Date of Award
7-29-2025
Degree Type
Thesis
Degree Name
Doctor of Philosophy (PhD)
Discipline
Social Sciences
Department
Sociology and Social Policy
First Advisor
Prof. AMOAH Padmore Adusei
Second Advisor
Prof. MOK Ka Ho Joshua
Third Advisor
Prof. CONNOLLY Creighton Paul
Dr ZHU Yidan Daisy
Abstract
Residents of informal settlements face various challenges due to inadequate social welfare and critical social infrastructure provided by the state, leaving them vulnerable to diseases. Neglected Tropical Diseases (NTDs)—forgotten diseases of forgotten people and diseases of poverty are major causes of morbidity and mortality in the Global South. In these situations, people usually rely on social capital and existing social infrastructure for resources and assistance in managing and preventing NTDs. However, this critical nexus of social infrastructure (i.e. community welfare centers, lady health worker centers, schools, and religious sites) and social capital has been largely neglected in existing research and policies.
To bridge this gap, this study aims to explore the awareness and understanding of NTDs among informal settlers and their perceptions and experiences regarding the availability and accessibility of social infrastructure. This study employs the health belief model (HBM) to find the relationships among the individual beliefs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy), NTDs preventive behavior, and health-related quality of life (HRQoL). The social capital embedded in HBM serves as a cue to action against NTDs. This study employs a mixed-methods design, incorporating 24 qualitative interviews and a cross-sectional survey involving 684 participants. The data was collected from six informal settlements across Karachi and Lahore, two urban centers with significant informal populations.
The results demonstrated limited awareness of NTDs among the residents, frequently recognized as “Wabai Amraz” (environmental diseases) without understanding the underlying causes. A high prevalence of diseases, including dengue fever, malaria, skin infections, stomach infections, leprosy and respiratory issues, was normalized as an inevitable part of daily life, exacerbated by poor environmental conditions and inadequate infrastructure. Healthcare access was severely constrained due to financial barriers, reliance on home remedies and unqualified quack doctors, and the marginalized political and legal status of informal settlements further hampered the development of social and healthcare facilities. The study found gaps and opportunities in the existing social infrastructure as residents relied on limited and fragmented disease-related information from sources like the Lady Health Worker Center, Polio vaccination teams, Schools, Mosques, and community structures like the Chairman Zakat office. The findings underscore that this existing social infrastructure has the potential to be mobilized for health awareness and NTD prevention. The results found a complex interplay of individual beliefs on NTDs preventive behavior and HRQoL. Surprisingly, higher perceived susceptibility and severity were associated with lower NTDs preventive behavior. However, perceived benefits and self-efficacy strongly motivate preventive actions. Furthermore, linking social capital appeared as a significant buffer, improving NTD preventive behavior and HRQoL by connecting residents to external resources and assistance.
The findings emphasize the urgency of raising awareness about the causes and prevention of NTDs in informal settlements and leveraging ‘linking social capital’ to mobilize government and non-government organizations to provide social welfare and healthcare services through community-driven initiatives. Recognizing informal settlements in urban development plans and ensuring access to critical social infrastructure and services is essential for tackling the underlying causes of NTDs.
Language
English
Copyright
The copyright of this thesis is owned by its author. Any reproduction, adaptation, distribution or dissemination of this thesis without express authorization is strictly prohibited.
Recommended Citation
Tariq, A. (2025). Mobilizing social infrastructure and social capital in informal settlements in response to neglected tropical diseases in Pakistan (Doctoral thesis, Lingnan University, Hong Kong). Retrieved from https://commons.ln.edu.hk/otd/266/
Included in
Development Studies Commons, Public Health Commons, Social Work Commons, Sociology Commons, Urban Studies and Planning Commons