Introduction Introduction Chapter 5 Chapter 5
Chapter 1 Chapter 1 Chapter 6 Chapter 6
Chapter 2 Chapter 2 Notes for Indicators Notes
Chapter 3 Chapter 3 Notes for boxes Notes for boxes
Chapter 4 Chapter 4 Indicators Indicators
CHAPTER 2 Printer Friendly printer friendly version
Chapter 1 People In Cities: Hope
Countering Desolation

The Unseen Dramas of the Urban Poor 3

Slums: Unparalleled Concentration of Poverty

The Persistent Disparities

Women's Empowerment and Well-being: The Pillars of Sustainable Cities

Social Contradictions in Growing Cities: Dialogue and Discord

The Changing Demographics of Growing Cities

Improving Urban Governance and Involving the Poor: The Right Thing to Do

Women's Empowerment and Well-being: The Pillars of Sustainable Cities

As women are generally the poorest of the poor . . . eliminating social, cultural, political and economic discrimination against women is a prerequisite of eradicating poverty . . . in the context of sustainable development.(21)

The social and physical amenities of cities facilitate gender-equitable change. Indeed, the concentration of population in urban areas opens many possibilities for women—whether migrants or natives—to meet, work, form social support networks, exchange information and organize around the things of greatest importance to them. Cities tend to favour greater cultural diversity and, as a corollary, more flexibility in the application of social norms that traditionally impinge on women’s freedom of choice.

Compared with rural areas, cities offer women better educational facilities and more diverse employment options. They provide more opportunities for social and political participation, as well as access to media, information and technology. Cities offer many roads to decision-making power through community and political participation. Women can use urban space to project their voices, to participate in community politics and development and to influence social and political pro­cesses at all levels.

Women stand to benefit from the proximity and greater availability of urban services, such as water, sanitation, education, health and transportation facilities; all of these can reduce women’s triple burden of reproductive, productive and community work and, in so doing, improve their health status and that of their children and families.


Urbanization increases girls’ access to education and promotes cultural acceptance of their right to education. Primary, and especially secondary, education for girls has crucial multiplier effects that increase women’s social and economic status and expand their freedom of choice. Educated women tend to marry later and have fewer and healthier children.(22)In adulthood, they have greater employment potential, income-earning capacity and decision-making authority within the household.(23)Other benefits include knowledge and capacities to maintain and protect their health, including preventing unwanted pregnancies and sexually transmitted infections (STIs), including HIV/AIDS. All of these are helpful in the fight against poverty. 

Families’ ability to enrol girls as well as boys in school, and to keep them there, strongly influences the extent and depth of urban poverty and the transmission of poverty from one generation to the next. Unfortunately, in countries with low overall enrolment, many girls in poor urban areas drop out before they are functionally literate. Demographic and Health Survey data point to four main reasons for this: lack of finances; early marriage and pregnancy; household responsibilities; and poor performance. School fees, uniforms and materials, loss of income or household help, expenditures on transport and other costs of sending children to school may be prohibitive for many poor families and reduce the urban educational advantage. If families are forced to choose, daughters are typically the first to do without or to be pulled from school. 

Data on within-city differentials reveal dramatic differences in access to education and levels of literacy between slums and wealthier neighbourhoods. In some countries, such as Bangladesh, Colombia, India and Pakistan, literacy of women living in slums is 30-50 per cent lower than those of non-slum communities.(24)Young people’s ability to continue in school is influenced by age at marriage, pregnancy and household headship. Young women and men in low-income households are more likely to have children, be married or head a household than their upper-income counterparts.(25)


Employment possibilities are far more diverse in urban areas for both men and women. Urbanization has significantly boosted women’s labour force participation.(26)Paid employment for women not only increases household income but can trigger transformations in gender roles and elevate women’s status in the family and society.

Worldwide, there has been a significant increase in women’s non-agricultural wage employment during recent years.(27)New opportunities have arisen, especially in tradable sectors(28)and in home-based businesses linked to global production networks.(29)For example, of the 50 million workers in export processing zones, 80 per cent are young women.(30)



The UNFPA Ethiopia country office supports the Good Samaritan Training Centre, an urban-based NGO providing vocational training to young women and girls, aged 18-25, with a view to enabling self-employment or finding paid work. The main target groups are street girls—girls from low-income families exposed to street life by economic deprivation, neglect, family break-ups, civil strife and war. Apart from training in different skills, such as leather handicrafts, weaving, knitting, sewing, embroidery and hairdressing, the Centre provides training on health, home management, nutrition and HIV/AIDS and family planning.

However, most growth of female employment is in the informal sector, which accounts for most new employment opportunities in the world,(31)and where women are a large majority, especially in Africa and Asia.(32)Informal employment is critical in enabling women to absorb the economic shocks that poor households experience. In this regard, women’s employment, paid and unpaid, is of fundamental importance in keeping many households out of poverty.(33)The downside is that much informal work is unstable, of poor quality and poorly paid.(34)


Physical and financial assets offer women more than economic well-being and security. Legal property tenure increases women’s opportunities to access credit, generate income and establish a cushion against poverty. It also empowers them in their relationships with their partners and their families, reduces vulnerability to gender-based violence and HIV/AIDS and provides a safety net for the elderly.

Women own less than 15 per cent of land worldwide.(35)In some countries, women cannot legally own property separately from their husbands, particularly in parts of Asia and sub-Saharan Africa. Lacking legal title to land and property, women have virtually no collateral for obtaining loans and credit, thus limiting their economic options. In some settings, although women can legally own and inherit property, custom dictates that men control it and that it passes only to male heirs on a man’s death. It is difficult or impossible in these circumstances for women to exercise their property rights in practice.

There is evidence that the difficulty of securing title to property in rural areas is prompting women to migrate to cities in hopes of securing property there, where prospects are assumed to be better.(36)Women may also have better access to legal information and support in urban areas. Because of the greater social dynamism and range of economic possibilities open to women, cities are likely to offer more opportunities to acquire property in the long run. 

Legal reforms are still necessary, however, to secure women’s equal rights to own property. Where laws are in place, cities continue to need programmes and recourse mechanisms to tackle informal barriers such as customary practices, low awareness of rights, the high cost of land and housing and discriminatory lending and titling policies. 

Property rights and access to credit are closely linked, so it is not surprising that women face difficulties in obtaining financial assets. Microcredit programmes have partially filled this need. Making its mark initially in rural settings, microcredit is also allowing poor urban women to leverage their capacities and improve their incomes.


Decision-making power is one of the main indicators of women’s empowerment. The prospects for women’s formal participation in politics are improving, despite the many challenges they face, including gender dis­crimination and prejudice, multiple poorly-rewarded responsibilities and calls on their time and energy, lack of support in crucial areas such as reproductive health and lack of resources.



Urban areas, with better-quality information, communication and technology, enable women to organize more quickly and more effectively, and allow groups that start off as small collectives to grow into larger networks and even international movements. The Huairou Commission, born out of the Fourth World Conference on Women in Beijing, is one such example. The presence of 35,000 non-governmental organization participants from around the world provided the momentum for the continued networking of these mostly women-led organizations, making it a true global movement that has influenced policymaking at the local, regional and international levels on issues of habitat and the environment.(1)

With increased ability to use news media, radio and television, messages can be disseminated instantaneously, encouraging learning in areas such as health, propelling specific causes of interest and advancing knowledge of women’s rights on a broad front. CEMINA (Communication, Education, and Information on Gender), for example, reaches thousands of listeners in some of the poorest communities across Brazil. With 400 radio programmes, the Women’s Radio Network brings education on gender equality, health and environmental issues into many homes.(2) 

From civic groups to savings groups, urban women have been active agents of change in their communities—working to meet shelter needs and improve essential services, upgrade slums and provide the backbone to economic security.(3)The Self-Employed Women’s Association, a trade union of 700,000 members in six Indian states, has set up facilities that provide health care, childcare and insurance services, research, training, communication and marketing, as well as housing and infrastructure for poor urban women working in the informal economy.(4)Such efforts often carry on without government or international support; however, when existing efforts of women are recognized and incorporated into programming, it has proven invaluable. The CAMEBA project is a vibrant demonstration of this: A slum upgrading project in Caracas, Venezuela, backed by the World Bank, it became more efficient and sustainable after the inclusion of the women’s groups which had already been working on the ground for several years.

In many cases, women’s organizations are able to do things other social movements cannot. Some of the disadvantages women face can be turned into strengths of sorts. Women and their organizations are less of a threat, not only to governments but to local gangs and the like. Thus, there are situations where men’s organizations would quickly be either corrupted or disrupted by the powers that be, whereas women’s organizations can gain power and support.(5)

Some governments have enacted quotas or parity laws to address these barriers and ensure that women have a critical level of participation in city councils and local governments.(37)Nevertheless, women make up only 16 per cent of members of national parliaments in Africa and Asia and 9 per cent in the Arab States.(38)These percentages are well below what is believed to be a “critical mass” for women to influence policy and spending priorities.

Despite this bleak picture in the capitals of nations, women’s participation in decentralized governance has increased. Local spheres of government offer greater opportunities for women’s empowerment and political participation, a situation that reflects positively on women’s prospects as urbanization increases. Moreover, countries with a higher percentage of women councillors are likely to have a higher number of women parliamentarians, which may, in turn, benefit women at the municipal level.(39)

Urbanization can thus be a powerful factor in creating the conditions for women’s empowerment. Turning this potential into reality is one of the most effective ways of promoting human rights, improving the living conditions of the poor and making the cities of developing countries better places in which to live.

Cities lend themselves to women’s social and political participation at many levels. For poor women whose lives have been confined to home, family and work, the act of joining an organization immediately broadens their prospects. When women actively participate in an organization, or take on leadership roles, they gain self-confidence, new skills, knowledge and a greater understanding of the world. Organizing can address many of the limitations that poverty imposes on poor women; it can begin to counter the costs and risks of informal work. It can also help to reduce poor women’s vulnerability, insecurity and dependence, including a lack of knowledge about the outside world and how it works.

Organizing also helps women who have few assets to pool resources, thereby increasing their economic power. Savings and credit groups may help the working poor access microfinance services, and producers with little capital may buy raw materials at wholesale prices by combining their resources.(40)

Such advantages could be enhanced with more support. Poor women need a representative voice in the institutions and processes that establish social and economic policies in a global economy, in order to continue improving the living and working conditions of the poor. International, regional and national negotiations regarding free trade agreements, the Millennium Development Goals and poverty reduction strategies all need to include the voices and concerns of the urban poor and, in particular, informal workers, the majority of whom are women. Ensuring a voice for poor urban women at the highest level requires that government and international organizations support the growth of their organizations and build capacity for leadership.


Access to health care is particularly critical for women, because of their reproductive functions, because they are disproportionately burdened with providing care for the elderly and the sick and because they do more to relieve poverty at the community level.(41)Better access to education and employment for women contributes to their overall empowerment, their capacity to exercise their right to health, including reproductive health, and, overall, improves their life chances.

These services and opportunities tend to be more readily available to women in urban than in rural areas. But for poor women, lack of time and money, as well as the lack of freedom to make household decisions, or even to move about the city, can negate these advantages. In urban areas, inclusive health policies and programmes, accompanied by better targeting of services and resources, could rapidly improve women’s health, in particular their reproductive health.

Gender relations and poverty condition how couples and families approach sexual and reproductive behaviour. Poor urban women are exposed to higher levels of reproductive health risks than other urban women. They are also less likely to obtain good-quality services. They are more likely to face gender-based violence in the home and on the streets and continue to be subject to harmful traditional practices.

Total fertility rates are lower in urban than in rural areas throughout the world.(42)But this does not mean that all urban women have the same access to reproductive health care, or even that they can all meet their needs for contraception. Poor women within cities are significantly less likely to use contraception and have higher fertility rates than their more affluent counterparts. At times their reproductive health situation more closely resembles that of rural women(43)(see Figure 4).

Figure 4: Total Fertility Rate for Residents of Urban Slum and Non-slum Areas and for Rural Areas: Selected African Countries, 2003-2004

Click here to enlarge image

Source: Based on data provided by: UN-Habitat. Urban Indicators, Phase III.

Unmet need for contraception among women predictably varies according to relative poverty. Surveys covering Asia, Latin America, North Africa and sub-Saharan Africa show generally higher levels of unmet need among the rural population when compared to the urban population, with poor urbanites midway between the rural and the urban population as a whole.(44)In South-East Asia, for example, estimated unmet need is 23 per cent among the urban poor, compared to only 16 per cent among the urban non-poor.(45)

Overall, poverty may be a better indicator of fertility patterns than rural or urban residence. For policymakers concerned with the rate of urban growth, it will thus be especially important to look at the interactions between population and poverty, and increasingly within urban settings.(46)Prioritizing women’s empowerment, augmenting their access to education and employment and providing good quality sexual and reproductive health information and services to both women and men leverages their choices and is conducive to smaller, healthier families. This helps meet the needs and rights of individuals, while simultaneously improving prospects for economic growth and human well-being.


Gender-based violence, with its tremendous physical, psychological and financial damage inflicted on women and society, is a feature of urban life, regardless of income or educational status. Violence in its various forms, from intimidation to sexual assault, restricts the ability of women to move in and around the city,(47)reducing their freedom to seek work, social services and leisure activities. Physical and sexual abuse is also a factor in unwanted pregnancies, sexually transmitted infections (including HIV) and complications of pregnancy.(48)

Women in urban settings are far more likely than their rural counterparts to report having ever experienced violence, in part because of the breakdown in cultural mores that govern relations between the sexes.

Women in urban settings are far more likely than their rural counterparts to report having ever experienced violence.(49)Part of this can be ascribed simply to better possibilities in urban areas for denouncing violence. Yet, women may, in fact, be at greater risk of gender-based violence in urban areas, because of the breakdown in cultural mores that govern relations between the sexes and the lower likelihood that neighbours would intervene. Poverty, the move to a new environment (in the case of migrants), unemployment, inadequate wages, social exclusion and racism can produce frustration among men and vulnerability among women. The most deprived are the most likely to be affected.(50)Street children and sex workers are especially vulnerable.(51)

Rapidly shifting norms regarding male and female roles can also increase domestic violence. Research in the Philippines found that poverty and urban residence are associated with a higher likelihood of intimate-partner violence.(52)A study of urban women in Moshi, United Republic of Tanzania, found that 21.2 per cent had experienced an incident of intimate partner violence in the year preceding the survey, and more than a quarter had experienced it at some time in their lives.(53)


Maternal mortality remains astoundingly high, at about 529,000 a year, more than 99 per cent in developing countries, and much of it readily prevent­able.(54)Four out of five deaths are the direct result of obstetric complications,(55)most of which could be averted through delivery with a skilled birth attendant and access to emergency obstetric services.

Skilled attendance and access to emergency care explain why maternal mortality is generally lower in urban areas, where women are three times more likely to deliver with skilled health personnel than women in rural areas.(56)However, poor urban women are less likely to deliver with a skilled birth attendant.(57)For example, only 10-20 per cent of women deliver with skilled health personnel in the slums of Kenya, Mali, Rwanda and Uganda, compared to between 68 and 86 per cent in non-slum urban areas.(58)

There are a number of reasons why poor urban women do not seek maternal care. These include poverty and the more pressing demands of other household expenses, other demands on their time given their many other responsibilities and the absence of supporting infrastructure such as transport and childcare.(59)

Shelter deprivation increases mortality rates for children under five. In Ethiopia, the mortality rate in slums (180 per 1,000 live births) is almost double that in non-slum housing (95). Similar differentials prevail in Guinea, Nigeria, Rwanda and the United Republic of Tanzania. Countries such as the Philippines and Uzbekistan, with much lower levels of child mortality, also show a relationship between shelter deprivation and child survival.

Although poor children born in cities are closer to hospitals and clinics, and their parents are generally better informed, they still die at rates comparable to rural children.(60)Overcrowded and unhealthy living conditions, without adequate water and sanitation, provide a rich breeding ground for respiratory and intestinal diseases and increase mortality among malnourished urban children.(61)



The number of slum dwellers in India is estimated at 40.3 million in the 2001 census, that is, about 14.2 per cent of the total urban population. A UNFPA project in the State of Maharashtra operates in five municipalities which have experienced rapid growth of urban slum populations. 

In remote and inaccessible slum areas, the project upgraded basic emergency obstetric care centres to provide comprehensive services. It is working with women’s groups to strengthen women’s knowledge and capacities in the area of reproductive health as well as the institutional and community mechanisms to address gender-based violence.

The project also provides spaces for adolescents to discuss their sexual and reproductive health issues in a safe and accepting environment; it fosters improved access to reproductive health information and services; and it provides opportunities for adolescents to build their life skills.

In addition, the project has set up voluntary community-based depots for non-clinical contraceptives. The value of this approach is that it links communities with health institutions, increasing accessibility.

In Kenya’s rural areas, almost twice as many infants or children under five years of age die per 1,000 live births compared to Nairobi, the capital city. However, mortality rates are much higher in the capital’s informal settlements, where around half of Nairobi’s population lives. In Kibera, one of Africa’s largest slums, nearly one child in five dies before its fifth birthday. Surveys in many other cities have also shown under-five mortality rates of 100-250 per 1,000 live births in particular settlements. 


In urban settings, the risk and prevalence of HIV/AIDS increases, but the longer-term possibilities of reducing the epidemic appear to be better there. Currently, the situation is bleak. Rural-to-urban migrants leave behind not only partners and family but often customary restrictions on sexual behaviour as well. Cash dependency, coupled with poverty and gender discrimination, may increase transactional sex; at the same time, it reduces opportunities for negotiating safe sex, especially for women and girls but also for younger men and boys. Injecting drug use tends to be higher in urban settings. Sexually transmitted infections and tuberculosis, which increase the acquisition and transmission of HIV, are also more common in urban areas.

Some rural people living with HIV migrate to cities for better treatment and care, including antiretroviral drugs. As a result, HIV prevalence is generally higher in urban than rural populations in sub-Saharan Africa, the epicentre of the AIDS epidemic.(62)Botswana and South Africa both have high urbanization levels and extremely high HIV prevalence. 

Urban poverty is linked to HIV transmission and reduces the likelihood of treatment. Street children, orphans, sex workers and poor women in urban areas are particularly vulnerable to HIV infection. Poor urban women are more likely to become victims of sexual violence or human trafficking, increasing their risk; moreover, they are less likely to know how to protect themselves.(63)Women threatened with violence cannot negotiate safe sex. 

There is, however, some good news. Recent evidence of a downturn in HIV prevalence in urban areas of some countries suggests that urbanization may have the potential to reduce the epidemic. Condoms—key for HIV prevention—and information about HIV transmission may be more readily available in urban areas. Stigma and discrimination may also be lower in urban areas, because of better education and more exposure to people living with HIV/AIDS.