Poverty and the Challenge of Urban Health in Nigeria

Poverty and rapid urbanization are two of the greatest challenges facing Africa today. UN-Habitat estimates that Sub-Saharan Africa cities have over 166 million slum dwellers most of who work in the informal sector where they simply do not earn enough to afford decent shelter and services.  Environmental amenities lag behind population growth; inadequate sanitation and waste management, and the poor state of public health infrastructure have led to the spread of a wide variety of water-borne and other communicable disease. It looks very unlikely that the targets of the Millennium Development Goals will be met in Africa by 2015, despite noticeable improvements in some areas. Poverty, slum conditions and infectious disease remain pervasive and persistent. The level of preventable child and maternal deaths is still high, and the pattern of government spending on the health sector remains inequitble as it tends to favor the well-off in society.   The paper considers ways to forestall the growth and spread of slums, and progressvely  upgraded existing ones; how poverty which leads to slum conditions can be alleviated in order to reduce the worsening disparities in access to health care. The central argument is that human development ought to be at the centre of the concern for sustainable urbanization in Africa. To achieve this, the paper considers how best to promote the growth of more inclusive and humane cities by reviewing discriminatory laws and codes which tend to inhibit the access of the poor to affordable land, healthcare and housing security. The concluding section  stresses the need for appropriate and well targeted urban health and other interventions by state and local authorities, the international development community, private sector and civil society organizations, and the urban poor themselves in a collaborative effort to build safer, healthier and more equitable cities