The prevalence of housing with improved water and sanitation has doubled in sub-Saharan Africa between 2000 and 2015, according to new research.

Using state-of-the-art mapping, researchers from the London School of Hygiene & Tropical Medicine, Imperial College London and the Malaria Atlas Project, University of Oxford, have provided the first accurate estimate of urban and rural housing quality in sub-Saharan Africa.

The findings, published in the journal Nature, reveal that the prevalence of improved housing doubled from 11% in 2000 to 23% in 2015, but the researchers also estimate that among the countries analysed, 53 million Africans in urban areas still lived in slum conditions in 2015.

“These findings highlight that poor sanitation remains commonplace across much of sub-Saharan Africa, which may be holding back progress to improve living conditions,” said Dr Samir Bhatt, from Imperial’s School of Public Health. “Our study demonstrates that people are widely investing in their homes, but there is also an urgent need for governments to help improve water and sanitation infrastructure.”

Adequate housing is linked with a number of health outcomes including mental health, respiratory disease, diarrhoeal disease, and vector borne diseases, such as malaria. Addressing the housing needs of a growing population is therefore key to sustainable urban development and the health and wellbeing of millions of Africans.

Improving health outcomes

Lead author Dr Lucy Tusting, from the London School of Hygiene & Tropical Medicine who conducted the work while at the Malaria Atlas Project, University of Oxford, said: “Adequate housing is a human right. The housing need is particularly urgent in Africa where the population is predicted to more than double by 2050. Remarkable development is occurring across the continent but until now this trend this had not been measured on a large scale.

Poor sanitation remains commonplace across much of sub-Saharan Africa, which may be holding back progress to improve living conditions Dr Samir Bhatt School of Public Health

“These results are a crucial step to reaching sustainable development goals as quickly as possible, and show that African housing is transforming, with huge potential to improve human health and wellbeing.”

In the study, researchers combined data from 661,945 households from 31 countries into a model that enabled them to map the prevalence of different house types across the African continent.

Housing was categorised using the UN description. Houses with improved water and sanitation, sufficient living area and durable construction were considered to be ‘improved’. Whereas housing lacking any one of these features was considered to be ‘unimproved’.

Education and wealth link

The prevalence of improved housing was highest in countries including Botswana, Gabon and Zimbabwe, and lower in countries such as South Sudan.

They found improved housing was 80% more likely among more educated households and twice as likely in the wealthiest households, compared to the least educated and poorest families.

The authors highlight that using a single definition to capture the full range of housing conditions across sub-Saharan Africa may limit the findings. The study also relied on national surveys which may not be directly comparable due to variation in their methods and data collection procedures, and which represent a limited sample of African households.

The researchers say these new data will be vital to guide interventions to achieve the United Nations’ goals, which aim for universal access to adequate, safe and affordable housing and to upgrade slums by 2030.

Dr Fredros Okumu, Director of Science at Ifakara Health Institute in Tanzania, and a co-author of the paper said: “The changes that we have observed are incredibly significant, especially since households mostly paid for these improvements with their own incomes and no external financing.

“From a public health perspective, this trend presents a massive opportunity for African governments to accelerate ongoing efforts against vector-borne diseases such as malaria, and to secure such gains for the long-term.”

The maps and data are available for download at https://map.ox.ac.uk/research-project/housing_in_africa/.

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‘Mapping changes in housing in sub-Saharan Africa from 2000 to 2015’ by Lucy S. Tusting et al. is published in Nature. DOI: 10.1038/s41586-019-1050-5.

This article is based on materials provided by the London School of Hygiene & Tropical Medicine.

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