Is There an Urban Advantage in Child Survival in Sub-Saharan Africa? Evidence From 18 Countries in the 1990s

Abstract

Evidence of higher child mortality of rural-to-urban migrants compared with urban nonmigrants is growing. However, less attention has been paid to comparing the situation of the same families before and after they migrate with the situation of urban-to-rural migrants. We use DHS data from 18 African countries to compare child mortality rates of six groups based on their mothers’ migration status: rural nonmigrants; urban nonmigrants; rural-to-urban migrants before and after they migrate; and urban-to-rural migrants before and after they migrate. The results show that rural-to-urban migrants had, on average, lower child mortality before they migrated than rural nonmigrants, and that their mortality levels dropped further after they arrived in urban areas. We found no systematic evidence of higher child mortality for rural-to-urban migrants compared with urban nonmigrants. Urban-to-rural migrants had higher mortality in the urban areas, and their move to rural areas appeared advantageous because they experienced lower or similar child mortality after living in rural areas. After we control for known demographic and socioeconomic correlates of under-5 mortality, the urban advantage is greatly reduced and sometimes reversed. The results suggest that it may not be necessarily the place of residence that matters for child survival but, rather, access to services and economic opportunities.

Which transition comes first? Urban and demographic transitions in Belgium and Sweden

“…To note, the infamous urban penalty has not been observed at the outset of urban development in less developed countries (Gould 1998). For instance, in Africa urban under-five death rates have been lower than rural death rates and the urban penalty only re-emerged late in the 20th century as a significant phenomenon in the poorest urban neighbourhoods of these countries (Bocquier, Madise, and Zulu 2011;Garenne 2010;Van De Poel, O'Donnell, and Van Doorslaer 2009). Also, the long-run and underlying influence of economic changes on population transition do not exclude a feedback effect of vital transition on economic development, such as the 'demographic dividend' produced by a favourable age dependency ratio (Bloom, Canning, and Sevilla 2003) under the condition that sufficient investment in human capital has been made through education (Cuaresma, Lutz, and Sanderson 2014).…”

Place and Child Health: The Interaction of Population Density and Sanitation in Developing Countries

“…Bocquier et al (2011) pointed out that urban advantages depend on the services and economic opportunities that a city provides, whereas Sastry (1996) noted that the effects of community-level variables on child health often depend on context-that is, that when exploring the effects of place on health, interactions are often important.…”

An Assessment of Association between Neighborhood Socioeconomic Status and Infant Mortality in High Focus States in India

“…This association, however, was attenuated after adjusting with other community and individual level factors. In most of the studies based on household surveys, household wealth indices based on information about household assets, consumer durables, quality of housing, and access to utilities and infrastructure were used as proxies to measure wealth status of the households [34] [35].…”