The Health Status of the Urban Poor

August 27, 2015

Whereas some slum areas in Nairobi continue to receive attention from donor organizations and the government, communities living in similar conditions in Nairobi’s central division seem to have fallen in the cracks with their plight oblivious to policy makers and donor organizations. This is very clear in the state of health in areas such as Ngara, Huruma, Mathare, viwandani and Korogocho. Nairobi governor Dr. Evans Kidero validated the findings by the African Population and Health Research Center that brought this concern into focus during a breakfast meeting hosted by World Bank and APHRC.

“Kibera has the best health outcomes because a lot of work has been done in the area as a result of the bad press that brought a lot of attention to the area and challenges facing the residents. On the flip side, Nairobi Central has the worst health outcomes perhaps because it is closest to the city center and hence tends to be ignored,” said Dr. Kidero.

Residents of the slum areas that fall under the central division continue to die of preventable and/or manageable causes such as Tuberculosis and HIV; injuries from homicide and road traffic accidents and lifestyle diseases accounting for 44%, 19% and 10% of the deaths respectively. This is regardless of the investment that has been put into the management of HIV/AIDS and the provision of free treatment for tuberculosis.

According to a recent study by the African Population and Health Research Center, children living in the slum areas have not be spared as they face death everyday with the leading cause of death among children five years and below being acute respiratory tract infections, HIV/AIDS, diarrheal diseases and other infectious causes. It is quite alarming that children continue to die of diarrheal diseases that are quite preventable and easy to treat. Respiratory infections could be attributed to poor choice of fuel for lighting and cooking that expose the children to the risk.

Speaking during a breakfast meeting to present the evidence from the Nairobi Cross-sectional Slum survey the director of medical services in the ministry of health, Dr. Nicholas Muraguri, hailed the research saying that such studies are very useful as they inform policies that would help improve the living standards of the people living in the slums. Muraguri termed the reported state of health in the slum as very disturbing as a lot has been done to improve on access of health services for children and the general public all the while acknowledging that a lot more needs to be done if the health of the residents is ever to be improved.

“We need to increase the access to health services not only in the availability of the infrastructure but also on the opening hours. This would require sex workers clinics to be opened till late into the night so as to increase accessibility,” the medical services director said.

Children do not seem to be accessing the free immunization services that the government has so readily made available in all government clinics. This may be on account of the parent’s busy schedule as they try to make ends meet and provide basic needs for their families, a challenge that Dr. Muraguri addressed.

“We need to ensure that our clinics are open till 10 at night so that more and more children will be immunized. We need to shape our work to suit the lifestyle of the people we serve,” said Dr. Muraguri.”

Speaking at the meeting Nairobi governor, Dr. Evans Kidero said that the investment in the informal settlements is still not sufficient and that is what informed and motivated the deployment of the National Youth Service to work on various projects in the slum areas such as the construction of extra clinics for the residents therein. Dr. Kidero agreed with Dr. Muraguri that the opening hours in the health centers need to be extended as this will ensure that emergencies are also attended to by trained medical personnel.

APHRC’s Executive Director, Alex Ezeh emphasized on the need for policy makers to use evidence generated by such studies to shape policies and execute strategies for change saying that research presents a great opportunity for government officials to provide solutions that would resonate with the people as the evidence that would inform the policies is from credible and reliable sources and so it would prompt people to believe in them.

The ministry of health has committed to working with nine other ministries within government to implement policies that would ensure that security and health of Kenyans is improved. He said that it is difficult to ignore the relationship between security and health and one cannot function well without the other.

“We want these clinics to be 24 hours so that it doesn’t matter what time you work. This will also be a project that would also seek to improve on the quality of care being provided at the clinics. We are looking at urban slums in a different way and this will start by ensuring that the health and the security concerns are addressed,” said the Director of medical services.