What we don’t talk about when we talk about urban poverty

The experience of falling into poverty varies for individuals living in urban areas. In large and affluent cities, numerous facilities are readily accessible to residents – healthcare, education, sanitation, sewerage, and other essential services.

This contrasts with rural areas where healthcare providers remain scarce, with underdeveloped infrastructure. In severe cases, individuals requiring medical attention in rural areas are often transferred to urban hospitals due to the limited facilities.

Nevertheless, closer access could have different implications for households with lower incomes. For example, public clinics are generally perceived as easily accessible to anyone, regardless of their socioeconomic status, due to their affordability. In the context of the urban poor in Kuala Lumpur, one study revealed that several structural barriers have hindered access to these facilities. One significant challenge is related to transportation. Many of the facilities are located far away from the patients’ homes, making it challenging to reach them. The trips to the clinics involve lengthy travel times and uncertain waiting periods for public transportation, which make it worse for those already struggling to make ends meet. Upon arriving at the clinics, they must deal with several issues, for instance, overcrowding, a shortage of healthcare staff, and limited operational hours.

These factors contribute to longer waiting times and sub-optimal access to medical services. The financial burden is also an important aspect of the equation. Those without private vehicles must allocate a portion of their limited resources to cover public or private transportation expenses. Married individuals also need additional funds to arrange care for family members during their absence from work, which puts an additional strain on their already tight budgets.

Likewise, in Jakarta, the capital city of Indonesia, a young mum faces difficulty in bringing her sick child to the doctor. Though the government has provided a national healthcare insurance scheme (BPJS), she is unable to pay its monthly instalment, even though it is only IDR 35.000 (RM10) per person.

The government also provides free healthcare services for the poor (Kartu Indonesia Sehat), but she was excluded from the beneficiaries’ data. Many healthcare providers are available near her home, with the closest, about 500m away. Yet, the healthcare service is still too far away for the young mother.

The reasons for poor people’s lack of access are diverse, and not only measured in one dimension. As mentioned above, the meaning of accessibility could be different for someone experiencing poverty. In urban areas, geographical accessibility may not be the most urgent problem for the poor. The lack of financial accessibility is their main problem, even if they live in a relatively high-income city.

In past years, the policies to eradicate poverty were highly focused on rural poverty, as urban areas were considered the centre of economic activity. This point of view comes from the dual economic theory, when urbanisation was considered a way to escape poverty in the rural agricultural sector, which was prevalent in the 1970s.

However, this point of view is still popular among the poor, as the number of poor people in many countries has increased, including in Asian nations. This is also accompanied by the fact that compared to the general population, the poor are urbanising more quickly – a phenomena known as ‘urbanisation of poverty.’

Meanwhile, poverty reduction in urban areas was more sluggish, and only a few of them benefitted from the poverty reduction programme for the poor.

The slow pace of poverty reduction in urban areas may be more effective if policymakers analysed the root cause of urban poverty. Past literatures have outlined some causes of urban poverty. In the 1960s, the lower education of adults and lower labour participation rates were some of the causes. In recent years, the causes of urban poverty have been more ‘complete’. In the 2000s, urban poverty was largely attributed to institutional change and poor governance.

For the urban poor, the city holds the allure of boundless opportunities. However, it is only in cities where good governance prevails that essential services are available to all. This necessitates that city authorities enhance their policies to ensure greater accessibility for the urban poor.

Otherwise, mere proximity to services will never truly bridge the gap for those living on the fringes of the city.

Dr Kanetasya Sabilla is a researcher at the National Research and Innovation Agency of Indonesia, while Dr Romi Bhakti Hartarto is a Postdoctoral Research Fellow at the Ungku Aziz Centre for Development Studies, Universiti Malaya, and an Assistant Professor at the Department of Economics, Universitas Muhammadiyah Yogyakarta, Indonesia.

The views expressed here are the personal opinion of the writer and do not necessarily represent that of Twentytwo13.