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      Revealing and Responding to Multiple Health Risks in Informal Settlements in Sub-Saharan African Cities

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          Abstract

          This paper underscores the need for detailed data on health and disaster risks for sub-Saharan African cities, particularly for their informal settlements. Systems that should contribute to the information base on health and health risks in each locality are rarely functional. In most cities, there is a lack of data on health risks, health outcomes, and health determinants; where data are available, they are usually too aggregated to be useful to urban governments. Such data shortfalls likely hide the scale of premature death, serious illness, and injury in informal settlements; limited data can also curtail the identification of particularly vulnerable urban residents. After outlining data shortfalls, this paper considers two sources of data that can help fill data gaps on health and health determinants. The first is from city case studies undertaken within a research programme called Urban Africa: Risk Knowledge (Urban-ARK). Urban-ARK’s findings reveal the large spectrum of health risks in informal settlements, ranging from ‘everyday’ risks (e.g. infectious and parasitic diseases) to small- and larger-scale disasters. The second is from data collected by slum/shack dweller federations, which offer qualitative and quantitative findings on health, disasters, and other health determinants in informal settlements. Our conclusion reflects upon the need for additional data on multiple risks to advance urban health and well-being and support the 2030 Agenda for Sustainable Development. It also highlights the need to strengthen accountable urban governance in sub-Saharan Africa.

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          Most cited references49

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          Closing the gap in a generation: health equity through action on the social determinants of health.

          The Commission on Social Determinants of Health, created to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it, is a global collaboration of policy makers, researchers, and civil society, led by commissioners with a unique blend of political, academic, and advocacy experience. The focus of attention is on countries at all levels of income and development. The commission launched its final report on August 28, 2008. This paper summarises the key findings and recommendations; the full list is in the final report.
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            The history, geography, and sociology of slums and the health problems of people who live in slums

            Massive slums have become major features of cities in many low-income and middle-income countries. Here, in the first in a Series of two papers, we discuss why slums are unhealthy places with especially high risks of infection and injury. We show that children are especially vulnerable, and that the combination of malnutrition and recurrent diarrhoea leads to stunted growth and longer-term effects on cognitive development. We find that the scientific literature on slum health is underdeveloped in comparison to urban health, and poverty and health. This shortcoming is important because health is affected by factors arising from the shared physical and social environment, which have effects beyond those of poverty alone. In the second paper we will consider what can be done to improve health and make recommendations for the development of slum health as a field of study.
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              Unjust waters: climate change, flooding and the urban poor in Africa

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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Journal of Urban Health
                J Urban Health
                Springer Science and Business Media LLC
                1099-3460
                1468-2869
                February 2019
                June 5 2018
                February 2019
                : 96
                : 1
                : 112-122
                Article
                10.1007/s11524-018-0264-4
                6391291
                29873038
                bbc52a16-43cd-404e-b93e-588e294fb70c
                © 2019

                http://www.springer.com/tdm

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