Abstract
Ouagadougou, the capital of Burkina Faso, is currently experiencing rapid population growth, mainly concentrated in the outskirts of the city. Since 2008, the Ouagadougou Health and Demographic Surveillance System (Ouaga HDSS) has followed 80,000 people living in five neighbourhoods on the periphery of the city, half of them living in poor, informal settlements. This urban population faces a complex burden of disease: children under five die mainly from infectious diseases, while the main causes of deaths among adults aged 15–59 are AIDS, cardiovascular diseases and accidents. In this analysis, we explore whether poverty is associated with greater mortality among small children and among adults and we examine how the risk factors associated with the main causes of death in these two age groups vary by socio-economic status. We find that children who are born to uneducated and poor parents are twice as likely to die as their counterparts likely because they have worse access to both preventive and curative health care. Young children living in informal areas are also twice as likely to die compared to others because, everything else being equal, they are more often ill, more often malnourished, and less likely to receive medical care; these outcomes can be related to the unsanitary environment. In contrast, adult mortality is higher in formal neighbourhoods. Since adult health behaviours are similar regardless of neighbourhood (everything else being constant), this excess mortality seems attributable to the relatively higher wealth of households in formal neighbourhoods: affluent adults are more often overweight and more likely to be HIV positive. Better educated adults have a lower risk of dying than others because, despite their higher rates of accidents and HIV infection, they are more likely to seek medical care.
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Notes
- 1.
At 26 per 1000, the infant mortality rate in the Ouaga HDSS is lower compared to the four HDSS located in rural Burkina Faso: Nouna, Kaya, Nanoro, Sapone (First comparative workshop for the Burkinane HDSS, April 2–7 2012, Ouagadougou, Institut Supérieur des Sciences de la Population, Université de Ouagadougou).
- 2.
Almost half (46 %) of residents 15 and older in the Ouaga HDSS neighbourhoods have never been to school, and the proportion is lower in the formal neighbourhoods (36 %) than in the formal neighbourhoods (59 %). While educational level and wealth are associated, the relation is far from systematic, since an important part of the economy remains informal; rich illiterates are common, as are jobless graduates.
- 3.
We tested two additional poverty indicators, but did not keep them in the final analyses. An indicator of household food insecurity (questions provided by J. M. Prevel and his team at the Institut de Recherche pour le Développement) proved not sensitive enough, with 70 % of households reporting severe food insecurity. Second, households headed by widowed/separated/divorced women were not associated with poorer health outcomes, even though women in general have less ability to generate revenue; economically successful women are probably over-represented in these households.
- 4.
Useable vaccination data were collected for children only at the third re-enumeration.
- 5.
During the two first years of data collection we report on here, causes of death were defined by a group of local doctors. Later, the Ouaga HDSS used a software to determine the causes of death: using that approach, over the 2009–2012 period and for adults aged 35 and over, AIDS is only the 7th causes of death (Rossier et al. 2014).
- 6.
Reporting of children’s deaths, while a problem during the first years of surveillance, appears to have become complete later on (Lankoande et al. 2016).
- 7.
Data on children’s vaccination in the Ouaga HDSS are available only from the third enumeration on.
References
African Population and Health Research Centre. (2002). Population and health dynamics in Nairobi informal settlements. Nairobi: African Population and Health Research Centre.
Baya, B., Zida, H., & Bonkoungou, Z. (2009). Recensement général de la population et de l’habitation 2006 (RGPH 2006). Rapport d’analyse des données du RPGH 2006. Thème 07: La mortalité. Ouagadougou: Institut National de la Statistique et de la Démographie.
Boyer, F., & Delaunay, D. (2009). Ouaga 2009, Peuplement de Ouagadougou et développement urbain. Rapport provisoire (pp. 250). Ouagadougou: IRD.
Brockerhoff, M., & Brennan, E. (1998). The poverty of cities in developing countries. Population and Development Review, 24, 75–114.
Carr, D. (2004). Improving the health of the world’s poorest people (Health bulletin n°1). Washington, DC: Population Reference Bureau.
Djourdebbé, F. B., LeGrand, T., Dos Santos, S., Soura, A., & Nikiéma, A. (2011). Effet de l’environnement immédiat sur la survenue de la fièvre chez les enfants de moins de 5 ans à Ouagadougou. Paper presented at the conference of the Union for African Population Studies, 5–9 december 2011, Ouagadougou.
Dos Santos, S., Djourdebbé, F. B., Nikiéma, A., Peumi, J.-P., & Soura, A. (2011). Risques environnementaux et santé des enfants. Caractérisation des populations et des quartiers à risque à Ouagadougou. Poster presented at the conference of the Union for African Population Studies, 5–9 December 2011, Ouagadougou.
Duthé, G., & Soura, A. (2011). La mortalité dans les zones de l’ODSS. Atelier des chercheurs de l’ODSS, 18–20 juillet 2011, Ouagadougou: ISSP.
Filmer, D., & Pritchett, L. (1999). The effect of household wealth on educational attainment: Evidence from 35 countries. Population and Development Review, 25(1), 85–120.
Filmer, D., & Pritchett, L. (2001). Estimating wealth effects without expenditure data – or tears: An application to educational enrollments in states India. Demography, 28(1), 115–132.
Guengant, J. P. (2009). Evolution passée et future de la ville de Ouagadougou. dans Boyer et Delaunay, Peuplement de Ouagadougou et développement urbain. Rapport provisoire (pp. 42–49). Ouagadougou: IRD.
Gwatkin, D. R., Rutstein, S., Johnson, K., et al. (2007). Socio-economic differences in health, nutrition and population within developing countries: An overview. Nigerian Journal of Clinical Practice, 10(4), 272–282.
Hacker, A., & Ryan, C. (2003). Prevalence of infant stunting in an urban Kenyan population: Comparison to the 1998 Kenyan health and demographic survey and the 2000 CDC growth grids. Nutritional Research, 23, 1643–1649.
INSD. (2009). Annuaire statistique (2008th ed.). Ouagadougou: INSD, Burkina Faso.
INSD and Macro International. (2004). Enquête Démographique et de Santé du Burkina Faso 2003. Ouagadougou/Calverton: INSD/ORC Macro.
Lachaud, J.-P. (2001). Dynamique de pauvreté et inégalité de la mortalité des enfants au Burkina Faso, Centre d’Economie du développement, Document de travail n°66, Université Bordeaux-Montesquieu IV, 2001.
Lankoande, B., Soura, A., Millogo, R., Compaoré, Y., & Rossier, C. (2016). Surmortalité des enfants dans les quartiers informels de Ouagadougou: Effet de composition ou effet de contexte? African Population Studies, 30(1), 2192–2202.
Magadi, M., Zulu, E., & Brockerhoff, M. (2003). The inequality of maternal health care in urban sub-Saharan Africa in the 1990s. Population Studies, 57, 347–366.
Marmot, M., & Commission on Social Determinants of Health. (2007). Achieving health equity: From root causes to fair outcomes. Lancet, 370(9593), 1153–1163.
Montgomery, M. (2009, juin). Urban poverty and health in developing countries. Population Reference Bureau, 64(2).
Murray, C. J., & Lopez, A. D. (1996). The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020 (Global burden of diseases and injury series, Vol. 1). Boston: Harvard School of Public Health.
Nikiema, A., Millogo, R., Rossier, C., & Ridde, V. (2011). Inégalités de l’accès aux soins en milieu urbain africain: le cas de la périphérie nord de Ouagadougou. Paper presented at the conference of the Union for African Population Studies, 5–9 december 2011, Ouagadougou.
Rossier, C., & Ortiz, I. (2011). Unmet needs for contraception in formal and informal neighbourhoods of Ouagadougou. Paper presented at the conference of the Union for African Population Studies, Ouagadougou, December 5–9 2011.
Rossier, C., Soura, A., Lankoande, B., & Millogo, R. (2011a). Observatoire de Population de Ouagadougou. Données du R0, R1 et R2: rapport descriptif. www.isssp.bf/ODSS
Rossier, C., Soura, A., & Lankoande, B. (2011b). Migration, pauvreté et santé à la périphérie de Ouagadougou. Paper presented at the Chaire Quételet, Louvain-la-Neuve, November 16–18 2011.
Rossier, C., Lankoande, B., & Ortiz, I. (2011c). Fertility differentials in formal and informal neighbourhoods of Ouagadougou? Paper presented at the conference of the Union for African Population Studies, Ouagadougou, December 5–9 2011.
Rossier, C., Soura, A., Baya, B., & The ODSS Group. (2012). The Ouagadougou health and demographic surveillance system. International Journal of Epidemiology. doi:10.1093/ije/dys090.
Rossier, C., Soura, A., Duthé, G., & Findley, S. (2014a). Non-communicable diseases mortality and risk factors in formal and informal neighborhoods, Ouagadougou, Burkina Faso: Evidence from a health and demographic surveillance system. PloS one, 9(12), e113780.
Rossier, C., Soura, A., Duthé, G., Lankoande, B., & Millogo, R. (2014b). Are the urban poor always worse off? Socioeconomic differentials in adult cause specific mortality at the periphery of Ouagadougou, Burkina Faso. Revue Quételet, 2(2), 61–80. doi:10.14428/rqj2014.02.02.03.
Soura, B. A. (2009). Disparités spatiales de mortalité infanto-juvénile à Ouagadougou: niveaux, tendances et facteurs explicatifs. Espace, Populations, Sociétés, 1, 159–174.
Victora, C. G., Wagstaff, A., Schellenberg, J. A., et al. (2003). Applying an equity lens to child health and mortality: More of the same is not enough. Lancet, 19: 362(9379), 233–241.
World Health Organization. (2008). The global burden of disease. 2004 Update. Geneva: World Health Organization.
Zeba, A., Delisle, H., Renier, G., Savadogo, B., & Baya, B. (2012). The double burden of malnutrition and cardio-metabolic risk widens the gender and socio-economicsocio-economic health gap: A study among adults in Burkina Faso (West Africa). Pub Health Nut [FirstView Article]. March 30 2012; 1–10. Available from: http://dx.doi.org/10.1017/S1368980012000729
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Rossier, C., Soura, A.B., Lankoande, B., Millogo, R.M. (2016). Health Disparities on the Periphery of Ouagadougou. In: Ramiro Fariñas, D., Oris, M. (eds) New Approaches to Death in Cities during the Health Transition. International Studies in Population, vol 12. Springer, Cham. https://doi.org/10.1007/978-3-319-43002-7_12
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