Coverage, Trends, and Inequalities of Maternal, Newborn, and Child Health Indicators among the Poor and Non-Poor in the Most Populous Cities from 38 Sub-Saharan African Countries.

Autor: Blumenberg C; International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil. cblumenberg@equidade.org.; Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St., 3rd floor, CEP 96020-220, Center, Pelotas, RS, Brazil. cblumenberg@equidade.org.; Causale consultoria, Pelotas, Brazil. cblumenberg@equidade.org., Costa JC; International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil.; Harvard University, Boston, MA, USA., Ricardo LI; International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil., Jacobs C; School of Public Health, University of Zambia, Lusaka, Zambia., Ferreira LZ; International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil., Vidaletti LP; International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil., Wehrmeister FC; International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil.; Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St., 3rd floor, CEP 96020-220, Center, Pelotas, RS, Brazil.; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada., Barros AJD; International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil.; Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St., 3rd floor, CEP 96020-220, Center, Pelotas, RS, Brazil., Faye C; African Population and Health Research Center, Dakar, Senegal., Boerma T; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada.
Jazyk: angličtina
Zdroj: Journal of urban health : bulletin of the New York Academy of Medicine [J Urban Health] 2024 Nov; Vol. 101 (Suppl 1), pp. 31-44. Date of Electronic Publication: 2023 Dec 18.
DOI: 10.1007/s11524-023-00806-y
Abstrakt: Rapid urbanization is likely to be associated with suboptimal access to essential health services. This is especially true in cities from sub-Saharan Africa (SSA), where urbanization is outpacing improvements in infrastructure. We assessed the current situation in regard to several markers of maternal, newborn, and child health, including indicators of coverage of health interventions (demand for family planning satisfied with modern methods, at least four antenatal care visits (ANC4+), institutional birth, and three doses of DPT vaccine[diphtheria, pertussis and tetanus]) and health status (stunting in children under 5 years, neonatal and under-5 mortality rates) among the poor and non-poor in the most populous cities from 38 SSA countries. We analyzed 136 population-based surveys (year range 2000-2019), contrasting the poorest 40% of households (referred to as poor) with the richest 60% (non-poor). Coverage in the most recent survey was higher for the city non-poor compared to the poor for all interventions in virtually all cities, with the largest median gap observed for ANC4+ (13.5 percentage points higher for the non-poor). Stunting, neonatal, and under-5 mortality rates were higher among the poor (7.6 percentage points, 21.2 and 10.3 deaths per 1000 live births, respectively). The gaps in coverage between the two groups were reducing, except for ANC4, with similar median average annual rate of change in both groups. Similar rates of change were also observed for stunting and the mortality indicators. Continuation of these positive trends is needed to eliminate inequalities in essential health services and child survival in SSA cities.
(© 2023. The Author(s).)
Databáze: MEDLINE
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