This study addresses important issues in infant and child mortality in Zimbabwe. The objective of the paper is to determine the impact of maternal, socioeconomic and sanitation variables on infant and child mortality. Results show that births of order 6+ with a short preceding interval had the highest risk of infant mortality. The infant mortality risk associated with multiple births was 2.08 times higher relative to singleton births (p<0.001). Socioeconomic variables did not have a distinct impact on infant mortality. Determinants of child mortality were different in relative importance from those of infant mortality. This study supports health policy initiatives to stimulate use of family planning methods to increase birth spacing. These and other results are expected to assist policy makers and programme managers in the child health sector to formulate appropriate strategies to improve the situation of children under 5 in Zimbabwe.

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SummaryTo examine trends in incidence of multiple births (MB) and their survival in infancy, we used population-based, longitudinal data derived from the Health and Demographic Surveillance System in Matlab, Bangladesh, from 1975 to 2002. Logistic regression was applied to determine the impact of a number of variables on mortality among MB in the first year of life. MB averaged 2% of all live births, but contributed 10% to all infant deaths. Infant mortality among MB was more than five times higher than among singletons. Mortality among MB declined by 27% in 1975-2002, considerably less than the 51% mortality decline among singletons in the same period. Infant mortality among twins and triplets was particularly high among children who were born to young mothers (<20 years), who were the first live birth, who were born after a short birth interval (<24 months) and whose mothers were unschooled. Mortality of MB was lower in the area with easy access to high-quality maternal and child-care services. Thus, good maternity and newborn care will improve the survival of MB.

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This study examines the effects of spouses' prior marital status and socio-demographic characteristics on the risk of divorce of 1762 Muslim marriages recorded in 1982-83 in Teknaf, Bangladesh. Grooms' prior marital status was categorized into never married, divorced, widowed or polygynous (already cohabiting with one or more wives) and brides' prior marital status was categorized into never married, divorced or widowed. Divorce was recorded by following the marriages prospectively for five years. Due to the fact that a longitudinal study design was used, the quality of the information presented here is considered to be high. A discrete-time hazard logistic model was used to estimate the effects of spouses' prior marital status and a number of socio-demographic variables on risk of divorce. Polygynous marriage, remarriage and divorce were found to be common in this traditional Muslim community. The odds of divorce were 2.5 times higher for grooms' polygynous marriages and 1.6 times higher for brides' remarriages compared to their peers' first marriages. The odds of divorce decreased with marriage duration. The groom's and bride's low socio-economic status, illiteracy, and early age at marriage increased the odds of divorce. The odds of divorce were much higher if there was no birth in the preceding six months.