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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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Notes

  1. See http://dhsprogram.com/data/

  2. For more on UN-Habitat and the Kenyan Government’s Kenya Slum Upgrading Programme (KENSUP), see https://unhabitat.org/books/un-habitat-and-kenya-slum-upgrading-programme-kensup/

  3. See Lines and Macau [38] and Karanja [32] for analysis of exchanges to Mumbai (where another community-led relocation set a key precedent) and for discussion of the role of Muungano’s technical support organisations such as Akiba Mashinani Trust (AMT).

  4. See www.theguardian.com/world/2017/aug/14/deaths-sierra-leone-mudslide-regent

  5. See www.theguardian.com/world/2017/sep/02/flood-waters-rising-urban-development-climate-change

  6. See http://knowyourcity.info/

  7. See http://knowyourcity.info/

  8. Sierra Leone’s slum-dweller federation profiled 32 settlements in Freetown, 1 in Makeni, and 1 in Waterloo; the Tanzanian profile includes 218 Dar es Salaam settlements, 38 from Morogoro, 29 from Mwanza, and 12 from Dodoma; and the Kenyan profile including 144 settlements in Nairobi, 37 in Kisumu, 30 Makueni, 28 Nakuru, and 18 in Naivasha.

  9. Latrines in Kisumu are “usually flooded during floods, leading to spillage of faeces all over thus risking diseases like cholera…Water pipes [can] burst near sewerage. Women take a lot of time to fetch water. Water managers hike the price whenever they feel like it” (quoted in Kisumu profile).

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Acknowledgments

This work was supported by the UK Department for International Development and Economic and Social Research Council grant Urban Africa: Risk Knowledge (ES/L008777/1).

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Authors and Affiliations

  1. International Institute for Environment and Development (IIED), London, UK

    David Satterthwaite & Alice Sverdlik

  2. Bartlett Development Planning Unit, University College, London, UK

    Donald Brown

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  1. David Satterthwaite
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Correspondence to David Satterthwaite.

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Satterthwaite, D., Sverdlik, A. & Brown, D. Revealing and Responding to Multiple Health Risks in Informal Settlements in Sub-Saharan African Cities. J Urban Health 96, 112–122 (2019). https://doi.org/10.1007/s11524-018-0264-4

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