A proposed risk assessment framework for public health responses : a case study of Melusi, an informal settlement in Gauteng, South Africa

Abstract

This study focused on Melusi, an informal settlement in Pretoria. The COVID-19 risk assessment framework in this study was developed from existing risk assessment frameworks which were reviewed in the context of COVID-19. Based on this evaluation the study proposes a COVID-19 risk assessment framework that was applied in the context of Melusi. Data was collected through a mixed method approach where primary data (qualitative) was collected from focus group discussions held with 21 community health workers stationed in the settlement, and the secondary data (quantitative) was retrieved from the University of Pretoria Community Oriented Primary Care (UP COPC) unit’s household data. Through the adoption of the mixed method approach, it was found that, in the context of COVID-19 in Melusi, the greatest exacerbators of the community’s vulnerability were the physical structure of the dwellings; household size; access to water and handwashing facilities; and the cleanliness of the communal bucket (portable) toilets. The community’s attitude towards masks, sanitizers and social distancing compromised the settlement’s overall preparedness. Lastly, the community’s resilience scores were lowered by the overall reliance on public transport for most community members and the nature of employment for most community members. These findings provide an indication of the need for more risk assessments at the informal settlement scale, which would facilitate in streamlining health responses in informal settlements.