The world continues to become more urbanized. 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 could cross 2 billion. This massive urban migration is driven by various factors, such as climate change, population growth, violence, economic changes, and poverty.

This unparalleled growth in slums has a range of health, violence, and humanitarian consequences which are largely borne by women and children. Not enough groups are working on this issue and may not even be fully aware of it. 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 comprehensive community-based approach to our programs. 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 (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

• Design programs to keep feedback loops short

• Create networks of learning within communities

• Engage the private sector where feasible