Urban Family Planning in Sub‑Saharan Africa: An Illustration of the Cross‑sectoral Challenges of Urban Health

Trudy Harpham, Moses Tetui, Robert Smith, Ferdinand Okwaro, Adriana Biney, Judith F. Helzner*, James Duminy, Susan M Parnell, John Ganle

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)
34 Downloads (Pure)


The multi-sectoral nature of urban health is a particular challenge, which urban family planning in sub-Saharan Africa illustrates well. Rapid urbanisation, mainly due to natural population increase in cities rather than rural–urban migration, coincides with a large unmet urban need for contraception, especially in informal settlements. These two phenomena mean urban family planning merits more attention. To what extent are the family planning and urban development sectors working together on this? Policy document analysis and stakeholder interviews from both the family planning and urban development sectors, across eight sub-Saharan African countries, show how cross-sectoral barriers can stymie efforts but also identify some points of connection which can be built upon. Differing historical, political, and policy landscapes means that entry points to promote urban family planning have to be tailored to the context. Such entry points can include infant and child health, female education and employment, and urban poverty reduction. Successful cross-sectoral advocacy for urban family planning requires not just solid evidence, but also internal consensus and external advocacy: FP actors must consensually frame the issue per local preoccupations, and then communicate the resulting key messages in concerted and targeted fashion. More broadly, success also requires that the environment be made conducive to cross-sectoral action, for example through clear requirements in the planning processes’ guidelines, structures with focal persons across sectors, and accountability for stakeholders who must make cross-sectoral action a reality.
Original languageEnglish
Pages (from-to)1044–1053
Number of pages10
JournalJournal of Urban Health
Issue number6
Early online date14 Jun 2022
Publication statusPublished - 1 Dec 2022

Bibliographical note

Funding Information:
The research for this paper was funded by the International Union for the Scientific Study of Population (IUSSP) as part of Bill & Melinda Gates Foundation Grant INV008737 aimed at supporting research and policy engagement on fertility and family planning in urban development. The authors thank IUSSP intern Lauren A. Law for her policy analysis and acknowledge the policy-analysis contributions of IUSSP fellows: Sunday Adedini, Nurudeen Alhassan, Moussa Bougma, Francis Levira, Eliphas Gitonga, Abdoul Nouhou, Elizabeth Oele, and Idrissa Ouili.

Publisher Copyright:
© 2022, The Author(s).


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