| Urban Health and Planning |
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For the first time in the history of the world, more people live in cities than in rural areas: in 20 years, 60 percent of the world will live in cities. In another 20 years, that number will climb to 70 percent. This unprecedented growth in the numbers of city dwellers in the developing world far outstrips the ability of these cities to provide infrastructure for new residents. This lack of infrastructure will lead to an estimated 2 billion people living in slums in the next 20 years. The urban poor face severe obstacles to their ability to be prosperous members of society: high child mortality rates, poor air and water quality, high rates of infectious diseases such as tuberculosis, lack of family planning, and insufficient access to water, sanitation, and hygiene. Many cities face a triple threat: infectious diseases which thrive when people are crowded together; chronic, non-communicable diseases including diabetes, cancers and heart disease which are on the rise with unhealthy lifestyles including tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol and urban health is often further burdened by road traffic accidents, injuries, violence and crime. Kenya has been asked to efficiently manage her resources, refocus attention to maternal health and put more emphasis on urban planning so as to make cities healthier as the urban population surges.The recommendation which came as the country marked the World Health Day follows research indicating that virtually all population growth occurs in urban settings with increased exposure to communicable diseases like Tuberculosis and HIV/AIDS. World Health Organisation Country Director David Okello said the increasing urban population also brought with it an increase in the number of the urban poor and an urgent need for adequate city planning by the government. “Many times I hear people refer to slums as informal settlements; they were not planned…people just came and started living in cities. If we continue to ignore them; if we continue to behave like they don’t exist then we have a crisis and I think we already have a serious one. We must do something about it,” he said. The WHO Country Representative added that about a third of Nairobi residents lived in slums noting that in 2007 the world surpassed the 50 percent mark of populations living in urban settings. “We haven’t reached there yet in Africa but we will be reaching there fairly soon- certainly by 2030 we will be there. The population of Nairobi is about roughly four million people but this figure keeps changing every year. How do we handle those living in the slums?” he posed. Margaret Meme, Head of Maternal and Child Health at the Public Health and Sanitation Ministry said the government must protect all pregnant women by providing quality medical services in order to reduce maternal deaths. She said that there was need for the government to give equal attention to maternal health as it gave to other human rights provisions. “The President lifted the death penalty but unfortunately we lose a pregnant mother every minute. Per day we lose 21 pregnant mothers while they are delivering. We have pregnant mothers who walk to health facilities and in some places they even go by wheelbarrow. Their human rights are violated,” she said. Dr Okello also proposed a public-private partnership as a means of promoting health in urban centres saying the joint effort would help increase chances of its success. He further said health was one of the key pillars that would help Kenya achieve Vision 2030 agenda. According to the WHO official development and health were interconnected and if a nation’s population was not in good health, development would be in jeopardy. Medical Services Director Francis Kimani on his part said there was also need to bring in men and use them to propagate for women’s health. He said there was need to educate the masses on some of the traditional systems which were hindering proper provision of health care to women. “There are men who believe that women must deliver at home to prove that they are women enough. Women because of wanting to retain their marriage labour at home until death. We need to bring men in a big way; each and every man who has a wife must make sure that he escorts her to her clinics,” he said adding that it was also vital to bring in opinion leaders and chiefs at the grassroots level to help educate the men. The Kenya Medical Research Institute aims at targeting the urgent needs of the urban poor and vulnerable to improve health care through quality research. “In general, urban populations are better off than their rural counterparts. They tend to have greater access to social and health services and their life expectancy is longer. But cities can also concentrate threats to health such as inadequate sanitation and refuse collection, pollution, road traffic accidents, outbreaks of infectious diseases and also unhealthy lifestyles," says Dr Margaret Chan, WHO Director-General. Despite these challenges, cities also bring opportunities. Five actions will significantly increase the chance people will be able to enjoy better urban living conditions:
The wide range of health issues in cities and its determinants require coordinated policies and actions across multiple disciplines including environment, transport, education, parks and recreation, and urban planning. Coordinated policies and actions are also needed to address the underlying conditions of major health issues in cities today. For instance, outdoor urban air pollution kills some 1.2 million people worldwide. Road traffic injuries among children are of significant concern in urban areas. Globally, road traffic injuries are the leading cause of death among youth aged 15–24 years, and the second leading cause of death for those in the 10–14 years old. In many cases, rapid population growth outpaces the municipal capacity to build essential infrastructure that make life in cities safe and healthy, leading to the proliferation of informal settlements. Urbanization, both in the developed and particularly in the developing world, is accompanied by a concentration of poverty. Today, an estimated one in three urban dwellers, amounting to nearly one billion people, live in urban slums and informal settings, signalling the call for urgent action to address their needs. |
