Urban-rural migration systems involve complex reciprocal relationships between urban and rural areas that are impacted by illness. Migrants in cities like Addis Ababa, Johannesburg, and Windhoek maintain ties to rural homes through remittances, forming interlinked livelihood systems. If urban migrants fall ill, most Johannesburg and Windhoek respondents would return home, while most in Addis Ababa would rely on family/community in the city. Sickness disrupts these interlinked systems through loss of remittance income and increased care burdens on rural networks.

1. Urban – Rural Linkages: the role of an interlinked livelihood system and implications for urban health in Addis Ababa, Johannesburg and Windhoek Scott Drimie, Girma Kassie & Jo Vearey University of the Witwatersrand Forced Migration Studies Programme Health and Migration Initiative

4. SENDING RECEIVING 0 5 10 15 20 25 30 35 40 45 50 Addis Ababa: Receive JHB: Receive Namibia: Receive Relative frequency (%) Money Food Goods

6. Sickness and HIV in Johannesburg : if the individual in the city becomes too sick to work, the majority will return back home Support 54% 67% Importance of food Burden on the household back home. Urban livelihood that supports another household ‘back home’ would be affected. 65% informal 48% formal

7. Sickness and HIV in Johannesburg : if someone ‘back home’ becomes sick with HIV/AIDS Send money home Return home to provide care 33% 19% Nothing 34% Bring to JHB 14% 63% 11% 6% 21% Informal Formal n = 457 Chi-square = 40.796; p = <0.001

8. Sickness and HIV in Windhoek: if the individual in the city becomes too sick to work, the majority will return home 60%