At the Heart of the Problem: Health in Johannesburg’s Inner-City

Helen Rees, Sinead Delany-Moretlwe, Fiona Scorgie, Stanley Luchters and Matthew F. Chersich BMC Public Health, 2017; At the Heart of the Problem: Health in Johannesburg’s Inner-City

A Supplement to BMC Public Health brings together articles on the health status and needs of people living in the inner-city of Johannesburg, South Africa.  In particular it focuses on the impact of the HIV epidemic and on identifying ways to improve healthcare service delivery.

Urban life in the twenty-first century is marked by numerous stresses and shocks, resulting from rapid urbanisation, frequent migration and crowding, massive unemployment, climate change, physical disasters, and disease outbreaks, among other challenges. This reality – according to the ‘100 Resilient Cities’ initiative of the Rockefeller Foundation – is why the concept of resilience is critical to a sustainable future: cities must learn to “survive and thrive, regardless of the challenge”.

In cities in the global South that face a heavy HIV burden, this health crisis is often inseparable from a wider set of interlinked social challenges, ranging from acute economic inequality to chronic political mismanagement and failed states. What ‘resilience’ means in such contexts is hard to imagine, but at the very least, as UNAIDS’ Michel Sidibé puts it, “people must be at the centre of the response”. 

Editors of this Supplement invited both current and past researchers from the Wits Reproductive Health and HIV Institute (Wits RHI) to contribute papers reporting demographic, epidemiological, ethnographic, and health service data collected in the inner-city over the last ten years.

The papers ask the following critical questions:

  • What are the realities of living in this most notorious pocket of Johannesburg’s inner-city?
  • What are the most pressing health needs?
  • How do we design and deliver effective and sustainable health interventions to these often hard-to-reach populations?
  • What public health lessons may be extracted from the data?

Collectively, the findings constitute a valuable resource to inform the design and implementation of cutting-edge, comprehensive HIV and SRH services in inner-city settings.

We can no longer ignore how social context and ‘place’ shape health and access to services. As a social disease, HIV has provided a powerful lens to focus our attention on the social and structural determinants of health, and the importance of reducing inequalities.

STRIVE papers

Intersections between polyvictimisation and mental health among adolescents in five urban disadvantaged settings: the role of gender

From fear to resilience: adolescents’ experiences of violence in inner-city Johannesburg, South Africa

Alcohol use and sexual risk behaviour among men and women in inner-city Johannesburg, South Africa

‘Leaving no one behind’: reflections on the design of community-based HIV prevention for migrants in Johannesburg’s inner-city hostels and informal settlements

Filter by