Progress towards the child mortality millennium development goal in urban sub-Saharan Africa: the dynamics of population growth, immunization, and access to clean water

Fotso, Jean-Christophe; Ezeh, Alex Chika; Madise, Nyovani Janet; Ciera, James
January 2007
BMC Public Health;2007, Vol. 7 Issue 1, p218
Academic Journal
Background: Improvements in child survival have been very poor in sub-Saharan Africa (SSA). Since the 1990s, declines in child mortality have reversed in many countries in the region, while in others, they have either slowed or stalled, making it improbable that the target of reducing child mortality by two thirds by 2015 will be reached. This paper highlights the implications of urban population growth and access to health and social services on progress in achieving MDG 4. Specifically, it examines trends in childhood mortality in SSA in relation to urban population growth, vaccination coverage and access to safe drinking water. Methods: Correlation methods are used to analyze national-level data from the Demographic and Health Surveys and from the United Nations. The analysis is complemented by case studies on intra-urban health differences in Kenya and Zambia. Results: Only five of the 22 countries included in the study have recorded declines in urban child mortality that are in line with the MDG target of about 4% per year; five others have recorded an increase; and the 12 remaining countries witnessed only minimal decline. More rapid rate of urban population growth is associated with negative trend in access to safe drinking water and in vaccination coverage, and ultimately to increasing or timid declines in child mortality. There is evidence of intra-urban disparities in child health in some countries like Kenya and Zambia. Conclusion: Failing to appropriately target the growing sub-group of the urban poor and improve their living conditions and health status - which is an MDG target itself - may result in lack of improvement on national indicators of health. Sustained expansion of potable water supplies and vaccination coverage among the disadvantaged urban dwellers should be given priority in the efforts to achieve the child mortality MDG in SSA.


Related Articles

  • Decline in Measles Case Fatality Ratio after the Introduction of Measles Immunization in Rural Senegal. Samb, Badara; Aaby, Peter; Whittle, Hilton; Seck, Awa Marie Coll; Simondon, Francois // American Journal of Epidemiology;1997, Vol. 145 Issue 1, p51 

    The epidemiology of measles has been investigated in Niakhar, a rural area of Senegal, during two periods, 1983–1986 and 1987–1990. Following a major increase in immunization coverage beginning in 1987, the case fatality ratio for all ages declined fourfold from the first to the...

  • Vexing Vaccines. Bowman, Darcia Harris // Education Week;7/28/2004, Vol. 23 Issue 43, p26 

    When whooping cough first turned up in Westchester County, New York, a year ago, it wasn't necessarily noteworthy. True, the contagious bacterial infection was once a major cause of death among infants and young children in the U.S. But that was before widespread immunization, and Westchester...

  • Benefits from Immunization During the Vaccines for Children Program Era -- United States, 1994-2013. Whitney, Cynthia G.; Fangjun Zhou; Singleton, James; Schuchat, Anne // MMWR: Morbidity & Mortality Weekly Report;4/25/2014, Vol. 63 Issue 16, p352 

    The article discusses a research study on the benefits from immunization during the Vaccines for Children (VFC) program era in the U.S. from 1994 to 2013. Data presented indicate the vaccine coverage rates among pre-school aged children from 1967 to 2012 and the estimated number of illnesses,...

  • Immunisation: Measles, Mumps & Misinformation. MARRON, LORETTA // Issues;Dec2013, Issue 105, p17 

    The article discusses the immunisation against measles and mumps and misinformation about it. It mentions the book "Melanie's Marvellous Measles" for its message that parents should let their children catch the disease instead of vaccinating them. A history of the measles mortality in Australia...

  • Rotavirus Vaccine: A Promise for the Future. Zaman, K. // Journal of Health, Population & Nutrition;Dec2008, Vol. 26 Issue 4, p385 

    The article discusses the future of rotavirus vaccine. It notes that the rotavirus vaccines, Rotarix by GlaxoSmithKline (GSK) and Rotateq by Merck, were tested in both industrialized and middle-income nations among over 60,000 infants which showed its safety and efficacy. It asserts that the...

  • Government of India's boost to Country's immunization. Yewale, Vijay // Indian Pediatrics;Sep2014, Vol. 51 Issue 9, p691 

    The article reports on four vaccines introduced by the government of India as part of its Universal Immunication Program (UIP). Information on the recommendations for Rotavirus vaccine, Measles-Rubella vaccine, and pentavalent vaccine is presented. A statement from Indian Prime Minister Shri...

  • Achieving comprehensive childhood immunization: an analysis of obstacles and opportunities in The Gambia. Payne, Sarah; Townend, John; Jasseh, Momodou; Lowe Jallow, Yamundow; Kampmann, Beate // Health Policy & Planning;Mar2014, Vol. 29 Issue 2, p193 

    Introduction Immunization is a vital component in the drive to decrease global childhood mortality, yet challenges remain in ensuring wide coverage of immunization and full immunization, particularly in low- and middle-income countries. This study assessed immunization coverage and the...

  • Cohort Profile: Growing Up in New Zealand. Morton, Susan M B; Atatoa Carr, Polly E; Grant, Cameron C; Robinson, Elizabeth M; Bandara, Dinusha K; Bird, Amy; Ivory, Vivienne C; Kingi, Te Kani R; Liang, Renee; Marks, Emma J; Perese, Lana M; Peterson, Elizabeth R; Pryor, Jan E; Reese, Elaine; Schmidt, Johanna M; Waldie, Karen E; Wall, Clare // International Journal of Epidemiology;Feb2013, Vol. 42 Issue 1, p65 

    No abstract available.

  • Immunization against Haemophilus Influenzae Type b in Iran; Cost-utility and Cost-benefit Analyses. Moradi-Lakeh, Maziar; Shakerian, Sareh; Esteghamati, Abdoulreza // International Journal of Preventive Medicine;May2012, Vol. 3 Issue 5, p332 

    Background: Haemophilus Influenzae type b (Hib) is an important cause of morbidity and mortality in children. Although its burden is considerably preventable by vaccine, routine vaccination against Hib has not been defined in the National Immunization Program of Iran. This study was performed to...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics