Full Citation
Title: Impact of High-Risk Fertility Behavior on Child Mortality: Evidence from Demographic and Health Surveys
Citation Type: Dissertation/Thesis
Publication Year: 2018
ISBN:
ISSN:
DOI:
NSFID:
PMCID:
PMID:
Abstract: Child mortality is a serious issue in most part of the developing world. Every year, 5.4 million children under-five (u5) die in the world. Reduction of the child mortality from 93/1000 live birth to 39/1000 live birth is an important Sustainable Development Goal (SDG). Out of 195 countries analyzed in SDG 118 countries have already achieved the target on under-five mortality and 26 countries will get SDG target by 2030 hopefully. Remaining 51 countries could not achieve the Millennium Development Goals (MDGs). High-risk fertility behavior (HRFB) is common in Africa and South Asia which can potentially affect child mortality. Various factors associated with child mortality have been identified in the previous literature. Among other factors, women’s age at a time of childbirth, the interval between births and the birth order of the child have been pointed out as significant risks factors of child mortality. These three factors have been treated as an HRFB. The aim of the current study is to analyze the HRFB and child mortality in a cross countries context. In this study, we have examined the association between u5 child mortality and various measures of HRFB, viz., women’s age (<18 years or >33 years), the interval between births (<24 months), and the birth order of the child (>3). The present study is based on data from the demographic and health survey (DHS) 1987-2016 from a total of 24 countries from South Asia and Africa (N=1,224,832). It includes the information about the women who were 15-49 and had given birth in the last five years. We emphasize the impact of the three measures of HRFB on the odds of u5 child mortality as well as different combinations of three measures. Bivariate descriptive analysis and a multivariate logistic regression model are used to analyze the relationship between HRFB and u5 child mortality. In pooled data analysis, results show the HRFB increases the risk of under-five (u5) child mortality. In any high-risk category, women within which one condition is found in any of the three factors (women age, birth interval and birth order) were 77% more likely to child die (AOR = 1.771, 95% CI: 1.722 - 1.821). In a single high-risk category, a significant association exists between mother’s age <18 y and child mortality but mother age at childbirth >=34 y were not significantly related to under-5 mortality. However, the children born with the birth interval <24 months were 4 times more likely to die than those children who were born when preceding birth interval was >=24 months (AOR = 4.995, 95% CI: 4.842-5.152). Moreover, the birth order is a protective factor. In multiple high risk categories, women age at birth <18 y and birth interval <24months (mo), women age at birth >34 y and birth interval <24mo, women age at birth >34 y and birth interval <24mo and birth order >3, or birth interval <24mo and birth order >3 were significantly associated with the likelihood of having u5 mortality among children in 24 countries of two regions (Africa and South Asia). Out of 24 countries, there are 16 countries in which the women age <18 y or >34 y is a significant risk factor of child mortality and there is not a single country in which it is a protective factor. The association between mortality risk and birth interval <24mo is highly significant in all countries. Birth order is not much important but it is consistent. Birth order does not have any evidence because it is a risk factor in some countries while it is a protective factor in other countries. The study concludes that HRFB increases the risk of child mortality. Outcomes of the proposed study possess some critical policy implications. The governments of South Asian and African countries need to invest more in the health care system to improve the quality of care of mother and neonates. The health management system should be improved to increase awareness for potential women to get proper care from the start of pregnancy. Also, potential mothers should focus on antenatal care (ANC).
User Submitted?: No
Authors: RUBI, ANEELA
Institution: COMSATS University
Department:
Advisor:
Degree: Master of Science in Economics
Publisher Location:
Pages: 67
Data Collections: IPUMS Global Health - DHS
Topics: Fertility and Mortality, Health
Countries: United States