Urbanization, Poverty, and Child Mortality in Africa

Michel Garenne, Institut de Recherche pour le Développement (IRD)

The study reviews the relationships between urbanisation, poverty and child survival in sub-Saharan Africa using DHS data. Under-five mortality appears higher or equal in rural areas compared to urban areas. However the relationship between urban and rural mortality is not stable, and cases of changing trends were documented, usually with convergence of urban and rural mortality, either by rising mortality in urban areas, or by faster decline in rural areas. The case of the urban poor is investigated using an innovative approach comparing wealthier and poorer households in urban and rural areas. Cases where the urban poor have a higher under-five mortality than rural areas, or higher than expected compared to other countries are investigated. Possible reasons for divergent patterns are explored, in particular patterns of migration and health policies. Special attention is devoted to the role of emerging diseases, in particular to HIV/AIDS, and increasing urban poverty.