Population,
Development
and
Environment in
Accra: a
collaborative
two-phase study
John K Anarfi, George Botchie, Samuel
Agyei-Mensah (University of Ghana)
Allan G Hill (Harvard University)
John R Weeks (San Diego State University)
Aims
To show how health in cities is strongly
affected by the local neighbourhood
To distinguish the effects of the socio-
economic status of households from the effects
of environmental factors on mortality and
health
To decompose the environmental factors into
a) physical and biological effects and b) effects
associated with the socio-economic
characteristics of the population of the
neighbourhood
To generalize the methods for application
beyond Accra
To suggest the best strategy for the
improvement of the health in cities in Africa
Socio-economic Indicator - AMA
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
185169253337421505589673757841925100910931177126113451429151315971681EA
% Households with Characteristics
Main sources of information
10% sample of HHs from 2000
census with EA shape files
Women’s Health Survey of Accra
2003
Quickbird Digital Globe multi-spectral
satellite image
Under 5 mortality in
Accra from the 2000
census
ACCRA – SAMPLE EAs FOR
THE WOMEN’S HEALTH
SURVEY 2003
ISSER, University
of Ghana at Legon
University of Ghana
Medical School at Korle Bu
Additional Studies
Cause of death from the Registry of Births
and Deaths 1999-2001 – 38,000
medically-certified deaths. Census 2000
denominators
2003 DHS survey
2003 World Health Survey
Census of health facilities and providers
Urban agriculture and malaria –
Klinkenberg & Donnelly
Household cooking arrangements and risk
factors for respiratory illnesses – Majid
Ezzati
Poverty and health: a weak association
Poverty and vegetation: % vegetative cover
and normalized difference vegetation index
Health and vegetation: % vegetative
cover and normalized difference
vegetation index
Source: Klinkenberg et al.
2005
Ga in Accra (%)
Akan in
Accra
The sorting
process at work
Source: