Urban segmentations and disparities of health in an African medium-sized city: from malaria to nutritional status in Bobo-Dioulasso (Burkina Faso)

Abstract

The urbanization is a phenomenon which modifies the living conditions and the environment on all the continents. Since 2007, more half of the world population lives in urban areas, a proportion which will still tend to increase: according to projections, by 2050, 70% of the world population will be urban. The extent of the phenomenon is particularly important on Asian and African continents. On this latter, urbanization started tardily but is accelerating and concerning specifically West Africa, by 2025, it is more half of the population which will be urban. However, much of cities of the developing countries are growing without control, exposing the populations to many environmental risks which have complex medical consequences, rather badly known. It is particularly the case of the medium-sized cities which however should play a significant role in the development. Not only they are badly known but they receive much less assistance than the capitals. What lets some suggest that they would cumulate the disadvantages of the city (pollution, destruction of social links, difficulties of housing, etc.) and those of the rural areas (difficulties in water supply, lack of schools, lack of health care structures, bad access to care, etc.). By developing a research program on the town of Bobo-Dioulasso, second city of the Burkina Faso, where the relations between urbanization and health were sparsely analyzed, particularly by the medical geographers, we aim to analyze the production of the inequalities of health taking into account urbanization process according to an original methodological approach. We do not use a strictly medical design of health, by considering the all urban space as a producer of health hazards. Several health indicators were used, among them malaria and nutritional states, both on adults from 35 to 59 years and on children from 6 to 59 months, resulting from districts which have been chosen to illustrate urban diversity in order to thus