BackgroundMalnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that historically accrued to residents of cities as compared to residents in rural settings is being eroded due to increasing proportion of urban residents living in slum settings. This study sought to determine effect of mother’s education on child nutritional status of children living in slum settings.MethodsData are from a maternal and child health project nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study involves 5156 children aged 0–42 months. Data on nutritional status used were collected between October 2009 and January 2010. We used binomial and multiple logistic regression to estimate the effect of education in the univariable and multivariable models respectively.ResultsResults show that close to 40 % of children in the study are stunted. Maternal education is a strong predictor of child stunting with some minimal attenuation of the association by other factors at maternal, household and community level. Other factors including at child level: child birth weight and gender; maternal level: marital status, parity, pregnancy intentions, and health seeking behaviour; and household level: social economic status are also independently significantly associated with stunting.ConclusionOverall, mothers’ education persists as a strong predictor of child’s nutritional status in urban slum settings, even after controlling for other factors. Given that stunting is a strong predictor of human capital, emphasis on girl-child education may contribute to breaking the poverty cycle in urban poor settings.

This paper contributes to conflicting evidence on the link between poverty and risky sexual behaviour by examining the effect of wealth status on age at first sex, condom use, and multiple partners using nationally representative adolescents' data from Burkina Faso, Ghana, Malawi, and Uganda. The results show that the wealthiest girls in Burkina Faso, Ghana, and Malawi had later sexual debut compared with their poorer counterparts but this association was not significant for Uganda. Wealth status was weaker among males and significant only in Malawi, where those in the middle quintile had earlier sexual debut. Wealthier adolescents were most likely to use condoms at the last sexual act, but wealth status was not associated with number of sexual partners. Although the link between wealth status and sexual behaviour is not consistent, there is evidence that poor females are vulnerable to infection because of earlier sexual debut and non-use of condoms. (Afr J Reprod Health 2007; 11[3]:83-98) RÉSUMÉ Est-ce que la pauvreté est un moteur des comportements sexuels risqués? Evidence tirée de l'enquête nationale sur les adolescents dans quatre pays africains. Cet article contribue à l'évidence contradictoire sur le lien entre la pauvreté et le comportement sexuel risqué tout en examinant l'effet que la situation de richesse a sur l'âge au moment du premier acte sexuel, l'emploi du préservatif et les partenaires multiples; ceci à l'aide des données à représentation nationale auprès des adolescents au Burkina-Faso, au Ghana, au Malawi et en Ouganda. Les résultats ont montré que les filles les plus riches au Burkina-Faso, au Ghana et au Malawi ont eu leur premier acte sexuel plus tard par rapport à leur homologues moins riches, mais ce rapport n'était pas significatif pour l'Ougnada. La situation de richesse était plus faible chez les mâles et elle était significative seulement au Malawi où ceux de richesse moyenne ont eu un premier acte sexuel plus tôt. Les adolescents les plus riches avaient plus la possibilité d'utiliser le préservatif au cours du dernier acte sexuel, mais la situation de richesse n'était pas liée au nombre de partenaires sexuels. Bien que le lien entre la situation de richesse et le comportement sexuel ne soit pas coherent, il y a l'évidence que les femelles pauvres sont vulnérables à l'infection à cause d'un début sexuel antérieur et le non emploi des préservatifs. (Rev Afr Santé Reprod 2007; 11[3]:83-98).

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.