Urbanisation and child health in resource poor settings with special reference to under-five mortality in Africa

• Published in: Archives of disease in childhood Vol. 95; no. 6; pp. 464 - 468
• Main Author: Garenne, Michel
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.06.2010; BMJ Publishing Group; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Africa - epidemiology; Biological and medical sciences; Child; Child Health; Child Mortality - trends; Child Welfare - trends; Child, Preschool; Children; Demographic aspects; Developing Countries; Diseases; Environmental hazards; General aspects; Health aspects; Health care; Health hazards; Humans; Infant; Infant Mortality; LDCs; Medical sciences; Medically Underserved Area; Miscellaneous; Mortality; Nutritional status; Pediatric diseases; Pediatrics - trends; Poverty; Prevention and actions; Prognosis; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Rural areas; Sanitation; Socioeconomics; Urban areas; Urban Health - trends; Urbanization; War; Young Children; Africa; Human; Pediatrics; Mortality; Reference; Developing countries; Urbanization; Child; Epidemiology; Public health
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.2009.172585

The health of children improved dramatically worldwide during the 20th century, although with major contrasts between developed and developing countries, and urban and rural areas. The quantitative evidence on urban child health from a broad historical and comparative perspective is briefly reviewed here. Before the sanitary revolution, urban mortality tended to be higher than rural mortality. However, after World War I, improvements in water, sanitation, hygiene, nutrition and child care resulted in lower urban child mortality in Europe. Despite a similar mortality decline, urban mortality in developing countries since World War II has been generally lower than rural mortality, probably because of better medical care, higher socio-economic status and better nutrition in urban areas. However, higher urban mortality has recently been seen in the slums of large cities in developing countries as a result of extreme poverty, family disintegration, lack of hygiene, sanitation and medical care, low nutritional status, emerging diseases (HIV/AIDS and tuberculosis) and other health hazards (environmental hazards, accidents, violence). These emerging threats need to be addressed by appropriate policies and programmes.