A presentation at the Public Health Association of British Columbia around the theme: Facing a Changing World: Transformative Leadership and Practice.

1. A Global Perspective On Urban Health
Equity. Case Study: The Lagos Metropolis.
Ebele Mogo, DrPH
Principal, ERIM Consulting
President, Engage Africa Foundation
Post-doctoral researcher, McGill University

2. Urbanization Is A Global
Phenomenon
● Since 2008, more people are living in urban areas than rural areas
(United Nations Population Fund, 2015)
● Highest urban growth rates in developing countries (United Nations
Population Fund, 2015)
● Cities provide access to information, technology, culture, socio-
economic growth (World Health Organization et al, 2010)
●Concurrently, there is the phenomenon of “hidden cities” - pockets
of intra-urban deprivation (Prasad et al, 2015)
●Cities are therefore also centres for crime, poverty, slum
proliferation, homelessness

3. Three focus areas for this
presentation
●An interdisciplinary approach to urban health equity research
●Research findings and the surprising similarities across contexts
●What transformative leadership can look like in view of these findings

4. Study overview
● Lagos metropolis - the fastest urbanizing region of the world (Coker
et al., 2015)
● Archival document analysis to understand government strategy for
urban development in Lagos (qualitative)
● Built environment audits to quantitatively assess the urban health
priorities in Lagos (quantitative)
● Interviews with government and civil society groups to understand
urban governance priorities (qualitative)

5. Qualitative research findings
● Need for greater engagement of communities esp. poor and informal in
planning and implementation
● With growth of public private partnerships need for transparency and
goal alignment
● Need to incentivize systemic thinking on urban health as a shared
priority
● Need to strengthen capacity of surveillance systems and to place equity
as a core value through disaggregation

6. Quantitative research findings
● Physical disorder, power supply, security, waste management,
governance, road infrastructure and provisions for active
transportation are the key urgent intervention areas for public health
● Need to account for informality in auditing settings such as this, and
to explore how to leverage informal service provision arrangements
for public health
● Neighborhood level underserved by government efforts
● Need to build community ownership and participatory governance of
neighbourhoods

7. What does transformative
leadership look like?
●A spatial lens is not enough.
Rather, we need to understand the broader phenomena at play across
contexts - urbanization, displacement, unplanned migration, pollution,
conflicting interests in the city (e.g profit versus human rights)

8. Some of the global challenges
are similar
●The need for inter-sectoral action
●Need to integrate local needs into policy level action
●The need to activate the local government
●The need for disaggregated data to uncover inequities
●There is a need for urban development that does not infringe on
human rights, especially that of the poor
●Therefore, cities as different as Lagos and Vancouver can learn
from each other

9. What does transformative
leadership mean in this context?
●The health sector can play a lead role in interdisciplinary and
multi-level research and action
Archival document analysis (informing policy using a social
determinants and socio-ecological lens)
Built environment audits (integrating contextual knowledge in
measuring built environment equity)
Interviews with government and civil society groups (understanding
governance using a social determinants and socio-ecological lens)

10. What does transformative
leadership look like?
●Outcomes focused research
Not just identifying the problems, but replicating what works across
identified phenomena
● what movements have worked and why?
● what works in intersectoral coalition building?
● what works in data driven policy making?
● what works in strengthening surveillance?
● what works in putting human rights and health equity at the center of
urban development?

11. In conclusion
We as health practitioners:
1) can frame health in a way that reflects a conceptual and not just
contextual grasp
2) can lead on action and research that is truly intersectoral and multi-
level
3) can lead knowledge sharing across global contexts
4) can lead research and knowledge translation around replicating what
works
= Transformative leadership

12. Thank you