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URBAN SOCIETY | Health, Children and Education

Improving health and education for all includes new forms of community and informal education programmes, public information centres, extensions to the coverage of primary education for marginal groups, health education schemes in schools and communities, environmental awareness projects, and community-based sanitation and waste recycling schemes.

quick links

local level city level
  international level websites

local level

AMICAALL (The Alliance of Mayors' Initiative for Community Action on AIDS at the Local Level) (2001) - Presentation - UN-AMICAALL / UNAIDS [pdf]

The AMICAALL approach rests on the premise that if individuals and communities are to take responsibility for addressing the various dimensions of HIV/AIDS, they will require a supportive policy and social environment characterized by good governance, decentralization and strong political leadership. It is labourintensive
work to put communities in the driver’s seat - it demands local coordination, planning, and action, supported by enabling national and international policies. AMICAALL aims to strengthen the capacityof local governments and political leaders to identify the socio-economic causes and consequences of HIV/AIDS, and to support multi-sectoral community-based responses to the epidemic. The initiative will especially focus on protecting the most vulnerable groups within communities (particularly children, young people and women) affected by the epidemic. It will build on local knowledge and capabilities, capitalizing on techniques traditionally used by communities themselves to support their sick, orphaned, and dying members. The strategy promotes partnerships between local government authorities, civil society organizations and communities and encourages partners to work together, rather than separately.

Chawla, Louise (2002) - "Insight, creativity and thoughts on the environment: integrating children and youth into human settlement development" - Environment & Urbanization, Vol 14 No 2, October 2002 - IIED [pdf]

This paper discusses the benefits of involving children in planning
and managing human settlements both for the children, as they learn the formal skills of democracy, and for the wider community, as young people contribute their knowledge, energies and perceptions about local environments, and remind adults of their rights and their special needs and vulnerabilities. Children learn active and responsible citizenship through opportunities to practise it – but this requires formal channels to incorporate children into school- and community-based programmes for evaluating, planning and caring for local environments. This paper reminds governments of the commitments they have made to such an approach in the Convention on the Rights of the Child, Agenda 21 and the Habitat Agenda. It also discusses what underlies effective children's participation in development planning, drawing on the author's work as coordinator of the Growing up in Cities programme and on other innovative policies and practices. This includes a realistic sense of what can be accomplished; supportive adults; and particular efforts to involve girls, the youngest and those from marginalized groups.

Fuentes, Patricio & Reiko Niimi (2002) -" Motivating municipal action for children: the Municipal Seal of Approval in Ceará, Brazil" - Environment & Urbanization, Vol 14 No 2 October 2002 - IIED [pdf]

Brazil - This paper describes how municipalities in the state of Ceará
(Brazil) were encouraged to compete to obtain a Municipal Seal of Approval, based on their performance in meeting children's needs and rights. It describes how the programme was implemented, including the criteria used to judge performance, the communication strategy to encourage municipal participation and the measures taken to avoid rewarding only the better-resourced municipalities. It also discusses the scheme's links with the Convention on the Rights of the Child and the 1988 constitution, with its support for local rights and guardianship councils and for decentralization and local democracy. It describes the results, which included major declines in infant mortality and child malnutrition rates, and improved school attendance and health care, and considers the implications: the scheme's capacity to mobilize civil society, local authorities and mayors in ways which deliver measurable progress for children despite no monetary reward for the successful municipalities and the small UNICEF budget that supported it.

Guerra, Eliana (2002) - "Citizenship knows no age: children’s participation in the governance and municipal budget of Barra Mansa, Brazil" - Environment & Urbanization, Vol 14 No 2 October 2002 - IIED [pdf]

Brazil - This paper describes the development of a children’s participatory budget council in the city of Barra Mansa (Brazil), to which 18 boys and 18 girls are elected by their peers to ensure that the municipal council addresses their needs and priorities. This council determines how a proportion of the municipal budget (equivalent to around US$ 125,000 a year) is spent on addressing children’s priorities, and its child councillors are also involved in other aspects of government. Each year since 1998, more than 6,000 children have taken part in discussions and assemblies to elect their child councillors and discuss their own priorities. The elected children learn how to represent their peers within democratic structures, to prioritize based on available resources, and then to develop projects within the complex and often slow political and bureaucratic process of city governance.

Kruger, Jill Swart with Louise Chawla (2002) "We know something someone doesn’t know: children speak out on local conditions in Johannesburg" - Environment & Urbanization, Vol 14 No 2 October 2002 - IIED [pdf]

South Africa - This article summarizes the findings of a four-site study of children’s needs and priorities, part of the process to transform Greater Johannesburg into a child friendly city. Applying the Growing Up in Cities model, it presents the voices of 10 to 14-year-olds from four diverse but representative areas of the city. For each of these areas, boys and girls describe their use of their local environments, the places they value or fear, the problems they face and their own priorities for making Johannesburg a better city. Based on these children’s experiences, a number of programme and policy responses are recommended, many of which will be relevant to other cities as well.

Mann, Gillian (2002) - “Wakimbizi, wakimbizi”: Congolese refugee boys’ and girls’ perspectives on life in Dar es Salaam, Tanzania - Environment & Urbanization, Vol 14 No 2 October 2002 - IIED [pdf]

Tanzania - This paper draws on interviews and discussions with 40
Congolese refugee boys and girls who live in Dar es Salaam. It describes their lives and the difficulties they face, and discusses the implications of their clandestine existence (since refugees are not meant to live in Dar but to stay in refugee camps). Children have to conceal their identities and often have their mobility restricted by parents for fear that they will be identified as refugees. Children talk about the harassment they suffer and how they learn to distrust all strangers. Many parents do not send their children to school because they feel their time in Dar is temporary. Most children still think of Congo as home and have little hope that things will improve if they stay in Dar es Salaam. The paper discusses the need to recognize
the rights of the “hidden” refugees, who are common and often numerous in many African cities.

Merkle, Caspar (2003) - "Youth participation in El Alto, Bolivia" - Environment & Urbanization, Vol 15 No 1 April 2003 - IIED [pdf]

Bolivia - This paper explores a paradox in the participation of disadvantaged youth in El Alto, Bolivia, in local processes and activities: although they are highly organized and active in social and cultural groups, they fail to involve themselves in the local political system. These young people, most of them the children of indigenous
Aymara migrants from rural areas, are marginalized within mainstream society (as exemplified by more affluent nearby La Paz), not only by their poverty but also by their cultural identity. They actively organize themselves in a wide range of groups, some of them focused on the arts, some recreational, and some in response to particular issues and campaigns. Many of these groups and activities are characterized by a critical stance, an articulation of young people’s discontent with “the system”. However, despite their legal right to vote and to be elected from the age of 18, they avoid involvement in the political process and the local neighbourhood organizations through which change, in theory, can be effected. This paper identifies the many constraints that contribute to this lack of involvement – including the corruption of local officials, the low level of political education and awareness, and the various regulations that make prosperity a prerequisite for real participation.

Nieuwenhuys, Olga (1997) - "Spaces for the children of the urban poor: experiences with participatory action research (PAR)" - "Environment & Urbanization, Vol. 9, No. 1, April 1997 - IIED [pdf]

This paper explains why participatory action research (PAR) could be so important in helping the children of the urban poor, and those who work with them, generate relevant insights into their specific needs and priorities and help them influence decisions that are taken about their lives. The paper begins by discussing the problems facing children in urban areas of the South and why more participatory research approaches which work with children have come to the fore. It then describes what participatory action research is (and is not) and why researchers and the institutions that fund them have difficulty in supporting such a research approach, especially in relation to children. The paper then addresses the three main implications for researchers who want to use PAR with children: taking responsibility for the children’s needs and priorities within the research; balancing participation and mediation; and ensuring the
research helps to negotiate more spaces for children in their environment and more power in their relationship with the state
and society.

Ramsey, Fiona (2002) - HIV / AIDS and Local Governance in Sub Saharan Africa - Occasional Paper N°1 - Urban Management Programme Regional Office for Africa, UNDP / UN-Habitat [pdf]

The objective of this paper is to highlight the challenges faced by Governments in the wake of the HIV/AIDS epidemic in sub-Saharan Africa. Case studies from South Africa and Cote d’Ivoire are presented in order to demonstrate how different countries are responding to the epidemic. These case studies review the national context and outline the responses being undertaken by all levels of government, as well as at the local level by NGOs, private, civil society and religious and faith-based affiliations. The national context in many countries has a direct bearing on the quality of the local response. In South Africa, for example, the controversies have limited the responses to the epidemic in a collective and coherent
manner. What is evident in these two case studies (as well as with the rest of the continent), is that the role of local government in this epidemic is fairly recent and will require assistance from central government, NGOs, the private sector, civil society, donor agencies, HIV/AIDS programmes, etc. in dealing effectively with HIV/AIDS in the workplace and the community.

UN-Habitat (2002) - Best Practice - Public Participation in free physical fitness program in Cordoba - [pdf]

Argentina - The PA.S.O.S. (For your optimal health) programme has as its main the primary health prevention.The activities are free and are directed by specialised personnel with medical control through the programme development. The original idea arose as a strategy to cover the needs of two populations segments: those that did not have the funds to assist to a specialised centre and people who made physical activity on their own, without any sort of control.

UN-Habitat (2002) - Best Practice -Partners Education Network's Schools Project [pdf]

South Africa - The project aims at improving the standard of education and teaching in 38 "adopted" schools situated in the previously disadvantaged areas of Zululand through a variety of interventions and improvements in facilities, the development of governing bodies and training of teachers and principals.

van Donk, Mirjam (2002) - HIV/AIDS and Urban Poverty in South Africa - DPLG, Pretoria [pdf]

The purpose of this paper is to explore HIV/AIDS as an urban development concern, with a particular focus on the link between HIV/AIDS and urban poverty. The next section looks at the concentration and manifestation of HIV/AIDS in urban areas. It examines why HIV/AIDS is concentrated in urban areas and which social groups are most vulnerable to HIV infection. In doing this, it highlights factors in the urban context that influence sexual behaviour and may constrain individual choice in sexual behaviour and access to HIV prevention methods. Poverty and inequality, particularly gender inequality, are identified as core factors in enhanced vulnerability to HIV infection.

Wyss, K. and L. Nodjadjim (2000) - Access to Health Care by Street Children in the Urban Context of N'Djamena, Chad - May 2000 ESF/Naerus Workshop [pdf]

Chad - Street children are one of the new categories of social actors resulting from the rapid urbanisation of cities of the South. Among the numerous problems they have to face daily, there are also obstacles related to disease and access to health care. This paper describes at the example of N'Djaména (Chad), their health problems as well as efforts to provide better health care through an action research approach.

city level

Arrossi Silvina (1996) - "Inequality and health in the metropolitan area of Buenos Aires" - Environment & Urbanization, Vol. 8 No. 2, October 1996 - IIED [pdf]

Argentina - This paper describes differences in unsatisfied basic
needs and in mortality rates by age group for the 20 districts
which make up the Metropolitan Area of Buenos Aires. It also
describes differences in causes of death by age group between
the central city (Capital Federal) and the inner and outer ring of
municipalities that surround it. The paper ends with a discussion
of why it is important to develop a more detailed statistical
picture of health differences between districts in cities and examines
also the difficulties in doing so.

Assani, Aliou (2001) - Equity and Access to Quality Care in Urban Areas: Urban Health Project Abidjan, Bamako, Conakry, Dakar and Niamey - Synthesis- UNICEF / French Ministry of Cooperation [pdf]

The strategies proposed for improving the quality and equity of care in urban areas are not only based on the findings of the Project studies, but also on promising experiences initiated in some countries in the sub-region, in the context of the health system reform. In fact, they constitute a Minimum Package of indispensable operational strategies for improving access to quality care in urban health centres, notably for disadvantaged people. Sooner or later, all the countries will have to adopt these
strategies. Differences between countries will relate to the process of implementation which will vary according to the specific context. Often, the implementation will require an in-depth reform of the health sector.

Dilip, T.R. & Ravi Duggal (2002) - Incidence of Non-Fatal Health Outcomes and Debt in Urban India - CEHAT [pdf]

India - Poor coverage of any health insurance programme and inadequacy of public health care system has made India a country where out of pocket expenditure for seeking health care contributed to 75 % of total expenditure on health care. This paper tries to study the above phenomenon by analyzing the household level financing of hospitalization care services in urban India using the 52nd Round National Sample Survey Data Sets.

Dilip, T.R. & Ravi Duggal (2003) - A study on Need for Public Health Care Services in Greater Mumbay - CEHAT [pdf]

India - This study report is based on a need-assessment survey conducted in connection with the BMC’s plan to set up a municipal general hospital in one of its ward. The study area is unique in the sense that it is the most populous ward in Greater Mumbai, and yet, it does not have a single public hospital within its limits. Data was collected from 1,035 households spread across three health-post areas around the proposed hospital.

UN-Habitat (2002) - Best Practice - Makati Health Program (Yellow Card) [pdf]

Philippines - The Makati Health Programme (MHP) was designed to provide residents of the city of Makati with monthly incomes not exceeding PhP8,000 (US$156) access to quality health care. The cost of health care in Philippine urban centers is so prohibitive that it is beyond the reach of citizens belonging to this income bracket.

UN-Habitat (2002) - Best Practice - Improvement of Living Conditions in Levice [pdf]

Slovakia - The Practice "Improvement of the life conditions in Levice" addresses some of the problems faced by the residents of Levice town. The practice engages various aspects and sectors of life that are cross-cutting in an integrated manner. The main objective of the practice is to provide better conditions for healthy life through the creation of more green areas and increasing the recreational options for children and youth.

UN-Habitat (2002) - Best Practice - Solidarity in Literacy Programme, Brasilia [pdf]

Brazil - The Solidarity in Literacy Programme was created in 1997 by the Solidarity Community Council, a forum for the development of social actions based on partnerships between the federal government, private organizations, and civil society. The Programme's principal objective is to institute provision of education for youths and adults through focus on municipalities that have the highest illiteracy rates in the country.

UN-Habitat (2002) - Best Practice - Doctors of Happiness, Sao Paulo and Rio de Janeiro - UN-Habitat [pdf]

Brazil - Doctors of Happiness (Doutores da Alegria) is Brazil's pre-eminent performing arts organisation devoted to bringing joy to hospitalised children two days a week, 48 weeks per year. Using clown theatre as its main language, experienced, professional artists perform delightful parodies of medical rounds where the healing power of humor is the chief medical treatment.

UN-Habitat (2002) - Best Practice - Maloka interactive center of science and technology [pdf]

Colombia - Maloka is, as its indigenous name indicates, urban landmark, encounter place and dialogue, where possible paths open for the individual's and the society's better future. It's a program of national projection that looks for the contribution of social change, through multiple strategies of democratized and permanent seeking for social appropriation of science and technology entertaining way.

UN-Habitat (2002) - Best Practice - Repapel: Paper Collection and Recycling in Schools, Montevideo [pdf]

Uruguay - The general goal of REPAPEL is to generate participatory activities in primary schools, enabling children to gain first-hand knowledge on how recycling benefits the Environment.The project involved the distribution of school supplies made of recycled paper, obtained from old newspapers and other wastepaper collected in the schools that participated in the project.

international level

International Labour Office: International Programme on the Elimination of Child Labour (2003) - IPEC Action Against Child Labour: Highlights 2002 - ILO [pdf]

This report highlights the strategy and current activities of the International Programme on the Elimination of Child Labour during 2002 and reviews the progress made thus far in achieving the targets set out in IPEC’s Programme and Budget for the 2002-03 biennium. In an effort to provide a more in-depth view of important topics that are germane to IPEC’s work and future strategy, three themes have been selected for discussion in Part II.

Riggio, Eliana & Theresa Kilbane - "The international secretariat for child-friendly cities: a global network for urban children" - Environment & Urbanization, Vol 12 No 2 October 2000 - IIED [pdf]

This paper discusses the establishment of an international Child- Friendly Cities Secretariat in Florence. The Child-Friendly Cities Initiative (CFCI), active since Habitat II, is a loose network of municipalities that are committed to improving the quality of life for their child residents. The paper describes some of the wide range of projects that have been undertaken in response to this initiative and lists the activities that the secretariat plans in order to support these efforts and share information about them.

Todd, Alison (1996) - "Health inequalities in urban areas: a
guide to the literature" - Environment & Urbanization, Vol. 8, No. 2, October 1996 - IIED [pdf]

Why should urban development professionals be concerned about variations in health statistics within and between urban areas? Firstly, because the statistics represent vast numbers of early deaths and debilitating illnesses. Secondly, because the distribution of health inequalities in urban areas reflects wider social inequalities: on average the urban rich live for longer and in better health than the urban poor. In Tondo, a squatter settlement in Manila, Philippines, nearly three times as many children die before their first birthday as in non-squatter areas, while diarrhoea is twice as common and tuberculosis nine times as common. In the Bronx, New York City, children are five times more likely to contract tuberculosis than their wealthier neighbours. In London, heart disease and respiratory diseases are twice as common in poor as in rich areas. A useful introduction to urban health inequalities is provided by the chapter on “Urban Environment and Human Health” in the 1996/97 World Resources Report, from which the above examples are taken.

UNICEF (2002) - "Poverty and Exclusion Among Urban Children" - Innocenti Digest No 10 - November 2002 - UNICEF Innocenti Research Centre [pdf]

For many, the image of a malnourished child, a child living in miserable circumstances and lacking access to basic social services, has a rural backdrop. Now, with a net increase in the urban population,
this picture is increasingly set in the slums of the world’s mega-cities. As Kofi Annan, the UN Secretary General has acknowledged, “Cities are often described as cradles of civilization, and sources of cultural and economic renaissance but, for the roughly one third of the developing world’s urban population that lives in extreme poverty, they are anything but that. Most of these urban poor have no option but to find housing in squalid and unsafe squatter settlements or slums. And even though the population of cities, like countries, has on average become older, slum dwellers are getting younger”. This Digest addresses the reality of these children. It highlights the chronic poverty and marginalisation they face: many spend their days digging in rubbish tips for something they can sell, and their nights on the streets, where they risk violence and exploitation. They lack a secure home, can’t afford access to health services or education, and there is nowhere safe for them to play. Denied a voice, they can neither denounce the conditions in which they live, nor realise their enormous potential to inform solutions.

web sites

World Declaration on the Survival, Protection and Development of Children; Agreed to at the World Summit for Children, 30 September 1990 [pdf]

1. We have gathered at the World Summit for Children to
undertake a joint commitment and to make an urgent universal appeal - to give every child a better future...

ILO - International Programme on the Elimination of Child Labour: Text of the Convention

Article 1:
Each Member which ratifies this Convention shall take immediate and effective measures to secure
the prohibition and elimination of the worst forms of child labour as a matter of urgency. [pdf]


Documents highlighting DFID's published work in support of health, children and education in urban areas:

Cameron, Sara (2001) - Bangladesh: Basic Education for Hard to Reach Urban Children - DFID / UNICEF [pdf]

Bangladesh - The Basic Education for Hard To Reach Urban Children project aims to serve harshly exploited working children. It was top down by design, but with good reason. It confronted widespread beliefs that denial of education for children in deeply impoverished families was an unavoidable fact of life. Such children were (and still are) expected to work, often in circumstances that are hazardous to their health and well being. Thus education for working children was not a priority of families, communities or government. The Hard to Reach project was an attempt to achieve an ambitious breakthrough in establishing recognition of the rights of working children.

"Defeating Disease through Housing" - Wakely, Patrick; Nicholas You (2001) – Implementing the Habitat Agenda: In Search of Urban Sustainability - DPU [pdf]

Bolivia - Fundación Pro Hábitat's 'Project Chagas 2000' brought together a range of problems faced by poor communities in Tarija, South Bolivia: health, housing, training and education. It enabled communities to increase their understanding of the problems and develop their own solutions to them. It also explored the wider implications of poor housing and the importance of community involvement and it scaling up.

"Healthy Cities Programme Turku" - Allen, Adriana; Nicholas You (2002) – Sustainable Urbanisation: Bridging the Green and Brown Agendas – DPU [pdf]

Finland - The Healthy Cities initiative involves various activities and projects, dealing with administration and the active participation of both city inhabitants and voluntary organisations. People are encouraged to exert their influence and act on issues they feel are important.

Riley, Liz; Janelle Plummer, Kevin Tayler & Patrick Wakely (1999) - Community Learning and Information Centres as a Tool for Sustainable Development - Working Paper no. 96 - DPU / GHK / DFID [pdf]

The central focus of the research is the community learning, information and communication (CLIC) processes that surround access to, and the delivery of, urban infrastructure and services by low-income communities and public sector bodies in India. Information, communication and learning are the basis upon which change takes place in people’s attitudes and actions.

Fighting Aids in Msunduzi (2002) - Sustainable Urbanisation: Bridging the Green and Brown Agendas - DPU / DFID [pdf]

South Africa - As the problem of HIV/AIDS is too big to be addressed by any one organisation, involvement of many organisations in a city is crucial to tackle this disease, by bringing together resources to sustain awareness, prevention, treatment and care.
Msunduzi, near Durban, is a city of 570,000 people in the epicentre of the South African AIDS pandemic.
Msunduzi has an HIV prevalence of approximately 18%, with an estimated 100,000 people living with
the virus, 250 AIDS-related deaths per month and 10,000 AIDS orphans.

Schilderman, Theo (2002) - Strenghthening the Knowledge and Information Systems of the Urban Poor - DFID / ITDG [pdf]

A key reason for embarking upon this research was that earlier surveys, evaluations and experience had concluded that development agencies and researchers who possess knowledge on urban development had not been very effective at disseminating that knowledge to the urban poor, resulting in only limited uptake and impact at the grassroots. There appeared to be various reasons for that: they were not spending enough attention to exploring the information needs and resources of the urban poor; dissemination was too often top-down and using inappropriate information resources; and, whilst some successful examples existed, participatory communication methods were still to some extent being developed and certainly needed wider replication.

2003 Development Planning Unit | Sikandar Hasan | Anna Soave | Khanh Tran-Thanh || Tina Simon