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In theory, living in urban areas offers the potential for improved health (Lawrence, 1999). However, in Nigeria and other developing countries, slums characterise most urban areas and this often comes with observable consequences. Some of the consequences include a high incidence of environmental hazards or conditions that induces them. In particular, slums threaten health, wellbeing and overall livelihoods, especially in informal settlements (Cairncross, Hardoy, & Satterthwaite, 1990; Northridge, Sclar, & Padmini, 2003; Northridge, Sclar and Biswas, 2003; Jha, Bloch, & Lamond, 2012). According to Vlahov, et al., (2007), informal settlements are areas of concentrated disadvantage, which often fall short of basic infrastructure and public services necessary to sustain health, such as water, sanitation, and drainage. More empathic, about 60% of Africa’s urban population who reside in informal settlements are vulnerable groups (UN-HABITAT, 2006 and World Health Organisation and United Nation Human Settlement Programme, 2010).
The case of Lagos, Nigeria’s primate city which has a concentration of over 100 blighted communities Heinrich Böll Stiftung Nigeria and Fabulus Urban, (2018), and has been described as probably the biggest continuous footprint of urban poverty on earth Lee, (2016) deserves attention. With the uncoordinated urban expansion, poor infrastructure and precarious environmental conditions, the entire metropolis pays a heavy health penalty. The Lagos Household Survey Lagos State Government, (2010) report show that 38% of residents had experienced flooding in the preceding year, 48% use unhygienic toilet facilities while 12% rely exclusively on water vendors for their domestic needs. A study by Akinyemi, et al., (2018), analysing health records of public hospitals in Lagos between 1999 and 2008 revealed 30,210 cases of typhoid fever, while records from Lagos State Ministry of Health (2012) revealed 1,712,857 cases of malaria parasite infection between 2006 and 2011.
Cities are a constellation of systems consisting of people with individual risk factors and different health care needs who are at constant interaction with divergent social and physical environment supported by different systems of health and social services. Hence, factors beyond the individual form the primary determinants of the health of urban populations according to Vlahov et al, (2007). According to him, poor health outcomes of slum dwellers ultimately result from factors outside of the health care system such as security of tenure, provision of basic services and livelihood opportunities. He suggested that research in these areas would be beneficial for the transformation of informal settlements into viable, safe and healthy communities.
Recent studies on informal settlements in Lagos have largely dwelt on tenure status (Agbola & Agunbiade, 2009; Olajide, 2010), livelihood and quality of life (Lawanson, Nwokoro, & Olajide, 2012) and climate change vulnerability (Olajide & Lawanson, 2014). Other studies addressing health had been in the context of air pollution Olowoporoku, Longhurst, & Barnes, (2012) and Orisaleye, Ope, Busari, & Adefuye, (2018), women and children Nwokoro & Agbola, (2011); Ogunsola, et al., (2013), neighbourhood environment and health (Lawanson & Fadare, 2013), as well as household vulnerabilities (Lawanson & Fadare, 2013). These studies, although community-based studies were mostly at the household level in upland communities.