[Ibadan Journal of Sociology, June, 2019, 9 ]
[© 2014-2019 Ibadan Journal of Sociology]71INTRODUCTION
The burden of under-five mortality poses a serious challenge to the social
and economic development of countries in sub-Saharan Africa (SSA)
(World Health Statistics, 2018). Although, there has been a reduction in
under-five mortality rate (U5MR) in SSA from 182 in 1990 to 76 deaths per
1000 live births in 2017, this estimate undermines the target of the
Sustainable Development Goal 3 (Target 3.2) to reduce U5MR to at least as
low as 25 deaths per 1,000 live births by the year 2030 (SDGs, UN, 2015;
UN-IGME, 2018). This high burden of 1 out 13 under five children dying
mostly from preventable and treatable causes is excessive compared to high
income countries where under five deaths occurred in 1 out of 185 (UN-
IGME 2018).
Studies have also shown that pneumonia, diarrhea and malaria still
remain the leading infectious diseases causing majority of U5M in West,
Central and sub-Saharan Africa (World Health Statistics, 2018). For
example, pneumonia and diarrhea account for 17 and 10 percents of U5M,
while malaria accounts for 13 percent of the deaths in SSA (UNICEF,
2015). While it is acknowledged that infectious diseases account for the
largest cause of U5M in SSA (World Health Statistics, 2018) the
environment and the socio-economic status (SES) to which children are
born affect their survivability (Zainal, Kaur, Ahmad, & Khalili, 2012;
Adedini et al., 2015; Arku et al., 2016; Beatriz, Molnar, Griffith, & Salhi,
2018)
Although the rate of U5M in the rural areas are 1.7 times higher
than in urban centers and 1.9 times higher among the poor than the rich
(UNICEF, 2015), it is believed that there is need to look beyond the rural-
urban differentials when comparing the group that are most affected with
this epidemic. Due to the influence of rural-urban migration in most less
developed countries (LDCs), urban expansion has become a common
demographic phenomenon in the cities. One of the consequences of this
expansion is the growth of urban slums and suburbs (Adekola, 2016),
particularly in high mortality rated countries. In regard to this, there is a
wide disparity in U5MR between the poor and the rich in urban centers.
Again, the emergence of slums in low income countries has led to a larger
proportion of urban dwellers living in harsh conditions (Siddiqui et al.,
2016; Gruebner et al., 2017), which indicates a likelihood of impacting
negatively on the survivability of children below the age five in such
environment.
This suggests that apart from the medical causes of U5M in many
LDCs, “there are likely social determinants of health within and across
different countries that influence health inequities due to the conditions in