Researchers from the International Center for Equity in Health (ICEH) have published two articles in the Journal of Urban Health supplement, which compiles studies on health inequalities in cities across the African continent.

Both ICEH articles used data from the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) in from Sub-Saharan African countries, a region where over 430 million people are estimated to live. Additionally, the urban population growth rate in this region this region's urban population growth rate exceeds 4% per year, and this increase has not been accompanied by a comparable improvement in infrastructure and health conditionsa comparable improvement in infrastructure and health conditions has not accompanied this increase. As a result, the poorest urban populations often live in more adverse conditions than the wealthiest. Understanding these populations and their characteristics is essential to improving their living conditions and helping them achieve their full health and well-being potential.

The article led by Fernando Wehrmeister addresses the complex issue of determining socioeconomic position in studies on health inequalities. The primary objectives of the study were to identify the most appropriate measure to distinguish poorer populations from wealthier ones in the largest cities of 38 countries, classify them by education levels, living standards, and inequalities, and correlate these estimates with macro-level determinants such as the Human Development Index (HDI) and its components.

The results indicate that a wealth-based poverty classification is more effective when analyzing survey data in large urban settings. These measures correlate well with absolute measures and can distinguish between poor and wealthy populations regarding various relevant socioeconomic outcomes.

This definition underpinned the poverty classification used in the article led by researcher Cauane Blumenberg, which assessed the coverage, trends, and inequalities of maternal, neonatal, and child health indicators. The indicators analyzed included health interventions such as demand for family planning satisfied with modern methods, number of prenatal antenatal care visits, institutional deliveries, and three doses of the DPT vaccine (diphtheria, pertussis, and tetanus), as well as impact indicators like stunting, neonatal mortality rates, and under-five mortality rates.

The results showed that, overall, intervention coverage was higher among the non-poor in cities compared to the poor. However, in all cities, the gap between poor and non-poor populations is narrowing for most health interventions, though not for the impact indicators. To achieve improvements in all aspects of urban health, it is crucial to adopt approaches that recognize African cities as unjust spaces but also as central to efforts aimed at achievingand central to efforts to achieve the Sustainable Development Goals (SDGs) agenda by 2030.

Both articles by ICEH researchers include supplementary materials with detailed data on each of the indicatorsindicator, which are essential for understanding the complex urban health systems of the African continent. Access the full articles and the entire supplement content at:  the Journal of Urban Health.