The Relationship between Access to Safe Water and Sanitation and Women’s Health in the Self-produced Settlements

Access to safe water and sanitation in self-produced settlements is a significant societal problem. Yet, there is a notable gap in understanding and evaluating the impact on women’s health, and how this intersects with public space. In Sub-Saharan Africa, nearly half of the urban population lives in self-produced settlements. These are complex environments that are continuously growing and are home to almost two-thirds of the population in cities such as Nairobi. Mathare, one of the largest self-produced settlements in Nairobi, exhibits notably poor health outcomes, with women experiencing diarrhoea at twice the average rate of Nairobi. In such a precarious context, the health of its inhabitants requires a specific approach. This paper devises a multidimensional framework for analysing and evaluating the key spatial and socioeconomic factors affecting women’s health in these self-produced settlements. It connects women’s health and well-being to broader structural disadvantages, such as insecure tenure, poor housing conditions, low monthly income and a lack of access to basic services. This case study emphasizes the critical importance of access to safe water and sanitation. Women's daily routines often revolve around water, exposing them to heightened risks of waterborne diseases such as diarrhoea or typhoid fever. Moreover, many women can only access water and sanitation in public spaces in Mathare, where they are particularly vulnerable to violence. This research also concludes how these risks perpetuate a cycle of poverty and vulnerability among women in these communities and emphasises the critical importance of implementing multidisciplinary policies and tailored approaches to enhance the health and well-being of women living in self-produced settlements

Archaeology · Business · Economic growth · Economics · Environmental health · Environmental planning · Geography · Human settlement · Informal settlements · Open defecation · Sanitation · Socioeconomics · Sociology · Water resource management · Child Nutrition and Water Access · Environmental Science · Medicine · Environmental Engineering

• Water insecurity and lived experiences in Nairobi, Kenya

  Open Access•Julia Foellmer, Dennis Musyoka et al.•Wellbeing Space and Society•2026

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