We have a certain amount of knowledge of the problems of urban
health in Africa. We also partly understand the determinants of
such problems: environmental, social, structural, and service
related. Multi-level research has enabled the role of 'place' for
health to be acknowledged and in particular, the importance of
social connections at the neighbourhood level. However, truly
multi-sectoral action for urban health, which reflects the multiple
determinants, is rare and often fails. Pilot projects are rarely
scaled up. More evaluative intervention research is needed and
researchers need to engage policy makers at earlier stages. We also
need to understand the urban policy process more - especially the
role of frontline workers in determining policy. Urban health
research has focussed on problems (vulnerabilities) and not
strengths or resilience. Using a more positive model of urban
health might enhance the research translation process (getting
research into policy and practice: GRIPP) and speed up action to
improve urban health. Trudy Harpham is a geographer and professor
emeritus of the London South Bank University where she taught Urban
Development and Policy. Over the past three decades she has played
a central role in establishing urban health as an urgent and
important field of research and in pushing it up on the
international health policy agenda.
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