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The application of last-generation spatial data modelling, integrating Earth Observation, population, economic and other spatially explicit data, enables insights into the sustainability of the global urbanisation processes with unprecedented detail, consistency, and international comparability. In this study, the land use efficiency indicator, as developed in the Sustainable Development Goals, is assessed globally for the first time at the level of Functional Urban Areas (FUAs). Each FUA includes the city and its commuting zone as inferred from statistical modelling of available spatial data. FUAs represent the economic area of influence of each urban centre. Hence, the analysis of land consumption within their boundary has significance in the fields of spatial planning and policy analyses as well as many other research areas. We utilize the boundaries of more than 9,000 FUAs to estimate the land use efficiency between 1990 and 2015, by using population and built-up area data extracted from the Global Human Settlement Layer. This analysis shows how, in the observed period, FUAs in low-income countries of the Global South evolved with rates of population growth surpassing the ones of land consumption. However, in almost all regions of the globe, more than half of the FUAs improved their land use efficiency in recent years (2000–2015) with respect to the previous decade (1990–2000). Our study concludes that the spatial expansion of urban areas within FUA boundaries is reducing compactness of settlements, and that settlements located within FUAs do not display higher land use efficiency than those outside FUAs. • Land Use Efficiency (SDG 11.3.1) is assessed in all FUAs of the world. • FUAs in the Global South show population growing faster than land consumption. • Development trajectories in FUAs show an improvement of efficiency in recent years. • Settlements within FUA commuting areas are not more efficient than those outside. • The proportion of urban centre population does not imply higher efficiency of the FUA. [ABSTRACT FROM AUTHOR]

Measuring rates of coverage and spatial access to healthcare services is essential to inform policies for development. These rates tend to reflect the urban-rural divide, typically with urban areas experiencing higher accessibility than rural ones. Especially in Sub-Saharan Africa (SSA), a region experiencing high disease burden amid fast urbanisation and population growth. However, such assessment has been hindered by a lack of updated and comparable geospatial data on urbanisation and health facilities. In this study, we apply the UN-endorsed Degree of Urbanisation (DoU or DEGURBA) method to investigate how geographic access to healthcare facilities varies across the urban-rural continuum in SSA as a whole and in each country, for circa 2020. Results show that geographic access is overall highest in cities and peri-urban areas , where more than 95% of inhabitants live within 30 min from the nearest HCF, with this share decreasing to 80–90% in towns. This share is lowest in villages and dispersed rural areas (65%), with about 10–15% of population more than 3 h away from any health post. Challenges in geographic access seem mostly determined by high travel impedance, since overall spatial densities of HCF are comparable to European levels. • The Degree of Urbanisation enables monitoring the urban-rural access to resources and services across boundaries worldwide. • This work characterizes distribution and accessibility of Health Care Facilities (HCF) by Degree of Urbanisation (DoU). • The accessibility to HCF at given travel time bins is shown by HCF tier of specialisation and share of covered population. • Access to HCF varies significantly across countries, and within countries by DoU territorial class (Fig. 7). • HCF are widespread in Sub-Saharan Africa but the inadequate infrastructure makes them inaccessible, notably in rural areas. [ABSTRACT FROM AUTHOR]