
Abstract: This study examines the impacts of urbanization on public health in the informal settlements of Kanyama and Chawama, Lusaka District, Zambia. Rapid and largely unplanned urban growth has outpaced infrastructure development in Lusaka, producing widespread deficits in water supply, sanitation, drainage, and housing that sustain a heavy communicable disease burden among residents of informal settlements. Using a qualitative phenomenological design, the study collected data from twenty-two adult residents through structured questionnaires combining closed-ended items and open-ended narrative questions. Data were analyzed using the six-phase thematic analysis process described by Braun and Clarke (2006). Five principal themes were generated: the water-disease connection; sanitation, shared suffering, and lost dignity; flooding as a seasonal health emergency; overcrowded homes and the intimacy of illness; and healthcare access: proximity without quality. Findings reveal that health challenges in these settlements are multidimensional, structurally produced, and gender-differentiated, consistent with the Social Determinants of Health Framework and the Urban Health Penalty Theory that guided the inquiry. Residents demonstrated detailed, experiential understanding of the mechanisms through which their living conditions generate illness, and articulated clear priorities for change. The study concludes that effective responses require cross-sectoral structural interventions in water infrastructure, sanitation, flood drainage, housing, and primary healthcare quality, rather than individual behavior change approaches alone. Recommendations are addressed to national government, health practitioners, urban planners, and development partners.
DOI: https://doi.org/10.5281/zenodo.19365844
