Accountability in Urban Health
“More than half of the world’s people live in cities, with one in three of those living in low- and middle-income countries doing so in informal settlements, sometimes known colloquially as slums, with inadequate access to services and opportunities to shape decisions about their environment. Our research will support the people in our focal communities to claim their right to health.”
Professor Sally Theobald, Liverpool School of Tropical Medicine, Principal Investigator, ARISE
Around the world, the number of people living in cities is growing rapidly. Transforming the lives of vulnerable people in informal urban settlements is vital to accelerate progress towards the Sustainable Development Goals (SDGs). This entails tackling complex, interrelated challenges of poor health, unequal access to services, insecurity and weak accountability. Rigorous research and evidence, combined with community engagement and ownership, must inform these efforts.
The ARISE Hub – Accountability and Responsiveness in Informal Settlements for Equity – is a new research consortium, set up to enhance accountability and improve the health and wellbeing of marginalised populations living in informal urban settlements in low- and middle-income countries.
TitleDigging into urban health: uncovering concepts and action for health and social justice in informal settlements
What’s it all about?Rapid urbanization is re-shaping social and economic life and, with it, human health and health systems. Most of the world’s population is now urbanized, yet one-third of urban residents live in precarious ‘slums’ and ‘informal settlements’. These city-dwellers typically lack access to healthcare and vital health-supporting services. Slums are widespread in the Global South but often hidden in plain sight, reflecting residents’ lack of voice as well as sectoral and disciplinary silos. This session asks how health systems can better engage with the social, economic and environmental realities of informal settlements, in hopes of improving residents’ health and promoting social justice. Urban areas often experience deeply entrenched health and social inequalities, but also concentrate knowledge, economic dynamism, and vibrant local organisations that can foster innovations in health-promoting practices. However, practical and conceptual approaches to deliver health systems for low-income urban residents often fail to address intersectoral challenges and the ubiquity of informality in the Global South. Vast amounts are spent on health services, while the social, economic and environmental determinants of health in informal settlements remain overwhelmingly neglected. Informal settlements are also poorly represented in official statistics, rendering them invisible to health officials and policymakers. To reveal new insights into slums and urban health dynamics, the session will be organised like an archaeological dig: it will go beyond superficial observations to analyse the underlying structural determinants of health, and participating urban researchers, policymakers, and practitioners will foster interdisciplinary dialogue that can promote health equity and the broader 2030 Agenda.
- Mr Robert Hakiza, a Congolese refugee in Uganda and director of Young African Refugees for Integral Development, will highlight urban displacement and associated risks to well-being. In particular, how urban refugees living alongside other low-income residents in Kampala struggle to access housing and healthcare, and face additional challenges of discrimination, lack of documentation, or language barriers.
- Mr Abu Conteh, an urban health researcher at the Sierra Leone Urban Research Centre (SLURC), will highlight the complex, undercounted health burdens in Freetown’s informal settlements, drawing on research into residents’ life histories and the roles of formal and informal governance structures.
- Dr Alice Sverdlik, an urban researcher at the International Institute for Environment and Development (IIED, UK) will highlight how health in informal settlements is influenced by multi-level factors including household poverty; inadequate shelter, services and infrastructure; unresponsive local governance and exclusionary planning.
- Dr Surekha Garimella is a researcher at the George Institute for Global Health (India) working on participatory approaches with waste-picking communities in Bangalore’s ‘informal spaces’. She will highlight collective community processes to improve health services entitlements for urban poor and marginalized residents.
- Professor Sabina Faiz Rashid is an anthropologist and the Dean of the BRAC James P Grant School of Public Health. She will highlight the social and structural inequalities which contribute to health vulnerability in informal settlements in Bangladesh
Shadowing Suvartha on her waste-picking route in Vijayawada
A photo essay by Shrutika Murthy, The George Institute for Global Health India
We have been involved in a number of processes to create guidelines on safeguarding in global health programmes. You can read more in our latest paper in BMJ Global Health.
Or you can read the findings of an international consultation on safeguarding by our colleagues Surekha Garimella and Bintu Mansaray.
We also have advice on safeguarding in the context of the COVID-19 pandemic.