Rapid urbanization is likely to be associated with suboptimal access to essential health services. This is especially true in cities from sub-Saharan Africa (SSA), where urbanization is outpacing improvements in infrastructure. We assessed the current situation in regard to several markers of maternal, newborn, and child health, including indicators of coverage of health interventions (demand for family planning satisfied with modern methods, at least four antenatal care visits (ANC4+), institutional birth, and three doses of DPT vaccine[diphtheria, pertussis and tetanus]) and health status (stunting in children under 5 years, neonatal and under-5 mortality rates) among the poor and non-poor in the most populous cities from 38 SSA countries. We analyzed 136 population-based surveys (year range 2000–2019), contrasting the poorest 40% of households (referred to as poor) with the richest 60% (non-poor). Coverage in the most recent survey was higher for the city non-poor compared to the poor for all interventions in virtually all cities, with the largest median gap observed for ANC4+ (13.5 percentage points higher for the non-poor). Stunting, neonatal, and under-5 mortality rates were higher among the poor (7.6 percentage points, 21.2 and 10.3 deaths per 1000 live births, respectively). The gaps in coverage between the two groups were reducing, except for ANC4, with similar median average annual rate of change in both groups. Similar rates of change were also observed for stunting and the mortality indicators. Continuation of these positive trends is needed to eliminate inequalities in essential health services and child survival in SSA cities.

快速城市化可能与基本卫生服务的获取不理想有关。在撒哈拉以南非洲 (SSA) 的城市尤其如此，那里的城市化速度超过了基础设施的改善速度。我们评估了孕产妇、新生儿和儿童健康的几个指标的现状，包括健康干预覆盖率指标（现代方法满足的计划生育需求、至少四次产前检查（ANC4+）、机构分娩和3 剂 DPT 疫苗（白喉、百日咳和破伤风））以及 38 个撒哈拉以南非洲国家人口最多的城市的贫困人口和非贫困人口的健康状况（5 岁以下儿童发育迟缓、新生儿和 5 岁以下死亡率）。我们分析了 136 项基于人口的调查（年份范围为 2000 年至 2019 年），将最贫困的 40% 家庭（称为贫困家庭）与最富裕的 60% 家庭（非贫困家庭）进行了对比。在最近的调查中，几乎所有城市的所有干预措施中，城市非贫困人口的覆盖率均高于贫困人口，其中 ANC4+ 的中位数差距最大（非贫困人口高出 13.5 个百分点）。贫困人口的发育迟缓、新生儿和 5 岁以下儿童死亡率较高（每 1000 名活产婴儿分别有 7.6 个百分点、21.2 人和 10.3 人死亡）。除 ANC4 外，两组之间的覆盖率差距正在缩小，两组的中位平均年变化率相似。发育迟缓和死亡率指标也观察到类似的变化率。需要继续保持这些积极趋势，以消除撒哈拉以南非洲城市基本卫生服务和儿童生存方面的不平等。