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

Abstract

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in ABSTRACTThere is considerable uncertainty about how reproductive factors affect child mortality. Joint determinants are difficult to control adequately for, and the studies that have dealt with selection in the most advanced ways have given diverging results. According to very simple models estimated from DHS data from 28 countries in sub-Saharan Africa, mortality is highest for first-born children with a very young mother. Also some other groups of children with a young mother, or of high birth order, have high mortality. Net of such age and birth order differences, a short preceding birth interval is associated with high mortality. The pattern does not change much if a number of other observed characteristics are controlled for, but a different picture appears if time-invariant unobserved mother-level characteristics are taken into account in a multilevel-multiprocess model. According to the latter models, the mortality of a first child goes up as the mother's age increases above 24, and younger siblings are adversely affected by the later start of childbearing as this means that their mother will be older when they are born. Avoiding a short birth interval reduces the chance that the next child dies, but this effect is weaker than suggested by the simpler models, and younger siblings have a disadvantage because their mothers are older than they otherwise would be. The conclusion is different if it is taken into account that a higher maternal age goes hand in hand with a later calendar period, which may reduce mortality. Assuming that the recent general mortality decline continues, the advice to a woman would be to avoid a very early first birth and short birth intervals. In addition to being an advantage in the short term, there are no disadvantages for the children she may have later. It is also discussed whether a woman's next child will have lower mortality than her most recently born child. The statistical analysis is backed up by a simulation experiment.Key Words: birth interval, birth order, child, DHS, infant, maternal age, mortality, multilevel-multiprocess models, sub-Saharan Africa, reproductive variables, simulation JEL codes: C30, I10, J13 SHORT ABSTRACT There is considerable uncertainty about how reproductive factors affect child mortality. Joint determinants are difficult to control adequately for, and earlier studies have given diverging results. In this study, multilevel-multiprocess models that control for t...

Impact of High-Risk Fertility Behavior on Under-five Mortality in Asia and Africa: Evidence from Demographic and Health Surveys

“…were more likely to die than those children with their mother's age >=18 years. These findings are consistent with some previous studies showing high mortality among children born from mothers (less than 18 years) [12,[36][37][38][39]. Another study shows that the mothers aged (13-19 years) have a high risk of neonatal mortality as compared to mothers of 20-34 years old [40].…”

“…Ample time is needed for the muscles of reproductive organs to gain strength and recover from depleted nutrition. Moreover, the chances of transmission of the disease increase significantly due to the short intervals [39]. Longer birth interval helps poorer families to recover from the economic losses and enables them to care new-borns [35].…”

“…months [39]. The short inter-pregnancy interval is associated with increased risk of premature membrane rupture, rupture of the uterus when women try vaginal delivery after caesarean, antepartum haemorrhage, anaemia, placental abruption which ultimately increases the risk of fetus mortality [53,54].…”

Taking birth year into account when analysing effects of maternal age on child health and other outcomes: The value of a multilevel-multiprocess model compared to a sibling model

“…This requirement is obviously satisfied in this case, since many women have more than one child. (See Steele, Sigle-Rushton, and Kravdal 2009, Väisänen 2017, and Kravdal 2018 for examples of how multilevelmultiprocess models have been used in demographic research recently. )…”

“…The reproductive factors are birth order and birth interval length in addition to maternal age. As already indicated, these are closely related to maternal age, and they have attracted much attention in the literature on how reproductive factors affect child health, mortality, and well-being (Barclay and Kolk 2017;Black, Devereux, and Salvanes 2005;Kravdal 2018). Birth year is also included in the mortality equation in most of the simulations.…”