Urbanisation and Poverty - International Development Committee Contents

Written evidence submitted by RESULTS UK

SUMMARY

  General statistics for health, education and income show that urban areas have an advantage compared with rural areas in terms of social indicators. However, aggregate statistics often hide significant internal differences within cities, masking the extent of urban deprivation. The poor live in informal settlements that are unrecognised by government and underserved by health, education, sanitation and other services.

How effectively are developing country governments and donors addressing the challenges presented by urban poverty?

— Vulnerable groups within the urban poor remain severely neglected. They face barriers to accessing services and are often served more efficiently by NGOs and informal systems than by government providers. DFID should encourage partnerships with non-governmental service providers to ensure that the poorest and most vulnerable are reached.

— The majority of funding allocated within urban environments does not target the most disadvantaged areas or groups. Sanitation funding in particular is often spent on upgrading existing networks, serving only formal areas of cities, rather than expanding facilities to informal settlements. A large percentage of health spending is directed to a small number of urban hospitals that do not serve the poorest communities.

  The provision of basic services and infrastructure in slums: housing, sanitation, water, health and education.

— Many urban infrastructure projects are not inclusive of informal areas and do not reach the poorest members of urban society.

— It is often extremely difficult for the urban poor to access services, due to: a lack of a permanent address, leading to denial of services; discrimination; lack of infrastructure such as piped water; informal working conditions with long hours; and gender issues.

— Health levels among the urban poor are seriously affected by substandard and overcrowded housing, leading to the rapid spread of disease. In addition, the urban poor often delay seeking healthcare and resort to expensive private providers. Inadequate treatment of infectious disease increases the chance of drug-resistant strains. DFID should continue to invest in research and development of new diagnostics, treatment and vaccines for communicable disease, as well as encourage and facilitate establishment of long-term social protection systems.

  Supporting opportunities for employment and livelihoods for the urban poor.

— Creating an environment in which the poor are empowered to work their own way out of poverty is fundamental to tackling the other aspects of urban disadvantage.

— Microfinance is a key tool and DFID should be channelling more resources through it.

— Investment in microfinance should allow it to go beyond credit, creating insurance and savings schemes so that the poor can develop a personal safety net to weather income and outgoing shocks.

  The role of property rights in improving the lives of slum dwellers.

— Lack of property rights discourages investment, both from private and public resources, meaning that slum improvements are often difficult and contentious.

— In informal settlements, which house the majority of the urban poor, provision of services is lacking because residents are frequently not recognised by the government as citizens with full rights.

— Where services are available they are often more expensive because infrastructure is less developed, creating a double burden for the poor. Informal settlements are not usually served by piped water, meaning that water must be carried or driven into the settlement for sale, increasing the price, while the lack of accessible public health care forces many slum dwellers to use private healthcare.

HOUSING

  1.1  Improving the living conditions of slum dwellers is a crucial component of global efforts to improve the lives of at least 100 million slum dwellers by 2020. If this is to be achieved on any meaningful scale it is clear that a massive investment will be needed. Central and local governments must assume a great deal of responsibility for making this happen, but they alone cannot meet the challenge. Mobilising private capital and enabling slum dwellers to improve their own housing conditions on a financially sustainable basis is crucial to achieving large scale results and microfinance has a key role to play in achieving this.

  1.2  Low income households are not an attractive clientele for most formal sector institutions and it estimated that over half of the population in the world is not served by mainstream housing finance.[144] The urban poor face many challenges in improving their living conditions, with irregular incomes and lack of access to long-term financing presenting perhaps the greatest impediments. This means that the poor either cannot afford to make improvements or are forced to borrow money from informal money lenders who frequently charge exorbitant interest rates leading to a downward spiral of debt and further impoverishment. Such problems are further compounded by a lack of legal rights to slum dwelling which make securing regular mortgages extremely difficult for the urban poor.

  1.3  The cost of a typical house in the developing world is on average 10 times more than most annual salaries (compared to 2.5 to six times as much in the developed world).[145] Because of the high costs involved the majority of the world's poor have to build and improve their homes in stages and on an informal basis. It has been estimated that at least 70 per cent of all new housing is built informally through incremental housing rather than new home construction.[146]

  1.4  Housing microfinance schemes offer a proven and effective means of overcoming such problems, providing small, flexible loans to individuals to make improvements to their homes, or to build new low-cost homes on land already owned by the family or provided by a low-income developer. Their greater flexibility also means that microfinance lenders can accept alternative forms of collateral and non-traditional forms of guarantees compared to normal mortgage lenders, removing another barrier traditionally faced by the poor. Furthermore, such schemes have proven to yield high repayment rates making microfinance a sustainable and dependable business venture for those prepared to make such investments.

  1.5  Making improvements to slum dwellings has many advantages compared to some resettlement programmes as it improves the quality of housing, infrastructure and services in the slums without splitting-up communities or forcing unnecessary upheaval and disruption compared to other methods such as slum clearance and forced resettlement. If DFID is to support potentially disruptive programmes it is important that they ensure slum dwellers are given the opportunity to input into both the planning and financing of the improvements. DFID should work to strengthen existing microfinance institutions and should work with them to ensure that microfinance for housing is made available to the very poor as well as the relatively better off.

  1.6  Any form of forced resettlement should be actively discouraged due to the reasons stated above. However, if handled properly, resettlement can dramatically improve the living standards of slum dwellers by taking them out of informal, unregulated and often dangerous slum areas to new more appropriate and better serviced planned developments.

  1.7  The most successful resettlement programmes are those that have significant input from those who will be living in them. Jamii Bora has provides an ideal example of how resettlement programmes can be run with their pioneering new town of Kaputiei in Kenya. This town, consisting of 2,000 homes and 3,000 business spaces as well as new schools has been designed with full participation of its members and is funded entirely through microfinance schemes. Each new house, consisting of two bedrooms, a bathroom, a kitchen and a sitting room costs the same each month as a one-room dwelling just outside the slums.[147] This groundbreaking project shows just what can be achieved with appropriate planning and commitment, and amply demonstrates the enormous possibilities of housing microfinance.

  1.8  DFID should learn the lessons provided by such innovative projects and incorporate the successful elements into their own strategies. The best solution, be it resettlement or building on current housing infrastructure will depend on the particular circumstances of different communities. DFID must ensure that strategies are implemented with the input of communities themselves. DFID is also well placed to assist in the dissemination of best practice methods through partner countries and NGOs with whom they work.

SANITATION AND WATER

  2.1  Over 1 billion people lack access to safe drinking water, the overwhelming majority of them in developing countries. In addition, latest indications show that some 2.6 billion people, more than 40% of the world's population, do not have access to basic sanitation. Safe water and sanitation is a vital goal in itself but it is also a prerequisite for achieving other targets. The lack of progress in sanitation is severely hampering progress towards meeting all of the MDGs, most notably in poverty reduction, infant and maternal mortality rates, combating disease and gender parity in education. Water and sanitation are vital for human health, and they are also one of the most cost-effective development investments that can be made; sanitation investments yield a return rate of $9.10 for every $1 invested.

  2.2  In urban areas the lack of safe water and sanitation facilities can lead to dire public health situations. For example, in slums such as Matopeni, on the outskirts of Nairobi, many residents who lack access to sanitation facilities resort to using "flying toilets"—plastic bags into which people defecate, then throw away as far as possible. Heaps of tightly-tied polythene bags adorn the roofs the settlement, attracting swarms of flies. Some have burst upon landing, while others clog the drainage system.[148] These conditions lead to high levels of infant mortality[149] and numerous other health issues.

  2.3  Despite this, water and sanitation coverage in cities is failing to keep pace with rapid urbanisation in developing countries. The MDG goal on sanitation is the furthest off track of all, and in some areas the number of people who are un-served by improved sanitation is actually growing rather than shrinking. According to the WHO, the world's urban population increased by 956 million between 1990 and 2006, while the number of new urban users of improved water increased by only 926 million and of improved sanitation by only 779 million.[150]

  2.4  Currently rural water and sanitation are further off track for meeting the MDG (for example, according to the Asian Development Bank approximately 26% of countries for which there is data available are off-track on urban water supplies, whereas over 45% are off-track for rural water supplies[151]). However, rapid urban growth, overwhelmingly occurring in informal settlements on the outskirts of cities,[152] which rarely provide basic water and sanitation services even to existing residents, means that urban areas are key for future investment in water and sanitation. The proportion of the world's population living in informal settlements is huge; although there are serious difficulties in defining "informal settlements", estimates are that much of the urban population growth expected in coming decades will be in informal settlements. WaterAid project that "urban centres will account for two thirds of the water and sanitation MDG coverage gaps within the next two decades."[153]

  2.5  Multilateral and bilateral assistance for housing and urban infrastructure totals less than $5 billion annually, and less than 20% of this amount is for slum upgrading.[154] If we look specifically at water and sanitation the picture is even worse: figures for the World Bank's sanitation lending scheme show that 65% of funds went to formal urban areas between 2000 and 2005, with slums receiving only 6%.[155] In order to tackle the growing number of slum dwellers without access to improved water sources and sanitation, international donors must refocus their efforts on informal settlements, expanding coverage rather than just upgrading existing infrastructure.

  2.6  While currently the largest number of underserved people are in Asia (China alone has more people without improved water sources than the whole of Africa), WaterAid report that "Africa has the highest annual slum growth rate (4.53% per year), more than twice the global average, and is expected to have the largest number of slums by 2020".[156] Against this background it is crucial for international donors to reconsider where spending on water and sanitation is directed. Currently aid in this sector is not going to the poorest regions or countries.

  2.7  Overall levels of aid to water and sanitation also give cause for concern. While aid to some sectors has doubled since the mid-1990s, aid to water and sanitation has reduced slightly. A major investment of ODA is needed; UN-Habitat argue that "Increasing total ODA is a prerequisite for achieving target 11 [of the MDGs, which is improving the lives of 100 million slum dwellers by the year 2020], as is a commitment to channelling a significant proportion to the urban sector".[157] Despite this, ODA alone cannot tackle the scale of need in slums, but must also be used to contribute to enabling the mobilisation of domestic capital through tackling the barriers to infrastructure investments in informal settlements.

  2.8  Access to clean water in informal settlements is rarely through official piped water supplies, which do not reach the majority of residents. Instead, slum dwellers depend on a huge variety of water sources, from illegal connections tapping into the "official" system, to sharing neighbour's connections, to buying water from vendors supplying water from private boreholes or transporting water purchased through the official system into the slum area. Price differences often favour the better-off residents of cities, as they have access to cheaper piped water.[158] Where there is no piped water, "water access tends to be characterized by diversity, inadequacy and high levels of sharing…the urban poor are confronted with lower quality and more expensive water services…However the key concern for the urban poor is not price but access."[159] Government and donor-sponsored investment in infrastructure must therefore go beyond improvement of the current piped water supplies, considering the mechanisms that the urban poor currently use to access water and ensuring that interventions are pro-poor, targeting poorer areas and developed in a participatory manner to ensure their appropriateness. If subsidies are to be used, as they are in Bogota, Colombia,[160] they must be designed in such a way as to ensure they will not be "captured" by the more wealthy.

  2.9  One of the major barriers to investment in water and sanitation infrastructure in informal settlements is the lack of security in land tenure. In many cities users can only apply for a connection to the piped water system if they have land security, and sanitation provision is similarly restricted. It is frequently difficult to mobilise resources for investment in water and sanitation infrastructure in informal settlements. Residents are likely to be unwilling to invest their scarce means in infrastructure that could be lost through eviction, while public authorities are often unwilling to be seen to encourage permanent settlement of sites through putting in services. In some cases informal settlements are built on private land, and services cannot be installed without permission from owners, who may be unwilling to give permission or to sell part of the land in order to avoid an impoverished settlement being established near their homes or businesses.[161]

  2.10  Lack of secure tenure can therefore be a major barrier to investment in infrastructure from both private and public sources; however the details of the problem are highly specific to the individual context. If water and sanitation services are to be successfully extended to cover informal settlements, considerable flexibility is needed from all parties, including international donors. Potential solutions to this problem are complex, but should be focused on preventing the threat of forced evictions in order to develop some security for investments and to ensure that the poor remain the beneficiaries of investment programs.[162]

  2.11  We believe that the Department for International Development should, as part of the dramatic increase of aid needed to reach the target of 0.7% of GNI, scale up investment in urban water and sanitation provision in order to tackle the rising numbers of underserved urban residents in the developing world. DFID should also advocate within the World Bank and other International Financial Institutions for increased investment, which must go beyond rehabilitating current infrastructure to ensure that water and sanitation is available to the huge number of urban dwellers living in informal settlements. DFID should work with their partners to tackle the issue of land tenure, ensuring that space is opened up to allow for domestic investment that is genuinely pro-poor and sustainable.

HEALTH CARE

  3.1  The highest attainable standard of personal health is an inalienable Human Right, which, despite considerable political rhetoric[163] and financial investment,[164] continues to be out of reach for millions. The Millennium Development Goals aim for universal healthcare by 2015, however in the 15 years since countries pledged to meet MDG targets, 283 million more slum dwellers have joined the global urban population.[165] If health related MDG targets are to be met there need to be significant steps made to meet target 11 of the MDGs, to improve the lives of 100 million slum dwellers by the year 2020.

  3.2  Considerable progress can be achieved by strengthening national health systems.[166] International donors must provide long term, predictable funding for a minimum of five years, to enable developing countries to adequately plan for strengthening national health systems to deliver basic services to those most vulnerable. Specific emphasis should be placed on human resources for health,[167] with many low-income countries having less than one health worker per 1,000 people against a minimum recommendation of 2.5/1,000.[168] This investment must include not only resourcing for qualified health professionals, but support for community based health workers and non-government and private sector initiatives which reach vulnerable communities in informal urban settings.

  3.3  Health system strengthening alone will not meet the needs of the growing number of urban poor, the majority of whom face challenges accessing formal health systems. Reasons for this may include stigma and discrimination amongst the general population, health staff unwillingness to work in slum areas because of safety concerns and denial of treatment at national health providers due to a lack of permanent address. Slum dwellers often turn to private medical practitioners, where they may receive sub-standard or expensive treatment. The urban poor are at a disadvantage in accessing care, yet it is reported they spend the same amount as the non-poor once they seek care, sustaining a considerable financial burden from illness.[169] National health system strengthening must include initiatives to scale up access to affordable health care for the urban poor. This may include pre-paid financing schemes for good-quality non-state providers and strategies to remove access barriers and user charges for national health services.[170]

  3.4  The majority of urban slum dwellers work in the informal sector, excluded from benefits available to formal sector employees such as minimum wages and regulated working conditions. Missing work means a loss of wages and slum dwellers may delay access to healthcare until an illness is acute. Once accessing healthcare, individuals may encounter the same difficulty attending clinics for regular follow up and treatment. International donors must support domestic governments in the implementation of social protection systems which reach the most vulnerable, including workers in the informal sector and women living in urban areas.[171]

  3.5  Little is known about the spectrum and burden of disease and morbidity in the informal settlements and urban slums of the world. The lack of such data hampers adequate health care resource allocation and provision of appropriate disease prevention services.[172] DFID's Research Strategy 2008-13 places an emphasis on knowledge gaps which are stopping progress towards the MDGs. We encourage the International Development Select Committee to call for emphasis within this strategy on assessment of the health burden and determinants of disease morbidity among slum residents at the community level.

  3.7  Chronic diseases such as TB are easily spread in urban slums. TB has been on the rise since the 1980s, with much of the spread concentrated in South East Asia and Africa, regions where the share of poor as a proportion of the urban population is highest. Although progress is being made, the disease continues to have a disproportionate effect in urban areas, particularly on those people living with HIV/AIDS. It is clear that the growing number of slum dwellers, with inadequate nutrition and as a result weak immune systems, living in overcrowded, unhygienic and unsafe environments with limited access to treatment services, facilitate the transmission of communicable diseases such as TB.

  3.8  Delay and inadequate treatment of chronic illnesses amongst slum dwellers may result in further complications, an example of this being the current rise in cases of multi and extensively drug resistant TB (M/XDR-TB).[173] M/XDR-TB pose a serious threat to global health security and severely undermine efforts to implement tuberculosis and HIV/AIDS strategies aimed at reaching MDG targets.[174] More than half a million new cases of M/XDR-TB are estimated to emerge annually as a result of inadequate treatment and subsequent transmission of TB; people living with HIV/AIDS are at particular risk of dying if affected. Drug-resistant TB is a man-made threat that has flourished because of a failure to adequately detect and treat normal TB, particularly within hard to reach urban communities.

  3.9  MDR and XDR-TB can be halted[175] but this will require flexible programs focused on community needs. An example of this can be seen in Operation ASHA, a non-profit organisation working in the urban slums in New Delhi. The organisation focused on the specific needs of the urban poor and established treatment centres within the community, located in small shops and huts. The centres are operated by community providers, from the early hours of morning till late in the night meaning that patients can procure medicines at a convenient time, without having to lose wages. In addition, highly trained counsellors from the slums served by the organisation are employed to support patients and address issues of stigma and discrimination. As a consequence of this community focused strategy, Operation ASHA has succeeded in reducing the default rate of TB treatment to virtually zero in the slum, thus halting drug resistant strains of the diseases.[176]

  3.10  Non-government organisations play an important role in meeting the health needs of urban poor. Domestic governments often do not have the capacity to regulate or work effectively with the private and non-profit sector and so do not capitalise on the role they play. DFID must provide direct support to governments to scale up and integrate these services in national health strategies.

  3.11  International donors must also place greater emphasis on investment in the research and development of new tools and vaccines to prevent and manage communicable diseases such as TB and Multi-drug resistant TB amongst the most vulnerable urban and rural populations. The British government has played a leading role in this to date and must call for other international donors to equally contribute.

  3.12  Clearly the physical aspects of urban poverty and slum dwellings (lack of access to clean water, poor sanitation, and poor nutrition) directly affect the health of the population and undermine investments made to improve other poverty indicators. The International Development Select Committee recommended in the report on the DFID Annual Report 2008[177] that more emphasis is needed on nutrition. Inadequate nutrition among the urban poor is directly linked to issues such as sanitation and water, education, health systems and social protection, gender equity, and the impact on and of diseases such as tuberculosis and HIV/AIDS. It is critical that DFID fully integrate a new nutrition strategy within existing poverty reduction and health care interventions.

  3.13  Action for Global Health[178] stress in their most recent report that allocation and delivery of aid must be "designed to achieve universal access to health and to benefit the poorest and most marginalised populations—through strengthening primary healthcare systems and addressing the social determinants of health". Governments must be supported to build health systems based on equity, disease prevention and health-promotion. Adequate investment is needed in other sectors including water and sanitation, food security and nutrition, education, social protection, infrastructure and the environment to ensure health strategies reach and fully benefit the most vulnerable populations.

EDUCATION FOR CHILDREN IN SLUM DWELLINGS

  4.1  With an increasing percentage of the world's poor concentrated in urban areas, and many of them living in informal settlements or slum dwellings, the provision of basic services for the urban poor is a growing concern worldwide. General statistics for health, education and income show that urban areas have an advantage compared with rural areas, but often aggregate statistics hide the large internal differences within cities.[179] Within-city data from UN-Habitat show significant educational inequalities between urban residents living in slum and non-slum areas, thereby challenge the perception of a uniform "urban advantage".[180]

  4.2  People living in slums, quite naturally, share many of the same problems in relation to education as poor people in general. Often they cannot afford to attend school because of the expenses involved; even though primary schools are free in many countries, indirect costs (such as uniforms, text books etc.) may prevent families from sending their children to school.[181] Transport burdens may limit children's access to school, particularly as many slums lack schools within their boundaries.[182] Poverty may force children and young people in slum areas to work from an early age, affecting their prospects of getting an education.[183] Targeted programs to tackle education disadvantage, such as Conditional Cash Transfers, should be focused on urban slums as well as on deprived rural areas in order to improve the educational opportunities for children and young people who would otherwise have to work.

  4.3  Poor living conditions can have a negative impact on education, since children do better in school when they have a safe home environment and access to essential services, such as water, electricity and sanitation.[184] Overcrowded houses, prevalent in slum dwellings, affect education both directly (lack of room to do homework and disrupted sleeping patterns) and indirectly (absenteeism from school due to illness resulting from overcrowding).[185] Improvements in the education system must therefore go hand-in hand with improvements in living conditions generally in slum areas, including programs for infrastructure and housing upgrading.

  4.4  There is some evidence that girls living in slum areas are at a disadvantage in relation to boys when it comes to education. Girls are kept at home more often than boys to do household chores and look after children, especially in slum dwellings where, due to the high proportion of migrants, there is an absence of extended family. A significant number of girls do not go on to secondary schooling because they become pregnant or are married early.[186] Finally, the issue of sanitation within poorly facilitated schools is, according to UN habitat, a serious barrier to education for girls, for whom proper toilet facilities are an important consideration.[187] Specific gender-targeted policies, improved access to sexual and reproductive health information, and improvement of sanitation facilities in schools can help girls to overcome some of the barriers to education. DFID should consistently press for a gender focus within country education plans that it supports, and ensure that specific problems affecting girls are addressed in project plans for the development of education services within slums.

  4.5  Children and young people living in slum dwellings can face barriers to education because of a lack of recognition of the settlements in which they live. Official planning policies often do not recognise informal settlements, and therefore frequently the authorities are reluctant to set up basic public services, such as schools, within them. Anna Tibaijuka from UN-Habitat argues that "people without secure tenure, without an address, are simply not considered citizens. They are denied services such as water and electricity, education and health, access to information, transport and waste collection, banking and insurance etc."[188] Several sources describe the lack of government schools in slum areas and congestion in the class-rooms;[189] referring to the Mathare Valley area in Nairobi and large slum areas in Asia, NORAD concludes that in these areas "the right to health and education does not apply".[190] The Kibera slum in Kenya faces similar problems: the area suffers from a significant lack of government schools, which means that the children and young people living there do not benefit from the free schooling introduced by the Kenyan government to the same extent as those living outside the slums.[191] Children and young people from the slums may also face discrimination when trying to access schools outside of the slum, as schools may refuse to enrol them because their settlement has no official status.[192]

  4.6  While international donors' support has been crucial to the removal of school fees in several developing countries, the case of Kenya demonstrates that policy changes in the education sector alone cannot ensure that all children are able to access the newly-free education system. DFID must work with its partner countries to tackle all barriers to basic education, including the issues of official recognition of slums and provision of basic facilities (more free local schools and improved living conditions), which are crucial for the improvement of the educational situation of children and young people living in the slums.

  4.7  In conclusion, we believe that DFID should work with its partners to address the specific needs of disadvantaged urban children, particularly in ensuring that all children, no matter whether they reside in formal or informal settlements, can access free schooling. To ensure that the poorest families can take advantage of free education systems they should support partners to roll out targeted interventions to address the problem of child labour and school absenteeism due to domestic duties among the children of slum-dwellers, including where appropriate conditional cash transfers.

SUPPORTING OPPORTUNITIES FOR EMPLOYMENT AND LIVELIHOODS FOR THE URBAN POOR

  5.1  Generating employment opportunities for the urban poor is vital to improving livelihoods and reducing poverty, and microcredit has long been recognised as effective tool for job creation and poverty alleviation in rural areas. However, microfinance schemes have emerged only quite recently as strategic ways of improving the economic circumstances (and hence living conditions) of the urban poor.

  5.2  There are very good arguments for emphasising access to credit in poverty alleviation strategies. Firstly; microfinance allows poor people to protect, diversify, and increase their sources of income, the essential path out of poverty. The ability to borrow a small amount of money for self-employment purposes is a proven and effective way of improving livelihoods not only for those who take the loans but for their families and wider communities.

  5.3  Microfinance also helps safeguard poor households against the extreme vulnerability that characterises their everyday existence. Loans, savings, and insurance help smooth out income fluctuations and mean there is money available to cover essential expenses even during financially difficult periods. The availability of financial services acts as a buffer for sudden emergencies, business risks, seasonal slumps, or events such as a flood or a death in the family, which can push many poor families further into poverty. Thus microfinance is an especially participatory and non-paternalistic development tool. It empowers and equips people to make their own choices and build their way out of poverty in a sustained and self-determined way.

  5.4  Microfinance is unique among development interventions: it can deliver these social benefits on an ongoing, permanent basis and on a large scale. Many well-managed microfinance institutions throughout the world provide financial services in a sustainable way, free of donor support. Microfinance thus offers the potential for a self-propelling cycle of sustainability and massive growth, while providing a powerful impact on the lives of the poor, even the extremely poor.

  5.5  Microfinance has grown tremendously in recent years, but estimates suggest that its potential market is £150 billion, compared with available capital of £2 billion. While it is difficult to quantify, recent estimates put the number of people of working age who lack access to financial services at three billion. Indeed, in many developing countries the number of people excluded from the mainstream banking sector is high, reaching 50% in Brazil, for example.[193]

  5.6  For DFID, microfinance is part of a broader strategy to promote stronger and more inclusive financial sectors. Whilst this must be welcomed it should be noted that DFID support for microfinance schemes is fairly minimal with just £23 million allocated to microfinance schemes in 2005-06.[194] It has been claimed by DFID that they have spent over £165 million to support microfinance and financial sector projects and had committed £140 million more at 31 October 2006[195] but their failure to disaggregate data make it difficult to verify.

  5.7  Although DFID undoubtedly recognises the benefits of increasing poor people's access to financial services for the purposes of increasing employment, the level of support given to microfinance schemes remains minimal and does not reflect the potential that microfinance offers for enhancing employment opportunities in urban settings. We would therefore recommend that DFID give far greater support, both financial and technical, to help further develop microfinance schemes in urban settings throughout the developing world. It is important to ensure that DFID's support benefits the very poor, making use of innovative microfinance initiatives that reach those who remain excluded from the commercial banking sector and from commercial ventures in microfinance, particularly in Africa where microfinance is not yet widely used. DFID should support existing and new microfinance institutions to enable them to go beyond offering credit and diversify into micro-insurance and micro-savings, allowing the poor to develop their own safety nets to improve resilience to income and outgoing shocks.

REFERENCES

Housing

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Sanitation and Water

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Health Care

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Education for Children in Slum Dwellings

Cities Alliance, Nairobi Inventory: Slum Profile,

see http://www.citiesalliance.org/doc/resources/Nairobi%20Inventory/SlumProfiles7_KasaniDivision.pdf

Garau, Pietro et al (2005): A home in the city. UN millennium project task force on improving the lives of slum dwellers, see http://www.unmillenniumproject.org/documents/Slumdwellers-complete.pdf

NORAD (Norwegian Agency for Development Cooperation), Poverty and Urbanisation—Challenges and Opportunities, Position Paper 2002,

see www.norad.no/items/1024/38/6893256588/UrbanisationEngelsk.doc

Stop Child Labour (2008): Country Report Kenya,

see http://www.stopchildlabour.eu/africatour2008/tour/kenya/final-country-report

UNDESA/DGDC (2006): Report on the World Urban Forum III Side event: Fighting Urban Poverty: Which Participatory Approaches?,

see http://unpan1.un.org/intradoc/groups/public/documents/UN/UNPAN024789.pdf

UNFPA (2007): State of the world's population 2007: Unleashing the potential of Urban Growth,

see http://www.unfpa.org/swp/2007/presskit/pdf/sowp2007_eng.pdf

UN Habitat 2006, State of the World's Cities, 2006-07,

see http://www.unhabitat.org/pmss/getPage.asp?page=bookView&book=2101

UN Habitat 2007, Urban Features: Children, Slum's first casualties,

see http://www.unhabitat.org/downloads/docs/5637_49115_SOWCR%2016.pdf

UNICEF (2008): Fatuma's Digital Diary: Girls' education in Kenya's largest slum,

see http://www.unicef.org/people/kenya_43469.html

Supporting opportunities for employment and livelihoods for the urban poor

Whitni Thomas, "Microfinance", in A Guide to Giving, 3rd Edition, Philanthropy UK (2009),

see http://www.philanthropyuk.org/AGuidetoGiving/Howtogive/Microfinance

Gareth Thomas MP, response to a question on "Microfinance Projects" from Peter Lilley MP, 26 Jan 2007,

see http://www.parliament.the-stationery-office.co.uk/pa/cm200607/cmhansrd/cm070126/text/70126w0007.htm

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144   Housing Finance International (December 2006). "Scaling up housing microfinance for slum upgrading". Sole, Regina Campa. Back

145   Inter Press Service. "World faces prospect of teeming mega slums" by Martin Schuijt. September 2005. Back

146   UN-Habitat. Twenty First Session of the Governing Council. 16-20 April 2007, Nairobi, Kenya. Back

147   Microcredit Summit Campaign, (2009) State of the Microcredit Summit Campaign Report 2009. Back

148   Inter Press News Agency (2006), "Flying Toilets Still Airborne", Joyce Mulama. Back

149   WaterAid report that the average under-five mortality rate across eight informal settlements in Nairobi is 35% higher than the national figure, while in some slums it is more than twice the rural figure. Back

150   WHO/UNICEF (2008) Progress on drinking water and sanitation. Back

151   Asian Development Bank (2009), http://www.adb.org/Water/Knowledge-Center/statistics/water-sanitation-mdgs.asp Back

152   UNESCO (2009) Water in a Changing World: World Water Development Report 3. Back

153   WaterAid (2008) Turning Slums Around. Back

154   World Urban Forum (2004) Dialogue on Urban Resources. This figure is at the optimistic end of the scale-WaterAid report that only 1% of housing and urban development aid goes to slums. Back

155   WaterAid (2008) Turning Slums Around. Back

156   WaterAid (2008) Turning Slums Around. Back

157   World Urban Forum (2004) Dialogue on Urban Resources Back

158   Maji na Ufanisi, an NGO working in the slums of Nairobi, report that water purchased from kiosks in the slums is on average three times the price of water obtained through the municipal piped system. See http://www.majinaufanisi.org/projects/k-watsan.htm IPS News service report that water in Lomas de Manchay, a large slum on the outskirt of Lima, Peru, costs $3.22 per cubic metre, while a few blocks away in Rinconada del Lago, one of the capital's richest districts, it costs 45 cents. See http://www.ipsnews.net/news.asp?idnews=46451 Back

159   Society for International Development (2008), Urbanization and Water Briefing Paper. Back

160   World Urban Forum (2004) Dialogue on Urban Resources. Back

161   We are grateful to James Morrissey of the Department of International Development, Oxford University, for input on the land tenure issue. Back

162   For more detail on possible solutions to the land tenure issue see "Informal Settlements and the Millennium Development Goals: global policy debates on property ownership and security of tenure", Alain Durand-Lasserve, Global Urban Development Magazine, Volume 2 Issue 1 March 2006, which can be accessed here: http://www.globalurban.org/GUDMag06Vol2Iss1/Durand-Lasserve.htm Back

163   Universal Declaration of Human Rights (1948) and the Alma-Ata Declaration (1978). Back

164   In 2007, DFID estimated that 20% of UK aid (£515 million a year) goes to health. Back

165   Tibaijuka, A (2007) Supporting towns and cities to achieve the MDGs: improving the lives of slum dwellers. http://www.thefreelibrary.com/UN+Chronicle/2007/December/1-p57 Back

166   DFID (2007) Working together for better health and WHO (2008) Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Back

167   WHO (2008) Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Back

168   WHO (2006) World Health Report 2006: Working together for success, WHO (2006) The global shortage of health workers and its impact http://www.who.int/mediacentre/factsheets/fs302/en/print.html Back

169   J Falkingham and C Namazie (2002) Measuring health and poverty: a review of approaches to identifying the poor http://www.dfidhealthrc.org/publications/health_poverty_vulnerability/Measuring_healthpoverty.pdf Back

170   DFID (2007) Working together for better health. Back

171   WHO (2008) Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Back

172   Riley et al (2007) Slum health: Diseases of neglected populations BMC International Health and Human Rights http://www.biomedcentral.com/content/pdf/1472-698X-7-2.pdf Back

173   Tan et al. (2003) Global plagues and the Global Fund: Challenges in the fight against HIV, TB and malaria http://www.biomedcentral.com/content/pdf/1472-698X-3-2.pdf Back

174   Beijing "Call for Action" 2009. Back

175   27 High-burden countries with M/XDR-TB released a "Call for Action" in April 2009 in response to increasing numbers. They call upon international donors to coordinated actions and pledge to use financing mechanism such as the Global Fund to Fight AIDS, TB and Malaria. The Global Fund currently has financing gap of between $4-$10 million which urgently needs to be filled. Back

176   Operation ASHA, Stop TB Partner http://www.stoptb.org/partners/partner_profile.asp?PID=60274 Back

177   International Development Committee Report: DIFD Annual Report (2008). Back

178   Action for Global Health (2009) Health in Crisis. Back

179   Garau, Pietro et al. (2005), A Home in the City: UN millennium project task force on improving the lives of slum dwellers: http://www.unmillenniumproject.org/documents/Slumdwellers-complete.pdf; and UNFPA (2007), State of the world's population 2006/2007: Unleashing the potential of Urban Growth: http://www.unfpa.org/swp/2007/presskit/pdf/sowp2007_eng.pdf Back

180   UN Habitat, (2007) State of the World's Cities 2007. Back

181   UNFPA (2007), State of the world's population 2006-07; and UN Habitat, (2007) State of the World's Cities 2007. Back

182   Garau, Pietro et al. (2005), A Home in the City. Back

183   http://www.unhabitat.org/downloads/docs/5637_49115_SOWCR%2016.pdf Back

184   Garau, Pietro et al. (2005), A Home in the City. Back

185   UN Habitat (2006) State of the World's Cities 2006. Back

186   UNFPA (2007), State of the world's population 2006-07; and UN Habitat, (2007) State of the World's Cities 2007. Back

187   UN Habitat (2006) State of the World's Cities 2006. Back

188   http://unpan1.un.org/intradoc/groups/public/documents/UN/UNPAN024789.pdf Back

189   http://www.citiesalliance.org/doc/resources/Nairobi%20Inventory/SlumProfiles7_KasaniDivision.pdf Back

190   NORAD (Norwegian Agency for Development Cooperation), (2002) Poverty and Urbanisation-Challenges and Opportunities, Position Paper Back

191   http://www.stopchildlabour.eu/africatour2008/tour/kenya/final-country-report/;
http://www.unicef.org/people/kenya_43469.html Back

192   UNFPA (2007), State of the world's population 2006-07. Back

193   Whitni Thomas, "Microfinance", in A Guide to Giving (2008), see http://www.philanthropyuk.org/AGuidetoGiving/Howtogive/Microfinance Back

194   Official response from DFID to a Parliamentary question tabled by Peter Lilley MP (26 January 2007). Back

195   ibid. Back

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Prepared 22 October 2009