Sharing Results from the Urban Health Study

The complete results from part one of the urban health study are now available online, and some results from part two were recently presented at the Health Systems Research Symposium.

Journal of Urban Health Supplement

Countdown undertook a multi-country study in sub-Saharan Africa to understand how living in urban slums or informal settlements impacts maternal, newborn and child health (MNCH). The first part of this study resulted in 11 papers plus an editorial which have been published in the Journal of Urban Health. The analyses include cross-country analyses related to measurement issues,  erosion of the urban advantage, and coverage of essential interventions,  plus eight country-specific analyses.

Although urban settings are often associated with better living standards and improved access to healthcare compared to rural settings, in sub-Saharan African two-thirds of urban residents live in informal or slum-like conditions.

“The findings point to significant issues with healthcare quality and living conditions affecting MNCH,” Cheikh Faye and co-authors wrote in the editorial. “An integrated approach to improving MNCH in cities must focus on the improvement of the quality of care, combined with addressing the social determinants of health inequities. The results underscore the importance of targeted analyses to guide city programs toward the poorest populations, but they also highlight the limitations of current data, primarily drawn from national surveys.”

Health Systems Research Symposium Poster Presentation

In addition to the secondary data analysis described above, the multi-country urban health study included mixed methods primary data collection in four African cities. One aspect of this study aimed to measure levels and determinants of person-centered maternity care (PCMC) among women living in urban informal settlements in Nairobi, Lusaka and Ouagadougou cities. Safia Jiwani, a Countdown researcher from Johns Hopkins University, presented these findings at the Health Systems Research Symposium in November.

PCMC was assessed using phone-based, home-based or facility-based exit surveys of women who received childbirth care in facilities serving urban informal settlements. The authors concluded that, “Women living in urban informal settlements in Nairobi, Lusaka and Ouagadougou experience inadequate person-centered maternity care and report poor communication with health providers.”  Delivery facility type and managing authority, provider type, and receipt of postnatal care were identified as important contributing factors to PCMC.