Urbanization and Demographic Change in Sub-Saharan Africa: Three essays on fertility and child mortality differentials in a rapidly urbanizing context

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Doctor of Philosophy (PhD)
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child mortality
internal migration
rural-urban differentials
sub-Saharan Africa
African Languages and Societies
African Studies
Demography, Population, and Ecology
Medicine and Health Sciences
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Nearly all demographic research on sub-Saharan Africa (SSA) utilizes a strict urban/rural dichotomy, which implicitly assumes homogenous demographic outcomes within these categories. In this dissertation, I use data from the Demographic and Health Surveys (DHS) to demonstrate that using an urban continuum reveals substantial differences in the demographic outcomes among SSA's growing urban settlements. In the first chapter, I use event-history analysis to examine whether SSA's long-held urban child survival advantage is diminishing, accounting for differentials in city size and potential bias in survival rates due to migration. I find the overall under-5 survival advantage of urban over rural areas persists but that there is a widening of the advantage in the largest cities over smaller urban areas. In the second chapter, I model annual birth probabilities to examine whether there is a discernible "urban effect" of lower fertility among internal migrants in West Africa. Results suggest an association of urban residence and lower fertility, as women who moved either to or from urban areas have lower annual odds of a birth compared to both rural non-migrants and rural-to-rural migrants. I also find that women who relocate to the largest cities have lower fertility than do women who move to smaller urban areas, suggesting that the influence of urban residence on fertility is strongest where fertility rates are lowest. In the final chapter, I estimate total fertility rates and under-5 mortality probabilities for cities of different size in West Africa by linking DHS cluster data to census and geographic information systems (GIS) data for four distinct urban sub-categories. Results show a clear gradient in fertility and child mortality in urban areas according to size, with the largest cities most advantaged; this gradient is as steep between the largest and smallest urban areas as it is between the smallest urban and rural areas. I use the findings from this dissertation to argue for wider use of urban continuums in demographic research on SSA instead of the continued reliance on a strict urban/rural dichotomy that obscures important nuances in the interrelationship of urbanization and demographic change in this rapidly-urbanizing region.

Michel Guillot
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