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The Impact of Childhood Mortality on Fertility in Rural Tanzania: Evidence from the Ifakara and Rufiji Health and Demographic Surveillance Systems

Colin Baynes, University of Washington
Almamy Malick Kante, Johns Hopkins Bloomberg School of Public Health
Jitihada Baraka, Ifakara Health Institute (IHI)
Amon Exavery, Ifakara Health Institute (IHI)
James F. Phillips, Heilbrunn Department of Population and Family Health, Columbia University, New York, NY 10032, USA

This manuscript examines the relationship between child mortality and subsequent fertility using longitudinal data on births and childhood deaths occurring to 15,291 Tanzanian mothers between 2000 and 2015. Generalized hazard regression analyses are employed to assess the effect of under-five year-old mortality on the hazard of conception, adjusting for birth year, birth order, multiple births, maternal age, child sex, educational attainment, marital status, and household wealth. Results show that childhood mortality accelerates parity progression. Time to conception is most reduced if an index child dies during its subsequent birth interval, representing the combined effect of biological and volitional replacement. This effect is slightly greater than that of the death of a previous born child during the next born child’s subsequent birth interval, an effect of volitional replacement. Deaths occurring during prior birth intervals were associated with accelerated time to conception during future intervals, which is consistent with hypothesized “insurance” effects of anticipating future child loss, but this is smaller than replacement effects. Investigation of high-order interactions suggest a tendency for insurance effects to increase as the demographic transition continues, and for wealthier families to exhibit a weaker insurance response, but stronger volitional response, to childhood mortality compared to poorer families.

Keywords: Fertility and childbirth, Longitudinal studies, Event history analysis, Mortality

See paper.

  Presented in Session 89. Health and Fertility