Intra-Urban Child Mortality Declines in Accra, Ghana

Livia Montana, University of North Carolina at Chapel Hill

While health gains in urban areas have outpaced progress in rural areas, inequalities appear to have grown larger, as richer urban residents have realized more health gains than their poor urban counterparts. Few studies have attempted to describe mortality trends within cities. The data for this study come from a UNHABITAT survey of slum areas in Accra, the Housing and Welfare Study of Accra, and the Demographic and Health Surveys. To control for individual, mother and household characteristics, a Cox proportional hazards model was used to predict the hazard of dying among all children under five during 1999-2008 for slum and non-slum areas. Separate models were fit for infants and children ages one to four. Results suggest mortality rates among slum dwellers have decreased at a sharper pace compared to those in non-slum areas, and that these declines are associated with the use of sachet water and duration of residence.