Thursday, 7 May 2015 00:00
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FOR the first time in history, more people live in cities than villages, resulting in new challenges to sustainable development. Suddenly it is urban people, often surrounded by wealth, that do not have access to basic rights. In the developing world, one-third of urban residents live in slums – about 860 million people. This number could to grow to over one billion by 2020.
This provides new challenges to development, says a new report released by Save the Children. It also points out Sri Lanka is one of the best places in South Asia to be a mother but insists around the world more and more people living in slums are losing the fight of lead healthy lives.
The 16th annual State of the World’s Mothers report, which delves into a comparison of the health disparities between wealthy and poor women and children living in cities around the world, ranked Sri Lanka and the Maldives at 92 among 179 countries.
The five indicators in the 2015 Mothers’ Index are: the lifetime risk of maternal death; children’s well-being as measured by their under-five mortality rate; educational status, as measured by children’s expected years of formal schooling; economic status, as measured by gross national income per capita; and political status, measured by women’s participation in national government.
According to the report, women in Sri Lanka face a one in 1,400 risk of maternal death from pregnancy-related causes while 9.6 children in 1000 die before their fifth birthday. In South Asia, Nepal ranked 114, Bhutan at 122, Bangladesh at 130 in the index while India ranked at 140 and Pakistan at 149. Afghanistan ranked the worst in South Asia at 152.
Urbanisation can have a positive or a negative impact on health. Infrastructure improvements such as better access to health services, education, sanitation and safe water supply that often accompany urbanisation can improve health.
But if urbanisation is unplanned and rapid, it is prone to producing informal settlements with insufficient housing, poor sanitary conditions and crowding, all of which can accelerate the spread of diseases and lead to a worsening health status. The research suggests urban population growth in developing countries has done and may continue to do both.
In general, nations that have high life expectancies and low mortality rates are highly urbanised. These are countries where city governments invest in sound policies. The improvements over the last 50+ years in mortality and morbidity rates in highly urbanised countries like Japan, Sweden, the Netherlands and Singapore are testimony to the potentially health-promoting features of modern cities.
But rapid and disorganised urbanisation can also lead to higher rates of under-5 mortality. This is especially true in low- and middle income countries when rapid urbanisation is combined with poor economic performance, poor governance, failure of national and urban housing policies, and institutional and legal failure.
For example, recent research from Nigeria found that the urban child mortality rate increased with urban population growth. The increase in deaths was linked to more people living in slum-like conditions than being removed from assistance.
The report calls on Governments to promote universal health coverage, develop comprehensive and cross-sectoral urban plans and mobilise excessive resources to deprived urban areas. Sri Lanka as a developing country has to take these aspects into consideration when utilising urban planning. In a fast transitioning world, the poorest are now right under our collective noses.
