Fertility and Reproductive Health in Developing Countries: What Is the Urban Dimension?

Mark R. Montgomery, Population Council

This paper reports new findings on reproductive health in the cities of developing countries, drawing from the forthcoming U.S. National Academy of Sciences report, Cities Transformed. We first set out a theory of reproductive decision-making in LDC urban environments, giving emphasis to urban socioeconomic diversity, neighborhood effects, social networks, and externalities. We then examine how relative poverty affects reproductive health. Using data from the DHS, we compare three groups: rural dwellers, the urban poor, and the urban non-poor. We find that the urban poor suffer from reproductive health disadvantages that are much like those afflicting rural populations; in some instances, the urban poor are just as disadvantaged as rural residents. Finally, we study the spatially concentrated urban poor---those who live in slums and squatter settlements---whose levels of disadvantage are found often to exceed rural levels. The paper concludes with a discussion of the urban services and program environment.