World Health & Population
Rapid urbanization and increasing urban poverty characterize much of Southern Africa, resulting in poor urban health. This study investigates inter-urban differences and determinants of undernutrition among marginalized communities. Using the 1992, 2000 and 2006/2007 Namibia Demographic and Health Survey data, we fitted hierarchical random intercept logit models, applied at 52 enumeration areas in the capital city (Windhoek), to estimate trends in undernutrition, and investigate risk factors associated with stunting and underweight. Findings demonstrate that undernutrition among children has risen (7.4% to 25.1%, p<0.001 for stunting; and 9.7% to 17.6%, p<0.001 for underweight, between 1992 and 2006/2007). The risk was pronounced for children from socioeconomically disadvantaged households (OR<1.53, 95% CI:[1.01, 2.31] for stunting and OR<2.16, 95% CI:[1.03, 4.89]for underweight). Evidence emerged of intra-urban variation in undernutrition. We argue that with increasing urbanization, comes the challenge of food insecurity and, consequently, malnutrition. For improved child health, urban planners should have targeted interventions for poor urban households and deprived neighbourhoods.
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