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Bruno Yempabou Lankoande

idence of close relatives is not collected in surveys such as DHS. To the best of my knowledge, no
attempt was made in the literature to estimate adult mortality by place of residence based on or-
phanhood data. However, few studies have used sibling survival data collected in the “maternal
mortality module” of the Demographic and Health Surveys (DHS) to explore urban/rural differences
in adult mortality in Sub-Saharan Africa. Their findings are not consistent, and this is likely due to
the different approaches adopted to circumvent the issue raised by the lack of information on the
place of residence or death of the siblings. De Walque and Filmer (2013) assumed that women and
their siblings share the same place of residence and concluded to a slightly higher mortality in rural
areas of Sub-Saharan Africa. It was an analysis of pooled data on sibling survival collected in 84
DHS surveys from 46 countries (33 of which were in Sub-Saharan Africa). The datasets covered the
period of 1975–2004 and adult mortality was measured as the risk of dying between the ages of 15
and 55. In addition to the issue of the sibling’s place of residence, the aggregated analysis con-
ducted by the authors will hide cross-country variations in the urban/rural disparities in adult mortal-
ity. Also based on sibling survival data of the DHS datasets, Günther and Harttgen (2012) docu-
mented urban/rural mortality differences at the country level in 14 Sub-Saharan countries. The risk
of dying between the ages of 15 and 45 was used as a measure of adult mortality. In complement to
the approximation made by De Walque and Filmer (2013), their analysis was restricted to siblings
reported by women who spent their entire life in an urban (rural) area. They found that in the 2000s,
out of 14 countries, urban adult mortality rates were higher than rural mortality rates for 11 countries.
For example, in Burkina Faso, urban/rural adult mortality ratio rose from 1.09 during the 10
years before the 1998 DHS to 1.33 also ten years before the 2003 DHS. These results were totally
inconsistent with estimates published in Burkina Faso’s census reports where an excess mortality in
rural areas was documented in 1984, 1995, and 2006 (INSD, 1989; 2000a; 2009a).
Faced with these inconsistent results and limitations inherent in the different methods, this paper
uses Burkina Faso as a case study to explore new strategies for providing better disaggregated mor-
tality indicators in countries lacking vital registration. Existing research on differentials in adult
mortality by urban/rural location are extended in two directions. First, I revisit together, the main
estimation methods that were used in isolation in previous studies despite their limitations. This in-
cludes the application of the orphanhood method that has never been used to look at mortality diffe-
rentials by urban/rural location. Second, the impact of limitations related to the different techniques
on mortality differentials is assessed by further analysis and thanks to the use of a specific sur-
vey conducted in 2000 which included questions on the place of residence and deaths of parents. The
study covers approximately the 1989–2006 period and starts with the presentation of the study set-
ting. Adult mortality by urban/rural location is then computed using indirect methods and multiple
data sources. The estimates are discussed and reconciled to offer a coherent picture of urban/rural
adult mortality differences in Burkina Faso. Lastly, I discuss technical issues related to adult mortal-
ity estimation by place of residence in Sub-Saharan Africa in general, and draw conclusions for the
measurement of differentials.

2 Data and Methods

2.1 Study Setting
Burkina Faso is one of the poorest countries in the world, with a population estimated at 14 million
inhabitants in 2006 (INSD, 2009b). The population size has grown at an annual rate of 3.1% between
the two last censuses (1996–2006), but the annual growth rate in the urban areas is as high as 7.1%,
more than twice the national average (INSD, 2009b). In recent years, the country has experienced a
rapid and poorly managed urbanization. As a result, a growing number of urban dwellers live in
slum-like conditions. For example, the share of slum dwellers was estimated at 30% in Ouagadou-
gou, the capital city (Boyer and Delaunay, 2009). The urbanization process is mainly driven by rural
exodus, emergence of new cities, and spatial extension of large urban centers such as Ouagadougou

International Journal of Population Studies | 2016, Volume 2, Issue 1 23