Every year more than 70 million people move to cities, often settling in slums that lack basic services and infrastructure. By 2030, the number of slum dwellers will cross 2 billion. Various factors, such as climate change, population growth, economic changes, and poverty drive this massive urban migration.

This unparalleled growth in slums has a range of health and humanitarian consequences that women and children largely bear. Not enough groups are working on this issue and may not even be fully aware. A perfect storm is brewing just on the periphery of our vision.

From the start of our work in Kenya and Zambia over 20 years ago, we have taken a community-based approach to our programs. We do not go into a community unless invited. All our staff are residents of the communities we serve, and local community participation is key to the design of all our programs. This has allowed us to build deep trust within the community even through difficult times (the AIDS epidemic) and on sensitive topics (the health of infants and children). Taking a comprehensive view has allowed us to address more of the factors influencing the problem in the community and become proactive to changes that occur over time.

Through our 20+ years of community-based work, we have learned a few lessons that we carry into our approach:

• Believe in the wisdom in the slum communities

• Partner readily with local government clinics - they are key to sustainability

• Collaborate readily and transparently

• Design programs to keep feedback loops short

• Create networks of learning within communities

• Engage the private sector wherever feasible