Infant death clustering in families: Magnitude, causes, and the influence of better health services, Bangladesh 1982–2005

Abstract

This analysis of infant mortality in Bangladesh focuses on explaining death clustering within families, using prospective data from a rural region in Bangladesh, split into areas with and without extensive health services (the area covered by the International Centre for Diarrhoeal Disease Research and the comparison area, respectively). The modelling framework distinguishes between two explanations of death clustering: (observed and unobserved) heterogeneity across families and a causal 'scarring' effect of the death of one infant on the survival chances of the next to be born. Keeping observed and unobserved characteristics constant, we find scarring in the comparison area only. There the likelihood of infant death is about 29 per cent greater if the previous sibling died in infancy than otherwise. This effect mainly works through birth intervals: infant deaths are followed by shorter birth intervals, which increases the risk of infant death for the next child.

Does Family Planning Reduce Infant Mortality? Evidence From Surveillance Data in Matlab, Bangladesh

“…The parameter estimates in the mortality equation in Table 3 are largely in line with the general conclusions about the determinants of infant mortality in developing countries (see Bhalotra and van Soest 2008;Omariba et al 2008) and Saha and van Soest (2011). A difference compared to our earlier study (Saha and van Soest) is that in the current study, the effect of lagged mortality on the probability of infant death is negative but insignificant, while in Saha and van Soest it was negative and significant at the 5 percent level when the birth interval was controlled for as an exogenous covariate (Table 5).…”

“…Estimates for the static equation for mortality of the first child are available upon request; they are very similar to those in Saha and van Soest (2011).…”

“…The data cover the period July 1982 to December 2005; the data before 1982 are not (yet) available for this type of research. A similar set of data was used in several companion papers like Saha and van Soest (2011), but this is the first time we also consider the contraceptive use data available after each birth.…”

Clustering of Neonatal Deaths inBangladesh: Results From theProjahnmo Studies

“…We restricted our investigation to babies born between 2001 and 2005. It was reasonable to look at only a short time window within which neonatal mortality rates (NMRs) were fairly constant because, over the years, there have been improved programmes for neonatal care and improvements in mothers' education and nutrition …”

“…Within countries, large proportions of childhood or neonatal deaths are clustered geographically and within certain households. Such clustering has been explained in some settings by variations in socio‐economic factors, access to care, maternal health, nutrition and genetic factors . There also tends to be within‐mother correlation such that a mother who has experienced one neonatal death is more likely to lose subsequent children in the neonatal period.…”