Testing the socioeconomic and environmental determinants of better child-health outcomes in Africa: a cross-sectional study among nations

Abstract

ObjectiveWe sought to test hypotheses regarding the principal correlates of child-health performance among African nations based on previous evidence collected at finer spatial scales.DesignRetrospective, cross-sectional study.SettingAll countries in Africa, excluding small-island nations.Primary and secondary outcome measuresWe defined a composite child-health indicator for each country comprising the incidence of stunting, deaths from respiratory disease, deaths from diarrhoeal disease, deaths from other infectious disease and deaths from injuries for children aged under 5 years. We also compiled national-level data for Africa to test the effects of country-level water quality, air pollution, food supply, breast feeding, environmental performance, per capita wealth, healthcare investment, population density and governance quality on the child-health indicator.ResultsAcross nations, child health was lowest when water quality, improved sanitation, air quality and environmental performance were lowest. There was also an important decline in child health as household size (a proxy for population density) increased. The remaining variables had only weak effects, but in the directions we hypothesised.ConclusionsThese results emphasise the importance of continued investment in clean water and sanitation services, measures to improve air quality and efforts to restrict further environmental degradation, to promote the UN’s Sustainable Development Goal 3 target to ‘… end preventable deaths of newborns and children under 5’ and Goal 6 to ‘… ensure access to water and sanitation for all’ by 2030.

Avaliação da governança na implementação dos ODS: Levantamento bibliográfico das contribuições teóricas ao tema (2015-2021)

“…O estudo utilizou dados de pesquisas realizadas antes e após o anúncio dos ODS em 2015 e concluiu que houve aumento das pontuações médias na legislação da água, política e administração, entre a pesquisa realizada antes e após o anúncio. Bradshaw et al (2019), em sua pesquisa sobre a influência de determinantes socioeconômicos e ambientais na saúde infantil na África, utilizaram a qualidade da governança como um dos indicadores de desempenho na saúde infantil. Uma das hipóteses formuladas pelos autores para o estudo é de que "a qualidade da governança de um país seria correlacionada com a saúde infantil média, dado as evidências de que aumentar a democracia e, portanto, reduzir a corrupção, geralmente melhora os resultados de saúde infantil."…”

Plenary Sessions

“…For example, air temperature and quality are among the most important of these, and there is now reliable evidence of the risk they pose to children's respiratory health and under‐five mortality (4)(5). By using advanced modeling techniques (6), the projected changes from climate and other environmental perturbations and the magnitude and time‐scale of the effects of climate change on child health can be predicted. This information is essential to allow governments and international health agencies to adopt timely, effective mitigation strategies and plan infrastructure development to optimize children's health outcomes.…”

Spatially explicit analyses of environmental and health data to determine past, emerging and future threats to child health

“…20 Environmental degradation drives poorer child health in Africa. 21 Low-and middle-income countries are likely to manifest closer links between environmental integrity and child health than high-income countries, 2 but environment in wealthy countries is still likely to be linked to health and well-being in children through such processes as access to green space and the microbiome benefits of exposure to nature. 22 Infectious diseases: As climate change increases temperature and moves rainfall away from the Equator, the prevalence of infectious diseases will likely increase with expanding ranges of their vectors.…”