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Public health in urban areas has been and will continue to be affected by global population trends. More than 50% of Southeast Asia’s total population is projected to be living in urban areas by 2025, which will exert additional pressure on urban health systems.
In general, public resources can be concentrated at lower cost in cities, which is effective in public health interventions through basic primary health care like immunization, clean water and waste disposal.
However, as this bulletin will demonstrate, these improvements in public health are not equitably accessible to all parts of society. Even major cities in the region such as Jakarta and Manila have large slums that are deprived of healthy living conditions. Not only are health centres difficult to access, the most basic amenities such as sanitation and piped water are also scarce.
What’s inside Bulletin #22?
- Urban Poverty and Health in Asia
- Protecting the health of Asia’s Urban Poor
- Healthcare-seeking behaviour in slums
- The unhealthy impacts of poor water and sanitation
- Unregistered and excluded: the government healthcare problem
One look at Asia’s skylines and the casual observer gets the impression that Asia is truly rising. The top ten financial centres in Singapore, Hong Kong, Tokyo, Shanghai and Taipei, followed by Kuala Lumpur, Mumbai, Bangkok, Beijing and Seoul tell a story of rapid growth and new wealth. However, with 1.5 billion people without access to conventional financial services, Asia is also home to the majority of the world’s unbanked.
In the East Asia and Pacific region alone, 55% of the population is unbanked. It is estimated that the total number of people without access to banking services is between 2.2 and 2.5 billion people.
What’s inside Bulletin #21?
- A moral imperative for action
- Evidence from the ATM survey on urban poverty
- Facilitating finance in slums
- Destitute poverty: the final financial frontier
- Outlook: the future of financial inclusion
Education is a vital tool for breaking the vicious cycle of poverty. Indeed, it is often claimed that educated children will be able to earn more money in the long run, eventually lifting the entire family out of poverty. This, in turn, leads to the future generations being better educated and able to enhance the financial well-being of families and communities. However, reality is rarely that simple. A 2006 OECD report on education notes that economic and social disadvantages are equally important elements to consider as they can severely hamper the educational experience of learners. While social disadvantages influence test scores and educational achievements in the developed world, in the developing countries of Southeast Asia, economic and social disadvantages are severe impediments to even accessing and attending school.
Download ATM Bulletin 20 (right click save as… 6 MB)
Despite efforts by nearly all governments across Southeast Asia to provide access to free education until secondary level, there remain several stumbling blocks that lead to low enrollment rates and unsatisfactory educational outcomes. For example, there are often additional costs beyond the tuition expenses, including the opportunity cost of foregone income from the child working to support a parents business or engage in independent economic activity. Poor service delivery represents another problem, where subsidies and other forms of assistance do not reach the poorest households.
Among the cities that the ATM team researched this year, Vientiane stood out for its small population and its close integration to the surrounding rural communities. Vientiane, the capital of Lao People’s Democratic Republic, is the second smallest ASEAN capital after Bandar Seri Begawan of Brunei Darussalam. It has a population of 700,000 people, which is tiny compared to 23 million in the Greater Jakarta Area, Manila (16.3 million), or Hanoi (6.5 million).
Despite being small and relatively underdeveloped, Vientiane has grown rapidly in the last few years. The economy is booming with a growth of 8% per year, and the country is set to join the World Trade Organisation in 2013. However, the growth is not distributed equitably with mining, forestry, hydro and tourism as the major drivers of the economy.
The poor are often left on the side lines, suffering from a lack of infrastructure and inaccessible services. The field interviews and case studies in this bulletin illustrate the tremendous challenges Vientiane’s administrators are faced with. In this bulletin we look into the following issues:
- wide service gaps for the poor, specifically in the areas of health and education;
In 2012, we traveled to four cities and conducted a survey on the challenges for the urban poor. The result are four bulletins containing primary data and case studies from the field.
The Asian Trends Monitoring team continues its reporting on the state of urban poverty in Southeast Asia. After the first two issues on Jakarta and Manila, the team now releases a bulletin on a city that is markedly different from the first two: Hanoi, Vietnam.
Unlike the more developed economies of Indonesia and the Philippines, Vietnam is very much an economy in transition. With its recent rise into the cluster of middle income countries (countries with a GDP per capita of US$1,000 or more), Vietnam has an opportunity to adjust its growth strategy to become more inclusive and lift millions of its people out of poverty. One of the best places to start would be its capital city. Hanoi, unlike Jakarta and Manila, is not quite a megacity, but it is definitely heading in that direction. Thus, Hanoi must rethink its strategies and models for service provision in order to remain inclusive and accessible throughout this period of growth.
This issue of the Asian Trends Monitoring Bulletin analyses the living conditions that Hanoi’s poor residents must contend with, and the services that are in place to assist them. More specifically, we look into the potential roles of empowerment strategies such as microfinance and social businesses as viable ways to close service gaps in cities like Hanoi.
The latest infographic from the ATM team tells a story about Hanoi, capital of Vietnam, and how it fares in its struggle to provide basic services for its people. The numbers and information in the infographic are a combination of secondary data from the World Bank, primary data from the ATM poverty profile survey, as well as information from interviews the team conducted in the field.
This infographic highlights the emerging issues that Hanoi’s poor must contend with. Although Vietnam’s GDP is growing and income levels among the poor are rising, it does not necessarily translate into improved access to services. There are several limitations to the government’s service provision capacity, which leads to things like a strict “poor list” of eligible households.
If you want to read more about poverty alleviation efforts in Hanoi, go to “Asian Trends Monitoring Bulletin 18: Empowering Hanoi’s Poor”, available online and as a PDF. In it, we discuss the different strategies for poverty alleviation that would be more effective in improving the lives of the poor without putting additional strain on the government budgets. We also conduct foresight analysis on the alternative futures of Hanoi, in order to help the people and planners in Hanoi decide what path they would like to take.
The international narrative on Manila paints the picture of a metropolis full of promise. Manila is the economic and political nucleus of a Philippines national economy that is at full throttle, with a gross domestic product (GDP) growth of 3.7% per annum and a GDP per capita of US$4,073 in 2011, adjusted for purchasing power parity. The country itself has a Human Development Index rank that is higher than its GNI per capita rank, implying that the Philippines is doing very well on non-income HDI indicators. Where the government leaves gaps in service delivery, often, a thriving civil society in Manila sets out to serve the needy. There is a plethora of non-government organisations operating in the various sectors of the city.
However, this growing megacity is not without its problems. Approximately 16.3 million people inhabit an area of only 38.55 square kilometres, which makes it the most densely populated city in the world. This density is highest in the poor areas of the city: people living in Manila’s slums have to cook, work, and share their lives with 72,000 other people per square kilometre. These people often have trouble obtaining access to the most basic amenities such as clean water, modern sanitation, and health care. Moreover, depressed housing conditions, lack of job opportunities and rampant inequality are worrying trends among Manila’s urban population.
Jakarta, Indonesia: capital of Southeast Asia’s largest democracy and the fourth most populous country in the world at 238 million (2011 data). Home to over 23 million people, the Greater Jakarta Area (Jabodetabek) is the largest megacity in Asia and the third largest in the world.
To outsiders, Jakarta is a shining example of Indonesia’s development. To businesses, it is a thriving market with a skilled labour force and skyrocketing consumption rates. To its middle class, it is a city that is still able to provide everything they need, despite stressful levels of congestion. But to its poor, Jakarta presents a very different picture.
Jakarta’s poor live in the scattered pockets of urban slums and witness a very different side of the city. To the poor, Jakarta is a city where basic services are out of reach and decent job opportunities are scarce. Despite their best efforts, they struggle even for minimum subsistence. How can a city growing so fast leave so many behind?