Quantifying within-city inequalities in child mortality across neighbourhoods in Accra, Ghana: a Bayesian spatial analysis

ObjectiveCountries in sub-Saharan Africa suffer the highest rates of child mortality worldwide. Urban areas tend to have lower mortality than rural areas, but these comparisons likely mask large within-city inequalities. We aimed to estimate rates of under-five mortality (U5M) at the neighbourhood level for Ghana’s Greater Accra Metropolitan Area (GAMA) and measure the extent of intraurban inequalities.MethodsWe accessed data on >700 000 women aged 25–49 years living in GAMA using the most recent Ghana census (2010). We summarised counts of child births and deaths by five-year age group of women and neighbourhood (n=406) and applied indirect demographic methods to convert the summaries to yearly probabilities of death before age five years. We fitted a Bayesian spatiotemporal model to the neighbourhood U5M probabilities to obtain estimates for the year 2010 and examined their correlations with indicators of neighbourhood living and socioeconomic conditions.ResultsU5M varied almost five-fold across neighbourhoods in GAMA in 2010, ranging from 28 (95% credible interval (CrI) 8 to 63) to 138 (95% CrI 111 to 167) deaths per 1000 live births. U5M was highest in neighbourhoods of the central urban core and industrial areas, with an average of 95 deaths per 1000 live births across these neighbourhoods. Peri-urban neighbourhoods performed better, on average, but rates varied more across neighbourhoods compared with neighbourhoods in the central urban areas. U5M was negatively correlated with multiple indicators of improved living and socioeconomic conditions among peri-urban neighbourhoods. Among urban neighbourhoods, correlations with these factors were weaker or, in some cases, reversed, including with median household consumption and women’s schooling.ConclusionReducing child mortality in high-burden urban neighbourhoods in GAMA, where a substantial portion of the urban population resides, should be prioritised as part of continued efforts to meet the Sustainable Development Goal national target of less than 25 deaths per 1000 live births.

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MIGRATION, TRANSLOCAL NETWORKS AND SOCIO-ECONOMIC STRATIFICATION IN NAMIBIA

Africa ◽

10.1017/s0001972011000477 ◽

2011 ◽

Vol 81 (4) ◽

pp. 606-627 ◽

Cited By ~ 22

Author(s):

Clemens Greiner

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Sub Saharan Africa ◽

Urban Migration ◽

Urban Networks ◽

Rural And Urban Areas ◽

Economic Stratification ◽

Rural And Urban ◽

Sub Saharan ◽

Price Differences

ABSTRACTRural–urban migration and networks are fundamental for many livelihoods in sub-Saharan Africa. Remittances in cash and kind provide additional income, enhance food security and offer access to viable resources in both rural and urban areas. Migration allows the involved households to benefit from price differences between rural and urban areas. In this contribution, I demonstrate that rural–urban networks not only contribute to poverty alleviation and security, but also further socio-economic stratification. This aspect has been ignored or neglected by most scholars and development planners. Using ethnographic data from Namibia, I have adopted a translocal perspective on migration and stratification, focusing on the resulting impact in rural areas where modern urban forms of stratification, induced by education and income from wage labour, are on the increase.

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Sexual Autonomy and Self-reported Sexually Transmitted Infections Among Sub-saharan African Women in Sexual Unions

10.21203/rs.3.rs-639480/v1 ◽

2021 ◽

Author(s):

Collins Adu ◽

Aliu Mohammed ◽

Eugene Budu ◽

James Boadu Frimpong ◽

Justice Kannor Tetteh ◽

...

Keyword(s):

Sexually Transmitted Infections ◽

Rural Areas ◽

Urban Areas ◽

Study Data ◽

Sub Saharan Africa ◽

African Women ◽

Odds Ratios ◽

Sexual Autonomy ◽

Sexually Transmitted ◽

Sub Saharan

Abstract Background Sexually transmitted infections (STIs) remain a major public health challenge worldwide. Despite the importance of sexual autonomy in the prevention and control of sexual and reproductive health disorders such as STIs, there are limited studies on the possible relationship between women’s sexual autonomy and self-reported STIs, especially in sub-Saharan Africa (SSA). This study, therefore, examined the association between sexual autonomy and self-reported STIs among women in sexual unions in SSA.Methods Data from the Demographic and Health Survey (DHS) of 31 countries in SSA conducted between 2010 and 2019 were analysed. A total of 234,310 women in sexual unions were included in the study. Data were analysed using binary logistic regression models and the results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs) at 95% confidence interval (CI). Results The prevalence of self-reported STIs among women in sexual unions in SSA was 5.8%. Approximately 83.0% of the women surveyed had sexual autonomy. Women who had no sexual autonomy were less likely to have self-reported STIs (cOR=0.52, CI: 0.46-0.54), compared to those who had sexual autonomy. Additionally, higher odds of self-reported STIs were found among women aged 25-29, compared to those aged 15-19 (aOR= 1.21, CI: 1.09-1.35); those who reside in urban areas, compared to those who reside in rural areas (aOR= 1.51, CI: 1.37-1.66) and those who were cohabiting, compared to those who were married (aOR= 1.65, CI: 1.52-1.79). On the other hand, lower odds of self-reported STIs were found among women who were exposed to newspapers (aOR= 0.89, CI: 0.82-0.95), those whose partners had primary education (aOR= 0.84, CI: 0.78-0.91), those who were not exposed to radio (aOR= 0.84, CI: 0.79-0.89), and working women (aOR= 0.86, CI: 0.80-0.93). Conclusion Findings from this study suggest that sexual autonomy is a significant predictor of self-reported STIs among women in sexual unions in SSA. Thus, instituting policies and programs that empower women and improve their levels of sexual autonomy may result in increased self-reporting of symptoms associated with STIs which subsequently help in minimising STI-related complications. Also, policies aimed at enhancing women’s sexual autonomy may reduce the burden of STIs in SSA, especially among women in sexual unions.

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Clinical Features of Rheumatoid Arthritis in a Sub-Saharan African Population: A 308 Study Cases in Senegal

Saudi Journal of Internal Medicine ◽

10.32790/sjim.2014.4.1.5 ◽

2014 ◽

Vol 4 (1) ◽

pp. 23-28

Author(s):

Souhaibou Ndongo ◽

Abdoulaye Pouye ◽

Emeric Azankpan ◽

Mourtalla M. Ka ◽

Thérèse Moreira Diop

Keyword(s):

Rheumatoid Arthritis ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Sicca Syndrome ◽

Sub Saharan Africa ◽

Cross Sectional ◽

Early Management ◽

Delay In Diagnosis ◽

Sub Saharan

Background: Rheumatoid arthritis, formerly rare in sub-Saharan Africa, is becoming increasingly reported. The objective study determines the epidemiological, clinical and biological features of rheumatoid arthritis at diagnosis. Methods: A cross-sectional study conducted at the rheumatology outpatient department of Aristide Le Dantec Teaching Hospital of Dakar in Senegal. Results: Three hundred eight patients with rheumatoid arthritis according, to American College of Rheumatology 1987 criteria, were included: 273 women and 35 men (ratio of 7:8). Median age was 41 years (Q1: 31; Q3: 53 years); predominant age group was 30-40 years. Ninety-three percent resided in urban areas and 7% in rural areas. Family history of chronic inflammatory arthritis was reported by 35.1% of patients. Thirty-nine percent of patients initially consulted a traditional healer. On admission, the median Disease Activity Score 28 was 6.5 (Q1: 5.5; Q3: 7.3). Rheumatoid arthritis was very active in 81.1% and a positive factor in 84% of patients. Cyclic citrullinated peptide antibodies assessed in 116 patients; 95 reported positive (81.9%). Of 169 patients, at least one extra-articular manifestation was presented; the most common, anemia and sicca syndrome. Conclusion: Rheumatoid arthritis was characterized by an important delay in diagnosis, a polyarticular presentation, and a high positivity of immunological markers. Extra-articular manifestations included mainly anemia and sicca syndrome. Early management and a better understanding of rheumatoid arthritis in sub-Saharan Africa are required.

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Understanding the Factors That Are Associated with Motorcycle Crash Severity in Rural and Urban Areas of Ghana

Journal of Advanced Transportation ◽

10.1155/2021/6336517 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

William Agyemang ◽

Emmanuel Kofi Adanu ◽

Steven Jones

Keyword(s):

Rural Areas ◽

Traffic Congestion ◽

Urban Areas ◽

Urban Traffic ◽

Sub Saharan Africa ◽

Crash Data ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Run Off ◽

Sub Saharan

Like many countries in sub-Saharan Africa, Ghana has witnessed an increase in the use of motorcycles for both commercial transport and private transport of people and goods. The rapid rise in commercial motorcycle activities has been attributed to the problem of urban traffic congestion and the general lack of reliable and affordable public transport in rural areas. This study investigates and compares factors that are associated with motorcycle crash injury outcomes in rural and urban areas of Ghana. This comparison is particularly important because the commercial use of motorcycles and their rapid growth in urban areas are a new phenomenon, in contrast to rural areas where people have long relied on motorcycles for their transportation needs. Preliminary analysis of the crash data revealed that more of the rural area crashes occurred under dark and unlit roadway conditions, while urban areas recorded more intersection-related crashes. Additionally, it was found that more pedestrian collisions happened in urban areas, while head-on collisions happened more in rural areas. The model estimation results show that collisions with a pedestrian, run-off-road, and collisions that occur under dark and unlit roadway conditions were more likely to result in fatal injury. Findings from this study are expected to help in crafting and targeting appropriate countermeasures to effectively reduce the occurrence and severity of motorcycle crashes throughout the country and, indeed, sub-Saharan Africa.

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How Mobile Technologies Are Leading to Economic Development in Sub-Saharan Africa

Encyclopedia of Information Science and Technology, Fifth Edition - Advances in Information Quality and Management ◽

10.4018/978-1-7998-3479-3.ch118 ◽

2021 ◽

pp. 1719-1726

Author(s):

Nigel McKelvey ◽

Adam Crossan ◽

Kevin Curran

Keyword(s):

Mobile Devices ◽

Mobile Technology ◽

Rural Areas ◽

Urban Areas ◽

Sub Saharan Africa ◽

Mobile Technologies ◽

African Countries ◽

The Difference ◽

Sub Saharan ◽

Technology Focus

Mobile technology today is increasingly being used to help improve underdeveloped and developing areas such as sub-Saharan Africa. With the statistics showing the number of adults in Africa owning mobile devices steadily increasing, mobile technology has been a popular area of interest to use to help improve areas such as healthcare and education throughout African cities and rural areas. Common that ways mobile technology is being used to help the residents of sub-Saharan Africa are in the sectors of health care and education. Mobile technologies being used in these areas whilst simple are incredibly effective and successful in helping to better the quality of health in education in sub-Saharan Africa. Many of the projects and systems developed using mobile technology focus mainly on urban areas. While reports state the huge increase in the number of those using mobile devices in Africa, along with the large estimated increase in the coming years, the difference between rural African countries and countries which contain urban cities is substantial.

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Clinical Features of Rheumatoid Arthritis in a Sub-Saharan African Population: A 308 Study Cases in Senegal

Saudi Journal of Internal Medicine ◽

10.32790/sjim.4.1.5 ◽

2014 ◽

Vol 4 (1) ◽

pp. 23-28

Author(s):

Souhaibou Ndongo ◽

Abdoulaye Pouye ◽

Emeric Azankpan ◽

Mourtalla M. Ka ◽

Thérèse Moreira Diop

Keyword(s):

Rheumatoid Arthritis ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Sicca Syndrome ◽

Sub Saharan Africa ◽

Cross Sectional ◽

Early Management ◽

Delay In Diagnosis ◽

Sub Saharan

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A multi-year analysis of kangaroo mother care outcomes in low birth weight babies at a Nyakahanga Hospital in rural Tanzania

African Health Sciences ◽

10.4314/ahs.v20i1.56 ◽

2020 ◽

Vol 20 (1) ◽

pp. 498-508

Author(s):

Linda A Winkler ◽

Agnes Stypulkowski ◽

Shana Noon ◽

Theophila Babwanga ◽

Jesca Lutahoire

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Rural Areas ◽

Urban Areas ◽

Very Low Birth Weight ◽

Kangaroo Mother Care ◽

Sub Saharan Africa ◽

Low Resource ◽

Popu Lations ◽

Sub Saharan

Background: Kangaroo Mother Care (KMC) requires few specialized resources, reduces mortality, and can be implemented in low resource environments. It is now recommended for implementation around the globe. Objectives: This paper discusses KMC use with low birth weight newborns at a Tanzania hospital providing valuable outcomes assessment of KMC use in rural areas of sub-Saharan Africa. Methods: The research used retrospective records (136 Low Birth Weight (LBW) and 33 Very Low Birth Weight (VLBW) ne- onates) supplemented by observations. Data included weights (longitudinal), survival period, and cause of death if it occurred. This hospital’s KMC use and study data began when the mother-baby dyad was referred, usually birth day. Results: This KMC group demonstrated 70% survival, but 77% of deaths occur within 24 hours. After the first 24 hours, KMC survival rate was 92%. Even VLBW neonates (<1000 g) had 37.5% survival among the KMC program. Prematurity and respi- ratory distress caused nearly half of the deaths, but hypothermia (19% of deaths) and infection were factors also. Conclusion: Our study indicates the value of KMC in rural low resource environments. Results are comparable to KMC pro- grams in urban areas where newborns begin KMC after stabilization and better than outcomes reported for comparable popu- lations not practicing KMC in rural sub-Saharan Africa. Keywords: Kangaroo mother care; low birth weight; neonatal mortality; premature infant.

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Foodscapes in urban spaces of Africa: implications for food and nutrition security among the urban poor

AAS Open Research ◽

10.12688/aasopenres.13283.1 ◽

2021 ◽

Vol 4 ◽

pp. 44

Author(s):

Fidelia A. A. Dake

Keyword(s):

Food Security ◽

Food Insecurity ◽

Rural Areas ◽

Urban Areas ◽

Urban Poor ◽

Urban Spaces ◽

Sub Saharan Africa ◽

Increased Risk ◽

Food And Nutrition ◽

Sub Saharan

Food security has been a global development agenda for several decades, and rightly so: nearly 945 million people were food insecure in 2005 and a decade later, this number declined to 784 million in 2014, only to rise to 821 million three years later in 2017. These global figures, however, mask variations in the extent of progress in different regions of the world. Progress towards achieving food security has been much slower in sub-Saharan Africa, and the region continues to be the worst hit by food insecurity. Furthermore, it is increasingly being recognised that food insecurity is prevalent in urban, and not just rural areas, and that the urban poor rather than the rural poor are particularly vulnerable, and at increased risk of being food insecure. Additionally, nutrition insecurity, a closely related component of food insecurity, is common among the urban poor and contributes to malnutrition. While several factors have been explored in trying to address the issue of food security, the potential role of foodscapes in urban spaces of Africa has been less researched. Recent evidence, however, indicates that foodscapes in urban areas of sub-Saharan Africa potentially contribute to food and nutrition insecurity, particularly among the urban poor. Addressing food and nutrition insecurity in sub-Saharan Africa will thus first require reframing the discourse about these issues from solely a rural to also an urban problem, and secondly improving access, especially availability of healthy and nutritious options that are also economically accessible, for vulnerable and at-risk groups; in particularly, the urban poor.

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Factors Contributing to Urban Malaria Transmission in Sub-Saharan Africa: A Systematic Review

Journal of Tropical Medicine ◽

10.1155/2012/819563 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 49

Author(s):

Prathiba M. De Silva ◽

John M. Marshall

Keyword(s):

Malaria Transmission ◽

Rural Areas ◽

Urban Areas ◽

Significant Risk ◽

Sub Saharan Africa ◽

Urban Malaria ◽

Vector Species ◽

Breeding Sites ◽

Sub Saharan ◽

And Control

Sub-Saharan Africa suffers by far the greatest malaria burden worldwide and is currently undergoing a profound demographic change, with a growing proportion of its population moving to urban areas. Urbanisation is generally expected to reduce malaria transmission; however the disease still persists in African cities, in some cases at higher levels than in nearby rural areas.Objective. This paper aims to collate and analyse risk factors for urban malaria transmission throughout sub-Saharan Africa and to discuss their implications for control.Methods. A systematic search on malaria and urbanisation was carried out focusing on sub-Saharan Africa. Particular interest was taken in vector breeding sites in urban and periurban areas.Results. A variety of urban vector breeding sites were catalogued, the majority of which were artificial, including urban agriculture, tyre tracks, and ditches. Natural breeding sites varied according to location. Low socioeconomic status was a significant risk factor for malaria, often present in peri-urban areas. A worrying trend was seen in the adaptation of malaria vector species to the urban environment. Urban malaria is highly focused and control programs should reflect this.Conclusion. As urbanisation continues and vector species adapt, continued monitoring and control of urban malaria in sub-Saharan Africa is essential.

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Recent Underweight and Overweight Trends by Rural–Urban Residence among Women in Low- and Middle-Income Countries

Journal of Nutrition ◽

10.3945/jn.114.203562 ◽

2014 ◽

Vol 145 (2) ◽

pp. 352-357 ◽

Cited By ~ 53

Author(s):

Lindsay M Jaacks ◽

Meghan M Slining ◽

Barry M Popkin

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Urban Residence ◽

African Countries ◽

Middle Income ◽

Rate Of Increase ◽

Nationally Representative ◽

Sub Saharan

AbstractBackground: Long-term trends mask critical recent dynamics in the prevalence of under- and overweight.Objective: The objective of this study was to compare annualized prevalence rates of both under- and overweight among nonpregnant women aged 19–49 y during the periods covering 1) the 1990s–the early 2000s and 2) the early 2000s–the late 2000s or early 2010s, by rural–urban residence.Methods: Data are from nationally representative surveys (29 Demographic and Health Surveys and 4 national surveys). Standardized protocols were used to measure weight and height. Underweight was defined as body mass index (BMI) < 18.5 kg/m2 and overweight as BMI ≥ 25 kg/m2.Results: From the 1990s to the early 2000s, most countries were making progress on decreasing the prevalence of underweight, especially in rural areas. Although many countries continued to make progress more recently, several countries in Sub-Saharan Africa that previously had a decreasing prevalence of underweight now have an increasing prevalence of underweight. For example, in rural areas of Senegal, the prevalence of underweight decreased 0.23% annually between 1992 and 2005, then increased 1.60% annually between 2005 and 2010. Meanwhile, the prevalence of overweight is increasing in nearly all countries, and in approximately half of all countries, the rate of increase is greater in rural areas than in urban areas. Although underweight persists as more prevalent than overweight in rural areas of many East Asian, South Asian, and Sub-Saharan African countries, the ratio of underweight to overweight in many countries has decreased over time, indicating that this trend is reversing.Conclusions: Select countries in Sub-Saharan Africa may be more susceptible to food crises and should be targets for intervention. At the same time, global health efforts need to focus on preventing overweight, particularly in rural areas, which are quickly catching up to their urban counterparts.

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