Trends in child mortality in Kenya: does the urban advantage still hold?

There is yet a consensus on the effects of rapid urbanization on child health outcomes in sub-Saharan Africa. This study seeks to describe and compare trends in childhood mortality in Kenya between urban and rural areas using DHS data for 1993, 1998, 2003 and 2008/09. Infant, child and under five mortality rates by cohort and urban-rural residence and key determinants are estimated. Results show a narrowing gap in urban rural differentials in childhood mortality. Generally, childhood mortality has declined in both rural and urban areas, but the decline has been more rapid in rural areas. The narrowing gap may be attributed to the fact that most urban residents in Kenya now live in slum areas; with very poor living conditions including water and environmental sanitation, livelihoods and health services, hence the rate of decline in childhood mortality in urban areas does not match that in rural areas.