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Addressing the health of children in urban poor areas through improved home-based care, personal hyginene and environmental sanitation and healthcare services

Final Report Summary - FAHOPHS (Addressing the health of children in urban poor areas through improved home-based care, personal hyginene and environmental sanitation and healthcare services)

Through exploratory and pilot studies in three sub-Saharan countries, this project's main objective was to examine the effectiveness of using a consistent and complementary system of home-based care, improved personal hygiene and environmental sanitation, and strengthened health service delivery -the 'three pillar approach'- on improving the health of under-five children in poor urban areas.

The project aimed at generating and disseminating information that contribute to the discourse in the development of policy options for improving the wellbeing of the urban poor in Ghana, Kenya, and Malawi and other African countries with similar urbanisation and poverty dynamics. Reducing the burden of child health on mothers and households in urban poor areas would ultimately lead to less expenditure on healthcare and free up scarce resources for other uses.

Through the planned multi-country and collaborative process, it addressed the health sector organisation in urban areas with active community participation. It also had a strong component of personal hygiene and sanitation and aimed at linking these three critical components of child health.

Beyond INCO-DEV objectives, this project's focus is in line with the millennium development goal that seeks to reduce child mortality by two-thirds by 2015. It also responds to national goals for the three countries of reducing childhood morbidity and mortality. Further, one of the goals of the dissemination activity was to bring together researchers and policy makers to discuss child health issues. This would bridge the gap between research and policy formulation, ultimately benefiting the urban poor.

There is evidence that children from poor families are the hardest hit by the deteriorating health and livelihood conditions in urban areas. Urban poverty is a common feature in the whole of sub-Saharan Africa, hence the results of this study contributed towards generation of knowledge and evidence that can be replicated in similar settings throughout the region.

This project addressed an area that has not received adequate attention. Urbanisation in Africa has occurred amidst economic down-turns and is expected to grow rapidly over the next 30 years (United Nations, 1996 and 1998). As a result of this rapid urbanisation and the inability of local economies to provide adequate basic services and employment opportunities, increasing proportions of the urban population are living below the poverty line, and with poorer health outcomes than even their rural counterparts (Brockerhoff and Brenan, 1998; APHRC, 2002; Zulu, Dodoo and Ezeh 2002; Magadi, Zulu and Brockerhoff, 2003; Taffa, 2003; UNICEF, 2002). Until recently the plight of the urban poor was overlooked mainly due to a generic assumption that urban dwellers were better-off compared to their rural counterparts. The emerging findings that slum residents, especially the children, exhibit poorer health outcomes than the rural residents necessitates increased attention to reduce the burden of disease, and therefore free the scarce resources to other basic necessities. This project aimed at addressing conditions that impact on child health to alleviate the burden of disease.