Document Type : Original Article


1 Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Department of Health Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran

2 Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Department of Health Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran

3 Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Department of Health Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran


Community empowerment has been proposed since the 1980s as a way to increase people’s power
to influence social determinants of health. However, community empowerment for health promotion
in urban slums still faces challenges. The present study examined interventions, challenges, actors,
scopes, and the consequences mentioned in various studies and with emphasizing interventions
and executive challenges tried to create a clear understanding of empowerment programs in slums
and improving their health. Narrative review method was used to conduct the study. Databases
including PubMed, Scopus, Embase, Web of Science, and Cochrane were searched. The selection
of studies was done according to the “community empowerment” defined by the World Health
Organization, the concept of bottom–up approach for health promotion of Laverack and Labonte’s
study and definition of slums by UN-HABITAT. Finally, Hare and Noblit’s meta-synthesis was used
to analyze the studies. From 15 selected studies, the most intervention proposed for empowerment
was identified to be “residents’ participation in expressing problems and solutions.” The challenge of
“creating a sense of trust and changing some attitudes among residents” was the greatest challenge
in the studies. Moreover, “improving living conditions and health services” were the most important
outcomes, “slum residents” and “governments” were the most important actors, and “sanitation”
was the most important scope among the studies. Having a comprehensive view to the health and
its determinants and attention to the factors beyond neighborhood and health sector would lead to
fewer implementation challenges and better intervention choices to health promotion of slum dwellers.


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