Bridging the North-South Divide in Evidence on Homelessness

UN-Habitat is all set to observe World Habitat Day on 5^th October 2020. The theme of the year is ‘Housing for All: A better Urban Future’. I thought to write about the need for research and generating evidence in the field of homelessness in the global south taking cues from the existing evidence base on homelessness, largely from the global North.

Homelessness is a complex global problem. It is difficult to predict an accurate number of homeless people across the globe due to varied definitional issues globally. The enumerator bias and the ‘hidden’ homeless who could not be found during the enumeration further add to an inaccurate estimation of the magnitude of the problem.

As per the UN (2015) estimate, as many as 1.1 billion people in urban areas alone all over the globe live in inadequate housing conditions and about 100 million have no house at all. The number of homeless in India also varies between 1.77 million (as per the Census of India 2011) to over 3 million (as estimated by civil society organizations) due to the issues inherent in the measurement of this complex problem.

The lack of identity documents and the consequent exclusion from the food security safety net provisions and health services burden this set of population further. Since the homeless in India, or for that matter, anywhere in the world do not constitute a homogenous group, their segregation by gender, caste/race, and age group portrays differential vulnerabilities shaped by the intersection of structural and individual features.  Homelessness is thus, one of the major challenges reflecting inequalities that get exacerbated due to intersections with several structural and individual factors.

The ambitious project of Housing for Everyone by 2022 in India under the Pradhan Mantri Awas Yojana (PMAY) is a welcome move yet housing alone is not sufficient a solution. There are some research networks, one of the notable being the India Homeless Resource Network and some regional and national organizations addressing homelessness in the country but still, there is a considerable lack of evidence in the area. The academic researchers, human rights activists, and civil society organizations need to join hands and generate more evidence to make the myriad challenges and needs of this diverse and heterogeneous homeless population visible to policymakers.

Drawing from Williams and Cheal (2001) I see homelessness as a process that involves both structural and individualistic attributes. The policy formulation requires meeting not only the housing needs but also addressing individual vulnerabilities resulting from lack of education, employment, life stage, gender, disability, and/ or any other individual barrier that may lead to being homeless again. Thus, ‘Housing First’ followed by tailor-made support seems to be a comprehensive solution theoretically, it is imperative to know what has worked or not worked in a specific context. Also, the barriers and facilitators in the process might prove useful for policy formulation. To this end, one needs to know what evidence exists in the field of homelessness.

Evidence and gap maps (EGMs) are an evidence synthesis study that makes evidence easily discoverable, navigable, and available. These maps are extremely useful for researchers, academicians, non-government organizations working for the rights of the homeless, and other stakeholders responsible for policy formulation. The visual representation of existing evidence and its quality not only saves time but also makes the available body of knowledge comprehensible. The research gaps may be easily identified and any duplication of research may also be avoided.

As a ready reference, anyone interested in the field of homelessness may refer to the EGMs created by Campbell Collaboration and Heriot-Watt University for the Centre for Homelessness Impact. The two EGMs tackle the complex questions of ‘what works’ (Effectiveness Map) as well as ‘Why Things work or not’ (Implementation Map) and visually represent the existing evidence [See White (2018) and White, Wood and Fitzpatrick (2018) for detailed reports on maps]. A snapshot of the effectiveness map of Homelessness is given as Fig. 1.

Fig 1: A snapshot of Homelessness Effectiveness EGM

An interesting observation, however, is that the studies on the map are mostly from North America (the USA and Canada). The same indicates the global imbalance in knowledge production. We may refer to the studies from the global north to understand what and why something worked in a specific country but to change the status quo, there is a greater need of knowledge and evidence produced from the global south. Nonetheless, it is important to contrast and compare the regional and contextual variations to understand and frame relevant research questions that cater to a specific population in a selected context. Referring to the EGMs to explore the global evidence may well be the first step towards coming up with relevant research questions and appropriate local solutions.

EGMs are vital online information retrieval systems and I would like to refer EGMs as ‘the lighthouse’ that helps users navigate the ocean of knowledge in a particular field. Anyone interested in knowing more about a particular study might have to surf further and the map usually has a hyperlink/URL for every study depicted on the map.

It could, however, still be a humongous task for some to access all the studies on account of lack of time, resources, and closed- access models of publication. The Intervention tool may prove of immense utility as it summarizes studies under a particular intervention. The goal of the intervention, location of evidence, implementation issues, and outcomes are summarized for each intervention. Also, the reliability, cost-effectiveness and impact for each intervention on the homeless population are given in a concise manner. A snapshot of the intervention tool with some of the parameters of studies under a particular intervention is given in Fig. 2.  The intervention tool is thus a reliable and accessible entry-point to evidence on homelessness interventions for decision-makers to commissioning, funding, and service delivery.

Fig 2: A snapshot of intervention tool indicating reliability, cost-effectiveness, and impact of evidence under the intervention ‘access to health services’.

The studies on the Homelessness EGMs have also been included in at least three reviews (to be published) on interventions on accommodation, health, and discharge. The protocols of two of these reviews may be found in the open-access journal Campbell Systematic Reviews [See Keenan et al (2020) and Hanratty et al (2020)]

To conclude, I would reiterate that there is a greater need than ever to make the voices from the global south heard through more rigorous and meaningful research to reduce inequalities. Let us engage, collaborate, generate more evidence, and work every single day towards the causes that make the world an equitable and a better place.

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