サハラ以南のアフリカにおける幼児死亡率における都市での優位性の縮小の要因を調査する
Elle Quirey Parker1,2, Gonnie Klabbers3
1Queen's University Belfast, Belfast, UK. eparker07@qub.ac.uk.
Journal of urban health : bulletin of the New York Academy of Medicine
|September 4, 2025
まとめ
サハラ以南のアフリカの子供生存における都市優位性は,非公式の都市化や都市内の不平等などの要因により縮小しています. これは伝統的な田舎と都市の比較を超えた微妙な研究の必要性を強調しています.
科学分野:
- 公衆衛生と疫学
- 都市保健研究
- サハラ以南のアフリカの保健システム
背景:
- 歴史的に見て,サハラ以南のアフリカ (SSA) の都市部よりも農村部での子供の死亡率は高く,都市部での優位性として知られています.
- 1980年代以降,この都市優位性は低下し,いくつかの地域では逆転が示されています.
- 現存する研究では 都市と農村の明確な定義が欠けていて この変化する傾向の原動力を探究する研究はほとんどありません
研究 の 目的:
- サハラ以南のアフリカ全土で 都市部での幼児死亡率の減少に寄与する要因を調査する.
- 都市部と農村部の環境,医療,社会人口,および病気に関連する決定因子の違いを調べる.
- 都市内の不平等と非公式の都市化が子どもの健康に与える影響を評価する.
主な方法:
- 1990年以降に出版された同級生審査による英語論文の範囲調査を実施した.
- SSAの都市と農村の子供の健康格差に関する研究のために,PubMed,Embase,Web of Scienceを含む主要なデータベースを検索しました.
- 体系的なレビューのためのPRISMA-ScRガイドラインに従った21の記事が含まれています.
主要な成果:
- 4つの主要な決定要因を特定しました. 環境,医療関連,社会人口統計,疾病/発病率関連で,都市と農村での重要性には違いがあります.
- 非公式な都市化とスラムの拡大がもたらす都市内格差の増大が,都市優位性の縮小の重要な要因であると強調した.
- 都市化と農村化の一貫性のない運用が観察され,しばしば空間的ニュアンスと文脈的要因が隠されている.
結論:
- 伝統的な田舎と都市の比較は,SSAの子供の健康の景観を捉えるには不十分です.
- 都市貧困と都市内不平等の空間的再構成が 子どもの健康に重大な影響を及ぼしています
- 将来の研究は,急速な都市化に伴う都市内の格差を考慮して,都市連続的なアプローチを採用すべきである.
キーワード:
子どもの健康幼児死亡率健康状態の格差幼児死亡率農村の健康農村 都市SSA についてサハラ以南のアフリカU5MR について5歳未満の死亡率都市での優位性都市保健都市部の人口都市スラム都市 農村さらに関連する動画
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