Rural-to-urban migration in Africa is increasing at a fast pace, fuelled principally by the prospects of a better life in cities. Many such migrants face challenges of unemployment and poor housing when they arrive in cities and end up living in poor neighbourhoods such as informal settlements (or slums). Slums are not just the first destination of recent migrants; some slum residents have lived there for decades. Another compounding factor is high fertility, which contributes to the rapid population growth in urban informal settlements in African cities. Living conditions in slums are very poor; there is overcrowding, poor sanitation, and lack of health facilities. As a result, health outcomes are generally poor. In her presentation, Professor Madise will look at some health outcomes (child health, maternal health and HIV status) of rural-to-urban migrants and residents of informal urban areas in selected African countries to demonstrate the disadvantage in health of such residents. She will make comparisons with other subgroups (e.g. non-slum urban and rural residents) and draw on some specific examples from her recent work in Nairobi City, Kenya, where she has shown that maternal mortality is 25% higher than in other parts of the country, and where the HIV prevalence is twice as high compared with the rest of the country. She will also discuss interventions for tackling the problem of ill-health amongst the urban poor and the challenges in implementing such interventions.
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