Save the Children Sounds Alarm on Plight of the World’s Urban Poor

When you think about very low- and middle-income countries you might assume that the poor in deep rural pockets in these countries have the highest chance for maternal and infant mortality. That isn’t the case according to Save the Children’s latest State of the World’s Mothers report released today.

The report says that it is the urban poor in countries like Haiti, Somalia, Niger and Mali, for example, who are suffering the most and have less access to health care, nutrition services, sanitation and clean water. Even as child mortality has decreased by 49 percent since 1990, the numbers do not fully tell the entire story. While resources have successfully helped the rural populations, the urban poor continue to suffer from a lack of overall services that will allow them to live and thrive.

“Our new report reveals a devastating child survival divide between the haves and have-nots, telling a tale of two cities among urban communities around the world, including the United States,” said Carolyn Miles, president and CEO of Save the Children in a statemtn. “For babies born in the big city, it’s survival of the richest.”

New data says there are 54 percent of the world’s population lives in urban areas. 860 million people live in urban slums in big cities like Delhi, Nairobi, Rio, and Johannesburg where the disparity between the rich and poor is incredibly stark. In fact, poor children in urban areas are two times more likely to die than their richer peers. In some countries, poor children are up to five times more likely to die before the age of five than their peers in a much higher income bracket.

Slum area - Addis Ababa
Slum area – Addis Ababa

Urban slums continue to grow because poor migrants from rural areas seek jobs in cities. This causes squatter communities and slum-dwelling as well as a perpetual cycle of poverty. These migrants often believe that it is better to live in crowded slums in the city than in their rural home towns because they can at least find work. The tradeoff, however, comes in the form of poor living conditions.

Six million children died in 2013, the vast majority of whom were among the urban poor. As aforementioned, it seems logical that urban centers would provide greater access to a higher standard of living. Unfortunately, the cost of affording a higher standard of living is outside the realm of possibility for millions of families. Save the Children notes that not all urban poor live in slums and also all people who live in slums are not poor, but largely speaking, slum areas are, for the most part, inhabited by extremely poor residents. 62 percent of Sub-Saharan Africans live in urban slums. In Asia, the proportion of the urban poor living in slums ranges from 25 to 35 percent, and in the Latin America, 24 percent of its population live in slums.

Due to the nature of slums – overcrowded, small, often makeshift dwellings – the urban poor are often subject to infectious diseases and waterborne diseases. Health services are nonexistent, save through many NGOs that provide social services to the urban poor like Carolina in Kibera that works in the Kibera slum in Nairobi, one of Africa’s largest slums. And Save the Children that provided needed health services for mothers and children in slums in Delhi, for example.

Save the Children provides a mobile clinic for mothers and children in Delhi, India. Photo: Jennifer James

“This place is like an island,” said Christina Tardy, 28, a resident of the West Point slum in Monrovia, Liberia in this year’s State of the World’s Mothers report. “The state does nothing here. It provides no water, no schools, no sanitation, no roads and no hospital.”

Despite the harsh realities of slum living, some large cities have vastly improved the lives of mothers and children including Addis Ababa, Cairo, Manila, Kampala, Guatemala City and Phnom Penh according to the report.

While developing countries have much work to do to provide better lives for its urban poor, the United States ranks 33rd on Save the Children’s Mothers’ Index. Washington, DC has the highest infant mortality rate (6 in 1000 live births) in the United States despite being the capital of the nation. This number is three times higher than both Tokyo and Stockholm.

What Can Be Done to Improve the Outcomes for the World’s Urban Poor?

Save the Children recommends that low- and middle-income countries need to include very specific plans to aid its citizens who are among the urban poor in their post-2015 sustainable development goals that will launch in September 2015. Some of the key recommendations are to provide affordable universal health care, step up proper sanitation and access to clean drinking water, invest in data collection in order to make necessary correction changes based on numbers and not on theories that might or might not work, scale up nutrition plans, and mobilize partnerships between governments, civil society, and NGOs in order to make progress happen for those who are most vulnerable who live in urban areas.

The Best Places to be a Mother

As in years past, the Nordic countries lead the world in being the best countries to be a mother and to raise children. Save the Children’s Mothers Index ranked countries based on maternal health, children’s well-being, educational status, and economic and political status. Sub-Saharan countries and Haiti rounded out the worst places to be a mother, with Somalia being the worst place on earth for mothers.


Read the entire report and see the full Mothers’ Index of 179 countries at

Photos: Jennifer James

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