Improving health in slums

Nearly a billion people live in slums across the developing world and that number is rising due to urbanisation. Slums are over-crowded neighbourhoods often made up of makeshift or derelict housing, without running water or sanitation.  Children under five years old living in slums are particularly vulnerable and have high rates of death, especially from diarrhoea. 


People living in slums have many health issues seen in the rural poor (dangerous childbirth, malnutrition, infectious diseases) alongside increasing risk of diseases linked to cities (traffic accidents, violence, heart disease). Even if slum residents live close to health services, they can have difficulty getting needed care. This can be because city authorities do not have the will or the resources to meet the needs of those living in the slums. It can also be because people living in slums can’t afford the cost of health care, or the time off work to seek care. The result is that many people living in slums go to low quality or unqualified clinics, or to various places (such as clinics run by charities to tackle specific issues e.g. HIV) but without joined-up care.


To date, research to improve the health of people who live in slums has been neglected. The NIHR Global Health Research Unit at the University of Birmingham is leading the world’s biggest international collaboration of research organisations, policy organisations and slum communities with the aim of improving health services for people who live in slums. Improving health services in slums will have a large impact on health in developing countries and because slums are over-crowded, better health services could benefit many people at once.
 ‘We aim to make progress in this direction across seven slums based in four countries; Nigeria, Kenya, Pakistan and Bangladesh,’ says project director Professor Richard Lilford CBE

The project runs until 31st March 2021. It will produce the following tools and information to support people who make decisions relating to health service planning:

  • Detailed slum maps, which have already been demonstrated to support health service delivery by aid organisations during crises (such as cholera outbreaks).
  • Knowledge of current demand and supply of health services in slums vital to planning future services.
  • A body of evidence on health service delivery relevant to slum populations, so policy-makers can learn what is happening in this area globally so that good practice is shared and failures are not duplicated.

Professor Lilford adds: ‘Outputs will support improvements in the organisation and effectiveness of health services, thereby delivering measurable benefits to one of the world’s most vulnerable and neglected population groups.’