Let's reverse the urban disadvantage

Monday 4 May 2015


  Save the Children works in some of the world’s toughest places to ensure that mothers and children survive and thrive. And through our global campaign, EVERY ONE, we are working hard to influence changes in policies, norms, laws and budgets so that we end preventable child deaths. The world has made remarkable progress towards this goal – 100 million children are alive today because of reductions in child mortality since 1990. Millions of mothers are alive today because of improvements in essential health care during pregnancy and childbirth. But there is a major unfinished agenda. Increasingly, further reductions in child and maternal mortality will depend on strengthened efforts in urban areas.

Every year, millions of families move from the countryside to towns and cities, in search of a better life. Yet in many cases, children and mothers in cities continue to face a high risk of death from preventable causes. In most countries, the poorest urban children are at least twice as likely to die as the richest children before their fifth birthday, and often face mortality rates well above the national average. We call this the urban disadvantage.

Our 16th annual State of the World’s Mothers report explores the urban disadvantage in rich and poor cities around the world. Among our most important findings:

  • The world is urbanising rapidly, with virtually all future population growth in developing countries expected to happen in cities. As a result, a greater share of child deaths will take place in urban areas.
  • In developing countries, the urban poor are often as bad as, or worse off than, the average rural family, and for many rural families, moving to the city often results in more – rather than less – hardship.
  • Few countries have invested sufficiently in the infrastructure and systems, including health care and water and sanitation, which are critical to addressing the basic health needs of the urban poor. More countries need to adopt universal health care as a national policy to help address the needs of the urban poor.

There is no simple solution to tackling child and maternal mortality in the world’s cities, but a number of the major cities cited in the report – such as Addis Ababa and Manila– have made real progress in addressing the health needs of the poorest families. These examples hold important lessons for other cities, and demonstrate the scope for progress even where resources are scarce and the burden of need is heavy.

Save the Children is proud to have contributed to these successes. We are working in urban settings around the world to improve care for pregnant mothers and newborn babies and provide improved nutrition, education and sanitation. We partner with local and national governments to create policies and strategies that make it easier for the poorest urban families to get essential services. We leverage the unique advantages cities have to offer – technology, highly skilled partners and existing services – that need to be made more accessible. Many more lives could be saved with fully resourced plans that ensure universal access to services for every mother and every child.

We must seize the opportunity that 2015 presents us, with the launch of the Sustainable Development Goals, to set the world on the trajectory to ending preventable deaths within a generation. I encourage you to take a look at the Take Action section of the report. It’s time for all of us to work to set things right – to reverse the urban disadvantage, once and for all.


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