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Population, développement et environnement dans la métropole d’Accra : une étude en deux phases

GH1

Les disparités spatiales de mortalité et de santé sont particulièrement aiguës dans les villes du Sud, dépourvues de mécanismes pour redresser ces inégalités. De plus, distinguer les effets de structures et des caractéristiques de la population des effets liés à la localisation représente souvent un défi en raison du manque de données. Mais pour notre étude sur Accra au Ghana, nous avons pu combiner les données de recensement, d’enquêtes et d’état civil à l’imagerie satellitaire et aux méthodes d’analyse spatiale ainsi qu’à l’évaluation des perceptions locales de l’environnement. Le projet indique plusieurs interventions réalisables limitant l’incidence de paludisme et des maladies diarrhéiques ainsi que les différentiels de santé entre quartiers. Un travail complémentaire est prévu pour quantifier le fardeau de morbidité par cause dans la ville, fournissant ainsi une justification économique pour l’intervention.

Fiche signalétique

Country : Ghana
Language : English, Twi
Team leader : Professor John K. Anarfi, Institute for Statistical, Social and Economic Research (ISSER), University of Ghana, POB LG 74, Legon, Accra, Ghana. Telephone : +233 21 501182, Fax : +233 21 500937, jkanarfi@yahoo.com
Team members :
 ; Name First name  ; Parent organisation  ; Description of Responsibilities ; ANARFI John K. ISSER ; University of Ghana ; Research Team leader and Director of the diverse activities undertaken by the project. Participation (...)

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Problématique, objectifs, contextes, enjeux

This research was designed to test the hypothesis that health levels in urban places are importantly influenced by the local neighbourhood environment, including the nature of the built environment (buildings and infrastructure), the socio-economic environment (including average levels of income and education as well as the availability and judicious use of resources), and the location of a neighbourhood within the broader urban environment (including its proximity to health clinics and (...)

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Méthodologie

The first phase of the project involved the collation of existing census, survey and health data for the city and organizing these data in a common geographical database. The primary unit of analysis was the 2000 census Enumeration Areas (EAs) of which there are 1741 in the city. The census data allow the calculation of a measure of early childhood mortality as well as providing detailed information about living conditions at the household level. The routine death registration data for (...)

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Résultats

For the first phase, we began with a relatively simple model of intra-urban health patterns in Accra, hypothesizing that there was spatial variability in health within Accra and that this would be explained by the local neighbourhood environment, including the nature of the built environment (buildings and infrastructure), the socio-economic environment community and contextual factors. Our results suggest that our original hypotheses were not wrong, per se, but that the health situation in (...)

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Conclusions et implications politiques

Generally, we have shown that there are very marked differentials in health and mortality in Accra which have a clear spatial expression. There are in addition very clear differentials in income with a similarly strong spatial pattern. Contrary to our expectations, at this ecological level of analysis, poverty was not very highly predictive of health. We did find a strong effect of ethnicity which serves as a measure for the strong effect of other sorting processes. We also found that using (...)

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