Contraceptive Use, Birth Spacing, and Child Survival in Matlab, Bangladesh

Abstract

To reduce infant mortality through improved family planning, a better understanding of the factors driving contraceptive use and how this decision affects infant survival is needed. Using dynamic panel-data models of infant deaths, birth intervals, and contraceptive use, this study analyzes the causal effects of birth spacing on subsequent infant mortality and of infant mortality on the use of contraceptives and the length of the next birth interval. Data are drawn from the Health and Demographic Surveillance System in Matlab, Bangladesh, where almost 32,000 births have been observed from 1982 to 2005. Our main finding is that complete contraceptive use could reduce infant mortality of birth order two and higher by 7.9 percent. The net effect of complete contraceptive use on the total infant mortality rate is small (2.9 percent), however, because the favorable effect on higher order births is partly offset by the rise in the proportion of high-risk first births.

COX’S PROPORTIONAL HAZARD MODEL AND CONSTRUCTION OF LIFE TABLE FOR UNDER-FIVE

“…The present finding is in line of the findings of Tsui and Creanga (2009) and Saha and Soest (2013). Mensch in his study on the effect of child mortality on contraceptive use and fertility in Colombia, Costa Rica and Korea, suggests that contraceptive use by women tends to reduce child mortality.…”

“…Mensch in his study on the effect of child mortality on contraceptive use and fertility in Colombia, Costa Rica and Korea, suggests that contraceptive use by women tends to reduce child mortality. Saha and Soest (2013) also express that complete contraceptive use could reduce infant mortality of birth order two and higher by 7.9%. The net effect of complete contraceptive use on the total infant mortality rate is small, because the favorable effect on higher order births is partly offset by the rise in the proportion of high-risk first births.…”

New evidence about effects of reproductive variables on child mortality in sub-Saharan Africa

“…However, an effect in this direction is theoretically plausible: There may be an accumulation of maternal health problems over age (Geronimus 1992) that outweighs various physiological and social advantages that have attracted more attention in this literature. Besides, adverse effects of maternal age from a quite low age or over the entire age span have been reported also in earlier studies of child mortality in a general poor population (Saha and van Soest 2013) or in a disadvantaged sub-group in rich settings (Powers 2013). Such effects have appeared also in studies of birth weight among minority groups in the US (Love et al, 2010) and the UK (Goisis and Sigle-Rushton, 2014).…”

“…The analysis was based on all 28 Demographic and Health Surveys (DHS) conducted in subSaharan Africa after 2010 and available at the end of 2015: Benin 2011, Burkina Faso 2010, Burundi 2010, Cameroon 2011, Congo (Brazzaville) 2011, Cote d'Ivoire 2011, Democratic Republic of Congo 2013, Ethiopia 2011, Gabon 2012, Gambia 2013, Ghana 2014, Guinea 2012, Lesotho 2009/10, Liberia 2013, Malawi 2010, Mali 2012, Mozambique 2011, Namibia 2013, Niger 2012, Nigeria 2013, Rwanda 2010, Senegal 2010, Sierra Leone 2013,Tanzania 2010, Togo 2010, Uganda 2011, Zambia 2013, and Zimbabwe 2010 1 For simplicity, women with at least one twin were left out, as in many earlier studies (Davanzo et al, 2008;Saha and van Soest, 2013). 2 The focus was on the mortality of children born less than 10 years before interview, as a compromise between analyzing a recent period and including many children.…”

“…Besides, other models with correlated fertility and mortality random terms have been used in studies of the importance of reproductive factors for child mortality in South Asia (Makepeace and Pal 2008;Saha and van Soest 2013;Bhalotra and van Soest 2008). However, fertility was modelled very differently in the latter studies, with equations for birth intervals after the first birth.…”