As the world moves rapidly towards a new policy agenda for the post-Millennium Development Goal (MDG) era, emerging priority themes include universal health coverage, sustainable cities, and the demand for human rights and accountability. It’s a fact that the world is rapidly urbanising with significant changes in our living standards, lifestyles, social behaviour and health. Thirty years ago, four out of every 10 people were living in cities, but by 2050 the UN predicts this number will grow to seven out of 10. The movement into urban areas outstrips the capacity of government to manage that change in ways that respect, protect and fulfil the rights of all people. The urban slums are dynamic physical, social and political spaces where the trends in development thinking and policy intersect and sometimes collide.
Bangladesh, one of the poorest and most densely populated countries in the world, has experienced rapid urban growth in recent decades. In recent years, urban population growth is about six per cent as opposed to less than one per cent in rural areas. This growth is mostly due to rural-to-urban migration where mostly poor populations relocate for better economic opportunities and settle in urban slums. Rapid urbanisation, coupled with the growth of urban slums, is likely to have profound implications on Bangladesh’s health profile according to research, especially on maternal and child health. Human Development Indicators confirm Bangladesh experienced much sustainable progress in human development and poverty alleviation despite years of chronic deprivation, hunger and injustice. Over the last few decades, more promising achievements were observed in the area of health and family planning. It is inspiring that Bangladesh is currently on track to achieve the primary target of MDG 4 and 5 with a goal to reduce maternal and child mortality. Despite these achievements, the condition in urban slums is worse compared to urban non-slum areas with respect to health, nutrition, housing, water and sanitation. This makes urban health and development issues, especially of the slum dwellers, a high priority.
People living in marginalised spaces like slums in cities around the world have limited scope to engage with power structures, access resources and direct change in their own lives. Their voices are rarely heard in policy debate. There is much to learn from both conventional and unconventional actor’s experience in the health and development spheres.
