International Conference on Urban Health 2018: Catalyzing Collaboration and Advancing Implementation Science Agenda Development in Sub-Saharan Africa

January 31, 2019

Dr. Elizabeth Kimani (APHRC), Dr. Jane Wanyama (IDI) and Dr.Ester Elisaria (IHI) presenting during the workshop on the three country urban nutrition assessment (Top – From L to R). Dr. Daniel Okello Ayen Director of Public Health and Environment at the Kampala Capital City Authority speaking during our panel presentation at ICUH (Bottom)

After nearly a decade, the International Conference on Urban Health (ICUH) returned to Sub-Saharan Africa. ICUH is a yearly conference organized by The International Society for Urban Health (ISUH) with support and leadership from the New York Academy of Medicine. In November 2018, it was hosted by Uganda Academy of Sciences in Kampala, Uganda, and carried the theme, “Managing Urbanization for Health,” which challenged participants to respond to the question “How can policy and practice maximize health outcomes in this time and these places of sprawling and ever-accelerating urbanization?”. Sessions responded to this question through six thematic tracks: (1) the governance of complex systems, (2) cities as economic engines, (3) culture and inclusivity, (4) disasters, epidemics, and the unexpected, (5) safety, security, and justice, and (6) spiritual health in the city.

Having the conference in Kampala afforded a timely opportunity for HEARD partners: East Central Southern Africa- Health Community (ECSA-HC), African Population Health Research Center (APHRC), Ifakara Health Institute (IHI), Infectious Diseases Institute (IDI) and others to refine approaches for ongoing implementation science efforts. Additionally, global stakeholders gathered at a HEARD-hosted session to share perspectives on emerging priorities in the area of adolescent health services in poor urban settings.

Workshop: Implementation Science Collaboration on Urban Health in East Africa: a three-country assessment of nutrition among the urban poor

Over the last two years, HEARD partners through the leadership of the ECSA-HC, created an Implementation Science Collaboration on Urban Health. Through the Urban Collaboration, local and global stakeholders in Kenya, Tanzania and Uganda will implement a joint assessment of their countries’ nutrition and water, sanitation and hygiene (WASH) systems and services targeting children and adolescents in poor urban areas. In preparation for this cross-country assessment, the HEARD Project organized a workshop at ICUH and held a panel presentation to garner stakeholder feedback and refine plans for assessment implementation and products.

Roughly 30 participants from partner institutions, universities, foundations and other interested implementers participated in the workshop, “Implementation Science Collaboration on Urban Health in East Africa: a three-country assessment of nutrition among the urban poor.”  Demonstrating the critical status of this issue within the region, and with the realization that it can only be successfully addressed through local ownership, the session was moderated by the Director General of the ECSA-HC, Dr. Yoswa Dambisya.  The discussion was led by Drs. Ester Elisaria from IHI, Elizabeth Kimani from APHRC, and Jane Wanyama from IDI who presented on progress and findings to date along with future plans. Dr. Daniel Okello (Kampala Capital City Authority) and Dr. Tollulah Oni (University of Cambridge) offered remarks and reflections at the end of the open session. Dr. Oni urged participants to share experiences from across contexts through the ISUH’s “collaboratorium” while Dr. Daniel Okello cautioned that links between academicians and policy makers need to be established as early as the research question development stage.

Consultation: “Tactical approaches to providing adolescent health services in urban settings” 

Another opportunity to leverage global stakeholders at ICUH was presented by HEARD’s convening of stakeholders attending the conference to discuss “Tactical approaches to providing adolescent health services in urban settings” with the purpose of identifying key areas for targeted implementation science and action to improve services for the most vulnerable adolescents in rapidly urbanizing settings. The conversation centered around implementation science and research priorities for partnership as well as program strategies and priorities for policy and advocacy.

Dr. Jim Sherry, professor at City University of New York School of Public Health and Director of the HEARD Project, alongside Professor Yoswa Dambisya, Director General of ECSA-HC, chaired the session, with remarks by the Executive Directors of IDI, Dr. Andrew Kambugu; IHI, Dr. Honorati Masanja; and APHRC, Dr. Catherine Kyobutungi.  IHI’s Honorati Masanja emphasized a need for better data, more inclusive advocacy and that we need to improve our ability to leverage technology to bring youth into the conversation.  Andrew Kambugu from IDI reinforced the need to engage adolescents in the services they use and highlighted the challenges of service integration and the need for technology driven solutions.  Dr. Catherine Kyobutungi of APHRC pointed to gaps in data on adolescents and the need to harmonize systems. Godwin Mindra, UNICEF/HQ, contributed that the most vulnerable urban dwellers are the newcomers/latest arrivals and that status as adolescents put them in “double jeopardy.” It was noteworthy to have the directors from four of the institutions currently part of the IS Collaboration on Urban Health in East Africa leading the discussion in collaboration with colleagues from UNICEF, The Challenge Initiative, USAID and others.

Key themes arising from the discussion included the need for: a holistic approach in understanding adolescents and their priorities; optimal cross-sector and system platforms for targeting adolescents; the improvement of advocacy efforts; the elimination of data gaps; and placing adolescents at the center of multi-sectoral approaches. Further, the need to employ innovative methods suitable for the urban adolescent context to document what works and does not was brought to the fore.

HEARD partners came away from ICUH 2018 with actionable, applicable conclusions, among them the value of consultative processes and the importance of engaging a growing number of stakeholders and look forward to further connecting with the global community at ICUH 2019 in China.