Researchers talk to government workers and civil society in Lagos to understand whether, and how, the Sustainable Development Goals and Social Determinants of Health feature in their work.

Take note urban leaders and international donors.

We have a problem: Given the centrality of governance to urban health and wellbeing, the World Health Organization has recommended that urban decision makers ‘ground’ development using a health lens. The intentions being firstly to embed values that stem from ensuring the health and wellbeing of all and secondly to create cross-sectoral networks to improve health especially for the marginalized. However, despite the exaggerated inequities and high burden of diseases in urban centres across Africa; approaches using urban health equity and environmental justice are not reflected strongly in practice.

We wanted to understand governance through the lens of health. So we applied a systemic health lens to test emerging priorities for urban governance in the city of Lagos. We interviewed government workers and community-focused organizations working on urban governance issues in the metropolis. The interview guide explored urban priorities in each ministry, the priorities accorded to urban health and resilience, and the actors and processes governing the metropolis.

What this study adds: Our research adds a deeper understanding of how intersectoral players perceive urban health and opportunities for investments that prioritize health. We found that:

  • Environmental issues and poor environmental management attitudes emerged as unanimous challenge
  • The private sector was viewed as a way to deal with growing resource limitations as, for example, civil society called for investments in pro-poor housing.
  • Many interviewees could not make the connection between health and their work suggesting a need to promote healthy urban governance.

Implications for city policy and practice: What is needed now is:

  • Investment in low cost, climate and health friendly, scalable solutions to urban health challenges
  • Framing public-private partnerships around health equity
  • Designing incentives to promote private sector investments in the needs of the urban poor

We also need an urgent critique of international donor agendas to see if they reflect an SDG lens. Other local action required includes:

  • Improving public attitudes to environmental health
  • Prioritizing the transfer of evidence to urban development policy
  • Training government and policy makers to see urban development issues through a health lens

Full article: Exploring government and civil society workers’ perceptions of urban health as a governance priority in the Lagos metropolis

Associated consultancy: ERIMConsulting

Authors: Ebele Mogo (@ebyral), Jill Litt, Jenn Leiferman, Beth McManus, Betsy Risendal, Lookman Oshodi (@oshlookman)
City Know-how editor: Marcus Grant