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URBANIZATION AND HEALTH: OXYMORON OR OPPORTUNITY?
Megan Christensen, Health Advisor
October 14, 2016
For the first time in history, more than 50% of the world’s population lives in an urban area.
By 2050, 70% of the world’s population will be living in towns and cities. (WHO 2010)
Urban Population Growth
Between 1995 and 2005, the urban population of developing countries grew by an average of 1.2 million people per week, or around 165,000 people every day. (WHO Bulletin Volume 88, Number 4, April 2010)
Opportunities Threats
Access doesn’t always equal quality!
Concentrate health risks and introduce new hazards
Transition from rural to urban is chaotic, resulting in a disorganized urban landscape
Poor people are rapidly being absorbed into urban slums
For vulnerable populations - urbanization is a health hazard, ripe for humanitarian disaster
Economic benefits of living in urban settings
Increased access to services?
Scale, coverage and reach in population dense areas
Technology: multi-media platforms and mobile devices
Cost-effective
(Urbanization – An Emerging Humanitarian Disaster. N Engl J Med 2009)
Garner support from national/top leadership (MOH, urban development and planning): relationships = successful partnership
Build and strengthen capacity, especially at mid-level or closer to community (district, sub-county, county)
Create a vision with the community and it’s structures
Equity- identify, map and link the extreme poor
Develop and train a volunteer network- consider the role of youth
Reactive and strengthen local health committees: put existing policies to work
“Seeing is believing”: create living laboratories or facilitate exchange visits
Push factor
What is the recipe for success?
Community boundaries, what constitutes a household and a resident
Who are the extreme poor?
Community mobilization approaches: who, how many, and scope of work
Social cohesion, change agents and sub-systems
Availability of beneficiaries
System for replacement and enrolling new beneficiaries
Service provision and timing
Political considerations: lack voice and recognition; ignored in planning
Urban environments require special consideration
Expanding informal settlements that are unplanned
Rapid population growth coupled with frequent migration in/out
Lack of services, especially hygiene and sanitation, to meet demands
Substandard infrastructure
Poor coordination, incentives, lack of participation, supervision
Rise of unlicensed/informal providers and unregulated facilities
Insecurity and violence
Demographic shift
National policies that overlook needs of urban populations
Systems and resources for scalability
Challenges
Do your homework: collect data about your target group and influencing groups and USE this information
Foster relationships and know your beneficiaries; identify, map and target the extreme poor
Put the community at the center and engage them from the beginning to generate buy-in and ownership
Everyone has a role (it’s not just about moms and babies). Understand, define and support specific roles for all stakeholders
Recommendations
Use program evidence to advocate for change
Taskforces and consortia of civil society and NGOs/PVOs are powerful
Consider scalability and sustainability from inception
Have an exit strategy
Don’t overlook DRR
Plan and build resiliency
M&E, surveillance, CHIS & HMIS: use and strengthen the local systems
Recommendations
The child survival programs were supported by the American people through the United States Agency for International Development (USAID) through its Child Survival and Health Grants
Program. The portfolio was managed by Concern Worldwide, US.. The views, ideas, options, and comments expressed in this material do not necessarily reflect the views of USAID or the United
States Government