Urban–rural disparities in adult mortality in sub-Saharan Africa

Oren, Ashira Menashe; Stecklov, Guy

doi:10.4054/demres.2018.39.5

Cited by 17 publications

(13 citation statements)

References 89 publications

(138 reference statements)

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“…In our study, the prevalence and probability of choosing a health facility as the place of delivery were higher among urban women in their reproductive years than those from rural areas. In most SSA countries, there are vast disparities between rural and urban areas in terms of the siting of health facilities including those providing skilled delivery services to the advantage of urban areas [ 35 – 37 ] and this reflects the higher health facility utilisation found in our study among urban women. Closely related to the rural-urban disparities was the fact that in our study, women who considered the distance to a health facility as a big problem had a lower probability of utilising health facilities for delivery.…”

Section: Discussionmentioning

confidence: 88%

Prevalence and determinants of the place of delivery among reproductive age women in sub–Saharan Africa

2020

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Introduction Maternal mortality is an issue of global public health concern with over 300,000 women dying globally each year. In sub-Saharan Africa (SSA), these deaths mainly occur around childbirth and the first 24hours after delivery. The place of delivery is, therefore, important in reducing maternal deaths and accelerating progress towards attaining the 2030 sustainable development goals (SDGs) related to maternal health. In this study, we examined the prevalence and determinants of the place of delivery among reproductive age women in SSA. Materials and methods This was a cross-sectional study among women in their reproductive age using data from the most recent demographic and health surveys of 28 SSA countries. Frequency, percentage, chi-square, and logistic regression were used in analysing the data. All analyses were done using STATA. Results The overall prevalence of health facility delivery was 66%. This ranged from 23% in Chad to 94% in Gabon. More than half of the countries recorded a less than 70% prevalence of health facility delivery. The adjusted odds of health facility delivery were lowest in Chad. The probability of giving birth at a health facility also declined with increasing age but increased with the level of education and wealth status. Women from rural areas had a lower likelihood (AOR = 0.59, 95%CI = 0.57–0.61) of delivering at a health facility compared with urban women. Conclusions Our findings point to the inability of many SSA countries to meet the SDG targets concerning reductions in maternal mortality and improving the health of reproductive age women. The findings thus justify the need for peer learning among SSA countries for the adaption and integration into local contexts, of interventions that have proven to be successful in improving health facility delivery among reproductive age women.

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Section: Discussionmentioning

confidence: 88%

Prevalence and determinants of the place of delivery among reproductive age women in sub–Saharan Africa

2020

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“…In this context, differences in health outcomes are more important when based on social strata within and between urban areas than on area of residence: Slum residents exhibit notable inequalities in health relative to non-slum urban and even rural populations. This phenomenon has been documented in mortality studies on sub-Saharan countries (Günther and Harttgen 2012;Menashe-Oren and Stecklov 2018;Rossier et al 2014;Rossier et al 2016). The spatial proximity of urban residents and their dependence on public resources leave them more vulnerable to contagious diseases than rural inhabitants (Freudenberg, Galea, and Vlahov 2005;Harpham et al 2003;Leon 2008).…”

Section: Urban-rural Differentials In Mortalitymentioning

confidence: 95%

Urban–rural differentials in Latin American infant mortality

Garcia¹

2020

DemRes

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BACKGROUND Infant mortality in Latin America has declined dramatically over the past six decades. The health transition in the region began in the main cities and has tended to proceed more rapidly in countries with higher levels of urbanization. Although urban-rural mortality differentials have consistently favoured cities, these gaps vary significantly across countries, subpopulations, and geographical areas.

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“…; Buckley ; Cai and Chongsuvivatwong ). However, considering that rural/urban adult mortality differentials may differ across developing countries (Menashe‐Oren and Stecklov ; Günther and Harttgen ), we tested the sensitivity of our estimates to variations in the mortality differential. Based on our calculations of adult mortality from DHS data, and using DHS macro data on rural and urban child mortality (ICF International ), we estimated a gradient of rural/urban mortality differentials.…”

Section: Estimating Net Rural‐to‐urban Migration By Age and Sexmentioning

confidence: 99%

“…While there is growing evidence of substantial urban‐to‐rural migration, particularly at older ages (Beauchemin ; Potts ), these data points should be treated cautiously. The rural/urban mortality differential (25 percent) assumption used in the CSRM is probably less applicable to older age groups (Menashe‐Oren and Stecklov ; Günther and Harttgen ). When this assumption is adjusted, the negative migration rates for older adults become smaller, as seen in Figure .…”

Section: Estimating Net Rural‐to‐urban Migration By Age and Sexmentioning

confidence: 99%