What Progress has Kenya made Towards MDG 7? APHRC launches 2nd round of the Nairobi Cross-sectional Slum Survey
By: Dr. Donatien Beguy, Research Scientist, and Project Manager, NCSS II
Last week APHRC hosted a breakfast meeting of stakeholders interested in Urban Health at the InterContinental Hotel in Nairobi. The forum discussed the plight of the urban poor in Kenya, looking at research findings covering the last ten years. The breakfast meeting also launched the second round of the Nairobi Cross-sectional Slum Survey (NCSSII)-- a study that we are very excited about at APHRC because it will help us to establish Kenya’s progression (or insufficiency) in meeting the MDG 7 target; seeking significant improvement in the lives of at least 100 million slum dwellers, by 2020.
The meeting began by shedding light on why the wellbeing of the urban poor matters in sub-Saharan Africa, and in Kenya in particular. Nairobi is a city with enormous slums, where between one and two million people live in cramped conditions without proper access to sanitation or affordable clean water. Nairobi has the highest growth rates per annum compared to the other growth rates in Africa. 75% of the urban population growth is absorbed by informal settlements. Informal settlements cover only 5% of the total residential land area of the city, but they are inhabited by at least half of the city’s population. (UN Habitat Nairobi Urban Sector Profile
What did APHRC learn from the original study?
The findings of the first NCSS (NCSS I) in 2000, showed that contrary to popular belief at the time—the urban poor were actually worse off than the rural poor. The study highlighted many of the health indicators that best capture the magnitude of health inequities between slum dwellers and other segments of the population in Kenya. In particular, the survey brought to focus the excess mortality and disease burden among the urban poor compared to any other subgroup in the country; their limited access to health care and family planning services; and the debilitating environment that characterizes slum life, including inadequate access to water and sanitation, poor housing conditions, high levels of unemployment and low and poor learning outcomes, not forgetting the complete absence of the public sector and other state players in the daily lives of slum residents.
Since the 2000 NCSS findings were released, policymakers at all levels in Kenya have been working-- in tandem with other partners-- to address some of these inequalities shown by the landmark study. For instance, Kenya’s Ministry of Health introduced a budget line for contraceptive commodities and made a policy shift on health service access whereby children under 5 years of age received free treatment at public health facilities. Other programs being implemented by the Kenyan Government and/or its development partners include the slum-upgrading program, the cash transfer program to the elderly, the Free Primary Education program, the Output Based Approach Voucher scheme, among others.
Stakeholders at the briefing were very interested in the NCSS II and are looking forward to hearing the key findings from the study that will be of interest to their work. For example, Concern Worldwide expressed their need to know more about child nutritional status, while the Food and Agricultural Organization (FAO) wanted more information on food security and whether some of their programs/interventions have improved food security in the slum areas. UN-Habitat was concerned about the definition of ‘slums’ which is sometimes unclear. The question is: how do we find a definition that best captures a slum settlement in the country as slum areas may be also be within non-slum communities? As for now, the NCSS II is based on what is currently defined as ‘slum settlement’ by the Kenya National Bureau of Statistics (KNBS) as our sampling frame is based on the 2009 Kenya Housing and Population Census.
After the interesting discussions on the technical aspects of the survey and the need to reinforce the engagement between researchers, advocacy groups and policymakers, Dr. Alex Ezeh (Director, APHRC) officially launched the second round of the Nairobi Cross-sectional Slum Survey. The ball is now in our court and I believe the strong team that is leading this project will successfully complete the survey between June and August this year. An important lesson to learn from this is that engaging with governments, policymakers, and advocacy groups is a challenging task but worth the effort. APHRC conducts relevant research because we want the research evidence we generate to be used for policymaking decisions and programmatic actions.
This is also an opportunity to say a big “thank you” to the team that made this meeting a success. The PEC team including Ruthpearl, Jessica, Diana, and Deborah has been incredibly effective in organizing the meeting under very tight timelines. Together, we produced a policy brief and a fact sheet that were distributed to the participants. I am also very grateful to the UWB team – Caroline, Blessing and Damar that helped put this together. There is still more work ahead for UWB and PEC as we strive to widely disseminate the NCSS II findings among various stakeholders within Kenya and in other parts of SSA. As the meeting indicated, the demand for such evidence exists and we must meet it!