PHA-Exchange> Case studies and human interest stories on Urbanisation

[claudio at hcmc.netnam.vn]

    From: Bridget Lloyd <bridget at hst.org.za>
___________________________________

Case studies and human interest stories on Urbanisation

The Global Health Watch provides an alternative assessment of the gross
inequalities in health worldwide, "watches" the institutions of global
health and development governance, and makes recommendations for new
approaches to some of the most intractable health problems in the world
today. 

We would like to ensure that people's health issues and indigenous health
issues are reflected within the second edition of Global Health Watch, and
would like your assistance and input in writing and sourcing human interest
stories written in a simple narrative style. Where it is not possible to
integrate stories submitted within chapters, we will put them on the web
site. We would like both positive and negative stories, successes and
failures, etc.

Please forward this request on to others and encourage people to write up
their experiences. The Urbanisation chapter framework is below and more
chapter frameworks are to follow.

More information on GHW can be found on www.ghwatch.org. The full edition of
GHW and a shorter advocacy document Global Health Action can be downloaded
from the GHW website.

 

Please submit case studies to ghw at hst.org.za. 

Best wishes

Bridget

Framework for the chapter on Urbanisation and Health

1. Definition, extent and trends in urbanisation:

 

-          What constitutes 'urban' and what are key-characteristics of the
urban setting (with implications for health and health equity) 

-          Current extent of urbanisation, viz percentage of global
population living in urban settings 
Trajectory of urbanisation, viz rate of growth of urban population in
different regions

 

2. Nature and context of urbanisation

-          Nature of urbanisation in past 50, and especially past 20 years.
Proportion of 'newly-arrived' urban population that is poor 

-          Factors driving urbanisation, e.g. natural increase and migration
(viz 'push' and 'pull' factors e.g. landlessness, rural 
pauperization, opportunities for employment, better availability of
services, conflict, etc) 

-          Similarities and differences between urbanisation in late
20th/21st Century compared to earlier urbanisation during economic expansion
of 19th/early 20th Centuries, viz industrialization and expansion of
employment vs. de-industrialization and shrinking of formal sector workforce
in many LIC's and MIC's


3. Health Aspects of Urbanisation / the urban setting

-          Health Impact (Disease pattern) of squalid urbanisation -
combination of 'pre-transitional' causes (nutritional deficiencies and
infections), plus 'new' urban infections eg Dengue Haemorrhagic Fever,
co-existing with growing epidemic of non-communicable diseases
(hypertension, obesity, diabetes) and escalating rates of violent trauma. In
SSA HIV/AIDS. Epidemiological polarisation vs transition

-          Environmental and social aspects of above disease pattern,
including poor housing and homelessness; poor diets with high content of
processed foods; inadequate/inaccessible sanitation, Water, refuse removal,
recreational facilities; alcohol and substance abuse; violence and trauma
etc.

-          Apart of urban (population) health, also examine "health of the
urban setting" e.g. the existence of increasing inequalities within a
territorial area has implications for overall (whole city) health (see
Wilkinson). Participation in decision-making / exclusion

-          Water is used as an example to illustrate this. E.g. the case of
Cochabamba

 

4. A critical view of approaches to addressing urban health problems

-          'Healthy Cities' Movement - diversity, successes and failures,
and reasons for failure 

-          Slum upgrading and current focus of Habitat 

-          Urban PHC and use of CHW's 

-          Policy initiatives e.g. public works programmes 

-          Comprehensive public health plans (Water: an example)


5. Critical analysis of "New and innovative" approaches

-          Examples of participatory urban governance and health action; 

-          Examples of 'partnerships' between government and private sector


6. Concluding comments; moving beyond local approaches (the need to move
beyond approaches that are limited to the "urban setting")






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