By: Madeline Taskier, Partnership Coordinator at Women Deliver
By 2030, more than 5 billion people will be living in urban settings, a trend that will have the greatest effect in Asia and Africa. Health care services in urban areas have not caught up with the rapid pace of population growth, leaving much of the urban poor without access to healthcare.
This week, at the Woodrow Wilson Center, the Maternal Health Task Force, UNFPA, and USAID co-hosted a policy dialogue series focusing on the state of maternal health in urban slums. Despite the relative proximity and concentration of health centers in urban compared to rural areas, poor women are still not able to access quality maternal health care.
Uncovering High-Need Urban Populations
- Urban settings are a mix of migrants, refugees, ethnic groups, and diverse economic populations. Finding common ground for health service provision and dedicated community leaders is challenging with a heterogeneous population.
- Slums are defined as informal living spaces which are frequently undocumented in government maps. When development and health organizations use census data to map the population and its needs, they systematically undercount the urban poor because the poor are included in an average with wealthy urban populations.
Urban Trends in Maternal Healthcare
Catherine Kyobutungi, from the African Population Health Research Center, presented a case study of maternal health in Kenyan slums illuminating some broader trends in urban maternal health service.
- 80% of women in Nairobi slums who die during childbirth do so without the presence of a skilled healthcare worker. Many of these women plan to give birth in their homes, but are transferred to understaffed health centers when they experience life-threatening complications.
- Transportation access is the largest barrier for women delivering in slums. In Nairobi, ambulances will not venture into the narrow roads of the slums at night, forcing a woman to deliver in her home.
- The majority of maternal healthcare centers are run by private organizations, not the government. But private healthcare doesn’t necessarily mean quality care—quacks and untrained healthcare regularly solicit their services in urban slum communities.
Solutions For Reaching the Urban Poor
- Governments need to recognize and formalize slum settlements and build them into their maps, census data, and public services.
- Governments need to have better regulation and training mechanisms for private healthcare providers in the slums in order to weed out practices that endanger the lives of pregnant women.
- Adolescents need to be reached at a young age with health education and access to contraceptives. Social marketing programs have shown us that HIV/AIDS prevention and contraceptive prevalence rates among youth can go up with innovative product pitches.
- MDG1 (eradicate extreme poverty and hunger) and MDG5 (improve maternal health) are inextricably linked. By mapping all levels of income generation among urban populations, policymakers and researchers can target “health vulnerability zones” and find the urban poor who lack access to services.
Check out the presentations from the session: