Slum decay in Sub-Saharan Africa: Context, environmental pollution challenges, and impact on dweller's health.

Abstract

Slum settlements are a very prominent feature of the urban landscape of Sub-Saharan Africa (SSA) countries and other lowand middle-income countries (LMICs). SSA cities such as Accra, Ghana; Lagos, Nigeria; Nairobi, Kenya; Addis Ababa, Ethiopia; and Johannesburg, Cape Town and Durban, South Africa are home to some of the world’s largest slums due to massive urban growth in these countries over the past two decades. SSA records the highest number of slum dwellers. About 62% of the region’s urban population resides in slums compared with 35% in Southern Asia, 24% in Latin America and the Caribbean, and 13% in North Africa.1 Uncontrolled urbanization is the main driver of slum proliferation in LMICs. SSA and South Asia are the most rapidly urbanizing regions of the world with the highest population growth in urban areas found in these two developing regions. The rapid increase in urban population in SSA countries has been attributed to the high rate of natural increase in towns, reclassification of settlements into urban areas, and rural-urban migration, which is highlighted as the most significant driver.2 According to Teye,2 these factors will continue to drive the urbanization process in SSA countries. Africa’s urban population has been growing at a very high rate from about 27% in 1950 to 40% in 2015 and projected to reach 60% by 2050. The United Nations Human Settlements Programme (UN-Habitat) defines a slum as an urban area with lack of basic services (sanitation, potable water, electricity), substandard housing, overcrowding, unhealthy and hazardous locations, insecure tenure, and social exclusion.3 Per this definition of a slum, it can be argued that such a settlement cannot experience any further decay. In this commentary, I document manifestations of further decay in slums of SSA. The commentary answers three important questions; (1) can there be any further decay in slums of SSA? (2) how is the slum decay manifested? and (3) how is the slum decay impacting the health of dwellers? The article will have important policy implications in the region and beyond, and should help better tailor interventions for upgrading slums to improve, promote, and protect the health of populations living in these settlements.