With an estimated urban population growth rate of 4.3%, Nigeria’s urban population is expected to double by 2050. The notable consequence of the rapid urbanisation that is taking place in the country is the expansion and increase in numbers of informal settlements within and around large cities. These informal settlements, referred to as urban slums, are characterised by poor housing, lack of basic amenities and poor access to urban resources, including health, nutrition and education.
Rapid urbanisation and the growth of unplanned urban slums have necessitated global attention towards ensuring social inclusion and equitable access to urban resources, particularly for vulnerable groups. A critical area of intense concern in Nigeria, and other low resource settings, is access to comprehensive and quality health services in urban slums. Urban slums have a relatively higher burden of communicable disease, and this can be attributed to overcrowding, poor ventilation, low economic status, and low literacy level. Moreover, financial access to quality healthcare for urban slum dwellers is further limited due to lack of social health insurance and heavy reliance on out-of-pocket payments. Hence, ensuring access to quality and affordable healthcare for this group of people should be prioritised.
Informal healthcare providers (IHPs) are a crucial source of healthcare in urban slums, essentially filling the gap caused by the absence of formal healthcare providers (FHPs). Informal healthcare providers include patent medicine vendors (PMVs), village health workers, traditional birth attendants (TBA), traditional healers and itinerant (travelling) drugs vendors, among others. These categories of IHPs are ubiquitous, they provide affordable healthcare to the urban poor, and they enjoy the patronage and confidence of slum dwellers. However, the health services they can provide to clients are limited to their skills and capacities, and there are legitimate concerns about the quality of health care that is provided by IHPs.
With focus on Enugu and Onitsha cities, the CHORUS project on urban health will develop and institutionalize health system linkages between the formal and informal sectors for improving the equitable provision and use of appropriate essential health services in urban slums in Nigeria. Specifically, it will:
- Strengthen the links between informal health service providers and formal health system to ensure delivery of essential and quality health services in urban slums and for the urban poor.
- Strengthen the capacity of non-formal health service providers to deliver quality health services within the limits of their capacity and practice.
- Identify the roles of various institutional structures in ensuring the formalisation and successful creation of linkages between the informal providers and formal health system in urban slums and for the benefit of the urban poor.
- Identify governance, monitoring, and supervision mechanisms that will be effective in managing the created linkages between the formal and informal providers within the public health system.
- Optimise measures for strengthening various health system building blocks to ensure effective and sustained linkage between the informal and formal health system for overall optimal health system performance in urban slums and for the urban poor.
Professor Obinna Onwujekwe
Professor Benjamin Uzochukwu
Dr Chinyere Mbachu
Professor Nkoli Ezumah
Professor Chidi Nzeadibe
Professor Chukwuedozie Ajaero
Dr Enyi Etiaba
Dr Chinyere Okeke
Dr Victor Onyebueke
Dr Tochukwu Orjiakor
Dr Aloysius Odii
Dr God’stime Eigbiromolen
See details of the team here
Some outputs from projects on urban health
- Examining the roles of stakeholders and evidence in policymaking for inclusive urban development in Nigeria: Findings from a policy analysis (https://www.springerprofessional.de/en/examining-the-roles-of-stakeholders-and-evidence-in-policymaking/19885662)
- An analysis of urban policies and strategies on health and nutrition in Nigeria (https://www.tandfonline.com/doi/abs/10.1080/17535069.2021.1976263)
- Analysis of equity and social inclusiveness of national urban development policies and strategies through the lenses of health and nutrition (https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01439-w)