Abstract

The vast majority of sub-Saharan Africa’s current urban population lives in slums (i.e. informal settlements) where inadequate access to safe water and basic sanitation remains a serious public health challenge. This chapter draws on field observations from Malawi, Kenya, Ghana, and Nigeria, and existing literature to highlight general trends and emerging discussions on the water–health nexus in urban slums of sub-Saharan Africa. Specifically, it reviews: 1) the urban ecology of slums in sub-Saharan Africa to draw attention to the features that compound the health consequences of drinking water scarcity; 2) water access in slums, including progress and major challenges; 3) underlying causes, major pathways, and health implications of water contamination; and 4) the role of sachet water as an example of an emerging primary drinking source. This chapter concludes by highlighting scholarly gaps and opportunities for future research at the interface of the urban–water–health nexus in urban slums of Africa, all in the context of continuing population growth and rapid urbanization.