The effect of child mortality on fertility behaviors is non-linear: new evidence from Senegal

Abstract

ACL-3International audienceThe present paper examines the relationship between child mortality and fertility at the micro level. We use individual data collected quarterly within the health and demographic surveillance system of the rural community of Niakhar (Fatick, Senegal). Birth histories of 2,884 women born between 1932 and 1961 are analyzed. The determinants of completed fertility are investigated using a standard Poisson Regression Model. The global effect of child mortality on total and net fertility is found to be positive. To our knowledge, this is the first paper to provide evidence for the child survival hypothesis—an effect of child mortality on net fertility—at the micro level. We further identify an inverted-U shaped relationship between child mortality and net fertility. The implication is that health policies aiming at reducing child mortality have indirect effects on desired fertility; yet only a steep decrease in child mortality would be likely to trigger fertility declines

Childhood mortality, intra-household bargaining power and fertility preferences among women in Ghana

“…This relationship was robust with consistency across model specifications and variable definitions. This result is also consistent with existing studies that sought to estimate similar relationships [6]. There was also significant evidence that suggest that aside child mortality, a woman’s bargaining power plays an important role in a woman’s fertility choices including the response to child mortality exposure or experience.…”

“…This implies that families facing relatively higher child mortality risk will adapt their fertility behavior accordingly. This hypothesis is known as the child survival hypothesis or hoarding motive [6]. In other studies, this hypothesis has been referred to as ‘anticipatory effect’ [13] or insurance effect [7].…”

“…In recent years, there has been growing interest in the relationship between child mortality and fertility in developing countries. Bousmah [6] used micro level data from a demographic and health surveillance system in a rural community in Senegal to explore the relationship between child mortality and fertility. Results from the standard Poisson regression model confirmed the child survival hypothesis with a positive effect of child mortality on both total and net fertility.…”

Childhood Mortality, Childhood Morbidity, and Subsequent Fertility Decisions

“…17 Both explanations may reflect the slow but ongoing fertility transition in rural Senegal. Such a downward inter-cohort trend has also been documented elsewhere for the case of the insurance effect [Bousmah (2017)].…”

Are sibling models a suitable tool in analyses of how reproductive factors affect child mortality?

“…This is apparently not well known to demographers and epidemiologists who analyse effects of reproductive factors on various child outcomes, but is highly relevant if infant or child mortality is the outcome, because the death of a child is widely believed to affect subsequent fertility (and therefore the reproductive factors of potential relevance for the next child). Indeed, several studies from contemporary poor settings have shown strongly elevated fertility after a child death, which probably reflects higher fecundity because of terminated breastfeeding and that many parents want to 'replace' their dead child (e.g., Bousmah 2017;van Soest and Saha 2018;Ewemade, Akinyemi, and DeWet 2019). A strong relationship between child death and subsequent fertility appears in Norwegian data as well (see below).…”