Panel on health service delivery in mega-cities and slums. Copyright: Sensoa More than half of the world’s population currently lives in cities, with one in three living in slums. By 2030, the world is projected to have 43 megacities with more than 10 million inhabitants, most of them in developing regions. While one in eight people currently live in 33 megacities worldwide, close to half of the world’s urban dwellers reside in secondary cities with fewer than 500,000 inhabitants. These secondary cities, particularly in Africa and Asia, are also expected to grow very fast. Reason enough for Be-cause Health, Belgium’s platform on international health, to take the urban turn, and put the spotlight on how to ensure the right to health in cities. In tandem with the Institute of Tropical Medicine, Sensoa organised two panels that took on the challenges of health service delivery in mega-cities and urban slums.
Too late, too little?
Adura Banke-Thomas (London School of Economics) pictured the realities of pregnant mothers in Lagos (Nigeria), in need of emergency obstetric care. In some parts of the city, the maternal mortality rate is as high as 880 out of 100,000 live births. Every day women fail to make it to the hospital in time. They cannot make their way through the city’s congested traffic. Or, when they do reach the hospital, they find that no doctor can attend to them or the medical staff is there but without the supplies and instruments to actually do their job. The mobility challenge is what has made Banke-Thomas and his colleagues set out on a mission to develop an e-platform to map the facilities in Lagos and the real-time travel of women trying to make it to the hospital. With Mothers at Risk, Rachel Hammonds and her colleagues are also trying to address the mobility needs of pregnant mothers, with a pilot for a ‘maternal Uber’ in Thiès (Senegal). It aims to train taxi drivers to assist women to reach hospitals for their antenatal, delivery and postnatal visits.
Taking young people seriously
Doreen Tuhebwe (Makarere University Uganda) considered the challenges of young people living in the Kisenyi slum (Kampala) and their sexual and reproductive health needs. Listening to young people, she tried to understand why existing SRH interventions are failing to deliver results. The study revealed that young people wish for a more holistic approach to care, including assistance to try and make a living: the continued increase in new HIV and STIs is tied up with the poverty they are faced with and the practice of transactional sex to sustain their livelihoods. Especially for those who drop out of school, existing services are unfit, as they are generally provided in English and question the SRH demands of minors.
Answering to people’s dependence on private health care providers
For many people residing in slums, private health care providers are the only ones they can turn to, as public health facilities are often too far away, and have extreme long waiting times. Yet, the quality of care is often poor and proper referrals are a challenge. In Kibra, the biggest slum in Nairobi, Save the Children has, with the Kenyan Ministry of Health, been building the capacity of private health care providers to ensure their respect for WHO guidelines and provide them with access to quality medicines, Elsie Nzale Sang explained. With 98% of private health care providers in Kintambo (Kinshasa), the ULB-coopération has also been trying to establish working relations with private health care providers, and make them collaborate with each other and the local health administration to improve the quality of care.
Adura Banke-Thomas (London School of Economics) pictured the realities of pregnant mothers in Lagos (Nigeria), in need of emergency obstetric care. In some parts of the city, the maternal mortality rate is as high as 880 out of 100,000 live births. Every day women fail to make it to the hospital in time. They cannot make their way through the city’s congested traffic. Or, when they do reach the hospital, they find that no doctor can attend to them or the medical staff is there but without the supplies and instruments to actually do their job. The mobility challenge is what has made Banke-Thomas and his colleagues set out on a mission to develop an e-platform to map the facilities in Lagos and the real-time travel of women trying to make it to the hospital. With Mothers at Risk, Rachel Hammonds and her colleagues are also trying to address the mobility needs of pregnant mothers, with a pilot for a ‘maternal Uber’ in Thiès (Senegal). It aims to train taxi drivers to assist women to reach hospitals for their antenatal, delivery and postnatal visits.
Taking young people seriously
Doreen Tuhebwe (Makarere University Uganda) considered the challenges of young people living in the Kisenyi slum (Kampala) and their sexual and reproductive health needs. Listening to young people, she tried to understand why existing SRH interventions are failing to deliver results. The study revealed that young people wish for a more holistic approach to care, including assistance to try and make a living: the continued increase in new HIV and STIs is tied up with the poverty they are faced with and the practice of transactional sex to sustain their livelihoods. Especially for those who drop out of school, existing services are unfit, as they are generally provided in English and question the SRH demands of minors.
Answering to people’s dependence on private health care providers
For many people residing in slums, private health care providers are the only ones they can turn to, as public health facilities are often too far away, and have extreme long waiting times. Yet, the quality of care is often poor and proper referrals are a challenge. In Kibra, the biggest slum in Nairobi, Save the Children has, with the Kenyan Ministry of Health, been building the capacity of private health care providers to ensure their respect for WHO guidelines and provide them with access to quality medicines, Elsie Nzale Sang explained. With 98% of private health care providers in Kintambo (Kinshasa), the ULB-coopération has also been trying to establish working relations with private health care providers, and make them collaborate with each other and the local health administration to improve the quality of care.
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