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. 2020 Feb 25;117(8):4027-4033.
doi: 10.1073/pnas.1907343117. Epub 2020 Feb 10.

Maternal cumulative prevalence measures of child mortality show heavy burden in sub-Saharan Africa

Emily Smith-Greenaway  1 , Jenny Trinitapoli  2
Affiliations

Maternal cumulative prevalence measures of child mortality show heavy burden in sub-Saharan Africa

Emily Smith-Greenaway et al. Proc Natl Acad Sci U S A. .

Abstract

We advance a set of population-level indicators that quantify the prevalence of mothers who have ever experienced an infant, under 5-y-old child, or any-age child die. The maternal cumulative prevalence of infant mortality (mIM), the maternal cumulative prevalence of under 5 mortality (mU5M), and the maternal cumulative prevalence of offspring mortality (mOM) bring theoretical and practical value to a variety of disciplines. Here we introduce maternal cumulative prevalence measures of mortality for multiple age groups of mothers in 20 sub-Saharan African countries with Demographic and Health Surveys data spanning more than two decades. The exercise demonstrates the persistently high prevalence of African mothers who have ever experienced a child die. In some African countries, more than one-half of 45- to 49-y-old mothers have experienced the death of a child under age 5, and nearly two-thirds have experienced the death of any child, irrespective of age. Fewer young mothers have experienced a child die, yet in many countries, up to one-third have. Our results show that the mIM and mU5M can follow distinct trajectories from the infant mortality rate (IMR) and under 5 mortality rate (U5MR), offering an experiential view of mortality decline that annualized measures conceal. These measures can be adapted to quantify the prevalence of recurrent offspring mortality (mROM) and calculated for subgroups to identify within-country inequality in the mortality burden. These indicators can be used to improve current understandings of mortality change, bereavement as a public health threat, and population dynamics.

Keywords: bereavement; child mortality; sub-Saharan Africa.

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Conflict of interest statement

The authors declare no competing interest.

Figures

Fig. 1.
Fig. 1.
IMR and mIM for mothers age 20 to 44 and age 45 to 49 in 20 sub-Saharan African countries between circa (c.) 1990s and c. 2010. Expressed per 1,000 live births (IMR) and 1,000 mothers (mIM).
Fig. 2.
Fig. 2.
U5MR and mU5M for mothers age 20 to 44 and age 45 to 49 in 20 sub-Saharan African countries between circa (c.) 1990 and c. 2010. Expressed per 1,000 live births (IMR) and 1,000 mothers (mU5M).
Fig. 3.
Fig. 3.
mIM, mU5M, and mOM among mothers age 45 to 49 in 20 sub-Saharan African countries between circa (c.) 1990 and c. 2010. Expressed per 1,000 mothers.
Fig. 4.
Fig. 4.
mOM and mROM among mothers age 45 to 49 in 20 sub-Saharan African countries between circa (c.) 1990 and c. 2010. Expressed per 1,000 mothers.
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