We have a certain amount of knowledge of the problems of urban health in Africa. We also partly understand the determinants of such problems: environmental, social, structural, and service related. Multi-level research has enabled the role of 'place' for health to be acknowledged and in particular, the importance of social connections at the neighbourhood level.
However, truly multi-sectoral action for urban health, which reflects the multiple determinants, is rare and often fails. Pilot projects are rarely scaled up. More evaluative intervention research is needed and researchers need to engage policy makers at earlier stages. We also need to understand the urban policy process more - especially the role of frontline workers in determining policy.
Urban health research has focussed on problems (vulnerabilities) and not strengths or resilience. Using a more positive model of urban health might enhance the research translation process (getting research into policy and practice: GRIPP) and speed up action to improve urban health.
Trudy Harpham is a geographer and professor emeritus of the London South Bank University where she taught Urban Development and Policy. Over the past three decades she has played a central role in establishing urban health as an urgent and important field of research and in pushing it up on the international health policy agenda.