Contextual characteristics influence infant mortality above and beyond family-level factors. The widespread practice of polygyny is one feature of many sub-Saharan African contexts that may be relevant to understanding patterns of infant mortality. Building on evidence that the prevalence of polygyny reflects broader economic, social, and cultural features and that it has implications for how families engage in the practice, we investigate whether and how the prevalence of polygyny (1) spills over to elevate infant mortality for all families, and (2) conditions the survival disadvantage for children living in polygynous families (i.e., compared with monogamous families). We use data from Demographic and Health Surveys to estimate multilevel hazard models that identify associations between infant mortality and region-level prevalence of polygyny for 236,336 children in 260 subnational regions across 29 sub-Saharan African countries. We find little evidence that the prevalence of polygyny influences mortality for infants in nonpolygynous households net of region-level socioeconomic factors and gender inequality. However, the prevalence of polygyny significantly amplifies the survival disadvantage for infants in polygynous families. Our findings demonstrate that considering the broader marital context reveals important insights into the relationship between family structure and child well-being.
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One study using the 1990 Nigerian Demographic and Health Survey shows that although polygyny is not associated with survival during the neonatal and childhood periods, it is positively associated with child survival during the postneonatal period (Ukwuani et al. 2002).
Some anthropologists (notably, Goody 1973) have refuted that economic factors motivate widespread polygyny and point to the importance of social and cultural features. Although we do not discuss this disagreement, we describe the social and cultural elements of polygyny.
Of the 48 countries in sub-Saharan Africa, we exclude 13 countries from our study because the DHS did not operate in these countries between 2000 and 2010 (Angola, Botswana, Central African Republic, Comoros, Côte D’Ivoire, Djibouti, Equatorial Guinea, Guinea-Bissau, Mauritius, Seychelles, Somalia, South Sudan, and Togo). Furthermore, we exclude five countries because the data are not publically available (Cape Verde, Eritrea, The Gambia, Mauritania, South Africa) and one country (Lesotho) because polygyny data were not collected, resulting in a final sample of 29 countries.
Response rates are published in the survey documentation reports for each country, which are available online (http://www.measuredhs.com/).
Although the DHS does include smaller aggregate units (i.e., “clusters”), they are not intended for contextually focused analyses but instead are enumeration areas that are drawn only for the purpose of sampling.
Samples for each region are large—on average, containing 964 households (ranging from 266 to 7,091), 1,145 women (ranging from 306 to 7,297), and 488 men (ranging from 80 to 3,358). As a result, the inclusion versus omission of the index household from the aggregate analyses makes no difference. For instance, in the Kigal region of Mali—the smallest sample of women (N = 306) for any of our regions—7.19 % of women are in polygynous unions. If we omitted the index family when creating this index, the value would vary across families by less than one-third of 1 %. Given that it makes little difference, we include the index family because (1) we prefer having a uniform value for each region, and (2) removing the index family alters but does not fully eliminate the correlation between the aggregate level and individual level (Raudenbush and Bryk 2002).
The cross-sectional nature of the data prohibits us from accounting for changes in family structure between a child’s birth and the time of the survey or, in the case of deceased children, the time of their death. Thus, it is possible that monogamous unions became polygynous after the child’s birth and/or death. In fact, entry into a polygynous family could be a direct response to the death of a child. We reduce the likelihood of misclassifying families’ structure by limiting the analyses to births that occurred in the five years prior to the survey; however, this bias is still possible and should be kept in mind when interpreting results.
A limitation of the female-to-male education ratio is that it reflects only one dimension of gender inequality (i.e., educational attainment). However, because education is a central determinant of individuals’ income, occupation, and health, it is an ideal measure for capturing inequalities between women’s and men’s life chances more broadly. The DHS also measures gender inequality through a series of questions about women’s involvement in household decision-making; however, these questions are asked in only two-thirds of the countries in our study, and are similarly limited by their focus on a single dimension of inequality.
A country-level fixed-effects approach allows us to control for constant, unobserved factors that vary across sub-Saharan African countries. Because a fixed-effects approach is less efficient, our analyses will yield more conservative estimates.
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Emily Smith-Greenaway wishes to acknowledge the support of the Predoctoral Traineeship in Family Demography (No. T-32HD 007514) by the Eunice Kennedy Shriver National Institute of Child Health and Human Development to the Pennsylvania State University Population Research Institute. We acknowledge assistance provided by the Population Research Center at Penn State University, which is supported by an infrastructure grant by the National Institutes of Health (2R24HD041025-11). We also wish to thank three anonymous reviewers for their comments, and several colleagues for providing us feedback on earlier versions of the manuscript: Lauren Bachan, Michelle Frisco, Monica Grant, Adam Lippert, Wayne Osgood, Jenny Van Hook, and the participants of the International Perspectives on Family Structures and Child Well-being at McGill University (November 30–December 1, 2012).
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Smith-Greenaway, E., Trinitapoli, J. Polygynous Contexts, Family Structure, and Infant Mortality in Sub-Saharan Africa. Demography 51, 341–366 (2014). https://doi.org/10.1007/s13524-013-0262-9
- Family structure
- Infant mortality
- Sub-Saharan Africa