Urbanization and Wellbeing in Africa

Urban Health and the Physical Environment

The Center’s research has over the last 15 years provided a window into the plight of the nearly one billion urban slum dwellers, the extent of intra urban inequities and the gradual erosion of the urban advantage in health in
Africa. We have also demonstrated the positive impact of increased attention and investment by governments and development partners in improving the living condition of slum residents. Emerging challenges such as security
could, however, continue to threaten gains made in improving slum living conditions. Slum growth seems to be an inevitability for sub-Saharan Africa’s rapidly growing cities, and poor health outcomes among slum dwellers will
increasingly influence overall urban and national health indicators. The dearth of evidence as to what works for slum communities demands a sharper focus on systems that can -and should- generate health and improve wellbeing.

With an overarching goal to characterize and understand the state and future of Africa’s urbanization, this Unit will work in three programmatic areas:

The signature issue for this Unit will be understanding and developing slum systems for health and wellbeing. We aim to clarify the role of slums as a feature of Africa’s urban spaces and determinant of overall urban well-being. This program will seek to map and track slum growth in Africa’s new and small towns, and deepen our understanding of slum-based and intra-slum inequalities in health, education and socio-economic status, and the impact of
slum residence on health and socio-economic trajectories over the life course. The program will also aim to characterize service delivery systems, and develop and assess service delivery models that are responsive to the slum context.

Through a program of work on environmental impacts on health and wellbeing in urban contexts, we will expand the scope of our existing research on air pollution and solid waste management to other environmental risks. We will aim to understand how key environmental risks affect health and wellbeing; investigate strategies to mitigate key environmental challenges facing urban populations; and understand the contribution of the urban built environment to physical and mental health and wellbeing. The program will also advance knowledge on how complex urban systems interact to create environments that promote or harm health and wellbeing.

The third program of work will be on the causes, course and consequences of rapid urbanization. This program represents an extension of our existing research into the pace and drivers of urbanization across Africa. We aim to further explore urban growth in small towns, examine regional perspectives of migration and linkages to urbanization, and contribute to the better definition of urban typologies in Africa. We are also seeking improved understanding of the direct and indirect impacts of rural-urban migration on urban support systems.

Featured Project

Complex Urban Systems for Sustainability and Health (CUSSH)

Program: Urbanization and Wellbeing in Africa

Complex Urban Systems for Sustainability and Health (CUSSH) is a four-year program that will run from 2018 – 2021. It aims to deliver strategically vital research on the complex connections between urban development and health within city systems.

CUSSH will utilize multidisciplinary methods to develop critical evidence on how to achieve the transformations that cities need to address the environmental challenges of the 21st century. In addition, it will provide transferable evidence on how to accelerate actions essential to achieving large-scale changes in sectors such as energy, transport, water, sanitation, and housing. The program will embed public engagement, training and co-generation of research throughout its duration.

The program’s objectives are:

  • Publish a systematic review of potential solutions for healthy sustainable urban development which addresses the role of technological innovation, city governance, financing mechanisms, infrastructure and behaviour change;
  • Establish methods for tracking and evaluation of the progress towards city-specific sustainability and health goals;
  • Develop and apply models of impact on population health, health inequalities, and socioeconomic and environmental components of alternative urban development pathways;
  • Use participatory methods to undertake continuous engagements with stakeholders in selected partner cities in order to test processes to help implement the transformative changes needed to meet sustainability and health objectives;
  • To develop a programme of public engagement and capacity building to ensure co-creation and use of research evidence by decision-makers and other stakeholders to help ensure environmental and health objectives receive appropriate attention in policy.

CUSSH is a global program that will be conducted in three countries representing high-, middle- and lower-income nations. These participating countries are Kenya, France and China. Two different-sized cities within each of the three countries will form the program study sites. In Kenya, the focal cities are Nairobi and Kisumu. The program will partner with the administrative authorities within these two cities and engagement towards this end has been ongoing since 2016. While the specific sectors that CUSSH will focus on have not been finalized, the transport, energy, housing and water sectors were identified as priorities during initial engagement with representatives from the two cities.


2018 – 2021


The program team consists of a diverse set of partners, led by the University College London (UCL). Other consortium members are the London School of Hygiene and Tropical Medicine, Buro Happold Engineering and the World Health Organization (WHO). The African Population and Health Research Center (APHRC) will lead the work in Kenya with the two cities – Nairobi and Kisumu.


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