Death of Preceding Child and Utilisation of Healthcare Services in West Africa

Joshua O. Akinyemi, University of Ibadan
Babatunde M. Gbadebo, University of Ibadan, Ibadan, Nigeria
Olanrewaju Eniade, University of Ibadan
Adebola Orimadegun, University of Ibadan

Research discourse about effects of child mortality on subsequent birth has identified behavioural replacement as a potential mechanism. Available evidence from high mortality settings of sub-Saharan Africa supports this hypothesis. Extending the argument further, an empirical question of research interest is “does experience of under-five death motivate women in high mortality settings of sub-Saharan Africa to seek preventive and curative health interventions for their subsequent children? We analysed the most recent reproductive history data from demographic and health surveys conducted in selected West African countries. Outcome variables included the following health and survival interventions for the index child: treatment of diarrhoea and symptoms of acute respiratory tract infection (ARI) as well as full vaccinations. Results showed that the odds of diarrhoea treatment were two times higher following the death of a preceding child in Benin (ORadj=1.97, CI: 1.24, 3.13). No such pattern was observed in the other five countries. Similarly, no significant relationship was observed between death of preceding child and treatment of ARI symptoms. The index child was more likely to be fully vaccinated following death of predecessor in Liberia (ORadj=1.97, CI: 1.16, 3.35). These findings suggest that childbearing women rarely learnt lessons from childhood mortality experiences.

Keywords: Children, Adolescents, and Youth, Health and Morbidity, Mortality and Longevity

See extended abstract.