Urbanization and Reproductive Health in Informal Settlements: A Rapid Review of Evidence from Sub-Saharan Africa
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Abstract
Sub-Saharan Africa (SSA) is increasingly urbanising. This rapid urbanisation has implications for social, economic, and health systems. We conducted a rapid review of existing literature to understand the dual impacts of urbanisation on reproductive health, focusing on populations in informal settlements within urban areas of SSA. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) were adopted for this review. Documents were retrieved from the following electronic databases and search engines: Scopus, Web of Science, PubMed, Google Scholar, JSTOR, Wiley Online Library and SpringerLink. The titles and abstracts of the publications were independently screened via Rayyan review management software. A total of 21 studies met the inclusion criteria. Key findings reveal that while urbanisation enhances access to maternal healthcare services and contraceptive use, it exacerbates disparities among informal settlement residents due to economic, systemic, and environmental barriers. Emerging themes include maternal and child health inequities, unmet contraceptive needs, and the double burden of communicable and non-communicable diseases. Strategies to mitigate these challenges include infrastructure development, community-based interventions, digital health innovations, and gender-sensitive policies. This review underscores the urgent need for integrated, context-specific approaches to address reproductive health disparities in urban SSA.
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Adawudu, E. A., Aidam, K., Oduro, E., Miezah, D., & Vorderstrasse, A. (2024). The effects of Ghana’s free maternal and healthcare policy on maternal and infant healthcare: A scoping review. Health Services Insights, 17, 11786329241274481.
Adebowale, A. S., Salawu, A. T., Fagbamigbe, A. F., Khasakhala, A. A., Palamuleni, M. E., & Fawole, O. I. (2023). Demographic and epidemiological transitions and burden of adolescent healthcare in sub-Saharan Africa: A review. African Journal of Reproductive Health, 27(7), 109–126.
Agblevor, E. A., Darko, N. A., Acquah, P. A., Addom, S., Mirzoev, T., & Agyepong, I. A. (2023). “We have nice poli-cies but…”: Implementation gaps in the Ghana adolescent health service policy and strategy (2016–2020). Frontiers in Public Health, 11, 1198150. https://doi.org/10.3389/fpubh.2023.1198150
Akpabio, E. M., Wilson, N. A. U., Essien, K. A., Ansa, I. E., & Odum, P. N. (2021). Slums, women and sanitary living in South-South Nigeria. Journal of Housing and the Built Environment, 36, 1229–1248.
Akwara, E., Pinchoff, J., Abularrage, T., White, C., & Ngo, T. D. (2023). The urban environment and disparities in sexual and reproductive health outcomes in the Global South: A scoping review. Journal of Urban Health, 100(3), 525–561.
Alaazi, D. A., Menon, D., & Stafinski, T. (2021). Health, quality of life, and well-being of older slum dwellers in sub-Saharan Africa: A scoping review. Global Public Health, 16(12), 1870–1888.
Amoadu, M., Ansah, E. W., Assopiah, P., Acquah, P., Ansah, J. E., Berchie, E., & Amoah, E. (2022). Socio-cultural factors influencing adolescent pregnancy in Ghana: A scoping review. BMC Pregnancy and Childbirth, 22, 834. https://doi.org/10.1186/s12884-022-05034-8
Bachwenkizi, J., Liu, C., Meng, X., Zhang, L., Wang, W., van Donkelaar, A., et al. (2022). Maternal exposure to fine particulate matter and preterm birth and low birth weight in Africa. Environment International, 160, 107053. https://doi.org/10.1016/j.envint.2021.107053
Banke-Thomas, A., Wong, K. L., Olubodun, T., et al. (2024). Geographical accessibility to functional emergency obstetric care facilities in urban Nigeria using closer-to-reality travel time estimates: A population-based spa-tial analysis. The Lancet Global Health, 12(5), e848–e858.
Batten, J., & Brackett, A. (2022). Ensuring rigour in systematic reviews: Part 6, reporting guidelines. Heart & Lung, 52, 22–25.
Besnier, E., Thomson, K., Stonkute, D., et al. (2021). Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in LMICs: An umbrella review. PLOS ONE, 16(6), e0251905. https://doi.org/10.1371/journal.pone.0251905
Damte, E., Manteaw, B. O., & Wrigley-Asante, C. (2023). Urbanisation, climate change and health vulnerabilities in slum communities in Ghana. Journal of Climate Change and Health, 10, 100189.
Dumbuya, S., Chabinga, R., Ferede, M. A., & Sabre, M. (2024). Climate change impacts on maternal health and pregnancy outcomes in Africa. Journal of Water and Health, 22(11), 2113–2131. https://doi.org/10.2166/wh.2024.123
Duminy, J., Cleland, J., Harpham, T., et al. (2021). Urban family planning in low- and middle-income countries: A critical scoping review. Frontiers in Global Women’s Health, 2, 749636. https://doi.org/10.3389/fgwh.2021.749636
Hamel, C., Michaud, A., Thuku, M., et al. (2021). Defining rapid reviews: A systematic scoping review and thematic analysis. Journal of Clinical Epidemiology, 129, 74–85. https://doi.org/10.1016/j.jclinepi.2020.09.009
Harpham, T., Tetui, M., Smith, R., et al. (2022). Urban family planning in Sub-Saharan Africa: Cross-sectoral chal-lenges. Journal of Urban Health, 99(6), 1044–1053.
Issa, E. H. (2021). Life in a slum neighbourhood of Addis Ababa, Ethiopia: Morphological facts and dysfunctions. Heliyon, 7(5). https://doi.org/10.1016/j.heliyon.2021.e07036
Kamalipour, H. (2023). Shaping public space in informal settlements: A case study. Sustainability, 15(4), 3781. https://doi.org/10.3390/su15043781
Kolowa, T. J., Daams, M. N., & Kuffer, M. (2024). Do informal settlements contribute to sprawl in Sub-Saharan Afri-can cities? Sustainable Cities and Society, 113, 105663. https://doi.org/10.1016/j.scs.2024.105663
Lukyamuzi, Z., Tetui, M., Fonseca-Rodríguez, O., et al. (2021). Quality of care in family planning services: Differ-ences between formal and informal settlements of Kira Municipality, Uganda. Frontiers in Global Women’s Health, 2, 656616. https://doi.org/10.3389/fgwh.2021.656616
Moher, D., et al. (2015). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA state-ment. PLOS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097
Mutua, M. K., Mohamed, S. F., Porth, J. M., & Faye, C. M. (2021). Inequities in on-time childhood vaccination in Sub-Saharan Africa. American Journal of Preventive Medicine, 60(1S), S11–S23.
Patterson, A. Q., Culbreth, R. E., Kasirye, R., et al. (2022). Self-rated physical health and disparities among youth in slums of Kampala. Global Public Health, 17(11), 2962–2976.
Sakketa, T. G. (2023). Urbanisation and rural development in sub-Saharan Africa. Research in Globalisation, 6, 100133.
Schmidt, L., Mutlu, A. N. F., Elmore, R., et al. (2021). Data extraction methods for systematic review automation. F1000Research, 10. https://doi.org/10.12688/f1000research.51763.1
Tripathi, S., & Maiti, M. (2023). Does urbanisation improve health outcomes? Asia-Pacific Journal of Regional Sci-ence, 7(1), 277–316.
UN-Habitat. (2022). World cities report 2022: Envisaging the future of cities. United Nations Human Settlements Programme.
UN-Habitat. (2023). Rescuing SDG 11 for a resilient urban planet: SDG11 synthesis report. United Nations Human Settlements Programme.
Weaver, E., Richmond, A., & Pegues, K. (2023). The health of women in Sub-Saharan African informal settlements: A literature review. GeoJournal, 88(3), 3389–3397.
Ziorklui, B. E. A., Okyere, S. A., Abunyewah, M., et al. (2024). Social capital and community-driven development in informal settlements. Habitat International, 145, 103016. https://doi.org/10.1016/j.habitatint.2024.103016