Urban inequities; urban rights: a conceptual analysis and review of impacts on children, and policies to address them

Development and Validation of the Quality of Life in the Neighborhood Questionnaire for Children 8 to 10 Years of Age (QoL-N-Kids 8-10)

Create and evaluate the psychometric properties of the Quality of Life in the Neighborhood Questionnaire for Children 8 to 10 years of Age (QoL-N-Kids 8-10). The present study was conducted in a medium-sized city in southeastern Brazil with children at four public schools and one private school. The study involved three phases: a) generation and validation of the content of the items through a qualitative study and expert panel (n = 8); b) face validity through a pilot study and interviews with children (n = 30); and c) application of the final version (n = 261) for the evaluation of internal consistency, temporal stability, construct validity and discriminant validity. All statistical tests applied during this step were interpreted considering a 5% significance level. Among the 56 items generated, 38 were maintained in the scale and submitted to face validation. In this phase, the children suggested the inclusion of an additional item, resulting in a measure with 39 items. The questionnaire was submitted to reliability tests (Cronbach's alpha) and exploratory factor analysis, leading to a questionnaire with 27 items distributed among five domains. The measures exhibited good internal consistency (Cronbach's alpha = 0.805) and good test-retest reliability (weighted Kappa = 0.305 to 0.724; intraclass correlation coefficient = 0.917). Regarding discriminant validity, differences between groups (p < 0.001) were found for sex, age, income and place of residence. The QoL-N-Kids 8-10 instrument exhibited satisfactory psychometric properties and has potential for the assessment of neighborhood quality of life in children eight to ten years of age.

Brazilian Children's Understanding of the Quality of Life in Their Living Environment: A Qualitative Study

(1) Objective: To understand the perception of Brazilian children about the Quality of Life (QoL) considering their living environment. (2) Methods: This is a qualitative study conducted with children aged 6–10 years, from a medium-sized Brazilian municipality, recruited from public and private schools. An adaptation of the “draw, write, and say” method was used to collect data. At first, all children (n = 252) drew a “neighborhood with QoL”. On the same day, the researcher analyzed the graphic elements of the representations and intentionally selected the two best-detailed drawings from each class (n = 49) and the children were invited to narrate them. The narratives were analyzed through content analysis. (3) Results: Two major themes emerged from the content analysis, namely, the physical environment and social environment. The first included the needs to live in a community, such as housing, places of leisure, essential services, and natural elements. The second was relationships with family and friends. (4) Conclusion: The children presented the meaning of an environment with QoL, pointing out essential items to have this ideal environment. The social environment and the physical environment were perceived interdependently; that is, any change in one of these aspects may affect children’s QoL.

Inequalities in child mortality in ten major African cities

BACKGROUND

The existence of socio-economic inequalities in child mortality is well documented. African cities grow faster than cities in most other regions of the world; and inequalities in African cities are thought to be particularly large. Revealing health-related inequalities is essential in order for governments to be able to act against them. This study aimed to systematically compare inequalities in child mortality across 10 major African cities (Cairo, Lagos, Kinshasa, Luanda, Abidjan, Dar es Salaam, Nairobi, Dakar, Addis Ababa, Accra), and to investigate trends in such inequalities over time.

METHODS

Data from two rounds of demographic and health surveys (DHS) were used for this study (if available): one from around the year 2000 and one from between 2007 and 2011. Child mortality rates within cities were calculated by population wealth quintiles. Inequality in child mortality was assessed by computing two measures of relative inequality (the rate ratio and the concentration index) and two measures of absolute inequality (the difference and the Erreyger's index).

RESULTS

Mean child mortality rates ranged from about 39 deaths per 1,000 live births in Cairo (2008) to about 107 deaths per 1,000 live births in Dar es Salaam (2010). Significant inequalities were found in Kinshasa, Luanda, Abidjan, and Addis Ababa in the most recent survey. The difference between the poorest quintile and the richest quintile was as much as 108 deaths per 1,000 live births (95% confidence interval 55 to 166) in Abidjan in 2011-2012. When comparing inequalities across cities or over time, confidence intervals of all measures almost always overlap. Nevertheless, inequalities appear to have increased in Abidjan, while they appear to have decreased in Cairo, Lagos, Dar es Salaam, Nairobi and Dakar.

CONCLUSIONS

Considerable inequalities exist in almost all cities but the level of inequalities and their development over time appear to differ across cities. This implies that inequalities are amenable to policy interventions and that it is worth investigating why inequalities are higher in one city than in another. However, larger samples are needed in order to improve the certainty of our results. Currently available data samples from DHS are too small to reliably quantify the level of inequalities within cities.