City Know-hows

Health on the margins: How social, political and environmental factors shape health outcomes in Harare’s informal settlements

Raw sewage flowing from makeshift pit latrines in Hopley informal settlement, Harare. Credit: (Matamanda, 2020, Urban Forum, 31.4 p. 482)

People living in informal settlements endure the disproportionate burden of health vulnerabilities due to poor living conditions, overcrowding and infrastructural neglect. I examine how social, economic, political and environmental forces converge to amplify health disparities in Harare’s informal settlements.

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Target audience

Urban planners who are responsible for the planning and management of informal settlements. City Health Officials who are mandated to ensure a healthy living environment in informal settlements and urban leaders (mayors and local councillors) who make strategic decisions about allocation of municipal resources.

The problem

Residents of informal settlements often face serious health challenges because they live in areas with poor infrastructure, overcrowded spaces, and low-quality housing. I examine how political decisions, social inequalities, and environmental problems all converge to create and deepen these health risks. There are limited studies that explore the intersections of these variables and the implications for health in informal settlements.

What we did and why

This article unpacks how political, social, and environmental processes intersect to create and worsen health vulnerabilities. A total of 32 informal settlement residents in Hopley and Hatcliffe Extension participated in focus groups, which helped in grounding the research in people’s lived experiences. By highlighting overlooked connections between processes, I am able to explain why health inequalities persist in informal settlements.

Our study’s contribution

The study foregrounds the role of urban governance and policy regimes in shaping the health landscapes of marginalized communities. I demonstrate how decisions made at municipal and national levels are experienced unevenly on the ground.

Impacts for city policy and practice

The article enriches global conversations on informal urbanism, health equity, and the right to the city, thereby informing more inclusive and context-sensitive approaches to urban health planning and intervention.

Further information

Full research article:

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