Urbane Gesundheit ist von globalem Interesse, da schon jetzt die Mehrheit der Menschen in Städten wohnt und dies zunehmend in Entwicklungsländern. Obwohl mentale Gesundheitsprobleme (z.B. Depressionen) in Entwicklungsländern stark verbreitet sind, wurden diese für die rasant anwachsenden Städte dieser Länder bisher nicht zufriedenstellend untersucht. Mit einem räumlich-epidemiologischen Ansatz werden in der vorliegenden Dissertation Faktoren identifiziert, welche das mentale Wohlbefinden der Slumbewohner Dhakas beeinflussen. Hierfür wurden Baseline Daten einer Kohortenstudie verwendet, welche Anfang 2009 in neun Slums in Dhaka durchgeführt wurde. Es wurden Daten von 1.938 Erwachsenen (≥15 Jahre) erhoben. Der WHO-5 Well-being Index wurde als Instrument zur Selbsteinschätzung des mentalen Wohlbefindens verwendet. Mentales Wohlbefinden war signifikant mit verschiedenen Faktoren der natürlichen Umwelt, der Sicherheit vor Überflutungen, sanitären Verhältnissen, sowie mit qualitativ hochwertiger, zufriedenstellender und beständiger Behausung assoziiert. Weitere mentale Gesundheitsassoziationen wurden in Bezug auf Bevölkerungsdichte, Zufriedenheit mit der Arbeitsstelle und mit der Einkommensgenerierung identifiziert, während für individuelle Faktoren wie Alter, Geschlecht, Krankheiten, Gesundheitswissen und Migrationshintergrund angepasst wurde. Räumliche Konzentrationen von gutem und schlechtem mentalem Wohlbefinden wurden festgestellt, welche auf massive Gesundheitsungleichheiten innerhalb der Slums hindeuten. Verschiedene Nachbarschaftskontexte wirken sich zudem in anderer Weise auf das Wohlbefinden aus als persönliche und Haushaltscharakteristika. In der Annahme, dass mentale Gesundheitsprobleme das Risiko physischer Krankheiten sowie die Unfallgefahr erhöhen, liefert diese Dissertation wichtige Informationen, um sowohl eine bessere Krankheitsversorgung als auch sinnvolle Krankheitspräventionsprogramme für die Slums von Dhaka und vergleichbarer Gebiete zu entwickeln. / Urban health is of global concern because the majority of the world’s population lives in urban areas, mainly in the global south. Although mental health problems (e.g., depression) in developing countries are highly prevalent, such issues are not yet adequately addressed in the rapidly urbanising megacities of these countries, where a growing number of residents live in slums. Little is known about the spectrum and burden of mental disease in urban slums. Using a spatial-epidemiological approach, this thesis identifies factors that contribute to mental well-being in the slums of Dhaka, the capital of Bangladesh, which currently accommodates an estimated population of more than 14 million, including 3.4 million slum dwellers. The baseline data from a cohort study conducted in early 2009 in nine slums of Dhaka were used. Data were collected from 1,938 adults (≥15 years). The WHO-5 Well-being Index was used as a measure of self-rated mental well-being. It was found that mental well-being was significantly associated with various factors such as selected features of the natural environment, flood non-affectedness, sanitation, and housing quality, sufficiency and durability. Further associations with population density, job satisfaction, and income generation were identified while adjusting for individual factors such as age, gender, diseases, health knowledge, and migration. Spatial clusters of poor and good mental well-being among different population groups were detected and point to severe health disparities both within and between the slums. Diverse neighbourhood conditions affected mental well-being differently from personal and household level characteristics. Given that mental health conditions could elevate the risk for physical diseases and contribute to injuries, this thesis may provide crucial information for developing better health care and disease prevention programmes in Dhaka’s slums and other comparable settings.

This doctoral thesis focuses on the evaluation of the World Bank (WB) performance in delivering development aid to the Least Developed Countries (LDCs). For this purpose, an extensive research was performed to analyze a set of 790 Implementation Completion and Results reports for key economic and financial indicators. Results of this research provide various insights for the appraisal and the results stage of project delivery of the LDCs in different continents. In the final part of the economic and financial analysis the minimum Social Return on Investment (SROI) of the LDCs including all project costs was calculated. This SROI ratio outcome of 1 and 1.06 in the weighted and 1.3 and 1.72 in the unweighted case indicate that projects delivered by the WB have a positive effect on the poor countries. In the second part of this research project the data set of the ICR reports was qualitatively researched for negative ratings according to 3 core assessment categories for the overall project performance: Sustainability, bank performance and borrower performance. As a result the most critical categories respectively risks were outlined. In conclusion, the research analyses and findings support the general demand to provide even more development assistance to poor countries.:Table of Tables and Figures List of Equations List of Abbreviations 1 Introduction 1.1 Introduction to the Topic 1.2 Assessing Poverty Problems and Achieving Economic Growth 1.3 Millennium Development Goals 1.4 Development Aid 2 Research Approach 2.1 Objective 2.2 Structure 2.3 Least Developed Countries 2.4 World Bank 2.5 Data Access and Relevance 2.5.1 Data Basis 2.5.2 Implementation Completion and Results Reports 2.5.3 Project Types 2.6 Term “Performance” 2.7 Study and Research Questions 2.8 Challenges of this Doctoral Thesis 2.9 Contribution of this Thesis 3 Economic and Financial Analysis 3.1 SROI Concept 3.1.1 SROI Definition 3.1.2 SROI Process and Impact Map 3.1.3 Cost-Benefit-Analysis 3.1.4 SROI Calculation 3.2 SROI of World Bank Projects 3.2.1 Purpose of the Cost-Benefit-Analysis 3.2.2 Indicators of the SROI Calculation 3.2.2.1 Net Present Value 3.2.2.2 Capital and Recurring Costs 3.2.2.3 Project Dates and Duration 3.2.2.4 NPV-horizon 3.2.2.5 Discount Rate 3.2.3 Types of NPV-Cost-Ratios 3.2.3.1 Pro-Rata-Capital-Costs Ratio 3.2.3.2 Total-Capital-Costs Ratio 3.2.3.3 Pro-Rata-Capital plus Recurring-Costs Ratio 3.2.3.4 Total-Capital plus Recurring-Costs Ratio 3.2.4 Calculation of the proper SROI Ratio 3.2.5 Portfolio Analysis 3.2.6 Sensitivity Analysis 3.3 Additional Economic and Financial Indicators 3.3.1 Economic Rate of Return 3.3.2 Benefit-Cost-Ratio 3.3.3 Net Benefit 3.3.4 Financial Net Present Value 3.3.5 Financial Rate of Return 4 Results of the Economic and Financial Analysis 4.1 Analysis Approach and Setup 4.2 NPV Outcomes at the Appraisal Stage 4.2.1 Appraisal NPVs of the LDCs 4.2.2 Appraisal NPV Continent Comparison 4.3 NPV Outcomes of the Result Stage 4.3.1 Result NPVs of the LDCs 4.3.2 Result NPV Continent Comparison 4.4 Appraisal vs. Result NPVs 4.4.1 Results of the LDCs 4.4.2 Continent Comparison 4.5 Economic Rate of Return Result Values 4.5.1 Results of the LDCs 4.5.2 Continent Comparison 4.6 Additional Economic and Financial Indicator Result Values 4.6.1 Benefit-Cost-Ratio and Net Benefit 4.6.2 Financial Net Present Value and Financial Rate of Return 4.7 Overall Project Performance 4.7.1 Definition 4.7.2 Overall Project Performance Ratings 4.7.3 Outcome Calculation for Non-Financial Indicator Projects 4.7.4 Verification of Outcomes and Conclusion 4.8 NPV-Cost-Ratios and SROI Calculation 4.8.1 NPV-Cost-Ratios of the ICR Reports 4.8.1.1 Overall Results 4.8.1.2 Continent Comparison 4.8.2 Standardized NPV-Cost-Ratios 4.8.2.1 Overall Results 4.8.2.2 Continent Comparison 4.8.3 Calculating the Minimum SROI Ratio 4.8.3.1 Overall Results of the Capital SROI Ratio 4.8.3.2 Continental Comparison of the Capital SROI Ratio 4.8.3.3 Overall Results of the Minimum SROI Ratio 4.8.3.4 Continental Comparison of the Minimum SROI Ratio 4.8.4 Making Meaning of the Results 4.9 Summary and Conclusion 5 Qualitative Data Analysis 5.1 Content Analysis 5.2 Sustainability 5.2.1 Sustainability Rating Definition 5.2.2 Sustainability Rating Categories 5.3 Bank Performance 5.3.1 Bank Performance Definition 5.3.2 Bank Performance Categories 5.4 Borrower Performance 5.4.1 Borrower Performance Definition 5.4.2 Borrower Performance Categories 6 Results of the Qualitative Data Analysis 6.1 Sustainability 6.1.1 Quantitative Assessment of Sustainability Ratings 6.1.2 Outcome of the Content Analysis 6.1.2.1 Types of Reasons 6.1.2.2 Overall Results 6.1.2.3 Results in Haiti 6.1.2.4 Continent Comparison 6.1.3 Excursus: Positive NPV Projects 6.1.4 Summary and Conclusion 6.2 Bank Performance 6.2.1 Quantitative Assessment of Bank Performance Ratings 6.2.2 Outcome of the Content Analysis 6.2.2.1 Types of Reasons 6.2.2.2 Overall Results 6.2.2.3 Results in Haiti 6.2.2.4 Continent Comparison 6.2.3 Summary and Conclusion 6.3 Borrower Performance 6.3.1 Quantitative Assessment of Borrower Performance Ratings 6.3.2 Outcome of the Content Analysis 6.3.2.1 Types of Reasons 6.3.2.2 Overall Results 6.3.2.3 Results in Haiti 6.3.2.4 Continent Comparison 6.3.3 Summary and Conclusion 7 Overall Summary and Conclusion 8 Critical Acclaim and Recommendations 9 Outlook and Future Research List of Appendices Appendix References