Slum Upgrading, Redevelopment, and Social Transformation

In the last one and a half decades, the Lagos state government has progressively embarked on upgrading the slum communities and bringing them to a level conducive to healthy living. A comprehensive Urban Renewal Programme was launched in 2001, which was based on a 1995 World Bank Study and covered 750 hectares of largely swampy terrain. The government created the Lagos State Urban Renewal Authority, which adopted a citywide approach supported by a $200 million World Bank (International Development Association, IDA)–assisted credit intervention. It is a 7-year upgrading project that commenced in October 2006 and ends in March 2013 (Lagos State Government 2009a). The project involves the upgrading of the worst 9 of the 42 slum communities identified in 1983. It targets 1.1 million inhabitants and 150,000 households whose average monthly income is about $170. The intervention involves upgrading dilapidated roads or footpaths, provisioning public toilets/bathrooms, sinking boreholes to provide water, building new schools and upgrading existing ones, developing health facilities, and creating youth empowerment through skill acquisition and capacity building.

For slum redevelopment, the government came up with a strategy of redeveloping slums in partnership with the private sector for funding the project. The upgraded slums in most cases feed into the redevelopment scheme.

Under this arrangement the property owners and tenants of the slums are duly consulted. The owners contribute their properties for redevelopment though a cooperative. Property developers are brought in to develop the property as high rise building so as to prevent displacement of the occupiers. As most propertires affected are mainly bungalows, the tendency is to redevelop the properties to 3 to 4 storey flats to compensate for land use allocation to roads, drainages, open spaces in the new developed areas and to avoid displacement of any of the residents of the slums. The property owners are given reasonable compensation for contributing their properties. After redevelopment, the property owners are allocated a three-bedroom flat in the high building and given the opportunity to purchase additional flats from the compensation received (plate 4.12).

During redevelopment the occupiers are temporarily displaced and provided transit housing. They are also given relocation allowances during this period. A typical example is the case at Oluwole in the Lagos Central Business District (CBD) where 39 displaced families were provided better alternative accommodation and also financially assisted to relocate. The residents were also equity holders in the redevelopment of their former abode with a reversion of the entire development after the redevelopment period.

This approach by the Lagos state government is a unique and a welcome strategy for Nigeria. It is significant to note that past slum redevelopment in Lagos (such as the one in Isale Eko, Maroko, and others) always led to some social dislocation. In addition, the slum redevelopment projects in Lagos were preceded by surveys to profile the communities. Community inclusion is an essential component of the urban regeneration process, which allows communities to prioritise their needs and inform the executing agency

The pursuit of slum redevelopment in this way ensured participation as the fortune, future, and social networks of the property owners were assured. This project was conceptualised at Isalegangan and to date about 13 families have signed up to submit their properties for redevelopment. This is a win-win approach for everyone.

The peculiar demographic and geographical features of Lagos state have created more challenges to its health-care system than any other state in Nigeria. The fact that 40 percent of the land mass is riverine, coupled with increasing urbanisation due to the continuous flow of migrants from other parts of the country has posed great challenges to health-care delivery. Thus, there are acute problems of communicable diseases, malnutrition, and poor maternal and child health care.

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  Free community-based primary health-care services.
  
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  Provision of comprehensive secondary health-care services.
  
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  Institution of the Health System Reform Programme (HSRP), which includes take-off of the State Health Insurance Scheme (SHIS).
  
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  Improvement of the health-care system and its management.
  
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  Reduction of the disease burden and improved access to health services.
  
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  Fighting HIV/AIDS as a development issue.
  
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  Improvement in health resources and their management.
  
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  Improvement in the quality of health services.
  
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  Improvement in consumer awareness/community involvement.
  
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  Promoting of effective partnership/collaboration and coordination.
  
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  Establishing of a communication strategy for the HSRP.
  
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  Establishing of a performance monitoring and evaluation system.
  

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  Eko Free Malaria Programme.
  
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  Blindness Prevention Programme.
  
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  Limb Deformity Rehabilitation Programme.
  
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  Free treatment for expectant mothers, children upto 12 years of age, and elderly people aged 60 years and above.
  
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  Emergency medical services incorporating the Lagos State Emergency Medical Service (LASEMS) and Lagos State Ambulance Services (LASAMBUS).
  
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  Commencement of the construction of maternal childcare centers in six locations: Isolo, Ajeromi, Gbaja, Ikorodu, Ifako-Ijaye, and the Lagos State University Teaching Hospital (LASUTH). These are expected to ease the pressure on Ayinke House, the state’s premier gynaecology and obstetrics centre.
  

The secondary tier of health-care services, which is mainly the preserve of the state government, has also been improved tremendously. There are at present 24 general hospitals most of which have been or are being refurbished. Their scope of services is being increased to bring them to the level of a fully fledged general hospital. The state government has worked closely with the local government to address the issue of primary health care. It has also made a conscious effort to look at preventive health care as a strategy. For this, immunisation campaigns have been intensified and many facilities been put in place at the primary health-care level. The administration has equally focused on non-communicable diseases that have a high mortality rate and have become prevalent in the state, including hypertension, diabetes, and cancer. Preventive services including public enlightenment, screening programmes, and public education have been embarked upon.

High mortality rates have been ascribed to the poverty level of Lagos’ inhabitants. The state government has, therefore, embarked on the policy of free medical services for tuberculosis patients, children under 10 years, and adults aged 60 years and above. Antenatal and general basic maternal care are also free.

The institutional framework for health-care services has been revamped. The Health Management Board has been decentralised and each hospital now has its own governing board. The old Hospital Management Board has been repackaged to become the Health Services Commission and its sole responsibility is to address the issues of human resources (such as recruitment, training, remuneration, and so on) in the health sector.