Abstract
BackgroundWith increasing urbanization in sub-Saharan Africa and poor economic performance, the growth of slums is unavoidable. About 71% of urban residents in Kenya live in slums. Slums are characteristically unplanned, underserved by social services, and their residents are largely underemployed and poor. Recent research shows that the urban poor fare worse than their rural counterparts on most health indicators, yet much about the health of the urban poor remains unknown. This study aims to quantify the burden of mortality of the residents in two Nairobi slums, using a Burden of Disease approach and data generated from a Demographic Surveillance System.MethodsData from the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) collected between January 2003 and December 2005 were analysed. Core demographic events in the NUHDSS including deaths are updated three times a year; cause of death is ascertained by verbal autopsy and cause of death is assigned according to the ICD 10 classification. Years of Life Lost due to premature mortality (YLL) were calculated by multiplying deaths in each subcategory of sex, age group and cause of death, by the Global Burden of Disease standard life expectancy at that age.ResultsThe overall mortality burden per capita was 205 YLL/1,000 person years. Children under the age of five years had more than four times the mortality burden of the rest of the population, mostly due to pneumonia and diarrhoeal diseases. Among the population aged five years and above, HIV/AIDS and tuberculosis accounted for about 50% of the mortality burden.ConclusionSlum residents in Nairobi have a high mortality burden from preventable and treatable conditions. It is necessary to focus on these vulnerable populations since their health outcomes are comparable to or even worse than the health outcomes of rural dwellers who are often the focus of most interventions.
Highlights
With increasing urbanization in sub-Saharan Africa and poor economic performance, the growth of slums is unavoidable
Africa is urbanizing at a faster rate than any other region in the world and by 2030, more than half of the population of sub-Saharan Africa will live in urban areas [1]
Current estimates from the UN HABITAT suggest that more than 70% of urban residents in sub-Saharan Africa live in slum or slum-like conditions
Summary
With increasing urbanization in sub-Saharan Africa and poor economic performance, the growth of slums is unavoidable. About 71% of urban residents in Kenya live in slums. Slums are characteristically unplanned, underserved by social services, and their residents are largely underemployed and poor. Africa is urbanizing at a faster rate than any other region in the world and by 2030, more than half of the population of sub-Saharan Africa will live in urban areas [1]. Population Health Metrics 2008, 6:1 http://www.pophealthmetrics.com/content/6/1/1 poor economic performance and lack of urban planning and regulation. This has resulted in an increase in the number and size of informal settlements or slums in many cities. Because of the informal nature of these settlements, they are underserved by health, education, water and sanitation, and garbage collection services
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