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Urban slums report the highest death rates for children under five

Children in world’s urban slums are twice as likely to die before they reach the age of five as their richer counterparts, according to the State of the World’s Mothers 2015 report released by the Save the Children Foundation last 5 May 2015.

The first-ever assessment of disparities in health among the the rich and the poor in cities worldwide, the report warned of the widening gaps in child survival rates among the rich and poor in almost half of the 40 developing nations surveyed.

Death among newborns in cities is common, the report revealed. However, in some cities, such as in Brazil and India, death rates among newborns could be 50% higher in urban slums than in the richer neighborhoods.

Malnutrition increases susceptibility of children in slum areas to diarrheal diseases and respiratory infections, further increasing chances of dying among children in slums. For instance, in Bangladesh, 50% of children living in slums under the age of five are stunted, while 43% are underweight. The figures are 33% and 26%, respectively, in wealthier areas in the country.

Lack of access to medical and health services was cited as a major factor in the skewed death rates among rich and poor children in cities worldwide. For instance, mothers giving births at home without the attendance of trained medical personnel can result to late recognition of newborn illnesses, inadequate newborn care, and delay in appropriate medical interventions.

“While urbanization in and of itself not inherently problematic, the pace and the sheer scale of urbanization has, in many places, far exceeded local government’s ability to provide essential services, including water, sanitation, and health care,” the report discussed.

Amidst the grim statistics, Dr. Carolyn Miles, President and CEO of Save the Children, found hope in cities such as Addis Ababa and Manila. “There is no simple solution to creating more equitable cities, but a number of cities cited in the report – such as Addis Ababa in Ethiopia and Manila in the Philippines – have been successful in addressing the health needs of the poorest families, and these examples could serve as models for other cities to follow,” she said.

Manila and Addis Ababa were among the major cities that were found to be making significant gains for the poorest children, which also include Cairo, Guatemala City, Kampala and Phnom Penh. Dr. Miles explained that while these cities have conducted various programs to address the inequity in access to health care services, three major strategies were found to be consistent. These are 1) better care for mothers and babies before, during and after childbirth; 2) increased use of modern contraception to prevent or postpone pregnancy; and 3) effective strategies to provide free or subsidized quality health services for the poor.

Dr. Miles stressed that cities have the advantage of technology, highly skilled partners, and presence of health care services to address the growing divide in survivability of children in cities of the world. What must be done is to provide enough resources to fuel lifesaving programs to make health services accessible to everyone.

Calling everyone to take action, Dr. Miles said, “It’s time for all of us to set things right - to reverse the urban disadvantage, once and for all.
As cities expand and transform into megacities, we must learn how we can correctly address the unique health concerns and problems that come with it. Join the discussion on health in megacities in Manila on August 24-27, 2015 at the Global Forum on Research and Innovation for Health 2015. (RICHMOND Q. ACOSTA)