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

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Abstract

The 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.

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Notes

  1. See for instance Sachs and Malaney (2002) for a review of the (potential) indirect demographic effects of malaria control policies.

  2. The idea that mortality decline alone is not sufficient to trigger net fertility decline can also been found in Doepke (2005), Boucekkine et al. (2009) or in the unified growth theory (e.g.,Galor 2005).

  3. Contrastingly, the decline of infant and child mortality that have preceded the demographic transition in Europe and the rest of the industrialized world has been faster and sharper on average (Corsini and Viazzo 1997).

  4. See Bulatao and Lee (1983) for an extensive review of the determinants of fertility in developing countries, and Bongaarts et al. (1984) for a focus on SSA countries.

  5. Winkelmann (2008) provides a review of the applications of count data models in the analysis of individual fertility with an emphasis on methodological issues.

  6. Concerns may be raised about the measurement of child mortality in Nguyen-Dinh (1997) as it is assumed that all children ever born were still alive at the time of the survey. Child mortality may thus be underreported.

  7. Niakhar HDSS has originally been set up and is still maintained by the Institut de Recherche pour le Développement (IRD).

  8. Although the causal link from child mortality to fertility is more tenuous, part of the correlation may be due to increased mortality due to higher fertility. Greater family size may adversely affect household constraints such as nutrition and childcare. In their systematic review of the literature on the effect of the number of births on women’s mortality, Hurt et al. (2006) do not find any negative effect of parity on mortality. And this is also true within our study area, as documented in Ronsmans et al. (2001). We argue that the direct effect of fertility on child mortality is likely to be negligible compared to the opposite effect. Endogeneity might still be a concern due to potential omitted variable bias. In addition to the inclusion of all individual-level determinants of fertility, we also include time effects in the model in order to circumvent the problem of omitted variables. Time effects are meant to capture unobserved factors common to all individuals in the sample—in particular the contextual (exogenous) development and spread of medical technology—thereby reducing the main potential source of omitted variable bias. With the impossibility to find legitimate instruments for child mortality, we nonetheless acknowledge the possibility of endogeneity bias due to omitted variables and should still remain cautious in pointing to the existence of a causal link from child mortality to fertility.

  9. The estimated coefficients are consistent with theoretical considerations and other related empirical studies. We find that Muslim and Christian women exhibit higher fertility rates than women having a traditional religion or being atheist. Women married to the household head have a fertility rate that is roughly 1.2 times higher than that of women who are not. Women belonging to less deprived households have lower fertility rates in comparison with extremely deprived ones (that is, deprived in each and every dimension of the calculated index). Women who were maids ended their reproductive life with significantly lower fertility rates than housewives and other active women. The fact that there is no significant difference in fertility rates between housewives and other active women is certainly due to the nature of Niakhar’s economy. Indeed, women reported as housewives dedicate their time to household’s agricultural production activities. The educational achievement of the household head appears to be positively associated with fertility rates (see Diamond et al. 1999 for a review of the complex education-fertility relationship). Concerns may be raised about the use of husbands’ educational attainment—used because of data availability—to tackle the eduction-fertility relationship. However, studies which use data collected from each spouse show that their education level (Cleland and Rodriguez 1988) or fertility desire (McIntosh 1999) have equal influence on fertility decision-making. Finally, mother’s age at first birth has a negative impact on fertility rates.

  10. The table is not presented here but is available from the author upon request.

  11. The table is not presented here but is available from the author upon request.

  12. Although we attempt to address the possibility of omitted variables bias, endogeneity might still be present. We thus remain cautious in arguing for the identification of a causal link from child mortality to fertility.

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Acknowledgments

The author would like to thank Yves Arrighi, Raouf Boucekkine, Olivier Chanel, Jean-Baptiste Combes, Valérie Delaunay, Daria Onori, Luis Sagaon Teyssier and Bruno Ventelou for helpful comments and suggestions.

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  1. Aix-Marseille University (Aix-Marseille School of Economics), CNRS & EHESS, 2 rue de la Charité, 13236, Marseille cedex 02, France

    Marwân-al-Qays Bousmah

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Correspondence to Marwân-al-Qays Bousmah.

Appendix

Appendix

See Table 3.

Table 3 Transformations used in Model 3 and Model 5
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Bousmah, MaQ. The effect of child mortality on fertility behaviors is non-linear: new evidence from Senegal. Rev Econ Household 15, 93–113 (2017). https://doi.org/10.1007/s11150-014-9264-7

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