Progress towards the child mortality millennium development goal in urban sub-Saharan Africa: the dynamics of population growth, immunization, and access to clean water

Fotso, Jean-Christophe; Ezeh, Alex; Madise, Nyovani; Ciera, James

doi:10.1186/1471-2458-7-218

Cited by 87 publications

(82 citation statements)

References 27 publications

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“…Twelve of these were included in previous studies (Table A3) for their well-documented effects on child mortality and health [12,16–18]. We added five additional interventions that have demonstrated a significant impact on child health and have available data in DHS and MICS: access to improved water, access to improved sanitation, BCG immunization, polio immunization, and care seeking for diarrhea [9,26–31].…”

Section: Methodsmentioning

confidence: 99%

“…For example, we tracked inequalities in three child health outcome indicators (infant mortality, under-five mortality, and stunting). Previous studies analyzed inequality in coverage for 12 child health interventions [12,16–18]; we added an additional five interventions in our study, including access to improved water, access to improved sanitation, Bacillus Calmette–Guérin (BCG) immunization, polio immunization, and care seeking for diarrhea. To our knowledge, this is the first study that provides a comprehensive picture of the progress made in reducing inequalities in child health outcomes and across 17 child health interventions for 88 countries between 2000 and 2014.…”

Section: Introductionmentioning

confidence: 99%

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Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Subramanian

et al. 2017

Global Health Action

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Background: Reducing child mortality was one of the Millennium Development Goals. In the current Sustainable Development Goals era, achieving equity is prioritized as a major aim. Objective: This study aims to provide a comprehensive and updated picture of inequalities in child health intervention coverage and child health outcomes by wealth status, as well as their trends between 2000 and 2014. Methods: Using data from Demographic Health Surveys and Multiple Indicator Cluster Surveys, we adopted three measures of inequality, including one absolute inequality indicator and two relative inequality indicators, to estimate the level and trends of inequalities in three child health outcome variables and 17 intervention coverages in 88 developing countries. Results: While improvements in child health outcomes and coverage of interventions have been observed between 2000 and 2014, large inequalities remain. There was a high level of variation between countries’ progress toward reducing child health inequalities, with some countries significantly improving, some deteriorating, and some remaining statistically unchanged. Among child health interventions, the least equitable one was access to improved sanitation (The absolute difference in coverages between the richest quintile and the poorest quintile reached 49.5% [42.7, 56.2]), followed by access to improved water (34.1% [29.5, 38.6]), and skilled birth attendant (SBA) (34.1% [28.8, 39.4]). The most equitable intervention coverage was insecticide-treated bed net for children (1.0% [−3.9, 5.9]), followed by oral rehydration therapy for diarrhea ((8.0% [5.2, 10.8]), and vitamin A supplement (8.4% [5.1, 11.7]). These findings were robust to various inequality measurements. Conclusions: Although child health outcomes and coverage of interventions have improved largely over the study period for almost all wealth quintiles, insufficient progress was made in reducing child health inequalities between the poorest and richest wealth quintiles. Future efforts should focus on reaching the poorest children by increasing investments toward expanding the coverage of interventions in resource-limited settings.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Subramanian

et al. 2017

Global Health Action

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“…1E). Urbanization in the developing world is likely to decrease access to clean water further (22). Conflict over water across political, ethnic, and socioeconomic boundaries has the potential to undermine food security if it erupts into violence (3) or produces large-scale migration (38,39).…”

Section: Environmental Systemmentioning

confidence: 99%

“…Even given adequate supply and access to food, nutrition security can be influenced by individual heterogeneity in physiology or disease (20,21) and by access to clean water, hygiene, and cooking practices (22,23). Evidence suggests that malnutrition can be affected by infectious disease, and, in turn, undernutrition (and potentially overnutrition) can shape susceptibility, transmission, and progression of infection, creating reinforcing feedbacks (2,13,20,(24)(25)(26)(27)(28).…”

Section: Complexity Of Food and Nutrition Securitymentioning

confidence: 99%

A systems science perspective and transdisciplinary models for food and nutrition security

Hammond

Dubé

2012

Proc. Natl. Acad. Sci. U.S.A.

183

143

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We argue that food and nutrition security is driven by complex underlying systems and that both research and policy in this area would benefit from a systems approach. We present a framework for such an approach, examine key underlying systems, and identify transdisciplinary modeling tools that may prove especially useful.complexity | agri-food | health | disease | environment N utrition is a fundamental human need, affecting health and well-being throughout the lifespan in myriad ways. A central concept in the study of human nutrition is food and nutrition security, which is typically defined as "when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life" (1). The absence of food and nutrition security can have significant consequences for individuals and for society, including malnutrition, obesity, disease, and poverty.Despite rapid growth in agricultural production over the past four decades, significant malnutrition persists. Average per-capita food consumption was below the recommended 2,200 kcal/d in 33 countries in 2003. Globally, more than 850 million people lack adequate access to food on a regular basis, with a third of these in East and Southeast Asia, another third in South Asia, and a quarter in sub-Saharan Africa. In sub-Saharan Africa, one of the most food-insecure regions, the number of hungry people has gone up by 20% since 1990; more than a third of the population is undernourished in such countries as Kenya and Tanzania. There are 126 million underweight children in the world and over 2 billion people who suffer from micronutrient deficiency (2-4).At the same time, there has been an alarming rise in obesity in the developed world (5, 6) and, increasingly, in the developing world as well (7-9). The obesity rate in the United States doubled between 1970 and 2000, to almost 30% (5); worldwide, nearly 1.5 billion people are now overweight or obese (9). Like malnutrition, obesity has significant implications for public health (10, 11) and health care costs (12). Obesity can coexist in the same populations as malnutrition, and it may be linked to the same forces that drive reductions in malnutrition (13, 14). Complexity of Food and Nutrition SecurityBoth phenomena, malnutrition and obesity, are manifestations of widespread food and nutrition insecurity. The determinants of this insecurity are complex. A primary driver of food security or insecurity is the agricultural food system. The agrifood system spans a series of interrelated processes, including production of raw food materials through farming and raising of livestock, processing and packaging for consumption, distribution, and utilization by consumers (15). These processes are affected by a range of influences, including diffusion of agricultural technology (16, 17), functioning of capital markets, infrastructure at both local and regional/global levels, organization of firms and supply chains, sociopolitical factors ...

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“…In SSA, shortages of potable water are critical development challenges confronting most countries (Nzeadibe & Ajaero, 2012) access to potable water in many SSA countries is by no means certain due to a variety of factors such as periodic droughts, limited availability of and pollution of available freshwater sources (Calow et al, 2010). Shortage of natural freshwater supply constrains socio-economic growth and development in many parts of SSA (Fotso et al, 2007). It constrains the regions' efforts towards poverty reduction, economic growth and food security (UN, 2010).…”

Section: Introductionmentioning

confidence: 99%

The Use of Desalination Technologies to Alleviate Water Shortages in Sub-Saharan Africa (SSA): Challenges and Recommendations

Chukwuma¹

2018

USPA

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Progress towards the child mortality millennium development goal in urban sub-Saharan Africa: the dynamics of population growth, immunization, and access to clean water

Cited by 87 publications

References 27 publications

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

A systems science perspective and transdisciplinary models for food and nutrition security

The Use of Desalination Technologies to Alleviate Water Shortages in Sub-Saharan Africa (SSA): Challenges and Recommendations

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