Inequalities and trends in under-five mortality between formal and informal settlements in Ouagadougou, Burkina Faso

Abstract The expansion dynamic of the city of Ouagadougou through the establishment of spontaneous habitat zones faded in 2015 by the banning of subdivision operations. This ban has been coupled with a strategy of servicing these urban spaces and the implementation of social policies such as free health care. It is in this context that this research tests the convergence of infant and child mortality levels between formal and informal neighbourhoods in the city. It is based on all-cause mortality data collected prospectively in the Ouagadougou Population Observatory (OPO) over the period 2010-2018. Analyses of these data are based on the calculation of allcause and cause mortality rates and a Poisson regression model. Over the entire period considered, children in formal neighbourhoods enjoy a health advantage compared to those in formal neighbourhoods. However, these inequalities have decreased over time, especially at the end of the (2016-2018) period, due to a more sustained decline in mortality in informal settlements. This sharp decline in mortality in informal settlements is explained by a rapid decline in deaths from malaria and respiratory infections. The pursuit of policies for the maintenance of informal settlements and the implementation of social policies targeting the poorest is likely to accelerate the mortality transition at the scale of the city of Ouagadougou.