Does is matter where I live International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 375 DOES IT MATTER WHERE I LIVE? COMPARING THE IMPACT OF HOUSING QUALITY ON CHILD DEVELOPMENT IN SLUM AND NON-SLUM AREAS IN GHANA Farouk R. Braimah and Elaine T. Lawson Abstract: Deteriorating physical characteristics and limited access to social services are said to typify a substantial number of the housing types in Ghana. The impact of these on vulnerable groups such as children remains largely unresearched. This paper compares the quality of houses in a slum (Old Fadama) and a non-slum (Asylum Down) community and its impacts on child development. Data was collected from 150 children between the ages of 9 and 17 years with the aid of semi-structured interviews. The findings showed housing quality was directly linked to income levels. Hence children in non-slum communities lived in better quality houses, had better access to sanitation services, and had better access to education and recreational facilities. The results served as the basis for a theoretical discussion and recommendations for improving child development through the provision of better quality houses, access to improved sanitation, and facilities for recreation. Keywords: children, education, Ghana, housing, non-slum, quality, sanitation, slum Farouk Rabiu Braimah, M.A. is the Executive Director, People’s Dialogue on Human Settlements, Accra, Ghana, and West Africa Focal Person, Slum Dwellers International (SDI). E- mail: rabiu_farouk@hotmail Elaine T. Lawson, Ph.D. (the corresponding author) is an environmental scientist who works as a Research Fellow at the Institute for Environment and Sanitation Studies, University of Ghana, Legon, P. O. Box LG 209. She also works closely with children through the Kinder Creative Exchange, a child rights organization in Ghana. E-mail: elaine_t@ug.edu.gh. International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 376 The factors that impact on a child’s life – family income, effective parenting, and a safe and secure environment – are all directly or indirectly influenced by a family’s housing conditions (Harker, 2006). At the United Nations World Summit on Children in 1990, governments were encouraged to develop interventions that help and protect children. In addition, the Declaration on the Survival, Protection and Development of Children sought to commit all member nations to improve child health and security, to enhance the role of the family, to develop appropriate education, to mount an attack on poverty, and to protect the environment. In a follow-up United Kingdom Implementation Report in 1992, it was acknowledged that work in the areas of education, health care, water supply, and sanitation need to be central to international development strategies to help children. Goal 7 Target 11 of the Millennium Development Goals aims at making significant improvements in the lives of at least 100 million slum dwellers by 2020 (Ssewanyana & Younger, 2008). Slum dwellers, particularly women and children, are vulnerable to natural disasters, such as floods, poor access to potable water and sanitation, and are prone to water-borne and respiratory diseases in urban areas. Thus the issue of good housing is key to any efforts to protect children. Housing, poverty, and children’s well-being are interrelated (Jack, n.d.). According to UN-Habitat (2010), adequate housing is one of the most basic of all human needs and is fundamental in order to enjoy all other human rights. Without adequate home and supportive nurturing environments in which to grow, children’s education and physical development are difficult to maintain, health is precarious, and social and moral development is impeded (Centre on Housing Rights Rights and Evictions [COHRE], 2000). Article 11(1) of the International Covenant on Economic, Social and Cultural Rights (ICESCR, adopted by the United Nations General Assembly in 1966) provides for the right of everyone to an adequate standard of living for themselves and their family, including adequate food, clothing, and housing, and to the continuous improvement of living conditions. Article 27 (1 and 3) of the United Nations Convention on the Rights of the Child (1989) also highlights the right of every child to a standard of living adequate for the child’s physical, mental, spiritual, moral, and social development. According to Bradley (2006), in order to assure well-being for children, parents must: (a) provide for their safety, (b) provide sustenance and other health-promoting supports, (c) foster socio-emotional competence, (d) provide stimulation and supports for learning, (e) monitor their activities, (f) supervise their behaviour, (g) provide routines, guidance, and directions that give structure to daily life and ongoing activities, and (h) provide social connections to key persons and institutions that facilitate the child’s adaptive functioning and long-term productivity. In Ghana, many households continue to live in poor housing conditions, where they lack a supportive nurturing environment and adequate housing. At the national level, the 1992 Ghanaian Constitution, specifically Article 28, Section 1(d), stipulates that children and young persons must receive special protection against exposure and physical and moral hazards. Also, the Children’s Act 560, 1998 provides for the best interest of children and protects the survival, protection and development of the child (United Nations Educational, Scientific and Cultural Organization [UNESCO], 2000; Government of Ghana, 1998). The Draft National Housing Policy Document, for instance, estimates the slum population in 2001 to be 4,993,000, at the annual growth rate of 1.83% (Government of Ghana, 2009). The figure is predicted to rise to 5.8, 6.5, and 7.1 million by 2010, 2015, and 2020 respectively. International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 377 Currently it is estimated that there are about 25 slum settlements in Accra, the capital city, and about 10 in Kumasi, which is the second largest city in Ghana. The country has experienced quick slum formation as a result of rapid urbanization and reclassification of villages as towns and cities (Ghana Statistical Service, 2002). Most of what is known about housing quality and how it affects child development comes from research done in North America and Europe (Evans, 2006). The relationship between housing and child development in Ghana is often underestimated. The result has been that, in spite all the numerous institutions, policies, and programmes focusing on child well-being and development, the housing conditions and living environments within which many children in urban Ghana live and grow continue to compromise their protection from physical hazards and hamper their social, moral, and cognitive development. Secure housing of good quality plays an important role in people’s well-being, but many children in Ghana find that they do not have sufficient access to such housing. This paper compares the housing context of children from a slum community (Old Fadama) and a non-slum community (Asylum Down) to understand the interplay between quality housing and child development in Ghana. The significance of this research lies in its contribution to existing work on housing and the child development, which has received little attention, especially in Ghanaian academic discourses. Secondly, it highlights policy issues that could serve as important entry points to advocate for an improvement in housing conditions for children and other vulnerable groups. Theoretical Issues Children’s rights issues have become a significant field of study in recent decades, largely due to the adoption of the United Nations Convention on the Rights of the Child (UNCRC) in 1989. Generally, children’s rights are regarded as human rights of children, which mainly focus on the rights of special protection and care afforded to children. Children’s rights include biological needs as well as the basic needs for food, education, health, safety, and social protection (Bandman, 1999; Huchzermeyer, 2006). Conceptually, children’s rights issues have become quite pronounced in the last decades (Franklin, 2001). Mangold (2002) hints that children’s rights are still not well defined, with no singularly accepted definition or theory of the rights held by children. This assertion is also supported by Rai (n.d.). Children’s rights have been explained differently by various authorities. These definitions cover a wide range of issues including civil, cultural, economic, social, and political rights. However, Mangold (2002) identified two distinct types of children’s rights: (a) those rights which see children as autonomous persons under the law and (b) those placing a claim on society for protection from harms perpetrated on children because of their dependency. Freeman (2000) provides classifications of rights that children should enjoy. The classifications include the economic, social and cultural rights, and the environmental, cultural and developmental rights. The former category includes conditions necessary to meet basic human needs such as food, shelter, education, health care, and gainful employment. The latter relates to the right of children to live in safe and healthy environments and the rights to cultural, political and economic development. International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 378 Housing and human rights According to Gready and Ensor (2005) housing has been largely regarded as a human rights issue and comes within the context of a rights-based approach to development. However Uvin (2002) argues that the rights-based approach is part of the “good governance agenda” promoted by the World Bank, which “was explicitly designed to be the complement, the political extension, of structural adjustment programs”. According to Brown (2003), the problem of inadequate or non-existent housing has reached crisis proportions globally. The UN Human Settlements Programme estimates that 600 million urban residents and one billion rural dwellers in developing countries live in overcrowded housing with poor water quality, a lack of sanitation, and no garbage collection. Inadequate housing can be considered a multifactorial epidemic – rapid urbanization, economic restructuring, natural disasters, and political events such as regime changes and wars all have contributed to the crisis. In developing countries, overcrowding and poor ventilation can encourage the growth of disease vectors such as mosquitoes, parasites, bacteria, and viruses. Noise and sheer physical safety, including vulnerability to violent crime, contribute to anxiety and depression in both developed and developing countries (Brown, 2003). Brown further asserts that some of the worst environmental health problems associated with housing, especially in developing countries, are unsafe water supplies, lead exposure, and poor indoor air quality (along with related dust and moisture problems). Housing and children’s well-being There have been a number of studies that have attempted to link housing with well-being. Some has assessed the relationship between housing and health in both developed countries and developing countries (Dunn, 2002; Lawrence, 2004; Mathee, von Schirnding, Montgomery, & Rollin, 2004; Ssewanyana & Younger, 2008; Herrin, Michelle, Amaral, & Arsene, 2013). A little improvement in the quality of basic housing can considerably increase sleep quality and quality of life among slum dwellers (Simonelli et al., 2013). This also applies to children who are even more vulnerable to the impacts of poor housing. Hence understanding sleep and daily life conditions in informal urban settlements could help to define what kind of low-cost intervention may improve sleep quality, quality of life, and reduce existent sleep disparity (Simonelli et al., 2013). The growing interest in issues that affect child development has been partly due to a movement toward accountability-based public policy that requires increasing amounts of data to provide more accurate measures of the conditions children face and the outcomes various programmes achieve. Thus the issue of the measurement of the well-being of children becomes crucial in developing interventions to shape the growth process of children, particularly with respect to the subject of housing for children (Ben-Arieh, 2000). According to Barnes, Butt, and Tomaszewski (2010), improving children's living standards is a top priority for government policy-makers. These authors noted that whilst the presence of a link between bad housing and child outcomes has been acknowledged in a number of studies, there is little evidence on how long children live in substandard housing and whether the duration of living in such housing is associated with other poor outcomes for children. Using five waves of panel data from a study on families and children in Britain, the evidence showed that the longer children live in a bad housing environment, the more vulnerable they are to a range of other negative outcomes such as poor education and poor health, among many others. International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 379 They contended that policy-makers need to focus on reducing the substantial number of children who live in substandard housing for long periods, and that interventions in housing provision for families are likely to lead to improvements in many other aspects of children's lives (Barnes et al., 2010). Overcrowded conditions have been linked to slow growth in childhood, which is associated with an increased risk of coronary heart disease in later life (Harker, 2006). In addition, almost half of all childhood accidents are associated with physical conditions in the home. Families living in properties that are in poor physical condition are more likely to experience a domestic fire (Harker, 2006). The Universal Declaration of Human Rights (UDHR) and the International Covenant on Economic, Social and Cultural Rights (ICESCR) are significant reference points for the enjoyment of the right to housing. The import of the provisions in these two documents is twofold: first, everyone, living everywhere, should enjoy some measure of entitlement not to be deprived of shelter; second, housing is an essential element for health and well-being. According to these two provisions, housing is a right and like all other rights, state parties are obliged to promote, protect, and fulfill the right to housing. Unfortunately, however, although it provides a clear and articulate safeguard, this conception suffers from a lack of clarity and enforcement mechanisms by states. Unlike the International Covenant on Civil and Political Rights (ICCPR) where most of the rights are justifiable and can be enforced in law courts, the ICESCR is more ambiguous. Housing context in Ghana Much of the housing stock in Ghana has been described as deteriorated with limited access to social services (Twum-Baah, Kumekpor, & de Graft-Johnson, 1995). According to Fiadzo (2004), rapid urbanization, low income levels, and the gradual withdrawal of public funds for housing have contributed to deteriorating housing conditions in the sub-Saharan countries of Africa. Indeed, the declining physical quality of the housing and lack of access to social services remain characteristic of much of the current housing stock in many of these countries (Twum- Baah et al., 1995; Government of Ghana, 2009). In Ghana, shelter is one of the critical challenges currently faced by the majority of both urban and rural inhabitants. This challenge, according to the Draft National Housing Policy (Government of Ghana, 2009), is attributable to rapid population growth and increasing urbanization. Consequently, overcrowding, poor housing quality, and lack of access to adequate sanitary facilities, water, and warmth to meet daily physical needs are the main characteristics of much of the housing stock in the country (Government of Ghana, 2009; UN-Habitat, 2010). Currently, the annual housing deficit in the country is variously estimated to be in excess of 500,000 units with supply figures hovering around 40,000 units. This is against the annual requirement of 120,000 units. This suggests an annual housing supply to demand ratio (for new housing) of about 35% (Government of Ghana, 2009). The lack of adequate housing, particularly in urban Ghana, has forced many households in the cities to live in overcrowded and unsanitary conditions leading to the creation and expansion of slums. As noted previously, the slum population for Ghana was estimated at 4, 993,000 people in 2001, growing at a rate of 1.83% per annum, and anticipated to reach 5.8 million by 2010 (Government of Ghana, 2009). The deplorable housing situation in the country exerts a heavy economic, social, and psychological burden particularly on children whose well- being has been directly correlated with the quality of the physical conditions of the living International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 380 environment including housing. Evidence shows that adequate housing can protect children and families living in dense urban areas from communicable and chronic diseases as well as injuries and accidents. Positive environments promote social interaction, limit psychological stress, and bolster the overall health of populations (United Nations Children’s Fund [UNICEF], 2012). This revelation has serious repercussions for children particularly those living in slums and other informal settlements where majority of the dwellings can be considered non-durable. Research Design Study areas This paper uses the definition of a child in the Ghana’s Children Act, 1998 (Act 560), which is “a child is a person below the age of eighteen years”. The study was undertaken in two communities in Accra, the capital city of Ghana and the country’s administrative capital and seat of government. The city accommodates 17.7% of Ghana’s total population of 24,223,431 (Ghana Statistical Services [GSS], 2012). This places a huge pressure on the already heavily backlogged housing stock and socio-economic facilities in the city, including education, health, sanitation, and utilities, with a resultant proliferation of slums as 38.4% (1,652,374 people) of the city’s population live in slums (Government of Ghana & UN Habitat, 2011). Old Fadama is an informal settlement in Accra. According to an enumeration report compiled by People’s Dialogue on Human Settlements (2010), the community has a population of 79,684 with a population density of 2,424.18 persons per hectare. On May 28, 2002, the residents of Old Fadama were served with an eviction notice by the Accra Metropolitan Assembly (AMA). In response to the eviction notice, letters of protest were written by a number of organisations to the Government of Ghana and the AMA outlining the international legal obligations that would be violated if the forced eviction of the Old Fadama community were to take place. A number of violations were also identified: namely, the lack of feasible alternatives to the planned eviction, short advance warning, poor consultations with slum dwellers, and a lack of housing alternatives. At the time of writing, Old Fadama was still a vibrant informal settlement, and still not captured in the city’s plans. Narrow and twisted roads, poor sanitation, wooden structures, and an apparent lack of environmental health facilities are visible. On the other hand, Asylum Down is a formal and non-slum settlement located within Accra Metropolis. The area accommodates a high proportion of business and corporate offices in Accra. Residential patterns are of acceptable standards with functional drainage and sanitation conditions. This paper is based on a descriptive and comparative study, designed to investigate the interplay between the housing quality and the development of children in the Old Fadama and Asylum Down communities. A three-stage sampling approach was to be used to select respondents for the study. These included the following: 1. Stage One: Selection of enumeration areas Under the household selection, the enumeration area (E.A.) map of both Old Fadama and Asylum Down was used. In each of the study areas, three enumeration areas were randomly selected. These enumeration areas were delineated based on the fact that there are marked International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 381 differences in terms of the physical conditions of housing and other social amenities found in each enumeration area in each community. This sampling strategy meant that data could be gathered from different areas in each community. This ensured that the data captured was a true representation of the conditions existing in each community. 2. Stage Two: Selection of households From each of the randomly selected enumeration areas, a total of 25 households were purposively selected. The criteria for the purposive selection were the presence of a child between the ages of 9 years and 17 years in the household and the ability of the child to respond to a questionnaire. 3. Stage Three: Selection of children Given that a total of 150 households were selected from the study areas, a child was purposively selected from each of the households making a total of 150 children. The main criteria for the selection of a child were that the child was between the age of 9 years and 17 years and had the ability to respond to a questionnaire. Respondents for key informant interviews were also purposively selected from diverse fields within the housing and child rights protection context. These included respondents from each the following: a. Ministry of Gender, Children and Social Protection b. Department of Social Welfare c. Civil society organisations; one from each community d. United Nations Human Settlements Programme (UN Habitat) e. Ghana Health Service (one health facility serving each community) f. Accra Metropolitan Assembly (planning department) Data collection An interview guide, which also doubled as a questionnaire, was designed based on preliminary analysis of available housing and its relationship with children’s education, health care, and social interactions of children. The process of designing the interview guide also involved consultations with key civil society organisations in the area of housing rights and academics and professionals in the field of housing. Ten questionnaires were pilot tested in each community after which the necessary changes were made to the structure and language of the questionnaires. It had four main sections: personal profile of respondents, assessment of participation in education, health care issues, and social life experiences such as issues of deviant behaviours. The questionnaires, made up of both open-ended and closed questions were administered to 150 children in both Old Fadama and Asylum Down. In Asylum Down, 75 children were interviewed comprising 34 males and 41 females. On the other hand, the 75 respondents interviewed in Old Fadama were made up of 27 males and 48 females. A second interview guide was designed to elicit qualitative data from policy and development practitioners on the subject of housing and child rights policy context. It highlighted issues of the child right policy environment in Ghana, housing policy and children’s International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 382 issues in Ghana, as well as education and health issues of children as they relate to housing environment. Secondary data sources involved a review of relevant literature and statistical data on the subject matter. Textbooks, journals, magazines, reports, policy documents, and other printed materials on the subject were consulted. Data was also gathered from the Internet to boost the quality of work. Ethical considerations It is important to consider the fact that the primary research was carried out with vulnerable people, living in very difficult conditions, often with many of their basic needs not being met. It was therefore necessary to consider the impact that the research had on the participants, how the research could benefit the respondents, and how the research could be disseminated once completed (Mayoux, 2006). Given that this is a child sensitive research project, it was of utmost importance to provide adequate protection for respondents. In the first place data collected from children were treated with anonymity and confidentiality. The appropriate ethical clearance arrangements were made with the Department of Social Welfare and the Department of Children before the administration of instruments. An arrangement was made for post-counselling of respondents who might be traumatized or experience discomfort during the survey. All field assistants were trained on child sensitive research methodologies before embarking on the data collection. Data analysis Quantitative data from the survey were analyzed using cross-tabulation analysis for areas of comparison between the occurrence of phenomena in Old Fadama and Asylum Down using Statistical Package for Social Scientist (SPSS) version 16.0. Relationship studies such as establishing the relationship between housing condition and participation in school and social life was done using cross-tabulation. Data generated from key informant interviews were transcribed and analyzed using thematic analysis where the emerging variables were coded and constituted into major themes as they related to the study objectives. Results Socio-demographic characteristics of respondents The age distribution of respondents indicates that respondents were predominantly between 10 and 12 years (Table 1). Females constituted the majority of the respondents in both communities. The female population was higher in Old Fadama where 36% of the respondents were males and 64% were females. In Asylum Down males constituted 45.3% of the respondents and 54.7% were females. International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 383 Table 1: Age Distribution of Respondents Educational level of respondents The educational levels of respondents can be found in Table 2. The majority (41.3%) of respondents from Old Fadama were in upper primary (Classes 4 to 6) compared with 42.7% from Asylum Down. It must, however, be noted that while only 1.3% of respondents in Asylum Down did not attend any school, 22.7% of respondents in Old Fadama did not attend school. Table 2: Level of Education of Respondents Old Fadama (%) Asylum Down (%) Pre-school 2.7 2.7 Lower Primary 17.3 21.3 Upper Primary 41.3 42.7 Junior High School 14.7 29.3 Senior High School 1.3 2.7 N/A 22.7 1.3 Old Fadama (%) Asylum Down (%) 7-9 Years 26.7 16 10-12 Years 30.7 45.3 13-15 Years 32 36 16-18 Years 10.7 2.7 International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 384 Ethnic background of respondents More than half of respondents from Asylum Down were Akan, followed by Ga. In Old Fadama 48% of respondents were Dagombas. This finding is confirmed by numerous studies carried out in the Old Fadama community which show that Dagombas who are migrants, form the majority of the population (Tutu, 2010; People’s Dialogue on Human Settlements, 2010). Parents’ occupation Although the informal sector is the biggest employer in Ghana controlling over 80% of the labour force, its low contribution to Gross Domestic Product (GDP) points to the sector’s low productivity. In addition, the sector is characterised by a lack of access to credit, a low level of technology, lack of social protection, high insecurity, and vulnerability. In view of the low educational levels needed for entry, the sector remains dominated by youth and women. In order to understand the socio-economic context within which children live and grow, it is important to examine the occupation of their parents or guardians. The results showed that majority of the fathers from both communities were self-employed or found in the informal sector. In Old Fadama, this constituted 66% compared with 48% in Asylum Down. Their occupations include casual labourers, artisans, petty traders, businessmen and women, among others (Table 3). While only 2.7% of fathers in Asylum Down were unemployed, about 10.7 % were not working in Old Fadama. Table 3: Occupation of respondents’ fathers Old Fadama (%) Asylum Down (%) Casual labourer 12 21.3 Artisan 10.7 9.3 Petty Trader 9.3 2.7 Civil/ Public Servant 9.3 18.7 Business person 34.7 14.7 Clergy 4 0 Unemployed 10.7 2.7 Others 9.3 30.7 International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 385 Similarly the majority of the mothers were self-employed, 80% in Asylum Down compared with 86% in Old Fadama. Petty trading remains the biggest occupational choice for mothers in both communities (Table 4). Unemployed mothers constituted 12% in Old Fadama as compared with 5.3% in Asylum Down. These findings have varying economic implications for child development in both communities. The ability of a child to enjoy good health and social amenities such as potable water and good sanitation, as well as good schools, all depend on a parent’s ability to afford them. Table 4: Occupation of respondents’ mothers Old Fadama (%) Asylum Down (%) Casual Labourer 14.7 6.7 Artisan 1.3 0 Petty Trader 56 65.3 Civil/ Public Servant 1.3 6.7 Business Person 14.7 8 No Occupation 12 5.3 Others 0 8 Respondents’ Housing Type of housing Significantly, many studies have linked the type of housing to the well-being of occupants (Fiadzo, 2004). Thus in the study, an attempt was made to examine the type of housing where children live in the study areas. The study assessed the following housing characteristics: (a) the type of dwelling and the main materials used in house construction; (b) occupancy status; and (c) household sanitation. Of children interviewed in Asylum Down, 68% lived in compound houses as compared to 74.7% of respondents from Old Fadama. This is consistent with the national statistics of housing type in Ghana. According to the Ghana Living Standards Survey (Ghana Statistical Services, 2008), about 79% of households in Ghana lived in compound houses. Living in compound houses is associated with the sharing of toilets and kitchens which impacts the well- being of children. Children are exposed to high noise levels, poor hygiene, and crowded areas. International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 386 It is estimated that only about 10% of households in Ghana live in bungalows, semi-detached houses, and flats or apartments, predominantly in higher-class urban areas. About 22.7% of respondents in Asylum Down lived in houses described as semi-detached as compared to 5.3% in Old Fadama. Whilst 2.7% of children in Asylum Down lived in separate bungalows, none of the children in Old Fadama did. This shows that respondents from Asylum Down were relatively better off in terms of housing type. Of children interviewed in Old Fadama, 58.7% indicated that there was only one room in their house while 18.7% and 12% had two and three rooms in their houses respectively. In Asylum Down, however, only 8% of respondents mentioned that their houses contained one room, with 14.7% of the children living in houses containing two rooms. On the basis of using the number of people occupying a room as an indicator for defining a slum, 50.6% of these children could be described as living in slum households; 25.3% of respondents in Old Fadama maintained that they shared a room with four people, 16% in Asylum Down did so. Also, 20% of sampled children in Old Fadama shared space with five other people compared with 12% in Asylum Down. A congested room means that children in Old Fadama comparatively have less private space in their rooms to study and play, which could have long terms debilitating effects on their academic and social abilities. Also, communicable diseases could easily spread and affect many children in living in this community (Freeman, 2000; Harker 2006). Quality of housing The housing quality was assessed by determining the materials used for constructing walls, roofs and the general living environments. The findings showed that 93.3% of houses in Asylum Down had their walls constructed of sandcrete blocks with 2.7 % and 4% respondents indicating that the walls of their houses were made up of wood or bamboo and metal sheets respectively. This is in sharp contrast to Old Fadama where about 66.7% of respondents indicated the walls of their houses to be made of wood or bamboo and 28% constructed of sandcrete blocks. Poor construction materials expose children to accidents (UNICEF, 2012). Of respondents from Old Fadama, 82.7 % mentioned iron sheets as roofing materials for their houses compared with 69.3% in Asylum Down. While most children in Asylum Down lived in houses with tiled roofs, those in Old Fadama have to contend with houses mostly roofed with mud, bamboo, and corrugated iron sheets. Hence houses in Asylum Down are roofed with more durable materials than Old Fadama. While a majority of respondents from both communities described their roofs as well sealed without any leakages (52% for Old Fadama as against 74.7% for Asylum Down), 16% of respondents in Old Fadama reported that their roofs leaked badly as compared with 1.3% in Asylum Down. In Asylum Down 57% of respondents described their living environment as poor with uncovered drains and no proper streets or alleys; 40% described it as fairly clean and decent with 2.7% characterizing their living environment as having well-covered drains and good streets. However, in Old Fadama, about 70.7% of children interviewed described their general living environment as poor with uncovered drains and poor streets. In addition, 22.7% maintained that the general living environment of Old Fadama was fairly clean and decent while 6.7% described it as having well-covered drains and good streets. Further, 5.3 % of children in Old Fadama International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 387 described their housing environment as very good compared with 13.3% in Asylum Down. On the other hand 30.7% of children in Old Fadama described their housing environment as very bad compared to 9.3% from Asylum Down. The perceptions of the children of their housing environments can be found in Figure 1. Figure 1: Respondents’ perception of their housing environments Availability of toilet facilities The availability of toilet facilities in a house is a good indicator of sanitation (Ferguson, Cassells, MacAllister, & Evans, 2013). Analysis of the results from the two communities shows that only 5.3 % of children interviewed in Old Fadama had toilet facilities located inside their houses or dwellings compared with 88% in Asylum Down. For dwellings with toilet facilities in Old Fadama, only 2.6% had flush toilets as compared with 70% in Asylum Down. Hence 77.3% of the children in Old Fadama relied on public toilets. Poor access or a lack of sanitation facilities has been consistently associated with diarrhea in children who live in poor countries (Bradley & Putnick, 2012). Children’s vulnerability to pathogens from contaminated water and poor sanitation relates both to their exposure level (children actively explore their environments and are unaware of problems pertaining to sanitation) and their level of immunity. Since children have a limited capacity to withhold bowel movements, the lack of toilet facilities in their homes affects their physical and mental health (Bradley & Putnick, 2012; Ludwig, Fernando, Firmino, & Joao Tadeu, 1999). Children in homes without toilets are exposed to gastrointestinal sicknesses such as diarrhea, cholera, and typhoid fever. This assertion is confirmed by the findings of the study as 73.3% of children in Asylum Down and 77.3% in Old Fadama mentioned malaria/fever as the most common illness. In addition, 13.3% of respondents in Old Fadama reported to suffer from diarrhea or gastrointestinal diseases as compared to 10.7% in Asylum Down. These findings International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 388 could largely be linked to the general housing conditions examined previously in this paper. Children in Old Fadama live in poor quality housing as compared to those from Asylum Down. Poor housing exposes children to mosquitoes and other vectors as well as the unfavourable weather that may persist out of the home. The finding is further confirmed by UN-Habitat’s (2010) state of the World Cities Report in which bad living conditions in urban slums were found to be responsible for more than half of the global child mortality caused by pneumonia, diarrhea, malaria, measles, and HIV/AIDS. Examination of Children’s School Attendance Children’s participation in education is essential if they are to realize their full potential as useful adult members of the society. However, a number of interrelated variables come into play to determine the quality as well as the level of children’s participation in education in any community. One such variable is housing. This section of the study therefore examines the interplay between housing quality and participation in schooling. The results showed that 98.7% of children interviewed in Asylum Down were in school compared with 77.3% in Old Fadama. Table 5: School attendance Old Fadama (%) Asylum Down (%) Do you attend school Yes 77.3 98.7 No 22.7 1.3 The high level of non-attendance recorded in Old Fadama could be attributed to the several factors. The first was poverty. The inability of parents and guardians to pay the school fees, buy uniforms, books, and other necessary educational materials meant that the children had to stay at home. Interestingly, the location of school did not significantly influence children’s school attendance in both communities. Tiredness was mentioned in both places, being attributed to too many household chores. Examination of children’s access to recreation Play, both spontaneous and organized, is an important component of healthy child development. When children play, they reap the benefits of physical exercise, develop advanced motor skills, and find relief from stress and anxiety (UNICEF, 2012). Play also promotes children’s cognition, creativity, and socialization. In urban settings, public play spaces can help mitigate the effects of overcrowding and lack of privacy in the home, and may enable children to mix with peers of different ages and backgrounds laying the foundation for a more equitable society (UNICEF, 2012). International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 389 Access to recreational facilities such as parks and gardens, playing grounds, or amusement parks enhance the psycho-social development of children. In Old Fadama 62.7% of children interviewed did not have access to any form of recreational facilities as compared to 38.7% in Asylum Down. Inaccessibility to recreational facilities for the children in Old Fadama can be attributed to the unplanned nature of the settlement, a squatter settlement which has been denied legal access to municipal services and infrastructure in the city. The few open spaces in this community are being used for residential and commercial purposes. The lack of recreational facilities can negatively affect the ability of children in this community to socialize, compete with children from other communities, and develop the necessary social skills needed for meaningful adult life in society. Children need plenty of opportunities for exercise and play to help them grow healthily and learn intelligently. Thus, comparing the opportunity for play and exercise between children in Old Fadama and Asylum Down, those in old Fadama compare less favourably and risk being less healthy and intelligent than their counterparts in Asylum Down (Bradley & Putnick, 2012). Of children sampled for this study in Old Fadama, 85% did not have access to toys and other playing materials that are generally believed to enhance intellectual development in children. Children in the Asylum Down community are therefore at a greater advantage when it comes to having access to toys and playing materials and hence enhancing their intellectual development. The lack of access to playing materials for most children in Old Fadama can be attributed to the generally high poverty levels among parents and guardians. It could also be attributed to a lack of knowledge on the part of parents regarding the importance of the use of playing materials by children. Conclusion This paper has sought to understand how location can influence children’s access to quality housing thereby affecting their development. All children have a right to safe housing of good quality; however, most of the children of the slums live in poor quality houses, in overcrowded spaces with poor access to sanitation. Mainstream approaches to development often view all children in urban areas as a homogeneous group and use statistical aggregates to determine resource allocation and programming actions. An equity-focused approach is needed to direct solutions precisely to those children who are hardest to reach (UNICEF, 2012). At the national level in Ghana, the 1992 constitutional provision on the protection of the child is not explicit on the kinds of legislative support or protection for children’s shelter needs. Our discussions with the key informants highlighted some policy options. For example, the housing needs of children have not received the same attention when compared to issues around health, education, and prohibitive practices. Yet these issues are all related, requiring a holistic approach in tackling them. The Ministry of Gender, Children and Social Protection has the mandate to promote and protect the rights of children in Ghana. As such, the ministry through its Children’s Department collaborates with many agencies and organizations for child promotion and protection work. However, the study noted that there is the need for further collaboration in the areas of children’s shelter needs. The governments at the local levels, which are the District Assemblies, need to work closely with the relevant ministries, departments and agencies in improving the quality of housing for children. Currently, collaboration and partnerships in terms of child programming International Journal of Child, Youth and Family Studies (2014) 5(3): 375–393 390 between the relevant Metropolitan, Municipal and District Assemblies (MMDAs), as well as with the traditional authorities, is weak and occurs occasionally and informally. This was a policy gap identified by all key informants in the study. The adoption of a child-friendly planning approach, which will ensure that children’s needs such as quality housing are mainstreamed into the planning processes, was also recommended. Child support legislations and policies must recognize this slum proliferation and the impact living in slums can have on children. 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