CORE Metadata, citation and similar papers at core.ac.uk Provided by Digital Library of the Tanzania Health Community Children in an Urban Tanzania Prepared by Eliana Riggio 6 June 2012 Contents Acknowledgements 4 Executive Summary 6 Methodological Note 8 1. Growing Up in Fast Urbanising Tanzania 9 Urbanisation Urban Poverty and Exclusion Growing Up in Informal Settlements PANEL: What Cities Can Do – To Promote Good Local Governance – To Address Poverty and Exclusion by Ensuring Access to Basic Services – To Favour Access to Land Tenure and Housing 2. The Urban Environment and Climate Change 27 PANEL: What Cities Can Do – To Protect the Environment and Adapt to Climate Change 3. Water, Sanitation and Hygiene 31 Water Sanitation and Hygiene Solid Waste Management PANEL: What Cities Can Do – To Increase Access to Water, Sanitation and Hygiene 4. Nutrition and Food Security 41 Child Nutrition Women’s Nutrition Household Food Security PANEL: What Cities Can Do – To Improve Nutrition and Household Food Security 5. Health and HIV and AIDS 51 Child Health Maternal Health HIV and AIDS PANEL: What Cities Can Do – To Strengthen Health and Combat HIV and AIDS 6. Education 62 PANEL: What Cities Can Do – To Achieve Universal Quality Education 2 7. Child Protection 73 Children Living and Working on the Streets Child Labour Trafficking of Children Violence PANEL: What Cities Can Do – To Ensure Child Protection 8. Places for Children 83 PANEL: What Cities Can Do – To Create Safe Places for Play, Recreation and Free Mobility 9. Children As Citizens 87 The Right to Participate Governance For and With Children PANEL: What Cities Can Do – To Foster Children’s Participation in Local Governance Bibliography 99 Notes 110 3 Acknowledgements A discussion on the urban child requires spanning through a wide range of themes relating to the multi-dimensional realms of cities and children. This report would not have been possible without the expertise of specialists who have contributed the perspectives of different disciplines, including urban planning and development, local governance, urban social policy, land tenure, water and environmental sanitation, maternal and child health, nutrition, food security, child development, education, child protection, child labour, justice for children, child participation and children‟s rights. The principal contributor to this volume is Flora Kessy, who has assisted the entire research process, by gathering and validating data, identifying sources, reviewing literature, liaising with resource persons, and providing overall insight into the choice of datasets by relying on her vast experience in policy analysis, economics and social development. Flora has been the point of reference for those who have in different ways enriched the present report. Sincerest thanks are owed to policy-makers, practitioners, researchers and social activists who are engaged in improving the condition of children in urban Tanzania and have generously shared their experience and expertise, in particular, Philotheusy Justin Mbogoro (Tanzania Cities‟ Network - TACINE), Barjor Mehta (World Bank), Phillemon Mutashubirwa (UN-HABITAT), and Mese Kinenekejo, Senior Health Officer, Rehema Sadiki, Health Officer and William Muhemu, Environmental Officer, Temeke Municipal Council Planning Office with regard to urban development and local governance, Meki Mkanga (Centre for Community Initiatives - CCI), Joyce Ndesamburo (Water Aid), Tumsifu Nnkya (Ministry of Lands, Housing and Human Settlement Development) and Tabitha Siwale (former minister, WAT-Human Settlements Trust) with reference to informal settlements, land tenure, environmental pollution, water and sanitation, Stefan Dongus (Ifakara Health Institute), Judith Kahama (Dar es Salaam City Council), Tausi Kida, (Economic and Social Research Foundation), Regina Kikuli (Acting Permanent Secretary Ministry of Health and Social Welfare), Joe Lugalla (Department of Anthropology, University of New Hampshire, USA), Masuma Mamdani (Ifakara Health Institute), Isaac Maro (Muhimbili Medical Centre), Donan Mmbando (Acting Chief Medical Officer, Ministry of Health and Social Welfare) and Paul Smithson (Ifakara Health Institute) concerning maternal and child health, Anthony Binamungu (PACT), Samwel Sumba James (TACAIDS), Gottlieb Mpangile (Deloitte), Fatma Mrisho (TACAIDS), David Sando (Management and Development for Health Tanzania), Mwiru Sima (Deloitte) and Geoffrey Somi (TACAIDS) in relation to HIV and AIDS, Benedict Jeje (Tanzania Food and Nutrition Centre), Joyce Kinabo (Sokoine University, Morogoro),Vera Mayer (WFP) and Mike Zangenberg (WHO) in the areas of nutrition and household food security, Richard Mabala (TAMASHA), Helima Mengele (TENMET), Elizabeth Missokia (Haki Elimu), Nicolas Moshi (Ministry of Education and Vocational Training), Rakesh Rajani (TWAWEZA East Africa), Leoncia Salakana (former ILO) and Suleiman Sumra (UWEZO) with respect to education, Kitilia Mkumbo (University of Dar), Koshuma Mtengeti (Children‟s Dignity Forum) and Justa Mwaituka (KIWOHEDE) regarding the adolescent child, Jacob Lisuma (ILO) and William Mallya (retired from ILO) with regard to child labour, 4 Matthew Banks (Children in Crossfire), Rita Kahurananga (SOS Villages Tanzania), Hellen Kijo- Bisimba, (Legal and Human Rights Centre), Levina Kikoyo (Family Health International), Sabas Masawe (Dogodogo Centre), Kidawa Mohamed (Zanzibar Association for Children‟s Advancement), Stephen Msechu (International Organisation for Migration), Justa Mwaituka (KIWOHEDE), Moses Ngereza (Caucus for Children‟s Rights), Tukae Njiku (Ministry of Community Development, Gender and Children) and Monika Peruffo (International Organisation for Migration) with reference to child protection. Thanks are due also to UNICEF Tanzania Programme Sections (Health and Nutrition, WASH, Education, Children and AIDS, Child Protection, Social Policy, Communication) and, especially, to Dirk Buyse (Children and AIDS), Omar El-Hattab (WASH), Edith Mbatia (Social Policy), Jacqueline Namfua (Communication), Rachel Harvey and Asa Olsson (Child Protection), Sudha Sharma (Health and Nutrition) and Harriet Torlesse (Nutrition). A particular debt of gratitude is owed to Rakesh Rajani (Twaweza) and Suleiman Sumra (Uwezo) for sharing Uwezo education datasets, and Sam Jones and Wei Ha (UNICEF) for data analysis. An important role has been played by non-government organisations that have carried out field consultations in major urban centres of Tanzania, namely, Caucus for Children‟s Rights in Arusha, Children‟s Dignity Forum in Dar es Salaam and Mwanza, KIWOHEDE (Kiota Women‟s Health and Development Organisation ) in Ilala and Mbeya, and Zanzibar Association for Children Advancement in Zanzibar. Finally, special thanks go to Alejandro Grinspun, for coordinating the project, Sara Cameron, who has recently retired from UNICEF, for managing the communication component of the report, and Dorothy Rozga, for placing the urban child on UNICEF Tanzania agenda. 5 Executive Summary One in four children being born in today‟s Tanzania is likely to be growing up in an urban area. It is projected to be one in three in the short time span of one generation. Tanzania is more urban than it perceives itself and official figures disclose. Urban Tanzanians feel emotionally rooted in their villages of origin rather than in the cities and towns where one quarter of the total population lives. Urbanisation figures fail to account for extensive high density areas just because they are not officially classified as urban. Despite a persisting rural self-representation, Tanzania is one of the fastest urbanising countries in one of the world‟s fastest urbanising regions. The nearly half urban population aged 0-18 may well be the first truly urbanised generation in the history of the nation. As urbanisation is rapidly transforming the physical, social and economic landscape of the country, how has Tanzania equipped itself to provide adequate water, sanitation, health care, education, protection services to meet the fundamental needs and rights of a swelling number of urban children and communities? National policy and programmatic frameworks still broadly target rural poverty, perceived as the nation‟s core development challenge. Urban poverty, growing alongside urban affluence, remains mainly unaccounted for and, as a result, unaddressed. The condition of poor and marginalised urban groups escapes official urban figures. Standard urban-rural disaggregation generates statistical averages that overshadow sub-municipal disparities. Also poverty lines tend to underestimate actual poverty. Based on mere consumption levels, they disregard living conditions, thus leaving unaccounted for several necessities that poor households are normally forced to acquire through cash purchases in a monetised urban economy. As a result, urban poverty is broadly overlooked and poor urban children, lost in skewed official estimates and tucked away in peripheral unplanned urban fringes, risk remaining invisible in development policy and investments. In-depth analysis based on sub-municipal data is urgently needed to accurately measure urban poverty in its multiple dimensions of income poverty, inadequate access to basic services and powerlessness. The assumption underpinning the limited attention that has been paid to urban poverty is that of an urban advantage. Undoubtedly, cities enjoy an edge over rural areas. Urbanisation drives the development of a whole nation. High population concentration,