The Nairobi Urban Health and Demographic Surveillance of slum dwellers, 2002–2019: Value, processes, and challenges

The Nairobi Urban Health and Demographic Surveillance System, managed by the African Population and Health Research Center, has been in existence since 2002. After almost two decades of surveillance, it is important to reflect on what the platform has achieved, its value-for-money, and utility in the population health and wellbeing research landscape. In this paper, we deploy a descriptive-analytical approach to articulate the historical dimensions, values, processes, challenges and lessons learned since the platform was established. We highlight its critical components, important developments over time and key findings that demonstrate its impact on livelihoods of vulnerable populations in urban slum settings of Nairobi. Additionally, this paper provides detailed background information for several multiple papers that utilize the NUHDSS data and are, together with the present paper submitted to the Journal of Global Epidemiology as part of the special issue titled “Epidemiologic Evidence from the Nairobi Urban Health and Demographic Surveillance Data”. From the evidence available, it is apparent that over the years, most health and socio-economic indicators have not significantly improved in the slum areas. The findings generated from the various thematic analytical papers underscores the need for improved programming, advocacy and policy-making that targets urban slums dwellers. We conclude that the longitudinal perspective of the Nairobi Urban Health and Demographic Surveillance System remains a vital platform for providing a more nuanced understanding of changes in the health and socio-economic status of urban slum dwellers, and allows the elucidation of intra-urban and intra-slum differences.