ArticleBMJ open2022
Quantifying within-city inequalities in child mortality across neighbourhoods in Accra, Ghana: a Bayesian spatial analysis.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation of the Community-based Health Planning and Services (CHPS) in rural and urban Ghana: a history and systematic review of what works, for whom and why.Frontiers in public health · 2023Pooled it
- Exposure of children to multiple long-term air pollutants (PMEnvironmental research letters : ERL [Web site] · 2026Article
- Measurement of urban vitality with time-lapsed street-view images and object-detection for scalable assessment of pedestrian-sidewalk dynamics.ISPRS journal of photogrammetry and remote sensing : official publication of the International Society for Photogrammetry and Remote Sensing (ISPRS) · 2025Article
- Article
- From consumption to context: assessing poverty and inequality across diverse socio-ecological systems in Ghana.Environmental research communications · 2024Article
- Investigation of Factors Influencing Infant Mortality at Greater Accra Regional Hospital, Ghana.BioMed research international · 2024Article
- Strangers in a strange land: mapping household and neighbourhood associations with improved wellbeing outcomes in Accra, Ghana.Cities (London, England) · 2023Article
- Spatial spillover impact of determinants on child mortality in Pakistan: evidence from Spatial Durbin Model.BMC public health · 2023Article
- Characterisation of urban environment and activity across space and time using street images and deep learning in Accra.Scientific reports · 2022Article
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Authors and funding
15 authors.
Funding
Abstract
objectiveCountries in sub-Saharan Africa suffer the highest rates of child mortality worldwide. Urban areas tend to have lower mortality than rural areas, but these comparisons likely mask large within-city inequalities. We aimed to estimate rates of under-five mortality (U5M) at the neighbourhood level for Ghana's Greater Accra Metropolitan Area (GAMA) and measure the extent of intraurban inequalities.
methodsWe accessed data on >700 000 women aged 25-49 years living in GAMA using the most recent Ghana census (2010). We summarised counts of child births and deaths by five-year age group of women and neighbourhood (n=406) and applied indirect demographic methods to convert the summaries to yearly probabilities of death before age five years. We fitted a Bayesian spatiotemporal model to the neighbourhood U5M probabilities to obtain estimates for the year 2010 and examined their correlations with indicators of neighbourhood living and socioeconomic conditions.
resultsU5M varied almost five-fold across neighbourhoods in GAMA in 2010, ranging from 28 (95% credible interval (CrI) 8 to 63) to 138 (95% CrI 111 to 167) deaths per 1000 live births. U5M was highest in neighbourhoods of the central urban core and industrial areas, with an average of 95 deaths per 1000 live births across these neighbourhoods. Peri-urban neighbourhoods performed better, on average, but rates varied more across neighbourhoods compared with neighbourhoods in the central urban areas. U5M was negatively correlated with multiple indicators of improved living and socioeconomic conditions among peri-urban neighbourhoods. Among urban neighbourhoods, correlations with these factors were weaker or, in some cases, reversed, including with median household consumption and women's schooling.
conclusionReducing child mortality in high-burden urban neighbourhoods in GAMA, where a substantial portion of the urban population resides, should be prioritised as part of continued efforts to meet the Sustainable Development Goal national target of less than 25 deaths per 1000 live births.
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