Maputo, Mozambique’s capital, is a fast-growing coastal city where most residents reside in informal or unplanned areas. Recent analyses estimate that between 75% and 80% of Maputo’s population lives in informal settlements, reflecting a pattern of spatial inequality and weak infrastructure provision. Academic and U.N.-Habitat assessments similarly note that at least 80% of the city is composed of informal settlements.
The municipality also struggles to meet the demand for basic infrastructure, including water supply, sewerage, solid waste management, energy, roads and communications. These deficits pose significant environmental and public health risks, particularly in peri-urban areas with self-built housing and unpaved roads. These conditions make Maputo a clear example of how urban health governance is inseparable from land use, infrastructure and local politics.
In such cities, health outcomes depend as much on municipal decisions about roads, sanitation and land tenure as they do on the formal health sector itself.
Informal Settlements, Infrastructure and Health Risk in Maputo
Studies of Maputo’s informal neighborhoods describe overcrowded, self-built housing, poor drainage and limited formal water and sanitation networks. Research on critical infrastructure in Maputo’s informal settlements shows that water pipes, stormwater drainage, sanitation, waste collection and public lighting are “almost nonexistent” in many areas. Some neighborhoods also still rely on unsafe sanitation and open defecation.
These conditions are explicitly linked to diseases such as diarrhea and cholera. Other studies on Maputo’s informal settlements document the links between socioeconomic status, settlement form and land consumption. They also highlight the exposure of low-income residents to flooding and other environmental risks.
This combination of dense informality and incomplete service coverage makes everyday environmental conditions a central driver of health outcomes. From a global health perspective, this means that interventions limited to clinics and hospitals will miss the root causes of disease burden. Effective urban health governance must therefore link health outcomes to improvements in water, sanitation, drainage, solid waste systems and safe housing in informal settlements.
City Government, Planning and Land
City-level politics are crucial in Maputo because the municipality controls or co-controls, key levers for planning, land management and basic services. Classic work on Maputo’s urban governance reveals that more than half of the city’s population lives in poverty. It also shows that most residents acquire land for housing through informal markets, reinforcing spatial and social inequality.
More recent analyses argue that informality is not an aberration but a dominant mode of urbanization in Maputo and that data on informal areas remain incomplete and outdated. This makes it harder for municipal authorities to plan and manage infrastructure in a way that reflects the realities of informal neighborhoods. U.N.-Habitat’s resilience work with the Municipality of Maputo, using the City Resilience Profiling Tool (CRPT), highlights institutional challenges related to data, coordination and long-term planning.
Recommendations of Actions for Resilience and Sustainability in Maputo focus on improving infrastructure, managing flood risk and strengthening local governance capacities. All of this underlines that urban health governance in Maputo is fundamentally tied to how the municipality regulates land, invests in infrastructure and engages with residents in informal neighborhoods.
Donors, Upgrading Programs and City-Level Investment
Maputo has been a focal point for large urban upgrading and infrastructure programs supported by international donors and development banks. A recent preprint and subsequent journal article on critical infrastructures in Maputo lists several major projects aimed at informal settlements, including:
- Maputo Urban Transformation Project
- Mozambique Urban Sanitation Project
- Maputo Metropolitan Area Urban Mobility Project
- Other neighborhood-level upgrading initiatives, such as the Chamanculo C and George Dimitrov projects
The World Bank’s Maputo Urban Transformation Project, approved in 2020, aims “to improve urban infrastructure and strengthen institutional capacity for sustainable urbanization in Maputo.” Components include informal settlement upgrading, city-center rehabilitation, sustainable urban growth in peripheral districts and institutional support. Progress reports indicate that hundreds of thousands of residents are benefiting from improved urban infrastructure, drainage, sanitation and roads in informal settlements.
The project also includes performance-based conditions to strengthen land tenure regularization, property tax reform and solid waste management. Earlier programs, such as ProMaputo, also supported by the World Bank and its partners, sought to modernize municipal administration, upgrade infrastructure and regularize land rights in selected neighborhoods. However, analyses note challenges including limited tenure regularization, relocation without secure alternatives and persistent deficits in basic services.
UN-Habitat’s Global Action Plan and Informal Settlement Health
At the global level, U.N.-Habitat has developed a Global Action Plan, titled “Accelerating for Transforming Informal Settlements and Slums by 2030,” which was launched in 2022. The plan is anchored in the Slums and Informal Settlements Network (SiSnet) and the Participatory Slum Upgrading Program (PSUP). It provides a framework for large-scale transformation of informal settlements through improvements in infrastructure, land tenure, community participation and policy reform.
U.N.-Habitat’s urban health work emphasizes that many determinants of health, including housing, transport, water, sanitation and public space, lie outside the health sector and within municipal mandates. It calls for integrated planning that positions health at the center of urban development efforts. Together, these initiatives position informal settlement upgrading and slum transformation as a core pathway for improving health outcomes in cities like Maputo.
They align local infrastructure projects with global frameworks for inclusive, climate-resilient and healthy urban development. This is exactly where urban health governance becomes a practical agenda: coordinating housing, infrastructure, participation and health objectives at the city scale.
Global Health Meets Local Politics
International health agencies are increasingly recognizing that city-level governance shapes health outcomes. The World Health Organization’s (WHO) initiative on Urban Governance for Health and Well-Being (2020–2028) works directly with mayors and city governments to strengthen participatory, multisectoral and multi-level governance, ensuring that health is at the center of decision-making. A companion WHO policy brief on governance and financing for urban health notes that governance structures and funding mechanisms are key challenges to achieving urban health goals.
It emphasizes the need for coordination across government levels and sectors. Maputo’s experience provides a clear, concrete example of these points:
- Health risks in informal settlements stem from gaps in infrastructure, such as water, sanitation, drainage and waste systems, as well as from land-use decisions.
- Major improvements rely on the authority and capacity of municipal governments, not just national ministries.
- Donor programs pass through city institutions and can either strengthen or bypass local systems.
For global health actors, this means that effective strategies must engage directly with municipal councils, planning departments, local utilities and community organizations, rather than focusing solely on national health ministries.
Conclusion
Maputo demonstrates that improving health in the Global South cannot rely on national policy alone. In cities where most residents live in informal settlements, health outcomes depend on urban health governance, which encompasses how city leaders plan, finance and implement infrastructure, as well as how they collaborate with donors and involve informal settlement residents in decision-making.
– Clara Garza
Clara is based in Los Angeles, CA, USA and focuses on Global Health and Politics for The Borgen Project.
Photo: Flickr
The IRC’s Use of AI in Crisis Zones
How Crisis Disrupts Education
Education offers critical skills that support children’s safety, development and long-term well-being. For those living through conflict or disaster, the loss of stable schooling can limit future opportunities. Education Cannot Wait reports that by the end of 2024, an estimated 234 million school-aged children in crisis settings required urgent assistance to access quality learning. This figure represents an increase of about 35 million in three years. Of this total, 85 million children, around 37%, were not attending school at all. Ten countries with the largest crisis-affected student populations, including Nigeria, Afghanistan and Bangladesh, account for more than 60% of these children.
How Crisis Drives Displacement
Crisis often forces people to leave their homes, whether through internal displacement or by crossing borders as refugees, asylum seekers or migrants. Displacement brings loss of housing and community as well as reduced access to essential services such as food assistance, health care and social support. Language barriers and legal restrictions can further limit services for those who have fled.
According to the United Nations (U.N.) Refugee Agency, around 123.2 million people were forcibly displaced by the end of 2024 due to persecution, conflict, violence and human rights violations. This represents one in every 67 people across the globe. Furthermore, the global figure rose by 7 million in one year. The conflict in Sudan created the largest displacement crisis, with 14.3 million people displaced. Syria and Afghanistan followed with 13.5 million and 10.3 million displaced people, respectively.
IRC Solutions in Action
The IRC began in 1933 as the International Relief Association, formed at the request of Albert Einstein to support people fleeing persecution. Today, the IRC assists communities affected by humanitarian crises. In recent years, the organization has expanded its efforts by integrating artificial intelligence tools such as aprendIA, Signpost and the newly launched ALMA. These innovations aim to strengthen access to information. Additionally, they improve service delivery and support people in crisis zones with faster and more reliable assistance.
Toward Safer Futures
The IRC’s use of AI in crisis zones shows how technology can strengthen humanitarian responses. Indeed, tools like aprendIA, Signpost and ALMA help crisis-affected communities access education, information and essential services more quickly and reliably. With continued collaboration and refinement, AI in crisis zones can play an even greater role in supporting people working toward safer and more stable futures.
– Sammi Li
Photo: Unsplash
Eliminating TB in Chhattisgarh Through Community Programs
Other programs, such as the Nikshay-Niramay Chhattisgarh 100-Day Campaign, intensified TB detection and treatment through door-to-door screenings and immediate diagnostic testing. TB affects the most vulnerable groups and has severe socioeconomic consequences for individuals, families and communities. For this reason, eliminating TB through community programs is a turning point for India.
The Problem
Between 2015 and 2023, India experienced a significant decline of 17.7% in TB incidence. However, 2.7 million cases were still registered in 2023. Also, the disease costs India an estimated $23 billion annually and the global TB response is underfunded.
For example, only 20% of the $5 billion research funding target was met in 2022. Most importantly, socioeconomic and health care factors affect diagnosis and treatment in the country, with often uneven progress across different areas. The main issues of national TB control are:
Consequently, vulnerable, rural, tribal and remote populations face the most significant access barriers, as distance from health facilities is a major reason for not seeking care. Although the public sector covers vulnerable groups financially, HR shortages, drug stockouts and poor diagnostics limit the services provided.
Especially among the needy, lack of trust and poor facility experience contribute to diagnostic delays and missed cases. As an example, rural districts like Niwari have poor awareness of TB and its stigma leads to delayed care. Also, for vulnerable groups, the economic burden of TB is often devastating since the spread of the disease increases unemployment.
A study based in Assam, Maharashtra, Tamil Nadu and West Bengal found that more than 50% of patients incurred catastrophic costs before diagnosis due to a nine-week delay in diagnosis.
TB in Chhattisgarh
Chhattisgarh, where about 80% of the population lives in rural areas, carries a heavy burden of communicable diseases. Tribal and remote communities face major health care barriers, including long travel distances, poor transportation, a shortage of qualified health care providers and limited diagnostic facilities. In addition, many TB cases in the state are diagnosed at secondary and tertiary health facilities, which reduces the effectiveness of household contact investigations.
A study conducted in urban slum areas of Durg district revealed that the population is particularly vulnerable due to high-density living, low socioeconomic status and limited access to structured health care.
The Solution
Chhattisgarh’s progress toward TB-free panchayats emerged from a model that placed communities, local governments and frontline workers at the center of the response. The TB-Free Panchayat Program built its strength on systematic door-to-door surveys, household contact screening and rapid referral. The program was led primarily by ASHAs (village health volunteers) who coordinated closely with gram sabhas (village-level legislative bodies) and primary health center teams.
These teams were trained to dispel stigma, identify presumptive cases and support adherence. Gram panchayats were encouraged to integrate TB activities into their regular development plans, including sputum transport and social support for vulnerable families. Special gram sabhas in tribal districts brought together youth groups, traditional leaders and TB champions.
These groups worked together to screen high-risk households. This joint effort helped communities see TB as a shared problem rather than an external medical issue. This approach produced measurable results. In Rajasthan, similar assessments showed that active case finding and community awareness reached some of the highest scores in programme evaluation, demonstrating that village-led structures can sustain screening and follow-up at scale.
Local voices in Chhattisgarh echoed this shift. Health Minister Shyam Bihari Jasiwal noted that success was possible only when society participated alongside the government, underscoring the sense of ownership communities have developed in their path toward TB-free status.
Looking Forward
Chhattisgarh’s progress demonstrates that TB can be reduced when communities take the lead in the fight against the disease. As panchayats take responsibility for screening, awareness and support, they strengthen trust and make early care possible for the people who need it most. The state’s experience proves that local leadership and consistent engagement can overcome long-standing barriers in rural and tribal areas.
With continued investment in frontline workers and community participation, Chhattisgarh can sustain these gains and serve as a guide for other states working toward a TB-free future.
– Angela D’Avino
Photo: Pixabay
Elimination of Malaria in Suriname: A First for the Amazon Region
The 70-Year Journey to Malaria Elimination in Suriname
Suriname’s elimination efforts began in the 1950s, targeting the country’s densely populated coastal regions with indoor pesticide spraying and the provision of antimalarial treatment. By the 1960s, these regions became malaria-free, yet the forested interior, covering 90% of the country, presented different challenges. Traditional open-style homes offered minimal protection against mosquitos, and economic activity, particularly resource extraction, facilitated widespread transmission.
In 1974, Suriname decentralized medical responsibility in the interior to its primary health care service, which recruited and trained health care workers from local communities to provide early diagnosis and treatment. Investment in community-based approaches such as this would prove vital.
However, a surge in often illicit gold mining around the turn of the century threatened elimination efforts. Research across the Amazon region demonstrates strong positive correlations between mining activity and malaria incidence. Mining involves frequent travel between malaria-endemic areas, and because 75% of gold miners in Suriname are migrant workers from neighboring Brazil and French Guiana, cross-border transmission rates grew dramatically.
By 2001, Suriname recorded more than 15,000 cases — the highest transmission rate in the Americas.
Yet with the adoption of several vital strategies, cases dropped dramatically after this peak. The last locally transmitted case of Plasmodium falciparum — the most dangerous variant — was recorded in 2018, followed by the final Plasmodium vivax case in 2021. After three consecutive years with zero indigenous transmissions, Suriname was granted a certification of malaria elimination from the WHO.
How Suriname Turned the Tide
Suriname’s government demonstrated strong commitment to malaria elimination, supported by international projects such as the Global Fund and the Amazon Malaria Initiative (AMI-RAVREDA). Nationwide malaria screening was implemented, including at border crossings, to build effective surveillance mechanisms and tackle cross-border transmission.
The introduction of rapid diagnostic self-tests proved crucial in addressing malaria in remote regions, including Indigenous territories and mining zones beyond the reach of central services. The Malakit Project was vital in accelerating the decline in malaria incidence between April 2018 and March 2020 by 43%.
The ability to self-test and, if necessary, self-administer appropriate medication prevents miners from leaving work sites for treatment. The financial burden of such absence has contributed to non-adherence to treatment and the pervasiveness of the disease.
Efforts similarly focused on the training and involvement of local communities. Marthelise Eersel, who leads Suriname’s Malaria Program, explained: “everywhere where there is a community, you can train people to diagnose and treat malaria and report back to you.” Malaria Service Deliverers have provided free diagnosis, treatment and prevention services, as well as education, in areas where central health systems have struggled to reach.
Because much of the country’s mining activity is illegal and many miners are undocumented, engaging with the central health system has been difficult. Hedley Cairo, Malaria Diagnosis Coordinator with the Ministry of Health, explained that health workers are never accompanied by police on visits to mining sites, nor do they ask for documents — an approach that has built trust with vulnerable populations.
Breaking the Poverty-Malaria Cycle
Research consistently demonstrates the economic burden of malaria. Increased transmission is estimated to slow economic growth in endemic countries by 0.7% to 3% per year. The disease contributes to absenteeism, hampers children’s educational development, discourages foreign investment and tourism and strains health care systems.
In Suriname, this connection is particularly evident in the interior. Indigenous and Maroon communities suffered consistently higher malaria rates than coastal and urban areas and are among the country’s most economically disadvantaged, with 29% and 32.9% of each community living under the World Bank poverty line. Gold mining, driven by economic necessity, became both a livelihood strategy and the primary driver of malaria transmission, affecting miners and their families.
Suriname’s Minister of Health, Amar Ramadhin, celebrated that elimination “will have positive effects on our health care sector, boost the economy and enhance tourism.” The timing is significant: Suriname is emerging from a severe economic crisis, with current poverty rates at 17.5%.
Malaria elimination removes one major barrier to economic development, freeing resources and human capital for education, infrastructure and other priorities. The health care system, previously stretched thin managing malaria cases, can now refocus on other pressing needs.
A Blueprint for the Region
The Amazon region accounts for 90% of the malaria burden in the Americas, with Brazil, Peru and Venezuela still recording high transmission rates. Successful malaria elimination in Suriname offers evidence that elimination is achievable, even in climates conducive to transmission. However, regional coordination is essential to sustain elimination in the face of reintroduction threats from neighboring countries and to support other nations’ elimination goals.
Looking Ahead
Suriname’s achievement offers a replicable blueprint: community-based solutions, universal health care access, innovative approaches to reach marginalized populations and sustained political commitment. There are encouraging signs that surrounding countries are learning from this approach. The Malakit Project operates in French Guiana, and Brazil and Colombia are beginning to establish networks of community health workers in some Amazon regions. As the first Amazon country to reach this milestone, Suriname has led the way forward.
– Caroline Sheehan
Photo: Flickr
Rising Inequality: Montenegro’s Poverty Crisis
Although concerns over Montenegro becoming too dependent on tourism persist, the European Union (EU) accession ambitions have prompted Montenegro to align its growth with social development. Similarly, International donors and NGOs are beginning to push for support of inclusive tourism and the promotion of rural development projects.
Montenegro’s Growing Wealth Gap Crisis
A major issue in Montenegro remains the growing wealth gap, with most wealth concentrated among the elites and foreign investors. In early 2025, the Ministry of Tourism began promoting small-scale entrepreneurship and rural tourism to distribute economic benefits more evenly across the country. Additionally, the seasonal nature of tourism in Montenegro makes tourism-related jobs insecure and low-paid, exacerbating the wealth divide, as a secure income is a rarity.
However, EU-funded initiatives are helping workers gain skills for year-round employment and supporting the economy through infrastructure development. Similarly, the government aims to introduce a new law, the “Permanent Seasonal Worker,” which will provide more stable employment for seasonal workers. This will enable a more secure economy and alleviate Montenegro’s poverty crisis.
Another prevailing issue in Montenegro is the regional inequality between the coast and the inland, largely driven by differing lifestyles and economic opportunities. Despite these challenges, infrastructure projects, such as roads and digital connectivity, are being expanded to rural areas to attract investment. For example, the EU is providing Montenegro with more than $88 million to reconstruct a 167 km railway, which will modernize the country’s transport network and promote a more sustainable transportation system.
These changes aim to create easy access across Montenegro and help reduce the nation’s poverty levels.
Balancing Tourism and Equality
Tourism in Montenegro affects more than just poverty; it also has significant environmental and social impacts. While women make up a large percentage of the tourism workforce, they are often excluded from higher-paying roles due to industry instability and prejudice. To address this, NGOs and EU programs fund and organize women’s job training and mentoring initiatives designed to promote independence and entrepreneurship in a difficult job market.
Tourism growth in Montenegro largely strains natural resources and risks exacerbating environmental degradation. However, the government is committed to promoting sustainable tourism standards and eco-certifications. By encouraging practices such as energy and water conservation in accommodations, Montenegro is reducing the environmental impact of tourism.
The country is also advancing a sustainable tourism strategy through participation in programs such as the international EU Ecolabel. Pushing for these limitations and using official certifications provides a surefire way to not only protect the environment but also continue the fight against Montenegro’s poverty crisis.
Final Remarks
Overall, Montenegro is working toward a more sustainable future in an effort to reduce its poverty rate. Its promotion of eco-tourism and cultural heritage projects aims to diversify tourism beyond just the coast, while also strengthening policy links between tourism revenue and social welfare to reprioritize Montenegrins. Nonetheless, poverty remains rife alongside booming tourism across the Adriatic Coast, with Montenegro beginning to promote initiatives aimed at inclusive tourism.
Montenegro also serves as a strong case study of how a small state can balance economic growth with poverty reduction through increased investment and policy alignment, promoting the well-being of its people and its tourism sector.
– Megan Burrows
Photo: Pexels
Why City-Level Politics Matter for Health in Maputo, Mozambique
The municipality also struggles to meet the demand for basic infrastructure, including water supply, sewerage, solid waste management, energy, roads and communications. These deficits pose significant environmental and public health risks, particularly in peri-urban areas with self-built housing and unpaved roads. These conditions make Maputo a clear example of how urban health governance is inseparable from land use, infrastructure and local politics.
In such cities, health outcomes depend as much on municipal decisions about roads, sanitation and land tenure as they do on the formal health sector itself.
Informal Settlements, Infrastructure and Health Risk in Maputo
Studies of Maputo’s informal neighborhoods describe overcrowded, self-built housing, poor drainage and limited formal water and sanitation networks. Research on critical infrastructure in Maputo’s informal settlements shows that water pipes, stormwater drainage, sanitation, waste collection and public lighting are “almost nonexistent” in many areas. Some neighborhoods also still rely on unsafe sanitation and open defecation.
These conditions are explicitly linked to diseases such as diarrhea and cholera. Other studies on Maputo’s informal settlements document the links between socioeconomic status, settlement form and land consumption. They also highlight the exposure of low-income residents to flooding and other environmental risks.
This combination of dense informality and incomplete service coverage makes everyday environmental conditions a central driver of health outcomes. From a global health perspective, this means that interventions limited to clinics and hospitals will miss the root causes of disease burden. Effective urban health governance must therefore link health outcomes to improvements in water, sanitation, drainage, solid waste systems and safe housing in informal settlements.
City Government, Planning and Land
City-level politics are crucial in Maputo because the municipality controls or co-controls, key levers for planning, land management and basic services. Classic work on Maputo’s urban governance reveals that more than half of the city’s population lives in poverty. It also shows that most residents acquire land for housing through informal markets, reinforcing spatial and social inequality.
More recent analyses argue that informality is not an aberration but a dominant mode of urbanization in Maputo and that data on informal areas remain incomplete and outdated. This makes it harder for municipal authorities to plan and manage infrastructure in a way that reflects the realities of informal neighborhoods. U.N.-Habitat’s resilience work with the Municipality of Maputo, using the City Resilience Profiling Tool (CRPT), highlights institutional challenges related to data, coordination and long-term planning.
Recommendations of Actions for Resilience and Sustainability in Maputo focus on improving infrastructure, managing flood risk and strengthening local governance capacities. All of this underlines that urban health governance in Maputo is fundamentally tied to how the municipality regulates land, invests in infrastructure and engages with residents in informal neighborhoods.
Donors, Upgrading Programs and City-Level Investment
Maputo has been a focal point for large urban upgrading and infrastructure programs supported by international donors and development banks. A recent preprint and subsequent journal article on critical infrastructures in Maputo lists several major projects aimed at informal settlements, including:
The World Bank’s Maputo Urban Transformation Project, approved in 2020, aims “to improve urban infrastructure and strengthen institutional capacity for sustainable urbanization in Maputo.” Components include informal settlement upgrading, city-center rehabilitation, sustainable urban growth in peripheral districts and institutional support. Progress reports indicate that hundreds of thousands of residents are benefiting from improved urban infrastructure, drainage, sanitation and roads in informal settlements.
The project also includes performance-based conditions to strengthen land tenure regularization, property tax reform and solid waste management. Earlier programs, such as ProMaputo, also supported by the World Bank and its partners, sought to modernize municipal administration, upgrade infrastructure and regularize land rights in selected neighborhoods. However, analyses note challenges including limited tenure regularization, relocation without secure alternatives and persistent deficits in basic services.
UN-Habitat’s Global Action Plan and Informal Settlement Health
At the global level, U.N.-Habitat has developed a Global Action Plan, titled “Accelerating for Transforming Informal Settlements and Slums by 2030,” which was launched in 2022. The plan is anchored in the Slums and Informal Settlements Network (SiSnet) and the Participatory Slum Upgrading Program (PSUP). It provides a framework for large-scale transformation of informal settlements through improvements in infrastructure, land tenure, community participation and policy reform.
U.N.-Habitat’s urban health work emphasizes that many determinants of health, including housing, transport, water, sanitation and public space, lie outside the health sector and within municipal mandates. It calls for integrated planning that positions health at the center of urban development efforts. Together, these initiatives position informal settlement upgrading and slum transformation as a core pathway for improving health outcomes in cities like Maputo.
They align local infrastructure projects with global frameworks for inclusive, climate-resilient and healthy urban development. This is exactly where urban health governance becomes a practical agenda: coordinating housing, infrastructure, participation and health objectives at the city scale.
Global Health Meets Local Politics
International health agencies are increasingly recognizing that city-level governance shapes health outcomes. The World Health Organization’s (WHO) initiative on Urban Governance for Health and Well-Being (2020–2028) works directly with mayors and city governments to strengthen participatory, multisectoral and multi-level governance, ensuring that health is at the center of decision-making. A companion WHO policy brief on governance and financing for urban health notes that governance structures and funding mechanisms are key challenges to achieving urban health goals.
It emphasizes the need for coordination across government levels and sectors. Maputo’s experience provides a clear, concrete example of these points:
For global health actors, this means that effective strategies must engage directly with municipal councils, planning departments, local utilities and community organizations, rather than focusing solely on national health ministries.
Conclusion
Maputo demonstrates that improving health in the Global South cannot rely on national policy alone. In cities where most residents live in informal settlements, health outcomes depend on urban health governance, which encompasses how city leaders plan, finance and implement infrastructure, as well as how they collaborate with donors and involve informal settlement residents in decision-making.
– Clara Garza
Photo: Flickr
Addressing Period Poverty in Uganda
About Period Poverty
Organizations such as the United Nations Children’s Fund (UNICEF) and the Pan African Think Tank define period poverty as inadequate access to menstrual hygiene health, products and education. This includes the inability to access pads, tampons or menstrual cups, as well as inadequate washing facilities, improper waste management and lack of education. While period poverty stems from multiple causes, the most frequently discussed is economic insecurity.
Period poverty is experienced by women and girls globally. Not every girl facing this issue is experiencing economic insecurity, but low- and middle-income areas are heavily affected. Families battling low income may not have proper access to menstrual or hygiene products or washing facilities due to inflation. According to a 2022 article by Context, prices of menstrual products in African countries doubled over a short period. In Ghana, where the inflation rate was 32%, prices rose from 5 Ghanaian cedi in 2021 to 12 in 2022. Low-income homes across Africa, including Uganda, sometimes reject their daughters’ requests for sanitary pads to afford food. As a result, 1 in 10 women and girls living in Sub-Saharan Africa miss school during their periods, accounting for about 20% of the academic school year.
Lack of Sanitation Facilities and Menstrual Education
Economic insecurity is not the only contributing factor. Another major driver is the lack of basic sanitation facilities in schools. More than 1.5 billion people worldwide do not have access to basic sanitation, such as private toilets. This alone keeps many girls out of school, as facilities may not be clean or may lack proper waste-disposal methods.
A final driver of period poverty is the lack of menstrual education. This affects girls by perpetuating stigmas and preventing them from understanding essential information about their menstrual cycle. In several countries, girls with periods face harmful cultural norms, including being labeled as “dirty” or restricted from certain activities. These stigmas stem from the lack of menstrual education provided in schools. Without basic knowledge of regular and irregular bleeding, hygiene needs or what symptoms require attention, girls may face health risks such as UTIs, dermatitis and unsafe practices such as transactional sex.
Period Poverty in Uganda and Its Effects on Girls
Affording and accessing menstrual necessities remains a widespread challenge in Uganda. More than half of the country’s female population is unable to meet their menstrual health needs. While the Government of Uganda has acknowledged period poverty as a critical issue that limits women and girls both developmentally and educationally, the problem remains prevalent.
“Ugandan girls would use old rags, clothes, and even toilet paper when they were on their period,” said Irene Nakitende, a Ugandan student at the University of North Texas, during a speech on period poverty.
Nakitende experienced period poverty in her youth in Uganda and recalled the main issues that contributed to it, including lack of education and sanitation facilities, as well as bullying. Many families could not afford pads and prioritized food instead. Because of this lack of products, girls often resorted to alternatives that led to leakage. Stained clothing resulted in embarrassment and bullying, causing many girls to stay home every month for one to five days and miss an average of 20% of classes during the school year.
The primary impact period poverty has on Ugandan girls is access to education. In Uganda, 19.8% of girls missed school at least once during the year because of their periods, and 17.3% reported absenteeism specifically during menstrual days. Missing such a high percentage of lessons reduces the likelihood of pursuing higher education after primary or secondary school.
Lack of education also includes limited menstrual education. Up to 66% of girls do not understand their periods until they experience them. Without information on menstrual pain, hygiene steps or warning signs of infections, girls face increased risks of UTIs, dermatitis and other challenges.
Ongoing Efforts
There have been precautionary guidelines created by Ugandan organizations to reduce period poverty. In 2015, the Ministry of Education and Sports (MOES) issued a guideline for schools in Uganda. The guidelines were created in response to the needs of young girls. In 2017, menstrual hygiene management was added to the Planning and Implementation Framework for Water, Sanitation and Hygiene (WASH). This greatly helped girls seeking safe and comfortable spaces to manage their cycles, as 574 secondary schools in Uganda now had proper menstrual hygiene management systems.
In 2019, the National Water and Sanitation Strategy was instituted in Uganda to increase access to sustainable water and proper hygiene services through facilities, teaching and awareness.
Looking Ahead
Continued investment in menstrual health education, sanitation facilities and affordable products can help reduce period poverty across Uganda. As government agencies, schools and nonprofits expand their support, more girls will be able to stay in school, protect their health and manage their periods with dignity. Strengthening these efforts offers a path toward greater equality and long-term social and economic development for women and girls nationwide.
– Keyly Rios
Photo: Flickr
Uganda Vision 2040: Foreign Direct Investment
Moving Beyond Aid
The Ugandan government’s vision for the nation’s future is one of economic independence and prosperity, a vision that a high dependence on aid renders impossible. Recent years have also seen a sharp decline in the global aid budget, with many wealthier nations slashing the amount spent on overseas assistance in favor of internal spending.
This comes at a time when poverty is still a persistent challenge in Uganda. Using the World Bank’s international poverty line of $3 a day, 59.78% of Uganda’s 50 million inhabitants live in poverty. It is important to note, however, that this figure was more than 80% before the turn of the century, showing remarkable progress. Using Uganda’s national poverty line, the percentage of people in poverty has dropped to 16.1%, though this figure stands at 74.2% in the arid northeastern region of Karamoja.
The Borgen Project spoke with H.E. Philip Rukikaire, Uganda Deputy High Commissioner to the U.K. He said, “Whereas Uganda has relied heavily on multilateral and bilateral aid since the late 1980s to support the recovery of the economy and also to transform into a middle-class economy, the government acknowledges that Aid is not sustainable.”
Set Targets
Recognizing the unsuitability of an aid-dependent economy to Uganda’s specific context, prompted the Ugandan government to implement Vision 2040, a 2013-launched document outlining the steps required to increase per capita income to $9,500, with a focus on driving investment.
Ten years later, Uganda Vision 2040 was supplemented with the Tenfold Growth Strategy. “The Tenfold Growth Strategy is the specific economic blueprint designed to achieve the quantitative leap required to meet the Vision 2040 goal,” said Ambassador Rukikaire. The strategy is anchored on four high-potential sectors: agro-industrial, tourism, mineral development (including oil and gas) and science, technology and innovation (ATMS). Many see these sectors as key to growing the economy tenfold from $50 billion to $500 billion by 2040.
Potential for Investment in Uganda
Uganda’s potential for foreign investment is vast. In 2024, the inward flow of Foreign Direct Investment (FDI) totaled $3.3 billion, an almost 200% increase from 2019. With a young, rapidly growing population, fertile soils, a substantial market size and regional integration through the East African Federation — and more recently the African Continental Free Trade Agreement — there are many advantages to potential investors.
As part of its broader strategy, the Government of Uganda has taken major steps to increase investment in the country. These include a 75% reduction in tariffs on machinery for factory use and a 100% tax deduction on costs related to training, research and mining. Additionally, the government has also offered additional benefits to incentivize investment in ATMS.
The Role of Foreign Service
A large role in stimulating investment in Uganda is played by the country’s diplomats. Indeed, in a recent meeting of Uganda’s Heads of Mission, the integral role of the foreign service in national development was restated. In the United Kingdom (U.K.), the Uganda High Commission works to encourage investment in each ATMS sector. This includes promoting Uganda Coffee, facilitating partnerships between NHS trusts in the U.K. and medical institutions in Uganda, and partnering with the Uganda Tourism Board to bring attention to Uganda’s unique tourist offerings.
U.K. Investments in Uganda
Many agreements have already been made, with the total U.K. Export Finance (UKEF) portfolio with Uganda set to surpass $1 billion in the coming year.
Current Challenges
Despite progress, challenges remain in actualizing the aims of Uganda Vision 2040. Corruption is a persistent barrier to investment, as is insecurity in the country’s border regions with South Sudan and the Democratic Republic of the Congo. Though there have been infrastructural improvements, investors remain disincentivized by poor connectivity.
Speaking on the U.K.’s relationship with Uganda, Ambassador Rukikaire stated, “The Labour government has signaled in its new ‘Africa Approach’ strategy its intention to prioritize Uganda in terms of investment that ultimately increases youth employment.” Through its international relationships, Uganda continues to make positive strides toward achieving the goals of Uganda Vision 2040 and the Tenfold Growth Strategy. Though challenges persist, the country demonstrates how to reduce poverty without overreliance on aid.
– Henry Weiser
Photo: Flickr
Thai Handicrafts Online: Selling Culture, Escaping Poverty
Thailand’s digital development has provided a new lifeline in recent years. Thai handicrafts are now sold online through social media platforms, e-commerce marketplaces and inexpensive smartphones, which connect rural artists with consumers worldwide. According to a World Bank study, digital technology may spur economic growth by generating more jobs, improving services and increasing productivity. What was once a small-scale, independent exchange is now part of the global digital economy. In addition to increasing revenue, the shift is reshaping what it means to preserve culture in the 21st century.
For many of these craftsmen, the internet serves as a means of escape from poverty rather than merely a platform for sales. Thailand has the second-largest digital economy in the Association of Southeast Asian Nations (ASEAN) region, accounting for an estimated 6% contribution to its gross domestic product (GDP). Local artisans are transforming tradition into opportunity by bringing Thai handicrafts online.
The Problem: Limited Market Access and Low Income
Thailand’s rural artisans have long been known for their exceptional talent in silk weaving, wood carving and pottery molding. However, many remain impoverished despite their artistic abilities. According to the Office of the National Economic and Social Development Council (NESDC), 3.43 million Thais with a monthly income of less than 3,078 baht were considered “poor” in 2024. The issue is a lack of opportunities, not a lack of talent.
Due to their remote locations from important trade hubs, rural farmers often face high transportation costs and limited access to reliable markets. In 2020, there were more than 2.3 million rural poor than urban poor, and the poverty rate was more than three percentage points higher in rural areas. Without branding knowledge or language skills to appeal to global buyers, their products struggle outside local markets. As a result, even skilled craftspeople often earn less than the federal minimum wage.
The E-Commerce Revolution
That reality is shifting as Thailand’s e-commerce industry experiences rapid growth. The digital marketplace, expected to reach more than $30 billion by 2025, is changing the way small businesses interact with customers. Thousands of rural business owners now have online stores selling Thai handicrafts through platforms like Shopee, Lazada, Etsy and TikTok Shop. With $684 million in online sales in 2024, Shopee is the largest online retailer in the Thai stationery, crafts and art supplies market.
With e-commerce growth predicted to reach 750 billion baht in 2025, the Department of Business Development is increasing efforts to help small and medium-sized enterprises (SMEs) adopt online selling. Communities previously closed off from formal trade now have new economic opportunities. Mobile phones and Wi-Fi connections have become transformative tools in villages once reliant on tourist foot traffic.
This digital transformation reflects a worldwide trend in reducing poverty. E-commerce increasingly serves as an equalizer for small-scale producers across Asia, Africa and Latin America. For every 10-percentage-point increase in mobile broadband usage, GDP initially increases by 0.8%. By connecting rural craftsmen to online markets, countries can pursue inclusive growth beyond urban industrialization. Thailand’s experience demonstrates how local entrepreneurship supported by digital access can contribute to poverty alleviation.
Success Stories: Digital Market Access in Action
All regions of Thailand are seeing the advantages of internet access. Isaan silk cooperatives in the northeast have transformed centuries-old weaving customs into successful online enterprises exporting handcrafted textiles to Japan and Europe. Hill tribe jewelry collectives in the north have drawn international attention by selling on Etsy, where buyers value originality and skilled craftsmanship. Meanwhile, small business owners participating in the One Tambon, One Product (OTOP) initiative have expanded their audience on TikTok Shop by using short videos as marketing tools. According to PCMI predictions, internet sales reached $38.5 billion in 2024 and are expected to rise to $58.5 billion by 2027.
Obstacles and Inequality
The advantages of e-commerce are still not equitably shared. High shipping costs, poor logistics networks and rural internet shortages continue to limit artisans’ ability to earn money online. Digital literacy remains a major barrier. Some producers rely on younger family members or middlemen to manage their online listings, leaving them vulnerable to unfair practices or irregular sales. According to an NESDC poll, 64.7% of people have below-average literacy skills, and 74.1% have below-average digital skills.
Experts are advocating for local e-commerce hubs and community-based digital ambassadors who offer shared resources such as Wi-Fi, photography studios and online marketing support. In the absence of such support, the digital gap risks reinforcing the barriers it seeks to dismantle. The National Citizen Digital Competency (NCDC) program aims to train 1,000 senior citizens nationally by 2024. Its goal is to raise Thai residents’ digital competency to an average evaluation score of 80 by 2027.
Policy and NGO Solutions
Governments and nonprofits have begun addressing these issues through initiatives that combine digital inclusion with poverty alleviation. With the expansion of its online presence, Thailand’s One Tambon, One Product (OTOP) initiative provides local manufacturers with a state-supported platform to sell Thai handicrafts globally. Additionally, the United Nations Development Programme (UNDP) has partnered with Thai authorities to deliver digital and financial literacy training for rural entrepreneurs.
Private-sector organizations have also taken action. Thousands of women artisans have benefited from Facebook’s #SheMeansBusiness Thailand initiative, using social media to create online businesses and access new revenue streams. These efforts form part of a broader plan to empower craftspeople through financing, capacity-building and digital inclusion. Experts advise continued investment in logistics infrastructure, affordable digital training and microloans that support sustainable business growth.
Digital Markets as Gateways to Dignity
Technology is more than innovation to Thailand’s rural craftsmen; it is access, empowerment and opportunity. Every digital payment, online store and smartphone connection brings rural artisans closer to financial independence. Across Thailand, local craftsmen are redefining livelihoods by turning traditional craftsmanship into sustainable online businesses.
The growth of the e-commerce market shows that expanding opportunities is as important to poverty alleviation as providing aid. Furthermore, Thailand’s experience offers a model for inclusive growth as digital infrastructure expands and more craftsmen acquire the skills needed to participate. Every handcrafted basket, woven scarf or silver bracelet sold online carries a piece of Thai culture and demonstrates how digital marketplaces can support dignity and opportunity.
– Katelyn Leano
Photo: Pixabay
Security or Sustainability? Deconstructing Military Expenditure
In the same year (2024), humanitarian aid totaled $24.2 billion, representing a decrease of nearly 10% from the previous year. At its current rate, the projected military spending for 2035 is between $4.7 to $6.6 trillion. An annual military expenditure of $6.6 trillion would be almost five times the spending at the end of the Cold War.
In 2024, governments invested 750 times more in defence infrastructure than the regular budget of the United Nations (U.N.). The figures prompt a deeper question: What would the world accomplish by investing this vast budget in achieving the SDGs? Channeling it toward development instead of defense? The following section explores these questions by drawing on data from the U.N. Secretary-General’s report.
Reorienting the Military Budget Toward Sustainable Development
Spending on militarization takes money away from achieving the SDGs and ending poverty. As of 2024, nearly 700 million people globally live in extreme poverty, while more than 3.5 billion people live in poverty based on a standard that is more appropriate for upper-middle-income countries. According to the U.N., it would cost $93 billion to end global hunger, less than 4% of the money spent on the military in just one year.
Every 1% increase in military spending is equivalent to a 1% decrease in publicly financed health services in low and middle-income countries. It would cost $370 million annually, a fraction of the current military budget, to provide basic health care to every person in low and lower-middle-income countries. Using 10% of the $2.7 trillion could ensure full vaccination for every child in the world.
More than 250 million children and young adults lack access to education. However, less than a quarter of this decade’s military spending could have provided 12 years of quality education for every child in low- and lower-middle-income countries. With $114 billion annually, 140 low- and middle-income countries could gain access to safe drinking water and sanitation.
In terms of employment, $1 billion could create more than 25,000 jobs in education, 17,200 in health care, 16,800 in clean energy and 11,200 jobs in the military. Therefore, the rise in global military spending, as opposed to humanitarian aid and development aid, is undermining the progress made toward achieving the SDGs. The report highlights how investing in development through health care, education and poverty alleviation rather than the military can help build a future that is sustainable and peaceful.
Voices for Disarmament and Demilitarization
Numerous international and civil society organizations are challenging militarization and actively advocating for disarmament. Amnesty International, Human Rights Watch and Action on Armed Violence are among the organizations working to shift existing global priorities toward a focus on peace. The Women’s International League for Peace and Freedom is also among the leading voices.
Through its Reaching Critical Will program, the organization actively promotes permanent peace through disarmament and demilitarization. It rejects militarism in all its forms, believing that it is an oppressive system which fuels inequality and conflict. Through its campaigns and initiatives, the organization advocates for disarmament, demilitarization and denuclearization with governments.
Final Remarks
The rising global expenditure on arms and military has led to the reallocation of development funds and a scaling down of humanitarian aid, which could have a positive impact on billions. Over the decade, while the answer to conflict has been investment in defense infrastructure, it has not helped create a world that is truly secure or sustainable. The call for demilitarization and disarmament is urgent to reclaim resources for restoring humanitarian aid and addressing pressing global challenges, creating a safer, more equitable world.
– Priya Doshi
Photo: Pexels
Green Skills in Sub-Saharan Africa: Powering Youth Employment
Solar Training Creates New Pathways to Work
In Kenya, demand for clean energy is growing as solar capacity expands. The Strathmore Energy Research Centre (SERC) in Nairobi offers accredited training programs in solar photovoltaics, system maintenance and hands-on installation, contributing to the development of green skills in Sub-Saharan Africa. SERC reports that many of its trainees go on to work for solar firms or start small installation businesses, generating new employment opportunities. By giving youth tangible technical skills, this training supports Kenya’s clean-energy transition while reducing youth joblessness.
Climate-Smart Agriculture Boosts Farmer Incomes
Agriculture still underpins livelihoods across rural Sub-Saharan Africa, so green skills must address farming in a changing climate. In Rwanda, the Ministry of Agriculture supports climate-smart techniques such as drought-resistant crops, efficient irrigation and improved soil management. Young farmers trained in these methods have reported higher yields and lower losses during extreme weather events. These green agricultural skills not only raise incomes but help build food-system resilience in regions vulnerable to climate shocks.
Youth Recycling Cooperatives and Eco-Construction
Waste management and recycling form another growth area for green jobs, helping expand green skills in Sub-Saharan Africa. In South Africa, youth-led recycling programs are engaging young people in waste collection, sorting and recycling for income. A recent project by WasteAid in rural South Africa supported training for young people in the informal waste sector, boosting livelihoods and promoting circular-economy jobs. Research shows that waste and recycling value chains can provide meaningful employment pathways for youth, especially when paired with skills training. These initiatives illustrate how recycling can simultaneously tackle youth unemployment and environmental degradation.
Urban growth and climate imperatives are generating demand for building professionals trained in sustainable methods. Many African cities now require construction technicians versed in low-carbon materials, energy-efficient design and waste-minimizing practices. Training programs in sustainable construction equip young people to step into this gap, improving employment prospects while shaping cleaner infrastructure. These skills support broader green-economy transitions and help reduce emissions in construction.
Green Skills Deliver Early Success Stories
Across Kenya, Rwanda and South Africa, early outcomes show the promise of green upskilling. Solar technicians trained in Nairobi are servicing off-grid installations and rural clinics. In Rwanda, youth applying climate-smart farming methods have enhanced productivity and weather resilience. And in South Africa, youth recycling initiatives are converting waste into income and fostering circular-economic models.
These stories show how expanding green-skills development can cut poverty, boost local economic growth and empower young people as climate-solution leaders in their communities. By investing in green skills in Sub-Saharan Africa, policymakers, educators and development partners have an opportunity to deliver jobs, climate resilience and sustainable growth through a single, aligned strategy.
– Lucy Williams
Photo: Flickr