Health Risks In Poor Urban Households In Nigeria

Until recently, the general perception was that child health outcomes are better in urban than in rural areas in sub-Saharan Africa. Due to this general perception, previous efforts on health are focused on children in the rural areas. However, the 2012 UNICEF State of the World Children Report shows that children in most of the urban areas across the globe are facing greater health risks associated with urbanisation. In Nigeria, about 50 per cent of the over 160 million people in the country live in urban areas. This study investigated if poor households are facing higher health risks in Nigeria and to explain reasons if so. The paper first used concentration index to determine the magnitude and direction of change in rural-urban disparity in child nutritional status measured by height for-age z-scores between 1999 and 2008. Secondly, it adjusted the gaps in children health outcomes for differences in rural and urban population characteristics. While concentration index was used to measure socioeconomic health inequality, Blinder-Oaxaca decomposition was used to determine the degree of health inequality between the rich and the poor in the urban and rural areas. The results showed that childhood malnutrition measured by negative height for-age z-scores persisted and even deteriorated to the disadvantage of children in poor urban households. The results further show that gaps in maternal and paternal levels of education, gaps in maternal heights and geo-political variations were the main causes of the prevalence of stunting amongst poor children in both rural and urban areas in Nigeria. The paper, therefore, argues that urbanisation without concerted efforts to reduce existing gaps in the determinants of health outcomes does not benefit the poor.