Neighborhood differentials in child mortality within urban settings of Kenya, Nigeria, Senegal and Uttar Pradesh, India

More than half of the world’s population resides in urban areas. In developing countries, the vast majority of future population growth will be in cities. In order to address the health needs of this growing population, timely data on within-city differentials in morbidity and mortality is necessary. Mortality rates within cities are typically not available in standard data sources such as the DHS, and thus intra-urban differentials in child mortality are unknown. Using baseline data from the MLE project in urban sites of Kenya, Nigeria, Senegal and Uttar Pradesh, India, we estimate infant, child and under-five mortality rates for slum and non-slum populations in major cities. The representative household samples of the urban populations in 5-6 major cities in each country were drawn to represent slum and non-slum populations, or the urban poor in cities where slum designations were not available (Nigeria and Senegal). These age-specific mortality rates show that mortality is generally higher among the slum populations compared to the non-slum urban populations in all four countries. We then explore the individual, household, community and geographic factors which contribute to higher rates of child mortality among urban slum dwellers as compared to non-slum dwellers.