Child health in urban areas

With the urban population increasing in both number and percentage, urban health inequalities has been rising up the research agenda. A crucial aspect of health, both for the MDGs and the post-2015 agenda, is maternal health. This paper looks at inequalities in the percentage receiving sufficient antenatal care and children born within a facility and assesses how these have changed over time. Countries which have been most successful in reducing inequalities while increasing the proportion of mothers with these services will be studied, and countries which have not succeeded in this way will also be assessed.
Using 125 Demographic and Health Surveys from 33 countries, new measures of wealth were constructed using Principal Components Analysis, applying only to urban residents, based on the assets that the household owns. Wealth was used both as a continuous measure (factor score) and in quintiles. The difference and ratio between richest and poorest quintiles was calculated, while concentration indices calculated.
Results indicated that countries were diverse in the evolution of inequality with some successfully reducing it and others showing an increase over time. Policies to improve maternal health should tackle inequalities, while still increasing the overall level of service use in the whole population.

In the slums of Nairobi, like elsewhere in Africa, children whose mothers were never married or divorced face a significantly higher risk of dying than children whose parents are married. Drawing on both qualitative and longitudinal quantitative data from two informal settlements in Nairobi, this study explores possible causal mechanisms, paying particular attention to the importance of poverty. We find that children living in the wealthiest households are 22% less likely to have a single mother than children residing in the poorest households. In-depth interviews support these findings and reveal the daily struggles single mothers face in meeting their children’s basic needs. However, in contrast to studies from Western societies, we find little evidence that poverty is the missing link explaining the increased risk of mortality among children of single mothers. Instead, we contend that limited support from fathers, coupled with isolation from kin and discrimination from neighbors render these children particularly vulnerable.

Objectives: We investigate the relationship between socio-economic status of urban currently married women and utilization of safe motherhood practices in EAG states.Data and Method- We used cross-sectional data from third round of District Level Household & Facility Survey-3 (DLHS) conducted in 2007-08. The analysis is based on 16,158 currently married women. The dependent variables in the analysis are utilization of safe motherhood practice. Utilization of safe motherhood includes those women who received full ANC, safe delivery and visited by any health professional within 42 days of delivery .The independent variables are: age of the respondent, place of residence, educational status, work status in last 12 months, religion, wealth quintile and caste of the respondents. Cross-tabulation and logistic regressions models have been used to fulfil objectives of the study Conclusion: The likelihood of utilization of safe motherhood practices for urban currently married women increases for those women who had 10 or more years of education (OR= 7.3; p<0.0) as compared to not educated women. Exposure of health related issues were more likely (OR= 2 p<0.0) to have utilization of safe motherhood practices.

Dengue fever is a global public health problem and requires efforts to be understood and controlled. It is estimated that fifty million dengue cases occur every year in more than 100 countries. Approximately two and a half billion people live in areas where dengue is endemic, which happens mainly in Asia, Africa and South America. We aim to understand in this paper: 1) What are the main socio-demographic and environmental determinants of morbidity and mortality due to dengue in Singapore?; 2) In a comparative analysis, what are the differences between the causal factors of dengue in Singapore in relation to those found in Brazil?; 3 ) Why is this an issue so difficult to equate to theses two countries public health authorities?; and 4) What are the feasible and effective policies that can be implemented in these distinct contexts? These issues will guide the present study, in which we will highlight the role of demographic dynamics (mainly morbidity, mortality and migration), besides the urban environmental sanitation conditions, to find explanations for this difficult problem to solve according to what global experience showed so far.

Ouagadougou, the capital of Burkina Faso, is currently experiencing rapid population growth. Since 2008, the Ouaga HDSS following 80,000 people living in five neighborhoods on the periphery of the city, half of them living in poor, informal settlements. First analyses of the mortality data collected show that the main causes of deaths among adults aged 15 to 59 are AIDS, cardiovascular diseases and accidents; adult mortality (15 to 59) is higher in formal neighborhoods. This excess mortality seems attributable to the relatively higher wealth of households in formal neighborhoods: affluent adults are indeed more often overweight and more likely to be HIV positive; better educated adults are more likely to have accidents. In this analysis, we test (using Cox regression and data on mortality from 2008 to 2012) whether wealthier adults are more often victim of premature death, controlling for a variety of factors at the individual and household level.

Deaths are not randomly distributed in the course of the year; they often exhibit distinct seasonal variations. In the northern hemisphere, seasonal patterns are mostly characterized by a summer trough and a winter peak in adult mortality, predominantly due to respiratory, cerebrovascular, and ischemic heart diseases. There has been little research conducted on seasonal mortality in developing countries because of the lack of adequate data. Tacking advantage of a long series of death records registered in the urban setting of Antananarivo since 1976, we examine seasonal patterns of all-cause and cause-specific mortality. We show that the seasonality of mortality is much more marked in young children and the elderly than in adults of working age. Child mortality is higher during the rainy season because of infectious and parasitic diseases, as well as nutritional deficiencies. By contrast, the elderly die more during the cold months of July and August, mainly because of diseases of the circulatory and respiratory systems. The seasonality of child deaths has significantly reduced over the last thirty years whereas it has not changed for people aged 60 and over.

Risk taking and experimentation is the order of the day for youngsters, which include experimenting not only with drugs, tobacco and alcohol, but also with sex. Heightened sexual urges in young people make them vulnerable to a whole host of problems, associated with sexuality- molestation, rape, teenage pregnancies, abortion and sexually transmitted diseases.
There is growing evidence to suggest that problem behaviours cluster together. They include alcohol and drug abuse, cigarette smoking and sexual precocity. Those who smoke cigarettes are more likely to use illicit drugs; drink heavily, and use some other drugs. These result in anti-social behaviour and traffic accidents, which are a major cause of death and disability in young persons. The use of tobacco, alcohol and other drugs is associated with poor performance in college, at work and in sports. The use of one drug is more likely to lead to multiple drug use. Substance use is primarily a social, rather than a solitary activity among youth. Peer pressures play a significant role in problem behaviour and may be particularly significant for the young person, who comes from a divided family, lives in unrewarding environment and is less successful at college, at sports, or in making friends.

Like other developing countries, India is undergoing rapid epidemiological transition as a result of its demographic, economic and social changes. India is moving from second to third stage of epidemiological transition. However, India is facing both double burdens of diseases that burden of communicable and non-communicable. Lack of accurate data on cause of deaths is a major hindrance to comprehensive assessment of epidemiological transition. The urban Maharashtra known to be the only state where the vital events registration is above 90%. The results are evident that Maharashtra is at third stage of epidemiological transition. Among all causes of death “Diseases of the Circulatory System” is ranked first from 1990 to 2006. For youth, the leading cause of death is “Injury and poisoning” for both males and females. In the adult groups, leading cause of death is” Infectious and parasitic disease”. Among adult males the leading cause of death is” Infectious and parasitic disease” and among adult female it is “disease of circulatory system”. For the old age group, “Disease of circulatory system is the leading cause of death in Urban Maharashtra for both males and females. This indicates that state is non-communicable diseases but the state is facing double burden of diseases.

The benefits of early initiation of breastfeeding for the health baby are well documented. World Health Organization (WHO) recommends early initiation of breastfeeding. A recent trial has shown that early initiation of breastfeeding could reduce neonatal mortality by 22% which would contribute to the achievement of the Millennium Development Goals (Edmond, 2006). There are few empirical studies on this issue in India, even though early initiation of breastfeeding important for child survival. Present study covers the practices related with early initiation of breastfeeding in slums of Kanpur City in Uttar Pradesh, India. There were 335 lactating mothers were interviewed, using a pretested structured questionnaire in eight slums of Kanpur City. There were 78 per cent of mothers know the advantages of breastfeeding, but only 38 per cent of mothers given colostrum to their babies. Generally new born babies get first breastfed after 2-3 days of delivery. It is considered that colostrum is not good for baby health. Goat milk is considered as very light and digest able for new born baby. During that period new born baby gets pre-lactation feeds like goat milk (82 per cent), cow milk (14 per cent), honey or gur (sugar syrup). Exclusive breastfeeding

Two related objectives are the concern in this article. The first is to suggest a conceptual framework for explaining the association between poverty and Common Mental Disorder (CMD) and the mediating factors. The second is to examine statistically the hypothesized role of poverty and other demographic, socioeconomic and behavioral risk factors on CMD. Data from the Urban Inequity Study Survey (UIS) that was conducted in Cairo, the capital of Egypt in 2007 are used. About 2000 adult females and 2000 adult males were interviewed. Few percent of the study population has non/minimal depression (15% and 16% among males and females, respectively) One quarter of males and one third of females have mild depression and one third of each have moderate. Females exceed males in mild and moderate depression (64.6% vs. 59.2%). about 20% of the females and one quarter of the males have severe depression. Level of depression significantly declines with education, marriage, and age. Sad events and other difficult life situations such as; spinsterhood, divorce or widowhood, and difficulty of carrying out the daily physical functions are strong risk factors. Neither poverty nor living in poor neighborhood is risk factor. Males, contrary to females, are significantly impacted by their work conditions.