Search

The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was set up in Korogocho and Viwandani slum settlements to provide a platform for investigating linkages between urban poverty, health, and demographic and other socioeconomic outcomes, and to facilitate the evaluation of interventions to improve the wellbeing of the urban poor. Data from the NUHDSS confirm the high level of population mobility in slum settlements, and also demonstrate that slum settlements are long-term homes for many people. Research and intervention programs should take account of the duality of slum residency. Consistent with the trends observed countrywide, the data show substantial improvements in measures of child mortality, while there has been limited decline in fertility in slum settlements. The NUHDSS experience has shown that it is feasible to set up and implement long-term health and demographic surveillance system in urban slum settlements and to generate vital data for guiding policy and actions aimed at improving the wellbeing of the urban poor.

Between 60% and 70% of Nairobi City's population live in congested informal settlements, commonly referred to as slums, without proper access to sanitation, clean water, health care and other social services. Children in such areas are exposed to disproportionately high health hazards. This paper examines the impact of mother and child migration on the survival of more than 10,000 children in two of Nairobi's informal settlements--Korogocho and Viwandani--between July 2003 and June 2007, using a two-stage semi-parametric proportional hazards (Cox) model that controls for attrition and various factors that affect child survival. Results show that the slum-born have higher mortality than non-slum-born, an indication that delivery in the slums has long-term health consequences for children. Children born in the slums to women who were pregnant at the time of migration have the highest risk of dying. Given the high degree of circular migration, factors predisposing children born in the slums to recent migrant mothers to higher mortality should be better understood and addressed.

Background: Many studies have established a link between weather (primarily temperature) and daily mortality in developed countries. However, little is known about this relationship in urban populations in sub-Saharan Africa. Objectives: The objective of this study was to describe the relationship between daily weather and mortality in Nairobi, Kenya, and to evaluate this relationship with regard to cause of death, age, and sex. Methods: We utilized mortality data from the Nairobi Urban Health and Demographic Surveillance System and applied time-series models to study the relationship between daily weather and mortality for a population of approximately 60,000 during the period 2003-2008. We used a distributed lag approach to model the delayed effect of weather on mortality, stratified by cause of death, age, and sex. Results: Increasing temperatures (above 75th percentile) were significantly associated with mortality in children and non-communicable disease (NCD) deaths. We found all-cause mortality of shorter lag of same day and previous day to increase by 3.0% for a 1 degree decrease from the 25th percentile of 18°C (not statistically significant). Mortality among people aged 50+ and children aged below 5 years appeared most susceptible to cold compared to other age groups. Rainfall, in the lag period of 0-29 days, increased all-cause mortality in general, but was found strongest related to mortality among females. Low temperatures were associated with deaths due to acute infections, whereas rainfall was associated with all-cause pneumonia and NCD deaths. Conclusions: Increases in mortality were associated with both hot and cold weather as well as rainfall in Nairobi, but the relationship differed with regard to age, sex, and cause of death. Our findings indicate that weather-related mortality is a public health concern for the population in the informal settlements of Nairobi, Kenya, especially if current trends in climate change continue. [ABSTRACT FROM AUTHOR]