Abstract
Background: Health and demographic surveillance systems (HDSSs) generate essential health and demographic data from longitudinal surveillance of populations resident in distinctly demarcated enumeration areas. The Cross River HDSS (CRHDSS) located in southern Nigeria includes distinct urban and rural cohorts. Concurrent surveillance of adjacent urban and rural communities provides an opportunity to identify differences in population characteristics and access or utilization of health services. In this paper, we report the result of comparative analysis of rural and urban cohorts of the CRHDSS from November 2012 to December 2018. Methodology: Data was collected through house-to-house interviews performed in 6-monthly cycles through the years. Information obtained included demographic characteristics, pregnancies, child birth, health-seeking behaviour, migration and deaths. Trained field workers collected data from all households in the demographic surveillance area with mobile Android devices (running the ODKCollect). Collected data were transferred electronically to a remote server running on ODKAggregate and further processed by MirthConnect on OpenHDS web application with a MySQL backend database. Data was exported, cleaned and analyzed with the R Statistical Computing Software. Results: Total population undergoing longitudinal health and demographic surveillance was 37,808 persons in 9,452 households with 18,414 males and 19,394 females. The rural cohort made up 47.4% of the population while the urban cohort was 52.6%. Population structure showed that while the rural cohort has a relative depletion of young adults, the urban cohort has preponderance of this population segment indicating the high rate of rural to urban migration. There is also a striking difference in pattern of utilization of reproductive health services by pregnant women. While 68.6% of childbirth in the rural cohort occurred outside the formal health service (at TBAs and at home), 79.1% of childbirth in the urban area occurred in formal health facilities. Both the crude fertility rate, infant mortality and under-five mortality rates were higher in rural than the urban cohorts. Conclusion: Surveillance data showed relative depletion of young adults from rural population cohort, suggesting high rate of rural to urban migration. Majority of childbirths in rural areas still occur outside formal health facilities, which may partly contribute to higher infant mortality rate in the rural cohort. This calls for more efforts to enhance reproductive health services and employment opportunities in rural areas. Keywords: Population, Health characteristics, births, deaths, health and demographic surveillance systems DOI : 10.7176/DCS/9-5-08 Publication date :May 31 st 2019
Highlights
Data on socioeconomic characteristics of households, health status and demographic changes of populations are vital in monitoring trends and for economic planning and projections
2.1 Study Area The Cross River health and demographic surveillance system (Cross River Health and demographic surveillance systems (HDSSs)) operates two research cohorts located within the southern senatorial district of Cross River State in south-south Nigeria, with a combined population of 37,808 persons in 9,452 households as at 2018
The first is a rural cohort located in the Akpabuyo Local Government Area (LGA) of the state and the second, an urban cohort located in Calabar Municipal, the state capital (Figure 1)
Summary
Data on socioeconomic characteristics of households, health status and demographic changes of populations are vital in monitoring trends and for economic planning and projections. While 68.6% of childbirth in the rural cohort occurred outside the formal health service (at TBAs and at home), 79.1% of childbirth in the urban area occurred in formal health facilities. Both the crude fertility rate, infant mortality and under-five mortality rates were higher in rural than the urban cohorts.Conclusion: Surveillance data showed relative depletion of young adults from rural population cohort, suggesting high rate of rural to urban migration. Majority of childbirths in rural areas still occur outside formal health facilities, which may partly contribute to higher infant mortality rate in the rural cohort This calls for more efforts to enhance reproductive health services and employment opportunities in rural areas.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
