TY - JOUR T1 - A perspective on urban health systems and research for equitable healthcare in Africa JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2022-010333 VL - 7 IS - 9 SP - e010333 AU - Ibukun-Oluwa Omolade Abejirinde AU - Uchenna Gwacham-Anisiobi AU - Clara Affun-Adegbulu AU - Jef Vanhamel AU - Sara Van Belle AU - Bruno Marchal Y1 - 2022/09/01 UR - http://gh.bmj.com/content/7/9/e010333.abstract N2 - Key messagesUrbanisation in Africa poses complex challenges for health due to ill-informed planning and governance, worsening gaps in the built environment and the quadruple burden of disease.Achieving equitable urban (health) benefits requires a framework for understanding how urban health systems are conceptualised, planned and governed.Five approaches and frameworks for analysing or implementing urban health strategies in sub-Saharan Africa were identified, but there is limited evidence on their use and effectiveness for informing equitable urban health systems.Participatory research and theory building can inform contextual adaptation of frameworks which are effective in other settings, contributing to closing gaps in differential outcomes.Over half of the world’s population reside in urban areas1 and 40% of the 30 fastest growing cities by population are in Africa.2 While it is expected that 68% of the world’s population will live in urban areas by 2050, the Population Division of the UN Department of Economic and Social Affairs projects that 90% of this increase will occur in Africa and Asia, with India, China and Nigeria alone accounting for 35%.3 The health and well-being of urban residents are linked to all dimensions of urbanisation including the natural and built environment, socioeconomic factors and institutional factors (eg, governance), and should be prioritised areas of action. Rapid urbanisation, more so in contexts of unresponsive governance and policies, significantly impacts the quality of life of people in many low/middle-income countries.Critical assessments by the WHO and the United Nations Human Settlement Programme (UN-HABITAT) show that, globally, urban dwellers disproportionately have poorer health outcomes. These are traceable to inequitable healthcare access, increased environmental and occupational hazards, as well as increased vulnerabilities to disease outbreaks due to the rapid growth of informal settlements.4 Urban areas are critical hotspots of overall population health, the most recent example seen … ER -