By 2050, urban populations in Africa will increase to 62%. The World Health Organisation (WHO) and UN Habitat in their 2010 report ‘Hidden Cities’ note that this growth constitutes one of the most important global health issues of the 21st century. TARSC as cluster lead of the ‘Equity Watch’ work in EQUINET implemented a multi-methods approach to gather and analyse diverse forms of evidence and experience of inequalities in health and its determinants within urban areas, and on current and possible responses to these urban conditions, from the health sector and the health-promoting interventions of other sectors and communities. We aimed to build a holistic understanding of the social distribution of health in urban areas and the responses and actions that promote urban health equity. The different stages and forms of evidence are presented in a set of reports and briefs and a final synthesis document. This report presents the findings of the separate search on holistic paradigms relevant to urban wellbeing, and an analysis of statistical evidence on health and wellbeing in east and southern Africa (ESA) countries using indicators drawn from these approaches. The findings indicated that ESA countries face a challenge if they seek to track progress in the multiple dimensions of wellbeing or to build an understanding from the quantitative data gathered. First, there are no data measured across the 16 ESA countries for many dimensions of a more holistic approach to wellbeing. Second, in ESA countries, the indicators that are measured are more commonly those of negative rather than positive wellbeing outcomes. This turns the focus away from the assets in society. It points out where the problems are, but not the progress in achievement of positive or affirmative goals. Third, where data do exist, they are poorly disaggregated to show urban areas separately or to show intro-urban inequalities or levels in specific social groups. Finally and importantly, the subjective views of people on their life satisfaction do not always match measured data, and needs to be elicited and taken into account more directly in planning for urban wellbeing, including for interpreting, validating, adding to or even challenging quantitative data.
Equity in health, Health equity in economic and trade policies, Poverty and health, Governance and participation in health, Monitoring equity and research to policy
Title of publication EQUINET Discussion paper 114: Responding to inequalities in health in urban areas: How well do current data measure urban wellbeing in East and Southern Africa?
Date of publication
‘Responding to inequalities in health in urban areas: How well do current data measure urban wellbeing in East and Southern Africa?’ EQUINET discussion paper 114, TARSC, EQUINET: Harare.
Urban, health, wellbeing, data, statistics; east and southern Africa
East and southern Africa region
Equinet Publication Type
Discussion paper, Equity indicators