High Child Mortality and Interventions Coverage in the City of Dar es Salaam, Tanzania: Are the Poorest Paying an Urban Penalty?

The 'urban penalty' in health refers to the loss of a presumed survival advantage due to adverse consequences of urban life. This study investigated the levels and trends in neonatal, post-neonatal and under-5 mortality rate and key determinants of child survival using data from Tanzania Demographic...

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Publicado en:Journal of Urban Health Vol. 101; no. 1; pp. 92 - 107
Autores principales: Kagoye, Sophia, Minja, Jacqueline, Ricardo, Luiza, Shabani, Josephine, Bajaria, Shraddha, Msuya, Sia, Hanson, Claudia, Mahundi, Masoud, Msuya, Ibrahim, Simba, Daudi, Ismail, Habib, Boerma, Ties, Masanja, Honorati
Formato: Artículo
Publicado: Springer Nature 2024 Suppl 1
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Acceso en línea:Ver este registro en EBSCOhost
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        au:
          Kagoye, Sophia
          Minja, Jacqueline
          Ricardo, Luiza
          Shabani, Josephine
          Bajaria, Shraddha
          Msuya, Sia
          Hanson, Claudia
          Mahundi, Masoud
          Msuya, Ibrahim
          Simba, Daudi
          Ismail, Habib
          Boerma, Ties
          Masanja, Honorati
        affil:
          https://ror.org/05fjs7w98 National Institute for Medical Research, Mwanza, Tanzania
          https://ror.org/04js17g72 Ifakara Health Institute, Dar Es Salaam, Tanzania
          https://ror.org/05msy9z54 Federal University of Pelotas, Pelotas, Brazil
          Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
          https://ror.org/00a0jsq62 London School of Hygiene and Tropical Medicine, London, UK
          https://ror.org/0479aed98 University of Dar Es Salaam, Dar Es Salaam, Tanzania
          https://ror.org/027pr6c67 Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
          Ministry of Health, Dodoma, Tanzania
          https://ror.org/02gfys938 University of Manitoba, Winnipeg, Canada
      su:
        Child mortality
        Demographic surveys
        Poor children
        Health behavior
        Rural children
        Neonatal mortality
      sug:
        subj:
          Child mortality
          Demographic surveys
          Poor children
          Health behavior
          Rural children
          Neonatal mortality
      keyword:
        Child Mortality
        Urban Penalty
        Child Mortality
        Urban Penalty
      ab: The 'urban penalty' in health refers to the loss of a presumed survival advantage due to adverse consequences of urban life. This study investigated the levels and trends in neonatal, post-neonatal and under-5 mortality rate and key determinants of child survival using data from Tanzania Demographic and Health Surveys (TDHS) (2004/05, 2010 and 2015/16), AIDS Indicator Survey (AIS), Malaria Indicator survey (MIS) and health facility data in Tanzania mainland. We compared Dar es Salaam results with other urban and rural areas in Tanzania mainland, and between the poorest and richest wealth tertiles within Dar es Salaam. Under-5 mortality declined by 41% between TDHS 2004/05 and 2015/2016 from 132 to 78 deaths per 1000 live births, with a greater decline in rural areas compared to Dar es Salaam and other urban areas. Neonatal mortality rate was consistently higher in Dar es Salaam during the same period, with the widest gap (> 50%) between Dar es Salaam and rural areas in TDHS 2015/2016. Coverage of maternal, new-born and child health interventions as well as living conditions were generally better in Dar es Salaam than elsewhere. Within the city, neonatal mortality was 63 and 44 per 1000 live births in the poorest 33% and richest 33%, respectively. The poorest had higher rates of stunting, more overcrowding, inadequate sanitation and lower coverage of institutional deliveries and C-section rate, compared to richest tertile. Children in Dar es Salaam do not have improved survival chances compared to rural children, despite better living conditions and higher coverage of essential health interventions. This urban penalty is higher among children of the poorest households which could only partly be explained by the available indicators of coverage of services and living conditions. Further research is urgently needed to understand the reasons for the urban penalty, including quality of care, health behaviours and environmental conditions.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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