Author: Sarah Sabry and Anupama Nallari at the Urban Hub @ Save the Children

Millions of children face unsafe, unequal, and unhealthy city environments. This blog outlines 24 compelling reasons  why cities and towns must do better for children. 

Today, most of the world’s children are growing up in cities and towns. Yet for too many children in low- and middle-income countries, urban life means inadequate housing, unhealthy living environments, limited and low quality learning, and few safe places to play and meet friends. With rapid urbanisation, growing inequality, and weak governance, children face a large number of challenges in cities. 

Below are 24 reasons why cities and towns must do better for children to ensure that every child can grow up healthy, safe, happy, and hopeful. 

Increasing inequality/inadequate housing

     1. Growth of urban slums 

Of the over 1 billion people living in slums globally, approximately 350 to 500 million are children. By 2050, without transformative action, the number of children in slums will triple to 1.5 billion.^[i]

Health

 Children growing up in slums face high risks of disease, malnutrition, and preventable deaths. 

     2. Water and Sanitation 

One-third of the urban population lacks access to safely managed sanitation services.² Lack of safe sanitation in dense slums puts children at high risk of diarrhoea, a leading cause of death in children under five.

     3. Child Malnutrition  

In low- and middle-income countries, one in four urban children under the age of five is malnourished. In slums and informal settlements, this often rises to 50–60%.^3,4 Undernutrition contributes to nearly half of all deaths among children under five, hinders their growth and development, and can lead to lifelong health problems.⁵ 

      4. Zero-dose children 

Children in slums are twice as likely to miss all vaccines (12.6% vs. 6.5%) compared to those from better-off families.⁶ Low immunisation in slums leads to higher rates of measles, mumps, diphtheria, and typhoid and child mortality. 

      5. Childhood obesity  

Childhood overweight and obesity are growing in cities. Globally, there are 391 million cases among school-age children and adolescents.⁷ 88% of overweight and obese children will be living in low- and middle-income countries by 2035.⁸  In cities, easily available ultra-processed foods and sugary drinks, and a lack of safe, walkable, and cyclable neighbourhoods, are contributing to childhood obesity.  

     6. Air pollution  

99% of children worldwide breathe unhealthy air, according to the World Health Organization.⁹  Children in slums often breathe air with particulate matter 10–12 times above the WHO limits due to the use of solid fuels, traffic, industry, and waste burning.¹⁰ 

     7. Waste 

About 45% of global municipal waste is not safely managed; in low-income countries, this figure exceeds 90%.¹¹ Slums are often located near dumpsites and lack waste collection, exposing children to contaminated water, air, and food, increasing disease, stigma and social exclusion. 

Early care, education and learning 

Schools and education in slums are inadequate, leaving millions of children without the education and skills they need to thrive. 

     8. Poor quality schools  

Schools in slums are often overcrowded and under-resourced. The number of secondary schools in poor neighbourhoods is limited, forcing children to travel farther and making attendance more difficult. 

     9. Early childhood gaps

Early childhood care is lacking in poorer neighbourhoods, which hurts children’s health and development and prevents many women from working. 

     10. Digital divide  

Globally, 2.2 billion children and young people aged 25 or less do not have internet connection at home.¹²  In slums, children and youth often lack access to the internet, devices, electricity, and safe learning spaces, widening the digital divide and limiting opportunities for skills and jobs. 

Built environment: streets and spaces

Children need safe, accessible streets and public spaces to play, move, and grow, yet many cities deny them this right. 

     11. Road safety 

Road traffic accidents are the number one cause of death for people aged between 5 and 29.¹³  Safe school journeys require 30 km/h speed limits, safe crossings, and continuous pavements. 

     12. Public transport 

In low-income countries in Asia and Africa, less than 40% of urban residents have access to public transport.¹⁴ Slums are often overlooked in public transport planning, forcing urban poor families to pay more to reach jobs, schools, and healthcare. 

     13. Walkability 

Streets are car-dominated and unsafe for pedestrians; 85% of roads with pedestrians and vehicles speeding over 40 km/h lack sidewalks.¹⁵  Walkable neighbourhoods enable children to move safely and independently, boosting health, confidence, citizenship and community connection. 

     14. Cycling 

Cycling is a healthy, environmentally friendly and affordable mode of transport. Yet most cities in the world lack safe cycling infrastructure and cycling cultures. 

     15. Public space 

Only 44% of the urban population has a public space within a 5-minute walk from their place of residence.¹⁶  Lack of safe and clean common spaces in slums limits play and harms children’s health and development. 

     16. Green spaces  

Between 2023 and 2024, 344 cities lost 158 million square meters of green space. In crowded slums, green space is often absent.¹⁷  Green spaces help children stay healthy and happy, learn better, build friendships, and care for nature. 

Climate risks 

Extreme heat, floods, and other disasters are intensifying the daily struggles of children in slums. 

     17. Urban heat  

Cities are heating twice as fast as the global average due to urbanisation and the heat island effect.¹⁸  Hot, dense and crowded slums without cooling infrastructure put children at risk of illness, missing school, and exposure to violence.¹⁹  

     18. Flooding 

1 in 3 children living in slums around the world are exposed to flooding.²⁰  Floods displace families, spread disease, disrupt schooling, and destroy belongings, lives and livelihoods

Inclusion and safety 

Girls, migrant children, children with disabilities, and street-connected children face distinct risks that demand targeted action. 

     19. Girls  

Many girls feel unsafe in cities.²¹  Unsafe cities expose girls and women to violence and abuse, and limit their access to education, services, and jobs. 

     20. Street-connected children 

Millions of children are living and working on the streets, mostly in cities in Africa, Asia and Latin America.²²  Street children face violence, hunger, disease, and exclusion, with little access to education, healthcare, or protection.  

     21. Children with disabilities  

Most of the world’s 240 million children with disabilities live in low- and middle-income countries in Asia and Africa, where cities lack disability-inclusive infrastructure and services.²³  In slums, they struggle daily with inaccessible housing, streets and toilets, exclusion from schools and services, and heightened risks of neglect and abuse. 

     22. Migrant and displaced children  

Most of the 50 million forcibly displaced children end up in urban slums and informal settlements.²⁴  In urban slums, they often face discrimination, violence, and language barriers on top of existing hardships. Climate change and conflict will further increase the forced displacement of children. 

Child participation 

Despite making up a large share of city populations, children and youth rarely get a say in decisions that affect them. 

     23. Civic participation  

Child and Youth participation in city governance is rare. In 2018, about 20% of youth in Commonwealth nations volunteered their time, and only 16% voiced opinions to officials.²⁵  Child and youth participation strengthens democracy, builds skills and confidence, and makes cities more inclusive, creative, and responsive. 

     24. How can we better shape urbanisation? 

Of all areas that will be urban in 2050, an estimated 60-75% are yet to be built.^26,27  Therefore, children’s lives, wellbeing, development and futures will be increasingly determined by the shape of urban planning and development. This enables us to incorporate children’s needs and voices into the urban planning agenda.  

Building cities where children can thrive 

The evidence is overwhelming: urban childhoods are unequal, unsafe, and increasingly at risk from climate change and poor planning. But cities also hold the power to change this story. With inclusive planning, equitable investment in health, education, protection and safe and inclusive public spaces, and a commitment to listening to children themselves, cities can become places where every child survives and thrives. 

For a more detailed understanding of the issues faced by children and young people in urban areas, visit the knowledge hub. 

Do you know of more reasons? Please share them with us at info@cities4children.org.  

Endnotes

About the Authors 

This blog was written by Sarah Sabry and Anupama Nallari at the Urban Hub @ Save the Children. Many thanks to Yamila Castro from Cities Alliance for reviewing this blog and providing valuable feedback.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. When re-sharing this content, please ensure accreditation by adding the following sentence: ‘This blog was first published by the Global Alliance – Cities4Children (www.cities4children.org/blog)’