ArticleBMJ global health2022
A growing disadvantage of being born in an urban area? Analysing urban-rural disparities in neonatal mortality in 21 African countries with a focus on Tanzania.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
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Who cites it
38 citing papers in PubMed.
- The Dilemmas and Opportunities of Co-Creating Health Interventions to Fit Local Contexts: An Ethnographic Study on the Adaptation of Clinical Guidelines in Tanzania.Health expectations : an international journal of public participation in health care and health policy · 2024Trial
- A machine learning approach to identify key socio-economic and demographic factors associated with neonatal mortality in Ethiopia.BMC public health · 2026Article
- Co-creation, co-design or co-production? Reflections on the development of urban health systems implementation strategies to improve access and quality of primary healthcare services in Bangladesh, Ghana, Nepal and Nigeria.Health research policy and systems · 2026Article
- Survival analysis of under-five mortality predictors: evidence from the 2011 and 2022/23 mozambique demographic and health surveys.BMC public health · 2026Article
- Maternal consumption of urbanized diet compromises early-life health in association with gut microbiota.Gut microbes · 2025Review
- 'One woman, one bed': prevalence and factors associated with women's experiences of respectful birth in urban Dar es Salaam, Tanzania - across-sectional survey.Global health action · 2025Article
- Estimating rates of treatment delay for malaria fevers among children in Sub-Saharan Africa 2006-2022.Nature communications · 2025Article
- From poverty to health: intraurban inequalities in child health indicators in low-income and middle-income countries during the SDG era.BMJ global health · 2025Article
- Modeling Geographical Accessibility and Inequalities to Childbirth Services in the Grand Nokoué Metropolitan Area, Benin.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Exploring the Factors Underlying the Narrowing Urban Advantage in Child Mortality in Sub-Saharan Africa: A Scoping Review.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Healthcare utilisation for febrile diseases in northern Tanzania: a randomised population-based cluster survey.BMJ global health · 2025Article
- Disclosing possible nonmedically indicated cesarean sections in 5 high-volume urban maternity units in Tanzania: a criterion-based clinical audit.AJOG global reports · 2025Article
- Improving complex health systems and lived environments for maternal and perinatal well-being in urban sub-Saharan Africa: the UrbanBirth Collective.Journal of global health · 2025Article
- Observational
- Spatial variations and predictors of neonatal mortality among births to HIV-infected and non-infected mothers in rural Zambia.PLOS global public health · 2025Article
- Nursing and midwifery workforce expansion as a strategic lever to reduce maternal mortality: Global evidence and policy implications from an ecological study.AIMS public health · 2025Article
- Determinants of Neonatal Mortality at a Referral Paediatric Hospital in Angola: A Case-Control Study Using Theoretical Frameworks.International journal of environmental research and public health · 2024Article
- High Child Mortality and Interventions Coverage in the City of Dar es Salaam, Tanzania: Are the Poorest Paying an Urban Penalty?Journal of urban health : bulletin of the New York Academy of Medicine · 2024Article
- Timing of cesarean section for prolonged labor in urban Tanzania: A criterion-based audit.AJOG global reports · 2024Article
- Temporalities of oxytocin for labour augmentation: a mixed-methods study of time factors shaping labour practices in a busy maternity unit in Tanzania.BMC pregnancy and childbirth · 2024Article
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9 authors.
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Abstract
introductionNeonatal mortality rate (NMR) has been declining in sub-Saharan African (SSA) countries, where historically rural areas had higher NMR compared with urban. The 2015-2016 Demographic and Health Survey (DHS) in Tanzania showed an exacerbation of an existing pattern with significantly higher NMR in urban areas. The objective of this study is to understand this disparity in SSA countries and examine the specific factors potentially underlying this association in Tanzania.
methodsWe assessed urban-rural NMR disparities among 21 SSA countries with four or more DHS, at least one of which was before 2000, using the DHS StatCompiler. For Tanzania DHS 2015-2016, descriptive statistics were carried out disaggregated by urban and rural areas, followed by bivariate and multivariable logistic regression modelling the association between urban/rural residence and neonatal mortality, adjusting for other risk factors.
resultsAmong 21 countries analysed, Tanzania was the only SSA country where urban NMR (38 per 1000 live births) was significantly higher than rural (20 per 1,000), with largest difference during first week of life. We analysed NMR on the 2015-2016 Tanzania DHS, including live births to 9736 women aged between 15 and 49 years. Several factors were significantly associated with higher NMR, including multiplicity of pregnancy, being the first child, higher maternal education, and male child sex. However, their inclusion did not attenuate the effect of urban-rural differences in NMR. In multivariable models, urban residence remained associated with double the odds of neonatal mortality compared with rural.
conclusionThere is an urgent need to understand the role of quality of facility-based care, including role of infections, and health-seeking behaviour in case of neonatal illness at home. However, additional factors might also be implicated and higher NMR within urban areas of Tanzania may signal a shift in the pattern of neonatal mortality across several other SSA countries.
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