Rethinking Urbanicity: Conceptualizing Neighborhood Effects on Women’s Mental Health in Kampala’s Urban Slums

TL;DR

This paper explores how neighborhood features in Kampala's slums affect young women's mental health, using participatory methods to highlight both stressors and protective resources.

Contribution

The study introduces a multidimensional understanding of urbanicity in slum contexts, emphasizing participatory insights from young women.

Findings

Neighborhood features like sanitation and drainage significantly impact mental health in urban slums.

Participatory methods reveal both stressors (e.g., flooding, violence) and protective resources (e.g., education, social networks).

Urbanicity should be viewed as a complex construct involving deprivation, exclusion, and resilience.

Abstract

Urbanicity is a recognized determinant of mental health, yet conventional measures such as population density or the rural–urban divide often fail to capture the complex realities of informal settlements in low- and middle-income countries. This paper conceptualizes neighborhood effects through the lived experiences of young women in Kampala, Uganda, drawing on participatory research from the NIH-funded TOPOWA study. Using community mapping and Photovoice, participants identified neighborhood features that shape wellbeing, including sanitation facilities, drainage systems, alcohol outlets, health centers, schools, boda boda stages (motorcycle taxis), lodges, religious institutions, water sources, markets, and recreational spaces. These methods revealed both stressors—poor waste management, flooding, violence, gendered harassment, crime, and alcohol-related harms—and protective resources, including education, places of worship, health centers, social networks, identity, and sports activities. We argue that urbanicity in slum contexts should be understood as a multidimensional construct encompassing deprivation, fragmentation, exclusion, and resilience. This reconceptualization advances conceptual clarity, strengthens the validity of mental health research in low-resource settings, and informs interventions that simultaneously address structural risks and promote community assets. The case of Kampala demonstrates how participatory evidence can reshape the understanding of neighborhood effects with implications, for global mental health research and practice.

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