The More the Merrier? Accounting for the Dynamic Role of Household Composition in Child Mortality in Sub-Saharan Africa

Ashira Menashe-Oren , Universite catholique de Louvain (UCL)
Philippe Bocquier, Universite catholique de Louvain (UCL)
Carren Ginsburg, University of the Witwatersrand, Johannesburg
Yacouba Compaore, Université Catholique de Louvain

Households are the backbone of societies, as the centre of a myriad of processes including childbearing, labour force participation and health care. Understanding the dynamics of households is thus important, yet little research examines the implications of living arrangements in sub-Saharan Africa. Household composition can affect the health and mortality of children. While parents play a critical role in their children’s survival, other household members have also been found to provide support for children, reducing child mortality. We examine the effect of household structure and composition on child mortality in sub-Saharan Africa where mortality remains highest and households are relatively large. Using readily available data from 27 health and demographic surveillance surveys which covers births, deaths and migrations in defined populations between 1990 and 2015, we examine households as time-varying entities. We evaluate the impact of household size, of the ratio of men to women in the household and the presence of specific members, such as grandmothers, on under-five mortality. We also consider whether the effect of the presence of mothers differs to the effect of fathers on mortality. We use Cox proportional hazard models, controlling for site and period effects. Our preliminary findings indicate that households are becoming smaller in sub-Saharan Africa, but larger households have a protective effect for children. Additionally, more women in the household lowers the risk of child mortality.

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 Presented in Session P2. Poster Session Ageing, Health and Mortality