Nairobi symbolises sub-Saharan Africa’s rapid urbanisation and population growth. Informal urban settlements have spread: home to an estimated 60-70% of Nairobi’s residents. The population of informal settlements in Nairobi is highly migratory and transient. Meeting the increasing demands of this new population is a huge challenge for policymakers.

Health and social issues

There is a substantial amount of information about health within Nairobi’s informal settlements, due to surveys in 2000 and 2012. Despite improvements in some environmental, health and educational indicators among residents, these are not uniform, and are worse among groups of younger women and women without formal education. Lack of drinking water and poor drainage were most commonly identified as priority needs by residents in the 2012 survey. Other concerns include housing, access to education, rubbish/sewer disposal and security. Childhood mortality in informal urban settlements was almost halved between 2000 and 2012. However, progress was not even, with girls faring worse than boys. 

Data suggests greater social fluidity and vulnerability in informal settlements than elsewhere in Nairobi and Kenya. The proportion of young people with secondary or higher education rose between 2000 and 2012 and the gap in educational attainment between male and female school-age residents narrowed. And yet, people living in informal urban settlements continue to be at a disadvantage compared to their counterparts elsewhere in Nairobi. Unemployment remained a major issue among residents, and the unemployment rate among women aged 20-24 is particularly high. High illiteracy rates among women aged 44-49 attest to the vulnerability of this age group. Contraceptive use and knowledge among young (aged 15-19), unmarried, sexually active women remain low and both young women and men are likely to have more sexual partners than in the rest of Kenya. Although the proportion of young people reporting alcohol and drug use fell between 2000 and 2012, the level of alcohol and drug use among orphaned young males was high, indicating the vulnerability of this group. According to research by LVCT Health, girls as young as 11 or 12 are vulnerable to sexual exploitation and abuse as a result of social and family fragmentation, limited access to education, gender-based violence, parental alcohol and drug dependence, food and accommodation insecurity and livelihood stress.


Devolution in Kenya has added a layer of governance at the county level and a set of powerful new governance actors. It has also brought some resources and development to the local level. 

After the survey of 2000, the conditions of residents in informal urban settlements in Nairobi became visible to policymakers for the first time. In response, a number of projects have sought to improve the quality of life. Projects include ‘slum upgrading’, maternity care, non-formal education, sanitation in schools, housing and HIV prevention and treatment.

According to SDI, informal urban settlement organisations in Nairobi and other cities in Kenya are relatively active. Muungano wa Wanavijiji (known as Muungano) is a slum dweller movement that emerged in Nairobi in the 1990s as a response to widespread informal settlement evictions. It joined the global SDI network in 2001.  The network has made visible the inequities and health vulnerabilities experienced by residents, for instance, the city’s poorest people in informal settlements pay far more for lower-quality water, sanitation and electricity than households elsewhere in the city. It has also demonstrated people’s capacity to improve their environment and demand their right to health. Muungano’s approach is based on SDI’s methods.

Recently, the state has responded positively to this organisation. In August 2017, the Kenya Gazette, the government’s official journal, declared an area of 550 acres (the area occupied by the Mukuru slums) to be a Special Planning Area (SPA). Usually, informal urban settlement interventions in Kenya are driven by international development agencies that then draw in city governments. In contrast, the Mukuru SPA is a project of the Nairobi city government. The SPA’s goal is to develop a plan that is incorporated into the city’s own 20-year vision. The approach includes all departments of the county, as well as consortia of civil society and development organisations. This has created a new narrative: one in which the improvement of informal settlements is a challenge for the whole city. The SPA has used research – including data collected and analysed by residents themselves – to frame the problem of informal urban settlements in a way that says, “Together we can.”

Read more

African Population and Health Research Center (APHRC). 2014. Population and Health Dynamics in Nairobi’s Informal Settlements: Report of the Nairobi Cross-sectional Slums Survey (NCSS) 2012. Nairobi: APHRC.