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Health in low-income countries has become associated with the provision of minimum guaranteed public health services though Essential Health Packages (EHPs). How far do EHPs deliver the human right to health for all? This study addresses this question through qualitative research into access to health care for vulnerable communities, using Malawi as a case study. This study shows that there are significant accountability gaps and perceptions of weak service provision in Malawi’s EHP in relation to some particularly marginalised (and stigmatised) groups that limit the right to health and the promise of “health for all”.

This study extends the body of qualitative work on EHPs in general and on Malawi in particular by exploring the perceptions of key stakeholders in relation to inclusivity and the delivery of health policies to particularly vulnerable groups. To do so, this study adopted an approach based on interpretive epistemologies (Scott, 2014). This study conducted largely unstructured interviews with a range of health stakeholders, speaking to stakeholders individually, rather than through focus groups due to the potentially sensitive nature of the topic.

The findings of this study are as follows: limited inclusion of civil society actors and local communities; local communities and local policymakers feel frustration with the gap between the promises of consultation in the EHP and the reality, and the difficulties of not having effective channels of communication; and exclusionary health practices for particularly vulnerable groups.

There are limitations based on the qualitative methodology, and in terms of the particularly vulnerable groups – the authors studied two such groups (people with disabilities and those who identify as LBTQ) but a wider survey of vulnerable groups is needed to extend and confirm the findings.

Greater attention to the health rights of vulnerable groups would improve access and services, even in the context of resource restrictions. This study suggests that a deeper engagement with human rights-based approaches would pay dividends in terms of increasing access to health in Malawi, even within the constraints of the EHP process. Furthermore, without this, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

Without addressing these issues, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

This paper makes an important contribution to the growing literatures on EHP in sub-Saharan Africa and Malawi in particular and to the importance of listening to stakeholder perceptions. It provides original data on stakeholder perspectives of the challenges associated with universalising health care in resource-constrained countries. To the best of the authors’ knowledge, it is one of the first papers to focus on the rights of disabled and LBTQ people in relation to EHPs.

Despite striving for resilience and a sustainable urban future, European cities face a multitude of crisis caused by both natural and human-induced risks. This paper asks two key questions: How have cities experienced and managed crises situations they encountered? and What are the plans and actions for embedding sustainability at a local level within a clear decision-making structure? Hence, it aims to examine urban resilience in the context of urban crisis and the associated health concerns that took place because of crisis situations, while identifying sustainable urban development initiatives and strategies that were conceived and implemented beyond crisis.

An evidence-based analytical approach is undertaken following two lines of inquiry. The first is case-based and identifies 11 cities that have experienced crisis situations and a further 10 cities that have instigated urban resilience strategies. The second is theme-based and engages with identifying strategies relevant to sustainable urban development at city and project levels. The outcomes of the two lines of inquiry are verified by mapping the lessons learned from the analysis to recent international guidance and a further co-visioning workshop with 6 experts.

The evidence-based analysis reveals key lessons which were classified under two primary types of findings: (a) lessons learned for a future urban resilience resulting from the 1st line of Inquiry (case-based) and (b) lessons learned for a future sustainable urban development resulting from the 2nd line of inquiry (theme-based). The verified lessons provide four areas that can be utilised as key priorities for future urban resilience and sustainable urban development including (a) Governance, effective communication, and decision making for city resilience and urban sustainability; (b) the social dimension of resilience and participatory practices for sustainable urban development; (c) from implicit strategies for health to positive impact on health; and (d) diversification of initiatives and localisation of sustainable development endeavours.

There is always limitation on what a bibliometrics analysis can offer in terms of the nature of evidence and the type of knowledge generated from the investigation. This limitation manifests in the fact that the analysis engages with the body of knowledge but not based on engaging physically or socially with the contexts within which the cases took place or through empirical investigations including systematic observations, focused interviews, and attitude surveys. While the study does not generate empirical findings, the rigour of the bibliometrics analysis offers a credible and reliable evidence on how cities experienced and managed crises situations and their current plans and priority actions for embedding and localising sustainable development measures.

This research conveys significant implications for policy, practice, and action in that it crystalises the view that understanding urban resilience and sustainability, at the city or urban level, requires coupling the two. The findings offer a solid foundation for a more contextualised, evidence-based examination of urban resilience and sustainability during and beyond crisis. Highlighting urban and health challenges that emerged from experienced crisis situations, how these were managed and developing an understanding of sustainable urban development and local resilience strategies elucidate insights that can be adopted and acted upon by city councils and built environment practitioners.

The analysis provides comprehensive insights into urban resilience and sustainable urban development at both city and continental Europe scales in the form of key lessons that represent the first step towards developing rudiments for building a better urban future. Little is known about resilience and sustainability at these scales. The originality of this work lies in the breadth and depth for capturing an inclusive understanding of urban resilience and sustainable urban development based on systematic inquiry and scrutinising the body of knowledge emerged over the past 2 decades.