This article presents findings from a study carried out in Keko Machungwa informal settlement in Dar es Salaam under the auspices of the Disaster Management Training Centre of Ardhi University, Tanzania. The settlement has experienced frequent flooding in the past five years, and this study explores the causes, risks, extent of flooding and coping strategies of residents as well as municipality and city officials. Key methods employed in capturing empirical evidence included mapping of zones by severity of flooding, interviews with households, subward leaders, and municipal and city officials. Non-participant observation, primarily taking photographs, complemented these methods. Laboratory tests of water samples taken from shallow wells in the settlement were performed to establish the level of pollution. In addition, records of prevalence of water-borne diseases were gathered from a dispensary within the settlement to corroborate flooding events, water pollution and occurrence of such diseases. Findings show that flooding is contributed to by the lack of a coordinated stormwater drainage system; haphazard housing development within the valley; and blocking of the water stream by haphazard dumping of solid waste and construction. Risks associated with flooding include water and air pollution, diseases, waterlogging and blocked accessibility. The most common coping strategies at household level are use of sandbags and tree logs; raised pit latrines and doorsteps; provision of water outlet pipes above plinth level; construction of embankments, protection walls and elevation of house foundations; seasonal displacement; and boiling and chemical treatment of water. Recommendations for future action at household, community and city level are made.

Urban poverty, ill health, and living in slums are intrinsically interwoven. Poverty is multidimensional and there is no agreement on a universal definition. UN-HABITAT has introduced an operational definition of slums that is restricted to legal aspects and excludes the more difficult social dimensions. The World Health Organization definition is more comprehensive and uses a health and social determinants approach that is strongly based on the social conditions in which people live and work. Health and improving the lives of people living in slums is at the top of international development agenda. Proactive strategies to contain new urban populations and slum upgrading are the two key approaches. Regarding the latter, participatory upgrading that most often involves the provision of basic infrastructure is currently the most acceptable intervention in developing countries. In urbanization of poverty, participatory slum upgrading is a necessary but not sufficient condition to reduce poverty and improve the lives of slum dwellers. Empowering interventions that target capacity development and skill transfer of both individuals and community groups-as well as meaningful negotiations with institutions, such as municipal governments, which can affect slum dwellers' lives-appear to be the most promising strategies to improve the slum dwellers' asset bases and health. Non-governmental organizations, training institutions, and international development partners are best placed to facilitate horizontal relationships between individuals, community groups, and vertical relationships with more powerful institutions that affect the slum dwellers' lives. The main challenge appears to be lack of commitment from the key stakeholders to upgrade interventions citywide.

Most urban dwellers in developing countries live in informal settlements in housing that is built incrementally. Low-income households most often have no access to formal housing finance institutions and largely depend on informal housing finance mechanisms in addition to the recently established shelter microfinance institutions. However, both formal and informal shelter-financing institutions have a requirement for savings. Based on empirical investigations in two informal settlements in Dar es Salaam, Tanzania, this paper explores the nature of savings in incremental housing development. The findings show that unpacking the concept of savings has the potential to uncover new opportunities for promoting housing finance in informal settlements, other than shelter microfinance.

All three of the interacting aspects of daily urban life (physical environment, social conditions, and the added pressure of climate change) that affect health inequities are nested within the concept of urban governance, which has the task of understanding and managing the interactions among these different factors so that all three can be improved together and coherently. Governance is defined as: “the process of collective decision making and processes by which decisions are implemented or not implemented”: it is concerned with the distribution, exercise, and consequences of power. Although there appears to be general agreement that the quality of governance is important for development, much less agreement appears to exist on what the concept really implies and how it should be used. Our review of the literature confirmed significant variation in meaning as well as in the practice of urban governance arrangements. The review found that the linkage between governance practices and health equity is under-researched and/or has been neglected. Reconnecting the fields of urban planning, social sciences, and public health are essential “not only for improving local governance, but also for understanding and addressing global political change” for enhanced urban health equity. Social mobilization, empowering governance, and improved knowledge for sustainable and equitable development in urban settings is urgently needed. A set of strategic research questions are suggested.

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