The world is urbanizing quickly. For the first time in recorded history, over half of the world’s population currently lives in urban areas. In Africa in particular, urbanization largely equates with growing slums. UN-HABITAT estimates that 72 percent of all urbanites living in Africa are in fact slum dwellers.
Urban slums are complex communities where poverty is only one of many challenges that impact the health and well-being of slum residents. Jhpiego has learned first-hand that “proximity to health services does not equal access to health services.” One striking example from Kenya is that the rates of infant and under-five mortality are greater in the urban slums of Nairobi than among the rural poor in Kenya, while immunization rates are lower.
Since 2005, Jhpiego has worked in Kenya and worldwide to address the health needs of the urban poor. With support from the Bill & Melinda Gates Foundation, the U.S. Agency for International Development, Merck/MSD, the Wallace Global Fund, the Waterloo Foundation and the Rockefeller Foundation—and in close partnership with local organizations—Jhpiego has translated its technical expertise to the context of poor, overcrowded slums in developing countries.
Jhpiego’s successful work and results were recognized in the 2010 joint World Health Organization and UN-HABITAT publication Hidden Cities: Unmasking and Overcoming Health Inequities in Urban Settings. Jhpiego’s approach has been to listen to the urban poor, and to link them to health care services to address real health needs in their community. Numerous community-based innovations have resulted—and thousands of lives have been improved. A few examples:
- To “bring health care services to the people,” Jhpiego has scaled up the availability of community-based family planning services. In partnership with MSD, and building on the Gates Foundation-funded Tupange program, Jhpiego has helped over 22,251 clients through December 2012 in slums across Kenya access the full range of family planning methods and other critical health services, including HIV counseling and testing and immunizations and deworming for children.
- Jhpiego has trained HIV-positive “expert patients” from the slums who test the medical knowledge of clinicians providing HIV treatment and care services. These expert patients now are regularly engaged to help strengthen the quality of HIV training in Kenya.
- In response to the threat of violent sexual assault, Jhpiego sponsored self-defense training to help women in the Nairobi slums ward off attackers at night. Community paralegals who were trained with Jhpiego support have helped police capture and convict nine rapists from the slums. Youth groups now patrol the slums at night to help protect their community.
- Jhpiego has helped organize young mothers’ clubs, which not only help single mothers care for themselves and their babies during and after pregnancy, but also help them earn income to support their new families.
Jhpiego will continue to build upon these successes by working closely with urban communities to address their health needs in the years ahead.
Population and Health Dynamics in Nairobi’s Informal Settlements, APHRC, Nairobi, 2002