UCLA Housing Voice

Ep 56: Property Rights and Public Health in Nairobi, Kenya with Singumbe Muyeba

• UCLA Lewis Center for Regional Policy Studies • Season 2 • Episode 30

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Studies in Latin America show that “secure tenure” —- protections against displacement by the government — can encourage resident-led development and economic growth in slum areas, as well as improve public health. Is the same true in the African context? And what happens if the government also provides quality, affordable housing along with secure tenure? Singumbe Muyeba joins us to share the results of his research on a slum upgrading program in Nairobi, Kenya.

Show notes:

Shane Phillips  0:04  
Hello! This is the UCLA Housing Voice podcast and I'm your host, Shane Phillips. This week we're very excited to be joined by Singumbe Muyeba for our first episode focusing on an African city, Nairobi, Kenya. Singumbe's research follows Kenya's slum upgrading program, and it looks at the relationship between public health, housing quality, and tenure security. Secure tenure means that people have protections against displacement by the government, often for things like slum clearance. Providing secure tenure to residents of informal and slum housing has been a priority in many developing countries, with some arguing that if you just give people a title to the land they live on, they can mostly take care of the rest and build their own homes without much other government support. Previous research, mostly in Latin America, has shown that secure tenure does provide health and mental health benefits, but we know less about how effective it is in the context of African cities. We also don't know much about the additional benefits that might come by providing both tenure security and quality affordable housing to poor residents. And that's what Singumbe's study looks at in the Kibera slum of Nairobi. 

It's worth our time to better understand the slums where hundreds of millions of people around the world live. But I think this research also has lessons even for countries with more advanced economies and less dire housing challenges. We talk about how slum upgrading programs tend to focus on economic costs and benefits and ignore things like health and happiness. And I would argue the same is true of how we talk about many policies in developed countries like rent stabilization and eviction protections. We also get into the shortcomings of relying on private markets to produce housing for the very poor, and the value of having a robust public housing program to complement that market. And there's just a whole bunch more in here. I think you'll enjoy it. 

The Housing Voice podcast is a production of the UCLA Lewis Center for Regional Policy Studies, with production support from Claudia Bustamante Divine Mutoni, and Phoebe Brous. As always, you can reach out via email with questions or show ideas at shanephillips@ucla.edu, and we always greatly appreciate when you can leave a five star rating and a positive review about the show. Now let's get to our conversation with Singumbe Muyeba.

Singumbe Muyeba is an Assistant Professor of African Studies at the University of Denver's Josef Korbel School of International Studies. And he is joining us today to talk about urban slum upgrading in Nairobi, Kenya, and specifically how conveying property rights and secure tenure affects physical and psychological health. Singumbe, thanks so much for joining us, and welcome to the Housing Voice podcast.

Singumbe Muyeba  3:02  
Thank you. It's good to be here.

Shane Phillips  3:05  
And my co-host today is Paavo Monkkonen. Hey, Paavo.

Paavo Monkkonen  3:08  
Hey, Shane, how you doing? It's great to meet you Singumbe, and I'm really excited about this conversation.

Singumbe Muyeba  3:13  
My pleasure.

Shane Phillips  3:14  
So first up, we will have our tour as always. Singumbe, what is a city that you know well, that you would like to tell our listeners about and show us around in?

Singumbe Muyeba  3:22  
Well, this was difficult to think through because I've lived in so many cities within a short time, but I will go back to Lusaka where I grew up and this is located in the central part of Zambia with a population of about 3.1 million. 

Just the city?

 Yes, yes, 3.1 million people. Zambia has about 18 million people and 3 million live in Lusaka. And the first stop would be the Lusaka National Museum. I enjoyed going there while growing up, and it has a lot of the history of Zambia including the colonial history. So Zambia was colonized by the British from 1884 to 1964. And there's a lot of displays of that history. And also just the process of political independence, gaining political independence, and the inauguration of the first president, Kenneth Kaounda, who I had the pleasure to meet when I was an undergraduate. It reminds me of all the wonderful things that I experienced growing up in Zambia, very friendly place. And the museum also has these original photographs of the process of democratization. Zambia had been a one-party state for 27 years after independence. So in 1991, it came democratic; it held its first multi-party democratic elections and changed presidents for the first time. Yeah, and all the presidents that have been there since. Another stop would be, you know, a restaurant called Comitereto, and that restaurants cooks all the foods, including Zambia staple food, which she might say cornmeal, some people refer to it as a cornmeal Cake; it's a little bit like polenta, but without all the butter and everything....

Paavo Monkkonen  5:35  
Uhm without the butter?

Singumbe Muyeba  5:36  
Yeah, so that is used to eat with, you know, things like T-bone steak or tilapia fish. And going back to the museum, they hold cultural events with the 72 different ethnicities displaying their culture, and dance. So I get the opportunity to enjoy some of the Zambian traditions and culture.

Paavo Monkkonen  6:03  
Take me to the museum, all day.

Shane Phillips  6:06  
So the article we're discussing today was published in a recent issue of the Journal of Urban Affairs, and it's titled 'Property Rights and Health for the Urban Housing Poor in Nairobi: Evidence from a Phased-in Natural Experiment'. A link to that study will be in our show notes, as always, in this study Singumbe uses this natural experiment in Nairobi to measure the impact of two distinct determinants of physical and mental health. First, is the impact of improved housing conditions, meaning basically safe quality, habitable housing. And second is the impact of secure property rights or secure tenure, especially ownership of land and the building or part of the building on top of it. We'll talk about why it's been challenging for researchers to disentangle the effects of improved housing and secure tenure. And to preview the findings a bit, he does find that both these things seem to play a role in different but perhaps overlapping ways. But this is also our first time discussing an African city on the podcast so we really appreciate the opportunity to learn from you about Nairobi, and about Kenya's efforts to improve housing conditions for a very rapidly urbanizing population. So we'll get to why tenure security is important in just a little bit but could you just give us a few sentences on what that really means? How do you define tenure security or secure tenure, and what distinguishes secure tenure from insecure tenure?

Singumbe Muyeba  7:40  
Yeah, thank you so much. And I really appreciate the opportunity to talk about the article. So when we think of tenure, first of all, tenure is about how people access land and housing, and they might access it through ownership, or they might access it through rental contracts. And when we talk about security of tenure, we're talking of people accessing housing or land securely, that is they are guaranteed of protection from the government against evictions, it means that they do not live in fear of being evicted, or that there's no possibility of them being evicted. So it's about that guarantee that they will not be evicted. And people who live in conditions, whether they own in an informal area, or they rent in an informal area. When they live in those conditions. They live with the fear that their houses might be destroyed in an eviction forcibly typically this happens with bulldozers coming to tear down houses and security forces, forcibly removing them. So people who leave security are those who are guaranteed that they will not be evicted.

Shane Phillips  9:05  
And I think it might be important to kind of make the point that certainly you can still be evicted for not paying your rent or if you own your home for not paying your mortgage but it's more of a protection against kind of arbitrary eviction or foreclosure or eviction without cause right?

Singumbe Muyeba  9:24  
Absolutely. So, this is really guarantee from the state, and if you are evicted forcibly, without cause, you can still go to the state and say "hey, I have these documents that prove that I own this property or I rent this property and I am living within the legal parameters, and therefore I should not be evicted" and the government will send, you know, the forces to be able to restore one to their own house and land

Shane Phillips  9:57  
Got it. So you open the article by reviewing some population and migration trends and housing conditions across the African continent. I think sharing some of that context might help the audience understand why this issue of tenure security is so important. Could you give us some of that overview that you mentioned in the beginning of the article? Yeah, absolutely.

Singumbe Muyeba  10:17  
So kind of a big picture. Globally, we have about a billion people who live in slums. So if we think about it, we are 8 billion people, 1 billion of those living in slums. If we focus on the African continent, the African continent has about 1.25 billion people, and this population is rapidly rising. We expect.... the projections by the United Nations, is that by 2050, Africa will have 2.5 billion people, which is unprecedented

Shane Phillips  10:53  
Double what it is today, right?

Singumbe Muyeba  10:55  
Absolutely. And with that, there are about 260 million people who live in slums. However, there are a lot more people that live in precarious conditions or in inadequate housing and who are in need of housing.

Shane Phillips  11:10  
Could you actually distinguish slum housing from just inadequate housing, what defines the difference between those two things?

Singumbe Muyeba  11:19  
So slum housing is more of the actual slum conditions, they can range from the kind of roofing or the kind of walls that are built, they are not up to standard, but inadequate housing includes not only those housing conditions, those physical housing conditions, but also overcrowding, and the like. And so when we look at inadequate housing, there is a study that was done by Barr and others in 2018, and it reveals that in across Africa, there are 51 million households that require adequate housing. And if we assume that, you know, there is a household size of about six to eight, across the African continent, we're really talking over 400 million people living in those conditions. But what is worse about it as well is within the African continent, those people that are living in slums are really living in inhumane conditions, these are conditions that us as human beings in the 21st century should not be living in right? So these are people exposed to the elements because they have built their housing out of zinc iron sheets, out of cardboard boxes, and so they are exposed to the elements, there is likelihood of fire. On top of that, because these are in areas where the government has not formalized, they have not zoned the area for housing, they do not have any legislation that allows them to provide services. And so there's a lot of garbage refuse, there is unsafe water supply, and so people they end up having diseases like dysentery and cholera, SAP virus, all sorts because of the nature of the conditions in these slums. 

Shane Phillips  13:27  
Yes, yeah. I think that's a really important point, though, that it's not just you know, the, the quality and conditions of the housing itself, but because of the environment that it's in all these other basic services and hygienic services, clean water, etc, are also often not provided for. So how about in Kenya and Nairobi specifically, since that is the focus of this paper, I just pulled some very basic stats and learned that Kenya's population has grown from 31 million in 2000 to 53 million people today. And its per capita GDP has increased about fivefold from around $400 to $2,000 in US dollars during that time. And that's adjusted for inflation. That's not the fastest growth among African countries, but it is definitely you know, among the better performers. GDP doesn't really tell us necessarily about how that wealth and income are distributed, though. So, you know, I'd be interested to hear more about that, and especially its housing conditions and some of the challenges and priorities that it has in the housing space.

Singumbe Muyeba  14:32  
That's a very important aspect of it. Inequality, as we are seeing has been rising globally, and particularly in Kenya we also see this. Nairobi has a population of about 4 million people, and Kenya itself in general has about, you know, it has about 51 million people - 70% of whom live in slum conditions. 

Shane Phillips  14:59  
Wow. 

Singumbe Muyeba  15:01  
And when we count these slum conditions, we're really including the rural area as well. So when the World Bank reports on slum conditions, they are also including about half of the population that lives in rural areas. But even in urban areas, about 70% of Nairobi, for example, Nairobi has 4 million people. 70% of Nairobi's population lives in slums, as well as slum conditions. And this has actually been getting worse. Of course, you've seen how the population has increased, it's almost doubling since 2000. And that means most of the population is actually moving towards urban areas, it's actually growing both in urban areas and rural areas. And that growth means for Kenya, which has a housing backlog of about 2 million households, it means that we're seeing more and more people moving to these slum areas. When we narrow down and focus on the biggest slum in Kenya, which is the second biggest slum across the African continent, Kibera - Kibera has 800,000 people, that is only one slum. There are several slums with so many hundreds of 1000s of people living in those lands. And we also know that, for Kenya, the rate at which the city, particularly Nairobi, is growing is about 4.5% annually. Most of the people who move from rural areas to urban areas, they go to slum areas because it's cheaper to access housing there.

Shane Phillips  16:56  
I'm sure there's not a whole lot of other options, even if they really were set on moving into a little more higher quality housing.

Singumbe Muyeba  17:04  
Absolutely. We know, for example, also from bars study that on average, and a government in Africa takes about nine years to provide housing to build housing that will accommodate the people that will move in to the city in a year. So nine years for one year, and we just expect that the slum population will continue to grow because of the slow production of housing.

Paavo Monkkonen  17:31  
Yeah, I think it's, you know, important to recognize that scale of the problem, the housing condition problem and kind of relative to what governments could potentially do in response to it. I mean, we talk a lot about, in California, you know, how the size of the number of people living without housing is such a scale, we could never, you know, afford to house all of them. But this is really a different order of magnitude, you know, in terms of the number of people that need improved housing conditions, and the the amount of resources that governments have is a lot lower. So turns us to different kinds of solutions like titling...

Singumbe Muyeba  18:08  
Absolutely. 

Shane Phillips  18:09  
So now that we got some of this context in place, let's have you tell us about that connection between secure property rights or tenure, security and health, either at the population level or at the household level. What do researchers and policymakers believe or speculate about how these things are connected, and, you know, to what extent have those expectations been supported by empirical studies? Going into your own research, what did researchers already know or establish or think about this connection?

Singumbe Muyeba  18:42  
So there are two main mechanisms that policymakers and scholars think about this, one is that with property rights, it's thought of in terms of a hierarchy of needs, so when you address the housing component, what happens is that households can now address some of their other needs. And one of these is access to food. So all the money and resources that would have gone into spending on housing once they have that housing secure, they are now able to spend more on food and therefore that should improve nutrition. And when there is improved nutrition, then we should expect better health. And we see this in the studies done by Tom Vogel, as well as a study done by Sebastian Kalyani and Shaq Broadsky in 2004, and Dalian Yasha Gretzky also go on and do another study in 2010, which looks at multiple variables and one of them also has to do with better health based on improved access to nutrition. But the other mechanism is that when housing is provided or property rights are provided, those are taken care of, household heads, and the entire households end up having lower levels of stress. And, you know, because of those anxieties that they might be evicted, when when they have secure housing, they have tenure security, they have better psychological health, they have they have lower anxiety. And with lower anxiety, comes fewer occurrences of chronic diseases like hypertension, you know, and diabetes. And then from that follows better psychological health, this comes from a study that was done by Gandaman back in about 2010. But all of these studies were located in Latin America, with very few studies, particularly, you know, studies looking at causal mechanisms, very few of them located in African continent.

Shane Phillips  21:01  
And, you know, I want to point out when you were talking about physical health, there, you are really talking about improved housing conditions and not secure tenure. If there have been any connections established or, you know, evidence that there's not a connection, let us know but I think that can just also lead us into our next question, which is about, you know, your study is trying to disentangle the health impacts of improved housing conditions from the health impacts of property rights and secure tenure. In this case, again, really referring to ownership of the land and housing in perpetuity. Could you say a bit about why it is important to isolate the roles of these two variables, and why it's been a challenge for researchers up to this point?

Singumbe Muyeba  21:43  
Right, the two, that's physical housing, the actual dwelling, and the property rights, those two are conceptually separate. We actually have literature that focuses specifically on housing provision, and we have literature that focuses specifically on property rights,

Shane Phillips  22:02  
Because you could have someone who has high-quality housing, but no protections against eviction or displacement at any time. And similarly, you could have someone living in slum housing or slum conditions, but they have title to the property, and they are protected against eviction. And so those are two very different circumstances, and you kind of... that really highlights the difference between those two characteristics.

Singumbe Muyeba  22:26  
Absolutely so in our minds, these things can operate conceptually different. But when we look at policy implementation, those often tend to go together. So most housing projects will deliver housing along with property rights, or, you know, it might just be that they there are certain cases where only property rights are provided to people that are untitled. But where governments provide housing, they often provide that along with titles. And so a lot of claims have been made around the effects of property rights, including what might actually be the effects of housing. So there's all of these interchangeable ways in which housing and property rights are said to have this impact. And so what that does is that it poses a challenge for how we understand the effects of property rights when housing is delivered, along with those property rights or the effects of housing, when property rights and housing are delivered together.

Paavo Monkkonen  23:32  
So I'm curious to know if I mean, before we talk about the research itself, a bit more preamble just to know about your own interest in this study and your own kind of priors on this topic, because I think there's kind of some debate and controversy around land titling as a way to improve people's housing conditions. Like you mentioned, a lot of this is happening in Latin America. And it's something that I've studied, and so you know, famously in Peru, Hernando Desoto, saying, "Oh, we don't need to actually help people improve their housing, by giving them subsidies for housing if we just give them secure property rights through land title, then they'll feel empowered to do it on their own". And it's kind of seen as this kind of free government policy where they didn't actually have to invest in housing subsidies. Just the difference in context, I think is really interesting for me to hear about. Coming into it, what were you thinking and how the contexts in a city like Nairobi might differ from a city like Lima?

Singumbe Muyeba  24:28  
Right. Yeah, so Hernando Desoto, I had Hernando de Soto, you know, at the back of my mind the whole time. So yeah, and he's, you know, the Mystery of Capital really influenced a lot of thought around this. And it was, right, he's saying, well, they're billions of dollars in assets, right, or trillions, he actually says trillions, that are located in slums of the world, and all of that has to happen is that people should be given property rights, and then that will breathe life into this dead capital right? And so when I was going into it, one of the things that was in my mind was to say, well, if the poor... I mean I had done research prior to this in Cape Town, there is a slum which is being upgraded by the government of South Africa, this is Khayelitsha, over 400,000 people. And I you know, I walked those streets of Khayelitsha, and I grew up in Zambia. So I also went to several slums within Zambia. And I thought I saw things very differently, particularly for some of the projects that had been upgraded, like ... and I wrote about this in George Compound in Zambia, where, even though people were given titles, there were 30-year titles law, the nature of housing that was felt, it was not the kind that Hernando Desoto was envisioning -  the diseases continued. But in those areas where the government actually provided property rights, and housing, it was a very different story. So this was something that I wanted to actually find out to say, "Okay, is it really just the property rights? What do we see when we just have property rights? And what do we see when we just have housing?" 

Shane Phillips  26:33  
I see. So there's this program in Kenya called the Kenya slum upgrading program launched in 2004. The acronym is KenSUP, I really liked that acronym, can you share some background on KenSUP? What are its goals? What kinds of things does it try to do to achieve those goals? And how did the approach it takes differ from business as usual, in Kenya prior to the implementation of, I'll say it one more time, KenSUP?

Singumbe Muyeba  27:01  
Right, well, KenSUP is one of these really, really important projects considering the background that Kenya has or that Nairobi has with that many people living in slums, and really a housing crisis for the poor. So this project was conceived in 2001, there were, you know, World Habitat Day celebrations. And people within the government were talking to say, "we're entering the new millennium, and we still have this large part of our population. And for us, as a housing sector, we're not the slums are just growing. So what can we do about it, and they started talking with UN-Habitat as well, and they ended up thinking, "Okay, we need this large project". The beginning was Kibera with 800,000 people. So the idea was to provide housing, using mortgages, for low income households, that are located in slums. And also for the government to actually provide the insurance for those mortgages, so that the poor do not have to pay anything more than what the house is worth. It was divided into four different locations for different zones. So there is zone A, Zone B, Zone C and zone D. And it was developed in a way to produce about 20,000 housing units. The first part was to house people who were located in Zone A, so Zone A had 6000 people. And those 6000 people were located in 1500 households. And the idea was to provide housing in phases. So for zone A, the government decided that it will move people to a temporary relocation area, and then build the housing and then move those people back.

Shane Phillips  29:18  
They're building the housing in Zone A where the people were living before tearing down their existing slum housing and replacing it.

Singumbe Muyeba  29:25  
Yes, what we call an in Situ upgrade. So in order for the government to build the housing in Zone A, it first of all had to build a temporary relocation site called Lanata. And the number of houses though, that were available in Lanata, were 600 - only 600 people.... 

Shane Phillips  29:49  
So that's not enough 

Singumbe Muyeba  29:52  
Absolutely not. Absolutely not enough, it was 600, you know, households that could be moved to Lanata. The rest had to find other areas in which to live and most of them ended up moving to other slums. And so in Zone A, the government built those houses. After building those houses, they then went through a raffle just a bit of a step back. In order for people to qualify to live in those houses that the government was building, they had to raise enough money, they had to save enough to be able to make a downpayment, starting as far back as 2005, the government moved people, started building these houses, and these houses were ready in about 2012. However, there were all sorts of complaints from some of the what we would cause slumlords, right? These are people who own multiple houses, in the slum, multiple slum houses, and they are really... they rent out, and so that's how they make a lot of their money. They were complaining because they own so much land and houses within the slum, they wanted more than one house to be allocated to each one of them. And the government refused because this was not formal housing. So a court case went on and then 2016, the courts declared that the government was in the right, and the next step was to hold a raffle in a stadium - in one of the main stadiums in Nairobi. All those people that had saved enough over the course of about 10 years, actually, were now able to submit the application. And then in the middle of the stadium, raffle was drawn out. And all those people who were selected, there were about 800, household heads were then given the keys and they had they signed a contract to move into the new housing, which was in Cannon.

Paavo Monkkonen  32:04  
Of the initial residents of that part of Kibera, those residents were the only ones that were eligible, then if they saved up, they could enter the raffle to get one of these new units. So it's a small subset of the original residents.

Singumbe Muyeba  32:19  
Absolutely. So what they did is for zone A, they had first of all done a socio-economic survey, and found about 6000 people, and then they provided each household head with a card, which would be an enumeration card, but that was also the card that gave them the qualification to also apply for housing.

Paavo Monkkonen  32:40  
It was that a politically controversial program, because it seems like from the beginning, people know that a lot of them are not going to get housing in the same neighborhood.

Singumbe Muyeba  32:49  
So it initially wasn't politically controversial, because the government had given this long period of time through which people could actually save. And so most people could actually afford over the course of 10 years to raise about 100,000 shillings, which is close to about $10,000. So over the course of, you know, 10 years, so there wasn't a lot of thought political, okay but, you know, the political side of things actually came up later now with the, with the distribution, the intended distribution, as these high-rise blocks were built. So the moment you know, the housing were built, and the raffle had been drawn, about 824 households moved into these units. So it was really a subset, first of all a subset of people from Zone A going into Langata. And then a subset of people from Lungata as well as those people who did not make it into Lanata ending up being housed in Canaan.

Paavo Monkkonen  34:03  
 interesting. And just Langata how far away was it from Zone A?

Singumbe Muyeba  34:07  
it was about two kilometers...

Paavo Monkkonen  34:11  
So it's in Kibera or outside?

Singumbe Muyeba  34:14  
It is across from Kibera. 

Paavo Monkkonen  34:16  
Okay

Singumbe Muyeba  34:16  
So Kibera is really big. It's really... it's across, but where Cannan was Zone A was located because Zone A became Cannan.

Paavo Monkkonen  34:26  
Yeah, because this is a always a problem with these kinds of housing programs where it's some kind of redevelopment and, you know, where do people live in the meantime, a lot of people that are relocated, then they end up not wanting to move back because they've already made a life in this new area. They have a new set of connections there. And so it's a kind of perennial challenge.

Singumbe Muyeba  34:46  
Absolutely. And it was quite a challenge in this case as well.

Shane Phillips  34:50  
So this setup, a natural experiment for you and based on what you just said, If I can kind of just summarize it quickly. You have people actually living in Zone B, which is nearby to Zone A. And these are people who were just there the whole time, they were always living in slum conditions. And so they had neither improved housing nor secure tenure. So they're sort of the control group, you have people who were moved from Zone A into Langatta, and in that state, they had improved housing conditions. And because some people stayed there, you're able to kind of evaluate them at the same time as the zone B people. And so they're sort of a partial treatment, just improved housing conditions, but they didn't have secure tenure that didn't know if they'd be able to stay there forever, and they probably would not. And then you have the people who won the raffle. And were able to move into Canaan estates, this improved housing conditions, rebuilt housing in Zone A. And so those people had both improved housing, and tenure security. So there the full treatment. So with that established, let's talk about the results here. And I think we can just skip ahead to the results that control for age and income and gender, and all these other relevant factors. I think it will not surprise listeners to learn or hear that residents of Canaan estates, the full treatment scored lower on fear of eviction than either of the other groups. They had improved housing and secure tenure. So I think that makes sense. But residents living in Langata, also scored lower on fear of eviction compared to residents in Zone B, which was that control group. And that's, I think, a bit more surprising, because Langata residents received improved housing, but they didn't have secure tenure. Could you share the scores that people reported on their fear of eviction, kind of what they represent, what they mean? And just contextualize those for each of the three groups?

Singumbe Muyeba  36:52  
Yeah. So in terms of the measures, or variables that I used; for tenure security, there were two different measures. One was fear of eviction, which asked the respondents looking back to the time you have lived in this house and neighborhood, to what extent does the possibility of an eviction worry you? And the respondents could choose any value from zero which represented that they had no worry to 10, which meant that they had, you know, this (is) the highest level that they could worry about it. The second measure was possibility  of eviction, which had the question 'to what extent would you agree with the statement that the possibility that we get evicted from this neighborhood is always present?' And again, it was a scale from zero to 10, with zero does not agree at all, and 10 agree very much. And so these were the two measures that looked at tenure security. And then in terms of physical health, there were three measures. One was just self reported health 'on a scale from zero to 10, how would you say your health is in general', so kind of the standard questions that you would get if you're filling in a questionnaire  having received health services here in the US. And then the other one was on physical pain, 'on a scale from zero to 10, how much physical pain have you felt in the past two weeks, as a result of ill health?', and zero was no pain, 10 a lot of pain. And then I also used a much stronger, more concrete measure, which was a BMI, and this is what was used by both the study done by Vogel as well as Galleon Yasha Gretzky, so BMI is body mass index, right, and to find that you calculate your weight divided by the square of your height. And the range of scores, if the score is above 22, it represents obesity. But lower weights than 17 really also represent that a person is unhealthy. And then for psychological health, it was a Standard Generalized Anxiety Disorder scale, which is used globally. It's an international measure. It's used by the World Health Organization. It is widely used here in the US as well. So for that one, there are several questions there about six different questions. Asking if one you know has felt distressed or sorrowful, has felt anxious or nervous, how often the person is worried. If one is able to control they're worrying, if they're depressed or hopeless, or have little pleasure in doing things. So these were the measures that we use. So when we see a gap of, let's say, three points in either fear of eviction or possibility of eviction, it's really on that scale from zero to 10.

Shane Phillips  40:17  
And to be clear, that was the gap, right? So how there was a three point gap in fear of eviction between the people in the Canaan estates, which is the improved housing with secure tenure. And that's the gap between them and the people in Langata, which is the just improved housing, and then there's another three-point gap going from Langata to the zone B control. So I mean, this is a six point gap on a 10-point scale, it's really, really inefficient. 

Singumbe Muyeba  40:46  
Right, absolutely. 

Shane Phillips  40:47  
And then how about the results for physical and mental health?

Singumbe Muyeba  40:51  
Right, so for self-reported physical health, the difference was point two, and that one actually ended up not being statistically significant, as well as, you know, physical pain and body mass index. So those ones were not statistically significant.

Shane Phillips  41:12  
And this is the gap like neither between Canaan estates, the full treatment and Langata, the partial nor between Langata and zone B, there was just no significant difference. 

Singumbe Muyeba  41:23  
Right.

Paavo Monkkonen  41:23  
Okay. I mean, that's not totally surprising if they hadn't been there... I mean, that's the kind of thing you would expect maybe five years, 10 years later, right, rather than immediately after moving.

Singumbe Muyeba  41:32  
Right, right. And there are some studies that have been done elsewhere where, you know, which try and look at some of these longer term impacts. So in this particular case, we do not see that that particular impact on physical health.

Paavo Monkkonen  41:48  
Right, I was wondering, just in terms of understanding kind of the differences between the people that were living in Langata, and Canaan estates, how insecure is their tenure and Langata. Because one of the things that I've learned doing research on kind of a similar topic in Mexico has people get the feeling of security of tenure in different ways. And so they, you know, they might not have the full deed in their name to their house, but they have enough paperwork, and they've paid some taxes on it. And they feel like pretty good at the government hasn't recently evicted. Anyone. So maybe you could just I'm curious to know, kind of what's the arrangement in this kind of, you know, improved housing, but not totally secure tenure environment of Langata?

Singumbe Muyeba  42:35  
Right. Yeah, that's a that's an excellent question. With Langatta, so when they moved into the housing, of course, they were moved into the housing freely, you know, they, it was free access, they were moved by the government, which gave them a certain level of security, you know. And all that they were required to do is to pay 2000 shillings every month, which is about $20 towards things like trash removal, and general maintenance of the environment, and, you know, including water, water supply. So they felt quite secure, and I did some qualitative interviews, and they felt quite secure. However, a few years into moving into Langata, those households that accumulated bills for paying that service fee, and there was one household that was evicted by the government for failing to make that payment. And so that caused that sort of insecurity that concern that yes, if we're not paying, we might be evicted.

Paavo Monkkonen  43:51  
Because otherwise, I mean, it could potentially be a pretty good deal. If you're if you're not paying that much in rent, and you have the improved housing, it might be almost better than Canaan estates.

Singumbe Muyeba  44:01  
Absolutely. Because yeah, because in Canada state, you have to pay Yeah.

Shane Phillips  44:07  
Yeah, not only save the big downpayment, fairly big as 10% but like it's, you know, significant amount of money. Yeah. Also, you have a mortgage right, that you're also paying.

Paavo Monkkonen  44:16  
Yeah. And it's, you know, one of the challenges with these kinds of government programs is once they're embarked on this housing, production and provision, they don't also want to be seen evicting lots of people for not paying because that will make them look bad. What in the Kibera in general, is there a lot of government you know, eviction of people or is that less common? 

Singumbe Muyeba  44:38  
So it's not common in Kibera, because of it being an informal settlement, basically...

Paavo Monkkonen  44:46  
Established

Singumbe Muyeba  44:47  
Exactly. Basically everyone is exposed to eviction. And historically, there was another project called the High Rise Project which the government evicted people from a section of Kibera. And, you know, they were saying, "well, we actually going to provide, you know, housing opportunities for people from Kibera" when it ended up being middle-class housing. And so people from Kibera do live in that fear that actually they will be evicted because they've seen this happen before. And you know, I don't know, you don't need to include this,  if you want but there is a golf course, that has actually eaten into Kibera, where the royal family from Britain goes to play golf.

Shane Phillips  45:40  
No, definitely including that. Oh boy! So we we haven't talked about mental health yet. And that's actually where you see a pretty significant impact on just the secure tenure aspects so can you talk about the results there?

Singumbe Muyeba  45:58  
Yes, absolutely. So in terms of generalized anxiety disorder, there were differences between, and this is now focusing on just the difference between Cannan and Langata so Langata, representing lack of property rights, with Canon representing people who actually got property rights with their housing. And we find that their anxiety disorder scores for people in Cannan were about three points lower than those in Langata. And what we are only left with to actually conclude is to say, well, property rights are the only thing that is different between these two groups.

Shane Phillips  46:47  
Yeah, that's a very large difference in scores. And I mean, to the extent there are other differences, one big one is like, again, they had to save a bunch of money and are paying on a mortgage. So if anything that's going to increase your anxiety a little bit relative to the people who are getting a much better deal in some respects in Langata. 

Singumbe Muyeba  47:05  
Absolutely. 

Shane Phillips  47:06  
So that's a really big impact, and I think an important finding, a question that this research raised for me was how secure tenure influences health in a context where residents don't have the opportunity to move into improved housing. We talked about how some folks might want to push for property rights - this is sort of the Hernando Desoto argument, pushing for property rights without also making public investments into improved housing. And I don't think this study tells us much about that. So you've provided this very strong evidence that improved housing plus secure tenure is better than improved housing alone. But how about secure tenure without improved housing? Is there anything the study can say about that? Or is that really just a question for future research?

Singumbe Muyeba  47:53  
Well, this study does kind of hint or give some indication that with property rights, we should expect better psychological health, regardless of whether housing has actually been provided along with the property. So the idea that people are no longer living in fear that they will be evicted, we should expect that their psychological health will be better. And, you know, this is an area that has not received as much attention as it should. Because what has been focused on in policy has been the economic benefits of property rights. And you see that with the World Bank, you see that with Hernandez DeSoto. And a lot of governments justify building housing and providing property rights using economic justifications. And what that has done is it has it has left us blind to some of these areas of social wellbeing that actually we see an impact on. But definitely there is need for more research that should actually look into into that data.

Paavo Monkkonen  49:04  
And I think I mean, this papers, I like it a lot, because most of the existing studies on this topic, or like you said, from Latin America, and they're titling programs where there's no infrastructure investment or housing improvement, it's just land titles. And so, you know, we've seen what the impacts of more secure property rights for people without any housing improvement, and in this case, we're seeing it with with housing improvement, but differences in security of tenure. So I think that's a really useful contribution.

Shane Phillips  49:33  
So this research was the future research that those other studies were recommending.

Paavo Monkkonen  49:39  
It's not just the...  I mean, you know, so I have this paper on on looking at the value of different levels of tenure security in Mexico. And the point that I elucidate I think in that paper is the local context and how much people are under threat of some kind of eviction is a big deal. And a lot of the research on this topic doesn't really take that into consideration. So they say "oh, look, this is the impact property rights". But it's like, well, if you're living in a daily threat of eviction is very different from a place where the government ever fix anybody, right? And so...

Singumbe Muyeba  50:08  
Exactly!

Paavo Monkkonen  50:09  
You know, more case studies of this nature are really important.

Singumbe Muyeba  50:12  
Absolutely, yes. And we are building up on all these existing research. And yeah, so we definitely need to do a lot more in that area,

Shane Phillips  50:23  
I do really just want to underline this point about looking at mental health and anxiety and so forth, you know, not just these economic outcomes, because it makes me think of the research from several years back about when they expanded, I think it was Medicare, and at least I think this was an Oregon study, where they found that at least within the first few years, deaths were not really significantly different or reduced but people were much happier, and they had better mental health. And I think you could imagine the same thing with something like rent stabilization, where there are economic costs that are real, but what we don't tend to measure is the impact on people's mental health of knowing like, my rent isn't gonna go up 20% next year, and I can't be evicted for no reason. So yeah, I think these are things that we, it's just harder to measure those or at least assign a value to them but I do think they're really important to consider. So I'm sure there have been a lot of lessons over the last 20 years of implementing KenSUP, the slum upgrading program, how, if in any way has its approach, or maybe even its goals and priorities changed over that time?

Singumbe Muyeba  51:33  
So KenSUP has had a number of shifts over time. And some of these have actually happened as a result of criticisms. One thing that we learned, and particularly from my study, so I'll tell you, when I did this study, and I had these results, I had the opportunity to go back to Kibera and to present these results to community leaders. And some of the residents, some of whom had been part of the people that I interviewed. And one of the things that kept coming up was to say KenSUP has not paid attention to vulnerable people, to widows, to orphans. And these are people who find it very difficult to save, even if you give them 10 years to be able to save for a house. And there were a lot of widows who lived in Zone A and right now the project is in is now housing people from zone B. And ofcourse COVID delayed the project but they're building houses about 20,000 houses, just to house people that were left out of Zone A and also people who are in Zone B. And again, the issue there has been that many widows were actually not able to benefit. And so the Housing Ministry has actually been making arrangements trying to figure out ways in which to provide housing, you know, not in form of mortgages, to these vulnerable groups. And KenSUP is not only providing housing, but it's also providing buildings, roads, providing pipes for clean water, and all of that. And, you know, all the suggestions that came out from the previous one, one was actually lack of participation or very low participation of the local community in informing how KenSUP is implemented. So they have established stronger sectoral... what they call Sectoral Executive Committees, so much stronger ones that are able to advocate for all the groups, including, first of all, in terms of infrastructure, but also advocating for vulnerable groups.

Shane Phillips  53:58  
That's great. So last question here, in your conclusion, you recommend that the World Bank, international organizations and Western governments should relax policies that discourage developing countries from making public investments in housing. And we haven't really talked about the fact that that has happened. But I think you can maybe go back to Paavo and I's episode with Diego Hill, and our discussion of the market enabling approach as kind of a deeper explanation of that push at the international stage. But could you tell us a little bit, you know, maybe just summarize why these organizations tend to discourage these public investments in housing, and then make the case for why they should change their policies or guidance?

Singumbe Muyeba  54:42  
Yeah, well, this goes back to the changes that happened under President McNamara, Robert McNamara in 1978 at the World Bank, where because a lot of countries right had been defaulting on their debts, there was this move to push the market as the way to go provide services for governments to actually be smaller. And when we look at housing, particularly for low-income housing, for the market, for investors, it's not a very lucrative area, the poor are not able to pay. And so a lot of the investment, the market goes towards middle-class housing or high-end housing, which leaves the poor really vulnerable. And the thing is that with the World Bank make giving conditions for their funding, that governments should not be involved directly in providing public housing, that means that the poor actually do not have a lot of opportunities for housing. Meanwhile, we are seeing this really crisis, you know, this housing crisis. And so what I recommend in the paper, is to ensure that some of those, they are not realistic, right, they are not realistic ways in which we can think of housing provision. And somehow, you know, this is why there is also the push for property rights, right because the poor will be given property rights, and then what do they do with that, right, they start to, you know, kind of build their own housing, when we see that, that that actually does not work. And I know that this also comes from this idea that when governments are lending, when the World Bank is lending to governments, it's actually lending to the poor. And so you'll find that those countries in which the poor have gotten more of an ability to pay for housing, actually end up receiving more funding from the World Bank, while those countries that have got the poor who are unable to pay actually do not receive as much World Bank funding. And so what we see is that the poor countries and those poor regions, which are worse off, end up being, you know...

Shane Phillips  57:03  
Fall further behind right? 

Singumbe Muyeba  57:04  
Exactly, yeah, exactly. And so that's actually why, you know, I make that recommendation.

Shane Phillips  57:12  
Well, I think that is a great place to end, some gourmet meal. Yeah. But thank you so much for joining us on the Housing Voice podcast.

Singumbe Muyeba  57:18  
Thank you so much, Shane, and thank you so much, Paavo. It has been such a pleasure. I've really enjoyed talking about my research, I don't get much of an opportunity so this is quite a big deal for me and I really commend you on what you're doing, helping dissemination of research in this way.

Shane Phillips  57:40  
You can read more about Singumbe's work on our website, lewis.ucla.edu. Show Notes and a transcript of the interview are there too. The UCLA Lewis Center is on Facebook and Twitter. I'm on Twitter at Shane D. Phillips, and Paavo is at elpaavo. Thanks for listening. We'll see you next time.

Transcribed by https://otter.ai

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