title: Understanding inequities in child vaccination rates among the urban poor: evidence from Nairobi and Ouagadougou health and demographic surveillance systems.
abstract: Studies on informal settlements in sub-Saharan Africa have questioned the health benefits of urban residence, but this should not suggest that informal settlements (within cities and across cities and/or countries) are homogeneous. They vary in terms of poverty, pollution, overcrowding, criminality, and social exclusion. Moreover, while some informal settlements completely lack public services, others have access to health facilities, sewers, running water, and electricity. There are few comparative studies that have looked at informal settlements across countries accounting for these contextual nuances. In this paper, we comparatively examine the differences in child vaccination rates between Nairobi and Ouagadougou's informal settlements. We further investigate whether the identified differences are related to the differences in demographic and socioeconomic composition between the two settings. We use data from the Ouagadougou and Nairobi Urban Health and Demographic Surveillance Systems (HDSSs), which are the only two urban-based HDSSs in Africa. The results show that children in the slums of Nairobi are less vaccinated than children in the informal settlements in Ouagadougou. The difference in child vaccination rates between Nairobi and Ouagadougou informal settlements are not related to the differences in their demographic and socioeconomic composition but to the inequalities in access to immunization services.
authors.affiliation: University of Ouagadougou, Ouagadougou, Burkina Faso, asoura@issp.bf.
authors.forename: Abdramane Bassiahi
authors.initials: AB
authors.lastname: Soura
authors.forename: Blessing
authors.initials: B
authors.lastname: Mberu
authors.forename: Patricia
authors.initials: P
authors.lastname: Elungata
authors.forename: Bruno
authors.initials: B
authors.lastname: Lankoande
authors.forename: Roch
authors.initials: R
authors.lastname: Millogo
authors.forename: Donatien
authors.initials: D
authors.lastname: Beguy
authors.forename: Yacouba
authors.initials: Y
authors.lastname: Compaore
mesh_terms: D002050:Burkina Faso; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D000069576:Health Equity / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007630:Kenya; D008297:Male; D011204:Poverty Areas; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*