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Journal of Population Economics

, Volume 24, Issue 2, pp 629–655 | Cite as

Uncovering the impact of the HIV epidemic on fertility in Sub-Saharan Africa: the case of Malawi

  • Dick Durevall
  • Annika LindskogEmail author
Original Paper

Abstract

We evaluate the impact of the HIV/AIDS epidemic on the reproductive behaviour for all women in Malawi, HIV-negative and HIV-positive alike, allowing for heterogeneous response depending on age and prior number of births. HIV/AIDS increases the probability that a young woman gives birth to her first child, while it decreases the probability to give birth of older women and of women who have already given birth. The resulting change in the distribution of fertility across age groups is likely to be more demographically and economically important than changes in the total number of children a woman gives birth to.

Keywords

Africa AIDS Demographic transition 

JEL Classification

I10 J13 O12 

Notes

Acknowledgements

We would like to thank Lennart Flood, Måns Söderbom, Rick Wicks and two anonymous referees for valuable comments. We also thank Sida/Sarec for financial support.

References

  1. Angeles G, Guilkey DK, Mroz TA (2005) The determinants of fertility in Rural Peru: program effects in the early years of the national family planning program. J Popul Econ 18(2):367–389CrossRefGoogle Scholar
  2. Barmby T, Cigno A (1990) A sequential probability model of fertility patterns. J Popul Econ 3(1):31–51CrossRefGoogle Scholar
  3. Becker G, Lewis HG (1973) On the interaction between the quantity and quality of children. J Polit Econ 81(2):S279–S288CrossRefGoogle Scholar
  4. Bell C, Devarajan S, Gersbach H (2004) Thinking about the long-run economic costs of AIDS. In: Haacker M (ed) The macroeconomics of HIV/AIDS. International Monetary Fund, WashingtonGoogle Scholar
  5. Bloom D, Mahal A (1997) Does the AIDS epidemic threaten economic growth. J Econom 77(1):105–124CrossRefGoogle Scholar
  6. Chimbwete C, Watkins SC, Msiyaphazi Zulu E (2005) The evolution of population policies in Kenya and Malawi. Popul Res Policy Rev 24(1):85–106CrossRefGoogle Scholar
  7. Corrigan P, Glomm G, Mendez F (2005) AIDS crisis and growth. J Dev Econ 77(1):107–124CrossRefGoogle Scholar
  8. Doctor HV, Weinreb AA (2003) Estimation of AIDS adult mortality by verbal autopsy in Rural Malawi. AIDS 17(17):2509–2513CrossRefGoogle Scholar
  9. Durevall D, Lindskog A (2009) How does communal HIV/AIDS affect fertility?: evidence from Malawi. Scandinavian Working Papers No 369, University of GothenburgGoogle Scholar
  10. Fabiani M, Nattabi B, Ayella E, Ogwang M, Declich S (2006) Differences in fertility by HIV serostatus and adjusted HIV prevalence data from an antenatal clinic in Northern Uganda. Trop Med Int Health 11(2):182–187CrossRefGoogle Scholar
  11. Fink G, Linnemayr S (2008) HIV, education, and fertility: long-term evidence from Sub-Saharan Africa. Harvard School of Public Health, Cambridge, MimeoGoogle Scholar
  12. Fortson J (2009) HIV/AIDS and fertility. Am Econ J Appl Econ 1(3):170–194CrossRefGoogle Scholar
  13. GoM (2007) Malawi HIV and AIDS monitoring and evaluation report 2007. Government of Malawi, LilongweGoogle Scholar
  14. Gray RH, Wawer MJ, Serwadda D, Sewankambo N, Li C, Wabwire-Mangen F, Paxton L, Kiwanuka N, Kigozi G, Konde-Lule J, Quinn TC, Gaydos CA, McNairn D (1998) Population-based study of fertility in women with HIV-1 infection in Uganda. Lancet 351(9096):98–103CrossRefGoogle Scholar
  15. Grieser M, Gittelsohn J, Shankar AV, Koppenhaver T (2001) Reproductive decision making and the HIV/AIDS epidemic in Zimbabwe. J South Afr Stud 27(2):225–243CrossRefGoogle Scholar
  16. Juhn C, Kalemli-Ozcan S, Turan B (2008) HIV and fertility in Africa: first evidence form population based surveys. NBER Working Paper No 14248Google Scholar
  17. Kalemli-Ozcan S (2003) A stochastic model of mortality, fertility and human capital investment. J Dev Econ 70(1):103–118CrossRefGoogle Scholar
  18. Kalemli-Ozcan S (2009) AIDS, reversal of the demographic transition and economic development: evidence from Africa. NBER Working Paper No 12181Google Scholar
  19. Lewis JC, Ronsmans C, Ezeh A, Gregson S (2004) The population impact of HIV on fertility in Sub-Saharan Africa. AIDS 18(suppl 2):35–43CrossRefGoogle Scholar
  20. Lorentzen P, McMillan J, Wacziarg R (2008) Death and development. J Econ Growth 13(2):81–124CrossRefGoogle Scholar
  21. Magadi MA, Agwanda A (2007) The link between HIV/AIDS and recent fertility patterns in Kenya. Measure Evaluation Working Paper No 07–92, Caroline Population Centre, University of North CarolinaGoogle Scholar
  22. McDonald S, Roberts J (2006) AIDS and economic growth: a human capital approach. J Dev Econ 8(1):228–250CrossRefGoogle Scholar
  23. Measure DHS (2008) Statcompiler database. http://www.statcompiler.com
  24. Morah E (2007) Are people aware of their HIV-positive status responsible for driving the epidemic in Sub-Saharan Africa: the case of Malawi. Dev Policy Rev 25(2):215–242CrossRefGoogle Scholar
  25. Neyman J, Scott E (1948) Consistent estimates based on partially consistent observations. Econometrica 16(1):1–32CrossRefGoogle Scholar
  26. Noël-Miller CM (2003) Concerns regarding the HIV/AIDS epidemic and individual childbearing: evidence from Rural Malawi. Demogr Res 1(10):319–348CrossRefGoogle Scholar
  27. NSO (National Statistical Office of Malawi) (1993) Malawi population and housing census 1987, vol II. NSO, ZombaGoogle Scholar
  28. NSO (2002) Census analytical report. NSO, ZombaGoogle Scholar
  29. NSO and ORC Macro (2001) Malawi demographic and health survey 2000—final report. NSO, ZombaGoogle Scholar
  30. NSO and ORC Macro (2005) Malawi demographic and health survey 2004—final report. NSO, CalvertonGoogle Scholar
  31. NSO and UNICEF (2008) Multiple indicator survey 2006: Malawi. NSO, ZombaGoogle Scholar
  32. Ntozi J (2002) Impact of HIVAIDS on fertility in Sub-Saharan Africa. Paper prepared for the fourth meeting of the follow-up committee on the implementation of the DND and the ICPD-PA Yaounde, Economic Commission for Africa in collaboration with UNFPAGoogle Scholar
  33. Oladapo OT, Daniel OJ, Odusoga OL, Ayoola-Sotubo O (2005) Fertility desires and intentions of HIV-positive patients at a Suburban specialist center. J Natl Med Assoc 97(12):1672–1681Google Scholar
  34. Papageoriou C, Stoytcheva P (2008) What do we know about the impact of AIDS on cross-country income so far? Working Paper No 2005-01 Department of Economics, Louisiana State UniversityGoogle Scholar
  35. Rutenberg N, Biddlecom AE, Kaona FAD (2000) Reproductive decision-making in the context of HIV and AIDS: a qualitative study in Ndola, Zambia. Int Fam Plann Perspect 26(3):124–130CrossRefGoogle Scholar
  36. Rutstein SO, Johnson K (2004) The DHS wealth index. DHS Comparative Report No 6 ORC Macro. NSO, CalvertonGoogle Scholar
  37. Santaeulalia-Llopis R (2008) Aggregate effects of AIDS on development. Washington University in Saint Louis, Saint Louis, MimeoGoogle Scholar
  38. Soares RR (2005) Mortality reductions, educational attainment, and fertility choice. Am Econ Rev 95(3):580–601CrossRefGoogle Scholar
  39. Soares RR (2006) The effect of longevity on schooling and fertility: evidence from the Brazilian demographic and health survey. J Popul Econ 19(1):71–97CrossRefGoogle Scholar
  40. Terceira N, Gregson S, Zaba B, Mason P (2003) The contribution of HIV to fertility decline in rural Zimbabwe, 1985–2000. Popul Stud 57(2):149–164CrossRefGoogle Scholar
  41. Ueyama M, Yamauchi F (2009) Marriage behavior response to prime-age adult mortality—evidence from Malawi. Demography 46(1):43–63CrossRefGoogle Scholar
  42. Werker E, Ahuja A, Wendell B (2006) Male circumcision and AIDS: the macroeconomic impact of a health crisis. Harvard Business School Working Paper No 07-025Google Scholar
  43. Westoff CF, Cross AR (2006) The stall of the fertility transition in Kenya. DHS Analytical Studies No 9. ORC Macro, CalvertonGoogle Scholar
  44. Yeatman SE (2009) The impact of HIV status and perceived status on fertility desires in Rural Malawi. AIDS Behav 13(suppl 1):12–19CrossRefGoogle Scholar
  45. Young A (2005) The gift of dying: the tragedy of AIDS and the welfare of future African generations. Q J Econ 120(2):423–466CrossRefGoogle Scholar
  46. Young A (2007) In sorrow to bring forth children: fertility amidst the plague of HIV. J Econ Growth 12(4):283–327CrossRefGoogle Scholar
  47. Zaba B, Gregson S (1998) Measuring the impact of HIV on fertility in Africa. AIDS 12(suppl 1):41–50Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Department of EconomicsUniversity of GothenburgGothenburgSweden

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