Urban health in developing countries: a review

Harpham, Trudy; Molyneux, Sassy

doi:10.1177/146499340100100202

Cited by 62 publications

(14 citation statements)

References 99 publications

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“…This result is comparable to the respective frequencies of 55.6% and 58.5% observed in Ouagadougou [1] and Cotonou [10]. This practice is widespread in both rural [24,31-33] and urban areas [1,2,34]. The main reason for this practice is its affordability; it involves only the cost of the drugs that are purchased; the patient is thus exempt from other costs related to transportation, consultation of health workers, and various technical examinations [35].…”

Section: Discussionsupporting

confidence: 81%

“…Malaria and fevers of unknown origin and diseases of the respiratory and digestive tracts predominate [1,2,30]. In this study, one-third of all surveyed patients had suffered from malaria and/or fever during the study period.…”

Section: Discussionmentioning

confidence: 82%

“…This scarcity of information limits our understanding of the health-seeking behaviour of patients in urban contexts, i.e. one in which the health care system is characterized, among other things, by a diversity of supply [2,11-14] and by an ongoing epidemiological transition with an increase of non communicable diseases.…”

Section: Introductionmentioning

confidence: 99%

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Health-seeking behaviour in the city of Lubumbashi, Democratic Republic of the Congo: results from a cross-sectional household survey

Chenge

Vennet

Luboya

et al. 2014

BMC Health Serv Res

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BackgroundConcerns about the occurrence of disease among household members generally initiate treatment-seeking actions. This study aims to identify the various treatment-seeking options of patients in Lubumbashi, analyze their health-seeking behaviour, identify determinants for the use of formal care, and analyze direct health care expenditure.MethodsA cross-sectional survey of households in Lubumbashi was conducted in July 2010. Information was collected from a randomly selected sample of 251 households with at least one member who had been ill in the 2 weeks preceding the survey.ResultsFrequently used initial treatment-seeking options consist of self-medication based on modern medicines (54.6%), the use of first-line health services (23.1%) and hospitals (11.9%), with a perceived effectiveness of 51%, 83% and 91% respectively. If people go for a second option, then formal health care services are most often preferred. The majority (60%) of patients’ spontaneous itineraries reflect the expected functioning of a local health care system, with a patient flow characterised by the use of a first line health facility prior to the use of hospital-based services. Chronicity of the disease is the main determinant of seeking formal care. Analysis of care expenditure reveals that drugs are the only line of expenditure in the informal system and the main source of expenditure in the formal system; costs do not discriminate between first-line health services and hospitals, and the payment system is regressive since the poorest patients pay the same amounts as the richest.ConclusionsThis study points to the importance of self-medication as the first therapeutic option for the majority of patients in Lubumbashi, whatever the nature of the health problem. There is a lot of room to rationalise this practice. Although formal care is not common initial therapeutic option, it is the source of care most patients turn to, especially when they believe having a chronic disease. Patients’ itineraries in this urban environment are complex; health managers should try and deal with this reality. Finally, our study indicates that poor patients face the same level of out-of-pocket payments as the more wealthy ones, hence the need for more equitable health care financing arrangements.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 82%

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Health-seeking behaviour in the city of Lubumbashi, Democratic Republic of the Congo: results from a cross-sectional household survey

Chenge

Vennet

Luboya

et al. 2014

BMC Health Serv Res

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“…They concentrated the benefits of Chadwick's sanitary revolution in safe water and sanitation, access to vaccinations and antibiotics, and safe childbirth and perinatal care. Cities provided families with more economic and educational opportunities, improved nutrition and more possibilities for healthcare 9. However, despite overall favourable health statistics in cities, several authors have pointed out large variations between countries and within cities, and the potential influence of slums on these variations 6 10 11…”

Section: Background: Cities Slums and Child Healthmentioning

confidence: 99%

Children's health in slum settings

Unger

2013

Archives of Disease in Childhood

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Rapid urbanisation in the 20th century has been accompanied by the development of slums. Nearly one-third of the world's population and more than 60% of urban populations in the least developed countries live in slums, including hundreds of millions of children. Slums are areas of broad social and health disadvantage to children and their families due to extreme poverty, overcrowding, poor water and sanitation, substandard housing, limited access to basic health and education services, and other hardships (eg, high unemployment, violence). Despite the magnitude of this problem, very little is known about the potential impact of slum life on the health of children and adolescents. Statistics that show improved mortality and health outcomes in cities are based on aggregated data and may miss important intraurban disparities. Limited but consistent evidence suggests higher infant and under-five years mortality for children residing in slums compared with non-slum areas. Children suffer from higher rates of diarrhoeal and respiratory illness, malnutrition and have lower vaccination rates. Mothers residing in slums are more poorly educated and less likely to receive antenatal care and skilled birth assistance. Adolescents have earlier sexual debut and higher rates of HIV, and adopt risky behaviours influenced by their social environment. We also know little about the consequences of this form of early childhood on long-term health-related behaviour (eg, diet and exercise) and non-communicable disease outcomes, such as obesity, heart disease and mental illness. Further attention to understanding and addressing child health in slum settings is an important priority for paediatricians and those committed to child health worldwide.

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“…[23] More recently, there is ample evidence indicating toward increasing mental health problems in urban centers of developing countries. [456]…”

Section: Introductionmentioning

confidence: 99%

Mental well-being of migrants in urban center of India: Analyzing the role of social environment

Firdaus

2017

Indian J Psychiatry

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Background:Rural to urban migration has become a salient feature of the country. However, there is a dearth of study highlighting impact of this movement on mental health of the migrant people.Aims:The main objective of the present study was to examine the relationship between specific components of social environment and psychological well-being of migrants in an urban center.Settings and Design:The National Capital Territory of Delhi was selected for intensive study and has an exploratory design supported by cross-sectional primary data.Methodology:A standardized questionnaire was used to obtain data about the socioeconomic characteristics of the respondents. For measuring the mental well-being, the World Health Organization Well-Being Index (WHO5) was used. The required information was procured through interview method from 1230 sampled respondents.Statistical Analysis:Influence of socioeconomic variables on mental well-being of the people was estimated through multivariate logistic regression methods. For different combinations of risk factors, five models were developed based on unstandardized likelihood coefficients.Results:Poor mental health was significantly higher among single/widow/divorced/separated (odds ratio [OR] =0.76, P < 0.01), unskilled (OR = 2.26, P < 0.01), daily wager (OR = 2.57, P < 0.01), and illiterate (OR = 2.55, P < 0.01). Longer year of immigration, younger age, and higher income level (P < 0.001) were positively related to mental health. Poor housing conditions (P < 0.001), adjustment problem (P < 0.001), and feeling insecure (P < 0.01) were independent predictors of poor mental health.Conclusion:Socioeconomic and environmental problem caused by the migrants and faced by the migrants is required in-depth study to formulate comprehensive policies.

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Urban health in developing countries: a review

Cited by 62 publications

References 99 publications

Health-seeking behaviour in the city of Lubumbashi, Democratic Republic of the Congo: results from a cross-sectional household survey

Health-seeking behaviour in the city of Lubumbashi, Democratic Republic of the Congo: results from a cross-sectional household survey

Children's health in slum settings

Mental well-being of migrants in urban center of India: Analyzing the role of social environment

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