Progress towards the child mortality millennium development goal in urban sub-Saharan Africa: the dynamics of population growth, immunization, and access to clean water

This paper, published in BMC Public Health, highlights the effects of urban population growth and access to health and social services on progress in achieving Millennium Development Goal (MDG) 4 – to reduce child mortality by two thirds by 2015. The paper examines trends in childhood mortality in sub-Saharan Africa (SSA) in relation to urban population growth, vaccination coverage and access to safe drinking water.

The paper finds that of the 22 countries included in the study, only five have recorded declines in urban child mortality in line with the MDG target of 4 per cent per year. Five countries recorded an increase in urban child mortality and 12 countries witnessed minimal decline. More rapid rate of urban population growth is associated with negative trends in access to safe drinking water and in vaccination coverage, and ultimately to increasing or timid declines in child mortality.

The paper concludes that failing to appropriately target the growing sub0group of the urban poor and improve their living conditions and health status may result in lack of improvement on national indicators of health. Sustained expansion of potable water supplies and vaccination coverage among the disadvantaged urban dwellers should be given priority in the efforts to achieve the child mortality MDG in SSA. [adapted from authors]